Leaving Surgery

[sj139]

Hi

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[Mad Jack]

Good luck out there. Surgery won't change though- there'll always be someone willing to take the abuse to take your place.

 

[Moose A Moose]

Sounds like you know what you need to do.

 

[mikeGR]

Generally, internship is the hardest year. The more senior you become, the more rewarding your work will be. Sure the hours and days off won't get any better, but at least you will get some satisfaction, hopefully. That said, I have seen people quit after 2, 3, and 4 years of residency. I think you should probably talk to one of your seniors that you trust. And from your description, your program doesn't sound super-benign...

 

[kemper6036]

I would say that all of us at some point have had similar feelings and I know for myself there have been moments where I questioned my career choices. In those times, I found it within myself to dig deeper and power through....some would call it grit. It sounds like you have most of the tools you need to succeed, but without grit, its going to be tough. Make sure whatever you decide, its for the right reasons and with your best interests in mind. Best wishes in this tough time for you

 

[SLUser11]

I dove into general surgery residency nervous but optimistic..

I am at a meeting, so can't type an eloquent response, but please don't quit yet. Your feelings are NORMAL! Many people have had them, and more than once, during the long training years. Intern year is grueling, and you don't yet have the coping skills you need to persevere.

You really need a female mentor who can reassure you and support you through the process.

A lot of what you describe is generational (i.e. need for frequent feedback, concentration on free time), so it's normal for your older attendings to resent this. They subscribe to the notion that "no news is good news."

I hope some of the female SDNers have a chance to interject, as their input is more meaningful than mine, e.g. @Winged Scapula and @dpmd among many others.

 

[doc05]

you need to quit. best of luck.

 

[dpmd]

I wish i has some magic words to make everything better, but I don't. Internship is hard but at my lowest point I never felt what you are experiencing. Maybe my program was just that much better. Maybe my expectations were set for something so bad that reality was better by default (i know that played into how i viewed medical school). Maybe my time in the army prepared me really well for physical and mental challenges. Maybe i prioritized differently than you (sleep won out over many things like studying beyond the bare minimum needed to function daily, showering more days than not, makeup, or going out with my husband or friends except for rarely).

What i advise you to do is care less about what other people used to do or their opinion on the current work hours. It isn't a contest of who has it worst. Learn to do your job the best way you can so that you maybe don't need to get to the hospital at 5 am (i assume this is prerounds time so if preroundimg is faster it could start later) or don't need to stay so many hours (i am assuming the time it takes to put in notes is part of the length of the day) or if you do stay because that is how coverage works then at least you have time for meals and breaks (we instituted cookie time on our icu rotation where the intern on service would get a bunch of dessert items from the caf since we got free stuff and bring it up to share with the icu nurses and whichever other residents were free in the afternoon-was a very therapeutic thing and let you do a bit of socializing, i am still friends with some of those nurses and things like that meant they invited me to eat at their frequent potlucks which is also pretty therapeutic). Think long and hard about what aspects feel like deal breakers and what you feel like you can live with because intern year is almost over and you may find the deal breakers will get better or you may just not be suited for a surgical residency as they currently exist.

It would be sad for you to give up your goal over something that will be improving soon. But i am not sure it is really sad for the specialty if you are lost to another specialty. I think a certain level of dedication is important to being a good surgeon and while not a perfect test, i think the difficult nature of residency is helpful in weeding out those who lack it. In my current practice i take call and sometimes am sleep deprived with a heavy workload afterward but I will still take care of my patients if they come back with a complication.

 

[Winged Scapula]

I am at a meeting, so can't type an eloquent response, but please don't quit yet. Your feelings are NORMAL! Many people have had them, and more than once, during the long training years. Intern year is grueling, and you don't yet have the coping skills you need to persevere.

You really need a female mentor who can reassure you and support you through the process.

A lot of what you describe is generational (i.e. need for frequent feedback, concentration on free time), so it's normal for your older attendings to resent this. They subscribe to the notion that "no news is good news."

I hope some of the female SDNers have a chance to interject, as their input is more meaningful than mine, e.g. @Winged Scapula and @dpmd among many others.

I'm at a meeting too (internet connection in the meeting rooms! Finally!!), so will respond more later.

 

[Trauma Surgeon]

I don't get it when people give the advice that it will get better after the intern year! Yeah, intern year sucks due to sleep deprivation, workload and at times the abuse, but at least one has not to make hard decisions and bear the consequences, you just do as you are told… In my case for each step of residency it was more work and more responsibility. The only positive thing was more autonomy and more surgeries (the only thing that make it worth staying in surgery). As attending the workload has increased compared to my residency, but in a different way, which I think is the reality for most of surgical colleagues out there.

 

[dynx]

Please see my reply in the thread "prelim surgery reconsidering blah blah blah". This is exactly the situation that person is going to run into.
First it has nothing to do with being female. As a man, I feel I can objectively state that.
Second, as mentioned above surgery wont change. You're not going to get positive feed back not enough anyway. Not now, not ever. For every thank you and "good job" there will be 10 complaints. Thats not your program, thats not the way surgery is structured, thats life. When you're a surgical attending it will be the same way because patients and administration are ungrateful in general. Surgical programs just introduce it early and don't baby you but when you're a radiology or dermatology attending you'll get there (but the hours and pay will be better so you'll be in a situation to see that its worth it).
Third you wont ever gain sympathy from anybody in surgery for 85 hrs a week and 4 days off. Not even close. those are good weeks in training.
Fourth constant anxiety of missing something will drive you to a system where you dont miss things (often). Peoples lives depend on this happening. And happening now, not when you're in charge. Thats why its constantly drilled into you. If you like feeling like you're doing something where you save lives then that comes with responsibility and anxiety, it wont go away.
fifth surgery doesnt "lose great minds" to other fields. You dont need to be brilliant. Work ethic, attention to detail and ability to focus when tired are far more important. And great minds aren't in the 74th percentile, there are about 26% greater minds out there we can lose 6% and have plenty. You can take your great mind and write papers on alopecia and we'll be just fine thanks.

Now for the positive part:
Everybody has felt like that. Everybody is tired. Everybody (almost) gains weight. Everybody feels unappreciated. Everybody thinks about quiting. As i've mentioned before there were nights during my fellowship where I sat in my car in the parking lot at 2am on my way in (I remember one vividly) where I was sure I was going to quit. The only thing that stopped me was that the program chair was comfortably asleep in his bed and by the light of day and a couple cups of coffee later I felt better. For the most part they'll tell you if you cant make it, i've seen plenty wash out and its not a mystery. So if nobody at your program is telling you "hey you're not cut out for this" then you can probably make it through. The question is if you want to or not.

 

[dpmd]

I don't get it when people give the advice that it will get better after the intern year! Yeah, intern year sucks due to sleep deprivation, workload and at times the abuse, but at least one has not to make hard decisions and bear the consequences, you just do as you are told… In my case for each step of residency it was more work and more responsibility. The only positive thing was more autonomy and more surgeries (the only thing that make it worth staying in surgery). As attending the workload has increased compared to my residency, but in a different way, which I think is the reality for most of surgical colleagues out there.

That is why I advised her to think about what aspect of it is the problem. If it is just the sleep thing that gets better (depending on the set up, as a chief we were on home call basically every other night so that might have been worse). Plus i think some people like the increased responsibility instead of just doing as they are told. And as an attending now i have times where there is way more workload than i did as an intern, but my ability to handle it better matches the workload so in that sense it is better (plus it is my own damn fault if i take a bunch of calls in one week or take call when i have scheduled stuff the next day which is infinitely more tolerable than if it is out of my control).

 

[dpmd]

Please see my reply in the thread "prelim surgery reconsidering blah blah blah". This is exactly the situation that person is going to run into.
First it has nothing to do with being female. As a man, I feel I can objectively state that.
Second, as mentioned above surgery wont change. You're not going to get positive feed back not enough anyway. Not now, not ever. For every thank you and "good job" there will be 10 complaints. Thats not your program, thats not the way surgery is structured, thats life. When you're a surgical attending it will be the same way because patients and administration are ungrateful in general. Surgical programs just introduce it early and don't baby you but when you're a radiology or dermatology attending you'll get there (but the hours and pay will be better so you'll be in a situation to see that its worth it).
Third you wont ever gain sympathy from anybody in surgery for 85 hrs a week and 4 days off. Not even close. those are good weeks in training.
Fourth constant anxiety of missing something will drive you to a system where you dont miss things (often). Peoples lives depend on this happening. And happening now, not when you're in charge. Thats why its constantly drilled into you. If you like feeling like you're doing something where you save lives then that comes with responsibility and anxiety, it wont go away.
fifth surgery doesnt "lose great minds" to other fields. You dont need to be brilliant. Work ethic, attention to detail and ability to focus when tired are far more important. And great minds aren't in the 74th percentile, there are about 26% greater minds out there we can lose 6% and have plenty. You can take your great mind and write papers on alopecia and we'll be just fine thanks.

Now for the positive part:
Everybody has felt like that. Everybody is tired. Everybody (almost) gains weight. Everybody feels unappreciated. Everybody thinks about quiting. As i've mentioned before there were nights during my fellowship where I sat in my car in the parking lot at 2am on my way in (I remember one vividly) where I was sure I was going to quit. The only thing that stopped me was that the program chair was comfortably asleep in his bed and by the light of day and a couple cups of coffee later I felt better. For the most part they'll tell you if you cant make it, i've seen plenty wash out and its not a mystery. So if nobody at your program is telling you "hey you're not cut out for this" then you can probably make it through. The question is if you want to or not.

I was just wondering if my reply was too harsh, but now i feel better about it. You speak much truth though (which is usually best given bluntly) even if i don't relate to the wanting to quit part (maybe it happened and i blocked it from my memory).

 

[dynx]

I was just wondering if my reply was too harsh, but now i feel better about it. You speak much truth though (which is usually best given bluntly) even if i don't relate to the wanting to quit part (maybe it happened and i blocked it from my memory).

Never? For me it was the lack of sleep thing. I normally wouldn't think of quiting and I normally wouldn't think about throwing something at someone but if you wake me up when tired both things can happen (or could...I'm much better now). I know some people really good with sleep deprivation but that's not me. I can function but I'm not happy about it.

 

[dpmd]

Never? For me it was the lack of sleep thing. I normally wouldn't think of quiting and I normally wouldn't think about throwing something at someone but if you wake me up when tired both things can happen (or could...I'm much better now). I know some people really good with sleep deprivation but that's not me. I can function but I'm not happy about it.

Not that i remember. I would often sleep from noon till 6 eat dinner then sleep until the next morning post call. I cried lots of times. I gained weight. I felt like i would never get good at stuff. But never thought of quitting. Might be because i failed to match ortho the year before and thought that was the worst thing in the world until i got diagnosed with thyroid cancer and had to get treated so by the time i started residency i was just so grateful to get the chance to do something else i enjoyed that it never occured to me that i could do anything else. Plus, basic training in the army was ridiculously hard for me but there isn't an option to quit and without that you only have to decide to be miserable or suck it up. Perhaps that attitude carried over for me.

 

[MediCane2006]

I'm still at work but will respond later this evening.

 

[MediCane2006]

I dove into general surgery residency nervous but optimistic. Out of all the fields I experienced in medical school nothing resonated with me like breast surgery. It was the operating room, the patient population, the genuine and full fledged feeling that it truly made a difference and saved lives. My sanguine nature, sensitivity, compassion and femininity lead people outside of the surgical field to tell me “I just don’t see you there”. But after reading Lean In and watching two fabulous female mentors who had succeeded I decided to take the plunge. After all I worked hard in medical school and made it into AOA; I wasn’t going to let a personality stereotype or my gender deter me.


But that plunge feels more and more like a belly flop as I flounder during my intern year. Despite a 74th percentile on the Absite and good evaluations I am drowning. The sleep deprivation, daily workload, lack of positive feedback, lack of mentorship and lack of consideration for personal life has done me in.


Aside from my 4 days off a month I have a 4am alarm clock to get me to the hospital by the strict 5am start. My shortest days are 13 hours and I estimate my average workweek to be 85hrs. America has not significantly increased the number of yearly surgical graduates so despite fewer hours than our predecessors there are proportionally less surgical residents to get more work done for an aging population with more surgical needs. And with the rise of the EMR we have more information to keep track of, more paperwork, less organic medical practice. Our attending surgeons constantly tell us how easy we have it and scoff at the duty hours. There is almost no positive feedback, which I suppose is tolerable. But even minor slip-ups will be brought to attention so I live in constant anxiety of missing something. I haven’t found great mentors. When I took a day off (one of my 4 allotted) for a loved ones medical procedure it caused a rift because my chief did not think my senior resident should have approved it. I also had a chief resident tell me how rude it would be if I (the only female in my intern class) were to ever get pregnant during the program. I’ve gained 10lbs and I have stopped exercising due to lack of time. I’ve cried multiple times in my car on the way home out of sheer exhaustion. And I went into surgery a well-adjusted and happy young woman with a good support system. My program is not even unreasonably malignant – I like and admire the people I work with.


I think this endeavor has been a belly flop and I am facing the reality that getting out of the pool may be a wiser decision than continuing to try to keep my head above water. I am living in an exhausted, overwhelmed state. Despite loving the OR I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology.

OK. I wanted to wait til I had some time to sit down and write a thoughtful response. As some background, I'm a PGY-10 currently in a pediatric craniofacial fellowship. I did a general surgery residency at a fairly traditional Northeast program, then a plastics fellowship, and now this fellowship. FWIW, I'm also a woman, although I think for the most part a lot of what you are going through is a somewhat gender neutral experience.

This is going to be a little long and rambling. I thought a lot about your post, and did some reflection about where I was emotionally during the first year or so of my training.

So let's start with the fact that intern year SUCKS. For everyone. Especially this time of year. As an intern, you are literally the lowest person on the totem pole in the entire hospital. Everyone, even the janitor, knows more than you do. You have to do the jobs no one else wants to do. If you are in a program where you get to go to the OR a fair bit, at least you can start to see the payoff, but otherwise you can often feel like you have forgotten what drew you to the field to begin with. People tend to say intern dysphoria hits around Jan/Feb, but honestly I think March/April was the low point for me. By this time you now know how to do "intern things" and are ready to move up to the next level, but you still have THREE MONTHS of being the service whipping boy, and by this point the senior residents are starting to check out emotionally, and everyone is kind of ready for the year to be over and it sucks.

Everyone has a different response to stress like this....mine is often to stress eat, drink too much, stop working out, and convince myself that I "deserve" to spend all my free time on the couch binge-watching netflix. Cue weight gain, emotional lability, and general feelings of worthlessness. I remember sitting in the locker room crying after a case, hiding in the bathroom to cry after rounds, and at one VERY low point basically bursting into tears at the nursing station when my awful chief resident yelled at me in front of the entire team and told me I killed a patient (I didn't). I gained 10 pounds on easier rotations, then lost them again on trauma and vascular. I was told I was disorganized, too tentative, technically inept, weak, sloppy, etc etc. I think my absite that year was 40th percentile.

So all of this is to say that what you are going through is NORMAL for intern year (and not just for surgery, medicine intern year is no joke either). And yes, the things that made intern year miserable for me did get better. I started operating more, getting more responsibility, I started to see my skills (at things like central lines, gallbladders, hernias, etc - not discharge summaries and TPN forms) improve exponentially, and suddenly everything got much more fun. I ended up being one of the more highly-regarded chiefs of my year and got a great fellowship. This will happen for you.

BUT there are things that will not get better. The hours you are working may improve SLIGHTLY when you don't have to pre-round, but you're still going to be getting up early and getting home relatively late. You probably aren't going to get a ton of positive feedback. People are still going to be upset when "minor details" get missed. And they should, because minor details in surgery can become major ones pretty quick. You're training to develop the neuroticism to check each patient's flowsheet carefully once you're an attending, to double check postop orders, to confirm that every task on your to-do list is done before you go home, because if not, people die. And honestly, while this is true for a lot of medical specialties, it's particularly true for surgery, in which most of our patients undergo a huge physiologic insult and we need to carefully ensure that they are recovering appropriately from it. And like @dynx and @dpmd alluded to, this isn't necessarily specific to surgery (Although surgery is a little more fast-paced and demanding), you are going to have long hours and little appreciation in pretty much any residency program that isn't something like dermatology. Not to be dramatic, but you are training to develop the mental and physical fortitude to be able to make quick decisions, think logically, and be attentive to details when you are tired, your kid is sick, your dog just died, you had a fight with your spouse, whatever.

So here comes the tough love part. I think you need to do some introspection, with a mentor or a friend, about why you chose surgery. You say that breast surgery particularly resonated with you - if that is because you enjoy women's health, working with a multidisciplinary oncology team, and guiding patients through their cancer treatment, then yes, you can probably find that same satisfaction in another field like medicine (with subspecialty in oncology perhaps). If you enjoy being in the OR and doing some procedures, anesthesia may also be attractive.

But if you really do love surgery, and operating, then I don't necessarily think you will find that elsewhere. For me, no matter how bad things got, I knew that surgery was the only thing I would ever be happy doing. And if you want to be a surgeon, you need to accept that becoming a surgeon comes with an intense training regimen. You SHOULD be in constant anxiety about missing something, not because "someone will yell at me" but because in just a few short years that is going to be YOUR postop patient and if you miss the fact that the urine output has been dropping for the last few hours, that little old lady is going to go into renal failure from ATN. Your seniors are teaching you to develop that hypervigilance that makes us wake up in the middle of the night and double check that repeat H/H got drawn. That's why they are beating you up over missing little things - the devil is truly in the details in surgery (and honestly, in most medical fields too). It does get easier, as you will start to learn what are the important details and what aren't, and as you transition to a more senior role you will develop more "big picture" thinking. But it's not going to go away, and it's not because people are being mean or unfair.

Your evaluations and ABSITE performance indicate you're doing great, keeping up with reading, and performing at a strong level which I promise you puts you ahead of a lot of your fellow terns (and me when I was your year). So keep that up!

Now. Let's talk about this whole gender thing. You say "I wasn't going to let my gender deter me" from your surgical dream. Yet your entire post reads like you're defining your performance and your difficulties by your gender. Let's be realistic here - female financial executives on Wall Street work 16 hour days on a regular basis and they have to do it in heels and a power suit. You are not struggling because you are a girl. You are not defying some stereotype by being a surgical resident and a girl. No one is going to give you extra sympathy because you're a girl. You can still be a well adjusted and happy young woman and a surgical resident. Yes, you have to get up early. Yes, you have to hit the gym after work when you're tired. Yes, you have to meal plan ahead, pack your lunches, take the stairs on days you can't work out, get up twenty minutes earlier to do your hair and put on some makeup, smile when you're tired and cranky. You need to plan ahead when you need time off, go through the proper channels, and then take it and ignore people who make snide comments. You have to do all these things as a professional woman no matter what field you are in. I think we (and I'm including myself in this) sometimes tend to over-dramatize how hard we have it as girls in a stereotypically male dominated field, but let's be honest. It's not 1950 any more. Your male colleagues for the most part are going through the same stuff you are. I think one of the worst things we can do as women in surgery is complain about how we have it so much harder than the boys, and I really try to stop myself any time I do it. It's a self-defeating path with no positive outcome. I promise, you can still be a happy, healthy, emotionally fulfilled woman and be a surgeon.

I'm going to sum all this up by saying I don't think you should quit. I think you are experiencing a lot of intern blues that are very common at this time of the year. However, I also think you need to reflect a little bit on if you are in surgery for the right reasons. Then, if you decide you do want to pursue surgery, you need to stop apologizing for your lack of a Y chromosome and just push forward to be the best surgeon (not female surgeon) you can be.

I am always available to chat by PM if you like, as well.

 

[dpmd]

I think we (and I'm including myself in this) sometimes tend to over-dramatize how hard we have it as girls in a stereotypically male dominated field, but let's be honest. It's not 1950 any more. Your male colleagues for the most part are going through the same stuff you are. I think one of the worst things we can do as women in surgery is complain about how we have it so much harder than the boys, and I really try to stop myself any time I do it. It's a self-defeating path with no positive outcome. I promise, you can still be a happy, healthy, emotionally fulfilled woman and be a surgeon.

A thousand times this. Most days no one bats an eye at my gender, and on the occasions it shows up it is stuff like a patient or family member thinking I'm the nurse-then apologizing when i correct them. Or the little old man who harmlessly flirts with me. Or the little girl who smiles because i am her doctor and tells me later she wants to be a doctor too. My residency program had a female department chair and sometimes our ratio was over 50% female residents. No one has refused to follow my orders because i am a woman, and no one has asked to change to a male surgeon (but i have had the opposit happen to my male colleagues). We really have come a long way from the times of the first women in medicine.

 

[LucidSplash]

OK. I wanted to wait til I had some time to sit down and write a thoughtful response. As some background, I'm a PGY-10 currently in a pediatric craniofacial fellowship. I did a general surgery residency at a fairly traditional Northeast program, then a plastics fellowship, and now this fellowship. FWIW, I'm also a woman, although I think for the most part a lot of what you are going through is a somewhat gender neutral experience.

This is going to be a little long and rambling. I thought a lot about your post, and did some reflection about where I was emotionally during the first year or so of my training.

So let's start with the fact that intern year SUCKS. For everyone. Especially this time of year. As an intern, you are literally the lowest person on the totem pole in the entire hospital. Everyone, even the janitor, knows more than you do. You have to do the jobs no one else wants to do. If you are in a program where you get to go to the OR a fair bit, at least you can start to see the payoff, but otherwise you can often feel like you have forgotten what drew you to the field to begin with. People tend to say intern dysphoria hits around Jan/Feb, but honestly I think March/April was the low point for me. By this time you now know how to do "intern things" and are ready to move up to the next level, but you still have THREE MONTHS of being the service whipping boy, and by this point the senior residents are starting to check out emotionally, and everyone is kind of ready for the year to be over and it sucks.

Everyone has a different response to stress like this....mine is often to stress eat, drink too much, stop working out, and convince myself that I "deserve" to spend all my free time on the couch binge-watching netflix. Cue weight gain, emotional lability, and general feelings of worthlessness. I remember sitting in the locker room crying after a case, hiding in the bathroom to cry after rounds, and at one VERY low point basically bursting into tears at the nursing station when my awful chief resident yelled at me in front of the entire team and told me I killed a patient (I didn't). I gained 10 pounds on easier rotations, then lost them again on trauma and vascular. I was told I was disorganized, too tentative, technically inept, weak, sloppy, etc etc. I think my absite that year was 40th percentile.

So all of this is to say that what you are going through is NORMAL for intern year (and not just for surgery, medicine intern year is no joke either). And yes, the things that made intern year miserable for me did get better. I started operating more, getting more responsibility, I started to see my skills (at things like central lines, gallbladders, hernias, etc - not discharge summaries and TPN forms) improve exponentially, and suddenly everything got much more fun. I ended up being one of the more highly-regarded chiefs of my year and got a great fellowship. This will happen for you.

BUT there are things that will not get better. The hours you are working may improve SLIGHTLY when you don't have to pre-round, but you're still going to be getting up early and getting home relatively late. You probably aren't going to get a ton of positive feedback. People are still going to be upset when "minor details" get missed. And they should, because minor details in surgery can become major ones pretty quick. You're training to develop the neuroticism to check each patient's flowsheet carefully once you're an attending, to double check postop orders, to confirm that every task on your to-do list is done before you go home, because if not, people die. And honestly, while this is true for a lot of medical specialties, it's particularly true for surgery, in which most of our patients undergo a huge physiologic insult and we need to carefully ensure that they are recovering appropriately from it. And like @dynx and @dpmd alluded to, this isn't necessarily specific to surgery (Although surgery is a little more fast-paced and demanding), you are going to have long hours and little appreciation in pretty much any residency program that isn't something like dermatology. Not to be dramatic, but you are training to develop the mental and physical fortitude to be able to make quick decisions, think logically, and be attentive to details when you are tired, your kid is sick, your dog just died, you had a fight with your spouse, whatever.

So here comes the tough love part. I think you need to do some introspection, with a mentor or a friend, about why you chose surgery. You say that breast surgery particularly resonated with you - if that is because you enjoy women's health, working with a multidisciplinary oncology team, and guiding patients through their cancer treatment, then yes, you can probably find that same satisfaction in another field like medicine (with subspecialty in oncology perhaps). If you enjoy being in the OR and doing some procedures, anesthesia may also be attractive.

But if you really do love surgery, and operating, then I don't necessarily think you will find that elsewhere. For me, no matter how bad things got, I knew that surgery was the only thing I would ever be happy doing. And if you want to be a surgeon, you need to accept that becoming a surgeon comes with an intense training regimen. You SHOULD be in constant anxiety about missing something, not because "someone will yell at me" but because in just a few short years that is going to be YOUR postop patient and if you miss the fact that the urine output has been dropping for the last few hours, that little old lady is going to go into renal failure from ATN. Your seniors are teaching you to develop that hypervigilance that makes us wake up in the middle of the night and double check that repeat H/H got drawn. That's why they are beating you up over missing little things - the devil is truly in the details in surgery (and honestly, in most medical fields too). It does get easier, as you will start to learn what are the important details and what aren't, and as you transition to a more senior role you will develop more "big picture" thinking. But it's not going to go away, and it's not because people are being mean or unfair.

Your evaluations and ABSITE performance indicate you're doing great, keeping up with reading, and performing at a strong level which I promise you puts you ahead of a lot of your fellow terns (and me when I was your year). So keep that up!

Now. Let's talk about this whole gender thing. You say "I wasn't going to let my gender deter me" from your surgical dream. Yet your entire post reads like you're defining your performance and your difficulties by your gender. Let's be realistic here - female financial executives on Wall Street work 16 hour days on a regular basis and they have to do it in heels and a power suit. You are not struggling because you are a girl. You are not defying some stereotype by being a surgical resident and a girl. No one is going to give you extra sympathy because you're a girl. You can still be a well adjusted and happy young woman and a surgical resident. Yes, you have to get up early. Yes, you have to hit the gym after work when you're tired. Yes, you have to meal plan ahead, pack your lunches, take the stairs on days you can't work out, get up twenty minutes earlier to do your hair and put on some makeup, smile when you're tired and cranky. You need to plan ahead when you need time off, go through the proper channels, and then take it and ignore people who make snide comments. You have to do all these things as a professional woman no matter what field you are in. I think we (and I'm including myself in this) sometimes tend to over-dramatize how hard we have it as girls in a stereotypically male dominated field, but let's be honest. It's not 1950 any more. Your male colleagues for the most part are going through the same stuff you are. I think one of the worst things we can do as women in surgery is complain about how we have it so much harder than the boys, and I really try to stop myself any time I do it. It's a self-defeating path with no positive outcome. I promise, you can still be a happy, healthy, emotionally fulfilled woman and be a surgeon.

I'm going to sum all this up by saying I don't think you should quit. I think you are experiencing a lot of intern blues that are very common at this time of the year. However, I also think you need to reflect a little bit on if you are in surgery for the right reasons. Then, if you decide you do want to pursue surgery, you need to stop apologizing for your lack of a Y chromosome and just push forward to be the best surgeon (not female surgeon) you can be.

I am always available to chat by PM if you like, as well.

I have been on call (and a postop patient of mine came in this morning with a compilation requiring a trip to the OR so I am still here because that's what being a surgeon is) and I was going to try to respond to your post but essentially everything has been said above very very well. Someone once told me "there's no crying in surgery" to which I replied "bull****." There's much less crying now that I'm a senior level resident but there are days when you feel beat up and I'm a cryer and its cathartic. There's just very little crying when there's a job to be done. Cry later, feel better, move on. Trying to pretend you don't have emotions just doesn't work. I once teared up while being chastised for something by an attending, he noticed, asked if there was something wrong with my eyes, I said allergies, and we moved on and he pretended to believe the lie because that's what I wanted at that moment. But mostly it's what you describe. In the car, at home when you feel exhausted and spent. Don't let yourself feel bad about feeling bad, it is normal and it is healthy as long as you don't let it become additive.

Also, get a pedicure. I always feel much better after getting one.

 

[dpmd]

I have been on call (and a postop patient of mine came in this morning with a compilation requiring a trip to the OR so I am still here because that's what being a surgeon is) and I was going to try to respond to your post but essentially everything has been said above very very well. Someone once told me "there's no crying in surgery" to which I replied "bull****." There's much less crying now that I'm a senior level resident but there are days when you feel beat up and I'm a cryer and its cathartic. There's just very little crying when there's a job to be done. Cry later, feel better, move on. Trying to pretend you don't have emotions just doesn't work. I once teared up while being chastised for something by an attending, he noticed, asked if there was something wrong with my eyes, I said allergies, and we moved on and he pretended to believe the lie because that's what I wanted at that moment. But mostly it's what you describe. In the car, at home when you feel exhausted and spent. Don't let yourself feel bad about feeling bad, it is normal and it is healthy as long as you don't let it become additive.

Also, get a pedicure. I always feel much better after getting one.

I found the 20 dollar chinese foot massage to be quite helpful post call

I should have arranged ahead of time for them to just let me nap for a while after because i sometimes fell asleep during.

 

[MediCane2006]

I have been on call (and a postop patient of mine came in this morning with a compilation requiring a trip to the OR so I am still here because that's what being a surgeon is) and I was going to try to respond to your post but essentially everything has been said above very very well. Someone once told me "there's no crying in surgery" to which I replied "bull****." There's much less crying now that I'm a senior level resident but there are days when you feel beat up and I'm a cryer and its cathartic. There's just very little crying when there's a job to be done. Cry later, feel better, move on. Trying to pretend you don't have emotions just doesn't work. I once teared up while being chastised for something by an attending, he noticed, asked if there was something wrong with my eyes, I said allergies, and we moved on and he pretended to believe the lie because that's what I wanted at that moment. But mostly it's what you describe. In the car, at home when you feel exhausted and spent. Don't let yourself feel bad about feeling bad, it is normal and it is healthy as long as you don't let it become additive.

Also, get a pedicure. I always feel much better after getting one.

YES...and if your OR allows it, a fierce red gel mani helps too....

 

[OMFS21]

 

[OMFS21]

.

 

[Taurus]

I came into medical school thinking I would go into surgery. After 6 weeks of it in 3rd year, I said hello no. Life is too short to punish yourself like that. I then chose radiology and it was the best decision ever. I worked 50 hours per week plus 1 weekend call per month in residency. As an attending, I work 45 hours per week plus 1 weekend call per month, 12 weeks vacation. I get to sit down and drink my coffee and eat my donut while I work. I walk around to take a break. I make neurosurgery income too. Grass can be greener on the other side.

 

[SLUser11]

Sad to watch that. When I was in late high school/college, many people pointed out that I looked a lot like the main character in this movie (Casper Van Dien). Watching the video now, the best description for me would be a fatter Michael Ironside...SLUser's roughnecks!

 

[Taurus]

Numbers or gtfo bruh

Lol. It's taboo to post salary numbers.

I realize how critical surgeons are to medicine and I interact with them all the time. I want to thank you all for sacrificing your life for it and at the end of the day you really are. I would never do it. I once did it in my career before switching to medicine and I vowed that I would never do it again unless I was building my own billion dollar business. In medicine, we are nothing more than cogs in a much bigger machinery. I would not sacrifice my life so that the hospital or insurance CEO can make millions off my labor. There needs to be a balance between serving patients, having a life outside of medicine, and being compensated appropriately so that you feel that all your years of sacrifice were justified.

 

[Winged Scapula]

@MediCane2006, @LucidSplash and @dpmd have done a wonderful job explaining their experiences, some of which are gender relevant and others which are gender neutral.

My experience was closer to that of Medicine's: I came from a somewhat nurturing medical school to a program where very little positive feedback was given and I was made to feel stupid on a daily basis. As I've posted here before, I recall thinking about quitting nearly every day. Tears of frustration were common but I learned to curb them in the OR. I did my work and tried to avoid those senior residents who were toxic or situations in which my (self described) inadequacies were highlighted.

Perhaps it was because I was older and had worked a real job or perhaps because I thought myself wiser, but I was just flummoxed by the idea that I would learn better/become a better surgeon by humiliation. Some of my co-residents were the most childish, unprofessional, inappropriate people I'd ever had the misfortune to meet. Yet most, when relieved of the stress and long hours and shared misery that was surgical residency, were supportive, understanding and truly great people. People with whom I shared an experience that no one else can understand or relate to.

I cannot say whether next year will get better for the OP; it may not. The question is whether or not you can stick it out and end up doing what you want. It is not true that you need to work > 80 hrs per week as a surgeon or that you need to to make "neurosurgeon money". A wise 3rd year going into PRS once told intern me, "I just have to keep my head down, out of trouble and then I can do what I want". She was miserable as well and I couldn't understand how she kept going, hating every general surgery case, but she did what she had to do.

We all gained weight; the men actually more than the women. All of us developed disordered home lives; some were unfaithful to their spouses, some divorced. Some of us were just never home due to the hours (I was lucky to have another surgeon at home so he knew what it was like). Others met their future spouses during residency while in the hospital.

But the OP sounds like much of her emotional stability comes from exhaustion. Like others have said, you won't get any sympathy from your attendings, especially those who trained more than 10 years ago about how tired you are/weight you've gained/lack of homelife. And as also noted, feedback is not something most attendings, in any speciality, are trained to give and it often does come down to, "no news is good news". You simply aren't going to get daily affirmations and that's the case whether its general surgery or dermatology. That's just not life. I'd suggest you work on streamlining your life, maximizing sleep when and where you can and reassess in the next few months. As you get to do more and feel physically better you may find you enjoy surgery once again. For me, 3rd year was wonderful; the last 2 weren't but PGY3 and the lab gave me enough energy to get through the final training.

best of luck to you

 

[dpmd]

WS, my experience in the army demonstrated that learning by humiliation is fairly effective so i never questioned it in residency.

 

[Thanatos]

I dove into general surgery residency nervous but optimistic. Out of all the fields I experienced in medical school nothing resonated with me like breast surgery. It was the operating room, the patient population, the genuine and full fledged feeling that it truly made a difference and saved lives. My sanguine nature, sensitivity, compassion and femininity lead people outside of the surgical field to tell me “I just don’t see you there”. But after reading Lean In and watching two fabulous female mentors who had succeeded I decided to take the plunge. After all I worked hard in medical school and made it into AOA; I wasn’t going to let a personality stereotype or my gender deter me.


But that plunge feels more and more like a belly flop as I flounder during my intern year. Despite a 74th percentile on the Absite and good evaluations I am drowning. The sleep deprivation, daily workload, lack of positive feedback, lack of mentorship and lack of consideration for personal life has done me in.


Aside from my 4 days off a month I have a 4am alarm clock to get me to the hospital by the strict 5am start. My shortest days are 13 hours and I estimate my average workweek to be 85hrs. America has not significantly increased the number of yearly surgical graduates so despite fewer hours than our predecessors there are proportionally less surgical residents to get more work done for an aging population with more surgical needs. And with the rise of the EMR we have more information to keep track of, more paperwork, less organic medical practice. Our attending surgeons constantly tell us how easy we have it and scoff at the duty hours. There is almost no positive feedback, which I suppose is tolerable. But even minor slip-ups will be brought to attention so I live in constant anxiety of missing something. I haven’t found great mentors. When I took a day off (one of my 4 allotted) for a loved ones medical procedure it caused a rift because my chief did not think my senior resident should have approved it. I also had a chief resident tell me how rude it would be if I (the only female in my intern class) were to ever get pregnant during the program. I’ve gained 10lbs and I have stopped exercising due to lack of time. I’ve cried multiple times in my car on the way home out of sheer exhaustion. And I went into surgery a well-adjusted and happy young woman with a good support system. My program is not even unreasonably malignant – I like and admire the people I work with.


I think this endeavor has been a belly flop and I am facing the reality that getting out of the pool may be a wiser decision than continuing to try to keep my head above water. I am living in an exhausted, overwhelmed state. Despite loving the OR I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology.

Some good advice above from people who have lived it and lived through it. To paraphrase another poster on another thread from long ago that I took to heart, general surgery is a truly a brutal thankless residency.

So you can bail if you want, and there's no shame in it. Hell everyone has thought about it, and anyone who says they haven't is lying. This job sucks....every job does, but this one sucks in special ways. So why do we do it....sometimes I don't know. Dynx posted in another thread (and referenced in this thread) about how people like us have this never say die attitude that propels us forward despite all the negatives, and I have to agree. If we didn't have that we would be out of here for greener pastures like many of our colleagues who shamelessly went straight into dermatology. People like us could do anything with our lives and pull it off, but we feel called to keep doing this to ourselves. The OR is cool though.

But before you go (if you go) there are a few things I think you should consider that may put things in perspective for you:

1) You're actually doing just fine. 74 on the absite is damn good, and if you don't think so go and ask all those people who scored under 5. Its important to know that if you're not getting hauled down to the principals office and getting yelled at you're doing great. I had a similar experience with intern year where I just kept going and going and going and going and never really heard anything ever. So you kinda wonder to yourself like I wonder how this is going, no one is really saying anything. So I just kept showing up and doing my thing. It was only by the end of year that I found out several of my co-residents got summoned to the chairman's office for a) yelling at pediatrics residents, b) yelling at medicine residents, c) yelling at ER residents, d) playing a (hilarious) prank on one of our malignant senior residents, e) yelling at medical students, f) failing the absite, g) sleeping through pages while transplant patients were coding, h) publicly disagreeing with attendings and changing orders against there direct instructions (seriously), i) not completing hours logs/evaluation in time......you get the idea. The thing is, like syphills and erectile dysfunction, most people aren't going to publicly bring up the time they got yelled out for obviously ****ing up and almost got fired....so you live in this weird bubble of never hearing anything and wondering how you're doing, but if you never hear anything you're actually doing quite well. Its a stupid inefficient system, and its not how I would do things, but its the way it is.

2) Things will get better. As an intern you are very inefficient, even if you don't think you are. As PGY2's we spent some time in the call pool with interns on some of our general surgery services, and I marveled at how "slow" my calls were that second year. It wasn't until one of my senior residents pointed out that you're just better at being a doctor so you get things done faster that I did some serious brain storming and realized the work was roughly the same. Intern year can be brutal, and even though you're not solely responsible for all the complex decision making the sheer volume of busy work you have to do can be soul crushing. Some days will be better than others, but they will end eventually. The remaining years will still hurt but they will hurt differently. As a chief resident you get to do a lot more of the good stuff....it has its own pain (dealing with attendings, getting blamed for things your interns do, etc) but the pleasure to pain ratio is much more favorable. My hours are actually worse in fellowship but its so much better, which is a whole other topic.

3) Your attendings are cry babies. And so were mine in general surgery....I got fed a constant stream of bull**** for years about how easy we had it with the hours regulations and nap time, and how they were going to hand out binkys and wubbys for the call rooms and etc etc etc. The facts are that we do just as many cases as they did (per ACGME data) although we have to learn more than one approach (ex lap). Or three approaches (ex lap, kocher, mc burney's before some ancient attending freaks out). It doesn't help that every attending uses different laparoscopic equipment (ports, cameras, staplers) and there are about 80 ways to do a lap ventral hernia. And this is without bringing up how they had like one pressor, three antibiotics, no outcomes reporting and everyone stayed in the hospital for 2 months after an appendectomy but I digress. It will only take 15 seconds for someone 20 years older than to me to complain about this part of the post. My favorite fact about how bad it was back in the day is the "we were on call every other night" thing. And they were.....for their own service. The average general surgery service carries what.....30 patients at the most? Imagine if you were only on call for those 30 patients on a colorectal service.....and not that service of 30 (or less) plus vascular plus pediatrics plus trauma plus whatever.....they didn't have to cross cover as much. Hell taking care of the my own service on call was usually easy because I knew the patients, it was watching after all the other services after people went home that was challenging (especially if as an intern you were taking care of patients on a service you hadn't rotated on yet). So don't listen to your attendings and don't let them discourage you, we can trace the whole "we had it much harder back in our day" argument all the way back to Socrates.

4) Your senior residents are selfish. I know we would all like to think that our chiefs made us work hard and wouldn't let us go to our grandparents funerals to teach us about the honored tradition of self sacrifice requisite to becoming a physician. But actually, they don't want you to go to weddings/funerals/get pregnant because if you're gone they have to do your work for you, and they really don't want to do that for obvious reasons. So don't take their criticism to heart. I'm not saying they don't have a point, because they shouldn't have to do your work for you, but you shouldn't self internalize it to make you feel inadequate.

5) The whole system is screwed up. My favorite story about education of all time is when I was in the 6th grade my dad wanted me to learn how to arc weld but he wasn't very good at it. So he paid an illiterate migrant farm worker from Mexico with a 3rd grade education who barely spoke English to teach me, because the guy was an incredible welder. He did not have an MD or a PhD, never had to attend a culture competency lecture, it was never expected of him to be an educator, and arc welding was not life or death. But he was patient and kind, and he was willing to stand next to me and watch me struggle without losing his ****.....he would show me what I was doing wrong and would correct my mistakes....he was encouraging and fun to work with. I have marveled over the years how this guy a) taught me great technique, and b) was not a total dick......but I have stood across the OR table from so many surgeons, the famous and obscure, old and young, from all over the world and very few could accomplish both of those things. If your program was anything like mine mentorship and education were not priorities, and I've truly come to believe that the majority of my attendings believed we existed to make their lives easier and that was it.

Ultimately if you decide you want to do this you just have to keep your head down and keep moving forward. As someone who spent a few years bottling up a nuclear fission level of white hot hatred for the people I worked for and with I know that is harder than it sounds. I wish i could take credit for this, but there is a great quote from this guy (Amazon product) where he talks about how you just have to survive. Like the Vietnam war, its not about how many of the enemy you take out....its about if you can get to the end and still be alive.

The next day you have off sleep....the whole day and night. Don't do anything, and I think you will realize you feel a little better. Then you will realize this isn't so bad really, and you don't have to be perfect. You just have to survive.

 

[ThoracicGuy]

Some good advice above from people who have lived it and lived through it. To paraphrase another poster on another thread from long ago that I took to heart, general surgery is a truly a brutal thankless residency.

So you can bail if you want, and there's no shame in it. Hell everyone has thought about it, and anyone who says they haven't is lying. This job sucks....every job does, but this one sucks in special ways. So why do we do it....sometimes I don't know. Dynx posted in another thread (and referenced in this thread) about how people like us have this never say die attitude that propels us forward despite all the negatives, and I have to agree. If we didn't have that we would be out of here for greener pastures like many of our colleagues who shamelessly went straight into dermatology. People like us could do anything with our lives and pull it off, but we feel called to keep doing this to ourselves. The OR is cool though.

But before you go (if you go) there are a few things I think you should consider that may put things in perspective for you:

1) You're actually doing just fine. 74 on the absite is damn good, and if you don't think so go and ask all those people who scored under 5. Its important to know that if you're not getting hauled down to the principals office and getting yelled at you're doing great. I had a similar experience with intern year where I just kept going and going and going and going and never really heard anything ever. So you kinda wonder to yourself like I wonder how this is going, no one is really saying anything. So I just kept showing up and doing my thing. It was only by the end of year that I found out several of my co-residents got summoned to the chairman's office for a) yelling at pediatrics residents, b) yelling at medicine residents, c) yelling at ER residents, d) playing a (hilarious) prank on one of our malignant senior residents, e) yelling at medical students, f) failing the absite, g) sleeping through pages while transplant patients were coding, h) publicly disagreeing with attendings and changing orders against there direct instructions (seriously), i) not completing hours logs/evaluation in time......you get the idea. The thing is, like syphills and erectile dysfunction, most people aren't going to publicly bring up the time they got yelled out for obviously ****ing up and almost got fired....so you live in this weird bubble of never hearing anything and wondering how you're doing, but if you never hear anything you're actually doing quite well. Its a stupid inefficient system, and its not how I would do things, but its the way it is.

2) Things will get better. As an intern you are very inefficient, even if you don't think you are. As PGY2's we spent some time in the call pool with interns on some of our general surgery services, and I marveled at how "slow" my calls were that second year. It wasn't until one of my senior residents pointed out that you're just better at being a doctor so you get things done faster that I did some serious brain storming and realized the work was roughly the same. Intern year can be brutal, and even though you're not solely responsible for all the complex decision making the sheer volume of busy work you have to do can be soul crushing. Some days will be better than others, but they will end eventually. The remaining years will still hurt but they will hurt differently. As a chief resident you get to do a lot more of the good stuff....it has its own pain (dealing with attendings, getting blamed for things your interns do, etc) but the pleasure to pain ratio is much more favorable. My hours are actually worse in fellowship but its so much better, which is a whole other topic.

3) Your attendings are cry babies. And so were mine in general surgery....I got fed a constant stream of bull**** for years about how easy we had it with the hours regulations and nap time, and how they were going to hand out binkys and wubbys for the call rooms and etc etc etc. The facts are that we do just as many cases as they did (per ACGME data) although we have to learn more than one approach (ex lap). Or three approaches (ex lap, kocher, mc burney's before some ancient attending freaks out). It doesn't help that every attending uses different laparoscopic equipment (ports, cameras, staplers) and there are about 80 ways to do a lap ventral hernia. And this is without bringing up how they had like one pressor, three antibiotics, no outcomes reporting and everyone stayed in the hospital for 2 months after an appendectomy but I digress. It will only take 15 seconds for someone 20 years older than to me to complain about this part of the post. My favorite fact about how bad it was back in the day is the "we were on call every other night" thing. And they were.....for their own service. The average general surgery service carries what.....30 patients at the most? Imagine if you were only on call for those 30 patients on a colorectal service.....and not that service of 30 (or less) plus vascular plus pediatrics plus trauma plus whatever.....they didn't have to cross cover as much. Hell taking care of the my own service on call was usually easy because I knew the patients, it was watching after all the other services after people went home that was challenging (especially if as an intern you were taking care of patients on a service you hadn't rotated on yet). So don't listen to your attendings and don't let them discourage you, we can trace the whole "we had it much harder back in our day" argument all the way back to Socrates.

4) Your senior residents are selfish. I know we would all like to think that our chiefs made us work hard and wouldn't let us go to our grandparents funerals to teach us about the honored tradition of self sacrifice requisite to becoming a physician. But actually, they don't want you to go to weddings/funerals/get pregnant because if you're gone they have to do your work for you, and they really don't want to do that for obvious reasons. So don't take their criticism to heart. I'm not saying they don't have a point, because they shouldn't have to do your work for you, but you shouldn't self internalize it to make you feel inadequate.

5) The whole system is screwed up. My favorite story about education of all time is when I was in the 6th grade my dad wanted me to learn how to arc weld but he wasn't very good at it. So he paid an illiterate migrant farm worker from Mexico with a 3rd grade education who barely spoke English to teach me, because the guy was an incredible welder. He did not have an MD or a PhD, never had to attend a culture competency lecture, it was never expected of him to be an educator, and arc welding was not life or death. But he was patient and kind, and he was willing to stand next to me and watch me struggle without losing his ****.....he would show me what I was doing wrong and would correct my mistakes....he was encouraging and fun to work with. I have marveled over the years how this guy a) taught me great technique, and b) was not a total dick......but I have stood across the OR table from so many surgeons, the famous and obscure, old and young, from all over the world and very few could accomplish both of those things. If your program was anything like mine mentorship and education were not priorities, and I've truly come to believe that the majority of my attendings believed we existed to make their lives easier and that was it.

Ultimately if you decide you want to do this you just have to keep your head down and keep moving forward. As someone who spent a few years bottling up a nuclear fission level of white hot hatred for the people I worked for and with I know that is harder than it sounds. I wish i could take credit for this, but there is a great quote from this guy (Amazon product) where he talks about how you just have to survive. Like the Vietnam war, its not about how many of the enemy you take out....its about if you can get to the end and still be alive.

The next day you have off sleep....the whole day and night. Don't do anything, and I think you will realize you feel a little better. Then you will realize this isn't so bad really, and you don't have to be perfect. You just have to survive.

 

[Trauma Surgeon]

Some good advice above from people who have lived it and lived through it. To paraphrase another poster on another thread from long ago that I took to heart, general surgery is a truly a brutal thankless residency.

So you can bail if you want, and there's no shame in it. Hell everyone has thought about it, and anyone who says they haven't is lying. This job sucks....every job does, but this one sucks in special ways. So why do we do it....sometimes I don't know. Dynx posted in another thread (and referenced in this thread) about how people like us have this never say die attitude that propels us forward despite all the negatives, and I have to agree. If we didn't have that we would be out of here for greener pastures like many of our colleagues who shamelessly went straight into dermatology. People like us could do anything with our lives and pull it off, but we feel called to keep doing this to ourselves. The OR is cool though.

The above post is the best and also the longest one that I have ever read on SDN! Worth reading twice!
The moderators should have a post where the best post of the month/year should be collected.

 

[MediCane2006]

Some good advice above from people who have lived it and lived through it. To paraphrase another poster on another thread from long ago that I took to heart, general surgery is a truly a brutal thankless residency.

So you can bail if you want, and there's no shame in it. Hell everyone has thought about it, and anyone who says they haven't is lying. This job sucks....every job does, but this one sucks in special ways. So why do we do it....sometimes I don't know. Dynx posted in another thread (and referenced in this thread) about how people like us have this never say die attitude that propels us forward despite all the negatives, and I have to agree. If we didn't have that we would be out of here for greener pastures like many of our colleagues who shamelessly went straight into dermatology. People like us could do anything with our lives and pull it off, but we feel called to keep doing this to ourselves. The OR is cool though.

But before you go (if you go) there are a few things I think you should consider that may put things in perspective for you:

1) You're actually doing just fine. 74 on the absite is damn good, and if you don't think so go and ask all those people who scored under 5. Its important to know that if you're not getting hauled down to the principals office and getting yelled at you're doing great. I had a similar experience with intern year where I just kept going and going and going and going and never really heard anything ever. So you kinda wonder to yourself like I wonder how this is going, no one is really saying anything. So I just kept showing up and doing my thing. It was only by the end of year that I found out several of my co-residents got summoned to the chairman's office for a) yelling at pediatrics residents, b) yelling at medicine residents, c) yelling at ER residents, d) playing a (hilarious) prank on one of our malignant senior residents, e) yelling at medical students, f) failing the absite, g) sleeping through pages while transplant patients were coding, h) publicly disagreeing with attendings and changing orders against there direct instructions (seriously), i) not completing hours logs/evaluation in time......you get the idea. The thing is, like syphills and erectile dysfunction, most people aren't going to publicly bring up the time they got yelled out for obviously ****ing up and almost got fired....so you live in this weird bubble of never hearing anything and wondering how you're doing, but if you never hear anything you're actually doing quite well. Its a stupid inefficient system, and its not how I would do things, but its the way it is.

2) Things will get better. As an intern you are very inefficient, even if you don't think you are. As PGY2's we spent some time in the call pool with interns on some of our general surgery services, and I marveled at how "slow" my calls were that second year. It wasn't until one of my senior residents pointed out that you're just better at being a doctor so you get things done faster that I did some serious brain storming and realized the work was roughly the same. Intern year can be brutal, and even though you're not solely responsible for all the complex decision making the sheer volume of busy work you have to do can be soul crushing. Some days will be better than others, but they will end eventually. The remaining years will still hurt but they will hurt differently. As a chief resident you get to do a lot more of the good stuff....it has its own pain (dealing with attendings, getting blamed for things your interns do, etc) but the pleasure to pain ratio is much more favorable. My hours are actually worse in fellowship but its so much better, which is a whole other topic.

3) Your attendings are cry babies. And so were mine in general surgery....I got fed a constant stream of bull**** for years about how easy we had it with the hours regulations and nap time, and how they were going to hand out binkys and wubbys for the call rooms and etc etc etc. The facts are that we do just as many cases as they did (per ACGME data) although we have to learn more than one approach (ex lap). Or three approaches (ex lap, kocher, mc burney's before some ancient attending freaks out). It doesn't help that every attending uses different laparoscopic equipment (ports, cameras, staplers) and there are about 80 ways to do a lap ventral hernia. And this is without bringing up how they had like one pressor, three antibiotics, no outcomes reporting and everyone stayed in the hospital for 2 months after an appendectomy but I digress. It will only take 15 seconds for someone 20 years older than to me to complain about this part of the post. My favorite fact about how bad it was back in the day is the "we were on call every other night" thing. And they were.....for their own service. The average general surgery service carries what.....30 patients at the most? Imagine if you were only on call for those 30 patients on a colorectal service.....and not that service of 30 (or less) plus vascular plus pediatrics plus trauma plus whatever.....they didn't have to cross cover as much. Hell taking care of the my own service on call was usually easy because I knew the patients, it was watching after all the other services after people went home that was challenging (especially if as an intern you were taking care of patients on a service you hadn't rotated on yet). So don't listen to your attendings and don't let them discourage you, we can trace the whole "we had it much harder back in our day" argument all the way back to Socrates.

4) Your senior residents are selfish. I know we would all like to think that our chiefs made us work hard and wouldn't let us go to our grandparents funerals to teach us about the honored tradition of self sacrifice requisite to becoming a physician. But actually, they don't want you to go to weddings/funerals/get pregnant because if you're gone they have to do your work for you, and they really don't want to do that for obvious reasons. So don't take their criticism to heart. I'm not saying they don't have a point, because they shouldn't have to do your work for you, but you shouldn't self internalize it to make you feel inadequate.

5) The whole system is screwed up. My favorite story about education of all time is when I was in the 6th grade my dad wanted me to learn how to arc weld but he wasn't very good at it. So he paid an illiterate migrant farm worker from Mexico with a 3rd grade education who barely spoke English to teach me, because the guy was an incredible welder. He did not have an MD or a PhD, never had to attend a culture competency lecture, it was never expected of him to be an educator, and arc welding was not life or death. But he was patient and kind, and he was willing to stand next to me and watch me struggle without losing his ****.....he would show me what I was doing wrong and would correct my mistakes....he was encouraging and fun to work with. I have marveled over the years how this guy a) taught me great technique, and b) was not a total dick......but I have stood across the OR table from so many surgeons, the famous and obscure, old and young, from all over the world and very few could accomplish both of those things. If your program was anything like mine mentorship and education were not priorities, and I've truly come to believe that the majority of my attendings believed we existed to make their lives easier and that was it.

Ultimately if you decide you want to do this you just have to keep your head down and keep moving forward. As someone who spent a few years bottling up a nuclear fission level of white hot hatred for the people I worked for and with I know that is harder than it sounds. I wish i could take credit for this, but there is a great quote from this guy (Amazon product) where he talks about how you just have to survive. Like the Vietnam war, its not about how many of the enemy you take out....its about if you can get to the end and still be alive.

The next day you have off sleep....the whole day and night. Don't do anything, and I think you will realize you feel a little better. Then you will realize this isn't so bad really, and you don't have to be perfect. You just have to survive.

This is an incredible post. Bravo.

Also, did this prank have anything to do with putting office furniture in a bathroom? (or maybe pranking senior residents is more common than I thought)

 

[Merely]

Lol. It's taboo to post salary numbers.

I realize how critical surgeons are to medicine and I interact with them all the time. I want to thank you all for sacrificing your life for it and at the end of the day you really are. I would never do it. I once did it in my career before switching to medicine and I vowed that I would never do it again unless I was building my own billion dollar business. In medicine, we are nothing more than cogs in a much bigger machinery. I would not sacrifice my life so that the hospital or insurance CEO can make millions off my labor. There needs to be a balance between serving patients, having a life outside of medicine, and being compensated appropriately so that you feel that all your years of sacrifice were justified.

Thank you for this advice for future med students, interesting insight.

 

[ItinerantSurgeon]

Listen up babe, gonna tell you why you're gonna be stayin' in surgery. Been a while since I been 'round these parts. Thoracics my game now, cardiothoracics to be exact 'cuz if you ain't operating on that myocardium you ain't really operating as the saying goes. Residency took an extra year after PD man stuck me on sabbatical in the lab so things would cool down between us and them ER consulting docs. Tensions been brewing mighty bad between departments for a while 'til it all poured over one night. But if any you gents claim you haven't been in a shouting match in the middle of the ER at 3 a.m. with an ER doc over some useless consult and had to be escorted out by security then I'm gonna have to call you a liar. Didn't write a single paper during that there research year, had a thirsty prelim rez wanting a cat spot do all that researching and number crunching while I teed off on the back 9 hole like a heavyweight do. Went in cardiothoracics and thought 'bout quiting qdaily. Old school fellowship program, 1 fellow, no mercy and even less excuses. Chairman had recently gotten off suspension for some divorcing fiasco. But if any you gents claim you haven't crossed state lines to avoid paying alimony to an ex-wife then I'm gonna have to call you a liar. Made it through now I'm throwing my weight around in private practice. Many a scrub nurses have cried, many a complaints have been written up, many a meetings with HR have been had. Make a long story short babe, you'll be fine. Keep going through. Just a lightweight now but you'll come out heavy on the other side if you don't quit. Would write more but gotta meet up early tomorrow for some mandated counseling sessions to keep my operating privileges. Shrink lady calls it "Intermittent Explosive Disorder". Suppose that's the diagnosis you want if you wanna be a real heavy in this specialty, besides the typical "Severe Narcissitic Grandiose Delusional Disorder".

 

[SLUser11]

Listen up babe, gonna tell you why you're gonna be stayin' in surgery. Been a while since I been 'round these parts. Thoracics my game now, cardiothoracics to be exact 'cuz if you ain't operating on that myocardium you ain't really operating as the saying goes. Residency took an extra year after PD man stuck me on sabbatical in the lab so things would cool down between us and them ER consulting docs. Tensions been brewing mighty bad between departments for a while 'til it all poured over one night. But if any you gents claim you haven't been in a shouting match in the middle of the ER at 3 a.m. with an ER doc over some useless consult and had to be escorted out by security then I'm gonna have to call you a liar. Didn't write a single paper during that there research year, had a thirsty prelim rez wanting a cat spot do all that researching and number crunching while I teed off on the back 9 hole like a heavyweight do. Went in cardiothoracics and thought 'bout quiting qdaily. Old school fellowship program, 1 fellow, no mercy and even less excuses. Chairman had recently gotten off suspension for some divorcing fiasco. But if any you gents claim you haven't crossed state lines to avoid paying alimony to an ex-wife then I'm gonna have to call you a liar. Made it through now I'm throwing my weight around in private practice. Many a scrub nurses have cried, many a complaints have been written up, many a meetings with HR have been had. Make a long story short babe, you'll be fine. Keep going through. Just a lightweight now but you'll come out heavy on the other side if you don't quit. Would write more but gotta meet up early tomorrow for some mandated counseling sessions to keep my operating privileges. Shrink lady calls it "Intermittent Explosive Disorder". Suppose that's the diagnosis you want if you wanna be a real heavy in this specialty, besides the typical "Severe Narcissitic Grandiose Delusional Disorder".

Thank you sir, I needed that. I will delay judgment on your authenticity, but I will say emphatically that your kind has been missed.

I've become an unintentional real-life figurative (and to some extent literal) heavyweight, and tonight carried some heavy blows that deepened the deadness behind my eyes. My recoveries have been longer and more noticeable, and I have been looking for a Guy Fawkes to adequately distract. I will kindly sit back and observe as you have your way with an anesthesiologist....

 

[markcinnn]

OP says a farewell speech:
"I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology."

Surgery subforum posters say:
[hang in there, worth it, I cried too, everyone says that, etc.]

Anyone else see the disconnect, besides the fact that OP hasn't responded since (4 days after her post)?

 

[doc05]

OP says a farewell speech:
"I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology."

Surgery subforum posters say:
[hang in there, worth it, I cried too, everyone says that, etc.]

Anyone else see the disconnect, besides the fact that OP hasn't responded since (4 days after her post)?

Yes. Based on that original post, the OP needs to quit. I could be wrong about this.... but I'm usually right.

 

[Lostin_space]

I dove into general surgery residency nervous but optimistic. Out of all the fields I experienced in medical school nothing resonated with me like breast surgery. It was the operating room, the patient population, the genuine and full fledged feeling that it truly made a difference and saved lives. My sanguine nature, sensitivity, compassion and femininity lead people outside of the surgical field to tell me “I just don’t see you there”. But after reading Lean In and watching two fabulous female mentors who had succeeded I decided to take the plunge. After all I worked hard in medical school and made it into AOA; I wasn’t going to let a personality stereotype or my gender deter me.


But that plunge feels more and more like a belly flop as I flounder during my intern year. Despite a 74th percentile on the Absite and good evaluations I am drowning. The sleep deprivation, daily workload, lack of positive feedback, lack of mentorship and lack of consideration for personal life has done me in.


Aside from my 4 days off a month I have a 4am alarm clock to get me to the hospital by the strict 5am start. My shortest days are 13 hours and I estimate my average workweek to be 85hrs. America has not significantly increased the number of yearly surgical graduates so despite fewer hours than our predecessors there are proportionally less surgical residents to get more work done for an aging population with more surgical needs. And with the rise of the EMR we have more information to keep track of, more paperwork, less organic medical practice. Our attending surgeons constantly tell us how easy we have it and scoff at the duty hours. There is almost no positive feedback, which I suppose is tolerable. But even minor slip-ups will be brought to attention so I live in constant anxiety of missing something. I haven’t found great mentors. When I took a day off (one of my 4 allotted) for a loved ones medical procedure it caused a rift because my chief did not think my senior resident should have approved it. I also had a chief resident tell me how rude it would be if I (the only female in my intern class) were to ever get pregnant during the program. I’ve gained 10lbs and I have stopped exercising due to lack of time. I’ve cried multiple times in my car on the way home out of sheer exhaustion. And I went into surgery a well-adjusted and happy young woman with a good support system. My program is not even unreasonably malignant – I like and admire the people I work with.


I think this endeavor has been a belly flop and I am facing the reality that getting out of the pool may be a wiser decision than continuing to try to keep my head above water. I am living in an exhausted, overwhelmed state. Despite loving the OR I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology.

*Cyber hug*

I totally get you. As someone who changed specialties given the sheer overwhelment of the amount of knowledge to have, and as someone who feels personal life is paramount, I feel your pain. A lot of the way certain medical specialties are done are especially awful not necessarily because they have to be, but because programs/attendings/etc make it that way. But what you describe does sound miserable and perhaps not worth it. As a woman, I think it's especially hard. If I were in your shoes, I would look into switching.
I do want to point out that all specialties have bad days - I'm in PMR and i've worked close to 12hours today, with a consult list reaching close to 40 patients, and still not done.

I agree with others that it does get better as you move up but with Surgery im afraid it won't get better, and the culture is the culture. Surgery will always be surgery. And you are absolutely right - while surgery is an essential field, and I'm personally in awe of those who can put up with the grueling elements of a surgical residency, there are many fields that do a lot of good that are not surgery.

Good luck with whatever you decide to do.

 

[Thanatos]

This is an incredible post. Bravo.

Also, did this prank have anything to do with putting office furniture in a bathroom? (or maybe pranking senior residents is more common than I thought)

Sadly the prank wasn't even that elaborate, basically we had a senior resident who treated us poorly. A couple of my co-interns paged her on call one afternoon and pretended to be transferring doctors from an outside hospital bringing her a trainwreck dumpster fire of a patient (like 95 yo with every possible comorbidity you can imagine, liver failure/renal failure, hep C, hiv, short gut, EC fistula etc) for management of a bleeding hemorrhoid (one piece of gauze saturated....per day!!!) and tried to convince her the charge nurse had already gotten report and they were just giving her a heads up the patient was one the way after they packed him up. She kept saying "I have not accepted this patient you cannot send them!!!" and they just going "whew thank god EMS got him on the stretcher okay.....hey where's the levophed.......Oh damn we forgot the cooler with the FFP!!!" And so on and so on......when she figured out it was them she did what any mature senior resident would do and lodged a formal complaint with the department so they would get in trouble. I've oscillated over the years on how much of a "family" your co-residents can (or cannot) be and it just makes me sad. When I was the trauma chief one of my co residents paged me pretending to be a family doctor moonlighting at a local prison saying a knife fight had broken out in their dialysis unit and they were sending me a school bus full of AV fistula traumas. He had me going for about 10 seconds and we spent weeks laughing about it......I though it was hilarious and tattling on him would not have crossed my mind.

Listen up babe, gonna tell you why you're gonna be stayin' in surgery. Been a while since I been 'round these parts. Thoracics my game now, cardiothoracics to be exact 'cuz if you ain't operating on that myocardium you ain't really operating as the saying goes. Residency took an extra year after PD man stuck me on sabbatical in the lab so things would cool down between us and them ER consulting docs. Tensions been brewing mighty bad between departments for a while 'til it all poured over one night. But if any you gents claim you haven't been in a shouting match in the middle of the ER at 3 a.m. with an ER doc over some useless consult and had to be escorted out by security then I'm gonna have to call you a liar. Didn't write a single paper during that there research year, had a thirsty prelim rez wanting a cat spot do all that researching and number crunching while I teed off on the back 9 hole like a heavyweight do. Went in cardiothoracics and thought 'bout quiting qdaily. Old school fellowship program, 1 fellow, no mercy and even less excuses. Chairman had recently gotten off suspension for some divorcing fiasco. But if any you gents claim you haven't crossed state lines to avoid paying alimony to an ex-wife then I'm gonna have to call you a liar. Made it through now I'm throwing my weight around in private practice. Many a scrub nurses have cried, many a complaints have been written up, many a meetings with HR have been had. Make a long story short babe, you'll be fine. Keep going through. Just a lightweight now but you'll come out heavy on the other side if you don't quit. Would write more but gotta meet up early tomorrow for some mandated counseling sessions to keep my operating privileges. Shrink lady calls it "Intermittent Explosive Disorder". Suppose that's the diagnosis you want if you wanna be a real heavy in this specialty, besides the typical "Severe Narcissitic Grandiose Delusional Disorder".

I think the genius of mysterioso was his slightly more subtle delivery, while hinting at self awareness. This one may be too forced to be legit.

OP says a farewell speech:
"I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology."

Surgery subforum posters say:
[hang in there, worth it, I cried too, everyone says that, etc.]

Anyone else see the disconnect, besides the fact that OP hasn't responded since (4 days after her post)?

Certainly a disconnect. I think in general we all feel frustrated oftentimes by what we do, and have a (pathological?) drive to just keep plugging away at it. In the end we do some awesome stuff and it can be very satisfying....the problem is once you walk away its almost impossible to come back. After all of this, the years of suffering and debt, it would be awful to walk away during a low point that could (and probably will) get better. My biggest concern with the OP is that I think a lot of their misery is a problem of perception exacerbated by sleep deprivation on a bad week....its easy to get discouraged when you're surrounded by co-workers who don't have your back and superiors who are constantly berating you. I just think its important to realize a lot of times it has nothing to do with you at all. Its okay to say the culture sucks and I don't want to be a part of it anymore, but you better be sure before you go. Especially when you consider every field has its shortcomings.

 

[TheTruckGuy]

I haven't read everything posted yet, but as someone seriously considering surgery, but not being a "can't imagine myself anywhere but in the OR" person, I appreciate the post and discussions above. Will read and join in the discussion after a shelf exam on Friday.

 

[Trauma Surgeon]

A little about surgical mentality…
Had late dinner with my chief of surgery last night (it ended 10:30PM). As a junior attending and the "only" trauma/emergency surgeon at our department I am in a position to make many suggestions for changes. But when it comes to changing things that are more of "cultural" nature than medical I get this answer from my boss:
"if you can't beat them, join them"…
It is unfortunately very frustrating… But probably the only way to survive and not ending your career...

 

[Ceusina]

Sadly the prank wasn't even that elaborate, basically we had a senior resident who treated us poorly. A couple of my co-interns paged her on call one afternoon and pretended to be transferring doctors from an outside hospital bringing her a trainwreck dumpster fire of a patient (like 95 yo with every possible comorbidity you can imagine, liver failure/renal failure, hep C, hiv, short gut, EC fistula etc) for management of a bleeding hemorrhoid (one piece of gauze saturated....per day!!!) and tried to convince her the charge nurse had already gotten report and they were just giving her a heads up the patient was one the way after they packed him up. She kept saying "I have not accepted this patient you cannot send them!!!" and they just going "whew thank god EMS got him on the stretcher okay.....hey where's the levophed.......Oh damn we forgot the cooler with the FFP!!!" And so on and so on......when she figured out it was them she did what any mature senior resident would do and lodged a formal complaint with the department so they would get in trouble. I've oscillated over the years on how much of a "family" your co-residents can (or cannot) be and it just makes me sad. When I was the trauma chief one of my co residents paged me pretending to be a family doctor moonlighting at a local prison saying a knife fight had broken out in their dialysis unit and they were sending me a school bus full of AV fistula traumas. He had me going for about 10 seconds and we spent weeks laughing about it......I though it was hilarious and tattling on him would not have crossed my mind.

Thanks for the good laugh! Both of those are hilarious. I sincerely hope to be pranked in a similar fashion during my residency.

 

[Winged Scapula]

WS, my experience in the army demonstrated that learning by humiliation is fairly effective so i never questioned it in residency.

I believe my experience growing up in a military family and then extended psychology studies made me question those tactics or at the very least rebel against them. YMMV


Sent from my iPhone using SDN mobile

 

[ACSurgeon]

I dove into general surgery residency nervous but optimistic. Out of all the fields I experienced in medical school nothing resonated with me like breast surgery. It was the operating room, the patient population, the genuine and full fledged feeling that it truly made a difference and saved lives. My sanguine nature, sensitivity, compassion and femininity lead people outside of the surgical field to tell me “I just don’t see you there”. But after reading Lean In and watching two fabulous female mentors who had succeeded I decided to take the plunge. After all I worked hard in medical school and made it into AOA; I wasn’t going to let a personality stereotype or my gender deter me.


But that plunge feels more and more like a belly flop as I flounder during my intern year. Despite a 74th percentile on the Absite and good evaluations I am drowning. The sleep deprivation, daily workload, lack of positive feedback, lack of mentorship and lack of consideration for personal life has done me in.


Aside from my 4 days off a month I have a 4am alarm clock to get me to the hospital by the strict 5am start. My shortest days are 13 hours and I estimate my average workweek to be 85hrs. America has not significantly increased the number of yearly surgical graduates so despite fewer hours than our predecessors there are proportionally less surgical residents to get more work done for an aging population with more surgical needs. And with the rise of the EMR we have more information to keep track of, more paperwork, less organic medical practice. Our attending surgeons constantly tell us how easy we have it and scoff at the duty hours. There is almost no positive feedback, which I suppose is tolerable. But even minor slip-ups will be brought to attention so I live in constant anxiety of missing something. I haven’t found great mentors. When I took a day off (one of my 4 allotted) for a loved ones medical procedure it caused a rift because my chief did not think my senior resident should have approved it. I also had a chief resident tell me how rude it would be if I (the only female in my intern class) were to ever get pregnant during the program. I’ve gained 10lbs and I have stopped exercising due to lack of time. I’ve cried multiple times in my car on the way home out of sheer exhaustion. And I went into surgery a well-adjusted and happy young woman with a good support system. My program is not even unreasonably malignant – I like and admire the people I work with.


I think this endeavor has been a belly flop and I am facing the reality that getting out of the pool may be a wiser decision than continuing to try to keep my head above water. I am living in an exhausted, overwhelmed state. Despite loving the OR I do not think the cost is worth the benefit. Surgery does not hold the monopoly on worthwhile fields that make differences in peoples lives. And until surgery decides to address the issues I have mentioned above I do not think it will ever stop losing great minds to fields like dermatology.

You've gotten great advice from many senior residents/attendings.

For anyone considering surgery who might stumble upon this thread: you should be very careful about pursuing general surgery if you're doing it only because of breast/endocrine surgery "resonates" with you. It'll be a long long 5 years of residency that do not at all resemble lifestyle as a breast or endocrine attending. Also, most endocrine surgeons and at least some breast surgeons still do bread and butter general surgery in their practice (or at least take call) which makes the lifestyle more surgical and less cush.

I often worry about students who "fall in love" with surgery after doing 4 weeks on our breast or endocrine service and think that the lifestyle of an academic endocrine surgeon is easily reproducible.

 

[ItinerantSurgeon]

I remember sitting in the locker room crying after a case, hiding in the bathroom to cry after rounds, and at one VERY low point basically bursting into tears at the nursing station when my awful chief resident yelled at me in front of the entire team and told me I killed a patient (I didn't).

I once teared up while being chastised for something by an attending, he noticed, asked if there was something wrong with my eyes, I said allergies, and we moved on and he pretended to believe the lie because that's what I wanted at that moment.

Tears of frustration were common but I learned to curb them in the OR.

My name is Intern
I round on the second floor
I pre-round a lot earlier than you
Yes, you've probably never seen me before

If you hear something late at night
Some kind of crying after some kind of fight
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was

He says it's 'cause I'm clumsy
Tying with one hand is not allowed
Maybe it's because I'm lazy
I try not to get him angry because he can get loud

They only insult you until you cry
After that you don't ask why
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore

Yes, I think I'm okay
I walked into the O.R. door again
If you ask that's what I'll say
And it's not like he'd admit it anyway

I guess I'd like to be alone
My spirit broken, another retractor thrown
Just don't ask me how I am
Just don't ask me how I am
Just don't ask me how I am

My name is Intern
I round on the second floor
I pre-round a lot earlier than you
Yes, you've probably never seen me before

If you hear something late at night
Some kind of crying after some kind of fight
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was

They only insult you until you cry
After that you don't ask why
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore

 

[dpmd]

Better effort. I smiled

 

[ThoracicGuy]

My name is Intern
I round on the second floor
I pre-round a lot earlier than you
Yes, you've probably never seen me before

If you hear something late at night
Some kind of crying after some kind of fight
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was

He says it's 'cause I'm clumsy
Tying with one hand is not allowed
Maybe it's because I'm lazy
I try not to get him angry because he can get loud

They only insult you until you cry
After that you don't ask why
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore

Yes, I think I'm okay
I walked into the O.R. door again
If you ask that's what I'll say
And it's not like he'd admit it anyway

I guess I'd like to be alone
My spirit broken, another retractor thrown
Just don't ask me how I am
Just don't ask me how I am
Just don't ask me how I am

My name is Intern
I round on the second floor
I pre-round a lot earlier than you
Yes, you've probably never seen me before

If you hear something late at night
Some kind of crying after some kind of fight
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was
Just don't ask me who the Chief Resident was

They only insult you until you cry
After that you don't ask why
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore
You just don't argue with the Chief anymore

8/10

 

[Buzz Me]

Lots of great advice from seasoned (and newer) posters above. My two cents...

Surgery residency is hard. No matter what medical school you go to (i.e. even if it was a "top school" as rated by US News/the "green" book/Pre-Allo forum, etc.), it's always a huge culture shock and rude awakening when you hit intern year, no matter what field you're in...and when you're at a tough general surgery residency and you're taking call for the first time and your pager is blowing up? That's when it's easy to feel overwhelmed. We've all been there.

I'm not going to talk about how things were "back when I was an intern" as those debates have been discussed ad nauseum in other threads. Suffice to say that everyone here that has gone through what you've gone through has also likely had thoughts of quitting at some point or another, likely on multiple occasions during intern year. Often after getting chewed out by an attending. Or after you make a mistake and the patient suffers because of it. Or after a particular angry family member yells at you. Or after you get written up by a nurse (rightly or wrongly).

What you need to figure out is whether this residency will be worth it in the end. And that's a hard question to answer. What I often tell students/residents is that, for the most part, most people going through med school like the part of their general surgery residency when they're actually DOING something. Sewing, tying, etc. (Not everyone, but many people. Some people just hate everything about surgery and would rather be in the library studying than scrubbed in the OR.) As long as they're actually involved in the case and not just watching, most people find the time flies by and they have an enjoyable experience. But what makes people decide to go into General Surgery is that they enjoy the OR and operating so much that they're willing to put up with all the yelling and beatdowns, all the long hours and stressful situations and sick patients. That's why most people don't go into General Surgery.

If you have it set in your heart that you're just using General Surgery as a stepping stone to a fellowship, and you're planning on just gritting your teeth for the next 5-7 years, well, that's a long road and not everyone can get through it. If you at least somewhat enjoy the patients and disease processes in General Surgery then it's much more realistic.

I understand where you're coming from. While I never seriously entertained the thought of quitting (and that's only because I have too much pride to quit), I certainly endured my fair share of beatdowns by the attendings (and nursing staff, and patients, and patients' family members) during General Surgery - and it only got worse during my Cardiothoracic Surgery fellowship. Been called every name imaginable (F-word, A-word, C-word). Worked way too many hours continuously, and way too many in a week. But for me it was all worth it. My goal of becoming a cardiothoracic attending was the light at the end of the tunnel, and that carried me through. In the end, things will get better (though I often say that the pain doesn't lessen as you progress each year, it only changes).

Best of luck, no matter what you decide.

 

[addy]

My goal of becoming a cardiothoracic attending was the light at the end of the tunnel, and that carried me through. In the end, things will get better (though I often say that the pain doesn't lessen as you progress each year, it only changes).

I don't mean to sound jaded or skeptical...I'm an M3 looking into the i6 program or CT after GS (more than likely CT after GS), but-- was it worth it? What is it about being a CT attending that made all the 'sacrifices' worth it? Realistically you're never going to get that time back or have a chance to live it again.

 

[mpdoc2]

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