Why I DIDN'T... Neurosurgery
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- Опубліковано 7 лип 2024
- Neurosurgery is an amazing specialty, I was seriously considering becoming a neurosurgeon until my surgery rotation in medical school, when I realized it wasn't for me. Choosing a specialty is one of the most important decisions you'll make in medical school and in your path to becoming a doctor. Neurosurgery is a fantastic specialty, but it's not for everyone.
This is my experience with neurosurgery, why it was high on my list of potential specialties, and tips for you if you're considering specializing in neurosurgery in the future.
Some of the things I loved about neurosurgery include the subject matter, more specifically the central and peripheral nervous systems. I loved the personalities and the emphasis on medical management as well - being well rounded in both surgical and medical techniques.
However, there are some things I didn't like. The outcomes are usually poor compared to other specialties, brain surgery is less precise than I expected, and the work life balance is one of the worst.
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TIMESTAMPS:
00:00 - Introduction
00:59 - My Experience with neurosurgery
05:39 - Surprising things about neurosurgery
10:00 - Tips for those considering neurosurgery
LINKS FROM VIDEO:
So You Want to Be a NEUROSURGEON [Ep. 6]: • So You Want to Be a NE...
#neurosurgery #whyididnt #medicalschool
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Disclaimer: Content of this video is my opinion and does not constitute medical advice. The content and associated links provide general information for general educational purposes only. Use of this information is strictly at your own risk. Kevin Jubbal, M.D. will not assume any liability for direct or indirect losses or damages that may result from the use of information contained in this video including but not limited to economic loss, injury, illness or death. May include affiliate links to Amazon. As an Amazon Associate, I may earn a commission on qualifying purchases made through them (at no extra cost to you).
Kevin, join me in the OR anytime, and I’d be happy to show you how beautiful, intricate, and delicate our surgeries can be. We don’t do “crude.” ☝🏻🙂
😂😂
He dropped out on what others considers a dream.
i wish i get the chance to be in the OR :(
I see you everywhere on UA-cam for some reason?
Ironically, both of you are good at "selling" neurosurgery.
sir it's nice to see you here
btw you do make really great videos and have a good sense of humour
As a neurosurgeon, your comment/observation regarding how "crude" it can be at times is spot on. However, there is a curious parallel that it is also incredibly unforgiving of surgical error; unlike, say, general surgery, where if you poke a hole in the bowel, you can simply sew it shut, if you cut a nerve in a spine surgery, or go slightly too close to the motor strip or speech center in a brain surgery, there is no recovery from it. The patient will suffer irreparable harm. Hence, the high incidence of malpractice lawsuits against neurosurgeons.
Very accurate. One of the major reasons I didn't go into NS was an experience scrubbing in with a famous professor of NS who was operating on an 18 yo boy who was really a great young man. What had appeared to be a potentially approachable tumor in his right hemisphere on exposure was obviously grossly malignant and much more aggressively invasive than anticipated. The whole room fell silent and the surgeon's eyes were tearing.
I knew I couldn't deal with that with any frequency.
Neurosurgery is fantastic but when I experienced being a first assist in a brain bypass surgery I attended as an Intern, after 12 hours, I realized this field was not for me at all. Exhausting and cumbersome. It is highly rewarding and intellectually stimulating, but it can be a very physically and demanding field especially the 7 year training. Kudos to the neurosurgeons for their work though.
Exactly. It seems interesting but hell no I don’t want to do 12+ hours of surgery.
When you have passion for something, that's 12 hours doesn't felt at all. Find that passion my Friend
It takes more than "passion" to do 12 hour surgeries for 30+ years. You have to have a tinge of masochism
@@mediokritet hahaha i need to figure out if i have a “tinge of masochism” 😂😂
This is exactly one of the reasons that draws me into neurosurgery (and orthopaedics to some extent) actually. I see general surgeons doing 15- 16 surgeries a day rushing patient in and out of OR every half and hour and on the other end neurosurgeons happily take 3 hours to just drilling into the vault. Theres just this sense of calm in neurosurgery OR inspite of it having some of the worst trauma case loads.
I have had 10 brain surgery because of my Hydrocephalus. Im glad for my Neurosurgeons
I’m not a neurosurgeon but I’ve spent 5 months on neurosurgery rotations so far and I’m applying for neurosurgery, and in my experience I’d agree that the bread and butter of neurosurgery is fairly crude: we’re talking spine and head trauma, it’s a lot of big fast movements and popping skull caps off in a hurry. But I love that you can have that PLUS the fine intricate details of a skull base meningioma all in one day.
These videos are great and I like the blunt honesty more than the so you wanna be series, please keep them coming!
Psychologically, you might find that some neurosurgeons keep a good sense of humour and relaxed demenaour amongst peers to try and offset the stress and negativity that occurs with poor or negative outcomes in patients. A coping mechanism perhaps to help process this. I've seen this before in other specialities, especially pre-hospital medicine and emergency medicine, cracking dark jokes and keeping things lighter than they are in reality.
Yeah, that’s called “gallows humour” and definitely exists among people in all varieties of dark/difficult fields of work!
@@SLPtoMD Thanks, I never realised there was an actual term for this! I will keep a mental note!
Brain tumor patient here! Loved my NS…he was straight forward and to the point..
When is “So you want to be a Rocket Surgeon” coming out?? 😂
There is areospace medicine
@@alitabatabaei4578 that is def something i am interested in learning more about
@@yasminrafael3681 it’s really cool ! You work with pilots and astronauts and help keep them healthy . It’s one of the specialty’s I’m interested in .
Dr. Kevin I slightly disagree with you in that neurosurgery is not precise surgery when compared to plastic surgery. Because both specialities are precise but in different ways. Neurosurgery depends on precise minimal surgical changes but in small dangerous area, as you work in a small limited surgical field and within limited bony structures and this needs high precision to do that minimal surgical work safely, wheres the same operation may be much easier and cruder if done in other area of the body like abdomen or subcutaneously as you always surrounded by precious structures during neurosurgery. On the other hand plastic surgery is much different as the amount of surgery neede and done is much much more than the neurosurgery and the surgical field is much capitious and the precision here is to apply the best geometric changes not to avoid injury of highly dangerous structures or to work in a narrow crowded field. That is why I consider plastic surgery is the basic pure surgery.
Thank you for sharing your perspective on neurosurgery!
Finally neurosurgery is tough field and the only port to it in my opinion is loving neuroscience and surgery together.
This is probably my favorite series
I just got into Medical school. In my country it's 6 instead of 4 years. Am really hoping to get into a neurosurgery residency program after Med school. Now I know that Dr. Jubbal can help me with his videos to find an alternative if I change my mind. God bless you sir!
I bet you're brazilian
@@laiane6070 Nope. I'm from Serbia
@@forLife-tl1kj Then Serbians and Brazilians are together in this
In lots of other countries medicine is undergrad 6 yrs course instead of postgrad 4 yr course in USA
@@menace2819 yup, usually 5 or 6 years here in the UK as an undergrad course (4 years for a postgrad course)
85 to 90% of what neurosurgeons do is back and peripheral nerve surgery. There are like 5,500 neurosurgeons (not including residents and fellows) only about 400 primarily work on the brain and skull.
It’s amazing to be able to make that choice. To think that he has the option to do neurosurgery and didn’t absolutely blows my mind. I’ve still (hopefully) got over 8 years of school left until I become a doctor (hopefully) and I would choose it in a second
I studied Neuroscience at UCSD and medschool at UCLA, love the symmetry haha
Woot!
@@kevinjubbalmd and wanna do neurosurgery at ucsd so thanks for the vid
I never went to med school; of all things fisheries biology, but if I did it would have been a discipline of surgery. To hear that neurosurgery uses more of a "coarse" application of the skill set, shattered my ideology.
I am a patient with a grade 4 astrocytoma and when I first met my neurosurgeon he was very calm and explained the awake resection and other questions that I had. Those people are like OG stuff to me.😁😁
In for example brain tumor removal they have to walk a fine line between removing as much as they can and considering the quality of life. If they remove too much then I can't speak or move properly anymore, losing quality of life.
I am currently doing fine! 😁 I had radiotherapy about 6 months ago and I am now on the home stretch with the chemotherapy. The scans are showing no growth of the tumor which is the objective of the treatment, so everything is going quite nicely. Of course the tumor will eventually start growing again but I will think about that when it is applicable. I had nice holidays and I have quite some things planned for myself.
Cheers!
Good luck!
A lot of people choose their specialties to feed their ego.
Do something that suits your personality,mental and physical stamina.
I had the same shock when it came to neurosurgery being less precise than I anticipated.
I'm disagree, Obviously it depends of the surgeon, like all surgical specialities. When I saw operate a few of my masters and others in the world I understood that there are Lighthouses that we have to emulate. People like Michael Lawton, Evandro deOliverira, and somuch others in the world in every country that are the Michaelangelos of Neurosurgery. Thats is the real Neurosurgery, others like my self we are working to became in that kind of surgeons. This isn't a 7 years residency is a life time.
DBS lead placement is the most precise operation that exists in the world. 1 mm targets 6 cm below the surface of the brain....
I like how even in the smartest circles, like a room full of doctors, there's stereotypes about who's the dumb one, like bro, NONE OF YOU are dumb 😂😂 it's funny tho
I know right 😂😂😂😂
Yeah i'm talking to you, orthopedics
For someone who wants to become a neurosurgeon heres my logic:
Theres too much emphasis on "coolness" and "not being crude"
Neurosurgeons save lives hitting the nail right on the head!
Say clipping an aneurysm or Deep brain stimulation etc etc !
Research is progressing rapidly any sort of big breakthrough could lead to a whole host of new neurosurgical surgeries/procedures opening up!
I've heard that Neurosurgery has the highest rate of depression and suicide among all surgical professions, due to the constant negative outcomes. As you say, they also have a great sense of humor... perhaps it's a coping mechanism to deal with the negativity. A friend of mine switched from neurosurgery to hand surgery, for 2.5 reasons: positive outcomes and subsequently affecting patients' lives in a productive way, and a more regular schedule (not being called in the middle of the night).
You mean your friend subspecialized in peripheral neurosurgery?(hand surgery)
Or you mean he changed his specialty completely and joined orthopedics(again for hand surgery)?
I've discovered depressed individuals often seem like the most cheerful people until you hear how dark they feel inside...
😢
That's great, I didn't know anything about you until recently good to know. Thank you.
Thanks for watching
I think it's not so detail oriented as plastics but it has to be precise cos brain looks similar everywhere but every gyri and it's parts have different functions so that if it isn't precise it can lead to a disaster
This is what i understood after reading Do No Harm by Henry Marsh
Nice video.
Actually it’s my dream to become a Neurosurgeon after I watched Anatomy 2, 2003
Neurosurgery is super glamorous and badass. I don''t have the energy for that or dedication. Props to those who do
WOW YOU ARE BIG DEAL MAN ! CRAZY ! I AM TRYIGN TO HUSTLE TOOOOOO. ER DOC HERE. BLESSING TO ALL
Dr. Jubbal can you do the same for Cardio thoracic surgery
But can you add also a aspect of which has the future scope of what you think will happen to the specialities ?
Video idea: top 5 crude specialty/precise specialty
Kevin, you mentioned the workaholic hours in NS. Is it because they eagerly choose that schedule or that the number of spots for NS residency is so limited(low)? A NS colleague of mine(I am ER) told me candidly he thought the low # slots it is to maintain prestige.
I majored in neuroscience at UCLA also! Now I’m a neurologist
did you regret it? cuz most of the neurologist that i know were saying that it isn't worth it and it's extremely draining. Pursuing neuro has always been my goal but now I'm getting second thoughts abt it
I really love this type of videos hahahaha I laugh hard with your sarcastic jokes with voice changes 😂
Hey it'd be really helpful if you'd make a video on the American Healthcare system
I have bad handwriting and recently finally got little fake plants for my desk (can't have real ones right now for reasons, but fake ones are a decent placebo lol) so I'm feeling very validated as a premed rn hahahaha
You have the important stuff down, all that other studying and stuff is secondary, you'll be a great Doc
@@PewPewFig Aww thank you, I know this is humorous but it's also well-timed kind encouragement and I'll take it lol, appreciate it! XD
Looking forward to the ortho video
i like how he used tom koracick as an example
Hey what are your thoughts on acute care surgery? Good direction? Worth it?
Make one over CT surgery!
also decided against neurosurgery for the same reason - surprised by lack of precision despite all the imaging advancements. they always sell room for research but the prognosis for neurosurgery patients has not changed significantly in the past 5 decades. that left me with plastics and vascular surgery: didn't want to deal with cancer and breasts weren't all that interesting to me. went on to vascular surgery!
IR is the new vascular surgery bro!
@@austinnoelmusic8306 actually debated between the two for few months. but the more you know, the difference between the two group is very significant: open procedures hat are still gold standard, endovascular skill sets maybe similar but way it is deployed in hybrid cases and in diff anatomy (as IR would with hepatic vessels), etc. How the service operates in community/academic practice is important too (primary vs consult). And endovacs complications are now making open operations so much more complicated!
"the prognosis for neurosurgery patients has not changed significantly in the past 5 decades" - Is that really true? Barely any advances since the 70s?
@@me-ln4pd nsgy largely treats one of two things - the brain and the spine. Of the brain pathologies, gbm makes up more than half of all brain tumors and unfortunately, it is notorious for its poor prognosis. for many decades, it has not made any meaningful improvements (some improvement on median survival for short-term but not so much on long-term survival)
Kevin curious question, do you ever miss practicing medicine? It must have been a passion of yours otherwise you wouldn't have pursued it in the first place. And entrepreneurship was also a passion and it's great that you're pursuing that full on at this stage of your life! But do you miss practicing medicine, treating patients, and the moral fulfillment with having helped somebody directly? If so, have you ever thought of completing family medicine and perhaps working once or twice a week as a GP in a clinic and the other 5-6 days you have for your other pursuits?
i don't think he has any intention of going back to restart in a new residency. who would?
People who are super smart and daring should be Entrepreneurs, not Doctors.
@@souviksen7497 actually they should be whoever they want to be
@@oneflute4726 My point being you don't need to be super smart to be a good Doctor.
Interesting insights, thanks for sharing.
In terms of meticulous detailed orientated facial reconstructions, do you think derm/mohs surgery can scratch the itch in that regard i.e. very pretty and transformative reconstructions? I like plastics but don't like the surgical lifestyle and I like the intellectual stimulation of making diagnoses so i'm hoping derm will be a good compromise but if mohs is super basic compared to facial plastics then maybe it's not worth it....
I think many things can scratch that itch. All depends on your interests
ENT may be a good choice. You've got the diagnostic and medical management aspects of the specialty, whilst having the scope to perform facial plastic procedures.
Mohs is what you make of it. Some dermatologists are really into doing their own reconstructions; others outsource to an ENT facial plastic surgeon. Derm residency is much lower acuity than ENT or plastics training. Good luck.
9:38 lmaaao my goodness I almost spit out my coffee hahahaha
So cool... Do Otorhinolaryngology please
Ent is awesome
Isn't the Neuro ICU now handled by Neuro Critical Care Doctors instead of Neurosurgeons ?
How did you do this whole video without using the word “spine” once? :)
Merry Christmas ⛄
May you please do why i didnt for urology cuz i really want to know your opinion
LOL I loved the editing, especially the little guy walking buy then… bam! Gets struck by “brain” lightning!
i'm not sure what's your saying about not precise but I work in spine tumor and it's very precise
The plant came out of no where !! 😂😂😂
What's the best place to hide something from an orthopedic surgeon?
A book.
Lol
Kevin is trying to be serious but can't stop being sarcastic
Yes, hence his arrogance and my dislike
It was really helpful
did you do a video about specialties that are less prone to midlevel creep? if not, can you do one please?
Why did this video appeared to me when I start thinking about neurosurgery 🙂
what about dermatology seems like an awesome one
it's just chill that you can do easy cases and then work shorter hours but it's competitive
If you are in the usa i think derm is quite at risk of midlevels taking over + the turnover of patients per 1 clinic day seems draining, like going through 40 patients every day in the clinic and if you are doing esthetics you know there will be a lot of difficult personalities in there
@@mediokritet it cant be too bad surely especially if u are a people person. i think derm will remain competitive becuase of its easy lifestyle. i dont think mid levels will take over. and also seeing 40 easy cases is better than seeing some insanely diffuclt surgery case in\ NS or PS .
Please can u give your opinion on ct surgery
That would be veeeeery helpfull 🙏🙏
I have a question wanna ask what you all think of doing independent plastic surgery residency after finishing neurosurgery ?
you have to do peripheral nerve surgery and craneofacial surgery, are the most closest
7:27 it has to feel incredibly draining for basically all neurosurgeons. I can't imagine
Patient average illness by surgical specialty: vascular, trauma>ct, transplant/onc>general, neuro>ortho
I work w Ortho surgeons who specialize in only trauma…and also w gen surg surgeons who sub specialize in onc… what do you mean?
Grt video!
The fact that neurosurgery patients have poor outcomes is a total myth. Every DBS patient and many spine patients are vastly improved after undergoing neurosurgery. In fact spine is probably the highest volume of neurosurgical cases in the world. People judge neurosurgery by neurosurgical trauma, bleeds and GBM which are a small proportion of neurosurgical patients.
Ok
it's interesting, the so you want to be a neurosurgeon came out just as it was the last day of classes during corona
First to enter and last to leave sums it up! God complex is cardiothoracic.
I’ve always wondered if it’s possible to become a neurosurgeon and have shorter (normal) hours.
it can be hard for a surgeon to get contracts with insurance companies if you don’t have hospital privileges anywhere, and most hospitals require surgeons to take call in order to have privileges. Call is where a lot of the long and late hours come from, seeing trauma, strokes, etc. maybe if you specialized in peripheral nerve disorders it might be possible to have a purely office based practice.
@@khyrand What is a typical call schedule like for a neurosurgeon?
Do you practice? I’ve visited your website and googled your name but can’t find your practice. Congratulations on your innovative concepts and outside of the box ideas to make a living with medical training
He left Plastic surgery residency at Loma Linda after a year of residency then started his own company.
how do you manage to do so many things, being a doctor, create all of this staff, could you give me some insight about it, by the way cool video, have a good one
Did you ever consider urology? If so, would love your perspective on why you didn’t do that!
If Neurosurgery was performed crudely then the surgeon will definitely loose his/her license. Many residents do not get to perform more than just trauma, not at all the programmes , the main big surgeries like endovascular, skull base, funtional , spine all fall under fellowships. This means 7 years residency +2-3 years fellowships and then you can tell whether what you perform is crude or the opposite. I hope you get my point, which is that the understanding and the skills of neurosurgery comes after spending atleast 10 in the field, then a neurosurgeon child is born, which is around at 45 - 50 years of age. It requires great precision to open sylvian fissure or any other fissure, your hands have to be very stable. You can’t have essential tremors and clip aneurysms. Many students join or want to get into neurosurgery just because its a big name being a neurosurgeon, money, and the list goesn on and on, just because its a hot trend in the USA or in any other country please dnt jump into this field without having actual interest. You would be operating long exhausting hours with back pain, your family crying they never see you at home etc. You need to know if your hands, mind and body is made for this field. Just have a look at Japan for example, they have so many neurosurgeons that most of them work in labs lifetime, no jobs for them. Same in countries like Finland where I have seen neurosurgeons working as General doctors. The video you have made is based on your view and you should see Dr. Aaron cohel gadils neurosurgical dissection courses on his website on neurosurgicalatlas or dr Theodore Schartz, Juha Hernesniemi, Madjid Sami. Just look at how they operate, they are meticulous, precise and accurate. Neurosurgery is far, way way far from crude, i’m surpised that residents have this opinion on Neurosurgery.
Please Make a Video on Oncologist
I had a brain/vascular issue that might have required surgery. I spoke to about a half dozen neurosurgeons and I didn't find any of them "badass." Instead, they were arrogant, egotistical, dismissive and a couple were downright rude. I understand that you have to have a lot of self-confidence in order to operate on someone's brain, but these guys were extreme. On the other hand, I also spoke with a few neurologists and found them to be compassionate, kind and more interested in me than themselves. In the end, I did find a neurosurgeon, but I had to go to Stanford Medical Center in California (I live in WA state). So, in my experience you have to go through a lot of neurosurgeons to find the right one. Or at least I did.
I think in general that’s how most doctors will be it’s 50/50 no in between… some people do it for the money some do it because they care about healthcare and people
What about cardiothoracic surgeon?
You missed a large part of neurosurgery. Spine and peripheral nerves are a huge part of the specialty with much better outcomes.
Russ Hanneman babyyyy!
I think you’re exaggerating the crude aspect just a tiny bit. Some of it is surprisingly rough around the edges, like tunnelling for shunts or difficult spinal reductions - but that’s the tip of the tip of the ice berg, virtually all of neurosurgery is exceedingly punishing for those who lack a gentle hand when you do even the most basic procedures, from a straight forward depressed skull fracture to an extradural haematoma. If you are left with an impression of crudeness in any part of neurosurgery you can be certain you’re dealing with a situation in which the person hasn’t considered the consequences fully.
in Korea i know that many t imes you have a plastic surgeon
and then when it comes to the time of an actual surgery someone else comes in and does the surgery like what is that?
also in mexico
@@franciscovillegas3638 oh wow mexico too?
damn
it's tough having these fake surgeons do the surgery instead of the real ones few people die because of it
Can you please make a UA-cam video about the physicians that work for The Social Security system [examiners ect.].
I'm taking NS and I have 1 week left!
its hardcore stuff i think you can summarize it like this, people who like it, are fine with it, it think its that easy
i'm an NP and i have successfuly taken out 30 tumors from this 79 year old guy during this 36 hour surgery
by myself
yes I was the surgeon. and the 3 assisstants. at the same time. because im good at multitasking
this video is severly offending
This is extremely alarming & pretty sure it would be illegal
@@jubranjubran4147 it's a joke referencing the video
goddamnit man find something fun to do
🤣 😂
Bye
why not internal medicine?
Do one that says “why I didn’t derm”
Next one should be Why I didn't Orthopedic Surgery 😁😁
Is It always impossible for an immigrant to get into surgery residency in USA? If there is research work mentioned in CV, is there really no chance?
there is always a chance, just look for it
Where's Why I didn't... Orthopaedic surgery??? Absolute neccessity
Yes please!
Agreed
Hey Dr. Jubbal, off topic but what's your thoughts on cryptocurrency?
Exciting space. I don’t know as much as I wish I did
In 0:46the views on the idea are 69420 haha
And also the likes and dislikes.
Neurology question for you.
Can a person have epilepsy but the MRI is clear?
Yesss
Yes. Quite common for people to have epilepsy without any structural abnormality visible on MRI or any other scans. There are changes in EEG though.
Yes. EEG/dEEG is used to diagnose epilepsy.
It can appear on EEG only during the seizure state
Thank you all🤩
Your comments were very helpful.
All of your video is i feeeeeeeeeeel👽
Another myth is work hours. I know plumbers, janitors and CEOs that work the same hours or more than I do as a neurosurgeon. How many hours you put in is basically your choice. For example, you can work solely for the VA 40 hours per week or you can have a practice working 80 hours per week.
What is "the VA"? Also, surely hospital/academic neurosurgeons can't choose their hours?
@@me-ln4pd The VA is the Veterans Administration hospital system. Also yes you can always choose your hours no matter what but ultimately with some exceptions the more you operate the more or less money you make.
please give english subtitle, thank u
Is it possible for a person to study a phD or a master degree and at the same time a resident?
I believe that (in the U.S at least) there are some M.D/PhD programs where you can do both at the same time
Absolutely! Depending on the university
In the US, you can be a med student and get a PHD or masters. You definitely cannot do this as a RESIDENT, unless you have 8 days in a weeksunlike the rest of us lol. It's literally not possible timewise
Your face lights up when you mention Plastics, do you ever feel like going back?
well, does not surprise me at all, guess i am not average
Do you know Jeffery Steinberg?