Do Surgeons Need Steady Hands? (Explained!)

One thing most people assume about surgeons, especially after seeing one too many medical dramas, is that they must be the coolest, calmest doctors in the room. All that intricate hand work, they make look easy. There’s no room for the shaky or unsteady, surely?

But do surgeons actually need steady hands?

Most surgeons don’t need super steady hands. There’s plenty of opportunity to rest their hands on machinery, trays and the body wall of the patient themselves. Surgeons specializing in finer work, especially those in cardiovascular or thoracic surgery, are more in need of steadiness.

So the good news is most people have the hand dexterity it takes to cut it in general surgery. As long as they don’t experience tremors!

We’ll dive into this issue a little deeper however. Here you’ll learn:

  • If surgeons have shaky hands
  • What kind of hands are best
  • How you can improve your hand strength and stability for surgery

As a med student with a keen interest in surgery myself, this is a topic I’ve had the chance to ask several surgeons about. I always find their answers pretty interesting!

Ready to find out more? Let’s go.

Do surgeons have shaky hands?

The vast majority of surgeons have stable hands. That’s something that’s been developed by lots of routine practice. Experience and confidence also helps.

Trainee surgeons just starting out, or med students on surgical rotations, are much more likely to experience shaky hands. This mainly comes down to a couple of factors:

  1. Nerves
  2. Lack of practice

Both these factors obviously reduce over time as students and trainees get more exposure to the task at hand (as well as via exercises – more on this later!)

Interestingly, some surgical residency programs do look at things like this in their assessment of potential surgeons.

“Shaky hands” mostly fits into a broader category called “technical mastery” (or something similar). It’s usually a five point scale people are graded on (0-5 ranging from inept to proficient). But this is mainly in the U.S. (other countries have different measurements).

The vast majority of residency programs don’t look at this however. General coordination (or a lack of) is considered far more important to a potential career in surgery than nervous hands!

What about essential tremors or other conditions?

Of course if you have something like an essential tremor (uncontrollable shaking) then surgery is most likely off the table. Being unable to control your hands (despite practice or stability aids) only puts patients at risk.

Other conditions that might make it difficult include:

  • Hyperhydrosis (sweaty palms)
  • Scleroderma (thickened skin)
  • Arthritis

But even in these circumstances technique can override mobility or stability shortcomings. Especially in the case of the very experienced.

Check out this video from Medschool Insiders if you need more confirmation…

Is this true for all surgery?

Another important thing to note is that not all surgery requires human hands (or the precision that comes with them).

A lot of modern surgery, especially in fields like neurosurgery and plastics, is done via machine. That takes away the threat of unsteady hands!

But surgeons are still needed for support in such operations. And hand stability is something they’ve likely developed through years of training anyway.

Good news if the machinery malfunctions and they suddenly need to jump in!

So, do surgeons drink coffee?

A well known side effect of caffeine is that it can sometimes cause mild shaking.

Surgeons still drink it however, especially orthopedics.

This article from the British Medical Journal (BMJ), highlights just how popular it is as a drink…

On average orthopaedic surgeons purchased the most coffee per person per year (mean 189, SD 136) followed by radiologists (177, SD 191) and general surgeons (167, SD 138).

So obviously they’re pretty confident it doesn’t impact their work!

Surgeons Hands

Obviously the bigger the hand, the more damage that can potentially be done.

Especially if said hand is less than steady.

So can surgeons have big hands?

Yes, surgeons can have big hands. There is no scientific proof that suggests any link between hand size and a lack of dexterity.

It could of course make doing “fine” work (precise incisions, sutures etc.) a little more challenging, but it’s definitely not a reason for anyone not to pursue surgery.

Again technique and practice are what it really comes down to.

Do surgeons get their hands insured?

Surgeons can get their hands insured via Individual Disability Insurance.

Usually they’ll take out this insurance at the beginning of their careers. There will be checks concerning their arms, back, neck and musculo-neural system as well as their medical history.

This insurance, in most cases, lasts their whole career.

What’s interesting is that the number of surgeons actually doing this is actually quite small though. The survey reported on in this NBC article, which asked 100 surgeons across the U.S., found that only 1 in 4 actually took out such insurance.

The same article also reports that one surgeon, Dr. Joseph Colella, insured his hands for about $8 million.

So you can see the potential importance!

How do surgeons get steady hands?

As previously mentioned, steady hands are something that come with time, practice and technique.

Would-be surgeons will pick up these skills in their residency placements and under the instruction of more experienced surgeons.

Med students can also work on developing steady hands (as well as hand-eye coordination) by practicing common surgical techniques.

I go into many of these in this article: How Do Med Students Practice Surgery? (Try-At-Home Examples!).

Hand exercises for surgeons

As for improving dexterity and hand stability there are a couple things surgeons can do.

Here are a few popular tools:

Keck Medicine of USC has also lots of good pointers. Here are a few of my favorites:

  1. Squeeze ball sets: 10-12 reps squeezing a ball as tightly as you can for 3-5 seconds
  2. Range of motion: make a fist, wrap your thumb over the fingers, hold then spread your fingers as wide as you can. Repeat.
  3. Wrist stretches and finger lifts

The last one is very similar to a favorite wrist routine of mine created by Tom Merrick. You can check this out in the video below…

Summary

You don’t need incredibly steady hands to become a surgeon. Technique and practice over time can help your control.

Unless you have a condition impacting your motor control, these things can be worked on and improved.

Don’t let your self-percieved clumsiness put you off the idea!


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