specialties with no surgery

[Teali]

Hi everyone,
I've come to realise that I want to go into a specialty with no surgery in it at all. When I think about it, so many specialities have surgical type procedures in them -- like in pathology you might carry out autopsies. Does anyone know which specialties have absolutely no surgical component?

---

Members don't see this ad.

 

[csmmedic]

uh, medicine?

and its subspecialties.

Does that mean you don't even want to go into EM or FP because you might be doing sutures, I&Ds, etc?

 

[Rendar5]

You'll have to clarify fi you mean a field without OR time or if you mean a field without any procedures, and what type of procedures are you trying to avoid?

 

[Teali]

I'm looking to avoid any kind of sterile operating procedures. I'd be ok for putting in IDCs etc that don't require scrubbing.

 

[Rendar5]

I'm looking to avoid any kind of sterile operating procedures. I'd be ok for putting in IDCs etc that don't require scrubbing.

It's easier to tell you what fields require OR time than what ones don't. Keep in mind that all fields will require time doing sterile procedures (like inserting central lines) at some point.

Full Surgery:
General Surgery and subspecialties
Neurosurgery
Orthopedics

Partial Surgery:
Ob/Gyn
Urology
ENT
Opthamology

Lots of Sterile Procedures:
Intervential Cardiology
Interventional Radiology

 

[J ROD]

I think Psychiatry will treat you well.....

 

[GoodmanBrown]

I think Psychiatry will treat you well.....

I think almost every specialty will require some sterile procedures during residency. But afterwards a lot of specialties wouldn't require it. Off the top of my head:

• psychiatry (J DUB's thought)
• neurology
• family med
• internal medicine & many of its subspecialties (endocrinology, rheumotology, infectious disease, heme/onc, nephrology, allergy/immunology, pulmonology, geriatric medicine, sleep medicine)
• Derm
• EM
• pathology
• pediatrics
• PM&R
• radiology

Now, some of these will have procedures where you need to have a small sterile site, but I don't think any of them would require scrubbing in. So, you're not incredibly limited.

 

[typhoonegator]

There's nothing "surgical" about an autopsy.

 

[Law2Doc]

I think almost every specialty will require some sterile procedures during residency. But afterwards a lot of specialties wouldn't require it. Off the top of my head:

• psychiatry (J DUB's thought)
• neurology
• family med
• internal medicine & many of its subspecialties (endocrinology, rheumotology, infectious disease, heme/onc, nephrology, allergy/immunology, pulmonology, geriatric medicine, sleep medicine)
• Derm
• EM
• pathology
• pediatrics
• PM&R
• radiology

Now, some of these will have procedures where you need to have a small sterile site, but I don't think any of them would require scrubbing in. So, you're not incredibly limited.

Neurology does LPs, rheumatologists like to stick needles into joints, ID folks may be involved in sticking needles into and draining pockets of infection (although they more often consult on this), pulmonologists pretty much all do bronchoscopy with biopsies, thoracentesis, etc, IR is a big component of every radiology residency these days (and IS surgery). Derm will regularly be doing punch biopsies of lesions to rule out cancers. EM does LPs, central lines, I&Ds, intubation, chest tubes. Peds residency will likely have a peds surg and Peds ED component which will be procedural. I'd say PM&R itself has few procedures, but folks have to do a prelim internship year in medicine to get there.
So that basically really leaves psych as the most "hands off" of the fields.

 

[ChubbyChaser]

Id say Psych, Rads, and Neuro would be the closest you are gonna get.

 

[Law2Doc]

Id say Psych, Rads, and Neuro would be the closest you are gonna get.

Again, in most radiology residencies you would do a few months of IR, and actually there are numerous pundits who will tell you that the future of surgery is going to be through radiology, so I'd say rads may be one of the worst choices actually if you want to stay away from the OR.

Neuro does LPs which is a sterile procedure.

Psych is the only one of the three that really has no sterile procedures. (In fact the only procedure I recall from my psych rotation was electroshock.)

 

[RoyBasch]

Out of curiosity why the opposition to procedures?
I have little interest in surgery, but I still think minor procedures are cool. Perhaps if we can get to the root of what you dislike about procedures that might help decide which specialties occasional procedures would be least problematic for you.
-Roy

 

[bydotte]

psych is it. good luck!

 

[GoodmanBrown]

Neurology does LPs, rheumatologists like to stick needles into joints, ID folks may be involved in sticking needles into and draining pockets of infection (although they more often consult on this), pulmonologists pretty much all do bronchoscopy with biopsies, thoracentesis, etc, IR is a big component of every radiology residency these days (and IS surgery). Derm will regularly be doing punch biopsies of lesions to rule out cancers. EM does LPs, central lines, I&Ds, intubation, chest tubes. Peds residency will likely have a peds surg and Peds ED component which will be procedural. I'd say PM&R itself has few procedures, but folks have to do a prelim internship year in medicine to get there.
So that basically really leaves psych as the most "hands off" of the fields.

Perhaps I should ask a clarifying question. The OP stated:

I'm looking to avoid any kind of sterile operating procedures. I'd be ok for putting in IDCs etc that don't require scrubbing.

So, does putting in an LP (for instance) require scrubbing in? I've seen an epidural be put in, and it doesn't require scrubbing in. You need to sterilize the injection area obviously and you use care to open your sterile packing and wear sterile gloves, but you're not scrubbing in a la general surgery.

So, my reading of the OP's OP and his clarifying post is that he doesn't mind sterile procedures per se, but doesn't want to scrub in. Clearly, L2D thought differently.

 

[ucsfstudents]

Psychiatry is a good option.

 

[Law2Doc]

Perhaps I should ask a clarifying question. The OP stated:
...
So, does putting in an LP (for instance) require scrubbing in? I've seen an epidural be put in, and it doesn't require scrubbing in. You need to sterilize the injection area obviously and you use care to open your sterile packing and wear sterile gloves, but you're not scrubbing in a la general surgery.

So, my reading of the OP's OP and his clarifying post is that he doesn't mind sterile procedures per se, but doesn't want to scrub in. Clearly, L2D thought differently.

The dude said he didn't want to do sterile procedures, surgery or autopsies. I took that to mean his issue was in the procedure, not the scrubbing. I cannot imagine the dude is okay with eg sticking a long needle into someone's spine so long as he doesn't have to wash his hands first.

 

[Gastrapathy]

The dude said he didn't want to do sterile procedures, surgery or autopsies. I took that to mean his issue was in the procedure, not the scrubbing. I cannot imagine the dude is okay with eg sticking a long needle into someone's spine so long as he doesn't have to wash his hands first.

So, you don't wash your hands prior to "sticking a needle into someone's spine"?

 

[J ROD]

There's nothing "surgical" about an autopsy.

😕

 

[GoodmanBrown]

The dude said he didn't want to do sterile procedures, surgery or autopsies. I took that to mean his issue was in the procedure, not the scrubbing. I cannot imagine the dude is okay with eg sticking a long needle into someone's spine so long as he doesn't have to wash his hands first.

I guess. He mostly states he doesn't want to operate. He mentions sterile once, but only in conjunction with "operating."

Anyway, it strikes me as odd that a med student is asking about which specialties have surgical components. Would (s)he already have a pretty good idea?

 

[45408]

There's nothing "surgical" about an autopsy.

You know, except the part about cutting someone wide open and being elbow deep in blood and guts.

 

[typhoonegator]

You know, except the part about cutting someone wide open and being elbow deep in blood and guts.

The goal of autopsy is not to heal. It is not sterile, nor do you scrub (usually). Standard surgical procedure is not followed. You cannot cause iatrogenic harm to your patient. There is no anesthesia.

Blood and guts do not a surgery make. Autopsy is a very important procedure, but it is not surgery.

 

[Law2Doc]

So, you don't wash your hands prior to "sticking a needle into someone's spine"?

You don't "scrub in" to do it. You need to wash your hands or use alcohol before seeing every patient, but to do most sterile procedures you simply have to put on sterile gloves.

 

[medstud2be]

Allergy is a pretty cerebral specialty.

 

[45408]

The goal of autopsy is not to heal. It is not sterile, nor do you scrub (usually). Standard surgical procedure is not followed. You cannot cause iatrogenic harm to your patient. There is no anesthesia.

Blood and guts do not a surgery make. Autopsy is a very important procedure, but it is not surgery.

I've seen many autopsies and surgeries. Someone who is trying to avoid anything that involves scrubbing in at all would probably find an autopsy to be too surgical for their tastes.

 

[OpalOnyx]

Neurology does LPs, rheumatologists like to stick needles into joints, ID folks may be involved in sticking needles into and draining pockets of infection (although they more often consult on this), pulmonologists pretty much all do bronchoscopy with biopsies, thoracentesis, etc, IR is a big component of every radiology residency these days (and IS surgery). Derm will regularly be doing punch biopsies of lesions to rule out cancers. EM does LPs, central lines, I&Ds, intubation, chest tubes. Peds residency will likely have a peds surg and Peds ED component which will be procedural. I'd say PM&R itself has few procedures, but folks have to do a prelim internship year in medicine to get there.
So that basically really leaves psych as the most "hands off" of the fields.

enjoyed reading this and learning about procedures within the various fields. my vote is that pscyh and FM probably has the least needles guts and gore.