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Being aggressive as a surgical resident

Discussion in 'Surgery and Surgical Subspecialties' started by tinar21, Aug 19, 2011.

  1. tinar21

    tinar21 Junior Member

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    I've recently learned that there's a general perception of me not being aggressive, particularly in the OR. While I'm not sure what this implies, I'm wondering if others have had this comment. In addition, I'm female, and unsure how much role that plays. And I'd like to know how to be more aggressive. I'm a categorical first year resident (but did a preliminary year last year). Thanks in advance.
     
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  3. LucidSplash

    LucidSplash Wire Jockey Trainee
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    I'm also a categorical female, newly minted PGY-2. I'm not sure how others handle it but here's my take on "aggressive" in the OR: one of the best pieces of advice I received as a student (from one of the female surgery senior residents) was to be ok with "No." She told me that I did a good job but that to improve my experience as a student on surgery, I should ask to do as much as possible. I did this as a student (in and out of the OR) and I was surprised by how much I was allowed to do (procedures, etc) just because I spoke up and asked to be shown how to do it and give it a shot. I heard "no" a lot too... but no one was upset that I was asking to do things and I'm sure I got to do more simply because I didn't wait for someone to ask me if I wanted to do it.

    I carried this over to residency and, to me, the residency version means I don't just stand quietly scrubbed in - if I'm first assisting and I know the next step or the next instrument needed, I ask for it. I don't just wait for the attending/senior resident to ask for it and then have me hold the clamp or such while he goes about his business. I try to be an active participant and make the case go smoother by anticipating. I have seen other junior residents hesitant about taking an instrument and applying it unless they are directly instructed to do so and I think that can be perceived as being passive and, like it or not, they are more likely to view the behavior as passive if you are a woman.

    Now to be clear, I'm not grabbing instruments out of the hands of others, I'm not being obtrusive, I'm not taking things off the Mayo stand, etc. I'm simply being an active participant in the case instead of allowing myself to be used as just another surgical tool. I think I've been allowed to do more in cases because of this.

    The last piece is that I ask questions - not about the case or the indication or such. But if someone does something a particular way that I haven't seen before or if I am corrected to do something differently, I try to make sure I understand the thought process behind it by asking specific questions. I think as junior residents it can be intimidating and you don't want to come across as "questioning the decisions" of seniors of attendings. But there's a difference between that and asking questions to better understand the "why" of what you are doing.
     
  4. ESU_MD

    ESU_MD Old School
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    Its about time for someone to dig up and repost some comments by the "Misterioso" that dude probably knows how to be aggressive, and the posts were quite entertaining
     
  5. blue2000

    blue2000 Senior Member
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    I think another way to improve on this feedback is don't put the brakes on yourself -- trust your staff to put the breaks on if you are trying something. I'm not telling you to be reckless. When I was training, my internal monologue was often anxiety ridden, and I often held back from trying something or doing something because I was nervous that I would harm the patient. Once I figured out that the staff would keep me out of trouble for the most part, that allowed me to be more bold.

    That being said, if you have staff that routinely get themselves into trouble, I would not follow my advice in those situations.
     
  6. aashiq

    aashiq Junior Member
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    Being aggresive could mean not standing in a corner quitey or assisting passively without being aware of what the operating person wants or not anticipating the next step and retracting accordingly.
     
  7. dpmd

    dpmd Relaxing
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    When I said it to the person I was taking through a lap chole it meant not to try to take down the filmy peritoneal adhesions cell layer by cell layer, a millimeter at a time. Being nervous about what you are doing while operating is not necessarily a bad thing, but at some point you need to step up and move the case along. Same thing goes for patient care. It is great to use the guidance of your seniors, but if you are asking every time you want to give tylenol or something "just to be sure they are ok with it" that is going to look bad.

    The trick is figuring out what things are ok for you to be bold on and what you should still ask about first. This will be unfortunately different for different seniors.
     
  8. 45408

    45408 aw buddy
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    Love it.
     
  9. Winged Scapula

    Winged Scapula Cougariffic!
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    The best attendings were the ones that felt confident that they could get you out of any disaster you created as a resident. I was always more assertive with them and consequently, did more and learned more.

    LOL...good point. Keep your name off the charts in those cases.
     

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