Name: 你想成為一名血管外科醫生嗎 [第 49 集］ (So You Want to Be a VASCULAR SURGEON [Ep. 49])
Uploaded: 2025-10-14T17:59:19.000Z
Duration: 12 min 55 s

所以你想成為一名血管外科醫生嗎？

You want to spend all your time operating on varicose veins and be the surgeon all other surgeons turn to to save the day?

你想花所有時間治療靜脈曲張，成為其他外科醫生都會找來救急的醫生嗎？

Let's debunk the public perception myths and give it to you straight.

我們來揭穿公眾認知的迷思，直接告訴你真相。

Dr. Jubbal medschoolinsiders.com welcome to our next installment in so youo Want to Be.

Dr. Jubbal medschoolinsiders.com 歡迎來到我們的「所以你想成為」系列下一集。

In this series, we highlight a specific specialty within medicine to help you decide if it's a good fit for you.

在這個系列中，我們會介紹醫學中的特定專科，幫助你決定它是否適合你。

You can find the other on our so youo Want to Be playlist.

你可以在我們的「所以你想成為」播放清單中找到其他集數。

Subscribe to vote on upcoming polls to decide what specialties we'll cover next.

訂閱並投票決定接下來要介紹哪些專科。

Vascular surgery is the medical specialty that involves the surgical and medical management of arterial and venous diseases.

血管外科是處理動脈和靜脈疾病的外科和內科治療的醫學專科。

Vascular surgeons care for patients with pathology involving all arteries and veins except those of the heart and brain, which are managed by their own respective specialists, cardiothoracic surgeons and neurosurgeons.

血管外科醫生會處理心臟和大腦以外的所有動脈和靜脈病變的患者，這些情況分別由心胸外科醫生和神經外科醫生處理。

A vascular surgeon operates all over the body and is incredibly, incredibly knowledgeable about a patient's vascular anatomy as well as the non vascular anatomy that must be avoided when exposing the vessel of interest.

血管外科醫生會在全身進行手術，並且對病患的血管解剖以及在暴露關注的血管時必須避開的非血管解剖有極其深入的瞭解。

Common conditions that vascular surgeons treat include carotid artery disease, aortic aneurysms, peripheral artery disease of the arms and legs, venous insufficiency, varicose veins and blood clots, and

血管外科醫生治療的常見病症包括頸動脈疾病、主動脈瘤、四肢周邊動脈疾病、靜脈功能不全、靜脈曲張和血栓，以及

hemodialysis, access, creation and maintenance, to name a few.

血液透析的建立與維護，這只是其中一部分。

Vascular surgeons must also always be available to other surgical specialties in the event that catastrophic bleeding occurs, which of course must be controlled.

萬一發生災難性的出血，血管外科醫生也必須隨時支援其他外科專科，以控制出血。

The specialty can be categorized based on the area of pathology that the surgeon specializes in.

這個專科可以根據外科醫生專精的病變區域來分類。

Vascular surgery involves two paradigms of surgical management for various conditions, open surgery and endovascular surgery.

血管外科手術包含兩種手術治療模式，分別是開放手術和血管內手術。

Open surgery involves making an incision to access the blood vessel of interest and operating on it directly.

開放手術是指透過切口來接觸目標血管，並直接進行手術。

One example of open vascular vascular surgery is a carotid endarterectomy in which the carotid artery, which is in the neck and supplies oxygen to the brain, is opened to allow for removal of the plaque that is causing the patient's symptoms, which could include weakness, dizziness, vision loss, severe headaches and difficulty speaking.

開放血管手術的一個例子是頸動脈內膜切除術，也就是在頸動脈（位於頸部，為大腦供應氧氣）進行手術，以移除造成病患症狀（可能包括虛弱、頭暈、視力喪失、嚴重頭痛和說話困難）的斑塊。

Another example would be an open abdominal aortic aneurysm repair in which a bulging of the aortic wall is replaced with an artificial tube graft to prevent the aneurysm from rupturing, which is often fatal.

另一個例子是開放式腹主動脈瘤修補術，也就是用人工血管接枝來替換主動脈壁的膨脹部分，以防止動脈瘤破裂，這通常是致命的。

One more example would a peripheral bypass, commonly from the femoral artery to the popliteal artery, to treat symptoms of impaired blood flow in the legs.

另一個例子是周邊動脈繞道手術，通常是從股動脈接到膕動脈，用來治療腿部血流不順的症狀。

Conversely, endovascular surgery is the minimally invasive approach that utilizes catheters, wires, balloons and stents to treat the same conditions.

相反地，血管內手術是一種微創方法，利用導管、導線、氣球和支架來治療相同的病症。

Using the previous examples, a needle can be used to access the femoral artery to deliver a stent to the internal carotid artery, a stent graft to the aorta, or a balloon to open up a blockage in the arteries of the leg.

以之前的例子來說，可以用針頭進入股動脈，將支架送到內頸動脈，或將支架移植物送到主動脈，或用氣球來打通腿部動脈的阻塞。

Vascular surgery, particularly endovascular aortic surgery, often involves creative solutions to treat complex aneurysms.

血管外科，特別是血管內主動脈手術，經常需要創新的解決方案來治療複雜的主動脈瘤。

The decision on whether to pursue open versus endovascular surgery is often complex and patient specific.

選擇開放手術還是血管內手術，這個決定通常很複雜，而且因人而異。

However, a good vascular surgeon will have all these options in their toolkit.

不過，一位好的血管外科醫生會將所有這些選項都納入他的工具箱中。

Vascular surgeons can have either private or academic practices.

血管外科醫生可以選擇私人執業或學術執業。

However, given the direction that medicine is going, private practices are more and more difficult to sustain and given the high overhead costs and perpetually decreasing reimbursement.

然而，考量到醫學的發展方向，私人執業越來越難以維持，因為營運成本高昂且給付不斷減少。

Generally, in academic practices, vascular surgeons work with residents and fellows, whereas in private practice they work with PAs, NPs or RN first assists in the OR.

一般來說，在學術執業中，血管外科醫生會與住院醫師和研究員一起工作；而在私人執業中，他們則在手術室裡與醫師助理、護理師或 RN 協同手術。

Private practice providers will tend to lean more heavily towards treating pad and venous insufficiency, mostly via minimally invasive procedures, which can be done in an office setting, allowing the patient to return home the same day.

私人執業的醫護人員傾向於更側重於治療周邊動脈疾病和靜脈功能不全，主要透過微創手術進行，這些手術可以在診間完成，讓病患當天就能回家。

Again, while not absolute academic, vascular surgeons will likely perform bigger, more complicated surgeries that require inpatient admission plus or minus ICU monitoring.

再者，雖然不是絕對的學術性質，但血管外科醫生很可能會執行較大、較複雜的手術，需要住院，並可能需要加護病房監測。

Let's clear up a common misconception about vascular surgery.

我們來釐清一個關於血管外科的常見誤解。

A common misconception is that vascular surgeons operate on varicose veins.

一個常見的誤解是，血管外科醫生會治療靜脈曲張。

While this is certainly true, it is a very small part of their job.

雖然這確實是他們的工作內容之一，但只佔他們工作的一小部分。

Most vascular surgery procedures are major surgery, often with high risk involved.

大部分的血管外科手術都是大型手術，通常伴隨較高的風險。

Unlike many other surgical specialties that rarely deviate from established routine treatments, vascular surgery requires you to be able to quickly adapt to different clinical situations.

與許多很少偏離既定常規治療的其他外科專科不同，血管外科要求你能夠快速適應不同的臨床情況。

Many other surgeons depend on vascular surgeons to be able to perform their procedures safely.

許多其他外科醫生依賴血管外科醫生來安全地執行他們的手術。

For example, certain spine surgeries require access to the spinal column, which is very close to major blood vessels, and

例如，某些脊椎手術需要接觸脊椎，而脊椎非常靠近主要血管，

In this case, a vascular surgeon would meticulously expose the spine for the spine surgeon, taking care to protect the nearby vascular structures.

在這種情況下，血管外科醫生會仔細地為脊椎外科醫生暴露脊椎，並小心保護附近的血管結構。

Trauma surgeons will sometimes call in their vascular surgery colleagues for help when major bleeding is encountered, either for control or reconstruction of the particular blood vessel that is bleeding.

創傷外科醫生有時會在遇到大出血時，請他們的血管外科同事幫忙，以控制或重建正在出血的特定血管。

Many of these collaborative relationships exist in the operating suite, and

許多這類合作關係都發生在手術室裡，而且

a vascular surgeon must be on staff for a hospital to safely offer surgery.

醫院必須有血管外科醫生駐診，才能安全地提供手術。

There are currently two training paths to be become a vascular surgeon.

目前有兩種訓練途徑可以成為血管外科醫生。

The first is an integrated residency where you match directly from medical school.

第一種是整合式住院醫師訓練，你從醫學院直接申請。

This residency option lasts five years, though it could last up to seven years depending on research requirements.

這個住院醫師選項為期五年，不過根據研究需求，最長可能到七年。

The alternative is a vascular surgery fellowship after completing either a general surgery, which lasts five years, or a cardiothoracic surgery residency or fellowship, the former being six years and the latter two to three years after a general surgery residency.

另一種選擇是在完成一般外科（為期五年）或心胸外科住院醫師訓練或進修後，再進行血管外科進修，前者為六年，後者則是在一般外科住院醫師訓練後兩到三年。

The vascular fellowship is an additional two years training regardless of which pathway is rigorous, which is similar to many other surgical specialties.

無論哪種途徑都很嚴謹，血管外科進修訓練額外需要兩年，這與許多其他外科專科相似。

This will include long hours in the hospital and long complicated surgeries.

這將包括長時間待在醫院以及冗長複雜的手術。

Based on our Specialty Competitiveness Index, which you can download from the link in the description, vascular surgery is the ninth most competitive medical specialty.

根據我們的專科競爭力指數，你可以在說明欄的連結下載，血管外科是第九具競爭力的醫學專科。

For the 2024 match cycle, there were 143 applicants for 84 positions or 1.7 applicants per spot and and those who were successful had an average step 2 score of 247.

在 2024 年的配對週期中，有 143 名申請者爭取 84 個職位，平均每職位有 1.7 名申請者，成功配對者的平均 Step 2 分數為 247。

Research in the field with relevant publications and presentations is expected.

期望在該領域有相關出版品和演講的研究成果。

In fact, those who match into vascular surgery now have an average of 12.8 research items in 2024, up from 10.5 in 2020, and

事實上，在 2024 年成功配對到血管外科的申請者平均有 12.8 項研究，高於 2020 年的 10.5 項，

this number is only expected to grow each year.

這個數字預計每年都會持續增長。

Publications consistently play a huge role in a candidate's ability to match into their desired programs.

出版品在候選人成功配對到理想計畫的能力上，一直扮演著非常重要的角色。

Despite how important it is, so many pre med and medical students still find research daunting and difficult to make headway on.

儘管研究如此重要，但仍有許多醫學院前學生和醫學生覺得研究令人卻步且難以著手。

That's why we created the Med School Insiders Ultimate Research Course, which distills the tactics I use to gain over 60 research items, learn to publish more in less time, build a research team around you, confidently present your work, and

這就是我們創立 Med School Insiders Ultimate Research Course 的原因，它濃縮了我用來獲得超過 60 項研究、在更短時間內發表更多論文、圍繞自己建立研究團隊、自信地展示作品的技巧，

much more using advanced tactics you won't find anywhere else because we innovated them.

以及更多使用你找不到其他地方的進階技巧，因為這些技巧是我們創新的。

Learn more@medschoolinsiders.com researchcourse the vast majority of vascular surgeons do not pursue additional training upon completion, as vascular surgery is already quite specialized.

在 medschoolinsiders.com/researchcourse 瞭解更多，大多數血管外科醫生在完成訓練後不會再進一步進修，因為血管外科本身已經相當專精。

A vascular surgeon can choose to subspecialize in aortic surgery and therefore must be comfortable with both the open and endovascular management of aortic aneurysms.

血管外科醫生可以選擇專攻主動脈手術，是以必須熟悉主動脈瘤的外科和內科治療。

Alternatively, they can choose to specialize in peripheral artery disease and opt to treat patients with impaired circulation to their hands and feet.

或者，他們也可以選擇專攻周邊動脈疾病，並治療手腳血液循環不良的病患。

Some will opt for training in cardiothoracic surgery, which will allow for additional open surgery of the ascending aorta and aortic arch, which falls under their purview.

有些人會選擇接受心胸外科訓練，這樣他們就能進行升主動脈和主動脈弓的額外開放手術，這屬於他們的職責範圍。

This would mean an additional two to three years of training, depending on the program.

這意味著需要額外兩到三年的訓練，具體取決於課程安排。

Vascular surgeons are commonly referred to as the firemen or firewomen of the operating room, as they're usually called when someone is in trouble and needs rescuing.

血管外科醫生常被稱為手術室裡的消防員，因為當有人遇到麻煩需要救援時，通常會找他們。

Further training in vascular surgery can, however, include traveling to a center with a particular investigational device exemption to learn an advanced endovascular technique on a device in trial that is not yet available to the broader market.

然而，在血管外科領域的進階訓練，可以包括前往設有特定調查裝置豁免的中心，學習一種尚未廣泛上市的試驗性裝置的進階血管內技術。

But this is not the norm as most vascular surgeons enter practice after their residency or fellowship.

但這並非常態，因為大多數血管外科醫生在完成住院醫師或研究員訓練後就會執業。

There's a lot to love about vascular surgery.

血管外科有很多值得喜愛之處。

First, vascular surgeons have the ability to operate all over the body, performing a combination of both open and endovascular surgery.

首先，血管外科醫生能夠在全身進行手術，結合開放手術和血管內手術。

Additionally, operating on minuscule arteries surgeries requires technical precision and a high degree of dexterity.

此外，對微小動脈進行手術需要精湛的技術和高度的靈巧度。

The hands on approach to medicine can be quite appealing.

這種親手實踐的醫療方式非常有吸引力。

This is one of the reasons I was so drawn to surgery when I was choosing my medical specialty.

這也是我當初在選擇醫學專科時，如此嚮往外科的原因之一。

Vascular surgery is a great option for those who love working with their hands, are meticulous and pay close attention to minor details.

血管外科非常適合那些熱愛動手操作、心思細膩且對細節極度關注的人。

Vascular surgery patients typically follow their surgeons for the rest of their lives as the nature of atherosclerosis is progressive, with most procedures turning back the clock rather than than curing the disease.

血管外科的病患通常會跟隨他們的醫師一生，因為動脈粥狀硬化的病程是漸進的，大多數手術都是延緩病情而非治癒。

Compensation is also on the higher end of the spectrum.

Vascular surgery is among the 10 highest paying medical specialties, coming in eighth above radiology at number nine and below cardiology at number seven.

血管外科是收入最高的十大醫學專科之一，排名第八，高於排名第九的放射科，低於排名第七的心臟科。

Vascular surgeons make over $550,000 a year, but of course, vascular surgery isn't for everyone.

血管外科醫生年收入超過 550,000 美元，但當然，血管外科並非適合所有人。

If you are someone who needs structure and has a hard time deviating from plan A, then vascular surgery will be a challenge.

如果你是那種需要結構、難以偏離計畫 A 的人，那麼血管外科將會是個挑戰。

Oftentimes, vascular surgeons are called in the middle of the night or on weekends for emergencies that are limb and life threatening.

血管外科醫生經常需要在半夜或週末因危及肢體與生命的緊急狀況而被 call 出去。

So while the compensation is excellent, the work life balance of a vascular surgeon leaves much to be desired.

所以雖然薪資優渥，但血管外科醫生的工作生活平衡卻有很大的進步空間。

It's also a challenging specialty to match into.

Of course, if you don't match into an integrated program, you could do a five year general surgery residency and then pursue a vascular surgery fellowship which lasts two years.

當然，如果你沒有進入整合課程，你可以先完成為期五年的普通外科住院醫師訓練，然後再攻讀為期兩年的血管外科進修。

But again, although the compensation is excellent, five to seven years of training on top of four or more years of medical school means it will take a long time before you see that $550,000 salary.

但話說回來，雖然薪資優渥，但加上醫學院四年或更長的學習時間，總共五到七年的訓練意味著要很久之後才能看到那 550,000 美元的年薪。

Another, less glamorous part of vascular surgery is the wound care and amputations that sometimes must be performed on unsalvageable limbs.

血管外科比較不那麼光鮮亮麗的一面，是偶爾必須為無法挽救的肢體進行傷口照護和截肢手術。

While these surgeries are not very glamorous, they are a necessary part of the job, particularly in a limb salvage program.

雖然這些手術不是那麼光鮮亮麗，但它們是工作中必要的一部分，尤其是在肢體挽救計畫中。

Finally, since many procedures are done via endovascular means using fluoroscopy, there is a great deal of radiation exposure.

最後，由於許多手術是透過血管內治療，並使用螢光透視，是以會暴露在大量的輻射之下。

This is done in either a hybrid operating room or angio suite with a C arm centered over the area of interest and the operators typically standing right next to it.

這是在複合式手術室或血管攝影室進行，C 型臂會對準關注的血管區域，操作人員通常就站在旁邊。

Although physicians wear protective shielding, it does theoretically increase the lifetime risk for certain malignancies.

雖然醫師會穿戴防護裝備，但理論上這會增加罹患某些惡性腫瘤的終生風險。

所以，你應該成為一名血管外科醫生嗎？

If you are detail oriented and enjoy caring for high risk, medically complex patients, you will likely thrive in the field.

如果你注重細節，並且喜歡照顧高風險、病情複雜的病人，你很可能會在這個領域蓬勃發展。

Good hands are necessary, but this is a skill that most can hone with practice.

靈巧的雙手是必要的，但這是一項大多數人可以透過練習來磨練的技能。

However, while the compensation is one of the highest of all medical specialties, if you prioritize a healthy work life balance, vascular surgery does not provide this.

不過，雖然薪資是所有醫學專科中最高的之一，但如果你重視健康的工作生活平衡，血管外科就無法提供這一點。

You could be called in for an emergency surgery at any time of day and on weekends.

你可能隨時需要被叫去進行緊急手術，無論是白天還是週末。

To become a vascular surgeon, you'll need to do well in medical school, thrive at standardized tests, stand out in your clerkship training, and

要成為一名血管外科醫生，你需要在醫學院表現優異，在標準化考試中脫穎而出，在臨床實習訓練中表現出色，並且

craft a stellar residency application so that you can match into this competitive surgical specialty.

精心準備一份出色的住院醫師申請，以便能夠進入這個競爭激烈的外科專科。

And before all of that, you'll need to get into medical school, which is a long, complex and tedious process.

而在這一切之前，你還需要考上醫學院，這是一個漫長、複雜且繁瑣的過程。

Our team of physicians were top of their class at the best medical schools and matched the nation's top residency programs.

我們的醫師團隊都曾是頂尖醫學院的佼佼者，並進入全國頂尖的住院醫師培訓計畫。

We've worked one on one with close to 10,000 pre med and medical students, helping them succeed in pursuing their ideal career paths.

我們與近 10,000 名醫學院預科生和醫學院學生一對一合作，幫助他們成功追求理想的職涯道路。

And our satisfaction ratings speak for themselves.

我們的滿意度評價也足以說明一切。

Learn more@medschoolinsiders.com for more videos, subscribe and check out our complete so youo Want to Be playlist, which has nearly 50 specialties and healthcare careers.

想了解更多資訊，請瀏覽 medschoolinsiders.com，訂閱並查看我們的完整「你想成為什麼樣的人」播放清單，裡面有近 50 種專科和醫療職涯。

接下來我們應該探討哪個專科呢？