Ever feel like an unnatural

[GassiusClay]

For all you folks out there, do ever feel like that there is a natural ability to do the job? Or more like comfort has to be built and feel like you can do it well? Can you really figure that out early on?

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[CambieMD]

For all you folks out there, do ever feel like that there is a natural ability to do the job? Or more like comfort has to be built and feel like you can do it well? Can you really figure that out early on?

Hi GassiusClay,

I think that as you learn you become more comfortable. Some people may catch on earlier but you learn this stuff. I was slow and awkward. I am not the fastest now but I can move a lot faster, safely, when I have to. You learn from doing cases. Sometimes my failures teach me more than smoothe cases. Hang in there.

Cambie

 

[rsgillmd]

For all you folks out there, do ever feel like that there is a natural ability to do the job? Or more like comfort has to be built and feel like you can do it well? Can you really figure that out early on?

You only really feel comfortable when you are left on your own. Next time you start a case, tell your attending to stand in the corner of the room if he/she is that nervous. Then you do everything. There is something different about knowing how much of a medication to give and having the attending give it, as opposed to you giving it yourself. If you need a little cricoid pressure, try to direct a medical student or nurse to do it for you. When you start and finish cases on your own you begin to develop the confidence that allows you to feel comfortable. Also as Cambie says, everything comes with experience.

My last general surgery call as a CA-3, my attending tells me to act as an attending for the junior resident. By then I had already done a bunch of cases on my own, so I was up for it. There were no disasters, but nothing went according to plan either. I'm my own biggest critic. I was disappointed in the little events that occurred but I wouldn't have changed anything I did either. My attending the next morning just laughed and said to me that this is all part of becoming an attending. You will have days that don't go smooth. Learn from them if you can. Then move on.

 

[Planktonmd]

The real learning starts after you finish your residency, but that doesn't mean everyone will reach the same skill level, some people will always be better than others.

 

[dhb]

For all you folks out there, do ever feel like that there is a natural ability to do the job?

yes just as there is a natural disability: just watch some of your attendings

As for how much time: i would say by CA3 you should be comfortable with any case that's thrown your way and you should be tuning your speed skills.

 

[coprolalia]

For all you folks out there, do ever feel like that there is a natural ability to do the job? Or more like comfort has to be built and feel like you can do it well? Can you really figure that out early on?

Some people are "slick" while others aren't. Same goes for surgeons. Same goes for nurses. Same goes for the guy pushing the mop on the floor.

It think this has to do more with genes than it does training. Some people indeed to just have natural ability, whatever that means exactly. Most people who played sports or are very good at video games since being a kid I think have a huge leg-up on manual procedural skills over their colleagues who didn't/weren't.

Don't underestimate eye-hand coordination and an inherent "common sense" that some people just seem to possess over others. I've met people in my residency who could recite Miller to you, backwards and forwards, but either sucked at doing procedures or get such tunnel-vision when a problem arises that they can't immediately think of anything more than a single option to get them out of it. To me, these people are dangerous.

Anesthesiology is essentially critcal care medicine on speed. Not everyone who gets into the field is cut out for that. Trust me, I've seen this firsthand. And, as someone who (I believe) "gets" it, it can be very frustrating observing others who don't.

-copro

 

[Gator05]

Have to give some props to my program, UF. They've had a "TTP" or transition-to-practice program in place for a while. Residents form their own group and run a set of OR's. In charge of those OR's with the attendings in the corner only. Induction, lines, lunches, OR scheduling, pre-ops, post-ops, call schedule, even billing. Additionally, senior residents on call usually given the phone and field the attendings' calls and supervisions (with appropriate support, of course).

A real eye-opener. More challenging to be on your own; more still to be supervising junior folks! The PP guys do have an entirely new set of skills to learn. Certainly not going to master this on TTP, but the 3-month introduction certainly seems like a big step up. Surveys to our graduates' groups do show this to be one of the most important rotations for PP.

 

[jetproppilot]

Some people are "slick" while others aren't. Same goes for surgeons. Same goes for nurses. Same goes for the guy pushing the mop on the floor.

It think this has to do more with genes than it does training. Some people indeed to just have natural ability, whatever that means exactly. Most people who played sports or are very good at video games since being a kid I think have a huge leg-up on manual procedural skills over their colleagues who didn't/weren't.

Don't underestimate eye-hand coordination and an inherent "common sense" that some people just seem to possess over others. I've met people in my residency who could recite Miller to you, backwards and forwards, but either sucked at doing procedures or get such tunnel-vision when a problem arises that they can't immediately think of anything more than a single option to get them out of it. To me, these people are dangerous.

Anesthesiology is essentially critcal care medicine on speed. Not everyone who gets into the field is cut out for that. Trust me, I've seen this firsthand. And, as someone who (I believe) "gets" it, it can be very frustrating observing others who don't.

-copro

I'd like to add to Cop's post:

uhhhh, Jet searches for words....

"Guess I can't."

 

[CambieMD]

The real learning starts after you finish your residency, but that doesn't mean everyone will reach the same skill level, some people will always be better than others.

I agree completely with the above statement. There is probably a very very small percentage of people who complete medical school and enter a residency and perform poorly. I have not been out of residency for long but I have a lot of experience with the post med school training process. I completed two residencies and two internships. Most docs who screw up during or after residency do not do so because they lack the skills necessary to function as physicians in a particular specialty. Some, many have personality disorders. Some people lack judgement in general. That may be evident in all aspects of their lives. Clinical judgement should improves over time.

Do not confuse the speed with which one learns with their ability to learn or be taught. Some take more time to learn and acquire knowledge differently.

Cambie

 

[coprolalia]

Clinical judgement should improves over time.

One would hope. But, I've seen examples where this clearly isn't the case. Some folks just don't "get" it.

-copro