Name: トラウマ外科医になりたいんですね【第8話 (So You Want to Be a TRAUMA SURGEON [Ep. 8])
Uploaded: 2021-01-14T11:04:05.000Z
Duration: 10 min 48 s
Description: VoiceTubeの動画で発音を聞きながら英語表現を覚えよう！学べる英語：

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.

Welcome to the next installment of our 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 entire list on our So You Want to Be playlist. If you want to help us

decide which specialty or healthcare professional to cover next, drop a comment down below with

If you'd like to see what being a trauma surgeon looks like, check out my second channel,

Kevin Jubbal, M.D., where I do a second series in parallel titled a 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 central nervous system in these countries, too.

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 crash, 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 exploratory

laparotomy, where the abdomen is opened and the abdominal organs examined for injury or

disease. Thoracotomies open up the chest, and tracheostomies are 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

To become a trauma surgeon, you'll complete medical school and then do 5-7 years of general

surgery residency, depending on whether your residency includes a two-year research block.

From there, most trauma surgeons do a 1-2 year fellowship in traumatology, surgical

critical care, or emergency surgery, for a total of 6-9 years of additional training

Pediatric trauma surgery is part of regular peds surgery training. Depending where the

ambulance takes the patient, sometimes it gets managed and triaged acutely at the adult

hospital, but ideally goes straight to the pediatric trauma center.

If you're interested in more specific types of trauma, there are other specialties to

consider. For example, orthopedic trauma focuses on surgical intervention of traumatic injuries

related to bones. If you want to deal with spine and cranial trauma, neurosurgery would

General surgery residency is middle of the road in terms of competitiveness, with an

average matriculant Step 1 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.

As a surgical specialty, your general surgery residency and trauma surgery fellowship will

be incredibly taxing with long and often unpredictable hours.

Rather than telling you what it's like to be a trauma surgeon, I'm going to hand it

over to my friend, Dr. David Hindin. 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.

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, too. 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 abdomen 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

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, 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 on someone's health, with actions that play

out in seconds to minutes. After all, what could have a larger impact than saving someone's

Trauma surgery also tends to attract surgeons who like to perform what we'd call “BIG”

operations. Many of these procedures involve making long incisions, creating major exposures

of vascular structures, and performing large-scale repairs of significant injuries throughout

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

And at the same time they're inspecting the intestines, they're also looking at

solid organs within the abdomen and different zones where your major vascular structures

lie - like your aorta - to see what other injuries may 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 “ED 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 out 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,

or stop bleeding. At this point, the surgeon performs what's called open cardiac massage,

which means squeezing the heart between one's hands to try to restore a heartbeat, like