Surgery has a reputation (largely deserved) of being a miserable residency with abusive people. But there is a huge upside, and that's operating.
While I would agree with the assessment that operating is the major upside of surgery, I think that the OR is when the abuse starts to come out. I had one resident who was really nice and kind in the holding area ....
turned into an ogre in the OR (he was so bad that one of his co-residents warned me later to never scrub in with this guy - too bad the warning came 2 days too late!) ....
and then turned back into a really nice guy in the PACU.
It was kind of a weird experience.
I found that a lot of residents, and some attendings, are super-fun to be around during rounds and on the floors - but they become really tense and borderline abusive in the OR.
Exposing MS3s to it early gives us the chance to attract high-quality students to the field.
I'm sure that it differs by program - but this is not what the gen surg and ENT residents made it seem like to me. Their reasoning was that you should not immediately allow ALL students to jump right in to the OR. Then, if you have high-quality, enthusiastic students who are genuinely interested in surgery, they will actually try harder, in order to "earn" the chance to do more interesting stuff in the OR - i.e, suturing, making the incision, scoping patients, etc. Those who are not actually interested, or are too lazy to make the effort, will not try and earn the right of doing more procedures, so they'll fall by the wayside.
It's probably personal preference on the resident's part, as to which approach works better.
It also gives the staff and residents the chance to pimp out the students, feeling out their knowledge base and work ethic.
True - but I think that the real demonstration of work ethic and knowledge base came during rounds, and particularly in your SOAP notes. A person who will willingly scrub in on every case in the OR, but only sees 1-2 patients (and refuses to see SICU patients) is probably not as hard a worker as someone who also scrubs in on every case in the OR, but sees 1/3 of the patients on the service before the intern comes in.
I would still maintain, however, that the ideal is to get MS3s into the operating room regularly.
I certainly believe that we should prioritize MS3s in OR cases over interns, especially if neither would be able to first-assist anyway.
Well, if this is truly how you feel, then all I can say is that the MS3s who will be working with you in the future are certainly extremely lucky!
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hahaha...i don't know if our class was just biased against surgery, but when I was an MS3, we had to draw straws as to who would 2nd assist. Ugh. It fascinates me who would enjoy retracting and suctioning....for a 9-hour Whipple or a 13-hour limb salvage! Hahaha...but then again, Im not going into surgery...teeheehee
Yeah, I think it depends on which students you happen to be thrown with. I got thrown in with a bunch of guys who kept talking about how "stoked" they were to go into the OR and do "stuff" - but were totally ill-equipped to handle the personalities in surgery, and couldn't stand the early AM pre-rounding.
I loved Whipples!
😍 Minimal retraction (yay Bookwalter!), some suction, a lot of suturing, and a lot of teaching about anatomy, vasculature, endocrine and GI pathophysiology, and learning about SICU care of very sick onc patients.
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