Surgery and intellectual challenge?

[rht7w]

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Can anyone tell me which surgical specialties/subspecialties (academic) are generally considered to be the most intellectually challenging? By intellectually challenging I am refering to things like opportunities for basic science research, continual advances in the field, relatively few routine or "typical" cases, use of creativity, ingenuity, etc. etc.

Last time I saw a post like this it quickly degenerated into a discussion about whether or not surgeons use their minds - I know that they do, or else I wouldn't be on this message board, so please don't do that here. But if those of you who are further along the path than I am could shed some light onto which fields you think are the most intellectually satisfying and why, I'd really appreciate it. Thanks..........

 

[neo]

Every field is medicine is developing rapidly and every field has its "routine" and "typical" cases. That being said, if you establish yourself as a world leader is some esoteric facet of your field in an academic institution, you can get the lion's share of the more complex, less common cases and do all kinds of cool research.

Not that im biased or anything but ENT/HNS is an amazing field for this. Tons of research being done in head and neck oncology, audio processing and hearing, neural processing, phonation and laryngeal reinvervation, etc. Some of the most complex anatomy, extremely dense layout of very critical vessels, nerves, muscles in an intricate bony matrix. Huge variety in the types of cases you can do. Small office procedures like tubes and huge 15 hour cases with composite resections and microvascular graft reconstructions. Intricate cases like middle ear reconstructions, cochlear implants, and big whacks like maxillectomies and radical necks.

But, as i stated earlier, you can find great research, interesting cases, and intellectual challenge in almost every field. You will most likely have to stay in academia to find it though. Private practice isnt really the place to be doing basic science research, etc. The trade off of course is much less pay for academia and pretty stiff competition for grants, lab space, tenure, etc. So you can figure out what's most important to you and decide accordingly. best of luck.

 

[vuillaume]

There's no real answer to this question. Cutting-edge research is going on in every single surgical/medical/neuro/gynecologic field. On the other hand, even in fields that presumably require more brain cells, there are plenty of practitioners who don't use them. A Hem/Onc guy in practice can lazily follow protocols without using his head even if we stereotypically think of oncologists as being brainiacs.

Choose what interests you, not what has the reputation for being intellectually challenging. And much of the time, what actually turns your crank is just a visceral/irrational affinity for a field, whether it's revascularizing hearts, sewing GoreTex grafts, performing sentinel node biopsies, or knee arthroscopy.

And in some cases, you just have to make the choice of what surgical "niche" would actually logistically permit you to have time to do research and all the activities ancillary to that (e.g. writing grants, attending meetings). For instance many don't think of lumpectomies and mastectomies as exciting or even intellectually stimulating surgeries, at the same time, this kind of practice may be great for someone interested in having protected lab time in an academically-fertile oncologic field. In contast, if you're doing a couple of Whipples a day, it might be hard to write a competitive RO1 NIH grant proposal (and a well-funded researcher might want at least 3 or 4 RO1's).

Using your mind is *your* choice, it's not imposed on you by what specialty you choose.

I get the impression that a lot of people who post to this board let what others think about a potential specialty sway them too much.

 

[iamubiquitous]

thats an oxymoron

just plumbing and excavation