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Joan Stewart

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  1. Pre-Health (Field Undecided)
    Hello, would anyone be able to tell me what the non-surgical veterinary specialties are? I am interested in becoming a vet, but am not keen on performing surgery. Would it be possible to make a decent living as a vet with the main focus being on physical rehabilitation? I would appreciate any insight. Thank you.
     

    twelvetigers

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      You never have to do surgery in practice if you find a clinic that is okay with that arrangement. It may be a little difficult, but it's doable. Alternately, you could pursue a specialty that does not require surgery. So, maybe dermatology? I feel like most require surgery of *some* type - cardiology does heart surgery and pacemaker placement, that sort of thing. Ophtho does eye surgery. Clinical pathology doesn't need surgery! Anatomic pathology involves things that have already died... you get my point.

      Rehab is definitely a thing that some vets get into. If you wanted to do exclusively rehab and acupuncture or something like that, it's definitely possible, but it could be hard to jump into right away without some years (doing regular medicine) under your belt.

      Do know that surgery is a required course, and you WILL do surgery during vet school. No way around that.

      What's the deal with surgery, though? A lot of pre-vets are really overwhelmed by, grossed out by, or uncomfortable with the idea of surgery, but once you get past the weirdness of it, most people are at least okay, and some of us actually like it quite a bit. You may surprise yourself. I wouldn't start planning now based on whatever experiences you've had so far.
       
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      jmo1012

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        I hate all things surgery, repair, bandage related, etc. I don't have to do any surgery as an ECC resident (or as a boarded person) although it is an option for those in my field to be cutting criticalists if they choose. I do have to do laceration repairs and bandage/wound management, however I'd ultimately like to end up in a job where I didn't have to do most of that and there are jobs like that out there.

        Internal med is one that doesn't do surgery per say. Derm does biopsies, so it would depend on what you would be willing to do with a scalpel, but that's pretty minor. There is a non-surgical neuro option as well where you don't have to be a neurosurgeon. There are rehab internships and residencies, or you can just do stuff as a general practicioner. Once you got through the requirements of a residency, you wouldnt technically have to do surgery with cardio (just refer the interventional stuff). Med onc does biopsies but again nothing big, and i don't think rad onc really does anything like that. Radiology clearly doesnt either. There are definitely GP jobs that don't require sx either, but it isnt necessarily the norm so it may take some time to find the right place.

        As TT said above, many people think they don't like surgery until they get some comfort and practice with it, so don't write it off completely. I suspect I partially fall into that category, but I really have no desire to have any sort of comfort and would greatly prefer to deal with complex physiology instead. Give me a respiratory distress, a DKA, or a pre/post op setpic abdomen any day.
         
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        Coquette22

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          Hi. My name is Coquette and I hate surgery. I do it, but it's far from my favourite part of the job. Is it realistic to do no surgery? That depends.

          If you go into specialty it's probably easier to avoid surgery altogether. In a perfect world, I'd be able to do an internship and internal medicine residency where I live now and I'd specialize in IM so I didn't have to do surgery. This is not a perfect world. So I'm a GP cause I don't want to move away.

          I'm getting more comfortable with surgery but I'll probably never enjoy it. This was compounded by my first two years in practice where we didn't have assigned surgery days, the practice owner did 99% of the surgeries and I wasn't paid on production, just straight salary. I'm in my third year of practice, and I've probably done more surgery in the past 2 months then in 2 years at my previous practice. Two major reasons: 1) assigned surgery days, so anyone that wants a surgery done on Tuesdays gets me, and 2) production pay, because surgery is a high ticket item so I have more incentive to do it rather than pawn it off on another vet. So I do spays and neuters, lump removals, lacerations, cystotomies and enucleations. Foreign bodies or pyometras I'd probably turf to Dr H cause she's better at it than me.

          So if you specialize or find a practice where someone else loves surgery and the production aspect isn't a factor then it's realistic not to do surgery. Otherwise you're probably going to do at least some routine surgeries.
           
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          Joan Stewart

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            So you gonna tell us what your concerns are, @Joan Stewart ? Or do we just have to guess?

            I mean, I'm just wondering if you think surgery is icky, or if it's something more than that.

            I don’t feel quite comfortable with the thought of performing surgery, because of the ick factor, as well as the responsibility it carries. I guess with enough exposure and mentoring, it’s something I could eventually become more comfortable with in time. How much does vet school really prepare you to perform surgery? I am a visual person who learns best with repetition, and I imagine performing one neuter in vet school wouldn't be nearly enough prep for me.
             

            jmo1012

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              I don’t feel quite comfortable with the thought of performing surgery, because of the ick factor, as well as the responsibility it carries. I guess with enough exposure and mentoring, it’s something I could eventually become more comfortable with in time. How much does vet school really prepare you to perform surgery? I am a visual person who learns best with repetition, and I imagine performing one neuter in vet school wouldn't be nearly enough prep for me.
              You should feel the same sense of responsibility for any form of medicine practiced, whether that involves surgery or not. Everything we do carries risk of some sort. Animals die from vaccine reactions. You can cause volume overload and death by giving fluids. Oxygen toxicity can occur if you put a pet in an extremely concentrated environment for a prolonged period of time. These are all things vets do that may seem relatively benign, but it's important to remember that life is a series of risks, checks and balances.
               
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              DVMDream

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                You should feel the same sense of responsibility for any form of medicine practiced, whether that involves surgery or not. Everything we do carries risk of some sort. Animals die from vaccine reactions. You can cause volume overload and death by giving fluids. Oxygen toxicity can occur if you put a pet in an extremely concentrated environment for a prolonged period of time. These are all things vets do that may seem relatively benign, but it's important to remember that life is a series of risks, checks and balances.

                I was going to say, there's a bigger chance of a complicated medical case going south than many surgeries. There's risk for everything. And you're responsible for every patient regardless of if it is an ear infection (you can cause ototoxicity with some medications) or splenectomy.
                 

                CalliopeDVM

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                  I don’t feel quite comfortable with the thought of performing surgery, because of the ick factor, as well as the responsibility it carries. I guess with enough exposure and mentoring, it’s something I could eventually become more comfortable with in time. How much does vet school really prepare you to perform surgery? I am a visual person who learns best with repetition, and I imagine performing one neuter in vet school wouldn't be nearly enough prep for me.

                  If you're not comfortable about the responsibility of surgery, how will you feel about the responsibility of medicine? There are lots of ways to make a living without doing surgery, either with or without a specialty, but not wanting the responsibility of surgery is a misplaced reason.
                   

                  twelvetigers

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                    This is all true. But, it's still a ways away - it's hard to imagine being responsible for all this stuff when you haven't even taken anatomy yet. It's important to realize there's a lot of responsibility being a vet, no matter what, but I wouldn't assume that you aren't cut out for it based on how you feel before you even start.

                    Do you have experience in a clinic shadowing or working with a vet?
                     

                    Coquette22

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                      I can kind of sympathize with the "not wanting the responsibility" aspect, so I think I can relate with what Joan is saying. Surgery feels like I have less time to deal with complications. Like if I drop a pedicle or a ligature slips, the animal bleeds and dies. It's more immediate in my mind and I feel like I'm less able to deal with the consequences. In my experience (or at least in my head) most animals won't die immeduately after a couple doses of the wrong medication and I feel more able to deal with the outcome.

                      Now some of this is just down to my comfort level. In other words, I feel way more confident in my ability to pick the right meds at the right dose and the right fluid type and rate etc. Likewise if I pick the wrong meds or the wrong dose I'm more sure that I can fix the complications. I'm not a confident surgeon AT ALL so when things go wrong I don't feel equipped to deal with it.

                      I did a cystotomy a few months ago to remove bladder stones. Dog did great in recovery, went home that afternoon. I laid awake all damn night terrified that my suture line on the bladder wall was going to fail and she was going to start leaking urine into her abdomen. I check my spays repeatedly through the day cause I'm paranoid a ligature is going to slip and they're going to start bleeding post-op.
                       
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                      LetItSnow

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                        I can kind of sympathize with the "not wanting the responsibility" aspect, so I think I can relate with what Joan is saying. Surgery feels like I have less time to deal with complications. Like if I drop a pedicle or a ligature slips, the animal bleeds and dies. It's more immediate in my mind and I feel like I'm less able to deal with the consequences. In my experience (or at least in my head) most animals won't die immeduately after a couple doses of the wrong medication and I feel more able to deal with the outcome.

                        Now some of this is just down to my comfort level. In other words, I feel way more confident in my ability to pick the right meds at the right dose and the right fluid type and rate etc. Likewise if I pick the wrong meds or the wrong dose I'm more sure that I can fix the complications. I'm not a confident surgeon AT ALL so when things go wrong I don't feel equipped to deal with it.

                        I did a cystotomy a few months ago to remove bladder stones. Dog did great in recovery, went home that afternoon. I laid awake all damn night terrified that my suture line on the bladder wall was going to fail and she was going to start leaking urine into her abdomen. I check my spays repeatedly through the day cause I'm paranoid a ligature is going to slip and they're going to start bleeding post-op.

                        I can sympathize with it, too. I mean, I understand what other people are saying about being responsible for any case, not just a surgical case, but I do feel like the balance sorta tilts toward the veterinarian with surgery, whereas a medicine case ... hey, I just give the meds, it's up to the animal to respond to them. I think it's just nuances either way; in the end you're responsible for your patient, period, but I can get why someone would feel like surgery is 'more' responsible, even if technically it's not.

                        So I get it. Surgery can be intimidating to people. The flip side, though, is that 'cut to cure' is SUPER satisfying. It really rocks to take a very sick animal - a FB, a GDV, etc. - roll into surgery, roll out fixed, recover and go home in a day or two a happy, recovering animal, knowing that without your intervention that animal had a very poor chance of survival.

                        But TT's right - it's super early in the process to worry about it much. A lot of people go to vet school positive they want to be a surgeon and doing a 180, and other people go thinking they'll hate surgery and end up loving it. *shrug*

                        There are plenty of jobs out there where surgery is minimized, I think.
                         
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                        Trilt

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                          There are definitely GPs out there where you don't have to do a lot of surgery. May just limit you going forward and you'll likely make less money.

                          I went into vet school super unexcited about surgery, and after some good experience I now enjoy it a lot. Way too early to worry about such things imo.
                           
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                          CalliopeDVM

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                            There are definitely GPs out there where you don't have to do a lot of surgery. May just limit you going forward and you'll likely make less money.
                            I think that's true if you're talking about simply taking out surgery from a GP job, but if a GP wants to add something in, it is less likely to make a dent in income potential -- like adding in certification in acupuncture or rehab medicine, for example.
                             

                            Trilt

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                              I think that's true if you're talking about simply taking out surgery from a GP job, but if a GP wants to add something in, it is less likely to make a dent in income potential -- like adding in certification in acupuncture or rehab medicine, for example.
                              ^very fair.
                               

                              Coquette22

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                                The flip side, though, is that 'cut to cure' is SUPER satisfying. It really rocks to take a very sick animal - a FB, a GDV, etc. - roll into surgery, roll out fixed, recover and go home in a day or two a happy, recovering animal, knowing that without your intervention that animal had a very poor chance of survival.

                                This is true. I also feel like surgery gets more of the glory. A few hours and boom the dog is fixed and the owners think you're a hero. Long term management of diabetes or CHF doesn't have the same gravitas to the general population. Remove a foreign body? You saved a life. Manage Cushing's? Oh look the hair grew back and the dog stopped peeing on the floor. Somehow it's not always as satisfying. ;)
                                 

                                cowgirla

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                                  Hi, I hate surgery too. I don't mind dentals, mass removals, neuters, laceration repairs.... basically avoiding the abdomen.

                                  There are specialties out there in which you wouldn't need to do surgery. General practice, most places are going to want you to do some surgery.
                                  Samesies. Dentals are somewhere between "don't mind" and "frustrating but satisfying," (but that is after $6000 worth of CE, not right out of school).
                                  Cutting off balls is always a good time. I like lacerations because it's like putting a puzzle together. Beyond that, I avoid what I can. Hate hate hate dog spays.

                                  I do <8 surgical procedures a month and would happily do less :-D
                                   
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                                  pooter

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                                    I felt similarly about the responsibility of surgery. Felt like that all through school and an internship (where I didn't get to do anything more exotic than lac repairs and the occasional spay). Then I started at an e-vet job where I was *expected* to cut, often under very nerve-wracking conditions, and much to my surprise my whole outlook on surgery changed. Now I feel an intense sense of control in the OR, and that's comforting. At the end of the day, I have very little control over whether my parvo puppy's fever stays down or whether the head trauma patient responds to mannitol. But, that uterine stump? It is not going to bleed. That enterotomy is not going to leak. Those bladder stones? Good luck causing an obstruction while rattling around in a vial on my desk. Even though I know (and have seen) that surgical complications happen even if your technique is perfect, I feel so much more in control just from having the problem in my hands - being able to look at it and physically fix it - than I do from pushing syringes of medications.

                                    Bottom line, OP has a long time to figure out what they want to do, and they might find their opinion changing with experience.
                                     
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                                    CalliopeDVM

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                                      I feel so much more in control just from having the problem in my hands - being able to look at it and physically fix it - than I do from pushing syringes of medications.

                                      Bottom line, OP has a long time to figure out what they want to do, and they might find their opinion changing with experience.

                                      OK, I know what you're saying, but that's a poor representation of what doctors do on medicine cases. I find medicine a lot more complex and challenging than surgery, especially when you add in the owner component.
                                       
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                                      pinkpuppy9

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                                        I can kind of sympathize with the "not wanting the responsibility" aspect, so I think I can relate with what Joan is saying. Surgery feels like I have less time to deal with complications. Like if I drop a pedicle or a ligature slips, the animal bleeds and dies. It's more immediate in my mind and I feel like I'm less able to deal with the consequences. In my experience (or at least in my head) most animals won't die immeduately after a couple doses of the wrong medication and I feel more able to deal with the outcome.

                                        Now some of this is just down to my comfort level. In other words, I feel way more confident in my ability to pick the right meds at the right dose and the right fluid type and rate etc. Likewise if I pick the wrong meds or the wrong dose I'm more sure that I can fix the complications. I'm not a confident surgeon AT ALL so when things go wrong I don't feel equipped to deal with it.

                                        I did a cystotomy a few months ago to remove bladder stones. Dog did great in recovery, went home that afternoon. I laid awake all damn night terrified that my suture line on the bladder wall was going to fail and she was going to start leaking urine into her abdomen. I check my spays repeatedly through the day cause I'm paranoid a ligature is going to slip and they're going to start bleeding post-op.
                                        So far, my biggest issue has been anesthesia. I'm paranoid and am a helicopter 'doctor' when I have a patient under. Now you're reminding me what can go wrong during/after surgery...right before we start our surgery course :p

                                        Although, to be fair, I deal with a lot of sick wildlife (esp. birds). If a bird wants to die, it will die under anesthesia.
                                         
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                                        Trilt

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                                          Surgery... in GP standard surgeries, I feel there's rarely a thing you can do that you can't fix. Ligature isn't tight enough, you're gonna get that adrenal squeeze but you ****ing find it. Anesthesia, especially with the resources and confines that a normal practice has, is much less easily fixable. I like anesthesia but good lordie do I have a healthy fear/respect.
                                           
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                                          DVMDream

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                                            I am vastly more comfortable sorting out anesthesia complications than I am trying to find a bleeding vessel in an abdomen. But that's just me.

                                            Agreed.

                                            That dropped pedicle freaks me out way more than anesthesia stuff. Even once I get that dropped pedicle controlled then I'm worrying that I clamped a ureter trying to clamp the pedicle.
                                             
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                                            Awapi

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                                              @Joan Stewart if you are open to areas other than clinical medicine, there are non-surgical options. I'm in public health - as an epidemiologist, I worked with public health veterinarians both at the federal and state/local level and there was no surgery involved, haha. Of course, there's also no patient care which might be a deal breaker for some, but several of them do relief vet work (no surgeries) on occasion if they miss the clinical side. There is also research - though if you get on the side of lab animal medicine/research you may start getting in to some surgical needs, but my colleagues who are lab animal vets are rarely asked to do that. At least at the research center I have colleagues at, they usually call in surgical specialists since the lab animals are so valuable.
                                               

                                              pooter

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                                                OK, I know what you're saying, but that's a poor representation of what doctors do on medicine cases. I find medicine a lot more complex and challenging than surgery, especially when you add in the owner component.

                                                Definitely wasn't my intention to minimize the work of medicine cases. You'll get no argument from me Re medicine being more complex. That was kind of my point. I live in awe of the people who can shepherd a cat out of DKA without breaking a sweat. My comment was meant to point out that the technique and the physical nature of surgery are a lot more rewarding for me - probably because I'm the kind of person who has always thrived on instant gratification. It's not about jock-style "I'm a surgeon who cuts things, rar!" posturing, and I'm sorry if it came across that way.
                                                 
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