previous hand injury & compatibility with surg speciality

[mm88]

Can you be a surgeon with a previous operative hand injury that causes intermittent pain?

I tore my thumb UCL a few years ago and had it repaired. Made it through some surgical rotations and went to the OR with no issues, but still have pain/trouble examining large knees (so I would modify the test by hanging their leg off the exam table and holding their lower leg between my legs etc.), no issues with manual dexterity or doing small procedures that I have identified yet.

Is this going to be a deal breaker if I want to do orthopedics? I have a thermoplastic splint I wore for a few sport med clinic days but it was pretty uncomfortable so I don't wear it regularly. If I had to wear it all the time, I could probable have a new one made. Is wearing supportive splints/devices like this frowned upon in surgical residencies?

Thanks!

[ZBL]

Why not get your hand reassessed by plastics/hand ortho? While not unusual to have chronic pain after surgery, it sounds like you have some functional impairment too. 

Depending on that, I personally could not fathom doing surgery if it exacerbated chronic pain. 6am is already painful enough. Prioritize your physical function and health over your preference to surgery would be my suggestion, but maybe other surgical people on here can weigh in if they'd still be a surgeon if they had chronic pain made worse by the job. 

[Edict]

On 3/20/2018 at 11:03 PM, mm88 said:

Can you be a surgeon with a previous operative hand injury that causes intermittent pain?

I tore my thumb UCL a few years ago and had it repaired. Made it through some surgical rotations and went to the OR with no issues, but still have pain/trouble examining large knees (so I would modify the test by hanging their leg off the exam table and holding their lower leg between my legs etc.), no issues with manual dexterity or doing small procedures that I have identified yet.

Is this going to be a deal breaker if I want to do orthopedics? I have a thermoplastic splint I wore for a few sport med clinic days but it was pretty uncomfortable so I don't wear it regularly. If I had to wear it all the time, I could probable have a new one made. Is wearing supportive splints/devices like this frowned upon in surgical residencies?

Thanks!

Yeah i'm sure you can do it. If you can bear the pain, you should do it if you love the specialty. No one frowns on you wearing a supportive device when you aren't in the OR. The only way they would frown is if: 1. you complain about your pain too much 2. it interferes with your ability to do your job

If you feel like the pain could become bad enough you would start to want exemptions, then you may want to reconsider the specialty. 

[mm88]

On 3/20/2018 at 9:26 PM, ZBL said:

Why not get your hand reassessed by plastics/hand ortho? While not unusual to have chronic pain after surgery, it sounds like you have some functional impairment too. 

Depending on that, I personally could not fathom doing surgery if it exacerbated chronic pain. 6am is already painful enough. Prioritize your physical function and health over your preference to surgery would be my suggestion, but maybe other surgical people on here can weigh in if they'd still be a surgeon if they had chronic pain made worse by the job. 

Thanks for the QoL slant to the response, appreciate it. It is thankfully not at the point that it is "chronic pain" per se, I can get through all my ADLs and such without pain. It's just aggravated by a couple very specific hand positions.

On 3/22/2018 at 5:51 PM, Edict said:

The only way they would frown is if: 1. you complain about your pain too much 2. it interferes with your ability to do your job

If you feel like the pain could become bad enough you would start to want exemptions, then you may want to reconsider the specialty. 

NO WHINERS ALLOWED IN SURGERY!  Worst case scenario they kick me out of the program and I just go back to being a GP, I guess?

I am just very curious as to what the attitude in surgical programs are towards people with some minor impairments or struggle with things. Everyone in the family med world seems quite collegial and supportive of struggling colleagues. I have heard the opposite about surgical residency programs and wonder if anyone could corroborate this. I don't want to go through the effort to try and re-enter residency if they will go out of their make things hard for me.

[Edict]

15 hours ago, mm88 said:

Thanks for the QoL slant to the response, appreciate it. It is thankfully not at the point that it is "chronic pain" per se, I can get through all my ADLs and such without pain. It's just aggravated by a couple very specific hand positions.

NO WHINERS ALLOWED IN SURGERY!  Worst case scenario they kick me out of the program and I just go back to being a GP, I guess?

I am just very curious as to what the attitude in surgical programs are towards people with some minor impairments or struggle with things. Everyone in the family med world seems quite collegial and supportive of struggling colleagues. I have heard the opposite about surgical residency programs and wonder if anyone could corroborate this. I don't want to go through the effort to try and re-enter residency if they will go out of their make things hard for me.

People are generally supportive, but the issue i find is if you can't do your job and others have to come in and support you constantly, people lose their patience. With surgery, a lot is on you, and you alone, which is why it is a bit different and the expectations are different. 

[PilotMD]

Only you can determine if it will be an issue. Surgery requires working with your hands 'most' of the time - over a 30+ year career. It's a very difficult job and surgical residency is no joke. What are surgeons (such as myself) going to care about when you are a resident - can you do the job. What are your patients going to care about when you are a staff surgeon - can you do the job. Thats it. Full stop. If the pain limits your ability to do the job (effectively or period) then this is not the place for you. So only you can really answer your own question. Honest advice - surgery is painful (training and somewhat in practice) in general relative to many (most) other specialties in medicine - if you are in a situation that is going to make your training/career more difficult, choose something else - I think you will be happier overall if you do. But if your hand does not limit you (dexterity, pain, etc) then join the club.

PMD

[goleafsgochris]

On ‎2018‎-‎03‎-‎23 at 7:41 PM, mm88 said:

 

NO WHINERS ALLOWED IN SURGERY!  Worst case scenario they kick me out of the program and I just go back to being a GP, I guess?

I am just very curious as to what the attitude in surgical programs are towards people with some minor impairments or struggle with things. Everyone in the family med world seems quite collegial and supportive of struggling colleagues. I have heard the opposite about surgical residency programs and wonder if anyone could corroborate this. I don't want to go through the effort to try and re-enter residency if they will go out of their make things hard for me.

This is not surgery specific.  But in life in general, people will always be supportive until it affects them.  Have to wear a brace?  Sure do it!  Have some pain?  People will say nice things about how that's too bad.  BUT the minute you start to take longer, not do a certain task (and someone else has to do it), complain about it so much that its irritating...the collegiality and supportiveness will go away instantly.  I promise.  This is true in any specialty, including family.  

[mm88]

On 3/25/2018 at 6:59 AM, goleafsgochris said:

This is not surgery specific.  But in life in general, people will always be supportive until it affects them.  Have to wear a brace?  Sure do it!  Have some pain?  People will say nice things about how that's too bad.  BUT the minute you start to take longer, not do a certain task (and someone else has to do it), complain about it so much that its irritating...the collegiality and supportiveness will go away instantly.  I promise.  This is true in any specialty, including family.  

That is a fair point.

Maybe I felt that it was not as big of an impact in family med because we usually don't burden our colleagues much in FM. There isn't a huge overnight call load during residency (very rarely got slammed with consults because someone was away) and FM residents are usually working one on one with a preceptor in clinic, so the burden on other residents is not as apparent when a resident is not carrying their load. Even as staff now, people tend to just have you help cover their inbox for a short time and then get a locum when something happens/they get ill, but I can see how it could be a bigger problem if you were practice sharing.

In surgical residency when call happens so often it might be horrible for others. If my thumb craps out during residency I'm sure I could still run the floor no problem (I messed it up during an IM rotation initially and was ok), do the consults, and do all the call. I'd probably just flunk out because I would have to let other residents operate more often which I don't think any surgery resident would complain about .

Jokes aside, thanks for the perspective.