So You Want to Be a TRAUMA SURGEON [Ep. 8]

so you want to be a trauma surgeon you've come to the right place in this episode of so you want to be let's talk about what it means to do trauma surgery the training process and some of the lesser-known upsides and downsides of being a trauma surgeon dr. Duval med-school insider.com welcome to our next installment of the so you want to be series where we highlight a specific specialty within medicine and help you decide if it's a good fit for you you can find the other videos on ours so you want to be playlists if you want to help us decide which specialty or healthcare profession to cover next drop a comment down below with your request if you'd like to see what being a trauma surgeon looks like in real life check out my second channel Kevin jabal MD where I do a second series in parallel titled eight day-in-the-life trauma surgery is a subspecialty of surgery primarily dealing with patients who have undergone a physical injury often in an acute setting not all trauma requires surgery and depending on the specific injury these patients may also need further treatment from neurologists internal medicine doctors and more the majority of injuries addressed by trauma surgery include those of the neck chest abdomen and extremities in Europe trauma surgeons treat most of the musculoskeletal trauma whereas neurosurgeons handle injuries to the central nervous system in the United States and UK however skeletal injuries are primarily handled by orthopedic surgeons and facial injuries are often treated by plastic surgeons or maxillofacial surgeons neurosurgeons typically manage injuries to the CNS in these countries to trauma surgeons must be familiar with a variety of general Surgical thoracic and vascular procedures trauma conditions can be described as blunt or penetrating blunt would include injuries from a motor vehicle accident Falls ATV rollovers and assaults penetrating injuries include gunshot wounds stab wounds and the like additionally they're dealing with high acuity situations often with little time and incomplete information with a patient in front of them who is rapidly decompensating the more traditional trauma surgical interventions often include procedures such as the exploratory laparotomy where the abdomen is opened and the abdominal organs examined for injury or disease thoracotomies open up the chest and tracheostomy SAR procedures for insertion of a breathing tube through the throat over the past few decades advances in trauma and critical care have led to more non-operative and sometimes minimally invasive treatment modalities this is good for patients as less invasive therapies often have better outcomes to become a trauma surgeon you'll complete medical school and then do five to seven years of general surgery residency depending on whether your residency includes a two-year research block from their most trauma surgeons do a one to two year fellowship in traumatology surgical critical care or emergency surgery or a total of six to nine years of additional training after Medical School pediatric trauma surgery is part of regular peds surgery training depending on where the ambulance takes the patient sometimes it gets managed and triage acutely at the adult hospital but ideally go straight to the pediatric trauma center if you're interested in more specific types of trauma there are other specialties to consider for example orthopaedic trauma focuses on surgical intervention of traumatic injuries related to the musculoskeletal system if you want to deal with spine and cranial trauma then neurosurgery would be your specialty general surgery residency is middle of the road in terms of competitiveness with an average matriculate step one score of 234 with the national average at 230 as with most surgical specialties trauma surgery is male-dominated although not as much as some other surgical specialties like neurosurgery or orthopedics and as a surgical specialty your general surgery residency and trauma surgery fellowship will be incredibly taxing and long with often unpredictable hours rather than telling you what it's like to be a trauma surgeon I'm gonna hand it over to my friend dr. David Hendon not only does he have an awesome YouTube channel that you should definitely check out but he's also a general surgeon with extensive trauma experience from his surgical residency at Temple University Hospital in Philadelphia without further ado here is dr. Hindon we joke around sometimes that trauma surgery is kind of like general surgery on steroids all of the regular principles that we have in general surgery are still there and many of the procedures and maneuvers are the same - in trauma surgery you might find yourself removing and reconnecting different portions of the small bowel and colon you might find yourself removing a portion of the lung or repairing a hole in the diaphragm and you might find yourself deep in the Abdo exposing the retroperitoneum to repair a vascular injury all of these are techniques and maneuvers and procedures that we might do in other areas of general surgery but the difference in trauma is the urgency and often the speed at which we have to do this work and just as trauma surgeons may have to perform surgery in a much more urgent timeframe these surgeons also must make decisions about patient management and take action often with limited information sometimes even in the blink of an eye but more on that in a few minutes there's a lot to love about trauma surgery it's a specialty that's fast-paced and exciting and more than any other area in surgery trauma is an environment where you can have an immediate and lasting influence in someone's health with actions that play out in seconds to minutes after all what could have a larger impact than saving someone's life trauma surgery also tends to attract surgeons who like to perform what we'd call big operations many of these procedures involve making large incisions creating major exposures of vascular structures and performing large-scale repairs of significant injuries throughout the body one of the most common procedures we do in trauma surgery is called an exploratory laparotomy in this surgery a long incision is made from the top of your abdomen just below the ribs straight down the midline to below the belly button once the abdomen is entered surgeons are able to quickly run the bowel meaning that they examine your entire intestines from end to end this type of procedure is typically carried out very quickly so that surgeons can quickly locate injuries for instance from a bullet or a knife wound and then determine the next best steps to stabilize the patient control any bleeding and repair the injury and at the same time they're inspecting the intestines they're also looking at solid organs within the abdomen and different zones or your major vascular structures lie like your aorta to see what other injuries might need to be addressed another trauma procedure that's unfortunately somewhat common in urban areas with a large amount of crime and violence is called an e d thoracotomy or a crash thoracotomy this is a procedure that's typically carried out in a portion of the emergency room called the trauma Bay and it's done for patients who come in without a heartbeat after a form of penetrating trauma in this procedure over the course of a few minutes a large incision is carried across the left chest the heart is released from the pericardium and a cross clamp is placed on the aorta to help reduce the amount of blood loss visible injuries to the heart and lung may also quickly be controlled with a clamp to help achieve hemostasis and stop bleeding at this point the surgeon then performs what's called open cardiac massage which means squeezing the heart between one's hands to try to restore a heartbeat like a kind of internal CPR as you can probably tell even though most specialties within surgery these days require a surgeon to specialize and commit to operating in one part of the body a trauma surgeon could find him or herself removing a portion of the lung repairing a bleeding cardiac injury removing a damaged spleen and repairing a hole in the intestines all in the same day and maybe all on the same patient another thing to love about trauma surgery is the mix of critical care medicine that's involved most trauma surgeons balance their time operating with helping to manage ICU patients this requires a more intellectual side of surgery that can often be a really nice balance to the more intense operative side of things also trauma surgery typically runs on a shift like schedule this means that while you might be incredibly busy while you're at the hospital once your shift is over one of your partners takes over your responsibilities and typically your time outside the hospital is then completely yours to contrast some surgeons within other specialties might be on-call 24/7 for their patients there's also a flip side to all of that excitement the high-intensity action-packed moments of trauma surgery can also come with their toll it can be exhausting and draining both physically and emotionally having critically ill badly injured patients often means that unfortunately there will be many patients who arrive in your trauma Bay that you just can't save having to break bad news to loved ones of patients on a regular basis is an emotional weight that can be hard to overemphasize this is an incredible burden that trauma surgeons have to carry and because traumas can occur at any time of the day trauma surgeons also have to be available 24 hours a day - that means that when you're on call at the hospital there's no guarantee what your day or night might be like things could be quiet all morning afternoon and evening and then trauma patients can suddenly start pouring in needing multiple operating rooms to open up to take care of the sudden volume shifts like this can be exhausting for surgeons and for some people they really do take a toll the unpredictability can also be a source of stress in itself also by the very nature of what trauma surgeons do it's one of the areas of surgery where you're unlikely to have patients seek you out to be their surgeon after all trauma patients aren't expecting to be having an emergency but along those lines it's good to know that most trauma surgeons also have an office practice of general surgery so these surgeons may be seeing patients who come to them for elective surgeries like hernia repair gallbladder surgery and other procedures at the end of the day trauma surgery is an incredibly meaningful and rewarding surgical specialty people who should go into trauma surgery are those who thrive within fast paced high-intensity environments people who like making a decision putting together a plan and executing it quickly and without hesitation if you're someone who prefers to mull over a decision trauma may not be the field for you trauma surgery is also ideal for people who thrive and working on teams everything we do requires close coordination with our colleagues and surgery nursing anesthesia and more and trauma surgery is also ideal for doctors and surgeons who like critical care medicine to surgeons who enjoy running an ICU and managing patients in intensive care finally trauma surgery is also ideal for people who like to have a shift work type schedule in their life so that when you're off you're truly off from the hospital and free of responsibilities this type of schedule and trauma makes the specialty really ideal for people who have other passions in life and wish to balance their surgical career with other time commitments outside of their surgical practice massive thanks to dr. Hindon for sharing his expertise in general and trauma surgery he has a super interesting story as a surgeon and medical technology innovator so be sure to check out his channel david Hindon MD link below which specialty should we cover next in hours so you want to be series let me know with a comment down below thank you all so much for watching and I will see you guys in that next one

Channel: Med School Insiders

Views: 123,426

Rating: 4.9825368 out of 5

Keywords: Pre-med, Premed, Med Student, Medical School, Med School, Medical Student, trauma surgery, general surgery, emergency surgery, so you want to be, trauma surgeon, emergency surgeon, general surgery subspecialties, trauma surgery myths, critical care, trauma surgery training, surgery residency, david hindin

Id: dd95CKvUQwQ

Length: 10min 48sec (648 seconds)

Published: Sat May 09 2020