Do Surgeons look down on medicine folks?

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NYCdude

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To preface this possibly inflammatory thread, I want to say that I had a blast on my surgery rotation and all my residents and most of my attendings were very friendly and personable people.

That being said, as a guy applying to medicine, I couldn't have helped feeling a little deflated whenever one of the surgery attendings would rag on medicine for calling x, y, and z consults or even one time when while rounding with one of the attendings, he literally laughed at one of the hospitalists for telling him what he thought of the patient that they were mutually following because he thought that the comment wasn't worth his time in terms of stopping him in the hallway and talking to him lol. The hospitalist looked like he was so embarrassed and I was like wow, this was literally another attending who was made to feel like a noob, yikes.

To be quite honest, surgery seems like it's probably a lot harder than medicine and subsequently a lot more fulfilling, so I can see why people in surgery would feel superior, but I'm wondering if they actually do lol.

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this thread reminded me of this meme.
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As a neurology resident...definitely agree, although I've never been able to pull-off the bow tie look!
Im kinda torn on the bow tie myself. On the other hand ties are a mobile petri dish. on the other hand I dont want to be the only guy wearing a bow tie.
 
To preface this possibly inflammatory thread, I want to say that I had a blast on my surgery rotation and all my residents and most of my attendings were very friendly and personable people.

That being said, as a guy applying to medicine, I couldn't have helped feeling a little deflated whenever one of the surgery attendings would rag on medicine for calling x, y, and z consults or even one time when while rounding with one of the attendings, he literally laughed at one of the hospitalists for telling him what he thought of the patient that they were mutually following because he thought that the comment wasn't worth his time in terms of stopping him in the hallway and talking to him lol. The hospitalist looked like he was so embarrassed and I was like wow, this was literally another attending who was made to feel like a noob, yikes.

To be quite honest, surgery seems like it's probably a lot harder than medicine and subsequently a lot more fulfilling, so I can see why people in surgery would feel superior, but I'm wondering if they actually do lol.

Don’t worry; at least you’re not going into emergency. Everybody hates us! I see the light leave physician’s eyes when they find out I’ve matched (or previously, planned on matching) EM, and much of the rest of my rotation is taken up by me being told of the ways not to suck as an emergency physician. LOL

But seriously, @Cyphix is right. Every specialty looks down on every other specialty, and specialists (and even moreso their residents) go through much pearl clutching when a physician not in their specialty’s area of expertise consults them for something that’s obviously (to them) trivial or not a “real” consult. Hospitals are like big high schools where people occasionally get healthier or pass beyond the veil.
 
Depends on your clinical setting. Residents and fellows generally get really annoyed with consults. The truth is that those simple consults don't take long. I have respect for surgeons, and one of the general surgeons where I did residency said that a general surgeon is an internist who completed his training.

Most of the surgeons at my institutions aren't good at really basic medicine, so, yes, I'll be happy to see the patient or be primary.
 
I know a family doc who believes FM and IM are the holy grail of medicine. As a preceptor, he looked down on us med students pursuing surgical fields and I heard the comment get around "they couldn't hack it in family anyway". Yeah. A FM doc said that.

Point being you'll find jerks in every field. Surgery is a tough residency and surgical fields more difficult to match into and complete, probably thereby producing saltier docs. Or you can go the other way and turn your inferiority complex in medicine into the same distain for other fields.
 
I hate the word folks. I hate it when Obama said it, and I voted for him.
 
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To preface this possibly inflammatory thread, I want to say that I had a blast on my surgery rotation and all my residents and most of my attendings were very friendly and personable people.

That being said, as a guy applying to medicine, I couldn't have helped feeling a little deflated whenever one of the surgery attendings would rag on medicine for calling x, y, and z consults or even one time when while rounding with one of the attendings, he literally laughed at one of the hospitalists for telling him what he thought of the patient that they were mutually following because he thought that the comment wasn't worth his time in terms of stopping him in the hallway and talking to him lol. The hospitalist looked like he was so embarrassed and I was like wow, this was literally another attending who was made to feel like a noob, yikes.

To be quite honest, surgery seems like it's probably a lot harder than medicine and subsequently a lot more fulfilling, so I can see why people in surgery would feel superior, but I'm wondering if they actually do lol.

The culture is a bit different at the university hospital. But I'm a critical care internist working at a large community hospital with all the surgical services available. I think for the most part we all get a long fine. We will all trade "stupid" consults but you ask someone's opinion when you're not sure and want a more expert opinion. And I give zero ****s if a surgeon thinks it's stupid. My question is always pretty simple. Does this guy need an operation? It's a yes or no question. And once it's documented and in the chart I've done my due diligence for my patient and potential gap in knowledge. Then I can go drink coffee.

It probably helps that I pull their asses out of the fire regularly when their patients crump and they need the ICU. I don't look down on them, it's what *I* do.

Though it is very easy to get irritated with consults that come in later in the day. Calling anyone less than an hour before their call ends is a recipe for getting some attitude and snark. Sometimes you have to but if you've had the patient sitting around all day and haven't called maybe you deserve some derision.

Something else that helps is imaging. Surgeons like to see ****. It's usually the biggest part of the deciding tree that allows them to tell you "no". Lol. Getting them something to look at that is appropriate will go a long way to them not thinking you are a farking *****. You consult people to get a nuanced opinion not start a please think for this idiot consult.
 
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I know a family doc who believes FM and IM are the holy grail of medicine. As a preceptor, he looked down on us med students pursuing surgical fields and I heard the comment get around "they couldn't hack it in family anyway". Yeah. A FM doc said that.

Point being you'll find jerks in every field. Surgery is a tough residency and surgical fields more difficult to match into and complete, probably thereby producing saltier docs. Or you can go the other way and turn your inferiority complex in medicine into the same distain for other fields.
I don't have an inferiority complex. If I did, I would apply to surgery to alleviate that lol. I'm just wondering if my future colleagues tend to think less of the field that I plan to go into. Based on that one guy's comment above, seems like at least one surgeon thinks that internist training is "incomplete."
 
Don’t worry; at least you’re not going into emergency. Everybody hates us! I see the light leave physician’s eyes when they find out I’ve matched (or previously, planned on matching) EM, and much of the rest of my rotation is taken up by me being told of the ways not to suck as an emergency physician. LOL

But seriously, @Cyphix is right. Every specialty looks down on every other specialty, and specialists (and even moreso their residents) go through much pearl clutching when a physician not in their specialty’s area of expertise consults them for something that’s obviously (to them) trivial or not a “real” consult. Hospitals are like big high schools where people occasionally get healthier or pass beyond the veil.
This I find really dumb. I asked one of the SICU residents why EM gets crapped on so much. He said, "they don't even try to manage the patient." I'm like uhhh... isn't their job just to stabilize the patient? And don't they need to get them out to the appropriate management team ASAP so that they can clear a bed for the next person who comes in? No response lol.
 
The culture is a bit different at the university hospital. But I'm a critical care internist working at a large community hospital with all the surgical services available. I think for the most part we all get a long fine. We will all trade "stupid" consults but you ask someone's opinion when you're not sure and want a more expert opinion. And I give zero ****s if a surgeon thinks it's stupid. My question is always pretty simple. Does this guy need an operation? It's a yes or no question. And once it's documented and in the chart I've done my due diligence for my patient and potential gap in knowledge. Then I can go drink coffee.

It probably help that I pull their asses out of the fire regularly when their patients crump and they need the ICU. I don't look down on them it's what I do.

Though it is very easy to irritated with consults that come in later in the day. Calling anyone less than an hour before their call ends is a recipe for getting some attitude and snark. Sometimes you have to but if you've had the patient sitting around all day and haven't called maybe you deserve some derision.

Something else that helps is imaging. Surgeons like to see ****. It's usually the biggest part of the deciding tree that allows them to tell you "no". Lol. Getting them something to look at that is appropriate will go a long way to them not thinking you are a farking *****. You consult people to get a nuanced opinion not start a please think for this idiot consult.
One of my friends who is a surgery resident said that most patients who get transferred to medicine do so because they want to just get them off their service, not because they can't adequately manage the patient. Do you feel like that ever happens in critical care?
 
One of my friends who is a surgery resident said that most patients who get transferred to medicine do so because they want to just get them off their service, not because they can't adequately manage the patient. Do you feel like that ever happens in critical care?

Maybe it’s where I’m training but any patient with a remotely complex or even simply non-surgical problem is sent on down to the medicine side. So I would say not true
 
One of my friends who is a surgery resident said that most patients who get transferred to medicine do so because they want to just get them off their service, not because they can't adequately manage the patient. Do you feel like that ever happens in critical care?

That's just typical surgical resident swagger.

But define "adequate". Not killing them while they are on your service? Good job? Again. It's different outside of the university setting with services and their small army of learners from students through to senior level residents and fellows.

I don't see a lot of dumps from surgeons in the community. If they are sick and need a vent and pressors or what not. That's not a dump. That handing off to the guy best able to help the patient instead of trying to half ass it while being in the OR and/or seeing patients in clinic (I don't have to devide my time like that). I also see a lot more ownership of patients in the community than in training. We all have to work together so there is a lot less of "here bitch manage this" and more "thanks for your help, I'm think my patient is in good hands".
 
Im kinda torn on the bow tie myself. On the other hand ties are a mobile petri dish. on the other hand I dont want to be the only guy wearing a bow tie.

One of the guys in my cohort rocks a wooden bow-tie. I thought they were really stupid before I saw him wear it, but he makes it work.
 
I fully understand and respect that my IM colleagues have different abilities and knowledge bases than I do. I would be miserable doing IM, so I am glad someone else does it.

Most of this competitive/ego stuff about what field is better than what field is a student/resident thing. Once you're done with training and out in the real world, everyone has their role to play and don't go around badmouthing each other.
 
wtf he must be drowning in poon if he can pull that off

I’m not sure. To be honest I feel like that would be f***ing weird. Is he trying to make the point that he always walks around with wood? In my eyes, the most attractive men are the ones who let their work do the talking. They don’t need accoutrements or fancy cars or anything else to show off. The way they carry themselves tells me all I need to know. But maybe that’s just me.


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I’m not sure. To be honest I feel like that would be f***ing weird. Is he trying to make the point that he always walks around with wood? In my eyes, the most attractive men are the ones who let their work do the talking. They don’t need accoutrements or fancy cars or anything else to show off. The way they carry themselves tells me all I need to know. But maybe that’s just me.


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He only wears it when the occasion calls for a tie, like an interview or something. Trust me, it looks good on him. It's not obnoxious, and I didn't realize it was wood until I was right in front of him.
 
I’m not sure. To be honest I feel like that would be f***ing weird. Is he trying to make the point that he always walks around with wood? In my eyes, the most attractive men are the ones who let their work do the talking. They don’t need accoutrements or fancy cars or anything else to show off. The way they carry themselves tells me all I need to know. But maybe that’s just me.


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I'm always walking around with wood
graucho.gif
 
2. Thinking you're a big shot and better than other physicians. I mean, you are...lol...but you don't need to go showing that

In my personal experience, both with attendings/residents, along with classmates who are going into surgery, surgeons definitely think they are better. Here's a quote from a surgeon participating on this thread, from another thread (bolded part above). They work hard, and need reasons to feel better about themselves.

That being said, i agree with other things said above. I wasn't able to rotate on another service without some kind of sh****g on another specialty. The hospital is a malignant environment overall.
 
In my personal experience, both with attendings/residents, along with classmates who are going into surgery, surgeons definitely think they are better. Here's a quote from a surgeon participating on this thread, from another thread (bolded part above). They work hard, and need reasons to feel better about themselves.

That being said, i agree with other things said above. I wasn't able to rotate on another service without some kind of sh****g on another specialty. The hospital is a malignant environment overall.
Lmao wow that's ****ed up. Suspicion confirmed I guess.
 
In my personal experience, both with attendings/residents, along with classmates who are going into surgery, surgeons definitely think they are better. Here's a quote from a surgeon participating on this thread, from another thread (bolded part above). They work hard, and need reasons to feel better about themselves.

That being said, i agree with other things said above. I wasn't able to rotate on another service without some kind of sh****g on another specialty. The hospital is a malignant environment overall.

Nice way to take my words out of context, buddy. Considering I was telling people what NOT to do, and making a joke about surgeons thinking they are.


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Nice way to take my words out of context, buddy. Considering I was telling people what NOT to do, and making a joke about surgeons thinking they are.

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Not trying to start a war with you here.
But you can't deny I bolded the segment where you stated frankly that You are better than other physicians. Yes you agree that one should not act as so, but as bolded, You believe you are truly better.

But happy at least you think not to act out on the fact that you think you are better. It's a good start. Many of my peers and residents can start by learning that.
 
Not trying to start a war with you here.
But you can't deny I bolded the segment where you stated frankly that You are better than other physicians. Yes you agree that one should not act as so, but as bolded, You believe you are truly better.

But happy at least you think not to act out on the fact that you think you are better. It's a good start. Many of my peers and residents can start by learning that.

In the bolded segment I literally wrote “lol” because I was joking. lighten up.


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The hospitalist looked like he was so embarrassed and I was like wow, this was literally another attending who was made to feel like a noob, yikes.

As a hospitalist, I too would be embarrassed if one of my surgical colleagues acted like that -- embarrassed for the surgeon and his lack of professionalism.
 
What I learned from this thread: I've gotta try some wooden bow ties.

In all seriousness, though, and getting back to the OP's question: where I work, all the services get along with each other. Sure, we all bitch about each other behind closed doors, but at the end of the day, I know that I can call literally any specialty in the hospital, day or night, and get an honest opinion about my patient, and help when we need it. Because what really matters is that we are giving the best care to our patients.

For a 4th-year, rotating med student to act like that, no matter how "silly" the consult is in his mind, is absolutely disgraceful.
 
To preface this possibly inflammatory thread, I want to say that I had a blast on my surgery rotation and all my residents and most of my attendings were very friendly and personable people.

That being said, as a guy applying to medicine, I couldn't have helped feeling a little deflated whenever one of the surgery attendings would rag on medicine for calling x, y, and z consults or even one time when while rounding with one of the attendings, he literally laughed at one of the hospitalists for telling him what he thought of the patient that they were mutually following because he thought that the comment wasn't worth his time in terms of stopping him in the hallway and talking to him lol. The hospitalist looked like he was so embarrassed and I was like wow, this was literally another attending who was made to feel like a noob, yikes.

To be quite honest, surgery seems like it's probably a lot harder than medicine and subsequently a lot more fulfilling, so I can see why people in surgery would feel superior, but I'm wondering if they actually do lol.

Surgery seems harder than medicine? Perhaps more time consuming, physically demanding, and saddled with prep work, but once you do your IM rotation, you'll see how much intellectual horsepower is required to diagnose patients that could have infinite number of pathologies, even weird sh** that pops up once in a blue moon. IM and ICU rounds are brutal.

Isn’t surgery more about the procedure than the differential diagnosis? It takes complex thinking to plan how you're going to cut the person open and sew them back up, but with the routine nature of the bulk of the surgeries (gallbladder removals, appendectomies, bowel stuff) it doesn't seem any more or less difficult, intellectually speaking, than forming a differential diagnosis and ruling out/in diseases until you come up with an answer. It's just different. Surgery is more tactile/mechanical. Surgeons are the mechanics and engineers of medicine. They do work their butts off and make great sacrifices to get to where they are, which is certainly admirable and worthy of respect.

Also, the surgeon you're referring to who laughed at a hospitalist sounds like an a-hole. You'll encounter many big egos in medicine. Don't let them get to you.
 
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Not trying to start a war with you here.
But you can't deny I bolded the segment where you stated frankly that You are better than other physicians. Yes you agree that one should not act as so, but as bolded, You believe you are truly better.

But happy at least you think not to act out on the fact that you think you are better. It's a good start. Many of my peers and residents can start by learning that.

You can’t seriously be that dense.
 
When I was a nurse, everyone bitch about EVERYONE. Us nurses were the biggest culprit of it all. I've accepted that it's the nature of the job. Obviously you shouldn't be malignant about it and rip **** into a co-worker but there's time and place for everything. I like to think of it as teachable moment. For example, go read the consult thread on surgery forum, lol.

The only time where I saw a surgeon low key flipped **** on another physician was when the Mohs Dermatologist called himself a surgeon. I swear, the flesh melt off the surgeon's face when the dermatologist called himself a surgeon. I don't remember verbatim but it was along the line of, "YOU did NOT complete a surgery residency. Please do not call yourself a surgeon!"
 
Dermatologists may not do GS residency, but certainly perform surgery. The GS was, per your description, rude. File this away under the heading: Some folks can be real jerks.¶Years back dermatologists rarely, if ever did MOHS. Times have changed. The US healthcare system has changed more. Let it go, move on, and don't let petty tyrants occupy your mind
 
Mohs surgery was invented by frederick mohs, a general surgeon. Its not an acronym, but a name. The reason it came over to derm was because it wasnt accepted in the gs community. Some of the facial reconstructions mohs surgeons do are extremely complex and intricate. These days, depending on the quality of your mohs service, plastics and ENT spend time on mohs. If you honestly think an appendectomy is more complex than some of these reconstructions, you arn't educated enough on the topic.
 
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On surgery, your patients get handed to you with a diagnosis.

While sometimes true, there are plenty of times where this isn't true as well. A large percentage of the time your patients get "handed" to you with an incorrect diagnosis, a vague symptom, or because of a line in a radiologist's impression.
 
Dermatologists may not do GS residency, but certainly perform surgery. The GS was, per your description, rude. File this away under the heading: Some folks can be real jerks.¶Years back dermatologists rarely, if ever did MOHS. Times have changed. The US healthcare system has changed more. Let it go, move on, and don't let petty tyrants occupy your mind

Mohs surgery was invented by frederick mohs, a general surgeon. Its not an acronym, but a name. The reason it came over to derm was because it wasnt accepted in the gs community. Some of the facial reconstructions mohs surgeons do are extremely complex and intricate. These days, depending on the quality of your mohs service, plastics and ENT spend time on mohs. If you honestly think an appendectomy is more complex than some of these reconstructions, you arn't educated enough on the topic.

I'm just a messenger. I'm not educated enough on the topic of Mohs. But I think where the disgust came from was not the differences between roles / job duty but the fact that someone who did not complete the grueling surgical residency / lifestyle calls themselves a surgeon. This was the explanation I got from the vascular surgeon that I was working with. I don't think he was looking down on Derm per se, but for the fact that their residency / fellowship was much cushier then those of surgical residency but have the privilege of calling themselves a surgeon.
 
Mohs surgery was invented by frederick mohs, a general surgeon. Its not an acronym, but a name. The reason it came over to derm was because it wasnt accepted in the gs community. Some of the facial reconstructions mohs surgeons do are extremely complex and intricate. These days, depending on the quality of your mohs service, plastics and ENT even spend time on mohs. If you honestly think an appendectomy is more complex than some of these reconstructions, you arn't educated enough on the topic.



Mohs surgery was invented by frederick mohs, a general surgeon. Its not an acronym, but a name. The reason it came over to derm was because it wasnt accepted in the gs community. Some of the facial reconstructions mohs surgeons do are extremely complex and intricate. These days, depending on the quality of your mohs service, plastics and ENT spend time on mohs. If you honestly think an appendectomy is more complex than some of these reconstructions, you arn't educated enough on the topic.

Some are complex, some aren't. This goes for ANY surgery. I'm retired from clinical medicine (GS), graduated MD 1981. I hear about shoddy reimbursements for MOHs from colleagues. Complexity of procedures? We're not children, students, and should understand the relative complexities depend on the case. I'm "not educated enough on the topic" is a fair statement. Let's leave it at that, and avoid bickering.
 
While sometimes true, there are plenty of times where this isn't true as well. A large percentage of the time your patients get "handed" to you with an incorrect diagnosis, a vague symptom, or because of a line in a radiologist's impression.

True. And even when the initial diagnosis is clear, a surgeon still needs to be able to generate ddx for post-surgical complications that arise.
 
When the degree is an MBBS, everyone’s a surgeon! 😉


But for real: I’ve had FM/IM joke about surgeons, I’ve dealt with surgeon attitudes... and I’ve dealt with big-name, cutting edge physician scientists and CEOs who are humble and awesome to be friends with.

The culprit is people, not vocation.

You will find that certain specialties attract certain types in a statistically aberrant way, but just as you wouldn’t want to seriously stereotype an ethnicity, it is sometimes bad form to stereotype specialties. (Even if those stereotypes often hold true...)

Just the 0.02 of a nurse. 😉
 
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