How accurate is Grey's Anatomy in terms of how the residents learn?

[DoctaJay]

Hey everyone, in Grey's Anatomy, it seems like the general surgery residents get to scrub in on CT cases, OBGYN cases, neurosurgery cases, etc. Is this the case in real general surgery residencies? Do you actually get to scrub in on cases like this so you know what type of fellowship you might want to take? Or do you just do gutt and butt for all five years. I apoligize in advance for my ignorance on the subject.

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[Blade28]

At our program, we have month-long rotations during intern year. I've gone through surg onc, ER, peds surg, plastics, g surg, gyn onc, ortho and urology so far. There are different rotations next year - e.g. CT surg, vascular, SICU, etc. So no, it's not quite like Grey's Anatomy.

 

[Krazykritter]

Hey everyone, in Grey's Anatomy, it seems like the general surgery residents get to scrub in on CT cases, OBGYN cases, neurosurgery cases, etc. Is this the case in real general surgery residencies? Do you actually get to scrub in on cases like this so you know what type of fellowship you might want to take? Or do you just do gutt and butt for all five years. I apoligize in advance for my ignorance on the subject.

Although I am just an M1, I know that it is not like you hear all the time on the show, "I'm on Neuro today." From what I understand, you do have months/weeks on different services where you gain experience in CT and other areas.

My guess would be that GS residents are the ones who pursue surgical specialties that do not have a fast track such as CT, Vascular, etc. That would be my guess as to the reason for rotating through different services.

 

[drrouz]

Hey everyone, in Grey's Anatomy, it seems like the general surgery residents get to scrub in on CT cases, OBGYN cases, neurosurgery cases, etc. Is this the case in real general surgery residencies? Do you actually get to scrub in on cases like this so you know what type of fellowship you might want to take? Or do you just do gutt and butt for all five years. I apoligize in advance for my ignorance on the subject.

In short no. I have never seen a general surgery resident on OB/GYN service. I have never seen a general surgery resident on a cardiac case...though senior residents do need/get thoracic experience. I have never seen an intern doing a neurosurgery case. I have never heard of a surgery resident being asked to work up a seizure (that was an early episode). Of course I don't have first hand experience of what goes on in 99.999999% of programs so someone else may disagree. My own opinion of Grey's Anatomy, from the few early episodes my wife forced me to stomach, is that the medical information is atrocious. People do like the drama though...again not me.

Oh... and if anyone has ever seen/held/defused a live rocket/bomb or any other explosive inside a patient please let me know...

I do understand that TV shows need to spice things up to keep an audience. Lord knows, no one would want to watch interns write notes, enter orders, and play phone tag.

 

[toxic-megacolon]

I don't get why they are all on call at the same time, and sit around with nothing to do so often.

 

[flashman]

Things vary by program a lot. I have personally done each of these things mentioned: two months on gyn/urology as a pgy3, doing hysterectomies, c-sections, laparoscopy; I did my vascular as a pgy 2 with a cardiovascular-thoracic group where you could scrub all the cardiac cases you wanted; as an intern we did a month of neurosurgery where one of the surgeons would let the resident "do a case" at some point in the month-open, resect tumor, and close-with a lot of help of course; on trauma it isn't all that uncommon to work up seizures, guy passes out and crashes car, you have to work up why, and many trauma services use consultants sparingly, doing workups themselves.

General surgery education is geared towards training you to be a whole body surgeon, though now the practice once you graduate is general surgery. When you take your boards you will be expected to know vast amounts of vascular, thoracic, trauma, pediatric surgery, ENT, gynecology, etc. This is a field where the training is 5-7 years. Also, it is not really a field for those who haven't selected a track, as mentioned above, like vascular, thoracic or plastics, because those really aren't the way that things work at most places (though more so with plastics.) General surgery is for people who aren't sure necessarily whch of the fields they want to enter other than not ortho, not urology, not ob, not ENT. Also as a surgeon you are expected in practice to know it all: you may be on call to an er and have to do a traumatic anything: thoracotomy, cardiac surgery, c-section.

I haven't seen more than a few seconds of the show. I bet though that the training is more and less exciting than on tv. It is an exciting field: you make life or death decisions very commonly, and encounter situations where its go time all at once. But not too glamorous: personal hygiene reaches new lows, lives have little else in them but work and family, you are chronically sleep deprived, and have 5 things that you should have gotten done last week, e.g. medical records, research projects, studying for textbook rounds/absite/boards.

All that being said its fun, exciting, stressful and fulfilling.


Just my 2 cents.

In short no. I have never seen a general surgery resident on OB/GYN service. I have never seen a general surgery resident on a cardiac case...though senior residents do need/get thoracic experience. I have never seen an intern doing a neurosurgery case. I have never heard of a surgery resident being asked to work up a seizure (that was an early episode). Of course I don't have first hand experience of what goes on in 99.999999% of programs so someone else may disagree. My own opinion of Grey's Anatomy, from the few early episodes my wife forced me to stomach, is that the medical information is atrocious. People do like the drama though...again not me.

Oh... and if anyone has ever seen/held/defused a live rocket/bomb or any other explosive inside a patient please let me know...

I do understand that TV shows need to spice things up to keep an audience. Lord knows, no one would want to watch interns write notes, enter orders, and play phone tag.

 

[Blade28]

They also take care of one patient each. No pre-rounds, always arriving when the sun's already up, leaving the hospital before sunset, improper scrubbing-in technique, etc., etc., etc.

 

[SLUser11]

I watched an episode of Grey's Anatomy with my brother (ER Doc), his wife and her sister (not in medicine). As medical professionals and trainees love to do, my brother and I couldn't help but point out how inaccurate everything is (the same game I played with other med school friends while we watched ER, scrubs, etc).

So as we were saying, "yeah, right like a GS resident would really do this..."

His wife broke in with, "Yeah, well, WE'RE NOT DOCTORS , and we're trying to enjoy a TV show....so, shut the f@#k up."

So, I STFU and enjoyed the fictional TV drama.....changed my whole perspective on sh#t.

 

[DoctaJay]

Things vary by program a lot. I have personally done each of these things mentioned: two months on gyn/urology as a pgy3, doing hysterectomies, c-sections, laparoscopy; I did my vascular as a pgy 2 with a cardiovascular-thoracic group where you could scrub all the cardiac cases you wanted; as an intern we did a month of neurosurgery where one of the surgeons would let the resident "do a case" at some point in the month-open, resect tumor, and close-with a lot of help of course; on trauma it isn't all that uncommon to work up seizures, guy passes out and crashes car, you have to work up why, and many trauma services use consultants sparingly, doing workups themselves.

General surgery education is geared towards training you to be a whole body surgeon, though now the practice once you graduate is general surgery. When you take your boards you will be expected to know vast amounts of vascular, thoracic, trauma, pediatric surgery, ENT, gynecology, etc. This is a field where the training is 5-7 years. Also, it is not really a field for those who haven't selected a track, as mentioned above, like vascular, thoracic or plastics, because those really aren't the way that things work at most places (though more so with plastics.) General surgery is for people who aren't sure necessarily whch of the fields they want to enter other than not ortho, not urology, not ob, not ENT. Also as a surgeon you are expected in practice to know it all: you may be on call to an er and have to do a traumatic anything: thoracotomy, cardiac surgery, c-section.

I haven't seen more than a few seconds of the show. I bet though that the training is more and less exciting than on tv. It is an exciting field: you make life or death decisions very commonly, and encounter situations where its go time all at once. But not too glamorous: personal hygiene reaches new lows, lives have little else in them but work and family, you are chronically sleep deprived, and have 5 things that you should have gotten done last week, e.g. medical records, research projects, studying for textbook rounds/absite/boards.

All that being said its fun, exciting, stressful and fulfilling.


Just my 2 cents.

Thanks alot, that was a very helpful post. In fact, everyone has been helpful. I guess why I want to know all this is because I really want to be a missionary surgeon, and I forsee me having to do alot of different procedures with very limited resources. So to me, it would be very very important to go to a program where I truly learn a little bit of everything. When choosing programs for residency, how would you possibly find out which programs have such a diverse training climate before you actually interview there?

 

[supercut]

Don't confuse one month of cardiac surgery, or one month of ortho, as an intern, with "training". In most cases, the intern's job is primairly care and discharge of floor patients. In the OR, the intern's main job is to hold retractors (though often you get to close skin as well). The ortho guys let me pound in a femur nail and drill a few holes, but that was it.

That said, there are programs that have some more diversity than others. Think community programs. And it's easy to find out, just ask the program secretary for a list of rotations. Many post rotation lists on their websites.

You won't find a program that will teach you how to do all the operations you may need to perform in the missionary setting. You also won't find a program that will teach you how to operate in third world conditions. (think no suction, no cautery, limited choice of suture and instruments) What you will learn, is a skill set and surgical judgement that will allow you to adapt to various situations. A friend of mine did a tour with Doctors without Borders after finshing residency, and he basically had to improvise a lot. But he had an incredible experience.

 

[mysophobe]

I'm glad someone pointed out what supercut said. At many programs, when you're on the neuro service or the cardiac service, you aren't actually scrubbing in and doing the procedures. Most of the time, you're doing what you do on the gen surg service as an intern (read: at many programs): managing patients on the floors. When you do get to scrub in, you don't really do much. Someone who's entire neuro experience is going to be all of 4 weeks isn't going to get to do a whole lot.

Btw, I'm in no way speaking for all programs, just personal experience and what I've heard from others.

 

[Blade28]

I'm glad someone pointed out what supercut said. At many programs, when you're on the neuro service or the cardiac service, you aren't actually scrubbing in and doing the procedures. Most of the time, you're doing what you do on the gen surg service as an intern (read: at many programs): managing patients on the floors. When you do get to scrub in, you don't really do much. Someone who's entire neuro experience is going to be all of 4 weeks isn't going to get to do a whole lot.

Btw, I'm in no way speaking for all programs, just personal experience and what I've heard from others.

It truly does depend on the rotation, hospital, residency program, etc. I'm pretty aggressive about getting into the OR and doing stuff, even though our program is traditionally top-heavy. Some attendings only let you close; some let you open and close; others will let you do the entire case, with supervision. (This is usually after they've worked with you in a number of cases and are comfortable with your skill level.)

Besides, in a lot of programs, the med students do all the retracting.

 

[DoctaJay]

Man...so is it possible to find out the level of participation residents have in their rotations at different programs before you list them for the match? Or is that something that you find out on interview day? Like is there any website I can read now that details this stuff?

 

[DW3843]

Man...so is it possible to find out the level of participation residents have in their rotations at different programs before you list them for the match? Or is that something that you find out on interview day? Like is there any website I can read now that details this stuff?

scutwork.com can be helpful

However, I have found that nearly every program I want to find out about on there either 1) has no review or 2) the most recent review is from 3 or 4 years ago, which really doesn't help me decide about a program that I won't be in for another 2 years.

 

[Leukocyte]

There is a reason why we have Neurosurgeons, Orthopods, ENT, Urologists...

A General Surgoen is a General Surgeon...He/she does General Surgery. No, "general" in general surgeon does not mean you know/get trained in every surgery

You will know what General Surgery is all about once you do your Surgery core, and few other electives in general surgery.

 

[Blade28]

Ask on your interviews. Ask your own program's residents who interviewed there.

 

[geekgirl]

Man...so is it possible to find out the level of participation residents have in their rotations at different programs before you list them for the match? Or is that something that you find out on interview day? Like is there any website I can read now that details this stuff?

no. there is no central information server (as much as many of use dream this site is that source).
but seriously, experiences on different services/at different hospitals differ. beacuase, ahem, we are all different people. that's why "vibe" and "fit" take on such grand meanings during interview season.
i do agree - there are programs where people operate. and where people do NOT. that aside, there is alot of in-between. and in that sea of in-between, you must find a place that works for you. and your style.
i am very good with trust. and not good at asking for trust - i.e. when attendings let me do stuff, it works. but i don't usually ask to do something that is not offered to me freely. but if you do offer, i will step up. without a doubt. so far, i've gotten to do quite alot
these things are subtle, but present. so watch out for fit. activity. approach. doctrine. and you should be great.

 

[mysophobe]

It truly does depend on the rotation, hospital, residency program, etc. I'm pretty aggressive about getting into the OR and doing stuff, even though our program is traditionally top-heavy. Some attendings only let you close; some let you open and close; others will let you do the entire case, with supervision. (This is usually after they've worked with you in a number of cases and are comfortable with your skill level.)

Besides, in a lot of programs, the med students do all the retracting.

Heh. Here, if there is an intern on the case, the med student either doesn't scrub in, or scrubs and just watches while the intern retracts--the exception being if there is a need for that many hands.

As for the asking or not asking to do stuff, I ask to do just about everything I can think of, and I don't care if it makes me a super-duper-dick-chaney-gunner. I learn best by doing stuff, so if they don't offer, I ask.

***I'm not taking a shot at your style or anything you said, just offering the other side of the coin.***

 

[DoctaJay]

Thanks everyonel for all your responses...and I've made my decision. For residency, I'm going to join Meridith and Izzy at Seatle Grace Hospital. It seems to be the only hospital that fits what I want.

 

[mysophobe]

Good luck.

 

[njbmd]

I don't get why they are all on call at the same time, and sit around with nothing to do so often.

Hi there,
This is the MOST un-realistic part of the show. Surgical residency is the end of boredom and being well-rested.
njbmd

 

[Zummy]

Thanks alot, that was a very helpful post. In fact, everyone has been helpful. I guess why I want to know all this is because I really want to be a missionary surgeon, and I forsee me having to do alot of different procedures with very limited resources. So to me, it would be very very important to go to a program where I truly learn a little bit of everything. When choosing programs for residency, how would you possibly find out which programs have such a diverse training climate before you actually interview there?

The two RURAL general surgeons I worked with btwn 1st and 2nd year med school (summer externship) did amazingly broad work. No, they weren't resecting brain tumors but while rotating with them, I recall things like one doing a c-section (the on-call OB/GYN was in the middle of another c-section), a knee arthroscopy (don't ask me why- I was too "fresh" to wonder why the orthopod wasn't doing it), correction of subclavian steal, some peds surg, etc. One did a tonsillectomy! Heck, I remember one getting called to try an intubation when the anesthesiologist was unsuccessful (for the record, the surgeon could not get it either).

I believe both had some their residency training in Chicago (different programs), neither had fellowship training.

 

[Blade28]

As for the asking or not asking to do stuff, I ask to do just about everything I can think of, and I don't care if it makes me a super-duper-dick-chaney-gunner. I learn best by doing stuff, so if they don't offer, I ask.

That's a great attitude! I wish some of our med students would be a little more assertive and aggressive about doing stuff in the OR or on the floor.

 

[DoctaJay]

Do you really think so? I'm usually kind of scared of asserting myself, because I don't want to seem overbearing and cocky (I'm already 6'5). I guess I would also be scared of asking to do something, then jacking it up. But I guess thats life. ...So the attendings or residents won't look at you weird especially as a med students asking to do things in the OR?

 

[geekgirl]

Do you really think so? I'm usually kind of scared of asserting myself, because I don't want to seem overbearing and cocky (I'm already 6'5). I guess I would also be scared of asking to do something, then jacking it up. But I guess thats life. ...So the attendings or residents won't look at you weird especially as a med students asking to do things in the OR?

i think this is a tricky issue, in which there are no definitive answers. alot gets transmitted in situations that is difficult to mold into hard and fast rules. because there's a difference between being enthusiastic and doing what you can on the floor and gunning or pestering people to do stuff.

you just have to feel it out for yourself. i've always made it absolutely clear that i want to do whatever i can, whenever i can. and that i'm always available to do things (either floor or in the OR). but i can't help but think it's sorta crass to pester people by asking to do stuff all the time (***no offense to other styles of living*** ). i do ask if there's anything i can do to help or to be useful. it's all in your own personality.

also, it depends on the institution. my school (and many of my away electives) were in relatively formal old-school institutions, where roles were quite clearly delineated. and the higher-ups liked to be in charge of when and if they threw you a bone. that said, i've also worked in more casual, community-type hospitals where i was much more comfortable asking to do stuff.

so, it depends. have some common sense and you'll be fine.

 

[Blade28]

Do you really think so? I'm usually kind of scared of asserting myself, because I don't want to seem overbearing and cocky (I'm already 6'5). I guess I would also be scared of asking to do something, then jacking it up. But I guess thats life. ...So the attendings or residents won't look at you weird especially as a med students asking to do things in the OR?

Hell no! Just ask - the worst thing that can happen is they say no.

Since my third year of med school I've been asking to do everything, and whatever they offer, I'll take. Opening. Bovieing everything. Applying clips or ties for hemostasis. Using the GIA staplers. Using laparoscopic instruments. Blunt and sharp dissection. Closing the abdomen. Placing intraop chest tubes or drains. Subcuticular skin closures. I love it all!

 

[drpectin]

I agree, sometimes they offer, but when they don't, ask.

Ask the resident if you don't know what to say, but usually a confident and calm demeanor and some interaction on your part with the attending will be enough to get you going on the right track.

 

[Roux-en-Y]

I agree, sometimes they offer, but when they don't, ask.

Ask the resident if you don't know what to say, but usually a confident and calm demeanor and some interaction on your part with the attending will be enough to get you going on the right track.

Blade and drpectin, I so agree. Also, cant be afraid to be wrong and must have a short-term memory of mistakes.

BTW, the few snippets i've seen of Grey's...I hate the show...i think it demeans our training by misrepresenting (serializing) it

 

[drpectin]

It just puts the wrong public image. TV shows evidently used to get approval from medical societies but never do now. Not that I think that the AMA speaks for me - they do NOT. But a show about surgical residents could at least talk to someone from the ACS.

The episode on the whole transplant fiasco with sandra oh (before you ask I read about it on a blog) put out the idea that surgeons do totally unethical things and probably made a negative impact on organ donation. Totally irresponsible.

 

[mysophobe]

It's all about ratings. They don't care what it does for public opinion, or if organ donation is now going to suffer, even though hundreds, even thousands of people already go waiting every year.

 

[LaCirujana]

Thanks alot, that was a very helpful post. In fact, everyone has been helpful. I guess why I want to know all this is because I really want to be a missionary surgeon, and I forsee me having to do alot of different procedures with very limited resources. So to me, it would be very very important to go to a program where I truly learn a little bit of everything. When choosing programs for residency, how would you possibly find out which programs have such a diverse training climate before you actually interview there?

There are a few programs out there that offer a rural surgery track (OHSU is one) that would give you more of the kind of training/exposure you might be interested in. Most programs have relatively decent websites that should have this kind of info on them.

 

[johnny_blaze]

this tv show is so crap. i dont remember surgery being that frickin competitive... i also dont remember fighting to scrub into the OR.. most of us are more interested in sleep... but i guess that doesn’t make for such a great tv show!
to be fair...i'll still watch the show... the main chick in it (i forget her name) and izzy are well fit

 

[tRmedic21]

Izzy's hot... Meredith is a stick. Although she's still got more flesh than Sandra Oh (the Oriental girl) Ugh!

 

[Biodude]

Of course Izzy's hot. She's played by Katherine Heigl

 

[surgdia]

to trmedic21.
"oriental" refers to a rug.
"asian" refers to a human.
A wise person once told me this, and I feel it's kept me from inadvertently offending many people.
sd

 

[tRmedic21]

I'm sorry? We can't say that someone is of Oriental heritage anymore? Wow, thanks for pointing that out... sorry if I'm not up on the latest in political correctness.

 

[tRmedic21]

Just out of curiosity, what are we supposed to call someone who has a darker skin color, you know, the non-Asian, non-Caucasian other race (I was taught in school there were three races)? Not sure what's considered to be proper nowadays, perhaps someone can tell me?

 

[Blade28]

this tv show is so crap. i dont remember surgery being that frickin competitive... i also dont remember fighting to scrub into the OR.. most of us are more interested in sleep... but i guess that doesn’t make for such a great tv show!

Well, sometimes we fight to get into the good cases.

 

[randomedstudent]

Just out of curiosity, what are we supposed to call someone who has a darker skin color, you know, the non-Asian, non-Caucasian other race (I was taught in school there were three races)? Not sure what's considered to be proper nowadays, perhaps someone can tell me?

some good advice I got once....ask the person how they define themselves.

 

[tRmedic21]

Yes, well, that's not always possible... I mean, are you going to refer to one person as Asian and the other as Oriental and the third as something else? And then Black and African-American and African-African and White and Caucasian and Pink and Pale and Yellow and Red and.... I mean come on.

I think people get way too damn hung up on this stuff. Personally. Of course nowadays, people want to find something to be offended about. It's much easier to play the victim that way.

 

[mysophobe]

I just call them black. No one has ever had a problem with that.

 

[johnny_blaze]

Well, sometimes we fight to get into the good cases.

fair enough, it probably varies from place to place but I've come across sort of an understanding that exists... if it's your patient on he/she is on your service then you get to scrub in. I’d ninja kick (chuck norris style!) anyone who was sneaky enough to try and steal my kool-aid… and i'm pretty sure my consultant would give me first dibs. I’ve yet to meet one that would sell me out.

on a separate note...
meredith is fit! i'd so do her. you just know she's a little sex minx.. rawr

 

[drpectin]

fair enough, it probably varies from place to place but I've come across sort of an understanding that exists... if it's your patient on he/she is on your service then you get to scrub in. I’d ninja kick (chuck norris style!) anyone who was sneaky enough to try and steal my kool-aid… and i'm pretty sure my consultant would give me first dibs. I’ve yet to meet one that would sell me out.

on a separate note...
meredith is fit! i'd so do her. you just know she's a little sex minx.. rawr

I assume that because of the un-freezing process you have no inner-monologue.

 

[Blade28]

fair enough, it probably varies from place to place but I've come across sort of an understanding that exists... if it's your patient on he/she is on your service then you get to scrub in.

Yeah but the problem is when there are two interns on the same service, or if you're fighting the PGY2 or PGY3 for the smaller cases.

Then again, if the other residents aren't interested in scrubbing in, then it's all good!

 

[yogalover01]

medical school ruined the show for me, it was my favorite show before med school and then I started picking out mistakes from it

 

[CyberMaxx]

medical school ruined the show for me, it was my favorite show before med school and then I started picking out mistakes from it

Lol way to resurrect an eight year old thread! One thing that I have found surprising is the number of my classmates who appear to have developed an interest in surgery in part from this TV show.

 

[TallScrubs]

According to this show, there is no such thing as ER doctors, and it is perfectly acceptable for an attending urologist to bust into an OR and tell a general surgeon how to do general surgery.

 

[trekker94]

Just out of curiosity, what are we supposed to call someone who has a darker skin color, you know, the non-Asian, non-Caucasian other race (I was taught in school there were three races)? Not sure what's considered to be proper nowadays, perhaps someone can tell me?

I say black.

 

[ThoracicGuy]

I say black.

Solid necrobump there...

 

[bizdr]

Hey everyone, in Grey's Anatomy, it seems like the general surgery residents get to scrub in on CT cases, OBGYN cases, neurosurgery cases, etc. Is this the case in real general surgery residencies? Do you actually get to scrub in on cases like this so you know what type of fellowship you might want to take? Or do you just do gutt and butt for all five years. I apoligize in advance for my ignorance on the subject.

On almost every hospital TV show - every Dr at some point will treat all kind of cases. You will see CT surgery docs talking to their patients like a Psych resident! You will see someone who seems to be an internist, scrubbing in on a surgery. They do have medical consultants, so they try to keep the facts fairly accurate - but the story line and relationships matter more than anything.