Things I Hate About Third Year

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My MS3 today did...

Ultrasound guided IJ central lines x2, first one I did the stick/wire and he did the rest. The second he did completely on his own with me gowned and gloved for moral support.
Paracentesis x1
2 SICU H&Ps
Presented 3 SICU patients including a postop OLT on rounds



Not all MS3s are created equal, but I thought that was a pretty good day for him.

Shedding tears of joy for that MS3. That's amazing.

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My MS3 today did...

Ultrasound guided IJ central lines x2, first one I did the stick/wire and he did the rest. The second he did completely on his own with me gowned and gloved for moral support.
Paracentesis x1
2 SICU H&Ps
Presented 3 SICU patients including a postop OLT on rounds



Not all MS3s are created equal, but I thought that was a pretty good day for him.

:'(
 
Shedding tears of joy for that MS3. That's amazing.

:laugh: me too. That was a bromantic story. I envision them climbing on top of a crotch rocket together and riding off to go play volleyball in jeans with the other fighter pilots. Snappy sexy dialogue abounding.

But seriously. I made a collage of different useless things I didn't like that amounted to an exaggeration in total. But also I think on the other side of this discussion there might be a propensity for delusions of clerk grandeur.

Whatever. 3rd years is fading from memory. I'm going to try to make the most of my sub-i's so I can be as ready as possible for internship. Minus the top gun stuff on surgery.
 
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My MS3 today did...

Ultrasound guided IJ central lines x2, first one I did the stick/wire and he did the rest. The second he did completely on his own with me gowned and gloved for moral support.
Paracentesis x1
2 SICU H&Ps
Presented 3 SICU patients including a postop OLT on rounds



Not all MS3s are created equal, but I thought that was a pretty good day for him.

I'm not even interested in surgery, but if you are willing to PM me which hospital you are at, I will put in an application to do a 4th year rotation at your hospital, as long as the other vascular residents are as awesome as you are. God forbid I go through the hell of a 4th year vascular surgery rotation and don't even get to do stuff MS3s do at your hospital.
 
I'm not even interested in surgery, but if you are willing to PM me which hospital you are at, I will put in an application to do a 4th year rotation at your hospital, as long as the other vascular residents are as awesome as you are. God forbid I go through the hell of a 4th year vascular surgery rotation and don't even get to do stuff MS3s do at your hospital.

I went to med school in the same city that mimelim is in. It's not uncommon that as 3rd and 4th years we were able to do a lot of hands on stuff like that; however, just like mimelim said, it is very student dependent. If your resident and attending like you/think you are competent and you show interest...then hell yeah you get to do awesome **** like that. If you don't appear competent to the resident and don't show much interest--you'll be standing in the corner watching.

With that being said, the program I am at now--med students don't seem to do quite as much here as I did as a medical student. Of course, they are gone half of the time for lectures, whereas we didn't have quite as many.
 
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I just don't understand how that happens. Aren't there interns and subIs and other junior residents around snapping those procedures up? On my subIs, I was like person #6 in line for any given procedure.
 
From what I've seen, it really depends on the culture of the institution. I've seen places where med students don't see patients in clinic or touch instruments in the OR (#6 in line, as you said). Then there's the other side of the spectrum: having the same role as a resident in clinic, doing procedures on the floor, doing all kinds of stuff in the OR, etc.
 
I just don't understand how that happens. Aren't there interns and subIs and other junior residents around snapping those procedures up? On my subIs, I was like person #6 in line for any given procedure.

This. If a senior level didn't want a procedure/case on any service, it went to the junior, followed by the intern, followed by the MS4. I had MS4s on my team on medicine that didn't do a single procedure.

I mean at my hospital at least MS3s are strictly forbidden from placing central lines after an issue a couple years ago where a MS3-placed line had the guide wire left in resulting in complications. Another went into the carotid rather than the jugular and was apparently left in... Unfortunate that medical student education was put on the chopping block rather than whoever was "supervising" said procedure. The first time I put in a central line (if I ever get to) I would at the very least want an upper level resident watching me like a hawk to make sure I didn't f up. No homo, but I might even be comfortable if they just moved my hands into exact pre-puncture positions like they were teaching a cute girl how to play pool.

Apparently the current MS4s (who were MS3s with me last year) tell me that none of them have placed central lines, just some radial a-lines on Anesthesia.
 
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My MS3 today did...

Ultrasound guided IJ central lines x2, first one I did the stick/wire and he did the rest. The second he did completely on his own with me gowned and gloved for moral support.
Paracentesis x1
2 SICU H&Ps
Presented 3 SICU patients including a postop OLT on rounds



Not all MS3s are created equal, but I thought that was a pretty good day for him.

Damn I wish I was on your service. I'd do fifty digital disimpactions to do that kind of stuff.
 
This. If a senior level didn't want a procedure/case on any service, it went to the junior, followed by the intern, followed by the MS4. I had MS4s on my team on medicine that didn't do a single procedure.

I mean at my hospital at least MS3s are strictly forbidden from placing central lines after an issue a couple years ago where a MS3-placed line had the guide wire left in resulting in complications. Another went into the carotid rather than the jugular and was apparently left in... Unfortunate that medical student education was put on the chopping block rather than whoever was "supervising" said procedure. The first time I put in a central line (if I ever get to) I would at the very least want an upper level resident watching me like a hawk to make sure I didn't f up. No homo, but I might even be comfortable if they just moved my hands into exact pre-puncture positions like they were teaching a cute girl how to play pool.

Apparently the current MS4s (who were MS3s with me last year) tell me that none of them have placed central lines, just some radial a-lines on Anesthesia.

**** that, i would definitely would not risk my education for subjective clinical procedure training. That puts a lot in perspective about medical school education.
 
This. If a senior level didn't want a procedure/case on any service, it went to the junior, followed by the intern, followed by the MS4. I had MS4s on my team on medicine that didn't do a single procedure.

I mean at my hospital at least MS3s are strictly forbidden from placing central lines after an issue a couple years ago where a MS3-placed line had the guide wire left in resulting in complications. Another went into the carotid rather than the jugular and was apparently left in... Unfortunate that medical student education was put on the chopping block rather than whoever was "supervising" said procedure. The first time I put in a central line (if I ever get to) I would at the very least want an upper level resident watching me like a hawk to make sure I didn't f up. No homo, but I might even be comfortable if they just moved my hands into exact pre-puncture positions like they were teaching a cute girl how to play pool.

Apparently the current MS4s (who were MS3s with me last year) tell me that none of them have placed central lines, just some radial a-lines on Anesthesia.

:confused:

All that does is produce undertrained and incompetent M4s and interns. Now instead of supervised students making mistakes, it will be residents making them which results in actual patient deaths since no one will be there to catch the mistake.
 
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:confused:

All that does is produce undertrained and incompetent M4s and interns. Now instead of supervised students making mistakes, it will be residents making them which results in actual patient deaths since no one will be there to catch the mistake.

If it's your first line, the upper level isn't going to leave you hanging as an intern...he or she will likely be in the room helping you out. Supervision doesn't all of a sudden disappear when you have that MD (or DO) after your name.
 
I just don't understand how that happens. Aren't there interns and subIs and other junior residents around snapping those procedures up? On my subIs, I was like person #6 in line for any given procedure.

We have 29 SICU beds with incredible turn over. Other than our liver transplant patients that hang around a while, we move people very quickly and end up with a lot of CVICU, NICU and MICU overflow. We average maybe 6-7 CVC, Quintons and A-lines a day just ballparking it. With our liver population we probably do 1 paracentesis or thoracentesis a day. Our SICU team is made up of 2 NPs, and 3 residents between R1 and R3 (last month was three R2s, this month is an R1, R2 and R3). We have intermittent M3s and M4s that rotate with us. If I have procedures someone is doing them with me. If there is a student or an intern in the unit I grab them. If not, I send a text to the GS/VS interns. If nobody responds by the time I get my supplies I text the MS3s on the acute care surgery service. If we are busy and I need to keep things moving, I'm going to mostly do the procedures myself and talk them through what I'm doing with the expectation that if we have time to do things slowly that they will do as much as they can.

If we have free time, I have no problem taking someone step by step through procedures.

Now, also keep in mind that we have a 40 bed CVICU with a major heat and lung transplant programs as well as an incredibly busy Vascular service next door to our SICU. They don't have a single medical student there. Lord knows how many lines and other things would be available to students...

This. If a senior level didn't want a procedure/case on any service, it went to the junior, followed by the intern, followed by the MS4. I had MS4s on my team on medicine that didn't do a single procedure.

I mean at my hospital at least MS3s are strictly forbidden from placing central lines after an issue a couple years ago where a MS3-placed line had the guide wire left in resulting in complications. Another went into the carotid rather than the jugular and was apparently left in... Unfortunate that medical student education was put on the chopping block rather than whoever was "supervising" said procedure. The first time I put in a central line (if I ever get to) I would at the very least want an upper level resident watching me like a hawk to make sure I didn't f up. No homo, but I might even be comfortable if they just moved my hands into exact pre-puncture positions like they were teaching a cute girl how to play pool.

Apparently the current MS4s (who were MS3s with me last year) tell me that none of them have placed central lines, just some radial a-lines on Anesthesia.

A radiologist left a guidewire in a patient and nearly killed them at a neighboring institution last year. On Vascular call an R4 called me after they put a triple lumen into the carotid. These are not MS3 mistakes. These are mistakes. When I do my lines I say out loud every single time, "Guidewire out" and make the person doing the line with me, or nurse acknowledge/verify that indeed the wire is out. When people who learn lines with me do their lines, they do the exact same thing. You learn by understanding theory and then having people with experience walk/talk you through things. If you aren't comfortable, someone should be helping you. I don't mean hand holding. I mean teaching. If you don't feel like you are getting that in medical school and residency, you are wasting your time.
 
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Everything. Third year blows. I often feel like my grade is already determined just based on who my resident is.
 
We have 29 SICU beds with incredible turn over. Other than our liver transplant patients that hang around a while, we move people very quickly and end up with a lot of CVICU, NICU and MICU overflow. We average maybe 6-7 CVC, Quintons and A-lines a day just ballparking it. With our liver population we probably do 1 paracentesis or thoracentesis a day. Our SICU team is made up of 2 NPs, and 3 residents between R1 and R3 (last month was three R2s, this month is an R1, R2 and R3). We have intermittent M3s and M4s that rotate with us. If I have procedures someone is doing them with me. If there is a student or an intern in the unit I grab them. If not, I send a text to the GS/VS interns. If nobody responds by the time I get my supplies I text the MS3s on the acute care surgery service. If we are busy and I need to keep things moving, I'm going to mostly do the procedures myself and talk them through what I'm doing with the expectation that if we have time to do things slowly that they will do as much as they can.

If we have free time, I have no problem taking someone step by step through procedures.

Now, also keep in mind that we have a 40 bed CVICU with a major heat and lung transplant programs as well as an incredibly busy Vascular service next door to our SICU. They don't have a single medical student there. Lord knows how many lines and other things would be available to students...



A radiologist left a guidewire in a patient and nearly killed them at a neighboring institution last year. On Vascular call an R4 called me after they put a triple lumen into the carotid. These are not MS3 mistakes. These are mistakes. When I do my lines I say out loud every single time, "Guidewire out" and make the person doing the line with me, or nurse acknowledge/verify that indeed the wire is out. When people who learn lines with me do their lines, they do the exact same thing. You learn by understanding theory and then having people with experience walk/talk you through things. If you aren't comfortable, someone should be helping you. I don't mean hand holding. I mean teaching. If you don't feel like you are getting that in medical school and residency, you are wasting your time.

Your posts make me wish I had gone to medical school somewhere that vascular surgery actually did teaching instead of just belittling everyone around them. I would have ended up a surgeon.
 
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Your posts make me wish I had gone to medical school somewhere that vascular surgery actually did teaching instead of just belittling everyone around them. I would have ended up a surgeon.

The vascular surgeons were the first people to show me I actually liked surgery, because they actually let me do stuff.

I walked into an OR one day, introduced myself to the attending, and he said to me: "Have you ever amputated a leg? Would you like to?" Took me through the entire the case. Showed me how to clamp and tie vessels, close deep tissue, etc. Before that, my job was always retract or hold the camera. After that, I spent every day I could in the vascular room, because I got to do small open procedures, put in lines, do some endovascular stuff, close big incisions, etc. Didn't matter the surgeon, it seemed every vascular attending was fine taking me through stuff.

I honestly think if I didn't have that experience I wouldn't have applied to a surgical field. Showed me the light at the end of the tunnel.

Of course, the rest of the year and most of M4 year I was back to bitch status. Hence my bitching above. I think I closed one incision on my home ENT subI.
 
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The vascular surgeons were the first people to show me I actually liked surgery, because they actually let me do stuff.

I walked into an OR one day, introduced myself to the attending, and he said to me: "Have you ever amputated a leg? Would you like to?" Took me through the entire the case. Showed me how to clamp and tie vessels, close deep tissue, etc. Before that, my job was always retract or hold the camera. After that, I spent every day I could in the vascular room, because I got to do small open procedures, put in lines, do some endovascular stuff, close big incisions, etc. Didn't matter the surgeon, it seemed every vascular attending was fine taking me through stuff.

I honestly think if I didn't have that experience I wouldn't have applied to a surgical field. Showed me the light at the end of the tunnel.

Of course, the rest of the year and most of M4 year I was back to bitch status. Hence my bitching above. I think I closed one incision on my home ENT subI.

It sucks that our experiences are so heavily weighted by one year, and lie in the hands of attendings and residents that don't think about the influence they have over us. I suppose I found an acceptable alternative, but I have a feeling I'll always think about what it might have been like.
 
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Everything. Third year blows. I often feel like my grade is already determined just based on who my resident is.

I had an attending who labeled me an idiot early because I couldn't name all of the criteria (3 major, 5-6 minor) for a specific diagnosis within the first week of the rotation. I ended up absolutely destroying the shelf exam but didn't honor the rotation because of his eval detailing how inadequate my clinical knowledge was. I got excellent evals from the other attendings, but we work with so few that his eval brought me down significantly. He also spent the least amount of time teaching and assessing my clinical knowledge, so that was nice. Third year, lol. I'm over it.
 
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My favorite part about third year though is definitely patients withholding information from you then bringing it up in front of the resident / attending, making you look like an incompetent fool.
 
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My favorite part about third year though is definitely patients withholding information from you then bringing it up in front of the resident / attending, making you look like an incompetent fool.

Don't worry. This will still happen in residency.
 
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I had an attending who labeled me an idiot early because I couldn't name all of the criteria (3 major, 5-6 minor) for a specific diagnosis within the first week of the rotation. I ended up absolutely destroying the shelf exam but didn't honor the rotation because of his eval detailing how inadequate my clinical knowledge was. I got excellent evals from the other attendings, but we work with so few that his eval brought me down significantly. He also spent the least amount of time teaching and assessing my clinical knowledge, so that was nice. Third year, lol. I'm over it.

Ahh that's the absolute worst thing about third year, in my opinion. There is such a large component of your grade determined by luck and who your evaluators are.
 
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I had an attending who labeled me an idiot early because I couldn't name all of the criteria (3 major, 5-6 minor) for a specific diagnosis within the first week of the rotation. I ended up absolutely destroying the shelf exam but didn't honor the rotation because of his eval detailing how inadequate my clinical knowledge was. I got excellent evals from the other attendings, but we work with so few that his eval brought me down significantly. He also spent the least amount of time teaching and assessing my clinical knowledge, so that was nice. Third year, lol. I'm over it.

I don't know why but your avatar and Michelangelo de Caravaggio are one, in my head. Who is that man? I must meet him.
 
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The vascular surgeons were the first people to show me I actually liked surgery, because they actually let me do stuff.

I walked into an OR one day, introduced myself to the attending, and he said to me: "Have you ever amputated a leg? Would you like to?" Took me through the entire the case. Showed me how to clamp and tie vessels, close deep tissue, etc. Before that, my job was always retract or hold the camera. After that, I spent every day I could in the vascular room, because I got to do small open procedures, put in lines, do some endovascular stuff, close big incisions, etc. Didn't matter the surgeon, it seemed every vascular attending was fine taking me through stuff.

When I was doing a vascular sub-I as an M4, I scrubbed a BKA with an intern and the attending. Literally the second the leg was off...the attending looks at the intern and says - "you guys got this, right?"

I don't know who was more terrified - me or the intern!
 
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My favorite part about third year though is definitely patients withholding information from you then bringing it up in front of the resident / attending, making you look like an incompetent fool.
This has definitely happened to me on more than one occasion :)
 
I had an attending who labeled me an idiot early because I couldn't name all of the criteria (3 major, 5-6 minor) for a specific diagnosis within the first week of the rotation. I ended up absolutely destroying the shelf exam but didn't honor the rotation because of his eval detailing how inadequate my clinical knowledge was. I got excellent evals from the other attendings, but we work with so few that his eval brought me down significantly. He also spent the least amount of time teaching and assessing my clinical knowledge, so that was nice. Third year, lol. I'm over it.
What a dick. What is this for? Jones Criteria?
 
What a dick. What is this for? Jones Criteria?

I kept it vague because I told a few of my friends about it. It's even more complicated than the Jones criteria because there's a bunch of "this or this" that would quality for major criteria. Even the residents who were present at the time couldn't name all of them either, which was the case most of the time he asked me something (e.g., "explain the balthazar score for pancreatitis"). I agree with the other posters about evaluations being luck of the draw. I'm not going into anything too competitive, so it didn't really bother me too much. Stuff happens.
 
futile.jpg
 
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Who gives a crap. These are just silly pimp things. Dude is a dick and we love to hate them for it. But what bothers me is the percentage of my cohort who will act the same way. If I'm an attending and another attending is pimping silly and acting serious about it, imma a tell him/her to stuff a cock in it.
 
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I should visit this thread if I ever become nostalgic about med school.

For me the worse was surgery. I had a 2 month old, who I would bottle feed at night, in additional to 80+ hour weeks - which helped cause my already crappy marriage to fall apart. It all started with an "outpatient surgery" 4 week module - but my scheduled attending took leave and instead I was put into GI surgical oncology which lead to having 1 day off in the four weeks. It was horrible, the fellow hated me and constantly harrassed me - the regular "pimping" plus personal comments - the way I talk, the tone of my voice, whatever I was wearing under my scrubs, if I shave, if I don't shave, my shoes, etc.. It got to the point that I asked her to please stop making personal comments and that they were making me uncomfortable - this made the situation worse - she stopped making personal comments but became even more aggressive with the pimping. Plus dealing with those wonderful scrub techs who loved making my life even worse.

It got to the point that our babysitter - who was premed - saw how much I "worked" and how horrible I was feeling - that she quit and instead joined a PA program.
 
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I had an attending who labeled me an idiot early because I couldn't name all of the criteria (3 major, 5-6 minor) for a specific diagnosis within the first week of the rotation. I ended up absolutely destroying the shelf exam but didn't honor the rotation because of his eval detailing how inadequate my clinical knowledge was. I got excellent evals from the other attendings, but we work with so few that his eval brought me down significantly. He also spent the least amount of time teaching and assessing my clinical knowledge, so that was nice. Third year, lol. I'm over it.
this is exactly why clinical years can be such a drag.
 
This. If a senior level didn't want a procedure/case on any service, it went to the junior, followed by the intern, followed by the MS4. I had MS4s on my team on medicine that didn't do a single procedure.

I mean at my hospital at least MS3s are strictly forbidden from placing central lines after an issue a couple years ago where a MS3-placed line had the guide wire left in resulting in complications. Another went into the carotid rather than the jugular and was apparently left in... Unfortunate that medical student education was put on the chopping block rather than whoever was "supervising" said procedure. The first time I put in a central line (if I ever get to) I would at the very least want an upper level resident watching me like a hawk to make sure I didn't f up. No homo, but I might even be comfortable if they just moved my hands into exact pre-puncture positions like they were teaching a cute girl how to play pool.

Apparently the current MS4s (who were MS3s with me last year) tell me that none of them have placed central lines, just some radial a-lines on Anesthesia.
it is for quality posting like this that I come here.
 
I should visit this thread if I ever become nostalgic about med school.

For me the worse was surgery. I had a 2 month old, who I would bottle feed at night, in additional to 80+ hour weeks - which helped cause my already crappy marriage to fall apart. It all started with an "outpatient surgery" 4 week module - but my scheduled attending took leave and instead I was put into GI surgical oncology which lead to having 1 day off in the four weeks. It was horrible, the fellow hated me and constantly harrassed me - the regular "pimping" plus personal comments - the way I talk, the tone of my voice, whatever I was wearing under my scrubs, if I shave, if I don't shave, my shoes, etc.. It got to the point that I asked her to please stop making personal comments and that they were making me uncomfortable - this made the situation worse - she stopped making personal comments but became even more aggressive with the pimping. Plus dealing with those wonderful scrub techs who loved making my life even worse.

It got to the point that our babysitter - who was premed - saw how much I "worked" and how horrible I was feeling - that she quit and instead joined a PA program.

****.
I need to stop reading this thread.
But I can't.
 
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I should visit this thread if I ever become nostalgic about med school.

For me the worse was surgery. I had a 2 month old, who I would bottle feed at night, in additional to 80+ hour weeks - which helped cause my already crappy marriage to fall apart. It all started with an "outpatient surgery" 4 week module - but my scheduled attending took leave and instead I was put into GI surgical oncology which lead to having 1 day off in the four weeks. It was horrible, the fellow hated me and constantly harrassed me - the regular "pimping" plus personal comments - the way I talk, the tone of my voice, whatever I was wearing under my scrubs, if I shave, if I don't shave, my shoes, etc.. It got to the point that I asked her to please stop making personal comments and that they were making me uncomfortable - this made the situation worse - she stopped making personal comments but became even more aggressive with the pimping. Plus dealing with those wonderful scrub techs who loved making my life even worse.

It got to the point that our babysitter - who was premed - saw how much I "worked" and how horrible I was feeling - that she quit and instead joined a PA program.
female surgery attendings are vicious.


I am watching you scapula.
 
I should visit this thread if I ever become nostalgic about med school.

For me the worse was surgery. I had a 2 month old, who I would bottle feed at night, in additional to 80+ hour weeks - which helped cause my already crappy marriage to fall apart. It all started with an "outpatient surgery" 4 week module - but my scheduled attending took leave and instead I was put into GI surgical oncology which lead to having 1 day off in the four weeks. It was horrible, the fellow hated me and constantly harrassed me - the regular "pimping" plus personal comments - the way I talk, the tone of my voice, whatever I was wearing under my scrubs, if I shave, if I don't shave, my shoes, etc.. It got to the point that I asked her to please stop making personal comments and that they were making me uncomfortable - this made the situation worse - she stopped making personal comments but became even more aggressive with the pimping. Plus dealing with those wonderful scrub techs who loved making my life even worse.

It got to the point that our babysitter - who was premed - saw how much I "worked" and how horrible I was feeling - that she quit and instead joined a PA program.

:(
i guess i don't mind studying a little more for step 1
 
If your resident/fellow/attending hates you and your evaluation is already sunk, why let it bother you?
 
I should visit this thread if I ever become nostalgic about med school.

For me the worse was surgery. I had a 2 month old, who I would bottle feed at night, in additional to 80+ hour weeks - which helped cause my already crappy marriage to fall apart. It all started with an "outpatient surgery" 4 week module - but my scheduled attending took leave and instead I was put into GI surgical oncology which lead to having 1 day off in the four weeks. It was horrible, the fellow hated me and constantly harrassed me - the regular "pimping" plus personal comments - the way I talk, the tone of my voice, whatever I was wearing under my scrubs, if I shave, if I don't shave, my shoes, etc.. It got to the point that I asked her to please stop making personal comments and that they were making me uncomfortable - this made the situation worse - she stopped making personal comments but became even more aggressive with the pimping. Plus dealing with those wonderful scrub techs who loved making my life even worse.

It got to the point that our babysitter - who was premed - saw how much I "worked" and how horrible I was feeling - that she quit and instead joined a PA program.

That sounds really tough :(
 
If your resident/fellow/attending hates you and your evaluation is already sunk, why let it bother you?
that question is so profound that I cant even start to think about it. It in true has the answer for all ours anxieties.
 
that question is so profound that I cant even start to think about it. It in true has the answer for all ours anxieties.

I've had bosses hate me before. If you're already on their **** list, **** 'em. Just don't do anything stupid that could get you in real trouble.
 
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I've had bosses hate me before. If you're already on their **** list, **** 'em. Just don't do anything stupid that could get you in real trouble.
the human mind is so fickle, I bet they would love you if only you brought some coffee and muffins in the morning.
 
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the human mind is so fickle, I bet they would love you if only you brought some coffee and muffins in the morning.

My strengths are sarcasm and cynicism, if I can't win people over with those, there will be no winning over.
 
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A box of warm Krispy Kremes can pick up where you fail.

Hmm, it must be that cynicism that I noted earlier but when people bring donuts into the office I usually either paint them as "sucker" or "suck-up".
 
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