How to cope on gen surg

[Abcdefghijkl]

Anyone have any suggestions on how to actually feel ok while on gen surg? I'm on 1 in 3 call and have had no minutes (let alone hours) of sleep any of those nights...they don't let me eat, they don't let me drink, they don't let me PEE!!! i feel like i'm a prisoner undergoing some sort of torture to break me!

what do you guys do to cope? ...i'm struggling

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[Blade28]

While you may not be able to eat or sleep during your call, you should at least have 5-10 minutes of downtime here and there to use the bathroom!

With regards to the other two things, follow the old adage: "sleep when you can, eat when you can."

 

[mules05]

While you may not be able to eat or sleep during your call, you should at least have 5-10 minutes of downtime here and there to use the bathroom!

With regards to the other two things, follow the old adage: "sleep when you can, eat when you can."

If you're good, you can accomplish a lot on those 5 minute bathroom breaks. Just pee quicker, and use the remaining 2 minutes to scarf down the granola bar hidden in your pocket (or even better, those little gel packets made for marathon runners that have like 200 calories and some caffeine per packet). Plus, if you're a girl and don't have to worry about aiming, close your eyes while on the loo. Three problems solved.

 

[Blade28]

If you're good, you can accomplish a lot on those 5 minute bathroom breaks. Just pee quicker, and use the remaining 2 minutes to scarf down the granola bar hidden in your pocket (or even better, those little gel packets made for marathon runners that have like 200 calories and some caffeine per packet).

Exactly!

 

[AF_PedsBoy]

As a extra time saver when I'm taking my two minute bathroom break in the middle of the day I do all my crying; that and I say, "****!!!!" a lot. The techs always look at me funny when I'm done using the bathroom...

 

[arthrodisiac]

i think you're fos about not being able to go to the bathroom. And as far as not being able to eat, if thats really true...carry around a syringe of 50% glucose and drink it.

 

[pillowhead]

i think you're fos about not being able to go to the bathroom. And as far as not being able to eat, if thats really true...carry around a syringe of 50% glucose and drink it.

uh, have you done a surgery rotation yet? it's not that people don't "let you" go to bathroom. you can literally go all day and there simply isn't time. it's hard to believe until it happens to you, but trust me, it happens.

 

[Llenroc]

Learn how to take a **** in the hospital everyday.

 

[SLUser11]

uh, have you done a surgery rotation yet? it's not that people don't "let you" go to bathroom. you can literally go all day and there simply isn't time. it's hard to believe until it happens to you, but trust me, it happens.

I think alot of that is time management problems, though. I always found time to go to the bathroom during my surgery rotations.

Also, I think it's safe to say that your residents are working harder than you, with more responsibilities, and I can promise you that they're finding time to go to the bathroom.

Eating can be more difficult, but I always found time to eat, too. I would be on the same rotation with classmates, with the same responsibilities, and would arguably be outperforming them, and yet at the end of the day, they were saying "I didn't get a chance to eat, pee, etc. There's just not enough time!" And I was well-fed with an empty bladder.

Seriously. It's time management, not the nature of general surgery, that's eliminating your potty breaks.

 

[toofache32]

A good ol' one-two punch with a cigarette and coffee usually does the trick for me.

 

[Doowai]

I carried protein bars etc in my pockets and it came in handy. Surgery rotations were tough - I had to do 3 months, one of them over December. I had one day off - Christmas day - they paged me but I did not answer the page.

I did all of my rotations with the same surgeon. My third month I left the surgeon on the way to a surgery and went into the bathroom to pee prior to a surgery. I knew my way around the surgical floor. I stopped to look in the mirror - check and make sure my nose hairs were under control etc - I opened the bathroom door and *boom* almost crapped my pants because the surgeon was standing RIGHT IN FRONT OF THE DOOR - I mean if I shut the door it would have been perhaps half an inch from their face - they appear disgruntled, looks at their watch and say "What the hell..... how long does it take you to pee? If you did not drink water you would not have to pee!" I just figured they would have gone to the surgical suite without me - I mean I had been there alot, and could find my own way there. But yes, surgeons like to stay busy and expect to move fast amd expect you to keep up.

How much surgery do you have to do? Remember it only lasts so long.

 

[Abcdefghijkl]

granted some days are less busy than others but really there are days where i'm scrubbed in the or retracting for hours or even not scrubbed but i can't just leave then between cases running to the wards dealing with things just in time to go back to the or.....and maybe i COULD run away for a few minutes but i would inevitibly get yelled at for taking too long and could potentially face some repercussions for acting "unprofessionally".

also, i've had 1 in 3 call my whole rotation and where I go to school, clerks get called for all ward issues. there have also been nights where i've been in emerg the whole night doing H&Ps for the residents who are also being run off their asses because there were so many consults

so i'm asking not because i think i'm the only one experiencing this but because i KNOW there are people out there who are able to manage gen surg well and even pick it as a specialty!!

 

[Doowai]

I never had 1:3 call as a clerk though - that does suck.

 

[Blade28]

so i'm asking not because i think i'm the only one experiencing this but because i KNOW there are people out there who are able to manage gen surg well and even pick it as a specialty!!

As others have said, it's all about time management. Definitely possible.

 

[Abcdefghijkl]

what do you do about the fact that you're only ever awake at home for 2 hours a day?

 

[toofache32]

what do you do about the fact that you're only ever awake at home for 2 hours a day?

sleep for one of them

 

[Blade28]

what do you do about the fact that you're only ever awake at home for 2 hours a day?

But that's how it can be in residency, too. If you get home around 6-7 pm, you're probably going to bed by around 9 pm. Gotta eat, try to read, watch a little TV, maybe make a couple phone calls - then go to bed.

 

[Winged Scapula]

This is fairly typical for a surgical residency, even in this post-80 hrs era.

I uesd to do my wash in shifts because I was too tired to stay up and put it in the dryer.

It means having lots of easy to prepare food at home and never trying to run out of essentials: soap, TP, etc. because who wants to run out to the store when they get home after a really long day?

I see lots of students taking a lot of time to do things or not being prepared. As othres have said, its time management:

Do not come to the OR late because you "need" to go to the cafeteria and sit down to eat breakfast after rounds (I actually had some students do that). Either eat before you come to the hospital or bring power bars with you.

Walk faster than me to the OR so you have time to pee and get into the room before I do.

Do a test run the day before you start the rotation, so you know where you are meeting, how to get there, where to park, how to get scrubs, maybe even what the census is.

If you have to call the lab for test results not on the computer, make sure there are no others you haev to do...save yourself another phone call. Same goes for looking at films.

Learn a system for memorizing your patient's results and your note, so you don't have to photocopy it or rewrite it so you have something to read from on rounds (I've also seen this done). A waste of time.

If there are students and residents that can pray 5 times a day without being obtrusive and missing things, surely you can eat and pee.

 

[TMZ2007]

I carried protein bars etc in my pockets and it came in handy. Surgery rotations were tough - I had to do 3 months, one of them over December. I had one day off - Christmas day - they paged me but I did not answer the page.

They are telling me right now that I'm working both Christmas eve and day... and being on call Christmas eve. Is this normal? It's kinda a holiday for me...

I'm also 1 in 3 and totally understand how you feel!

 

[toofache32]

Learn a system for memorizing your patient's results and your note, so you don't have to photocopy it or rewrite it so you have something to read from on rounds (I've also seen this done). A waste of time.

You memorize your patient's info?

 

[plastikosmd]

"It's kinda a holiday for me... "


i still remember what my dean of students said at his opening remarks on my
first day of med school

"you are gonna miss out on weekends, holidays, birthdays, family events..
etc......just like your patients."

 

[TMZ2007]

"It's kinda a holiday for me... "


i still remember what my dean of students said at his opening remarks on my
first day of med school

"you are gonna miss out on weekends, holidays, birthdays, family events..
etc......just like your patients."

thanks. that makes me feel better about putting my faith on the back burner.

 

[plastikosmd]

maybe you can find a way to take care of your patients and celebrate your faith as they may not be mutually exclusive, ...good luck

 

[Abcdefghijkl]

all i can say is that thank god i only have 8 more days in gen surg until the mandatory rotation i'm gonna have to do in residency----i just don't think i'm cut out to be a general surgeon

 

[Blade28]

I had bad luck during my intern year - was on in-house overnight call for my birthday, Thanksgiving, Christmas, New Year's and Valentine's day.

Beat that!

But yeah, what KC said. Time management is crucial - as is sleeping when you can to maximize your energy. I've also done laundry in shifts before. The tough thing is finding free time during business hours to go to the doctor/dentist, pick up dry cleaning, go to the bank, get a haircut, etc.

Luckily I have a small gym at my apartment complex so I can go there easily.

 

[Winged Scapula]

You memorize your patient's info?

Yes. Its a valuable skill and one that is expected as a resident, or at least in every hospital where I've trained. I've seen other attendings downbrade medical students for presenting the patient while reading the progress note.

Its okay to peek at your patient list from time to time, say for vitals or unusual labs, but you should not be reading from them like cue cards.

 

[Winged Scapula]

I had bad luck during my intern year - was on in-house overnight call for my birthday, Thanksgiving, Christmas, New Year's and Valentine's day.

Beat that!

A man with a fear of commitment shouldn't have a date on Valentine's Day anyway...too many implications.

But yeah, what KC said. Time management is crucial - as is sleeping when you can to maximize your energy. I've also done laundry in shifts before. The tough thing is finding free time during business hours to go to the doctor/dentist,

Yep. Pretty much missed out on those until fellowship.

pick up dry cleaning

Dryel and my grocery store had a dry cleaner in it. Killed two birds...

go to the bank

On-line banking. Saved me, really.

get a haircut, etc.

Pretty much did without as well. Easier for a female prolly, although my ex's hair grew to waist length when both he and I didn't have time to get it professionally cut.

Luckily I have a small gym at my apartment complex so I can go there easily.

That and your calf contractions in the OR!

 

[Blade28]

Yes. Its a valuable skill and one that is expected as a resident, or at least in every hospital where I've trained. I've seen other attendings downbrade medical students for presenting the patient while reading the progress note.

Agreed - that's a big no-no. I don't like it when med students Xerox their notes before placing them in the chart, then read off them in rounds.

I mean, we don't expect you to memorize every single vital sign and lab (that takes a couple years of residency to get down pat), but at least know the important ones, or any grossly abnormal ones!

A man with a fear of commitment shouldn't have a date on Valentine's Day anyway...too many implications.

That and your calf contractions in the OR!

Damn you and your well-honed (through years of surgical beatdowns) memory!

I actually got asked out last Valentine's Day by a nurse I'd only very briefly worked with...long story, will save it for another thread. Needless to say I was completely flustered and shocked and wasn't suave at all!

 

[Sir Buckethead]

"Pretty much did without as well. Easier for a female prolly, although my ex's hair grew to waist length when both he and I didn't have time to get it professionally cut."

That's gotta be hyperbole. We are talking years, unless he was fabio.

Sorry, sorry, I'll go back to pre allo where I belong.

 

[Blade28]

"Pretty much did without as well. Easier for a female prolly, although my ex's hair grew to waist length when both he and I didn't have time to get it professionally cut."

That's gotta be hyperbole. We are talking years, unless he was fabio.

It kinda sounds like he didn't cut his hair for 5+ years.

 

[toofache32]

Agreed - that's a big no-no. I don't like it when med students Xerox their notes before placing them in the chart, then read off them in rounds.

I mean, we don't expect you to memorize every single vital sign and lab (that takes a couple years of residency to get down pat), but at least know the important ones, or any grossly abnormal ones!

I guess I wasn't talking about reading a script. I was thinking about how some a$$hole residents like to ask "what was his sodium 6 days ago?" and actually seemed surprised when the student has to look it up.

 

[Winged Scapula]

"Pretty much did without as well. Easier for a female prolly, although my ex's hair grew to waist length when both he and I didn't have time to get it professionally cut."

That's gotta be hyperbole. We are talking years, unless he was fabio.

Sorry, sorry, I'll go back to pre allo where I belong.

It was years that neither of us had our hair cut. His was shoulder length when we started dating and it grew to waist length (no hyperbole, really) before he cut it off as a suprise for me.

I was post call. I was not happy.

Not Fabio, but I thought he was pretty sexy with the long hair (which explains more than lack of time as to why he didn't cut it.) It didn't take 5 years as it grew pretty fast...prolly more like 3 years as I remember he wore it long for fellowship interviews. Matched at a program where the PD also had long hair!

Sorry for the thesis...I know you didn't really care.

 

[Winged Scapula]

Damn you and your well-honed (through years of surgical beatdowns) memory!

That and being female...I remember everything a man says to me!

 

[Blade28]

That and being female...I remember everything a man says to me!

Must...remember...this...

 

[Winged Scapula]

Must...remember...this...

My ex used to comment that it would have been easier to be with some air-head because she would probably be too distracted by shiny objects to remember what he said.

I can look at shiny objects and listen to you at the same time!

 

[toofache32]

I can look at shiny objects and listen to you at the same time!

you mean....like a #10 blade?

 

[Winged Scapula]

you mean....like a #10 blade?

I prefer a #15 (or an 11 at times), but yeah!

 

[Blade28]

I can look at shiny objects and listen to you at the same time!

So that's how everyone manages to criticize me as I'm (1) making a skin incision with a 10 blade; (2) opening a vessel with an 11 blade; (3) cutting a clump of tissue containing a tied-off vessel with a 15 blade!

 

[AF_PedsBoy]

I guess I wasn't talking about reading a script. I was thinking about how some a$$hole residents like to ask "what was his sodium 6 days ago?" and actually seemed surprised when the student has to look it up.

If it's been normal you say, "It was normal." If it's an abnormal lab result you SHOULD be trending it. As a med student I used to carry a single page folded into quarters for each patient with the H&P summary on the front, the meds on the back, and on the inside any SIGNIFICANT labs or studies. Keep in mind, in many residencies the attending may switch up to every week, and will need to know trends and past studies you may already take for granted. And while med students only carry 3-5 patients, they need to keep track of 15-30 patients which is where YOU come in

 

[Winged Scapula]

If it's been normal you say, "It was normal." If it's an abnormal lab result you SHOULD be trending it. As a med student I used to carry a single page folded into quarters for each patient with the H&P summary on the front, the meds on the back, and on the inside any SIGNIFICANT labs or studies. Keep in mind, in many residencies the attending may switch up to every week, and will need to know trends and past studies you may already take for granted. And while med students only carry 3-5 patients, they need to keep track of 15-30 patients which is where YOU come in

You can actually fit 30 pages, folded in half in an average lab coat pocket.

Our patient lists were printed on one page, which I folded once lengthwise and then across. I could carry a hold month's worth of patient data, including labs, VS, test results, etc. with me.

 

[t33sg1rl]

You must be tall... all pockets are not sized alike. I'm not a big person and my coat pockets are about HALF the size of the pockets on the larger people's coats. It's really, really, annoying.

 

[Winged Scapula]

You must be tall... all pockets are not sized alike. I'm not a big person and my coat pockets are about HALF the size of the pockets on the larger people's coats. It's really, really, annoying.

No...just average (5'5") but I think the pockets on the long coats may be bigger than the med student coats. And I tend to order men's coats because I find it hard to locate women's coats with the cloth buttons. So that may be the reason as well.

 

[VoiceofReason]

These stories have to be exceedingly exaggerated. The way you guys make it sound, g surg training has crossed over from rigorous, through inhumane, and into seventh circle of hell in sight of satan's prison.

I'm only a lowly MS-0 but I've been enamored of g surg for a while now, and this is what I'll be shooting for going into medicine ( I know, opinions change. But only knowing what I do, I really like g surg). How can it possibly be this bad? Nobody would do it if you couldn't even urinate once in a while. How is that even safe for the patient to have a resident running on empty and holding in a dump that should have come out an hour ago?

 

[Blade28]

I'm only a lowly MS-0 but I've been enamored of g surg for a while now, and this is what I'll be shooting for going into medicine ( I know, opinions change. But only knowing what I do, I really like g surg). How can it possibly be this bad? Nobody would do it if you couldn't even urinate once in a while. How is that even safe for the patient to have a resident running on empty and holding in a dump that should have come out an hour ago?

What exactly is that, an MS-0? You just started med school? (Isn't that an MS-I?) Or you're a pre-med who's applying to med school now? Or who's been accepted?

Back to the topic at hand...while bathroom breaks are obviously necessary, there are many days when you just don't have time to eat lunch or dinner. Or sleep. Trust me.

 

[VoiceofReason]

Sorry I've seen it written in other posts. What I was trying to convey there is that I've been accepted but I haven't started yet (9 months and counting).

I mean, I could see myself losing sleep a couple nights a week and even going long stretches without eating (a balanced meal) a couple days a week. By that I mean like 2 or 3 tops. If its much worse than that I don't think I'll end up doing it. Again, I know its early but a man can still be curious about these things.

 

[Blade28]

Well you know many rotations will require Q3 or Q4 overnight call, right? OB and General Surgery are both notorious for this.

 

[SoCuteMD]

These stories have to be exceedingly exaggerated. The way you guys make it sound, g surg training has crossed over from rigorous, through inhumane, and into seventh circle of hell in sight of satan's prison.

I'm only a lowly MS-0 but I've been enamored of g surg for a while now, and this is what I'll be shooting for going into medicine ( I know, opinions change. But only knowing what I do, I really like g surg). How can it possibly be this bad? Nobody would do it if you couldn't even urinate once in a while. How is that even safe for the patient to have a resident running on empty and holding in a dump that should have come out an hour ago?

G-surg IS that bad at MANY places. I would know. Today is day 15. I broke 200 hours today. I've been in the hospital for no less than 10 hours of every day but one of the past 15. I got meal tickets on November 1st to cover breakfast, lunch, and dinner for the entire month of November. I should have used 31 of them. I've only used 20, and my team has ordered delivery for one of those missed meals. The day of my first short call I went from lunch to lunch the following day without eating anything because I was in the OR when the cafeteria closed for the night and I was back in the OR the next AM before it opened for the day. I usually get to pee, but only because there are bathrooms everywhere in this hospital.

In the OR I can do nothing right. I cut the sutures too long, too short, I take too long, the scissors won't cut (this was actually my fault today, apparently...). These are things that WILL get you screamed at by some attendings.

I get up at 4 every morning. Every fourth night I am required to work until 11, which really means working until 11, wrapping up the last few things and getting out at 11:30. Alternately it means getting pulled into the OR at 10:45 and being there until the case is finished. You are still expected back, on the floor, at 5 AM the next day no matter how late the case goes. If your fourth night falls on Friday or Saturday you stay until the following morning (usually around 10 AM). If it's Sunday, you come in from 6 AM (yay, an extra hour of sleep!) until 11 PM.

It's fine to be curious as an MS-0, and I'd encourage you to take a look around, but I'd ask that you refrain from criticizing the clinical med students and their discussions of rotations. They are what they are, and we need a place to vent just as those in the midst of the application process need a place to do so.

 

[Blade28]

In the OR I can do nothing right. I cut the sutures too long, too short, I take too long, the scissors won't cut (this was actually my fault today, apparently...). These are things that WILL get you screamed at by some attendings.

I get up at 4 every morning. Every fourth night I am required to work until 11, which really means working until 11, wrapping up the last few things and getting out at 11:30.

Unfortunately much of this continues during residency.

And we don't always get out by 12.

 

[UT_mikie]

I get up at 4 every morning. Every fourth night I am required to work until 11, which really means working until 11, wrapping up the last few things and getting out at 11:30. Alternately it means getting pulled into the OR at 10:45 and being there until the case is finished. You are still expected back, on the floor, at 5 AM the next day no matter how late the case goes. If your fourth night falls on Friday or Saturday you stay until the following morning (usually around 10 AM). If it's Sunday, you come in from 6 AM (yay, an extra hour of sleep!) until 11 PM.

Mmm... Short call.. that would be nice. Our surgery service doen't have any short call and I've been Q3 this last week. Yea, g-surgery is pretty bad. I have destroyed the 80 hr/wk several times this month. (So ha!) And my longest shift so far is 34 hours w/o any sleep. The people work you hard. I got stuck with a pretty bad resident and intern who don't necessarily treat us all that well. That being said all of the attendings are great at my school. They are happy to be there, never yell at students and are always supportive and eager to teach us. The yelling is mostly directed towards residents and interns whenever they screw up, I don't think I've yet been yelled at yet, although I've gotten hit with alot of sarcasm.

Surgery is a tough field and I think most schools try to give us an accurate representation of what its like. Most attendings are still taking call at least Q5, and one of my R3 residents was still doing work well into the evening post call one day. So its not like we're doing any more work than what they are doing, in fact we're doing alot less. But I've never met a bunch of people who were willing to put up with so much **** to do what they love. They love being in the OR. More power to them.

now with that defense of surgery, I will now gladly pronounce that after this rotation is over, I will never get anywhere near an OR for the rest of my life unless I'm the patient under anesthesia. Good bye surgery! YEA!!!

 

[SoCuteMD]

Mmm... Short call.. that would be nice. Our surgery service doen't have any short call and I've been Q3 this last week. Yea, g-surgery is pretty bad. I don't think I've been under 80 hours/wk once this month. (So ha!) And my longest shift so far is 34 hours w/o any sleep. The people work you hard. I got stuck with a pretty bad resident and intern who don't necessarily treat us all that well. That being said all of the attendings are great at my school. They are happy to be there, never yell at students and are always supportive and eager to teach us. The yelling is mostly directed towards residents and interns whenever they screw up, I don't think I've yet been yelled at yet, although I've gotten hit with alot of sarcasm.

Surgery is a tough field and I think most schools try to give us an accurate representation of what its like. Most attendings are still taking call at least Q5, and one of my R3 residents was still doing work well into the evening post call one day. So its not like we're doing any more work than what they are doing, in fact we're doing alot less. But I've never met a bunch of people who were willing to put up with so much **** to do what they love. They love being in the OR. More power to them.

now with that defense of surgery, I will now gladly pronounce that after this rotation is over, I will never get anywhere near an OR for the rest of my life unless I'm the patient under anesthesia. Good bye surgery! YEA!!!

At least you get post-call days. I figured out it works out to the same hours when you add short call plus the next day, so we don't actually get any extra sleep. In fact, if you add my short call day and the next day, it was 35 hours last week.