"Love the OR?"

[SplenoMegastar]

Hi - I'm a third year medical student almost halfway through the year, and so far the only rotation I've been consistently excited about is surgery. A few questions:

1) This may sound dumb, but when people say you need to "love the OR," I imagine they don't expect that I'll enjoy the (occasional) getting yelled at by scrub nurses, surgeon yelling at anesthesia or scrub techs, etc., but just that I can tolerate or ignore that part and love the actual work. Is that a fair assumption? I feel comfortable in the environment overall, and most of the time it's great, but those are not behaviors I'd want to have to deal with as an attending.

2) My PhD is on the immune response to sterile injury and wound healing. I feel pretty confident that this is the sort of work that I would want to do going forward. When thinking about residency programs, it seems to make sense in my case to try to get the best clinical training I can, and that my options would be limited if I only applied to programs with good wound healing labs around. Would it be a very bad idea to do research after residency rather than during residency? I understand that it is required by some programs.

3) Should I try to meet with the chair of surgery before I plan my fourth year (March) or would that be seen as way too early since I wouldn't have grades from my sub-I's?

Thanks for reading.

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[ACSurgeon]

Hi - I'm a third year medical student almost halfway through the year, and so far the only rotation I've been consistently excited about is surgery. A few questions:

1) This may sound dumb, but when people say you need to "love the OR," I imagine they don't expect that I'll enjoy the (occasional) getting yelled at by scrub nurses, surgeon yelling at anesthesia or scrub techs, etc., but just that I can tolerate or ignore that part and love the actual work. Is that a fair assumption? I feel comfortable in the environment overall, and most of the time it's great, but those are not behaviors I'd want to have to deal with as an attending.

2) My PhD is on the immune response to sterile injury and wound healing. I feel pretty confident that this is the sort of work that I would want to do going forward. When thinking about residency programs, it seems to make sense in my case to try to get the best clinical training I can, and that my options would be limited if I only applied to programs with good wound healing labs around. Would it be a very bad idea to do research after residency rather than during residency? I understand that it is required by some programs.

3) Should I try to meet with the chair of surgery before I plan my fourth year (March) or would that be seen as way too early since I wouldn't have grades from my sub-I's?

Thanks for reading.

1) No one loves being abused

2) Even some programs that require research *might* waive that requirement for those who have done extensive research in medical school (esp with PhD). This is something to ask about during interviews. Not sure how peds/surg onc/PRS feel about not doing research during residency if you already have a PhD with a ton of basic science research. Again, something to ask mentors in those fields (esp if potentially considering one of the above). I would imagine many academic programs would have wound-healing type research… if you chose to do this type of research during residency.

3) As far as I know, you only meet with the chairman for LORs. Not to plan 4th year. You need a mentor in surgery that will help you plan 4th year rotations and guide your application process (e.g. bounce ideas off of regarding your personal statement, programs you apply to, etc).

4) apparently you're breaking the law by posting in the surgery forum as a student . @Winged Scapula can attest to this

 

[Winged Scapula]

Hi - I'm a third year medical student almost halfway through the year, and so far the only rotation I've been consistently excited about is surgery. A few questions:

1) This may sound dumb, but when people say you need to "love the OR," I imagine they don't expect that I'll enjoy the (occasional) getting yelled at by scrub nurses, surgeon yelling at anesthesia or scrub techs, etc., but just that I can tolerate or ignore that part and love the actual work. Is that a fair assumption? I feel comfortable in the environment overall, and most of the time it's great, but those are not behaviors I'd want to have to deal with as an attending.

If you're being yelled at as an attending, something is wrong. As we've noted before about a community practice, not only does the surgeon need to be collegial but so does anesthesia, and the OR staff. After all, you're bringing them business. No one is yelling at me, nor am I yelling at them (because, unlike AMCs, the PP anesthesia group can refuse to work with me if I abuse them).

2) My PhD is on the immune response to sterile injury and wound healing. I feel pretty confident that this is the sort of work that I would want to do going forward. When thinking about residency programs, it seems to make sense in my case to try to get the best clinical training I can, and that my options would be limited if I only applied to programs with good wound healing labs around. Would it be a very bad idea to do research after residency rather than during residency? I understand that it is required by some programs.

I'm not sure what you are referring to in regards to doing "research after" residency; are you talking about outside of training or a job? If you decided to do research during residency, bear in mind that some programs will allow you to spend your research years elsewhere if they cannot provide you the lab you need or if you want to work with someone specific not at your residency program. We have residents who've left to work at the NIH or other campuses.

3) Should I try to meet with the chair of surgery before I plan my fourth year (March) or would that be seen as way too early since I wouldn't have grades from my sub-I's?

Thanks for reading.

I think that's fine to meet early if you need something specific, otherwise I would plan to meet with surgical faculty and not necessarily the Chair.

And as @lazymed notes, I will move this to the Allo forum where it should have been posted. Those who wish to reply can do so there.

 

[DermViser]

Hi - I'm a third year medical student almost halfway through the year, and so far the only rotation I've been consistently excited about is surgery. A few questions:

1) This may sound dumb, but when people say you need to "love the OR," I imagine they don't expect that I'll enjoy the (occasional) getting yelled at by scrub nurses, surgeon yelling at anesthesia or scrub techs, etc., but just that I can tolerate or ignore that part and love the actual work. Is that a fair assumption? I feel comfortable in the environment overall, and most of the time it's great, but those are not behaviors I'd want to have to deal with as an attending.

2) My PhD is on the immune response to sterile injury and wound healing. I feel pretty confident that this is the sort of work that I would want to do going forward. When thinking about residency programs, it seems to make sense in my case to try to get the best clinical training I can, and that my options would be limited if I only applied to programs with good wound healing labs around. Would it be a very bad idea to do research after residency rather than during residency? I understand that it is required by some programs.

3) Should I try to meet with the chair of surgery before I plan my fourth year (March) or would that be seen as way too early since I wouldn't have grades from my sub-I's?

Thanks for reading.

I think by "loving the OR" -- it's really true when it comes to Surgery residency. Finishing General Surgery residency really is a major accomplishment. It's not really recommended for the faint of heart.

The attrition is high for a reason. You really will be spending hours upon hours everyday, learning your craft, many times at the detriment of other things in your life. When you go home your work is not done: you have to read up on your cases the next day, read up on the anatomy, reading up in Greenfield or Sabiston's, etc. THAT is why it's so difficult. You don't get to just do the fun stuff of cutting and suturing. It's ALL THE OTHER STUFF that you'll have to deal with - all of thus with sleep deprivation. What you're mentioning as far as getting yelled at, etc. is the tip of the iceberg as far as all the other stuff.

That's why you REALLY have to love doing Surgery and can't imagine yourself doing ANYTHING else.

 

[operaman]

Hi - I'm a third year medical student almost halfway through the year, and so far the only rotation I've been consistently excited about is surgery. A few questions:

1) This may sound dumb, but when people say you need to "love the OR," I imagine they don't expect that I'll enjoy the (occasional) getting yelled at by scrub nurses, surgeon yelling at anesthesia or scrub techs, etc., but just that I can tolerate or ignore that part and love the actual work. Is that a fair assumption? I feel comfortable in the environment overall, and most of the time it's great, but those are not behaviors I'd want to have to deal with as an attending.

2) My PhD is on the immune response to sterile injury and wound healing. I feel pretty confident that this is the sort of work that I would want to do going forward. When thinking about residency programs, it seems to make sense in my case to try to get the best clinical training I can, and that my options would be limited if I only applied to programs with good wound healing labs around. Would it be a very bad idea to do research after residency rather than during residency? I understand that it is required by some programs.

3) Should I try to meet with the chair of surgery before I plan my fourth year (March) or would that be seen as way too early since I wouldn't have grades from my sub-I's?

Thanks for reading.

1) Getting yelled at by scrub nurses is a rite of passage. In fact, if you don't ever get yelled at, you should auto fail because you clearly didn't show up. It gets better though. Once they get to know you and are comfortable that you're not one of the stupid students who will contaminate their field and f-up their day, they don't yell so much. It also helps to get to the OR early while they're setting up and offering to help out and introducing yourself.

That aside, you do have to love the OR, or at least really hate rounding. Usually those two go together. Maybe I could put it this way... If you could only do ONE of the following, which would you pick?
a) Bedside teaching rounds with William Osler
b) Radical mastectomy with William Halsted
c) Bedside teaching rounds with Tinsley Harrison
d) Neck dissection with George Crile

2) Nothing to add to what's already been said

3) If your chair is approachable, I'd definitely meet with him but just informally to talk about surgery and get to know him. More important meetings will come later. For now, just help him put a face with a name. Hopefully your performance on the rotation and other work with the department and overall awesomeness will make sure he hears your name frequently from faculty and residents.

 

[Kaustikos]

I love it. I don't know how to explain it or if I'm naive being a fourth year. But despite the grueling 8 - 10 hour long cases, I still find no problem getting up in the morning for the next case.
I like the staff. Once you understand their personality and why they're like this, it gets better.
Rounds is tolerable because there's no time wasted. **** gets done and we move on.
Is it always enjoyable? No. The times I try and fail at something and getting told so bluntly can break your confidence. But when I do it again and get it right and the attending/resident acknowledges it... It's an amazing feeling. Then there are times where **** hits the fan and you're in the middle of a crisis and try not to **** up. Try to be there only if needed. Being told to move away/get out.
Surgery can be a rollercoaster at times and I'm glad I haven't let it get to me. Keep calm and realize its nothing personal.
In the end: I can tell I love it considering I have no issue getting up at 4 and leaving at 6. I only hope it doesn't change.

 

[DermViser]

I love it. I don't know how to explain it or if I'm naive being a fourth year. But despite the grueling 8 - 10 hour long cases, I still find no problem getting up in the morning for the next case.
I like the staff. Once you understand their personality and why they're like this, it gets better.
Rounds is tolerable because there's no time wasted. **** gets done and we move on.
Is it always enjoyable? No. The times I try and fail at something and getting told so bluntly can break your confidence. But when I do it again and get it right and the attending/resident acknowledges it... It's an amazing feeling. Then there are times where **** hits the fan and you're in the middle of a crisis and try not to **** up. Try to be there only if needed. Being told to move away/get out.
Surgery can be a rollercoaster at times and I'm glad I haven't let it get to me. Keep calm and realize its nothing personal.
In the end: I can tell I love it considering I have no issue getting up at 4 and leaving at 6. I only hope it doesn't change.

But was your surgery rotation really like actual hours for a surgical intern? Medical students are much more protected now, so the MS-3 rotation in surgery isn't necessarily as realistic as being a surgical intern both in time and actual expectations. Or maybe you did a surgical sub-I.

 

[ACSurgeon]

But was your surgery rotation really like actual hours for a surgical intern? Medical students are much more protected now, so the MS-3 rotation in surgery isn't necessarily as realistic as being a surgical intern both in time and actual expectations. Or maybe you did a surgical sub-I.

If you have a strong work ethic, love the nature of the work, and at least in theory accept the trade off that is becoming a surgical resident, even a protected MS-3 can decide on surgery as a career. Because, even a month or two of 'residency simulation' as a sub-I falls way short of several years of non-stop working your tail off as a resident.

 

[DermViser]

If you have a strong work ethic, love the nature of the work, and at least in theory accept the trade off that is becoming a surgical resident, even a protected MS-3 can decide on surgery as a career. Because, even a month or two of 'residency simulation' as a sub-I falls way short of several years of non-stop working your tail off as a resident.

Deciding on a surgical career is easy and one can have a strong work ethic (on an 8 week rotation) and love the nature of the work. It's actually doing it which is the problem and it's hard to fathom the trade off you have to accept as a surgical resident for YEARS on end. Surgery residency truly separates the boys/girls who want to do surgery, from the men/women who do surgery. A surgical sub-I won't approximate it exactly, but it's definitely a lot more closer than the MS-3 clerkship in terms of pushing yourself to approximate realistic hours and duties, assuming your goal isn't JUST to snag a letter.

 

[Kaustikos]

But was your surgery rotation really like actual hours for a surgical intern? Medical students are much more protected now, so the MS-3 rotation in surgery isn't necessarily as realistic as being a surgical intern both in time and actual expectations. Or maybe you did a surgical sub-I.

I won't say I compare at all to residents. I'll say that I work on average 12 hours a day and Ive been doing it the past two months. I honestly don't care since I don't have to log it. I do my SubI in surgery next month and another in November. I'll let you know how it feels. But so far, it hasn't really impacted my energy. Sure I do get tired at the end but it's not like I fall asleep. Again, I'm not saying I do the hours residents do. But I'm not doing nothing.
Also, the hour restriction is bull****. Sure, they say don't come in before 5. But please have the round reports ready by 5:30...
And you don't learn by treating surgery like a 9-5 job. The best moments for me have been when I've stayed when I "didn't have to". I've gotten lucky.
So am I breaking the rules? Not now since I'm a fourth year. People say that I'm doing an elective and shouldn't be there this long... But it's hard when there are so many experiences and different cases available for me to help out in.