I think the more accurate definition of "playing the game" is not voicing your concerns about the issues that are going on in your program that everyone seems to "accept" (lack of equipment, unsafe practices, abusive behavior, etc.). It has nothing to do with skill level. People in every field, specialty and discipline suffer abuse and it is not necessarily a result of poor performance or " folks refuse to take that next step of being THE doctor ". Residents quickly learn to keep their mouth shut, even if it isn't in the interest of the patient or even the betterment of their education. So when someone steps up , or whistleblows in a way, that person will suffer. It can be anything from questioning an outdated technique to asking for more didactics. The unfortunate practice of playing the game also unfortunately leads to residents to treat the abused as if they deserve bad treatment for speaking up, even if they agree completely with the accusations or criticisms made by the abused. It is horrible and isolating and acceptable because everyone is afraid of becoming the next victim.
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agree w/this, for the most part. I think that in general OB/gyn and some surgical programs (such as general surgery and some others) tend to be the most "malignant" because they attract more absolutist personalities and they tend to work harder than most other specialties, which makes people tired and cranky. Also I feel that the risk of harming patients and the risks of lawsuits probably weighs heavily upon peoples' minds, particular the attendings.
Family practice tends to attract more friendly personalities, so if you just want to do OB you might troll around or do some quiet phone call making and see if there might be an FP place perhaps with OB fellowship that you could transfer to.
Also, there are more specialties that you could move into that are not that competitive. Physical med/rehab tends to probably have a lot of "nice" people as well and probably not malignant. Most pathologists I know are relatively soft spoken and probably not going to try to ream you out all the time, although might not be the most gregarious people ever. But not sure about the pathology job outlook. Ditto for nuclear med.
I agree somewhat with the idea that if you aren't sure you can get something better, and you actually like your specialty field, and you don't think they are likely to throw you out, you might want to suck it up, especially if you've only got a couple years left. You might get into a crappier program, particularly if the PD is going to obstruct you. Do you think they want to keep you but torture you? Why won't they just let you resign if you're driving them crazy? I wouldn't resign without reasonable possibility of getting into another residency like fp or IM, but you seem articulate and probably not foreign (based on the way you write) so I would think if the PD didn't poison your application you could probably get something in another specialty.