WOW! Okay, first, you should not feel like you have to lie to be a good surgery resident. If you are lying...then in my opinion you are not a good surgery resident. If you really feel like what you say above - you should just quit now b/c there are plenty of people who would love to have your job and maybe you've just picked the wrong specialty.
The only part I can even begin to agree with in your list of whiney complaints is the lying about hours - you should not have to lie about hours. But if you're sleeping at all on call, then staying all morning to finish work, you're not being efficient with your hours - the 80 hours assumes you are actually working every single hour of that 80 hours.
You know what I'm tired if is residents who act like spoiled little kids like you sound like. You have a PRIVELEDGE to take care of patients and learn how to do surgery - and you seem to have no appreciation for that.
Seriously, people trust you to cut them open, put your hands inside them...and all you can think about is "faking" interest in their case because it happens to be late in the day! I'm sure if your mother were having surgery you'd love that her doctor was really just thinking about getting done with the case to go home as soon as possible.
For M and M's...please remember your attendings are letting residents do at least part of their cases. Now, as the supervising physician they certainly have some responsibilty, yet they give their time day in and day out to teach YOU how to do surgery - did you ever think that they could proably do the surgery better without a resident in the room? that they daily risk residents making mistakes in the OR that they would not have made and then have to help try to fix it? - yet you think they should take all the blame for the complications. Even if they are directly responsibile for the complications, you were working together as a team and it's often a good exercise for residents to learn how to explain complications, even if they weren't directly responsible. I don't know the specific instance you're talking about, but I doubt it's always some total lie and the attending had 100% fault for the complication and the resident 0%, yet it all got blamed on the resident - give me a break!
And don't even gimme that "sticking around post-call when the work could easily be done by the morning team" - if you wanna be a shift worker, go do ER or anesthesia. Really! I never, ever, want to hear any resident complain about morning work unless they are truly staying up all night every night. Usually, if you do, you can start rounds earlier, get your morning work done early, then the work is done and you can leave early...without dumping on the morning team and without neglecting your patients. You seem to forget that this job is about taking care of patients, not just doing "work". Even scutwork is always somehow tied to patient care. Again, if you mother was the patient, would you want her doctor wishing to pass off her care to the next doctor as soon as possible so he could go home...or would you want the doctor who admitted her last night, knew her well, go ahead and finish up those orders on her/check the final results of her CT with radiology/whatever?
I am in the middle of year 4 of surgery residency. I don't have to "fake" enthusiasm for late cases - I actually like to operate...sure I have a home life and sometimes it's incovenient, but it's not every night, not all the time, and the way I feel is every patient I do surgery on is a chance for me to learn how to handle this case someday when I'm on my own in the future - and every case has the potential to be a learning experience even if you've done a bunch of that case before. Sure, I'm tired post-call, but I work efficiently all night, finish my work in the morning...and if it's a super-busy morning and I have to stay till the last legal minute...well, that's what I have to do to make sure the patients get taken care of. I try to never loose sight of the fact that I'm part of paitent care, we all are. I cannot let myself think of the patients as just "work" like you do.
well, this in a nutshell is exactly why i left surgery and am now applying in IM. the OP was venting, and like a typical surgical resident, you berate him for his "whiney complaints". and then if he's working over 80 hours, you then
blame him for not being efficient, as if you know him, his program, or how he's allocating his time. my "whiney complaint" is that whenever i went over the 80 hours, it was always somehow my fault, and while that is insulting enough, what really bothered me most was what i hope everyone sees in this post--you used this as an opportunity to blame the intern for not being efficient and made him feel bad about not being efficient enough, whereas you could have just used this as an opportunity to teach him how to be more efficient. rather than be supportive to a fellow surgical resident, you embarrass him. why? cause that's how you were treated as an intern?
taking care of patients is a privilege and i cherish that privilege. but who are you to assume that the OP doesn't view it as a privilege too? the OP was talking about not liking the way he feels he has to lie about his hours to be a "good surgical resident", and i too was expected to lie and not report that i was working 95-100 hours/week. i was expected to lie about the fact that i wasn't getting the 10 hour respite between shifts, or the other ACGME rules that we were instructed to follow, and if i didn't want to lie, then people like you labeled me as a "whiney complainer"--not a "good surgical resident"--and rather than acknowledge that
maybe the rules were
actually being broken, i found myself dealing with self-righteous, manipulative colleagues who i thought were supposed to be role models and teachers turning the situation around and always finding some way to make everything my fault, and in the process putting a twist on it to imply that it was because i was stupid or inefficient or incompetent. instead of helping the person or showing some degree of support, all you do by insulting and blaming them is SILENCING them, and they can't even come on these boards and vent because there's someone like you to rub more salt in the wound. it is so callous and insulting to imply that any of this is a reflection on how much someone cares about his patients, and by labeling anyone who has a gripe about the system or is being abused or taken advantage of as a "whiner" or "spoiled little kid" just perpetuates the toxic culture of surgery, and anyone reading your post that's planning on going into surgery is going to take away the message that if they have a problem, turning to a senior resident will elicit a reaction like yours, so they stay silent. they learn to stay silent, and for fear of being insulted or embarrassed, they perpetuate this culture of silence.
this is all learned behavior, and it's so well-known as part of the infamous "surgical culture". i'm willing to bet that
fourthyear was given the same self-righteous, arrogant lecture by a 4th year resident when he was an intern, and because they feel they have to accept this treatment or else be labeled a "bad intern" or a "whiner" or "spoiled baby", they actually start believing it. i didn't, and i knew this was a toxic environment where people
chose to act like this towards each other, and i don't want to waste my life working with people who actually treat each other like this. instead, i'm going to spend my career working with people who would NEVER have the audacity nor arrogance to question my loyalty towards or respect for the privilege i have to take care of patients. a legitimate complaint about a flawed system doesn't have anything to do with their view of medicine.
and if someone doesn't want to stick around post-call, that's what i call a RESPONSIBLE physician, not a "spoiled child". i don't want an exhausted resident who sticks around post-call because he thinks it's the only way to show he cares about patients touching my mother with a ten foot pole. if you care about your patients, you won't let arrogance get in the way of safety.
