feeling down

[medstudent0258]

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Hi everybody-
I just started residency and a couple of things are getting me down. First, I really dislike grossing. I did a rotation in medical school but did mostly microscopy and only observed grossing. I think I might dislike it so much because I am totally alone on my surgpath rotation. There are three hospitals at my program so we are dispersed. It makes me sad because I think it would be so much more fun to do it if I could hang out with some of my fellow residents who are in the same boat as me. Also, the support staff are not very nice. They seem to get frustrated when I am slow or ask a lot of questions and are not chatty, friendly at all. It's actually really depressing. What do you guys think? Am I screwed?

 

[KeratinPearls]

Hi everybody-
I just started residency and a couple of things are getting me down. First, I really dislike grossing. I did a rotation in medical school but did mostly microscopy and only observed grossing. I think I might dislike it so much because I am totally alone on my surgpath rotation. There are three hospitals at my program so we are dispersed. It makes me sad because I think it would be so much more fun to do it if I could hang out with some of my fellow residents who are in the same boat as me. Also, the support staff are not very nice. They seem to get frustrated when I am slow or ask a lot of questions and are not chatty, friendly at all. It's actually really depressing. What do you guys think? Am I screwed?

Well that really sucks. You should have a chief resident helping you or a surgical pathology fellow if you have one. If these ppl arent willing to help you ask a friend in the program to help you (hopefully you've found one already). Ask for help because if you do something wrong and screw up you will unfortunately be blamed for it. Hell if no one is helping you then let us know which program you are at because this is scary. Ask the attending on the case if all else fails.

 

[TMZ2007]

Sounds like your problem is not grossing itself, but difficult working conditions in your gross room/department. Being able to work well with unpleasant personalities is part of the job. Don't count on any sort of positive chance occurring either. Departments tend to have huge amounts of inertia, entrenched staff and faculty, irrational methods of doing things, etc.

That being said, grossing does eventually get easier/faster and more interesting when you advance beyond the stage of "cut meat into small pieces and shove into cassettes".

However, if you are genuinely disgusted/disturbed at dead tissue lying in front of you on the cutting board, there is definitely nothing you can do about that until you are done with residency (short of switching to CP only).

As long as you are not having to gross late into the night and are getting enough preview time before sign out, things could be much worse.

 

[KCShaw]

Agree with the working environment comment. Some programs just aren't as user friendly, especially for timid new residents. If you're not getting appropriate training or supervision for what you're doing then that's a significant problem. But if it's just that the training isn't very friendly, well, that's unfortunate but also not necessarily rare. Only you will be able to decide whether you can rant against the system, can slog through it and find a satisfactory, if not "happy", middle ground, or ultimately need to go somewhere else or do something different. But only 2 weeks in isn't a great sample size on which to come to a "final" conclusion, I don't think. Eventually grossing becomes more rapid and routine, and you can focus on the parts you find interesting.

 

[medstudent0258]

I think my initial post may have been a little misleading. I work with an experienced PA who is really good at his job but never smiles. I was just hoping for a more lively learning environment. I guess my situation just sucks right now and I have to just keep going and hope it gets better. This isolation is making me miss clinical medicine, which I never thought would happen.

 

[caffeinegirl]

Hang in there. Realize that this is a temporary situation. Now is the time to try and reach out to your support system like your friends and family. This is but one rotation of many, and is not representative of your life post-residency.

Residency can really suck. But that is universal to all specialties and is inherent to the training process. What you're going through is very common...including the adjustment period to a new setting, new program, and new people. Remember why you chose pathology, and hang on to that during these times.

For a fun read, a little bit of nostalgia
http://forums.studentdoctor.net/showthread.php?t=181852

 

[Thrombus]

If you need "chattiness", you may be in the wrong field.

"Chatty" pathologists generally do not get much work done.

 

[Entgegen]

For a fun read, a little bit of nostalgia
http://forums.studentdoctor.net/showthread.php?t=181852

Yaah sure posted a whole lot back then.

 

[medstudent0258]

Thanks guys, it's nice to get some encouragement. I don't want to complain to my other residents because I'm so new and don't want to seem like a complainer/downer so it's great to come here for some support. Caffeinegirl, you are totally right. I need to look at this as temporary and realize parts of my training are really going to suck. Thanks for reminding me to keep some perspective.

 

[yaah]

Yaah sure posted a whole lot back then.

No wife, no kids back then.

 

[KCShaw]

Rather than complaining or quietly slogging through it, you could become the funny chatty weirdo. Might want to wait until you learn to gross first though, in case your funny drives everyone away.

It's not easy to change the culture of the gross room, but it is possible. Personal experience has held that as long as the work is getting done in a timely fashion with good results, most people can put up with anything from silence to hilarity. Unfortunately some people just can't deal with even minor distractions while working, so the work might not get done quickly/well, so it can be a delicate balance.

Alternatively you could become more dull and morose than everyone else and let it be your own little private running joke.

 

[Gotti]

You could do blood bank. I heard all along the interview trail that if you like people so much, go do blood bank. Now multiple attendings have confirmed the need to be social to do blood bank. Its awesome. You have just enough interaction with other clinicians to not feel isolated. Yet you never deal with patient complications or other bs or have to call nursing homes to find an opening. Plus you spend large parts of the day chatting with the blood bank nurses or if you are more laboratory inclined, the technicians. Also, a good enough amount of science to be intellectually stimulated or if you are into politics, you can work on changing local or national blood bank policies. I've even heard some blood bankers become hematology consultants, getting up early in the morning to round on patients and then talk to other clinicians about their recommendations.

 

[medstudent0258]

What is the job outlook like for those that do a blood bank fellowship? Do you have to live in a big city? Work at an academic center?

 

[Gotti]

I don't know what the job outlook for blood bank is but haven't heard about it being worse than any other path job. I've only heard people graduate all able to get jobs. On the interview trail, one fellow who was graduating told me blood bank is the best secret and deal in medicine.

Its a great deal. My seniors agree my blood bank attending only works 20-25 hours/week even though he is full-time. While I'm on my rotation here, I spend most of my day talking to the lab techs or the nurses about Captain America versus Spiderman. When an antibody screen pops up positive, I spend a hour chatting up with my senior how its possible a patient developed those antibodies. Talk about mental masturbation.

A patient invited me to her place for margaritas even though I all do is have the nurse transfuse her to make her feel stronger. I don't have to punish any patients with meds or big needles in their backs.

 

[KCShaw]

What is the job outlook like for those that do a blood bank fellowship? Do you have to live in a big city? Work at an academic center?

Those are the jobs that seem to get the most press, but don't forget Red-Cross jobs and jobs at similar regional or even local blood banks/blood centers. Jobs off-site from a hospital blood bank might not get as many or the same kinds of transfusion related questions, but probably get the more interesting antibody issues. Given that it seems like every county in every state seems to want its own cancer center where regular transfusions take place, I think there are more directorship type jobs out there than people realize (though some may be consolidated, so one person manages several small'ish centers). Can be a good gig if you've got some good techs. Not so much if you don't.

 

[Torsed]

Hi everybody-
I just started residency and a couple of things are getting me down. First, I really dislike grossing. I did a rotation in medical school but did mostly microscopy and only observed grossing. I think I might dislike it so much because I am totally alone on my surgpath rotation. There are three hospitals at my program so we are dispersed. It makes me sad because I think it would be so much more fun to do it if I could hang out with some of my fellow residents who are in the same boat as me. Also, the support staff are not very nice. They seem to get frustrated when I am slow or ask a lot of questions and are not chatty, friendly at all. It's actually really depressing. What do you guys think? Am I screwed?

Look man you just need to be cool. All of this absolutely blows to begin with and it would help to have a senior resident/fellow to lean on, but it sounds like you are alone. Just do your best. Use the guides in Rosai or Lester's to help you gross the big stuff, thats why the are there.

As far as lonliness, get with those residents and hang out for dinner or something or make some plan for ya'll to help each other out so you don't have to gross until two a.m. Just gotta focus on learning, grossin' is important, but its routine after a while, take what looks important and don't screw up the margins. I wouldn't sweat grossin' as much as trying to learn the histopathology, thats whats on the boards and then in life, bust your stuff reading about your cases. All this gets better and you can evenutally master it. Maybe you should think of it all as your profession and not as a job, we don't make boxes.

Hope it works out, it usually does, every year will get better for you.