Will being bad at dissection translate to being a bad surgeon?

[CaptainJackSparrow83]

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If I wanted to be a surgeon, and If i do a poor job at dissection, will that translate to being a bad surgeon? I feel like its a stupid question but it does worry me.

I had to dissect the hand today, and I was accidentally nicking arteries and tendons. I accidentally ripped some tendon while blunt dissecting.

 

[Smurfette]

If I wanted to be a surgeon, and If i do a poor job at dissection, will that translate to being a bad surgeon? I feel like its a stupid question but it does worry me.

I had to dissect the hand today, and I was accidentally nicking arteries and tendons. I accidentally ripped some tendon while blunt dissecting.

No.
In surgery, you'll be familiar with the anatomy better than when you are learning it as a student, and vessels are easier to identify in living patients. Hitting nerves and muscle can cause twitches that can help you realize you are working near something important. You also have better instruments (sharper, more precise, geared toward certain tissue types, etc.) available to you in an OR setting. Hands are tough because there are so many structures present.

Sometimes it is hard to tell initially what a structure is. But you learn how to figure it out; there's a reason why it takes 5+ years to train a surgeon.

 

[Treebeard]

What if I do not particularly like dissection? I've been doing alright but find it fairly laborious and feel like I could learn just as well from the 3d models and diagrams. Does this mean surgery may not be for me? Or are they different enough that it's not really relevant?

 

[Smurfette]

What if I do not particularly like dissection? I've been doing alright but find it fairly laborious and feel like I could learn just as well from the 3d models and diagrams. Does this mean surgery may not be for me? Or are they different enough that it's not really relevant?

You have to dissect in surgery. It's different, though, and it's not as painfully slow (unless the pathology requires it) as in anatomy lab.

I personally don't find 3D models and diagrams to be the same as practice on actual tissue, because I can't get a feel for surrounding fat and other things (like anatomic subtleties) that are present in real life. People don't look like those diagrams and models in real life. I'm already a surgeon though, so my needs are not about memorizing anatomy and function but applying the anatomy to how I do a procedure. In anatomy lab, it's all about how you learn the material and what works best for you. You need to pass the exams and learn the material, and maybe dissecting is too tedious and slow to feel productive for you if you can just sit down with a model and memorize. Don't use anatomy as a litmus test for becoming a surgeon; you will have your surgery clerkship to see if surgery "clicks" for you.

 

[68PGunner]

What if I do not particularly like dissection? I've been doing alright but find it fairly laborious and feel like I could learn just as well from the 3d models and diagrams. Does this mean surgery may not be for me? Or are they different enough that it's not really relevant?

ROFL. Don't be a surgeon if you don't like cutting up bodies. It's that simple.

 

[Crayola227]

There is something to be said for the fact that surgeons like cutting on people. Or whatever procedures it is that they do. It can vary sooooooo much.

Inserting a cochlear implant is surgery; so is removing a colon. They are very different procedures.

That said, just learn anatomy for now. Besides anatomy, do you like working with your hands? Like, a lot? That matters.

What is often said, and was true for me, is that many people know the first day they are in the OR. Not the anatomy lab mind you, the *OR*.

I like butchering whole chickens, I loved anatomy lab, like to build things out of wood, embroider, etc. But I knew the first day I was in the OR that it wasn't for me. I tried to keep an open mind during my surgery clerkship. I was fascinated by everything taking place, but the OR was not where I wanted to be long term.

Surgery is something that can really choose some people, and it can really unchoose you. Thinker vs cutter distinction can happen easily for most. So don't stress.

And if it doesn't choose you/immediately turn you off right away, still don't stress. Lots of time and experiences and hours stand before you, and mentorship, to sort it out.

Also, it's natural to wonder all this at the start. We all did!

 

[CaptainJackSparrow83]

There is something to be said for the fact that surgeons like cutting on people. Or whatever procedures it is that they do. It can vary sooooooo much.

Inserting a cochlear implant is surgery; so is removing a colon. They are very different procedures.

That said, just learn anatomy for now. Besides anatomy, do you like working with your hands? Like, a lot? That matters.

What is often said, and was true for me, is that many people know the first day they are in the OR. Not the anatomy lab mind you, the *OR*.

I like butchering whole chickens, I loved anatomy lab, like to build things out of wood, embroider, etc. But I knew the first day I was in the OR that it wasn't for me. I tried to keep an open mind during my surgery clerkship. I was fascinated by everything taking place, but the OR was not where I wanted to be long term.

Surgery is something that can really choose some people, and it can really unchoose you. Thinker vs cutter distinction can happen easily for most. So don't stress.

And if it doesn't choose you/immediately turn you off right away, still don't stress. Lots of time and experiences and hours stand before you, and mentorship, to sort it out.

Also, it's natural to wonder all this at the start. We all did!

im not sure if its a sin to think this way, but surgery is just too much thinking for me based on what ive seen in anatomy lab. i have to think constantly is this fascia, is it fat, is it an aponeurosis , is it a tendon, etc. (this is just my experience from the hand) and peeling back skin. I feel internal medicine is more of my niche if i dont quit medicine all together because its largely on patient symptoms and signs etc.

Just hoping not to close doors too early because I am probably the reason people get questions wrong on anatomy practicals conducted at my table.

 

[Tenk]

I'm not a surgeon but I do my fair share of invasive procedures and cutting. I thought anatomy dissection was boring and smelly. I find procedures to be a completely different game. I think the only way to know for sure will be to try it and see! They are very different entities.

 

[Crayola227]

im not sure if its a sin to think this way, but surgery is just too much thinking for me based on what ive seen in anatomy lab. i have to think constantly is this fascia, is it fat, is it an aponeurosis , is it a tendon, etc. (this is just my experience from the hand) and peeling back skin. I feel internal medicine is more of my niche if i dont quit medicine all together because its largely on patient symptoms and signs etc.

Just hoping not to close doors too early because I am probably the reason people get questions wrong on anatomy practicals conducted at my table.

The term "thinker vs cutter" shouldn't be taken to imply that cutters don't think and only thinkers think. Everyone in medicine thinks. It's just that some mostly think and don't cut, and others think AND cut A LOT. It's just a metaphor that boils down intricately complex occupations that takes over a decade to train human beings to do to one word.

There's a difference between thinking as in problem solving, and the sort of self monitoring that takes place when you are learning, particularly a physically oriented task, for the first time. First time I drove a car at 55 mph or rode a bike is a different sort of "always thinking" then the always thinking of doing algebra after you've mastered a math skill. Which itself is a different type of thinking than learning it to begin with or memorizing something.

Also, surgeons are still always thinking and problem solving during a surgery, it's just different. And many surgeons have told me (and I believe based on limited experience) it's definitely different than what you are describing during anatomy lab.

 

[Crayola227]

im not sure if its a sin to think this way, but surgery is just too much thinking for me based on what ive seen in anatomy lab. i have to think constantly is this fascia, is it fat, is it an aponeurosis , is it a tendon, etc. (this is just my experience from the hand) and peeling back skin. I feel internal medicine is more of my niche if i dont quit medicine all together because its largely on patient symptoms and signs etc.

Just hoping not to close doors too early because I am probably the reason people get questions wrong on anatomy practicals conducted at my table.

I was really good at dissections and my table got picked out more than once for a structure I preserved. However, I've at times been considered below average to peers at picking up some procedures.

Don't read too much about your career in medicine from how the dissection at your table is going. Not a real one to one relationship here.

A lot of us were so "grossed" out by gross anatomy that we wondered how we could possibly cut it with human beings. Gross anatomy changes your definition of gross from the start, which helps, actually. Real humans are usually a LOT less grosser, and it's rare that it's worse than GA on an average day, in most fields.

You might not go into path, but you can certainly get through 3rd year and intern year if you can make it through gross anatomy. The yuck factor definitely gets better.

Fields outside of internal medicine can also have a similarly fewer number of procedures compared to the total gamut of healthcare, however, as pointed out, the average procedure, like say an incision and drainage of an abscess, or a woman's pelvic exam and pap smear, or suturing skin, is really nothing like what you're doing now in terms of difficulty or grossness.

 

[OrthoTraumaMD]

If you don't like the concept of dissection, why do you want to be a surgeon?


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[libertyyne]

Is cleaning fat to identify structures a normal part of surgery? I feel like i have spent an inordinate amount of time cleaning fat so I can identify structures. Not fun, tedious , and not very satisfying. I suppose with enough practice I would know exactly where to cut. The head dissection on the other hand was very satisfying, saws, chisels , power tools, and the need to be extra nimble.

 

[CaptainJackSparrow83]

If you don't like the concept of dissection, why do you want to be a surgeon?


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I am truly in the process of planning to quit medical school all together. The thing is before I pull out I want to make sure I have thought of all career options that fit my desired pay/ career opportunities etc).

 

[MSTP18]

Cadavers in anatomy lab don't look anything like a real human body. Speaking both from the experience of seeing surgeries and autopsies on unfixed cadavers.

 

[Jojos]

not necessarily. not liking though, that should make you think a bit about being a surgeon.

 

[MediCane2006]

If I wanted to be a surgeon, and If i do a poor job at dissection, will that translate to being a bad surgeon? I feel like its a stupid question but it does worry me.

I had to dissect the hand today, and I was accidentally nicking arteries and tendons. I accidentally ripped some tendon while blunt dissecting.

Nope. Hated anatomy and Gross lab, and almost didn’t pass. Love, LOVE surgery.

There’s no correlation.

 

[CaptainJackSparrow83]

Nope. Hated anatomy and Gross lab, and almost didn’t pass. Love, LOVE surgery.

There’s no correlation.

What would you say the point of anatomy dissection is then? Our school wants us to make our bodies look perfect in terms of trimming off fascia and fat . I dont see why we cant have prosected bodies and just use those, save ourselves some time.

 

[MSTP18]

What would you say the point of anatomy dissection is then? Our school wants us to make our bodies look perfect in terms of trimming off fascia and fat . I dont see why we cant have prosected bodies and just use those, save ourselves some time.

Expecting you to make your cadavers look like prosection models is the mistake, not the use of cadavers itself. I do think you learn the material better (and from a more practical angle of viewing) through active dissection rather than just a book or looking at prosections but you only need to remove as much fat/fascia as you need to confidently and correctly identify the structures, not all of it.

I also think to some extent that the experience of dissecting a person is kind of transformative (even for those who don't realize it) and is beneficial for us to have at the beginning of med school.

 

[Espressso]

What would you say the point of anatomy dissection is then? Our school wants us to make our bodies look perfect in terms of trimming off fascia and fat . I dont see why we cant have prosected bodies and just use those, save ourselves some time.

Prosections are nice to go and check to see what a clean dissection should look like. Or if you accidentally cut an important nerve or artery, you can go see how it tends to supply the muscle/organ/etc.

But dissecting yourself is - I think - a really strong form of learning. And honestly, I'm not the biggest fan of gross anatomy lab at my school. My cadaver isn't lean, I have to come in after hours to trim fat. But I will admit, I can learn a lot just by being in there and seeing where things connect, how vessels flow, how tissue feels.

 

[Treebeard]

ROFL. Don't be a surgeon if you don't like cutting up bodies. It's that simple.

Which type of surgeon spends 2-3 hours clipping fat off of nerves? If that is an accurate description of the job then you are correct, I don't want to do it.

 

[Raryn]

I once heard a surgeon say he could teach a monkey to operate, but he couldn't necessarily teach a monkey to not operate.

That is, you'll have 5-10 years to learn the technical aspects. Unless you have zero coordination whatsoever, you'll be fine. They're the least of the job. Outside of extremes, the difference between a good surgeon and a crappy surgeon isn't the technical ability. It's their judgement.

 

[Crayola227]

Which type of surgeon spends 2-3 hours clipping fat off of nerves? If that is an accurate description of the job then you are correct, I don't want to do it.

not fat but something similar in vascular surgery when they have to dissect down to vessels like the femoral artery

 

[Menander's Bust]

Lolno I was an anatomy TA and anatomy like surgery is just a physical skill. The more you do it the better you get. Not sure there’s really any long term benefit in being “good” at dissecting cadavers since they are nothing like living people and there’s no cadaver dissecting job in medicine besides being an anatomy professor.

Btw residency is where you really develop surgical skills so just because you aren’t great at surgery the first 20 times you assist doesn’t mean you can’t be a surgeon. A LOT of surgery nowadays is laparoscopic, robotic, trans-vascular, etc., which have even less to do with dissecting a cadaver than open surgery.