Dear Surgery Residents: go %&$# yourselves. Sincerely, MS3

[JGimpel]

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[JGimpel]

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[Perrotfish]

Wow your surgical rotation blows. I'm glad I didn't have to deal with the crap I bolded up above. Most places are fine with you eating when you get the chance, and don't do this whole "be there before the other students!!" nonsense.

He's not really talking about your MS3 surgery rotation. He's talking about an audition rotation for a competitive field at a desirable location in a top hospital. If that's what you're going for, then his advice isn't terrible, maybe its even good. However I agree with the posters who said his post didn't make any sense in the context of the thread. This isn't a thread for people who want to go into surgery and are asking how to succeed at an audition. It's for MS3s (and some still bitter residents) who don't give a **** about surgery and want to express their frustration at the miserable, pointless, anachronistic surgical hazing that we all need to slog through. No one here was asking how to squeeze an honors out of the misery, they were just moaning about being miserable in the first place.

 

[KnuxNole]

That sucks though, feeling like you have to compete with your fellow colleagues :/

It seems gunner-like to come in earlier before other people. Unless you mean for EVERY student to come in early, for everyone to have equal shares in cases, etc.

Like perrotfish said, your outline for a sub-I is good for those who want to go into surgery and know what's to be expected. For everyone else, the surgery rotation for MS3 was more than enough

 

[ArcGurren]

No you just had a different experience. That is exactly why when threads such as this one arise, it is important to recognize that while the OP needs to vent, the experience isn't the same for everyone. As I've said often before, my experience on Peds was much more unpleasant than on Surgery when I was a student.

In residency, our students always had morning and evening rounds, you could not wear scrubs except when on Trauma, and lunches were not guaranteed (and there was no physician lounge even if we did eat). Students did tend to get 8 hours of sleep even when "on call" because there was a stupid rule that they only had to stay until 1030 pm.

We had morning rounds but in the evening the most we did was run through the patient list (if that). Evening rounds just sounds terrible.

 

[JGimpel]

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[Winged Scapula]

So many people in page after page complained about what their surgical rotation was like and I was in the hopes that me putting some time into a post like I did would help them know what could be ahead and not catch them off guard and have them complaining so much. Many personality types in surgery would be offended if the student comes in and expects it to be like any other rotation. I had many months of surgical rotations in different hospitals and I put in what was expected of me to do well.

If some of the other students that have been on a 9-5 surgical rotation want to chime in, great. If their rotations were easier than mine, good for them. If they were closer to what I outlined, they really shouldn't be complaining and this thread has gone on for too many pages. If you're doing an audition rotation, everything counts and what I posted is DEFINITELY not out of the norm. Show up enough times at 5AM with other students you're competing with halfway through their first coffee and you learn how to adapt. If anyone else has been on a sub-I neurosurgery, derm-onc surgery, vascular surgery and trauma surgery rotation and wants to post about it, I highly encourage it.

Feel free to ignore my posts, especially ljn. It takes less than a minute to ignore all of my posts forever. I wish the rest of you the best of luck and hope that your schedule isn't the same as I had for many, many months.

Thank you for the offer and the education, but as a SURGICAL ATTENDING and SDN MODERATOR/ADMINISTRATOR, I do not have that luxury. I am well aware of what surgical rotations are like having done them as a student, resident, fellow and now attending. If your comment was not directed toward me, then I apologize (but when you quote someone, usually what follows is meant as a response to them).

I am not saying that your post is not warranted or valuable, however:

1) if you have already posted this in the NSGY subforum, crossposting it here is a TOS violation;

2) this thread was not about "what is my surgical core" going to be like, nor was anyone asking that, therefore it seems misplaced. Perhaps its just my impression.

3) you might want to ramp down the rancor; it does not serve you well

 

[Winged Scapula]

We had morning rounds but in the evening the most we did was run through the patient list (if that). Evening rounds just sounds terrible.

Eh...they were usually pretty quick and comprised mostly of reading notes from consults put in during the day, doing post-op checks, and making sure everything was ready for sign out. We aren't talking about mediciney type rounds.

 

[KnuxNole]

The schedule is definitely part of the hazing process until you realize that the intern or PGY1 you spend most of your time with as an MS3 or MS4 is on such a schedule and they won't like seeing you yawn or groan if you're still there at 5:01PM. I had one away rotation where the MS3 basic surgery rotation people were either on service or on call every day and pretty much never left the hospital. I don't think either one of them was even going into surgery, but they had to cancel a lot of their plans to visit or have visitors because they thought it would be a typical IM/FP schedule of 7AM to 5PM. Doing a surgical rotation right after a Psych rotation is the worst wake up call. Ouch!

Bottom line, you may not be going into the field you have to rotate through, but if you have realistic expectations of what you're getting into, especially your first surgical rotation, you'll be able to plan for it, and that way the main idea of my post. I've had pretty good luck with my contributions on SDN, but there are the few that argue just to argue or pick apart something just because they have nothing better to do. I guess it's time to take a break.

Enjoy your 8-5 surgical rotations.

haha, I hope you aren't saying that in a negative way...considering I would LOVED to do an 8-5, no weekends surgery rotation. Sadly, had to wake up at 5

I know you had good intentions, and that is not what people are picking at. I think it's just the over the top manner. A mere 3rd year won't come close to spending 24/7 in a hospital, and living/breathing surgery when they get home. The most they do is do shelf studying, read, or do nothing. Especially if they had downtime to read on patients/shelf studying during the day.

Also, it depends on the school. I hope there aren't too many hospitals in the US which are insanely malignant. I'd feel sorry for those poor souls. After all, they shouldn't spend every ounce of their day revolved around work D:

 

[ArcGurren]

Eh...they were usually pretty quick and comprised mostly of reading notes from consults put in during the day, doing post-op checks, and making sure everything was ready for sign out. We aren't talking about mediciney type rounds.

I would imagine not haha (although frankly if I were a medicine attending I'd limit my rounds to an absolute maximum of 3 hours). Usually on medicine we would update our own patients' sign outs and just leave after letting the intern know.

My surgical day as an MS3 usually ended with finishing post-op checks (though the interns were typically on top of that), running the list, and leaving (we were not required to stay until sign-out to the night-team). We also managed a fairly good system where the student(s) staying on overnight call would take the later surgeries so that everyone else would get out by latest 6:30 pm.

 

[Perrotfish]

The schedule is definitely part of the hazing process until you realize that the intern or PGY1 you spend most of your time with as an MS3 or MS4 is on such a schedule and they won't like seeing you yawn or groan if you're still there at 5:01PM.
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I don't think everyone is disagreeing with your assessment of what does and does not annoy surgeons, I think they're disagreeing with your perspective. You seem to think 'surgeons hate to see you eat, sleep, sit, or yawn, therefore you shouldn't do those things'. Meanwhile the other posters in this thread argue 'Surgeons don't like to see you eat, sleep, sit, or yawn, therefore f--k surgery'.

To be honest, if you need to get up at 3:00 a.m., work and starve until 10 p.m., and smile through the whole thing (without yawning) to impress somene enough that they'll let you do it all AGAIN for 5-10 more years of residency and fellowship (at minimum wage!) that should be a sign that this career is not worth the price of admssion.

 

[Winged Scapula]

I don't think everyone is disagreeing with your assessment of what does and does not annoy surgeons, I think they're disagreeing with your perspective. You seem to think 'surgeons hate to see you eat, sleep, sit, or yawn, therefore you shouldn't do those things'. Meanwhile the other posters in this thread argue 'Surgeons don't like to see you eat, sleep, sit, or yawn, therefore f--k surgery'.

To be honest, if you need to get up at 3:00 a.m., work and starve until 10 p.m., and smile through the whole thing (without yawning) to impress somene enough that they'll let you do it all AGAIN for 5-10 more years of residency and fellowship (at minimum wage!) that should be a sign that this career is not worth the price of admssion.

Perhaps for you.

But I would do it again. For some of us, the price of admission is worth the show. I enjoy my career and my life.

 

[JourneyAgent]

I don't think everyone is disagreeing with your assessment of what does and does not annoy surgeons, I think they're disagreeing with your perspective. You seem to think 'surgeons hate to see you eat, sleep, sit, or yawn, therefore you shouldn't do those things'. Meanwhile the other posters in this thread argue 'Surgeons don't like to see you eat, sleep, sit, or yawn, therefore f--k surgery'.

To be honest, if you need to get up at 3:00 a.m., work and starve until 10 p.m., and smile through the whole thing (without yawning) to impress somene enough that they'll let you do it all AGAIN for 5-10 more years of residency and fellowship (at minimum wage!) that should be a sign that this career is not worth the price of admssion.

Agreed but I actually love his posts because they provide the comic book villain that makes it enjoyable to sling obscenities at in retrospective catharsis. Rather than this lot of measured, polite, surgical apologists and PR people who put up such a concerted front precisely to avoid associative identity with the not so few Gimps out there that typify the surgical hoohah machismo. The type that think its so awesome to be them that they can describe a litany of biblical proportions of sacrifices of exactly how you might just be them if you're just so lucky.

Like a 35 y/o with a mullet and popped collar driving a camaro and bragging about how much they bench press to a snickering crowd of teeneagers.

Really. It's douche performance art par excellence.

 

[Winged Scapula]

Agreed but I actually love his posts because they provide the comic book villain that makes it enjoyable to sling obscenities at in retrospective catharsis. Rather than this lot of measured, polite, surgical apologists and PR people who put up such a concerted front precisely to avoid associative identity with the not so few Gimps out there that typify the surgical hoohah machismo. The type that think its so awesome to be them that they can describe a litany of biblical proportions of sacrifices of exactly how you might just be them if you're just so lucky.

Like a 35 y/o with a mullet and popped collar driving a camaro and bragging about how much they bench press to a snickering crowd of teeneagers.

Really. It's douche performance art par excellence.

That's a fabulous evocative description.

Thanks.

 

[JGimpel]

Thank you for the offer and the education, but as a SURGICAL ATTENDING and SDN MODERATOR/ADMINISTRATOR, I do not have that luxury. I am well aware of what surgical rotations are like having done them as a student, resident, fellow and now attending. If your comment was not directed toward me, then I apologize (but when you quote someone, usually what follows is meant as a response to them).

I am not saying that your post is not warranted or valuable, however:

1) if you have already posted this in the NSGY subforum, crossposting it here is a TOS violation;

2) this thread was not about "what is my surgical core" going to be like, nor was anyone asking that, therefore it seems misplaced. Perhaps its just my impression.

3) you might want to ramp down the rancor; it does not serve you well

I was aware that cross-posting questions was in violation of the TOS, but not that posting helpful information from one area in another was. I apologize for that.

I saw the complaints as unrealistic expectations met with in a stress that maybe could be avoided if the users could see what was possible.

The offer of ignoring my posts was not directed at you at all, it was at users that like to pick apart people's efforts that take time away from other things in the act of being helpful. They are definitely free to ignore my posts if they feel that strongly against them.

I didn't return the continued attacks in kind, but if it my comments were out of line, I apologize for that. It seems strange that other members that have had little or no experience in this area seem fit to comment on a subject such as this, but maybe I am mistaken.

 

[Winged Scapula]

I was aware that cross-posting questions was in violation of the TOS, but not that posting helpful information from one area in another was. I apologize for that.

Yes, all cross-posting, whether questions or responses are in violation of the TOS.

I saw the complaints as unrealistic expectations met with in a stress that maybe could be avoided if the users could see what was possible.

Perhaps but as others have pointed out, its not the work that troubles (most of) them or lack of knowledge about what was expected but the boorish unpleasant behavior found amongst our surgical colleagues. Most students are eager to learn and IF the expectations are laid out, they will adhere to them. Even if they aren't eager to learn, I find that most will "toe the line" simply for fear of ruining their grade transcript.

The offer of ignoring my posts was not directed at you at all, it was at users that like to pick apart people's efforts that take time away from other things in the act of being helpful. They are definitely free to ignore my posts if they feel that strongly against them.

I didn't return the continued attacks in kind, but if it my comments were out of line, I apologize for that. It seems strange that other members that have had little or no experience in this area seem fit to comment on a subject such as this, but maybe I am mistaken.

Not strange. Clearly you are not aware of the rules of the internet where anyone can post on everything and anything even if they have no experience or knowledge of a subject. Call it the Wicki-fication of the world.

Also bear in mind that while non-students are welcome in all forums especially when offering help, you must tread lightly. Just as I do not appreciate Pre-Med students coming into the Surgery forum telling us how our training sucks (and us by extension), it is not appreciated for us to come into the medical student forums with an attitude.

You are correct; the Ignore function is greatly underutilized. Your comments were not out of line, they just seemed misplaced since we weren't talking about how to make the rotation better or what the expectations were. Your comments are spot on for someone doing an AI who is going into surgery. They are probably unrealistic for the average student who just wants to pass his core surgical rotation.

 

[PikminOC]

back to the OP..
wait until you get a job and a nurse or SW is an administrator and your boss....
then the fun really begins..
surgery is otherwise a cakewalk compared to the personalities you will deal with as an attending..

 

[SLUser11]

Agreed but I actually love his posts because they provide the comic book villain that makes it enjoyable to sling obscenities at in retrospective catharsis. Rather than this lot of measured, polite, surgical apologists and PR people who put up such a concerted front precisely to avoid associative identity with the not so few Gimps out there that typify the surgical hoohah machismo. The type that think its so awesome to be them that they can describe a litany of biblical proportions of sacrifices of exactly how you might just be them if you're just so lucky.

Like a 35 y/o with a mullet and popped collar driving a camaro and bragging about how much they bench press to a snickering crowd of teeneagers.

Really. It's douche performance art par excellence.

I truly love the poetic nature of your posts.

For other students in this thread: Don't be too surprised that surgery (and surgery subspecialty) residents are coming into this thread and making inflammatory statements. After all, it is simply a defensive retort to a thread telling them to "go f#$% yourselves."

Certainly, as you go farther in your training, life gets harder. TheProwler has much more on his plate than the average MS3, and studying/tests never go away. If anything, the consequences of not studying become greater with time (getting fired/dismissed, failing boards/not being able to practice, killing patients) .

However, I don't think heavy responsibility and a hard lifestyle should give the resident license to be an a-hole. I think the "surgical apologists" in this thread have done a good job of demonstrating the more proper way to behave.

Like any group, we don't enjoy being typecasted, and we don't believe it is fair or accurate to make blanket statements about a group as heterogeneous as surgery (and surgery subspecialty) residents. It's no different than saying "Dear nurses" or "dear medical students" or "dear left-handed people."

Once again, I have to warn students that those with the most angry, narrow-minded behavior during med school are the ones most likely to turn into the stereotypes that they hate. It is their destiny.

 

[JGimpel]

I truly love the poetic nature of your posts.

For other students in this thread: Don't be too surprised that surgery (and surgery subspecialty) residents are coming into this thread and making inflammatory statements. After all, it is simply a defensive retort to a thread telling them to "go f#$% yourselves."

Certainly, as you go farther in your training, life gets harder. TheProwler has much more on his plate than the average MS3, and studying/tests never go away. If anything, the consequences of not studying become greater with time (getting fired/dismissed, failing boards/not being able to practice, killing patients) .

However, I don't think heavy responsibility and a hard lifestyle should give the resident license to be an a-hole. I think the "surgical apologists" in this thread have done a good job of demonstrating the more proper way to behave.

Like any group, we don't enjoy being typecasted, and we don't believe it is fair or accurate to make blanket statements about a group as heterogeneous as surgery (and surgery subspecialty) residents. It's no different than saying "Dear nurses" or "dear medical students" or "dear left-handed people."

Once again, I have to warn students that those with the most angry, narrow-minded behavior during med school are the ones most likely to turn into the stereotypes that they hate. It is their destiny.

I applaud the other residents for maintaining their composure in light of such commentary from people they help train and this attending for going to bat for us.

I have never before seen an SDN thread started with the intention of telling Residents to go F themselves, then allowed to go on after asking "Why are these people such epic c*nts?" Whomever is moderating this thread, please, PLEASE close it before this rift gets drawn out any further.

 

[Winged Scapula]

I applaud the other residents for maintaining their composure in light of such commentary from people they help train and this attending for going to bat for us.

I have never before seen an SDN thread started with the intention of telling Residents to go F themselves, then allowed to go on after asking "Why are these people such epic c*nts?" Whomever is moderating this thread, please, PLEASE close it before this rift gets drawn out any further.

It is not a TOS violation to vent about one's experiences with certain specialties. Had this thread been opened in the Surgery Forum, that would have been a different story, but it is not SDN policy to close threads that simply make people angry, as long as they don't violate the TOS. Censoring things we don't like is not the right thing to do.

As a matter of fact, I think this thread has evolved into a measured discussion between surgical residents, attendings and students which might not happen otherwise. And for that valuable reason, the thread *should* stay open as long as those posting continue to treat each other in a reasonable fashion.

 

[KnuxNole]

Agreed, if you close down the venting of frustrations, it would imply that it's bad to ever vent about surgery. Constructive conversations like the ones in this thread are very helpful to see BOTH sides and to see the rights/wrongs of both sides. I'm sure the surgery residents want to know how the other side feels, as well as the med students and how residents feel.

With the exception of that cringeworthy neurosurgeon(who i don't think came back after one post...he would blow a fuse if I was his med student xD), all the surgery residents/attendings who posted here have been helpful.

 

[Winged Scapula]

Agreed, if you close down the venting of frustrations, it would imply that it's bad to ever vent about surgery. Constructive conversations like the ones in this thread are very helpful to see BOTH sides and to see the rights/wrongs of both sides. I'm sure the surgery residents want to know how the other side feels, as well as the med students and how residents feel.

With the exception of that cringeworthy neurosurgeon(who i don't think came back after one post...he would blow a fuse if I was his med student xD), all the surgery residents/attendings who posted here have been helpful.

Thanks for your input. Interspecialty venting is normal. You guys do it about us, we do it about the ED and Anesthesia, and so on. These threads can foster a dialogue which I can guarantee you aren't going to get IRL.

 

[deleted303591]

For every surgical resident we hear whining about how much they hate knowing how to manage diabetes or every medical resident who complains about taking care of psych patients... ugh.

 

[JourneyAgent]

I applaud the other residents for maintaining their composure in light of such commentary from people they help train and this attending for going to bat for us.

I have never before seen an SDN thread started with the intention of telling Residents to go F themselves, then allowed to go on after asking "Why are these people such epic c*nts?" Whomever is moderating this thread, please, PLEASE close it before this rift gets drawn out any further.

[YOUTUBE]http://www.youtube.com/watch?v=Xz7_3n7xyDg[/YOUTUBE]

 

[neusu]

With the exception of that cringeworthy neurosurgeon(who i don't think came back after one post...he would blow a fuse if I was his med student xD), all the surgery residents/attendings who posted here have been helpful.

Hardly cringeworthy, and for the record I do not yell or dress down students/residents in front of the team.

If my post was offensive perhaps you need to reevaluate as to why you are offended. I suspect it is defensiveness from identifying yourself with the students I am criticizing is the underlying issue.

 

[KnuxNole]

Hardly cringeworthy, and for the record I do not yell or dress down students/residents in front of the team.

If my post was offensive perhaps you need to reevaluate as to why you are offended. I suspect it is defensiveness from identifying yourself with the students I am criticizing is the underlying issue.

That's good, because being nice to people 100% is the best way to go! I think it was just the arrogant tone and the "do your dang job and shut your mouth!" that took people aback. I do think complaining on the job is bad...it's best to "vent" after the rotation is done for the day with friends. However, I do think if someone was to yawn due to being up at 5am, it shouldn't be the end of the world(i know you didn't say that but was mentioned elsewhere). edit: I don't mean yawning in the OR or when someone is speaking on rounds, but doing a task for pre-rounds by yourself/with another classmates and yawning once due to the early nature

 

[Golding]

Why are these people such epic c*nts?

I'm so bothered by surgery all I can do is make a list of phrases that sum it up:

1. trickle-down abuse
2. passive aggression
3. silence
4. eye contact avoidance
5. glorified supply caddy
6. sarcasm
7. disingenuous
8. Schadenfreude
9. defenselessness

Having rotated at a site that was definitely abusive and had those exaggerations of what people tend to characterize as the "surgical personality", I've tried to become more involved with med students and their education while they rotate through the service. Through our rotation, the medical students don't have that bucket of supplies to carry around during rounds. They are expected to see the patients on the floor and come up with plans for them each day. The plans are then compared with the intern's plans and if time allows then the rationale for the difference is explained. The interns teach the med students with their own formatted lectures, as well as go over patients and the algorithms when on call or in clinic.

So sometimes it bothers me to see MSIII's (or MSIV's, who are often more problematic) who take the attitude of that above. Too often I've run into students who peripherally round on only one patient, or disappear for an entire day, or skip out on assigned call, or any number of disrespectful behaviors towards the residents that try to make it a learning environment. For as much generalization I see about the flaws in a surgeon's character, is there any introspection from the med student (or considering how the thread evolved, among residents in other fields)?

While the abusive rotation full of "surgery personalities" was not enjoyable emotionally, I learned a great deal about surgical patients, and never saw medical students dare to do the kind of things I've been seeing at my current institution. Sometimes I feel like I'm being taken advantage of as a result of avoiding that stereotypical personality.

 

[Perrotfish]

So sometimes it bothers me to see MSIII's (or MSIV's, who are often more problematic) who take the attitude of that above. Too often I've run into students who peripherally round on only one patient, or disappear for an entire day, or skip out on assigned call, or any number of disrespectful behaviors towards the residents that try to make it a learning environment. For as much generalization I see about the flaws in a surgeon's character, is there any introspection from the med student (or considering how the thread evolved, among residents in other fields)?

While the abusive rotation full of "surgery personalities" was not enjoyable emotionally, I learned a great deal about surgical patients, and never saw medical students dare to do the kind of things I've been seeing at my current institution. Sometimes I feel like I'm being taken advantage of as a result of avoiding that stereotypical personality.

I will say, I do think that the eclectic nature of what you learn on a surgical rotations makes the rotators more hostile than the hours or residents alone justifies. I honestly think medical students do have a pretty good idea of what knowledge bases they do and don't need to develop for their chosen fields, and they can be incredibly apathetic about the less useful ones. I could imainge that would offend anyone who was genuinely trying to teach. I think that students would be better behaved on a medicine rotation of similar quality and character.

 

[Golding]

I will say, I do think that the eclectic nature of what you learn on a surgical rotations makes the rotators more hostile than the hours or residents alone justifies. I honestly think medical students do have a pretty good idea of what knowledge bases they do and don't need to develop for their chosen fields, and they can be incredibly apathetic about the less useful ones. I could imainge that would offend anyone who was genuinely trying to teach. I think that students would be better behaved on a medicine rotation of similar quality and character.

I do often hear people talk about how they're not going into surgery anyway, but I still have a hard time accepting that as a good reason for students to do some of the things they do. Medicine doctors still should know the basics of working up a patient. Everyone has their stories of terrible consults (being consulted on whether a patient has a TDC or a Port-a-Cath comes to mind), and I do think a lot of those stem from physicians not willing to learn about what they consider "another field".

 

[JourneyAgent]

Having rotated at a site that was definitely abusive and had those exaggerations of what people tend to characterize as the "surgical personality", I've tried to become more involved with med students and their education while they rotate through the service. Through our rotation, the medical students don't have that bucket of supplies to carry around during rounds. They are expected to see the patients on the floor and come up with plans for them each day. The plans are then compared with the intern's plans and if time allows then the rationale for the difference is explained. The interns teach the med students with their own formatted lectures, as well as go over patients and the algorithms when on call or in clinic.

So sometimes it bothers me to see MSIII's (or MSIV's, who are often more problematic) who take the attitude of that above. Too often I've run into students who peripherally round on only one patient, or disappear for an entire day, or skip out on assigned call, or any number of disrespectful behaviors towards the residents that try to make it a learning environment. For as much generalization I see about the flaws in a surgeon's character, is there any introspection from the med student (or considering how the thread evolved, among residents in other fields)?

While the abusive rotation full of "surgery personalities" was not enjoyable emotionally, I learned a great deal about surgical patients, and never saw medical students dare to do the kind of things I've been seeing at my current institution. Sometimes I feel like I'm being taken advantage of as a result of avoiding that stereotypical personality.

Why are you taking it personally? It seems to me they're doing more harm to those med students who do show up on time ready to work. Surely, your job is easier or most certainly not dependent on their attendance. Write a note about their behavior to the clerkship director or whoever does the evals and move on with your very busy days.

I mean, I never did any of those things, worked hard and only was graded average in surgery because I didn't study the cases overnight, to be prepared for pimping that was thoroughly irrelevant to the shelf exam. And somewhere off the map entirely of my chosen profession. This didn't bother me. The people who wanted surgery went for that stick with gusto. I have little ability to feign interest in academic minutia of a field that doesn't bear fruit for my future. But I was always interested in the medical management of surgical patients.

We should have little to disagree about. There's a lot of a-holes in surgery. What makes it worse is the ultra competitive exchange between those interested in it and those doing it. The rest of us just have to stand around and wait for the curtain call. And celebrate our exodus from it. Which is what this thread is about. Deal with it. The same way I dealt with you guys for 8 weeks. And another 4 before I'm done.

We know there's plenty of slackers who have dangerous attitudes towards their responsibilities. Deal them a failure or a bad eval. I won't defend them. Or take it personally.

Make a thread about it. I'd read it with interest.

My plans for being at your level is to take anyone interested under my wing, regard performance matter-of-factly, and to not give a crap about the young surgeons or whathaveyou of the disintersted that almost invariably can't stand my field.

 

[Golding]

Why are you taking it personally? It seems to me they're doing more harm to those med students who do show up on time ready to work. Surely, your job is easier or most certainly not dependent on their attendance. Write a note about their behavior to the clerkship director or whoever does the evals and move on with your very busy days.

I mean, I never did any of those things, worked hard and only was graded average in surgery because I didn't study the cases overnight, to be prepared for pimping that was thoroughly irrelevant to the shelf exam. And somewhere off the map entirely of my chosen profession. This didn't bother me. The people who wanted surgery went for that stick with gusto. I have little ability to feign interest in academic minutia of a field that doesn't bear fruit for my future. But I was always interested in the medical management of surgical patients.

We should have little to disagree about. There's a lot of a-holes in surgery. What makes it worse is the ultra competitive exchange between those interested in it and those doing it. The rest of us just have to stand around and wait for the curtain call. And celebrate our exodus from it. Which is what this thread is about. Deal with it. The same way I dealt with you guys for 8 weeks. And another 4 before I'm done.

We know there's plenty of slackers who have dangerous attitudes towards their responsibilities. Deal them a failure or a bad eval. I won't defend them. Or take it personally.

Make a thread about it. I'd read it with interest.

My plans for being at your level is to take anyone interested under my wing, regard performance matter-of-factly, and to not give a crap about the young surgeons or whathaveyou of the disintersted that almost invariably can't stand my field.

Likewise, why take your interaction with certain surgeons personally? In a way, that's my original point. Surgery is often labelled as the field that has a lot of a-holes, when the reality is that you can make such (or the same) broad generalizations about anyone in the hospital - med students included.

Your solution towards troublesome med students is individualized, so why is your solution towards troublesome surgery residents so generalized? You didn't "deal with me" for 8 weeks. You dealt with a specific group of people that I have no connection to outside of taking the same exams.

 

[SLUser11]

Your solution towards troublesome med students is individualized, so why is your solution towards troublesome surgery residents so generalized? You didn't "deal with me" for 8 weeks. You dealt with a specific group of people that I have no connection to outside of taking the same exams.

Love it.

There comes a point during training, or afterward when you are an attending, where you realize that students don't necessarily have a strong understanding of what is relevant and what is not. Then, there comes another point where you realize that being liked is less important than ensuring the quality of the student's education. Some residents, desperate for validation, will become pushovers who sacrifice the substance of their educational opportunities in order to be labeled the "cool resident," and that really bothers me.

Because of their inexperience, students are not really in a position to definitively label an activity or exercise as "low yield" or "high yield." Typically they will label things that suck as "low yield" and easy activities that simultaneously celebrate their awesomeness as "high yield." Pretty much anything that is hard, takes time, is uncomfortable, requires an early start, etc. is low yield by their measurements.

Now, certainly surgeons-in-training suffer from the same near-sightedness, and they can't always identify the most educational activities for themselves or for the students they supervise.

I agree with those who believe it's an imperfect system. However, I disagree with those who believe it's wise to ignore areas of medicine that they've determined to be irrelevant to their career choice, because they don't really possess the amount of experience necessary to understand what their future entails.

Regarding perspective, I've had the luxury of being a medical student, a surgical resident, a fellow, and an attending. I've also worked in multiple different practice environments, including the urban academic center, county hospital with bullets whizzing by, cush community hospital, etc. During my time, I've utilized a great deal of knowledge that I gained on my core MS3 clerkships in areas other than surgery.

I don't believe that I've forgotten what it's like to be a student. I remember that time very well, including all the ups and downs, the unfair situations, the conflicting obligations, the feelings of irrelevance/ineptitude, the fatigue, etc. Instead, I've gained experience that has allowed a better understanding of the situation. And, at my current level as a junior attending, I still have a lot to learn.

I think it would be quite naive to assume that all changes in behavior as one progresses in training are due to forgetting what it's like to be in the previous role. Even the most self-absorbed student must concede that increased experience and maturity play a role here.

 

[JourneyAgent]

Likewise, why take your interaction with certain surgeons personally? In a way, that's my original point. Surgery is often labelled as the field that has a lot of a-holes, when the reality is that you can make such (or the same) broad generalizations about anyone in the hospital - med students included.

Your solution towards troublesome med students is individualized, so why is your solution towards troublesome surgery residents so generalized? You didn't "deal with me" for 8 weeks. You dealt with a specific group of people that I have no connection to outside of taking the same exams.

You would have a point. If Newtonian physics stopped exerting its influence on hills and turds. My solution to a-hole supervisors....really...what does that even mean. This isn't a solution. It's half comical angry rant at the gods of medicine for forsaking us in your humorless hinterlands.

You have the luxury of being self-satisfied and pedantic. I have the luxury of observing how you can't stop competing at who's best even when it doesn't matter and for calling a culture of producing a-holes what it is.

If you must have it, victory and the field is yours. This conversation becomes more tedious the more it involves only the lawyerly of your kind.

 

[alpinism]

Love it.

There comes a point during training, or afterward when you are an attending, where you realize that students don't necessarily have a strong understanding of what is relevant and what is not. Then, there comes another point where you realize that being liked is less important than ensuring the quality of the student's education. Some residents, desperate for validation, will become pushovers who sacrifice the substance of their educational opportunities in order to be labeled the "cool resident," and that really bothers me.

Because of their inexperience, students are not really in a position to definitively label an activity or exercise as "low yield" or "high yield." Typically they will label things that suck as "low yield" and easy activities that simultaneously celebrate their awesomeness as "high yield." Pretty much anything that is hard, takes time, is uncomfortable, requires an early start, etc. is low yield by their measurements.

Now, certainly surgeons-in-training suffer from the same near-sightedness, and they can't always identify the most educational activities for themselves or for the students they supervise.

I agree with those who believe it's an imperfect system. However, I disagree with those who believe it's wise to ignore areas of medicine that they've determined to be irrelevant to their career choice, because they don't really possess the amount of experience necessary to understand what their future entails.

Regarding perspective, I've had the luxury of being a medical student, a surgical resident, a fellow, and an attending. I've also worked in multiple different practice environments, including the urban academic center, county hospital with bullets whizzing by, cush community hospital, etc. During my time, I've utilized a great deal of knowledge that I gained on my core MS3 clerkships in areas other than surgery.

I don't believe that I've forgotten what it's like to be a student. I remember that time very well, including all the ups and downs, the unfair situations, the conflicting obligations, the feelings of irrelevance/ineptitude, the fatigue, etc. Instead, I've gained experience that has allowed a better understanding of the situation. And, at my current level as a junior attending, I still have a lot to learn.

I think it would be quite naive to assume that all changes in behavior as one progresses in training are due to forgetting what it's like to be in the previous role. Even the most self-absorbed student must concede that increased experience and maturity play a role here.

Awesome post. Completely agree. It's also one of the main reasons I refuse to be part of the admissions process at my school (1/4 of our adcom are med students) . How the hell can I (or any other med student) decide who will make a good physician when we haven't even finished med school or residency and have No experience in the real world working as an attending.

I guess I've been lucky so far, haven't really run into many surgeons who are complete a**holes. Sure, there are a few here and there (like in any other career field or specialty in medicine) but for the most part they are just less "warm and fuzzy" and "coddling" than other services. If you make a mistake, be it something you did or forgot to do, they'll call you out on it. Like others have said, many surgeons fell that respect must be earned not automatically given.

We had a complex trauma case come in yesterday at the end of my shift. Ended up staying an extra 7hrs into the night to assist w/ the surgery even though I could've left on time. When I got back to my locker there was a personal handwritten note from our attending thanking me. The residents were really greatful esp since they had to be back at 530 this morning.

 

[Perrotfish]

:I think it would be quite naive to assume that all changes in behavior as one progresses in training are due to forgetting what it's like to be in the previous role. Even the most self-absorbed student must concede that increased experience and maturity play a role here.

Anytime maturity and experience advises a course of action that just happens to be the most convenient and self affirming for the voice of maturity and experience, I consider it suspect. I think premeds, medical students, and residents genearlly have a much clearer view of what is and is not necessary for their education than the attendings, particularly attendings who are also academic faculty. While experience and maturity plays a role in their decision making, unfortunately ennui, cognitive dissonance, and a lifetime of institutionalization probably play a greater role.

Doesn't it bother you how the correct course NEVER seems to be to change the system? Our system of medical education (other than residency) has been essentially frozen in amber for nearly a century now. It was designed at a time when the vast majority of residents were general practitioners in small towns, when most of our modern specialties didn't exist, when tertiary care didn't exist because there was no way to evacuate anyone to them, and in fact when most of what we do now would have been considered science fiction. Yet we do almost exactly the same rotatons for the same amount of time. Doesn't that suggest that, maybe, the attendings who are in charge of the system have somewhat of a bias in maintaining the status quo rather than adapting to new circumstances? That maybe they need the perspective of students who aren't as biased towards the current system of education?

 

[gravitywave]

Anytime maturity and experience advises a course of action that just happens to be the most convenient and self affirming for the voice of maturity and experience, I consider it suspect. I think premeds, medical students, and residents genearlly have a much clearer view of what is and is not necessary for their education than the attendings, particularly attendings who are also academic faculty. While experience and maturity plays a role in their decision making, unfortunately ennui, cognitive dissonance, and a lifetime of institutionalization probably play a greater role.

Doesn't it bother you how the correct course NEVER seems to be to change the system? Our system of medical education (other than residency) has been essentially frozen in amber for nearly a century now. It was designed at a time when the vast majority of residents were general practitioners in small towns, when most of our modern specialties didn't exist, when tertiary care didn't exist because there was no way to evacuate anyone to them, and in fact when most of what we do now would have been considered science fiction. Yet we do almost exactly the same rotatons for the same amount of time. Doesn't that suggest that, maybe, the attendings who are in charge of the system have somewhat of a bias in maintaining the status quo rather than adapting to new circumstances? That maybe they need the perspective of students who aren't as biased towards the current system of education?

Totally disagree with the bolded. Most medical students need to be disabused of preconceptions more than they need to be protected from the capriciousness of personality. Myself included.

It honestly surprises me that you still feel this way now that you're on the other side as a resident. Were your clerkships really that malignant, or... what? The vast majority of medical faculty/residents that I've worked with seemed to understand the position of a student quite well, were very reasonable about what they expected you to be responsible for, and were perfectly happy to engage us at the level of what we really needed to take away from the service to whatever our future plans were, provided the student appeared interested in knowing these things.

Honestly, your solution of medical training on the trade school model threatens to further compartmentalize the profession, reinforcing the institutionalization you so abhor. It certainly won't help with what interdepartmental rancor is already out there.

 

[Perrotfish]

Totally disagree with the bolded. Most medical students need to be disabused of preconceptions more than they need to be protected from the capriciousness of personality. Myself included.

It honestly surprises me that you still feel this way now that you're on the other side as a resident. Were your clerkships really that malignant, or... what? The vast majority of medical faculty/residents that I've worked with seemed to understand the position of a student quite well, were very reasonable about what they expected you to be responsible for, and were perfectly happy to engage us at the level of what we really needed to take away from the service to whatever our future plans were, provided the student appeared interested in knowing these things.

Honestly, your solution of medical training on the trade school model threatens to further compartmentalize the profession, reinforcing the institutionalization you so abhor. It certainly won't help with what interdepartmental rancor is already out there.

Like I said, to me a big sign that our medical school is not suited to our current system of medicine isn't just that its broad, its that its broad in the exact same way that it was 100 years ago. The same length of education, the same organic chemistry class, the same 8 week surgery rotation. If we wanted to avoid conflicts why not rotate through the departments that we more routinely have conlicts with, like the ED, radiology, and pathology? You can be a medical school without having rotations in any of those things. For that matter what about having us rotate through nursing, billing, social work, case management, or legal? We have almost daily fights with those people, after all, while most teams hardly ever argue with their surgical consults.

I'm not sure I'm offering the best solution, but when you talk to the entrenched faculty the solution always seems to be 'stay the course'. I'm not sure I have the right solution but I'm almost certain that wrong solution is to keep doing the same thing the same way, forever and ever

 

[evilbooyaa]

Like I said, to me a big sign that our medical school is not suited to our current system of medicine isn't just that its broad, its that its broad in the exact same way that it was 100 years ago. The same length of education, the same organic chemistry class, the same 8 week surgery rotation. If we wanted to avoid conflicts why not rotate through the departments that we more routinely have conlicts with, like the ED, radiology, and pathology? You can be a medical school without having rotations in any of those things. For that matter what about having us rotate through nursing, billing, social work, case management, or legal? We have almost daily fights with those people, after all, while most teams hardly ever argue with their surgical consults.

I'm not sure I'm offering the best solution, but when you talk to the entrenched faculty the solution always seems to be 'stay the course'. I'm not sure I have the right solution but I'm almost certain that wrong solution is to keep doing the same thing the same way, forever and ever

I agree with you on that (as a lowly MS3). I do not think that it is outrageous to require at least ED and radiology rotations for all medical schools (and preferably during the 3rd year or beginning of 4th year). However, it is a conundrum because you will not get enough support to eliminate any other rotation from the service (even if I wish we had EITHER family medicine OR outpatient internal medicine, NOT both), so where does it all fit? I do not think medical schools should be fully compartmentalized by specialty(my only personal exception to this is if a school shortens by a year to fast-track someone into PCP territory, just for the sake of the country).

 

[Psai]

Ok I agree you have to speak up for procedures. However, except surgical rotations, procedures are somewhat rare at my school.


Sometimes. But, give me 20 minutes with uptodate + medscape, 90% of the time I will get a much more complete answer than any attending could provide off the top of their head. If we are doing something which doesn't agree with what I read then it makes sense to ask questions. However, again this would produce very few questions and make me look 'uninterested.'



Taking blood to the lab. Making appointment for patients for my resident's pt I am not even following. Refilling paper in the printer. Getting the resident's lunch.

I obviously know how to walk. Likewise I know how to talk on the phone. This isn't teaching me crap. It is simply the resident abusing the med student so they have less work to do. I realize residents are overworked. Fine. But this 100% definitely isn't my job. Hire a personal assistant if you can't handle it yourself.



My point is my 'job' isn't to increase your productivity. I am a student, you are a paid employee. I pay ~$100+ a day to learn. Apart from procedures, I learn more going home and reading than following my resident around doing paperwork. Hell, even if they taught me to do the paperwork that would be fine, that would have a little educational value. However, me watching you put orders in on cross-cover pts I know nothing about is useless.


Bottom line, perception is king. For most med students perception (i.e. your grade) trumps learning.

I wonder what your thoughts about this are now as a resident.

 

[link2swim06]

I wonder what your thoughts about this are now as a resident.

Well I'm not a surgery resident.

Med students certainly slow me down not speed me up. And by no means do any of my work but I'm still nice to them and teach them if there is downtime.

 

[Kaustikos]

Well I'm not a surgery resident.

Med students certainly slow me down not speed me up. And by no means do any of my work but I'm still nice to them and teach them if there is downtime.

You're a Savior and a gentleman.

Sent from my One using Tapatalk

 

[SLUser11]

I love this thread! I forgot how much I enjoy arguing with strangers on the internet.

I really enjoy the 2012 version of me, BTW. It's amazing how we all evolve and change with more experience.

 

[Pisiform]

Why in the world 3rd year med students need to be on call? We cant do anything, just follow around residents, is it necessary to
Be their bitch over the weekend and overnight too? **** it

 

[Pisiform]

Yeah why on earth would you take call?? There's definitely nothing that ever happens at night that might be worth seeing, doing, or experiencing!!

Much less learning something about the job you're going to spend the next several years doing and having some concept of how to do it!!

Worthless!

Yes I learn a lot when you dont even talk to me, nor look at my soap notes which i spend time writing at 5am in the morning or when you ignore me or be sarcastic when i ask a question. Oh, and just by following you around, seeing you type up notes while I stand behind you, i learn a lot!

 

[Winged Scapula]

Yes I learn a lot when you dont even talk to me, nor look at my soap notes which i spend time writing at 5am in the morning or when you ignore me or be sarcastic when i ask a question. Oh, and just by following you around, seeing you type up notes while I stand behind you, i learn a lot!

Then that sounds like a system problem with your school or an individual problem with your interns (who are probably too busy learning to be interns to handle the additional teaching of medical students).

In a well run program, taking call with the more senior residents overnight can lead to more autonomy, more opportunities to scrub in and to see things you wouldn't during the day. Patients always like to die in the middle of the night, the best traumas come in then, etc.

 

[PL198]

Then that sounds like a system problem with your school or an individual problem with your interns (who are probably too busy learning to be interns to handle the additional teaching of medical students).

In a well run program, taking call with the more senior residents overnight can lead to more autonomy, more opportunities to scrub in and to see things you wouldn't during the day. Patients always like to die in the middle of the night, the best traumas come in then, etc.

hard to call it a system problem when it seems to happen more often than not.

I can understand surgery call for students for the reasons you said, but any other service makes really no sense and in my experience you rarely get called in and are just stuck sitting at hospital all night for no reason.

don't even get me started on pagers. still waiting for the mythical med student page

 

[Kaustikos]

hard to call it a system problem when it seems to happen more often than not.

I can understand surgery call for students for the reasons you said, but any other service makes really no sense and in my experience you rarely get called in and are just stuck sitting at hospital all night for no reason.

don't even get me started on pagers. still waiting for the mythical med student page

Well, to be fair... Not all calls are exciting. You think every page is OMG important? Nope. So, if anything, it let's you know how much residents enjoy call.

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[Señor S]

So, if anything, it let's you know how much residents enjoy call.

That's not much of a justification though. We'll suffer in our turn; in the meantime, please keep the education: sadism ratio to a minimum.

 

[Kaustikos]

That's not much of a justification though.

Not really justification but the truth. It'd be impossible to have an awesome experience for every student.

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[operaman]

A lot of it is simply what you make of it. I had a great experience as a 3rd year on surgery and I think night call was the best part of the rotation. I got to do a lot of stuff, see a ton of patients, and got a sense of what it felt like to be up for >24 hours in the hospital. My residents asked me what kind of stuff I was interested in and what I wanted to see and they made sure to involved me with relevant things when possible. Even the interns, while busy and trying to figure out which way was up, were kind and helpful to me. Oddly, when we had our feedback session at the end of the rotation, many of the other students blasted the night calls much like people in this thread have done. In this case, they all had the same night float team that I had, yet came away with drastically different experiences. While you can chalk some of that up to variance between nights, I think much of it has to do with what your expectations are going in and how hard you work to make your experience into something worthwhile.