Oh, the great med-surg debate! Have any of you heard this?

  • “New grad nurses must work med-surg.”
  • “Med-surg is where you want to go…you need to make sure you master and keep your skills sharp.”
  • “Every new grad nurse needs at least two years of med-surg before you can go do something else.” 

School is bad enough, but during all that schooling, you still have to decide where you want to start your career.

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Do New Nurses Have to Start in Med-Surg?

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No new nurses do not have to start in med-surg. New nurses are getting hired in nursing specialties like the ER and ICU all the time. They’re hard to get into, so many recent grads will still have to work on the medical-surgical floor.

I have no issues with med-surg nursing, and while it can be a great area to start, not every new grad nurse needs or wants to go into med-surg.

Maybe there was a time you had to start on the med-surg floor, but with the shortage of nursing and where we are at in healthcare, that’s not the case any longer.

Example Scenario

I’ll tell you why I don’t think starting in med-surg is good advice anymore with a scenario.

Let’s say you wanted to go work in the operating room or a psychiatric facility. Instead of going right away, you were told to go spend a couple of years in med-surg as a new grad nurse just to “get your skills down” .

You do the two years or so of med-surg, and then you go into psych or the OR.

Let’s say you spend five or ten years in psychiatric medicine or the OR. After a couple of years, how much of med-surg will you remember, let alone after 5 or 10 years?

I would argue probably not a lot. Those skills that were “sharpened” would now be very “dull”. You would only remember what you need to do your job in psych or the OR effectively.

I’ll give you another scenario. Let’s say at the end of those 10 years, you decide to change specialties and move back into med-surg nursing or another specialty.

I would argue that when you apply for those nursing positions, they’re going to treat you similar to a new grad nurse because you have never worked in that specialty or you’ve been out of that specialty for a long time.

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Figure Out Where You’re Going

Knowing your destination makes it easier to identify the road you need to get there.

Thomas N. Uzuegbunem, BSN, RN

What I would recommend is to do a career vision cast. Doing a career vision cast forces you to think about where you want to end up in your career.

Knowing your destination makes it easier to identify the road you need to get there.

For example, suppose your goal was to become a certified registered nurse anesthetist (CRNA). In that case, you already know you should probably start in the intensive care unit (ICU) or the emergency room (ER).

What if you wanted to become a pediatric nurse practitioner? Wouldn’t it make sense to start working in pediatrics to better prepare for that role?

I would argue that starting in med-surg as a new grad nurse would probably slow down those goals mentioned above.

Related Article: 5 Best Jobs for New Nurses

Not Every Nurse Wants to do Patient Care

This is a nurse case manager. Nurse case managers while very important to the healthcare system do not perform direct patient care.

Here is something else to think about. Not every nurse wants to do patient care.

I have met a lot of nurses and nursing students that don’t want to participate in direct patient care forever, and that’s ok.

I have met a nursing student who was in the process of finishing up nursing school and was already accepted to go to law school. His plan was not to do patient care at all.

What if your goal was to do case management?

Or research?

What about teaching?

Should you be compelled to work med-surg before doing what you actually want to do?

There are many jobs and avenues you could go after nursing school that doesn’t involve direct patient care, and starting in med-surg wouldn’t necessarily be needed for them.

What Do Managers Care About?

…skills can be taught. What is harder to teach is a nurse that cares about their personal brand…is a leader…and cares about pursuing excellence…

Thomas N. Uzuegbunem, BSN, RN

What about what managers care about? Somebody might say that managers want to see that you have been through med-surg.

Do they really?

While depending on the position, this may or may not be true. I believe it is important to note that skills can be taught. What is harder to teach is a nurse that cares about their personal brand.

A nurse that is a leader and has leadership qualities. A nurse that cares about pursuing excellence in their job every day.

Find Your Next Nursing Job

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Using Med-Surg Nursing as a Stepping Stone

I should mention that it’s important to know that some areas will be harder to get into fresh out of nursing school than others.

You should still try if that’s what you want, but areas such as OR nursing, ER nursing, or even ICU nursing can be very competitive.

This means that you might have to use med-surg as a bridge to get you there.

Key Takeaways

Here are my final thoughts on working med-surg as a new grad nurse.

There is nothing wrong with med-surg or starting on a medical-surgical floor.

If a new grad nurse doesn’t know where they would like to start their career, med-surg can be a good starting point.

But if you already know what you want, why delay it!

What are your thoughts? Do you think that there is an area of healthcare that all new nurses should start in? Please share this article to get the word out and educate others.

Related Articles on Med-Surg as a New Grad Nurse

Frequently Asked Questions

No, it’s not. There are a lot of different nursing specialties new nurses can work in to get a great first-year experience that sets them up for a successful nursing career.

Yes, there’s nothing wrong with starting your career in medical-surgical nursing especially if you’re not sure what direction you want to take your nursing career in.

a medical surgical floor


  1. Thank you for the article, I was really debating where to go. I really want to do dialysis and people were looking at me crazy because I didn’t see it neccessary to do med-surg first right after nursing school. So, thanks

  2. thank you! I fell in love with psychiatric nursing and everyone was scaring me that I would lose all my skills. Thanks for reassuring me that med/surg is always something I could go to if I so wish.

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