Ask a neurosurgery resident anything

[neusu]

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Thanks again for this thread! Would you recommend doing a neurosurgery elective at a highly competitive/well-known program or at a less competitive/well-known program? I'm assuming the less competitive/well-known program would give me the best opportunity to match into Neurosurgery.

Depending on your home program, I generally tell people to do two away rotations. Pick one place where many students rotate so you can have somewhat of a direct comparison and pick another place where you think you'd really like to go.

 

[scene]

Have you ever left an instrument inside of somebody's head/body? If so, how high was your malpractice premiums after they found out?

 

[AlteredScale]

What do you learn as an intern and PGY-1?

What year of residency would you say was the toughest and why?

What is your favorite type of case to come across?

Do you get along with the neurologist?

 

[neusu]

What are some of the sacrifices, besides for sleep and stress, that you've had to undertake for your neurosurgery residency?

Sleep and stress are the most common and ever present sacrifices. I've had to miss weddings/graduations/baby showers, scale back on my hobbies, read more for work than for pleasure (though I often do enjoy reading for work), and give up any semblance of a normal 9-5 M-F kind of life.

Life is a series of compromises, for residency often work takes priority over most other things.

 

[Guero]

What are some of the sacrifices, besides for sleep and stress, that you've had to undertake for your neurosurgery residency?

Goodness gracious, what was with the insta-ban?

 

[neusu]

Have you ever left an instrument inside of somebody's head/body? If so, how high was your malpractice premiums after they found out?

I have never been involved in a case with a retained foreign body. In any scenario where things go less then optimal, being upfront and honest with the patient never hurts. Depending on how things go it may not have any influence on malpractice premiums.

 

[tiedyeddog]

This is kind of personal, but any help would be appreciated!

I have the chance to start third year with a neurosurgery elective. I won't have had my surgery rotation yet so i am worried about making a good impression. I can also do another elective In Neurosurgery later on, after my core surgery rotation.

Would it be a terrible idea to do a neurosurgery elective without any other rotation under my belt? Should I do something else first?

 

[neusu]

Thanks so much, great reply. I'm trying decide between the two specialities so thank you for your response!

They're both pretty great, have some great surgeries, and very interesting anatomy. From what I gather from my ENT friends, it lends itself to being a lifestyle specialty more readily than neurosurgery if that's a consideration for your decision.

 

[armpitsOFmight]

Hey Neurosurgeon,

Do you work with any bone doctors?

 

[neusu]

What do you learn as an intern and PGY-1?

What year of residency would you say was the toughest and why?

What is your favorite type of case to come across?

Do you get along with the neurologist?

As a PGY-1/intern, learning how to work in a hospital as a doctor is the primary objective. In essence, how to use the ordering/documentation systems (paper or EMR), how to evaluate patients, where to go for supplies/studies, and how to know who is sick and who is not.

Each year of residency is tough, but from what I gather regarding neurosurgery, in particular, the two toughest are the PGY-2 (NS-1) year and PGY-7 (Neurosurgery Chief) year. In each, you work a lot and have a new role with a lot of responsibility.

My favorite cases are vascular or brain tumors. Vascular is exciting and challenging technically and anatomically.

We get along very well with our neurology colleagues.

 

[neusu]

This is kind of personal, but any help would be appreciated!

I have the chance to start third year with a neurosurgery elective. I won't have had my surgery rotation yet so i am worried about making a good impression. I can also do another elective In Neurosurgery later on, after my core surgery rotation.

Would it be a terrible idea to do a neurosurgery elective without any other rotation under my belt? Should I do something else first?

I'd take the later elective so you have a better feel of how the hospital works and can shine. If you haven't already, try to get involved with the department early. See if there are any projects you can work on or case reports you can write up.

 

[AlteredScale]

How has technology helped with surgeries? Any new, exciting procedures that are in the forefront of neurosurgery in terms of being "futuristic"?

How was your very first neurosurgical experience? And did that experience play a key role in your pursuing neurosurgery?

 

[neusu]

Hey Neurosurgeon,

Do you work with any bone doctors?

Hi there. Not sure what you mean by bone doctors. We do spine and cranial surgery, which are both bones. We also work closely with orthopedics on trauma patients with polytrauma involving bones outside the cns or the spine when we are not covering for spine. Hope this helps.

 

[Vinay01]

1. When you are operating, do you lean your wrists on something to stablize movements made with instruments within the brain/spine or are you constantly fighting against gravity during the procedures

2. Do you listen to music in the OR

3. When was the last time you went to the movies

4. where is waldo

5. do you speak any languages outside of English

6. how fast can you repeat the alphabet backwards

7. are you religious

8. how often do you sleep in the hospital

9. what do you think of ben carson

10. how do you position your hands on a steering wheel

11. have you ever used adderall while performing surgery/is it allowed

12. what is the longest you've stayed up as a result of residential work

13. were you a gunner in medical school

14. what has been the most discouraging event that has happened to you on the road to becoming a neurosurgeon

15. what was your gpa in college

16. do you ever feel inadequate

17. do you know any neurosurgeons that never take any days off

18. what is your favorite porno site

 

[neusu]

How has technology helped with surgeries? Any new, exciting procedures that are in the forefront of neurosurgery in terms of being "futuristic"?

How was your very first neurosurgical experience? And did that experience play a key role in your pursuing neurosurgery?

Technology has helped in neurosurgery immensely both in and out of the operating room. In the OR we have progressed from hand powered drills and the Gigli saw to pneumatic/electric drills and craniotomes. Neurosurgery is constantly evolving using microscopes, endoscopes, ports, minimally invasive approaches, and novel new instrumentation as well as becoming early adapters and developers of new technologies such as endovascular neurosurgery.

My first experience was shadowing a neurosurgeon during undergraduate. I can't say it really played a key role in my pursuing neurosurgery, but I think it helped cement the difference between neuroscience and neurosurgery. While I love neuroscience, and understanding how the brain works, being able to use that knowledge in a meaningful way and augment abnormal function or pathology, directly, is what most interested me.

 

[neusu]

1. When you are operating, do you lean your wrists on something to stablize movements made with instruments within the brain/spine or are you constantly fighting against gravity during the procedures

Resting really depends on the procedure and which instrument. For finer cranial procedures or over the spinal cord, typically more caution is taken by resting the wrist on the field or using two hands with an instrument. Fighting gravity seems to be more of an issue with the neck when wearing a headlight or the back when wearing lead.

2. Do you listen to music in the OR

Music in the OR tends to be attending dependent if they allow it, pick, or let the resident pick. If it's my choice, I'll put on whatever I'm in the mood for (which is highly variable) and that the OR staff will tolerate.

3. When was the last time you went to the movies

I had to think about this one, probably the Dark Night Rises. Generally, I prefer to stay in and watch a movie instead of go out to the theater.

4. where is waldo

This really depends on the picture you're asking about.

5. do you speak any languages outside of English

Aside from English I can get by in Spanish, French, Italian, and German.

6. how fast can you repeat the alphabet backwards

I can't say I have ever tried this, likely not very fast.

7. are you religious

No

8. how often do you sleep in the hospital

Hardly ever! Most call nights it was busy enough I did not get any sleep and if I am not on I go home.

9. what do you think of ben carson

While I haven't operated with him, I have met him on a couple of different occasions and he seems nice enough.

10. how do you position your hands on a steering wheel

Ten and two, unless I'm shifting and then it's 10 and the transmission.

11. have you ever used adderall while performing surgery/is it allowed

I have never used adderall. I suspect if you have a prescription for it, it would be allowed to operate using adderall

12. what is the longest you've stayed up as a result of residential work

40 hours

13. were you a gunner in medical school

Gunner is a bit of an overused term. I didn't brag or try to sabotage people, but I did well and people in my class seemed to understand this despite our class not posting grades or being ranked. We had a pretty collegial group and stuck together so I don't really think anyone was a gunner

14. what has been the most discouraging event that has happened to you on the road to becoming a neurosurgeon

The most personally discouraging events were probably incidental things people I respect or admire said when I was already down about something. As I'm sure most surgery residents (or medical students who have rotated on surgery) can relate, certain more abrasive or malignant attendings have a knack for saying harmful things at the right time. If your confidence is already shaken, having another nuclear bomb dropped on you can have a lasting adverse effect.

15. what was your gpa in college

3.9

16. do you ever feel inadequate

Ever so often. When I was a junior resident this feeling came more often, and I tell my junior residents often "fake it until you make it." No one can really externally tell you feel inadequate, unless you tell them. Portraying confidence will often convey to others you know what you're doing and allow you to build confidence. That being said, never be afraid to ask for help, when appropriate, and know how when needed.

17. do you know any neurosurgeons that never take any days off

What do you qualify as a day off? Every neurosurgeon I know has days they don't come in to the hospital/clinic. Many/most I know rarely have a day where they aren't involved in some capacity with neurosurgery, be it studying for a case/boards, reading journal articles, or working on a research project.

18. what is your favorite porno site

Interesting question. Honestly not even sure what's out there at the moment. Perhaps you have some suggestions?

 

[Guero]

. . . Interesting question. Honestly not even sure what's out there at the moment. Perhaps you have some suggestions?

redtube(dot com) and xhamster(dot com) come to mind 😏 you can find normal and not so normal stuff on either. 😏

Great, honest answers!

 

[tiedyeddog]

I'd take the later elective so you have a better feel of how the hospital works and can shine. If you haven't already, try to get involved with the department early. See if there are any projects you can work on or case reports you can write up.

I am going to take the later elective, thanks for the advice!

Another question: can I cold email residents and see if I can follow them around or would that be annoying?

 

[Vinay01]

wow you actually answered my silly questions. I shall relish in this moment

 

[AlteredScale]

How do you feel about hospital food?

What is your favorite food?

Have you tried In-n-Out? (used to work there haha)

Have you splurged on anything? New car? New house? Drills for the operating room? New specs?

 

[wholeheartedly]

What is your most frustrating moment in the last week (medical or not)?

 

[neusu]

I am going to take the later elective, thanks for the advice!

Another question: can I cold email residents and see if I can follow them around or would that be annoying?

This really depends on the resident. Many are open to the thought and more than willing to help facilitate shadowing opportunities. If you are already a medical student, it should be easier. For undergraduates, working with the residency coordinator is more important as having confidentiality paperwork filed with the hospital is typically required.

 

[imnamerican]

The most personally discouraging events were probably incidental things people I respect or admire said when I was already down about something. As I'm sure most surgery residents (or medical students who have rotated on surgery) can relate, certain more abrasive or malignant attendings have a knack for saying harmful things at the right time. If your confidence is already shaken, having another nuclear bomb dropped on you can have a lasting adverse effect.

In the long run, do you feel like abrasive behavior from attendings at this stage in your training makes for stronger residents and future clinicians? Or is this just a relic of old-school medical training that will die out as new generations of doctors come into their own?

 

[neusu]

How do you feel about hospital food?
We get it for free so I like that. The options tend to be rather limited.

What is your favorite food?

I like barbecue, but a good steak is hard to beat.

Have you tried In-n-Out? (used to work there haha)

I have tried In-n-Out, it is pretty good. I also formerly worked in fast food.

Have you splurged on anything? New car? New house? Drills for the operating room? New specs?

No, I haven't really splurged on anything. I don't particularly feel the need to just buy something for the sake of buying it, and the belongings I currently have are holding up well thus far.

 

[JuliusSeizure]

Love reading this whole thread cover to cover so far. Nice information. I'm starting MS-1 this fall and will keep your info and tips in mind 😉.

I've always known I've wanted to do surgery. Will have to see in the coming years where I fit best!

 

[AlteredScale]

Can you describe your typical day?

What's the most bizarre case that you've come across so far?

Have you had to deal with relaying a death to a patients family post-op? If so, how did affect you personally and how did you cope?

PS. Tried contacting some academic neurosurgeons (attending surgeons) for shadow purposes and still no replies. Rats haha.

PSS. Sorry for all the questions

 

[neusu]

What is your most frustrating moment in the last week (medical or not)?

This last week has been pretty stress free, I can't say anything was significantly more frustrating than the norm and I can't think of the trivial event that would qualify as the most frustrating. Perhaps ask again another week!

 

[smiley27]

I'm sure it varies widely from program to program but can you comment on your program's operative autonomy? How early on in your residency did you start doing major operating? How early on were you single-scrubbed in on a case? Do you feel that the nature of neurosurgery that you have more operative autonomy and earlier on than other surgical residencies? Basically, how early on did you start feel like a big swinging dick?

Thanks. Great thread.

 

[neusu]

In the long run, do you feel like abrasive behavior from attendings at this stage in your training makes for stronger residents and future clinicians? Or is this just a relic of old-school medical training that will die out as new generations of doctors come into their own?

I am more of the opinion that it is not helpful. I certainly learn better when I am not constantly in fear. It will likely die down, but not out. No one is arguing that surgery is not hard, but there is no need to be malignant about it on top of an already difficult time.

 

[neusu]

Can you describe your typical day?

Rounds at 6, meet in the neuro ICU and see our patients. Break off and see any patients who need extra attention (exam changes, concerning findings, etc.) Breakfast and imaging rounds with the chief, run the list, make plans, view images from new admits/consults overnight. To the OR at 730 or 8. Depending on the day/case do anywhere from 2 to 6 cases. Between cases, grab a drink or a bite to eat. Check on my post-ops. Check-in with the floor/unit junior resident. Done in the OR between 5 and 9. Check in with the on call resident, see if he needs any help before I head out. Go home, eat dinner/read/relax. Repeat

What's the most bizarre case that you've come across so far?

There are so many. Generally an aggressive tumor or infection can be bizarre with the amount of invasiveness and resilience of the pathology. Trauma can also be bizarre, having to remove foreign bodies from the brain.

Have you had to deal with relaying a death to a patients family post-op? If so, how did affect you personally and how did you cope?

In neurosurgery having the talk is not uncommon. There is only so much we can do with medicine and surgery, and if the patient is past that limit we are out of options. It is hardest when an elective or straightfoward case doesn't go well, and this is rather rare.

PS. Tried contacting some academic neurosurgeons (attending surgeons) for shadow purposes and still no replies. Rats haha.

Keep at it and give it time. I am sure they are busy and may just be late in responding.

PSS. Sorry for all the questions

No problem, that's what I'm here for.

 

[AlteredScale]

Rounds at 6, meet in the neuro ICU and see our patients. Break off and see any patients who need extra attention (exam changes, concerning findings, etc.) Breakfast and imaging rounds with the chief, run the list, make plans, view images from new admits/consults overnight. To the OR at 730 or 8. Depending on the day/case do anywhere from 2 to 6 cases. Between cases, grab a drink or a bite to eat. Check on my post-ops. Check-in with the floor/unit junior resident. Done in the OR between 5 and 9. Check in with the on call resident, see if he needs any help before I head out. Go home, eat dinner/read/relax. Repeat
.

Thank you for the response.

Wow, well I can certainly say that my only day that is 2% that crazy is Sunday: 4am-1230pm shift at Sbux, Eat/shower/study before my 330-730 volunteer and then study back at my work till closing. That is absolutely amazing, especially that "repeat" part.

How much coffee do you drink?

 

[neusu]

I'm sure it varies widely from program to program but can you comment on your program's operative autonomy? How early on in your residency did you start doing major operating? How early on were you single-scrubbed in on a case? Do you feel that the nature of neurosurgery that you have more operative autonomy and earlier on than other surgical residencies? Basically, how early on did you start feel like a big swinging dick?

Thanks. Great thread.

My program has a graded operative autonomy based on resident skill, case difficulty, and attending preference. I mostly began operating when I was a PGY-2 and would single scrub on appropriate cases for that level (shunts, acdf, lumbar lami/disc/fusion, sdh/edh, simple tumors) and double scrub more senior level cases when possible (complex/skull base tumors, aneurysms/avms). As the year progressed attendings who I worked with and were comfortable would give me more responsibility from initially positioning/opening/closing at the beginning to the critical portion of the case by the end of the year. Neurosurgery does seem to allow for more operative autonomy than other residencies, but a lot of the skill sets are built off of smaller cases. For example, learning to do a burr hole in a shunt or turn a bone flap on a subdural gives the resident the experience of opening a cranial case that is necessary for more complex cases. Similarly, becoming familiar with the instruments, and how and when they are used reinforces the techniques required for more difficult pathologies.

For what it's worth, it is fairly easy to get cocksure early on, especially with the amount of latitude granted to the neurosurgery junior resident. That being said, neurosurgery is a particularly humbling field when it comes to complications. Doing the right thing for the patient and checking your ego at the door keeps this to a minimum.

 

[neusu]

Thank you for the response.

Wow, well I can certainly say that my only day that is 2% that crazy is Sunday: 4am-1230pm shift at Sbux, Eat/shower/study before my 330-730 volunteer and then study back at my work till closing. That is absolutely amazing, especially that "repeat" part.

How much coffee do you drink?

Sounds pretty intense. I'll usually have a cup in the morning. Sometimes when I was on overnight I'd have a cup around 2am. You get used to being awake all of the time after a while.

 

[tiedyeddog]

What has been the one or two toughest things on your journey to where you are now? Anything that stands out over the years?

Getting into medical school? Step 1? Applying to residencies? Being a new intern?

 

[AlteredScale]

Sounds pretty intense. I'll usually have a cup in the morning. Sometimes when I was on overnight I'd have a cup around 2am. You get used to being awake all of the time after a while.

\


To the most minuscule scale ever you're saving lives and healing. I'm steaming milk and making people fatter.

Thank you for all the info and insight doctor. I will be sure to take your advice and wisdom to heart!

 

[neusu]

What has been the one or two toughest things on your journey to where you are now? Anything that stands out over the years?

Getting into medical school? Step 1? Applying to residencies? Being a new intern?

Every step of the way there are significant challenges. Looking back at the threads in the pre-allo or allopathic forums it sometimes makes me smile. Certainly, every challenge creates a sense of anxiety and desire for reassurance that everything will be all-right. I was as neurotic a pre-med as everyone else.

When I was an undergrad, I stressed about grades and the MCAT, worked late in the lab to get data for a pending deadline or my thesis. I worried there wasn't enough time in the day to get it all done. After I got my MCAT score and applied I worried about getting interview invites and scheduling interviews. Then I worried the school(s) I loved wouldn't reciprocate.

In medical school I worried I wouldn't be able to keep up. There was so much material coming from every direction so fast and everyone around me was so smart. I took on another research project and fell in love with neurosurgery. The USMLE Step 1 was scary, one shot at one test to determine your future. I'd never studied for one single test for 6-straight days let alone 6-straight weeks. Rotations were a whole different world. New terms, a whole culture that you don't get exposed to regardless of how much shadowing you do. I worried I couldn't keep patients straight, didn't have the right information, would not perform well in the OR or on the wards. They call SubI's "audition rotations," what if it went poorly? I applied for residency and worried about getting interviews, then getting them scheduling so I didn't miss any, and trying to afford them all. After submitting rank-lists the waiting game was horrible. Did I rank them in the right order? What if I don't match? What if I hate where I match? Maybe I shouldn't have ranked x or y program. I have to fit Step 2 in here somewhere.

Medical school is over in a flash and residency begins. Orientation is a blur. Suddenly you're a doctor, on the wards or in the ICU, actually in charge of things. Patients get better or worse because of decisions you make. You're in the OR and actually doing surgery. You cut someone open, sew them back up. Being on call, alone at night, when the proverbial **** hits the fan is scary. Patients have tubes coming out of their mouth, nose, chest, urethra, rectum, and/or brain. I'm not a cardiac surgeon, I'm just covering their patients, how do I know the postop CABG needs his chest re-opened at the bedside? It's 3:30 AM, my postop GSW head from earlier is now in multisystem organ failure, DIC, and bleeding from every IV site/ears/nose/mouth/bladder/rectum/EVD and the chief's words of wisdom were "keep him alive tonight."

As we move through life, our perspective changes, and what once was an insurmountable hurdle becomes in retrospect another bump in the road.

 

[Lucidity]

Every step of the way there are significant challenges. Looking back at the threads in the pre-allo or allopathic forums it sometimes makes me smile. Certainly, every challenge creates a sense of anxiety and desire for reassurance that everything will be all-right. I was as neurotic a pre-med as everyone else.

When I was an undergrad, I stressed about grades and the MCAT, worked late in the lab to get data for a pending deadline or my thesis. I worried there wasn't enough time in the day to get it all done. After I got my MCAT score and applied I worried about getting interview invites and scheduling interviews. Then I worried the school(s) I loved wouldn't reciprocate.

In medical school I worried I wouldn't be able to keep up. There was so much material coming from every direction so fast and everyone around me was so smart. I took on another research project and fell in love with neurosurgery. The USMLE Step 1 was scary, one shot at one test to determine your future. I'd never studied for one single test for 6-straight days let alone 6-straight weeks. Rotations were a whole different world. New terms, a whole culture that you don't get exposed to regardless of how much shadowing you do. I worried I couldn't keep patients straight, didn't have the right information, would not perform well in the OR or on the wards. They call SubI's "audition rotations," what if it went poorly? I applied for residency and worried about getting interviews, then getting them scheduling so I didn't miss any, and trying to afford them all. After submitting rank-lists the waiting game was horrible. Did I rank them in the right order? What if I don't match? What if I hate where I match? Maybe I shouldn't have ranked x or y program. I have to fit Step 2 in here somewhere.

Medical school is over in a flash and residency begins. Orientation is a blur. Suddenly you're a doctor, on the wards or in the ICU, actually in charge of things. Patients get better or worse because of decisions you make. You're in the OR and actually doing surgery. You cut someone open, sew them back up. Being on call, alone at night, when the proverbial **** hits the fan is scary. Patients have tubes coming out of their mouth, nose, chest, urethra, rectum, and/or brain. I'm not a cardiac surgeon, I'm just covering their patients, how do I know the postop CABG needs his chest re-opened at the bedside? It's 3:30 AM, my postop GSW head from earlier is now in multisystem organ failure, DIC, and bleeding from every IV site/ears/nose/mouth/bladder/rectum/EVD and the chief's words of wisdom were "keep him alive tonight."

As we move through life, our perspective changes, and what once was an insurmountable hurdle becomes in retrospect another bump in the road.

Great post Neusu...seriously.

 

[daymann]

Can you give a general depiction of the personalities of the orthopedic surgeons you've met?

Also, I'm curious to know your MBTI personality type.

 

[neusu]

Can you give a general depiction of the personalities of the orthopedic surgeons you've met?

Also, I'm curious to know your MBTI personality type.

Quite an interesting question. To be honest, most of the orthopaedic surgeons I have met, who are in practice (spine surgeons aside) are toolboxes. Most of the orthopaedic surgery residents I have met are great guys, hard working, smart, willing to do whatever is necessary to help, and all-around great people.

My Meyers-Briggs Personality Type (MBTI) is ENTJ - extraversion, intuition, thinking, judgment. I personally do not place a lot of stock in Meyers-Briggs, but it seems to fit in this case.

 

[Catman21]

Did you know your Meyers-Briggs Personality Type off the top of your head?? is my question

 

[neusu]

Did you know your Meyers-Briggs Personality Type off the top of your head?? is my question

Haha, yeah. I did know my Meyers-Briggs Personality Type off the top of my head. We covered it in the first year of medical school during neuro or psych or something.

 

[daymann]

Quite an interesting question. To be honest, most of the orthopaedic surgeons I have met, who are in practice (spine surgeons aside) are toolboxes. Most of the orthopaedic surgery residents I have met are great guys, hard working, smart, willing to do whatever is necessary to help, and all-around great people.

My Meyers-Briggs Personality Type (MBTI) is ENTJ - extraversion, intuition, thinking, judgment. I personally do not place a lot of stock in Meyers-Briggs, but it seems to fit in this case.

Thanks for the answers =)
Yeah MBTI isn't all that.. Getting a general feel for different personalities that go into different specialties is just intriguing to me haha

 

[neusu]

Thanks for the answers =)
Yeah MBTI isn't all that.. Getting a general feel for different personalities that go into different specialties is just intriguing to me haha

Neurosurgery has a lot of people with a similar personality type. Personally, I felt I fit in well, but I suppose it's not for everyone.

 

[MD or PhD]

Undergrad instituion?

Major?

additional degrees?

 

[deleted393595]

Undergrad instituion?

Major?

additional degrees?

Still hard to see. Can you please use a bigger font size?

 

[Status Sciaticus]

Have you ever said "its a beautiful day to save lives" before performing a surgery?

 

[The Buff OP]

Have you ever said "its a beautiful day to save lives" before performing a surgery?

+1

 

[The Buff OP]

What is your opinion on medical students that are graduating in their late 20s or early 30s (31-33) and want to go into neurosurgery? Is it worth being close to your 40s at the end?

 

[DrEnderW]

What is your opinion on medical students that are graduating in their late 20s or early 30s (31-33) and want to go into neurosurgery? Is it worth being close to your 40s at the end?

Interested in this as well. Will be graduating med school at 30.

 

[jram2323]

how is dating life in med school vs residency?

Do you feel that your residency choice has impacted your dating life? (in a positive or negative way)