Advice for female general surgical intern?

[SMS]

Hi all--

I've been reading the "advice to interns" threads over the past several weeks with interest, and I guess I was wondering if there was anything any of the women in surgery could pass on about their experiences in internship. Or, of course, if there was a great thread on the subject that I missed due to my newbie status on SDN. :wink:

Thanks!

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[docronmd1]

SMS,
Head for the website <a href="http://www.womensurgeons.org" target="_blank">www.womensurgeons.org</a> That is the website of the Association of Women surgeons. Click on publications and read the Pocket Mentor. I think you will find it very useful

 

[Winged Scapula]

Take the "advice" in the Pocket Mentor with a grain of salt. I found some of it condescending (ie, I don't think you need to be reminded to keep feminine products with you when on call. Duh!) and some of it old-fashioned. While to be sure there ARE faculty members who still aren't used to having women in the OR (other than scrub nurses and students) and there is still some "boys will be boys" attitude/behavior (at least once a month I have to delete a nude photo from the call room computer wallpaper or some other thing like that ), I find (at least here), things aren't as bad as the Pocket Mentor makes it out to be.

Probably the best use of AMWA IMHO are the forums. If you register, you can read and post to their forums - a suprising number of female residents and attendings actually answer threads there.

The best piece of advice I can give you is to be yourself but don't use "traditional" female behaviors when frustrated. This essentially turns out to be "don't cry" or complain about being on your period, or being treated differently because you're female. No one respects this and it just gives those boys who want to more ammunition against you.

 

[SMS]

Hi--

Yeah, those basic rules are pretty much the way I got through the surgical rotations in med school!

I looked through the Pocket Mentor (also very solid advice--thanks!).

 

[mary]

Do any of you have any advice regarding taking medicine on a regular basis during a hectic call schedule? I am on the pill and I am worried about not being able to take it at the right time and messing up my cycle when I start rotations. Does anyone else have any words of wisdom? Any advice, practical or otherwise (besides condoms)?
Mary
PS. Can't wait for the patch!

 

[tussy]

•••quote:•••Originally posted by mary:
•Do any of you have any advice regarding taking medicine on a regular basis during a hectic call schedule? I am on the pill and I am worried about not being able to take it at the right time and messing up my cycle when I start rotations. Does anyone else have any words of wisdom? Any advice, practical or otherwise (besides condoms)?
Mary
PS. Can't wait for the patch!•••••I keep an extra package of pills in my locker at the hospital. I take them the nights i'm on call. Don't worry though, being a surgery resident is the best birth control -- there is no time to meet anyone, or if you're already in a relationship, there is no time to DO anything but sleep.

 

[Winged Scapula]

Funny you should ask about OCP - while I do now keep some with me, I have found it difficult to remember to take it at the same time each day, what with the schedules being so unpredictable. Keeping the packet close by - either in a locker that you can reliably access at the same time each day or in your coat pocket would make sense.

I suppose its fortunate that my fertility is waning somewhat, with all the pills that I've missed (unlike tussy, I haven't found myself THAT tired to give up some things! :wink: ).

 

[tussy]

•••quote:•••Originally posted by Kimberli Cox:
•Keeping the packet close by - either in a locker that you can reliably access at the same time each day or in your coat pocket would make sense.
•••••Lab coat pocket??? that could get embarrassing

 

[Winged Scapula]

•••quote:•••Originally posted by tussy:
• •••quote:•••Originally posted by Kimberli Cox:
•Keeping the packet close by - either in a locker that you can reliably access at the same time each day or in your coat pocket would make sense.
•••••Lab coat pocket??? that could get embarrassing•••••Hmmm, maybe for some. But I'm a female over 30 years old and have no qualms about people knowing I'm on the pill or that I have a sex life. I don't advertise it, but it's a natural function and I see no reason to be embarassed about it. Besides, who's looking in my pockets?

BTW, you can carry a little zipper bag to money, pills, etc. which can attach to the inside pocket of your scubs. I had one during medical school which worked well - have been meaning to find another as it was really handy.

 

[tussy]

In general as a female surgery resident i haven't run into too many difficulties. I've been treated quite well in my own program (my gen surg program is very woman friendly having had many women before me go thru). My seniors (all men this year) put us thru a little initiation ritual at the beginning of the year party (drinking, smoking cigars, etc. not that bad), but since then have been incredibly protective of us (my chief even put in a complaint on my behalf when he witnessed an ER nurse hassling me).

I've run into a few difficulties on some off service rotations. I had an old staff neurosurgeon tell me that my skirt was inappropriate attire for his clinic -- it was a long conservative grey wool skirt with a matching jacket. I was told that if i was working in a mans world i should dress like a man and wear slacks. I of course corrected him on the incorrectness of his comment.

My problem is that when i'm exhausted and i get angry or upset i cry easily, which is incredibly embarrassing. It's difficult trying to explain that my red runny eyes are due to "allergies". One of my collegues broke down in tears when she was post call and the attending wouldn't let her escape and continued to yell at her telling her that crying was inappropriate behaviour. Of course she couldn't stop at that point. It just went on and on. If anyone has any advice on how to prevent tears please share.

 

[Winged Scapula]

tussy - I don't there is a single one of us out there who hasn't had the same fears or experienced the same thing. I posted several months back about a certain day when I was exhausted and frustrated and humiliated and how I just couldn't hold back the tears. Unfortunately, some SDN Users saw that as a "weakness" which "proved" I wasn't fit to be a surgeon. It is my fear (and I'm sure yours) that we have colleagues who feel the same.

There is a BIG difference between crying constantly or even frequently, and using tears to your advantage and crying because it is a release - much the same as going to the gym, or yelling at someone (behaviors which our male colleagues use frequently).

I wish I had some techniques to avoid crying but I don't...I'll be checking this space frequently for tips. I'm pretty sure the AMWA forums had this topic going awhile back, might be worth checking.

 

[2003doc]

For pill carrying- I carry Tylenol around in one of those small ~ 2 inch cylindrical pill carriers; you know, the travel-sized type that you see sold in gas stations. It fits very well in scrub pockets. I think Dramamine is also sold in those little tubes as well. So if you're shy about guys seeing your OCP's, maybe this will work; it could be Tylenol for all they know. :wink:

 

[md03]

This is for Tussy..

Your chiefs put you through an initiation ritual???? That's pathetic, like college fraternity stuff. I'm sitting here stunned to learn that the chiefs feel like they can pressure their subordinates into engaging any kind of behaviour.

Thanks for passing that on, though. Now I have another question to add to my list of questions to ask on interviews. I don't want to be in a situation where I'm pressured to drink, which I really can't do because of health/medication issues.

Anyone concerned about taking medications, I never really found it to be a big deal. I have been taking medications for most of my life, so it's a natural as brushing my teeth. Though so far as a student I've usually had a little down time in the evening to go brush my teeth and take my meds. If I didn't have that time, I'd just keep it in my little container that is always in my white coat that has ibuprofen, immoduim and the like in it.

 

[LaCirujana]

As an alternative to OCPs--has anyone tried Lunelle? It's a once/month IM injection that works like taking your birth control pills just once and having it work for the whole month. You still have a period and it doesn't seem to have most of the side effects associated with Depo-Provera. Kind of handy, since you don't have to remember to take a pill every day and having an erratic schedule isn't a problem. (You do have to get a shot each month, but I worked it out with one of my OB/Gyn buddies to just get me a supply--yes, I paid for it--and the syringes so I could give them to myself).

 

[UI2003]

•••quote:•••Originally posted by LaCirujana:
•As an alternative to OCPs--has anyone tried Lunelle? It's a once/month IM injection that works like taking your birth control pills just once and having it work for the whole month. You still have a period and it doesn't seem to have most of the side effects associated with Depo-Provera. Kind of handy, since you don't have to remember to take a pill every day and having an erratic schedule isn't a problem. (You do have to get a shot each month, but I worked it out with one of my OB/Gyn buddies to just get me a supply--yes, I paid for it--and the syringes so I could give them to myself).•••••I'm on month #2 of Lunelle and my appetite definatly seems to have decreased vs. the Depo (thank God). Now all I have to do is workout 5 days a week and eat like a rabbit to undo all the Depo damage

 

[UI2003]

•••quote:•••Originally posted by Kimberli Cox:
•tussy - I don't there is a single one of us out there who hasn't had the same fears or experienced the same thing. I posted several months back about a certain day when I was exhausted and frustrated and humiliated and how I just couldn't hold back the tears. Unfortunately, some SDN Users saw that as a "weakness" which "proved" I wasn't fit to be a surgeon. It is my fear (and I'm sure yours) that we have colleagues who feel the same.

There is a BIG difference between crying constantly or even frequently, and using tears to your advantage and crying because it is a release - much the same as going to the gym, or yelling at someone (behaviors which our male colleagues use frequently).

I wish I had some techniques to avoid crying but I don't...I'll be checking this space frequently for tips. I'm pretty sure the AMWA forums had this topic going awhile back, might be worth checking.•••••Haha - anyone who thinks crying is a reason why someone shouldn't do a residency has obviously never had a bad day on the floors! I don't worry about what my collegeagues think of me because I assume a certain percentage of them have already written me off just for being a woman. Plus, I've seen enough men get pushed to tears to know that it's not just us ladies! Personally, I find it easier to hold back the tears if I'm sufficiently pissed off enough. In these (thankfully) rare situations, I tend to look as though I'm about to wring someone's neck (which amazingly will make even an attending back off). But in the one or two instances I can think of where I actually cried after a confrontation, I always quickly found a quiet corner and pounded on something until I felt better (avoid mirrors in times like these - ow). Guys get to yell but a woman yelling comes across as shrilly hysteria. I just cut my losses, turn around and walk away. I'd rather clean up the pieces later than let em see me cry :wink: I agree with you about crying as a release - sometimes you just gotta let it out...or else you run the risk of releasing your pent up stress on loved ones or worse yet, your patients.

 

[tussy]

•••quote:•••Originally posted by md03:
•This is for Tussy..

Your chiefs put you through an initiation ritual???? That's pathetic, like college fraternity stuff. I'm sitting here stunned to learn that the chiefs feel like they can pressure their subordinates into engaging any kind of behaviour.
.•••••It wasn't that bad, and i didn't feel pressured into participating. It was actually quite fun. It was really a big welcoming party for the new PGY1s. We went sailing, had a nice dinner and then a social evening at the program directors house.

 

[Winged Scapula]

•••quote:•••Originally posted by UI2003:

Haha - anyone who thinks crying is a reason why someone shouldn't do a residency has obviously never had a bad day on the floors! I don't worry about what my collegeagues think of me because I assume a certain percentage of them have already written me off just for being a woman. Plus, I've seen enough men get pushed to tears to know that it's not just us ladies! Personally, I find it easier to hold back the tears if I'm sufficiently pissed off enough. In these (thankfully) rare situations, I tend to look as though I'm about to wring someone's neck (which amazingly will make even an attending back off). But in the one or two instances I can think of where I actually cried after a confrontation, I always quickly found a quiet corner and pounded on something until I felt better (avoid mirrors in times like these - ow). Guys get to yell but a woman yelling comes across as shrilly hysteria. I just cut my losses, turn around and walk away. I'd rather clean up the pieces later than let em see me cry :wink: I agree with you about crying as a release - sometimes you just gotta let it out...or else you run the risk of releasing your pent up stress on loved ones or worse yet, your patients.[/QB]••••Yes, obviously some of the medical students don't know how bad it can be. Mostly its just the exhaustion that gets to me. I'd definitely like to be able to let off steam at work - and I KNOW my BF would rather I did than take it out on him ("Why can't you just yell at the nurses or someone else at work, rather than me?" he says with a sad puppy dog look! :wink: )

The men DO seem to be forgiven more often when they yell than do female residents. Maybe its just my perception, but it is a common behavior (ie, thinking the women are bitches and the men are just having a bad day).

 

[Winged Scapula]

•••quote:•••Originally posted by md03:
•This is for Tussy..

Your chiefs put you through an initiation ritual???? That's pathetic, like college fraternity stuff. I'm sitting here stunned to learn that the chiefs feel like they can pressure their subordinates into engaging any kind of behaviour.

Thanks for passing that on, though. Now I have another question to add to my list of questions to ask on interviews. I don't want to be in a situation where I'm pressured to drink, which I really can't do because of health/medication issues.

Anyone concerned about taking medications, I never really found it to be a big deal. I have been taking medications for most of my life, so it's a natural as brushing my teeth. Though so far as a student I've usually had a little down time in the evening to go brush my teeth and take my meds. If I didn't have that time, I'd just keep it in my little container that is always in my white coat that has ibuprofen, immoduim and the like in it.•••••While I know your message was addressed to tussy, I thought I'd weigh in.

There IS still a fair bit of male-oriented activities despite the influx of female residents, especially in surgery. Drug company fetes are getting better but they still sponsor things like dove hunting, cigar nights, drinking binges, etc. - activities *typically* more often associated with males. One of the attendings who is appalled by this (a male, even) told me that, "at least they've stopped having the outings to strip clubs...or at least they aren't making it well known!" <img border="0" title="" alt="[Eek!]" src="eek.gif" />

At any rate, in my humble experience, no one is forced to go along with things like drinking. Early on there are lots of social events and everyone is encouraged to go along; it does help to forge a bond with your fellow residents. However, depending on the group of course, but I can't imagine anyone will *make* you drink or do anything you aren't comfortable with. Some people like to drink "near beer", ordering it from the bar, and just avoiding the question. If you don't care to go that route, I would just explain that you don't drink - for whatever reason: health, medication interactions, etc.

 

[tussy]

•••quote:•••Originally posted by Kimberli Cox:

There IS still a fair bit of male-oriented activities despite the influx of female residents, especially in surgery. Drug company fetes are getting better but they still sponsor things like dove hunting, cigar nights, drinking binges, etc. - activities *typically* more often associated with males. One of the attendings who is appalled by this (a male, even) told me that, "at least they've stopped having the outings to strip clubs...or at least they aren't making it well known!" <img border="0" title="" alt="[Eek!]" src="eek.gif" />

At any rate, in my humble experience, no one is forced to go along with things like drinking. Early on there are lots of social events and everyone is encouraged to go along; it does help to forge a bond with your fellow residents. However, depending on the group of course, but I can't imagine anyone will *make* you drink or do anything you aren't comfortable with. Some people like to drink "near beer", ordering it from the bar, and just avoiding the question. If you don't care to go that route, I would just explain that you don't drink - for whatever reason: health, medication interactions, etc.[/QB]••••My program is very social. We have about 40 residents in the program in total (PGY1-5). We have social events about once every month. Usually the events involve drinking -- we even have drinks at journal club. But we have a fair number of people in the program that don't drink (for religious or personal reasons), and they are never excluded. We like those people because they become the designated drivers -- saves on taxi fares.

Don't worry. Residency is lots of fun. WE work hard and then we play hard. You'll survive.

 

[njbmd]

Hi all,
As for birth control, I went for the Depo shot. It fits my hectic schedule. I have an OB-Gyn that will track me down in the OR if I am late for an appointment. Again, like Kimberli, no amount of stress can overcome Mother Nature! I find sex and wonderful outlet for stress and frustrationl

Like Kimberli, I keep a small pill bottle handy with things like Tylenol, Advil etc. I also keep T.E.D. hose and several pairs of shoes in my locker. Sometimes changing to a different pair makes all of the difference! Beyond that, I just plow through like the rest of the folks. We are all under stress and working pretty hard.

I have smoked cigars with the "boys" (thank God you don't have to inhale and a good martini will kill the taste) and put up with a little locker room humor. I generally smile or laugh and roll my eyes. Almost everyone here is just great! I haven't found anyone who was downright condescending or disgusting.

I am enough of an anomalie,(large (tall), female, African-American surgical intern) that the old boys can take their pick of what to discriminate against anyway. I have a very thick skin. When I do cry, it is usually out of frustration at my performance and not because of any particular comments. I do have a very high tolerance for criticism and usually learn something from the process.

Above all, I love surgery and I am generally too busy to do much reacting to anything that does not further my skills and career. This is a great residency program for females!

 

[Winged Scapula]

•••quote:•••Originally posted by njbmd:
•

Above all, I love surgery and I am generally too busy to do much reacting to anything that does not further my skills and career. This is a great residency program for females! •••••I was disappointed I didn't match there for Plastics; I loved it there!

BTW, by your description you sound like someone I did a visiting elective in Plastics with at UVA. Any chance that might be you (ie, she was a student at Georgetown)?

 

[njbmd]

•••quote:•••Originally posted by Kimberli Cox:
• •••quote:•••Originally posted by njbmd:
•

Above all, I love surgery and I am generally too busy to do much reacting to anything that does not further my skills and career. This is a great residency program for females! •••••I was disappointed I didn't match there for Plastics; I loved it there!

BTW, by your description you sound like someone I did a visiting elective in Plastics with at UVA. Any chance that might be you (ie, she was a student at Georgetown)?•••••Hi Kimberli,
That's wasn't me but I probably know the person that you might be describing. There were not that many of us (big, African-American females) who went into General Surgery from the DC area. There was a lot of interaction between the students of color in the three medical schools in DC through the Medical Society of DC (MSDC) activities and SNMA. I used to post lots of messages about going into General Surgery on the Medschool.com message boards.

 

[tussy]

I have a stupid question for you ladies. What do you guys wear for a bra when you're on call at night. I've been struggling with this all year. First, if you wear the bra to bed it's really uncomfortable. But, if you don't wear it and have to get out of bed and run to the floor or the ER you can't go braless under your flimsy OR greens. As anyone found a workable solution for this dilemma??

 

[njbmd]

•••quote:•••Originally posted by tussy:
•I have a stupid question for you ladies. What do you guys wear for a bra when you're on call at night. I've been struggling with this all year. First, if you wear the bra to bed it's really uncomfortable. But, if you don't wear it and have to get out of bed and run to the floor or the ER you can't go braless under your flimsy OR greens. As anyone found a workable solution for this dilemma??•••••Hi there,
I wear one of the one-piece running bras almost all the time while I am in the hospital. It is comfortable and can be worn with or without a shirt. Since these bras are made of cotton/spandex type material, they are very comfortable and nothing moves on those "runs" to the ER in the middle of the night. <img border="0" title="" alt="[Eek!]" src="eek.gif" />

 

[Lindsee]

Along the lines of another stupid question - what about hair? I have long hair that takes forever to dry. Is having a wet mop a big no no? Should I just chop it all off? Any suggestions?

 

[tussy]

Long hair is no problem. It will dry during rounds in the morning and be dry in time for the OR. Also, you can tie it back for the OR and post call. I've spent this whole year growing my hair long!

 

[md03]

thanks for anwering my question, folks. I'm finding myself starting to get a little paranoid, I guess. At first, it never occured to me to think that women might be treated differently. When I did my surgery rotation, I was the only female on the team, and I didn't feel like I was treated any differently. Then I started to hear from some other women in my class (who had been on teams with the few female residents) who are going into surgery who said that when they talked to the female surgery residents, they were all miserable and all felt they were subjected to more abuse than their male counterparts. Based on my personal experience on my OB rotation (OB here is very female dominated and most students -including myself -report being treated very poorly by OB residents) I was orignially thinking that I might prefer a program with fewer females.

When I started hearing these things about the female surgery residents from my classmates, I started to get a little concerned. Plus, one of the surgery faculty, after I finished the rotation, expressed to me her concern...she thinks I can't handle a surgery residency physically due to my age (I'm the oldest in the class at a school that is "nontraditional" friendly).

So now I'm thinking that I'm going to have to be very careful about the programs I rank. I'm feeling like many will percieve me as having two strikes against me...female and age. I'm starting to hear things about the program here that anyone who is different won't be treated well. And while I really don't mind the locker room talk much (sometimes it's pretty interesting to see what really goes on in men's minds), I also don't feel that abuse is an effective education tool. I realize that any program will have a few faculty that do feel that way, but now I guess I'm getting overly concerned. Not enough to scare me away from surgery, in fact, I'm now more determined to do it.

So perhaps I've been a little oversenitized to things that seem on the surface as abusve. I'm glad to hear that you guys have had good experiences.

 

[tussy]

•••quote:•••Originally posted by md03:
•thanks for anwering my question, folks. I'm finding myself starting to get a little paranoid, I guess. At first, it never occured to me to think that women might be treated differently. When I did my surgery rotation, I was the only female on the team, and I didn't feel like I was treated any differently. Then I started to hear from some other women in my class (who had been on teams with the few female residents) who are going into surgery who said that when they talked to the female surgery residents, they were all miserable and all felt they were subjected to more abuse than their male counterparts. Based on my personal experience on my OB rotation (OB here is very female dominated and most students -including myself -report being treated very poorly by OB residents) I was orignially thinking that I might prefer a program with fewer females.

When I started hearing these things about the female surgery residents from my classmates, I started to get a little concerned. Plus, one of the surgery faculty, after I finished the rotation, expressed to me her concern...she thinks I can't handle a surgery residency physically due to my age (I'm the oldest in the class at a school that is "nontraditional" friendly).

So now I'm thinking that I'm going to have to be very careful about the programs I rank. I'm feeling like many will percieve me as having two strikes against me...female and age. I'm starting to hear things about the program here that anyone who is different won't be treated well. And while I really don't mind the locker room talk much (sometimes it's pretty interesting to see what really goes on in men's minds), I also don't feel that abuse is an effective education tool. I realize that any program will have a few faculty that do feel that way, but now I guess I'm getting overly concerned. Not enough to scare me away from surgery, in fact, I'm now more determined to do it.

So perhaps I've been a little oversenitized to things that seem on the surface as abusve. I'm glad to hear that you guys have had good experiences.•••••If you really want to do it then do it. Don't let anyone else's experiences shade your decision. If you feel abused as a resident and you decide that it's just not worth it to you then you can always switch out later. You have to give it a try. Goodluck!

 

[Winged Scapula]

•••quote:•••Originally posted by tussy:
•I have a stupid question for you ladies. What do you guys wear for a bra when you're on call at night. I've been struggling with this all year. First, if you wear the bra to bed it's really uncomfortable. But, if you don't wear it and have to get out of bed and run to the floor or the ER you can't go braless under your flimsy OR greens. As anyone found a workable solution for this dilemma??•••••Well, since I am rather...ahem...well endowed, I am more comfortable with a bra on 24/7. It doesn't bother me to sleep in one - but I generally wear a sports bra anyway when on call because of the potential for running (or if its slow, going to the gym).

 

[Winged Scapula]

•••quote:•••Originally posted by Lindsee:
•Along the lines of another stupid question - what about hair? I have long hair that takes forever to dry. Is having a wet mop a big no no? Should I just chop it all off? Any suggestions?•••••During medical school I got up extra early the first day of my surgery rotation to wash and dry my hair...this lasted until I saw that the female residents often arrived with wet hair. This is what I do now...my hair is invariably wet when I arrive for rounds in the am. It dries quite nicely on rounds but if I have to go the OR early my hair is a fright when I take the cap off - so I generally mist it wet again.

I'm sure you'll find something that works for you - most female surgical residents have shorter hair (my is a few inches below the shoulder) but if you can get it all in a cap or two and keep it clean and out of the way, wear whatever suits you.

 

[Winged Scapula]

•••quote:•••Originally posted by md03:
•

So perhaps I've been a little oversenitized to things that seem on the surface as abusve. I'm glad to hear that you guys have had good experiences.•••••I'm closer to 40 than I am 30 and only during 1 interview was I asked about my age. I think I'm able to keep up with the "kiddies" just as well - any lack of stamina is NOT due to my age, but just my general laziness!

There will always be programs in which the different are shunned and treated poorly. I had a wonderful experience during medical school and thus was rather shocked to find that there are academic surgeons who don't seem to like to teach or thrive on humilation or just plain ol' poor social skills to "educate". I'd have to say that the most difficult part of this past year for me has not been the hours but dealing with some of the social inadequacies of my colleagues. You'd think they were raised by wolves.

Like tussy notes, if you really want to go into Surgery you shouldn't let the experience at your medical school deter you. However, things will be tough regardless of where you go and you must REALLY want it. Nearly every surgical resident I came into contact with during medical school begged me to change my mind if there was possibly anything else I could be happy doing. While they might have overreacted I see now that unless you really enjoy it, the lifestyle is difficult to deal with.

 

[njbmd]

•••quote:•••Originally posted by Lindsee:
•Along the lines of another stupid question - what about hair? I have long hair that takes forever to dry. Is having a wet mop a big no no? Should I just chop it all off? Any suggestions?•••••Hi there,
My hair is about three inches below my shoulders and pretty thick. I too, leave the house with it wet. It does not dry fast but I pull it back into a ball with a scrunchie and I wear one of the men's caps (they are cooler) to keep it pretty flat and take care of the wisps around my face.

If your hair is short, you have to do something with it unless you practically shave your head. One of my medical resident chums is Asian (very tiny) and wears a buzz. She looks great but I need my hair for warmth on those cold nights.