EVAR, TEVAR, CEA, various bypasses peripheral fluoroscopy, amputations, what else? To other specialists, even vascular surgery can be repetitive. Oh, and the patients suffer lots of complications. Nothing beats spending all day doing an aorta-bifem only to have the patient die of a stroke the next day.
There is repetition in everything in life. I am not disputing that in any way shape or form. However, I do think that surgery, at a large referral center is going to be one of the less repetitive fields. I am biased, like everyone, by where I am training. Maybe to you EVAR and TEVAR are single entities, but we rarely, if ever, do a straight forward infrarenal EVAR. I think I've seen one in the last year. (This has its own training problems as well) When you add in the hybrid cases that we do (average 1-2 a week), we have more of this:
Than straight forward cases. We also have a huge dialysis access group, which is almost the definition of repetition for most people. But, at the "last resort" centers, no two cases are the same. From central venous reconstructions to brachial-atrial grafts to Heros to Hybrids etc, it is hard really get bored.
I think the nature of Vascular problems is that you rarely really 'fix' anything and are simply temporizing and invariably, when the patient re-presents, things are much worse than before and this repeats until they are unsalvagable. Depending on your patient population; community, first presentation vs. tertiary, last presentation or somewhere on that long road in between, your practice can be highly repetitious or extremely varied.
Again, I'm not arguing that things aren't repetitive no matter what you do. I am simply saying that I think that of all the clinical things I have been exposed to, this probably minimizes it the most, for me.
Those are perfectly fine answers that any vascular surgery interviewer would want to hear. There's also nothing there that sounds like it couldn't come out of the mouth of any well-prepared interviewee. If I'm trying to decide why to choose one applicant over another, then the question hasn't furthered that goal. If the interviewee is ill-prepared or has a personality disorder that he can't hide for 6 hours, then it will come out regardless of whether that question is asked.
The question simply requires an applicant to have thought about it for a little bit. I talked with applicants last year when they applied. There were many that really hadn't thought that hard about it, which is a little scary.
Give him a break; he's still a starry eyed junior resident (advice from our Chief of Staff, a Vascular Surgeon who guffawed when he read the comment that Vascular isn't repetitive).
He'll figure out that EVERY field of medicine and surgery is repetitive at some point.
With regards to complications, mimelim likes those - he likes sick patients. The exact thing that drew me away from the field. The day I spent an entire Saturday on call doing a fem-distal and to have the patient have a cold foot an hour later was the cincher.
I don't think I would ever say that I "like" complications. I prefer to do things that push my limits. Even today rounding, one of our attendings said with regard to Vascular Surgery, "Always prepare for failure. Celebrate the victories, but always have the next move in mind."
