Is surgical residency easier if you're a total jerk?

[SomeFakeName]

Let me explain...there is 3rd year general surgery resident who is unbelievably abrasive, condescending, and as big of a jerk as you could possibly imagine. But the thing is that he is only this way towards med students, other residents, and nurses/PAs. When working with patients and attendings, it seems as if his attitude changes 180-degrees and he suddenly becomes Mr Nice Guy. His patients seem to love him and as far as I know none of the attendings complain about him.

From what I gather, I think he acts this way to make residency easier on himself since the nurses seem so scared of him that rumor is that they are afraid to call him because his temper will explode (as it has several times in the past) if he thinks he is being "disturbed" by trivial matters. I'm not joking when I say you can almost feel the tension rise among a group of nurses when they are around him or even at the mention of his name.

The same thing goes for the other surgical residents he works with in that he is hated by virtually all of them and I've yet to hear a good thing said about him, except that a lot of them do agree that he is pretty slick when it comes to operating.

So I don't know, is he "acting" this way around residents and nurses to make life easier for himself during residency, and then turning around and being all nice and sincere when around patients and attendings? Anybody else deal with this type of resident before?

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[triathlete411]

I worked with one resident who was very condescending towards me and the interns on my team, but was excellent with patients and attendings. At first I took it as a personal affront, but then I realized that it wasn't that this resident was being intentionally abrasive, it's just that I wasn't a priority. I kept working hard and was pleasantly surprised to find out that it didn't go unnoticed. This same resident who couldn't waste a minute to give me the time of day gave me a great critique.
Anyway, the answer to your initial question of do you have to be a total jerk is no. The caveat is that some people don't handle high stressed environments in the best way and take it out on the perceived weaker people - something that I wouldn't take personally.

 

[felson]

Unless you stay in academia, the jerks won't do well in private practice where patients and referring physicians have options. Patients also are more likely to sue the physicians they have poorer rapport with when there is poor outcome.
We had a nasty female attending surgeon who could act super sweet to the face of her patients. Unfortunately for her a patient undergoing lap chole was not adequately anesthetised and heard her calling her (the patient) a fat pig. The patient sued, got some money and this attending was reprimanded.

 

[njbmd]

Hi there,
You don't need to "act" in any way to do well and get the most out of your surgery residency. While the work is extreme, you will find that you get plenty of cooperation and help from attendings, fellow residents, nurses, RTs and others if you treat everyone with respect. While you may have an MD or DO behind your name, you weren't born knowing everything there is to know in medicine. You can't be on the ward 24-hours a day and 7 days a week. I know that most of the jerk residents that I have encountered gradually found themselves distanced from their fellow residents and ancillary hospital staff. When they found that important bits of information were not getting to them in a timely manner because of their behavior, they tended to temper their poor interpersonal skills. Yelling and other forms of attempted intimidation do not make for good team management.

When you find yourself in the shoes of surgical resident who is attempting to just get the job done and learn in the process, you quickly realize that you need the whole team working with you. Cooperation and respect go a long way in getting what you need to give good patient care.

njbmd