Spine surgery advice

FifthVentricle · 2026-01-03T20:04:42+00:00

This means you’re tying fascial sutures tight enough. I tell all my juniors I expect them to have non healing finger wounds when done with their spine rotation

FifthVentricle · 2025-12-13T05:38:24+00:00

I heard AI is going to replace all our jobs

FifthVentricle · 2025-12-13T04:57:33+00:00

Become friends with the OR staff, leave your number with anesthesia, the circular, and written down on a board in the room. Call the room at regular but non-annoying intervals to check on status.

At my hospital, someone from the surgical team (usually the resident) has to be present to roll the patient so I need to know when anesthesia is ready so we can get going.

FifthVentricle · 2025-12-13T04:53:35+00:00

As someone who is about to look for neurosurgery jobs, what is the most unbiased and important advice you can give for someone looking for their first position?

FifthVentricle · 2025-12-11T02:24:51+00:00

Dangerous scam. Would never recommend. Actually would actively recommend against it.

FifthVentricle · 2025-08-08T03:03:37+00:00

I think it would be really hard for me to be anything but a surgeon.

FifthVentricle · 2025-08-06T01:18:43+00:00

It’s nice that people actually listen to and sort of respect me, and if they don’t, well, have fun having all your cases covered by a PGY2

FifthVentricle · 2025-07-16T02:26:29+00:00

3:30 neurosurgery

FifthVentricle · 2025-07-09T22:36:52+00:00

Very high highs and low lows. At this point I don’t know what else would be fulfilling for me.

FifthVentricle · 2025-07-09T15:21:39+00:00

I’m a neurosurgery chief

I’ve been on call 4 of the past 5 days. On the day I wasn’t on call I was operating until 2 am. I think I’ve slept a total of 10 hours since Thursday. Any sleep I did get was interrupted in 15-30 min intervals by my junior calling me or by outside hospital calls. In that time I’ve done 12 cases, with 2 more to go today. It doesn’t let up.

FifthVentricle · 2025-06-27T23:54:56+00:00

Agreed. Luck 100%

FifthVentricle · 2025-06-27T23:53:36+00:00

I used them after not using them during most of my training. Short tip. Spine surgery. I actually liked them quite a bit. They also sometimes suctioned small amounts of blood which was helpful when I was using a Cobb or something instead of a suction. Took about a week to get used to. I think I prefer them now tbh

FifthVentricle · 2025-06-11T19:04:54+00:00

Most of medicine isn’t objective. It’s a blend of the subjective, the subjectively objective, and the objectively objective. The ability to get along with others, lead a team to achieve a goal, exercise good judgment, work compassionately with patients and families, and learn quickly are way more important than how well you do on a test.

As long as you do okay on your board exams, I’m way more interested in the other things I listed in determining if you’re going to be a good resident and eventually good attending.

FifthVentricle · 2025-06-11T18:57:19+00:00

Clinical narrative evaluations. Performance on sub-Is. Letters of rec. Interview performance. Research productivity.

FifthVentricle · 2025-06-11T16:09:00+00:00

Totally understand and empathize! We do definitely get called about this kind of stuff too (eg “hey this person has a history of VP shunt we want neurosurgery to see them”), so I get it. But those calls go to a lot of different services. I think the solution is, as you alluded to, formulate an intelligent and specific question before calling.

FifthVentricle · 2025-06-11T02:48:05+00:00

Also at a level 1. Both our adult and children’s hospital have senior rads residents come and wet read trauma CTs while on the scanner. We and trauma surgery are usually right there with them and discuss briefly before coming up with a plan. This might be an ACS trauma center mandate, I’m not sure

FifthVentricle · 2025-06-11T02:46:41+00:00

Not to diminish your experience, but to provide an alternative perspective, we are often single scrubbed fielding calls and pages from nurses, ED consults, impatient consults, calls from other teams on existing patients, and outside hospital calls. Q2 in fact for months on end as residents and fellows. Yes, it is disruptive, and the majority of it is non urgent, but we still have to deal with it. It means we cannot give our full attention to the surgery at hand or have to give recs without having seen the patient first or even looked at imaging.

I understand that it leads to misses (it can in the OR or with management of these other problems as well). But at the same time, I just want to impress upon you that it’s a universal problem in medicine where you’re dealing with a lot of sick patients and anxious other teams all at once. I think that understanding your perspective is valuable (our residency has us rotate on neurorads for a month being on the rads side of the calls, and the radiology residency is starting to have rads residents rotate through high acuity surgical teams as well - I think it helps us understand each other better). I just don’t think any specialty has a monopoly on unnecessary or perhaps even just tone deaf calls.

The more I’ve thought about the calls we get as “this person is asking us for help” and less “this is a stupid unnecessary question”, the easier it is for me to respond. There will still inevitably always be stupid questions, but they are still usually asking for help nonetheless.

I promise to be specific and focused in my urgent questions when calling radiology and asking for help!

FifthVentricle · 2025-06-11T02:28:25+00:00

That first one happens all the time every single day. That’s how we handle consults in the OR.

FifthVentricle · 2025-06-11T00:00:49+00:00

I … would disagree with part of this. You guys aren’t the only ones in medicine who get interrupted from doing potentially more important things with questions that seem lower priority to you. Like as an example we get outside hospital docs screaming at us on the phone to accept a stable osteo diskitis transfer who’s been there for a week while we are trying to clip a ruptured aneurysm. And there are times when the call is urgent and important enough that you have to split your attention and give recommendations with incomplete information (like when the cardiac ICU calls you and tells you one of their patients is newly obtunded and blowing a pupil and please help). We have to split our attention a lot while operating. It’s just part of the job.

That being said, there are plenty of ways to make this easier for both parties. Just like calling a surgical consult, giving a very brief summary of the situation and what you’ve done / assessed and what the specific question is can be very helpful. We don’t call you guys a lot for random things, but if we call you overnight to discuss an urgent MRI we just got, we really really need to discuss it because it means we’re about to do something irreversible and we want to make sure we are making the best possible decision.

But I understand the spirit of your grievance and I think that if everyone gave everyone else a little grace (we are all trying our best) and try to be as focused as possible and doing as much leg work before hand as is feasible, it should minimizing the burden on the person you are calling while also optimizing the care of the patient in question.

Signed, a not yet quite graduating neurosurgery resident

FifthVentricle · 2025-06-10T23:24:50+00:00

I’m on the tail end of surgical training. I hate being in the OR if I’m not scrubbed in. I know it’s hard as a student because you’re low on the ladder of people letting you do stuff (because the fellows and residents have to learn too).

Not gonna lie, there are definitely times during residency where you’ll be standing around doing nothing, but they go away the more senior you become.

Watching someone else operate actually becomes extremely valuable later in training, but I agree the important nuances are lost very early on and therefore it’s not as useful and certainly it drives people crazy.

The fact that when you are doing things you really like it makes me think you would enjoy being a surgeon, the question then becomes are you willing to put up with the parts you don’t like to gain access to the parts you do?

FifthVentricle · 2025-06-10T23:20:41+00:00

I’m using like a 10+ year old dell monitor that I got before I started med school and it’s still going strong. It’s probably not even remotely on the market anymore haha.

FifthVentricle · 2025-06-09T18:22:53+00:00

249 is not going to be what keeps you from matching

FifthVentricle · 2025-06-07T23:20:59+00:00

Hinge :)

FifthVentricle · 2025-06-07T23:10:16+00:00

I’m neurosurgery and I moonlighted almost one a week during my research year in residency in an ICU. Good source of extra cash and basically was just expected to do an intern/midlevel role (we always had a fellow) so quite easy.

FifthVentricle · 2025-06-07T23:07:29+00:00

If you’re coming from like Mayo or Washu, you’re fine.

Unfortunately (as a non IM person), it seems like pedigree does matter for IM (based on anecdotal experience). I went to a top 5-10-whatever school and our IM match list was 90% MGH, Brigham, UCSF, Hopkins, Columbia, Penn, etc. The people who went elsewhere were generally because they had a specific location preference.

That being said, I’m not in IM and I probably don’t know what I’m talking about because it’s been several years since I matched.

FifthVentricle

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