How bad is the bullying in a surgical residency? Should I be deterred from a specialty because of how "bad" that specialty's residency will be like?

[CuriousMDStudent]

I am a MS2 interested in a surgical specialty. Whenever I tell people that I want to do this specialty, my peers warn me against doing a residency in it because they say that residencies in surgical specialties involve a lot of verbal abuse and bullying and that I couldn't handle it.

This is interesting advice to receive because there is no way I can predict if I'll be bullied in a surgical residency. And also there's a possibility I can be bullied if I went into a medical residency. So I don't know if I should factor this into my specialty choice.

I would honestly say I'm someone who doesn't really appreciate being bullied like anyone else. If given critique, I take it seriously and think hard on how to improve. But I don't want to be bullied for no reason. I think that would make me miserable.

Input or thoughts on this would be appreciated.

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[MedScat]

For me, the surgical culture was just not what I was looking for. Everyone was so intense and kind of mean at times. Of course theres some people who are nice but, the general culture was very hierarchal and just not...chill. I discovered this by doing my rotation and I would not recommend counting out a specialty without rotating first. Everyone is different and to you, you might realize its not that bad. You might enjoy the organization of the OR and the graduated responsibility. Lifestyle should be factored in to your specialty choice but, you have to figure out how much of a priority it is to YOU. The culture also depends on the program/people so when you're interviewing for residency/doing away rotations you must factor these things in. Some places will be more toxic than others and you can somewhat pick that up on interview day, even in this virtual world.

 

[Lem0nz]

It varies wildly based on location and residency setting. Academic programs have earned their malignant stereotype for a reason - because many of them are malignant. Clearly not all of them. Community programs have earned their reputation as kinder/gentler for the same reason, however, they can make it an uphill battle to achieve ______ fellowship training after completion. Again, depends on the program. Some surgical subspecialties are generally felt to be harder than others so if you could be more specific we may be able to guide you. That isn't always because they're more toxic, or have more bullying, but rather it is because they can be smaller/more isolating and have heavier call burden which means that even light bullying or abusive culture can have a greatly magnified effect.

In general, all surgical training is dramatically improved from what it is 5, 10, and 20 years ago and will likely continue to make incremental improvement.

 

[Wordead]

Depends what you call bullying. There's a spectrum from physical abuse to being yelled at constantly to simply getting straightforward criticism that's meant to be beneficial to you, and not everyone can differentiate them. But generally if you have thin skin a surgical residency can be difficult.

 

[Browns99]

I am a MS2 interested in a surgical specialty. Whenever I tell people that I want to do this specialty, my peers warn me against doing a residency in it because they say that residencies in surgical specialties involve a lot of verbal abuse and bullying and that I couldn't handle it.

This is interesting advice to receive because there is no way I can predict if I'll be bullied in a surgical residency. And also there's a possibility I can be bullied if I went into a medical residency. So I don't know if I should factor this into my specialty choice.

I would honestly say I'm someone who doesn't really appreciate being bullied like anyone else. If given critique, I take it seriously and think hard on how to improve. But I don't want to be bullied for no reason. I think that would make me miserable.

Input or thoughts on this would be appreciated.

Listen, take what your "peers" warn you against with a grain of salt. It's ridiculous when med students or anyone else for that matter say stuff like that. Sure, sound advice may be that surgical specialities can me rigorous and some programs reach a level of malignancy(Although sometimes malignant its thrown around in place of hard work, other times it is applicable) which only you will know if you are capable and up to those rigors.

I say if you are very well prepared and become strongly interested in a surgical speciality after you have been exposed, then go for it.

 

[Gurby]

One of my most memorable moments on the residency interview trail... I was asked what I was looking for in a program, and I gave my canned answer about how I was looking for a program with a supportive culture, where the attendings and senior residents had a focus on mentorship and education. And the interviewer said, "you won't find that here. Our program is not warm and fuzzy like your medical school." .... I thanked them for their honesty, and off my rank list they went....

The academic surgery residency I am at now is about as warm and fuzzy as you can imagine - an attending reached out to give me their cell and offered to help unload my moving truck before I arrived, lots of invites to dinners, everyone is great to work with in the OR 95% of the time.

I think there likely is no avoiding big egos and mean people here and there in the surgery world, you will have to work with them at some point and you will get yelled at and feel belittled. Most likely you'll deserve it, and you'll get better from the experience and not make that mistake again. And even people who are very nice will lose their patience at some point, for example when it's 4am and you've been operating for 12 hours doing some terrible case and things are not going well and you have the B team in the OR and the scrub techs / anesthesia team are making mistakes left and right, the atmosphere is going to be unpleasant.

 

[DarkHorizon]

Not to pick on you or anything OP, but you’ve now made three or four threads regarding surgical specialties and your concerns, which appear to be very stereotypical and gross generalizations. I’m not sure who’s telling you all this, but it’s likely people who are not in surgery.

If you really are as interested as you say, you need to find mentors that are in the field. Go hang out with residents in the field. See if they will let you hang around on a weekend to take call with. Go to morning didactics and grand rounds to get a feel for yourself.

When I started this journey, I was cautioned by everyone that surgeons are workaholic egomaniacs. But none of those people were surgeons themselves or even in any field that dealt with surgeons. I had doubts, and all I heard was how hard they worked and how they all had god complex and were jerks.

I was lucky to find a mentor as an M1 who paved the way for me. He had just finished residency and could relate to all my concerns. He was the nicest guy in the world and is like my older brother now. I was able to interact with residents and see for myself. I made up my mind and never looked back. Throughout the way, I found more mentors who further solidified my decision. By M2 year, it was Ortho or bust.

 

[deleted50541]

Depends what you call bullying. There's a spectrum from physical abuse to being yelled at constantly to simply getting straightforward criticism that's meant to be beneficial to you, and not everyone can differentiate them. But generally if you have thin skin a surgical residency can be difficult.

Exactly. I never saw what one might call outright bullying in residency. But there were definitely certain residents who got scrutinized and criticized more than others by both senior residents and attendings. Frankly, a lot the comments and criticisms I heard were reasonable and justified that were meant to highlight deficiencies in thinking, poor surgical technique, and errors that posed potential patient harm.

It was almost never personal (except from a certain attending who once said to me, "it's not you, but it is you" when he wanted the chief to help him). But those who did take it personally seemed to fall into a pattern of mistakes and struggled to shake the moniker of a "weak resident".

 

[CuriousMDStudent]

Not to pick on you or anything OP, but you’ve now made three or four threads regarding surgical specialties and your concerns, which appear to be very stereotypical and gross generalizations. I’m not sure who’s telling you all this, but it’s likely people who are not in surgery.

If you really are as interested as you say, you need to find mentors that are in the field. Go hang out with residents in the field. See if they will let you hang around on a weekend to take call with. Go to morning didactics and grand rounds to get a feel for yourself.

When I started this journey, I was cautioned by everyone that surgeons are workaholic egomaniacs. But none of those people were surgeons themselves or even in any field that dealt with surgeons. I had doubts, and all I heard was how hard they worked and how they all had god complex and were jerks.

I was lucky to find a mentor as an M1 who paved the way for me. He had just finished residency and could relate to all my concerns. He was the nicest guy in the world and is like my older brother now. I was able to interact with residents and see for myself. I made up my mind and never looked back. Throughout the way, I found more mentors who further solidified my decision. By M2 year, it was Ortho or bust.

I do have my own mentors who have been great. The issue is that it sometimes sounds "too good to be true". I guess that's why I listen to my classmates and hesitate about how tough the specialty can be or how rigorous the work will be. I think I will trust my mentors more. Thanks!

 

[Browns99]

I do have my own mentors who have been great. The issue is that it sometimes sounds "too good to be true". I guess that's why I listen to my classmates and hesitate about how tough the specialty can be or how rigorous the work will be. I think I will trust my mentors more. Thanks!

Find new classmates, LOL.

 

[ACSurgeon]

I am a MS2 interested in a surgical specialty. Whenever I tell people that I want to do this specialty, my peers warn me against doing a residency in it because they say that residencies in surgical specialties involve a lot of verbal abuse and bullying and that I couldn't handle it.

This is interesting advice to receive because there is no way I can predict if I'll be bullied in a surgical residency. And also there's a possibility I can be bullied if I went into a medical residency. So I don't know if I should factor this into my specialty choice.

I would honestly say I'm someone who doesn't really appreciate being bullied like anyone else. If given critique, I take it seriously and think hard on how to improve. But I don't want to be bullied for no reason. I think that would make me miserable.

Input or thoughts on this would be appreciated.

Depends on how you define bullying.

Surgical fields are known to be rough around the edges. Feedback is rarely sugar coated. An irritated chief or attending will make it known that they’re irritated even if it’s not “fair”.

If you’re able to have thick skin and blow things off, you won’t perceive harsh words or encounters as bullying and you’ll do fine. If you get offended easily and can adjust to an environment where people will tell you what they think without regards to your feelings, then yes you might want to look at something else.

Yes rough personalities exist in all fields and you can get lucky at a very friendly surgical residency and you can get unlucky at a very “rough” medical program. Nonetheless, you make decisions based on the “norm” or average culture of a specialty when trying to decide and accept that you could have an experience outside the norm no matter what you choose.

 

[ACSurgeon]

OP- one more thing about the negative surgery stereotypes. They exist for a reason. There’s some truth to them. Some people experience them in a harsher way than others. If you notice in all your threads the surgeons rarely deny the existence of these problems but they try to give you a more realistic expectation, as it isn’t miserable 24/7, but some weeks or rotations can be. Some jobs as an attending can also be bad, but you can more easily just get another job.

I might get flak for this: but non-surgeons who speak very strongly against surgery are bitter about a bad experience or need to convince themselves that they made a good choice by avoiding surgery. Because, at the end of the day, everyone who didn’t do surgery knows they missed out on doing some cool stuff. I mean, that’s obvious 😉.

Similarly, surgeons who want to paint a super positive picture and claim to have zero regrets etc etc might also be trying to convince themselves that they made the right choice.

The truth lies somewhere in the middle. OP, you’ll have spend time with surgical types and see if you fit in and see if you like it enough to go through a more grueling track than average. Best of luck!

 

[operaman]

There’s an old saying that goes: the nicest neurosurgeon can make the meanest pediatrician cry. There are definitely certain personality types drawn to each specialty, but only you can determine whether or not you fit in.

How you define bullying is really the crux of your question. For me, over 3 different institutions and 10 years of school and training, I can say I never experienced anything I’d call bullying or abuse. I got yelled at and reprimanded some times, but that’s just part of learning in a high stakes high pressure field.

Along the way, I’ve been in some feedback sessions, especially as a student, where classmates on the same service as me were giving feedback to the course director and saying our rotation was abusive and unfair and that they were bullied. While I try and give people the benefit of the doubt, since I was with them 95% of the time I can say confidently that they were full of crap.

Some people just interpret everything adverse as a personal affront and find bullying and abuse where none exists. If your classmates are picking up on this trait in you, then they might be on to something. If you’ve already felt like M1/M2 were “abusive” then yeah, surgical training might be a long and difficult road for you.

 

[longhaul3]

I'm in one of the most intense programs in the most intense specialty of all. There are a lot of beatings and firm words handed down. A bad decision or a missed check box can lead to someone going back to the OR or dying within minutes to hours. Multiply this by the 100 patients you're immediately responsible for and add in the reality that almost no other doctors or nurses share the sense of urgency and you realize that it is not the same game that non-surgeons play, dealing with usually more chronic issues and sometimes more esoteric problems that allows (and can require) more deliberation and time.

What gets lost in the emotional harshness of this culture is that it's almost never personal. Bullying implies that there is some personal bone to pick. In my experience that has only happened when a resident brought it upon himself.

 

[Chelsea FC]

I'm in one of the most intense programs in the most intense specialty of all. There are a lot of beatings and firm words handed down. A bad decision or a missed check box can lead to someone going back to the OR or dying within minutes to hours. Multiply this by the 100 patients you're immediately responsible for and add in the reality that almost no other doctors or nurses share the sense of urgency and you realize that it is not the same game that non-surgeons play, dealing with usually more chronic issues and sometimes more esoteric problems that allows (and can require) more deliberation and time.

What gets lost in the emotional harshness of this culture is that it's almost never personal. Bullying implies that there is some personal bone to pick. In my experience that has only happened when a resident brought it upon himself.

Then you see docs in the same positions do the same job without the as*hole attitude attached. Which kinda shows me it’s not necessary for the job it just attracts people with that type of attitude.

 

[Browns99]

There’s an old saying that goes: the nicest neurosurgeon can make the meanest pediatrician cry. There are definitely certain personality types drawn to each specialty, but only you can determine whether or not you fit in.

How you define bullying is really the crux of your question. For me, over 3 different institutions and 10 years of school and training, I can say I never experienced anything I’d call bullying or abuse. I got yelled at and reprimanded some times, but that’s just part of learning in a high stakes high pressure field.

Along the way, I’ve been in some feedback sessions, especially as a student, where classmates on the same service as me were giving feedback to the course director and saying our rotation was abusive and unfair and that they were bullied. While I try and give people the benefit of the doubt, since I was with them 95% of the time I can say confidently that they were full of crap.

Some people just interpret everything adverse as a personal affront and find bullying and abuse where none exists. If your classmates are picking up on this trait in you, then they might be on to something. If you’ve already felt like M1/M2 were “abusive” then yeah, surgical training might be a long and difficult road for you.

Well said!

 

[operaman]

Then you see docs in the same positions do the same job without the as*hole attitude attached. Which kinda shows me it’s not necessary for the job it just attracts people with that type of attitude.

This is actually a very good point - there are plenty of really good hearted and kind surgeons which does make you wonder why some have such crappy attitudes. It’s clearly not necessary most of the time.

My sense thus far is that this is largely due to insecurity. In surgery, your flaws in technique and decision making are often immediately apparent. Your skill level is somewhat discernible by other staff and certainly by any fellow surgeons in your same field. While in other fields a poor decision may take years to get noticed, a surgical flaw may result in a near immediate complication. People are definitely watching too, especially in academia where you’re surrounded by other surgeons.

I honestly feel like I’m being watched and scrutinized more closely now as an attending than I ever was in training. Maybe I’m just paranoid because I have really awesome and supportive partners, but I’ve been around long enough to know that when attendings of mine were messing up, they were definitely talked about and some even faced real consequences in terms of posting privileges, required oversight, etc. So I’m definitely extremely cautious and conservative in my decision making because I need to get a few years of good solid outcomes under my belt.

I think this pressure and scrutiny can be brutal for “less gifted” surgeons. The nicest attendings I had were usually some of the best surgeons in our department. The douches were some of the worst. I know there are exceptions to this, but it seemed to hold true as a general principle, and I think the inherent pressures of the field probably contribute to this as much or more than the self selection of certain personalities.

 

[nimbus]

Some of the kindest and most caring people I have ever met happen to be surgeons. They run the gamut. I wouldn’t let that affect your choice of specialty.

 

[Dr G Oogle]

I might get flak for this: but non-surgeons who speak very strongly against surgery are bitter about a bad experience or need to convince themselves that they made a good choice by avoiding surgery. Because, at the end of the day, everyone who didn’t do surgery knows they missed out on doing some cool stuff. I mean, that’s obvious 😉.

this. You know how people say “all IM does is round” and “radiologists hare people” etc. it’s an outsiders perspective based on a superficial observation without any insider knowledge. Surgery in general is a tough job, when you think about it, people instill way more trust in us then any other specialty, they are literally letting us cut them while they are unconscious and believe that we are the reason that they will be better. This is stressful. Surgery is not pediatrics and outpatient medicine where there is plenty of time for coddling and hand holding (another superficial observation on my part), so some people will be short or gruff and sometimes grumpy more often than other specialties. You may not get a pat on the back if you’ve done something great all the time. Lots of days might suck, and it seems like stuff piles on. Surgery ultimately it is one of the most fulfilling careers out there, but it’s not for everyone, and sometimes people wash out, and those peoples opinions have to be taken with a grain of salt. I was in another specialty before doing urogyn, and I have very specific opinions about that other specialty which are not congruent with what the people within the specialty say. And when I talk with students about the other specialty I make it a point that what I say is from someone who “washed out” of that specialty.

Finally, there is very little tolerance for outright bullying in any training program and there are now multiple safe avenues for reporting this stuff. At my own institution multiple attending as have been asked to resign or were fired or reprimanded for bullying to the significant betterment of the training programs.

 

[bGMx]

Surgery in general is a tough job, when you think about it, people instill way more trust in us then any other specialty, they are literally letting us cut them while they are unconscious and believe that we are the reason that they will be better. This is stressful.

I would argue that psychiatry asks for equivalent trust but in a different sphere, especially if you add psychotherapy into the practice. One is trust in mechanical ability to not kill you, and the other is trust in the meta-mechanical manipulation of the phenomena of your experience.

 

[Matthew9Thirtyfive]

You know how people say “all IM does is round”

I mean I’ve done 9 weeks on IM now, and that’s pretty much all we’ve done. So it’s a stereotype for a reason lol.

 

[Dr G Oogle]

I mean I’ve done 9 weeks on IM now, and that’s pretty much all we’ve done. So it’s a stereotype for a reason lol.

They also write notes 😉

 

[Matthew9Thirtyfive]

They also write notes 😉

We write our notes during rounds here, so I consider that part of rounding.

 

[nimbus]

I did an elective NICU rotation during anesthesia residency and 6 hours of rounding from 7am til 1pm after 24 hours (7am-7am) of call was HARD. I learned a lot and developed an appreciation for pediatricians, NICU nurses, and NICU NPs, but I was very happy to get back in the OR.

 

[jstwannagraduaaate!!!]

Could someone speak on the stereotypes of the personalities of IM subspecialists like cardio/pulm/gi?

 

[nimbus]

Could someone speak on the stereotypes of the personalities of IM subspecialists like cardio/pulm/gi?

They’re the internists that don’t get off on sodium

 

[Dr G Oogle]

Could someone speak on the stereotypes of the personalities of IM subspecialists like cardio/pulm/gi?

They are all true 😉

 

[YCAGA]

Not to pick on you or anything OP, but you’ve now made three or four threads regarding surgical specialties and your concerns, which appear to be very stereotypical and gross generalizations. I’m not sure who’s telling you all this, but it’s likely people who are not in surgery.

If you really are as interested as you say, you need to find mentors that are in the field. Go hang out with residents in the field. See if they will let you hang around on a weekend to take call with. Go to morning didactics and grand rounds to get a feel for yourself.

When I started this journey, I was cautioned by everyone that surgeons are workaholic egomaniacs. But none of those people were surgeons themselves or even in any field that dealt with surgeons. I had doubts, and all I heard was how hard they worked and how they all had god complex and were jerks.

I was lucky to find a mentor as an M1 who paved the way for me. He had just finished residency and could relate to all my concerns. He was the nicest guy in the world and is like my older brother now. I was able to interact with residents and see for myself. I made up my mind and never looked back. Throughout the way, I found more mentors who further solidified my decision. By M2 year, it was Ortho or bust.

Is it chill to ask residents in a surg sub we are interested in if we can come in on the weekend? I don’t want to annoy them

 

[SlitLampExam]

One should consider that if a residency has an extreme amount of bullying, it could end your career as a doctor. That is not too common but it is not an extremely rare event.

 

[ChordaEpiphany]

Depends what you call bullying. There's a spectrum from physical abuse to being yelled at constantly to simply getting straightforward criticism that's meant to be beneficial to you, and not everyone can differentiate them. But generally if you have thin skin a surgical residency can be difficult.

Depends on how you define bullying.

Surgical fields are known to be rough around the edges. Feedback is rarely sugar coated. An irritated chief or attending will make it known that they’re irritated even if it’s not “fair”.

If you’re able to have thick skin and blow things off, you won’t perceive harsh words or encounters as bullying and you’ll do fine. If you get offended easily and can adjust to an environment where people will tell you what they think without regards to your feelings, then yes you might want to look at something else.

Yes rough personalities exist in all fields and you can get lucky at a very friendly surgical residency and you can get unlucky at a very “rough” medical program. Nonetheless, you make decisions based on the “norm” or average culture of a specialty when trying to decide and accept that you could have an experience outside the norm no matter what you choose.

Can't echo this sentiment enough. It's true not just in surgery, but in every workplace.

Different people react to criticism very differently. By medicine standards, a PhD is the most "cush" training program you could imagine. Still, we had a rotating student blow up just last week and call the whole lab "toxic." Her peer mentor, one of the most reasonable people I've met, asked her (kindly) to stay past five a few times and told her she needed to work on her attention to detail after messing up an experiment for the 5th time in a row. Every year, out of the ~30 PhD students who join the program, about 2-3 are completely incapable of tolerating criticism. They almost always leave the program, and they will all tell you that their mentor was a bully/toxic, yet the graduates of the lab will sing that same mentor's praises.

People also give criticism differently. What really what matters is not the delivery of the criticism, but whether or not that criticism is fair. I've seen people bully their mentees or underlings for their own mistakes or for things that are impossible to predict. I'd rather be yelled at constructively than subtly torn down by unfair critiques.

 

[Banco]

Highly dependent on program and hospital culture.

6 months into GS internship, have never been bullied, chewed out, or even come close to it; never seen it be done to a coresident either - and trust me, we've made tons of mistakes.

 

[doyouhaveaflag]

OP, as others have recognized, you've posted in several places a few concerns about pursuing a surgical specialty. I think you'll find the answers you need when you rotate in surgery. Sure, there are different personalities that typically go into different specialties. Even within surgery, the personality of one subspecialty can be very different from another. You'll find out if we're "your people" when you rotate.

I think a point that a poster above made was very astute, where they said that people take commentary and criticism very differently. One person's humorous heckling may seem like toxic criticism to another. If you've one anything like dance or sports or music at a high level, I think the experience is very similar. If an attending is doing it right, there will be constant feedback to you as a resident learning to operate. Some of that feedback may be negative, but it's necessary so you become a safe surgeon. Attendings vary in how mean/kind/humorous they are in the delivery of the message. However, it's how it's received that's more important in determining one's experience as positive or negative.

Additionally, things have changed in recent years and wellness is being taken more seriously. Toxicity is no longer being tolerated in many places. I don't know about other surgical specialties, but the ACGME withdrew accreditation for two plastic surgery programs in April. In at least one instance, it was due in part to being a highly abusive environment. The ACGME sent a message that it was unacceptable.

 

[ACSurgeon]

OP, as others have recognized, you've posted in several places a few concerns about pursuing a surgical specialty. I think you'll find the answers you need when you rotate in surgery. Sure, there are different personalities that typically go into different specialties. Even within surgery, the personality of one subspecialty can be very different from another. You'll find out if we're "your people" when you rotate.

I think a point that a poster above made was very astute, where they said that people take commentary and criticism very differently. One person's humorous heckling may seem like toxic criticism to another. If you've one anything like dance or sports or music at a high level, I think the experience is very similar. If an attending is doing it right, there will be constant feedback to you as a resident learning to operate. Some of that feedback may be negative, but it's necessary so you become a safe surgeon. Attendings vary in how mean/kind/humorous they are in the delivery of the message. However, it's how it's received that's more important in determining one's experience as positive or negative.

Additionally, things have changed in recent years and wellness is being taken more seriously. Toxicity is no longer being tolerated in many places. I don't know about other surgical specialties, but the ACGME withdrew accreditation for two plastic surgery programs in April. In at least one instance, it was due in part to being a highly abusive environment. The ACGME sent a message that it was unacceptable.

Be careful counting on the ACGME though because programs warn residents about their uncertain fate if the program goes under….

 

[CuriousMDStudent]

Wow. I haven't checked this thread in a while. Thank you for everyone for your input. I got so many different opinions but I think that I will find out when I go into my surgery rotation.

Many of the surgeons in my field have been very nice to me when I work with them in research or shadowing but it's not the same as actually working with them in the OR. So I will see how the rotation is. Have a nice day.

 

[ortnakas]

Is it chill to ask residents in a surg sub we are interested in if we can come in on the weekend? I don’t want to annoy them

Not a surgeon, but in general:

Okay to ask.

Not okay to insist, to not take no for an answer, or to go in if told not to.