How to cope on gen surg

[smq123]

Since the above post is the originial post, it doesn't seem like the OP is trying to "avoid having to do more work that he really wanted to." Seems like he was just trying to figure out how to find time to "pee".

No - I meant the OP in the thread in which Anka posted his "Shut up and Deal" post.

The post which SLUser111 used to say that Anka was being hypocritical was posted in another thread, one in which a third year student was asking advice on how to deal with an incompetent intern. The OP in THAT thread was asking how to diplomatically switch to another team or how to report his incompetent intern. Different story from the OP of this thread.

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[AwesomO]

I don't complain while I'm in the hospital. I can't complain while I'm at home - too many other issues at home to take care of first. If you can't vent on the internet, then where CAN you vent? Or is venting a privilege that only residents have?

If someone tells you to stop venting and you don't feel like listening then ignore them. You're on the internet no one here has any real authority over you. If anything I would think as a 3rd year student it would be amusing to be able to openly vent about a difficult rotation and know that nobody could penalize your for doing so.

 

[Hoo\/er]

"It's kinda a holiday for me... "


i still remember what my dean of students said at his opening remarks on my
first day of med school

"you are gonna miss out on weekends, holidays, birthdays, family events..
etc......just like your patients."

Patients suck.

 

[climbingdocs]

Patients suck.

 

[LovelyRita]

I have to say as a resident (in the DO world), being the teacher is kind of exhausting, moreso than I thought it would be. I take the time to sit down with new students on the service and rap with them a little bit on the way to "survive" our service, I give them a handout, etc, and try my best to make sure they don't feel lost or neglected. I try to get a feel for where they've rotated in the past so I can form a thought on what I can/ cannot expect from them. I try to lecture them once a week.

All I'm going to say right now is that I'm surprised and disappointed at the lack of knowledge I'm seeing....it's not always this way, but we're going thru a not-so-great phase of students...people who seem bummed out, depressed, have chips on their shoulders, etc. And trust me, our students' work hours are not even close to what you some of you are describing. They don't have to take call. As a resident, I'm much more receptive to the relaxed (even if they acknowledge their ignorance), content type who seem eager to learn and help. Oh well, I guess sometimes people are off or are distracted by their lives, etc.

The other thing is, that many people don't realize, is that residents are, many times, the sole teaching resource for students. And even though a med student is paying up to $35K+ for an education, we do not see one cent of it. We volunteer our time, in essence, while we are trying to hone our own skills.

So anyway, if you want to "survive" your surgery service, read NJBMD's posts and Kim Cox's posts and of course the first chapter of surgery recall on how to be a good student....follow this advice and you'll be golden. Especially if you are interested in surgery.

 

[8744]

I think alot of that is time management problems, though. I always found time to go to the bathroom during my surgery rotations.

Also, I think it's safe to say that your residents are working harder than you, with more responsibilities, and I can promise you that they're finding time to go to the bathroom.

Eating can be more difficult, but I always found time to eat, too. I would be on the same rotation with classmates, with the same responsibilities, and would arguably be outperforming them, and yet at the end of the day, they were saying "I didn't get a chance to eat, pee, etc. There's just not enough time!" And I was well-fed with an empty bladder.

Seriously. It's time management, not the nature of general surgery, that's eliminating your potty breaks.

Does anybody else think its wierd that that anybody would minimize the hell-on-earth that is a general surgery rotation by insisting that you can, with better time management, work in a few minutes here or there to eat and take a crap?

Good Lord. Its no wonder that general surgery, as a specialty, seems to decrease in popularity every year.

 

[PeepshowJohnny]

Does anybody else think its wierd that that anybody would minimize the hell-on-earth that is a general surgery rotation by insisting that you can, with better time management, work in a few minutes here or there to eat and take a crap?

Good Lord. Its no wonder that general surgery, as a specialty, seems to decrease in popularity every year.

*Cough* http://forums.studentdoctor.net/showthread.php?t=471719

 

[dan0909]

reading this thread made me want to die, just thinking about my general surgery rotation (which was relatively light).

 

[Ypo.]

All I'm going to say right now is that I'm surprised and disappointed at the lack of knowledge I'm seeing....it's not always this way, but we're going thru a not-so-great phase of students...people who seem bummed out, depressed, have chips on their shoulders, etc.

It sounds like you really do a good job teaching your students, so good for you. I can tell you from my perspective I really appreciate residents who do that.

As far as the students who seemed bummed out, all I can say is that I haven't found any of the rotations I've been on yet to be 'boring' but what I have found boring is:
1) Not having any responsibility over the patient
2) shadowing (unless it's a cool procedure you haven't seen before)
3) Not having your ideas on how to treat the patient at least considered, without the attending/resident taking a moment to educate me why they disagree with my assessment/plan.

When the above three conditions are met, I tune out and I'm sure it registers on my face even though I try to hide it. Unfortunately that can be construed as boredom even though it's not.

On the other hand, when I get thrown into a patient's room and asked to present, I get interested. When the doctor actually considers what I recommend, I get really excited because I feel like I'm relevant to the patient's care. If the doctor disagrees with my plan, but explains why, I really appreciate that because then I learn.

I guess I just wanted to interject the possibility that at times what you may be seeing is not necessarily students who are bored, but students who are disengaged from the patient's care and who may not know how to become more engaged or else are not assertive enough to get more involved. That's been my problem at least.

 

[climbingdocs]

I agree with above

 

[LovelyRita]

It sounds like you really do a good job teaching your students, so good for you. I can tell you from my perspective I really appreciate residents who do that.

As far as the students who seemed bummed out, all I can say is that I haven't found any of the rotations I've been on yet to be 'boring' but what I have found boring is:
1) Not having any responsibility over the patient
2) shadowing (unless it's a cool procedure you haven't seen before)
3) Not having your ideas on how to treat the patient at least considered, without the attending/resident taking a moment to educate me why they disagree with my assessment/plan.

When the above three conditions are met, I tune out and I'm sure it registers on my face even though I try to hide it. Unfortunately that can be construed as boredom even though it's not.

On the other hand, when I get thrown into a patient's room and asked to present, I get interested. When the doctor actually considers what I recommend, I get really excited because I feel like I'm relevant to the patient's care. If the doctor disagrees with my plan, but explains why, I really appreciate that because then I learn.

I guess I just wanted to interject the possibility that at times what you may be seeing is not necessarily students who are bored, but students who are disengaged from the patient's care and who may not know how to become more engaged or else are not assertive enough to get more involved. That's been my problem at least.

This is good for me to consider. Thanks. I guess I remember feeling that way on some rotations, but, of course, never surgery , and I know that I need to keep my students stimulated as much as possible, but the group I have now is just weirdly inept. But, that means I can make them better.

 

[snowhite]

I really appreciate the information in this thread. I just finished my general surgery rotation and it honestly was very similar to a lot of the stories mentioned. It's strange though because after awhile you get used to not sleeping or eating. I got used to being half delirious and lost 10 pounds in 2 months. I'm now in Internal Medicine and I HAVE NO IDEA what to do with my free time. It's the strangest thing. I feel lost now.

Anyway, my advice is just to appreciate it for what it is. Surgery is like a rite of passage to becoming a doctor and one in which will provide conversation-entertainment in future reminiscences (unless you're crazy and going into surgery. )

 

[snowhite]

This is good for me to consider. Thanks. I guess I remember feeling that way on some rotations, but, of course, never surgery , and I know that I need to keep my students stimulated as much as possible, but the group I have now is just weirdly inept. But, that means I can make them better.

Haven't seen you in awhile, M! It sounds like you're doing a great job in residency. Wish my hospital had a lot more residents like you.

 

[LovelyRita]

Haven't seen you in awhile, M! It sounds like you're doing a great job in residency. Wish my hospital had a lot more residents like you.

Yup, life's good. You're a KCUMBer! You could've come up here to rotate
Anyway, hope things are good for ya, and hang in there! Keep in touch!

 

[SoCuteMD]

Yesterday my team lost a patient on the table. I was the med student on the case. The death wasn't entirely unexpected, but I wasn't aware of this going in. Without giving too many specifics, there was no negligence or malpractice involved and this was a good end for this particular patient given his condition. That didn't make it any less heartbreaking for the entire team in the OR - surgeons, nurses, anesthesiologists, and everyone else. It was a tough day, but probably a day when I had the opportunity to see the best in people. I know I won't express this properly, but seeing the pain people felt at this loss - the loss of someone who wasn't a family member or a friend, but who was more than just a part of their job - made me feel better about surgery and about being a future physician.

I had some time to reflect on this experience and I realized how small all my other complaints about my surgery rotation seem in comparison to what happened. They are no less real, or even valid, but somehow seem inconsequential compared to what our team endured yesterday.

 

[filter07]

Boy this thread is depressing.

I'm almost half way done with internship and I've only had one rotation where I didn't have a time to eat or pee. It also happened to be my first rotation. I think the problem is that I felt a duty to get things done rather than "sneaking out" to eat or pee. I felt guilty for "neglecting" my clinical duties.

Later on in the year I was able to eat AND pee. Here's how. I realized that unless patient care depended on it, I didn't have to do everything right that second. I think they call it prioritizing. So I prioritized taking care of my basic needs over running down to radiology to get a final read on something just so I could have that information ready for the chief or attending. Patient care didn't depend on it, just an opportunity to impress someone. I refused to kill myself just to a monkey dance for the chiefs or attendings.

It's difficult as medical students; they are always being watched and evaluated. So I can see that they would be more concerned about looking good in front of people. But as an intern, my attitude was more like, I'm not going to do something just to please someone, or just in case someone asks me some random question at a random moment. They can yell at me if they want or think less of me; whatever. All I know is that I do my best for the patients, not for the attendings or chiefs who have been ignoring their patients while operating all day, who all of a sudden want to know random things about patients at 5pm. Remember, most of the time when someone above you wants to know what someone's random lab value is, it's not because they want to test you, it's because they don't know it and are depending on you to tell them. Obviously important data you should know, but if they want to know what the final read on a KUB was, on a patient who subsequently has had bowel movements and are tolerating their diet, remember that it's not necessarily a failure that you don't know that data. It's their stupid fault for asking irrelevant details that no longer concern patient care.

Another thing is that I got more efficient.

I think it is bad for general surgery to expect people to eat lunch for 5 minutes, hold their urine for hours upon hours, not let people scrub out when they really need to, or make post-call interns stay until 6 or even 9pm so that they can round after the late add-on case is done. Instead of telling people to be tougher or more efficient, residents should look at whether all of this punishment is really necessary, or whether there needs to be some serious reform in surgical training.

General surgery does NOT have to be like what's been described in this thread. I think a lot of the reason why it's as bad as it is now is because the lower levels (med students and interns) are being EXPLOITED. Plain and simple. While the upper levels are operating with nary an interruption all day, the interns are managing the floor, the ICU, consults, the hospital-to-hospital transfers, discharges, admission, post-op orders, order clarifications, calls from patients from outside the hospital, and so on. If there was a system in place to help balance the load, as there are in other specialties, General Surgery would not be like this. It's just that no one cares enough about you to change.

 

[beasleys]

Hi, I am wondering please. I am international med student here on U.S. for visiting rotations. I am to start surgery soon next month maybe and these posts scare me!! I talk to some friends who were already here before and they say same thing, yes? Why are surgery peoples so angry and spiteful all the time? I hear they even make fun of the clothes people where. So insecure they are, right? If people have advices for me, I appreaciate it very much and thanks!

 

[mimelim]

Great thread... a lot of it is finally relevant to me and now I can understand what everyone was talking about in regard to third year. Man is it a journey. About to finish my last week of surgery and I could not be more excited and relieved.

Surgery is a mind**ck. You will be tested more than you ever imagined. The surgery residents literally accomplish more from 5 am- 7am than most other specialties do in an entire day, rounding on a service of up to 30-40 patients. My intern's pager goes off 24/7, he is constantly demeaned in front of the group, and then he is asked difficult surgical management questions which he won't know the answer to and then has to make a presentation on (this is after working a 16 hour shift). Surgeons round, have clinic, see consults, and operate. As far as I know, every other medical specialty does ONE thing primarily, not FOUR.

This rotation has made me realized I could never do surgery. It takes your entire emotional capacity to make it through one day in surgery... this coming from a medical student with minimal responsibility. I cannot believe how hard some of these individuals work and how they are willing to dedicate their entire life to making sure the surgery service is running smoothly. I have no idea how people have the time to go home, read, and somehow master some of these surgeries after working 120 hour weeks. Although not the right fit for me, I have nothing but utmost respect for anyone entering a surgical field and preparing for the day to day rigors seen only in surgery residency.

Two words: Time Management.

 

[JackShephard MD]

54 month bump!

Two words: Time Management.

So, do you have to do research to match vascular?

 

[LabMonster]

Great thread... a lot of it is finally relevant to me and now I can understand what everyone was talking about in regard to third year. Man is it a journey. About to finish my last week of surgery and I could not be more excited and relieved.

Surgery is a mind**ck. You will be tested more than you ever imagined. The surgery residents literally accomplish more from 5 am- 7am than most other specialties do in an entire day, rounding on a service of up to 30-40 patients. My intern's pager goes off 24/7, he is constantly demeaned in front of the group, and then he is asked difficult surgical management questions which he won't know the answer to and then has to make a presentation on (this is after working a 16 hour shift). Surgeons round, have clinic, see consults, and operate. As far as I know, every other medical specialty does ONE thing primarily, not FOUR.

This rotation has made me realized I could never do surgery. It takes your entire emotional capacity to make it through one day in surgery... this coming from a medical student with minimal responsibility. I cannot believe how hard some of these individuals work and how they are willing to dedicate their entire life to making sure the surgery service is running smoothly. I have no idea how people have the time to go home, read, and somehow master some of these surgeries after working 120 hour weeks. Although not the right fit for me, I have nothing but utmost respect for anyone entering a surgical field and preparing for the day to day rigors seen only in surgery residency.

When in Rome - or when on surgery as a student - do as the residents do. Surgeons are different. They have a different mindset than their medicine etc colleagues. On my rotation, we worked incessantly, I didn't sleep much but I loved it. I loved taking an H&P blueprint and converting it into a surgical plan then actually going in and changing a person's anatomy to modify their physiology.

As a third year - your surgery reference can be some of your strongest. If you bust your ass for a surgeon, know your patients, are useful in the OR and useful post-op, in my opinion, your work will be rewarded. Even if you don't want to do surgery, a strong LOR from surgery in your application can help you out.

Embrace the suck. It will pay off.

 

[Metfan2987]

I hate the OR...it is the bane of my existence

 

[45408]

Two words: Time Management.

And multi-tasking like a motherf*****r.

 

[SLUser11]

Two words: Time Management.

Great thread! I forgot about this one.

Almost 5 years later, I stick by my comments....

I hope SoCuteMD finally got a chance to eat lunch. Her final post on the subject illustrates the number of ups and downs that occur on a surgery clerkship.

Now that I'm a little more experienced, it's amusing to see how much general surgery is romanticized by both students and residents. My advice to students is to not allow histrionic residents to draw you into their drama. Sure, these residents work hard, but many of the hardships are self-imposed. Like I said back in '07, two people can do the same amount of work in the same environment and have drastically different perceptions of what happened...and one will be fine while the other has an empty stomach and over-distended bladder.

 

[ArcGurren]

Necrothread much? But seriously, for the love of all that is holy... I had a miserable general surgery experience (two very very busy services one after the other) and was worked to the bone but if I had to take a leak, even if it meant leaving the OR, I had to take a damn leak. I wasn't going to wet my pants just to satisfy the ego of the person operating. I also did find time to eat (albeit fairly quickly). I feel like there's a lot of melodrama and overstatement.

 

[AlexMorph]

Necrothread much? But seriously, for the love of all that is holy... I had a miserable general surgery experience (two very very busy services one after the other) and was worked to the bone but if I had to take a leak, even if it meant leaving the OR, I had to take a damn leak. I wasn't going to wet my pants just to satisfy the ego of the person operating. I also did find time to eat (albeit fairly quickly). I feel like there's a lot of melodrama and overstatement.

Agree. It may have sucked but there was always time to attend to basic needs such as eating and going to the washroom. And no, they did not occur at the same time...

 

[viper930]

IMO, posts like the OP's are irritating as hell. If you can't find time to have a snack or take a leak at ANY point in medical school, its more than likely your problem and not the rotation's. Is there an attending watching over you at all times? Are you never sent to go see a consult on your own or do a wound check without direct supervision? Cant you make a pitstop in the bathroom on way to said consult or wound check? To me, the fact that you can't squeeze simple necessities of life into your schedule means that you are an overachiever/masochist and are purposely leaving those things out to get back from your independent tasks as quickly as possible. Take a step back and realize that its not worth it. Whoever is evaluating you is not going to remember your pissant contributions to the service anyway, let alone that you took 15 minutes for a consult + piss + granola bar instead of 11 for just a consult.