Do I need to smile now?

[Perrotfish]

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So, I think one of the few consolations of Intern year is that no one expects you to be happy. In fact, I feel like comedic misanthropy is almost a job requirement. When I ask any Intern how they're doing they either say something depressed with a groan (another night of oozing ostomys...) or something obscenely cheerful with deadpan overexagerated sarcasm ('nothing but rainbows and handjobs'). Affected misery seems to be to Intern year what baggy pants were to middle school: you know you kind of look like an *******, but you don't want to single yourself out by not playing along.

So my question: as Intern year draws to a close, is it optional to carry my sad clown routine into the rest of residency, or do I need to go back to the third year of medical school fake smile thing? I'm pretty clear that misery is no longer expected from senior residents, since a lot of them seem to be brimming with positivity and professionalism, but can I keep up this routine instead? I feel like I'm going to be more comfortable with the wailing/gnashing/rending role until I get through this entire residency ordeal. Of course, I will plaster on a smile if necessary.

 

[rachmoninov3]

Being able to plaster on a smile is a quality you will need for the rest of your life. Depending on your residency, being an upper level is MUCH better than being an intern, so your smile won't seem as fake. Sure, the hospital still controls much of your life, but it still beats intern year. You have some experience to go with your knowledge, the nurses know this and respect it, and your hours get better. Of course, after July, you get to supervise the new interns and deal with their attitudes.
Just remember: residency is a temporary condition.

 

[survivordo]

Just be happy, makes everything much more pleasant for yourself and those around you.

Survivor DO

 

[peppy]

I think people will appreciate it if you try to act pleasant to them, but you don't have to go overboard with the cheerful thing. I've seen a lot of med students come through my service, and sometimes it is so obvious that they're being fake with their cheerfulness/enthusiasm that, well, I kind of want to smack them or something. Come on, man. We both know you're not THAT thrilled to be here.

The light at the end of the tunnel is getting closer. You've made it through a year. You should be happy about that at least. Though residency is often some combination of tedious and stressful, there are still worse jobs out there.

 

[Neuronix]

In medicine the rules are:

Professionalism = passive-aggressive
Effort = financial motivation

You're there to generate revenue. Failing that, you're there at the mercy of your superiors who probably took a lower paying job in academics in large part to have you to decrease their workload and make their day better.

If you don't make their day better, you get bad evals, and you don't win the game--whichever game you're playing (prestige, money, saving the world). It just makes good sense to feign enthusiasm and move on.

If you don't like that, there's always becoming the attending and making others below you miserable. I don't recommend it, but it's the way of the world.

 

[Top Gun]

We all know intern year blows. But I promise you it gets better as an upper-level. And maybe some days you'll actually be able to (gasp) smile without faking it. It won't be rainbows and unicorns, but it will be better as you go. You know more, your attendings will trust you with more responsibility, you won't have to deal with all the stupid little pages from the nurses, you'll get to do some nice electives, and you'll have less scutwork dumped on you. Once you get through intern year, you begin to see the light at the end of the tunnel.

 

[Instatewaiter]

So, I think one of the few consolations of Intern year is that no one expects you to be happy. In fact, I feel like comedic misanthropy is almost a job requirement. When I ask any Intern how they're doing they either say something depressed with a groan (another night of oozing ostomys...) or something obscenely cheerful with deadpan overexagerated sarcasm ('nothing but rainbows and handjobs'). Affected misery seems to be to Intern year what baggy pants were to middle school: you know you kind of look like an *******, but you don't want to single yourself out by not playing along.

So my question: as Intern year draws to a close, is it optional to carry my sad clown routine into the rest of residency, or do I need to go back to the third year of medical school fake smile thing? I'm pretty clear that misery is no longer expected from senior residents, since a lot of them seem to be brimming with positivity and professionalism, but can I keep up this routine instead? I feel like I'm going to be more comfortable with the wailing/gnashing/rending role until I get through this entire residency ordeal. Of course, I will plaster on a smile if necessary.

The reason your seniors are smiling is because it gets better. The ****ty jobs are left for the intern. You get more time to think about patients, more time to do stuff for patients and more time to doctor as a junior/senior resident.

We have an addage at my hospital- Intern year you bleed, JAR year you read, SAR year you lead. It gets better but you have to get over the bleed part first.

 

[Arcan57]

The "everything sucks" act is reasonably adaptive in intern year (it may help avoid excess work depending on the conscience of your superiors), but is maladaptive at the senior/attending level. Friendly attendings get consulted more than their sullen peers.

 

[Neuronix]

Friendly attendings get consulted more than their sullen peers.

You're assuming that the academic attendings want to be consulted . I was reminded more than once as a medical student on specialty services not to be so friendly as to invite more consults.

In private practice it's a whole different ball of wax. In competitive markets, it's unbelievable, unethical, and often illegal. Still, being a big schmoozer will help tremendously.

 

[45408]

I worked just as many hours as a PGY-2 as a PGY-1, and I had more days on call and fewer days off. The equal hours stemmed from the 30 hour restriction dropping to 28 hours. Being on call more was because the interns could no longer take call. I agree that everyone trusts you more (including yourself), and you're given more room to roam. In surgery, that means you get more operative privileges too.

Do you need to smile? Sometimes. I'm not a big proponent of faking a good attitude, but nobody likes a mope. I try to be friendly and smile when I'm meeting a patient, especially since their day is almost certainly worse than yours. I've got fellow residents who don't really smile much at work, but they're intelligent and work their asses off, so nobody really cares.