Miserable on surgery rotation

[NWwildcat2013]

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I don't need to describe in detail how I feel. Many have before so I'll spare you.

My question is what happens if I can't sustain fake interest in all of this? I'm a hard worker and good student but I'm having trouble functioning in this environment. The only thing driving me is fear of a poor grade.

When asked to scrub in or participate in anyway in the OR Id rather say "no thanks". Really admire the skill and smarts of these surgeons but I have zero interest and I'm not sure what they expect from a student who is not interested at all. Just hard work during rounds? Just showing up to surgeries? At this point I just want to pass.

I thought I wanted to do surgery and have tried hard to like it but I was completely ignorant of what it's like. I guess in a way I am happy that I learned this about myself.

Any advice for getting through this? From someone who doesn't like surgery or a surgeon who has seen students like me?


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[Crayola227]

don't know what to tell you brah..... welcome to medicine, where no matter what field you go into, even your true love, you spend like 80% of your time wiht BS you hate

there's a reason it's called work and you gotta get paid to do it

so, I don't know what advice to give you besides suck it up

Actually,

I am nowhere near surg/ob/gyn adjacent, and I think surgeons are crazy people who meet criteria for addiction to their field. They remind me of the workhorses from Animal Farm, Orwell's book. They are the workhorses of medicine, as Cesar Milan the Dog Whisperer might say, the "high energy dogs." I think most are a lot of fun to grab a beer with ironically, but I don't like working with them. Diametrically opposed personalities you could say.

Anyway, despite all that, I'm the first now to defend everyone in medicine getting a decent amount of surgical experience. In AND out of the OR. For the vast number of MD grads and where they end up, there's a lot of things you'll need to know.

Morning rounds were much more educational than I thought. The dressing changes - that's when I probably learned the most about wound care and healing, learning to distinguish a "good" looking stoma takedown (none of them look good is my point, that's why you need this exposure) that's healing well, post-op dehissence, etc. (**** did I spell that right?). How much erythema is normal and how much is concern for infection? People skip their post op follow up all the time, and while it's not supposed to be your job, it's good to have a feel when you can take those staples out.

Generalists, PCPs, hospitalists, and ED docs, etc will all see patients in various stages of healing (or not healing, post op). We're not experts but we need to be able to recognize post op complications as much as the next doc.

Lastly, us other docs are usually the ones referring people for surgery, we're usually the first "gatekeepers" on the way to the OR if you will. We need to recognize surgical problems and refer. Also, we need a healthy respect for surgery and what that puts a patient through. People seem to think that surgery goes down as cleanly and precisely as taking apart and putting back together Lego blocks - when the truth is it has more in common with the last time you skinned and pieced out a whole chicken than it does Lincoln Logs. Anyone that has gone under the knife will not emerge the "same" even if the goal was just to correct pathology. Things don't come back together all that cleanly. We need to see the surgical chaos and respect it as a last resort not an easy fix.

Those 3 hours holding the retractor is when you will be present to see an artery get nicked and dealt with. That's when you'll see an unexpected anatomical variant lead to a nicked nerve and some post op symptoms. That's when you'll get a chance to see how a hemorrhage is controlled. You'll see how easy it is for things to go wrong and appreciate the difficulty. You'll understand the uncertainty that surgeons deal with.

I've come around to the view that this is valuable knowledge for all MDs to be running around with which is why I support really putting on a surgeon's cap and walking a mile in those shoes for a few weeks. I've cleared patients for surgery, risk stratified, referred, called urgent surgical consults, and managed patients medically pre and post op, and relied on surg recs to manage patients. I need to understand their "language" and thought process and notes. It's all ****ing relevant.

I think we need to do a better job of explaining why surgery rotations matter to non-surg bent students. Point out what they can be getting from those hours in the OR watching. If nothing else it should teach you some hefty respect for surgery.

Anyway, what was described does not sound like a good approximation of walking a mile in a surgeon's shoes. Studying for the shelf isn't enough IMHO to get what you should be getting out of the rotation.

TLDR:
need to learn respect for the surgical process and understand where you fit into it no matter what field you go into
take it from someone who hates all things surgical, those rotations are relevant to all MDs in one way or another IMO
read the above for some ideas on what you should be getting out of the rotation as a non-surg bent person[/USER]

 

[KinesiologyNerd]

Bad news, welcome to 3rd year. Just try to appreciate what that specialty is about and where it fits into your desired specialty. Oh and make sure to keep your screaming internal.

 

[NWwildcat2013]

Good perspectives all. I'm not trying to say this isn't worth it or educational but just trying to think about how I can approach it since I can't trick myself into enjoying it.


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[Crayola227]

Good perspectives all. I'm not trying to say this isn't worth it or educational but just trying to think about how I can approach it since I can't trick myself into enjoying it.


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I don't know why, most of it was boring but the times I got to get a fist in someone I thought was pretty rad
sometimes, I would just think to myself, man, no one gets to have these sorts of experiences, it's pretty special to cut on people like they're meatbags
really made me appreciate mortality
maybe I just like drama and the sight of blood

 

[NWwildcat2013]

Soooo which is it?...

I knew you'd post that and that's why I qualified my original post with "I tried hard to like it but can't". I literally had you in mind when I wrote my post.

I think I was lying to myself. Denial. Trying to force a square peg into a round hole etc. Finally let myself feel what I wanted after pushing those feelings down for years and thinking "I'll like it eventually".

Anyway, I do like the OR (except scrubbing in and not being able to pee or itch an itch)... So maybe gas and I still like small procedures so maybe GI. I don't think disliking actual surgery doesn't mean I can't enjoy the former two.


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[dozitgetchahi]

Most of us medical students hated our surgery rotations. You're not feeling/experiencing anything unusual.

Keep up your motivation by remembering that this is cool stuff at the end of the day - how many people get to scrub into surgeries anyway? I saw a kidney tx and it was amazing - broke me out of the sleep-deprived daze for a few hours for sure. 3rd year is full of cool experiences, even if many of them involve situations you'd prefer to never have to deal with ever again.

I will say that a number of people I knew had some sort of episode midway though our surgery rotations where it suddenly, temporarily seemed 'really cool' - even though we were completely miserable. It's some sort of sleep-deprived variant of stockholm syndrome and it definitely passes. Don't listen to it or else you might become one of the surprisingly large fraction of surgery residents who wash out after they realize they actually hate the specialty.

 

[zagnes1]

Honestly, I was extremely miserable on my surgery rotation too. My first two weeks were a nightmare for me. Like @sloop said once about medicine, I would take a shower after getting back and wonder what I was doing with my life. I hit rock bottom. I could not stand the nonstop yelling in the OR, the crazy attendings, the mean scrub nurses, or just standing there watching people bovi and suture for 6 hours (or being yelled at for retracting horribly). I just had no interest. The surgery culture was really weighing me down. I could not for the life of me envision any career in surgery or see why anyone would want to do something where the culture was just so rancid.

By pure luck on my third week, I ended up seeing a procedure that one of my medicine patients got. I instantly got brought back to the conversations I had with her and all the questions that she had about the procedure itself (which obviously I didn't know the answers to). In that one procedure, I obtained all the answers to her questions. And then my mindset changed. No matter what field you go into, you will have patients who will receive surgeries, and I realized that it would be a good idea to at least know what each procedure would entail. Especially for people like us who have no surgical specialty interest, this is our one and only opportunity to be in the OR and to actually witness firsthand what these surgeries are like. If you think about it, how many other people in this world get the privilege of being that close to someone's body during a surgical procedure?

To sum this up, you can get a lot out of any rotation, no matter how much you hate it. I know it sucks to have to go in everyday dreading your time in the OR, but honestly, if you try to spin it positively, you will be happier, and you will find ways to make this experience meaningful (You're paying $70,000 for this education after all even if you get screamed at 😉). It will also make your time on surgery much more bearable, trust me.

Also, I'm pretty sure despite this my surgery residents knew I wasn't going into surgery anyway haha. Didn't really affect my evals. I think most people in surgery realize that surgery tends to be pretty polarizing because after all, all surgery residents were once med students too and had friends who hated it I'm sure.

 

[Crayola227]

I knew you'd post that and that's why I qualified my original post with "I tried hard to like it but can't". I literally had you in mind when I wrote my post.

I think I was lying to myself. Denial. Trying to force a square peg into a round hole etc. Finally let myself feel what I wanted after pushing those feelings down for years and thinking "I'll like it eventually".

Anyway, I do like the OR (except scrubbing in and not being able to pee or itch an itch)... So maybe gas and I still like small procedures so maybe GI. I don't think disliking actual surgery doesn't mean I can't enjoy the former two.


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Kid, I'm a leftie too, and you dun ****ed up.

You NEED to suture left handed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

You'll never be able to, double gloved, with a needle driver, to get the tip of that needle right at the Q-subQ junction.
Unless you're tellling me you're pretty ambidextrous but it sounds like no.

You need to grow some balls. And make everyone live with the fact you're left handed. Yes, while teaching me to suture, I have had surgeons ask me, "Are you sure you're left handed?" Like somehow what hand I use to write has escaped me for 20 years and it's all been a terrible mistake.

Some studies suggest left handed surgeons do better on some measures because we're all a little more ambidextrous than righties by necessity.

Anyway, that might help your enjoyment of surgery.

Plus, there's not that many fields where you'd never have to throw a stitch. So do yourself, me, and your patients a favor and use your brain and the right (left) hand.

 

[NWwildcat2013]

Kid, I'm a leftie too, and you dun ****ed up.

You NEED to suture left handed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

You'll never be able to, double gloved, with a needle driver, to get the tip of that needle right at the Q-subQ junction.
Unless you're tellling me you're pretty ambidextrous but it sounds like no.

You need to grow some balls. And make everyone live with the fact you're left handed. Yes, while teaching me to suture, I have had surgeons ask me, "Are you sure you're left handed?" Like somehow what hand I use to write has escaped me for 20 years and it's all been a terrible mistake.

Some studies suggest left handed surgeons do better on some measures because we're all a little more ambidextrous than righties by necessity.

Anyway, that might help your enjoyment of surgery.

Plus, there's not that many fields where you'd never have to throw a stitch. So do yourself, me, and your patients a favor and use your brain and the right (left) hand.

Oh I do suture left handed. Sorry if my post was confusing. Im just saying that mimicking the actions of a right handed teacher can be confusing and its an extra step of mental processing and I think it slows me down and inhibits retention.

You make a good point about it potentially being an advantage. I actually am fairly ambidextrous.

I should have requested a left handed resident or attending 🙂 We need to stick together. Its tough out there being handed needle drivers in a righty orientation and all.

 

[Crayola227]

Oh I do suture left handed. Sorry if my post was confusing. Im just saying that mimicking the actions of a right handed teacher can be confusing and its an extra step of mental processing and I think it slows me down and inhibits retention.

You make a good point about it potentially being an advantage. I actually am fairly ambidextrous.

I should have requested a left handed resident or attending 🙂 We need to stick together. Its tough out there being handed needle drivers in a righty orientation and all.

People don't appreciate how much more awkward it is to unclick those those needles drivers as a leftie....

 

[KinesiologyNerd]

People don't appreciate how much more awkward it is to unclick those those needles drivers as a leftie....

So don't lock them?

 

[ProfMD]

So don't lock them?

The scrub nurse locks the needle driver after loading the needle.

I guess a left handed surgeon could load all his/her own needles, but that would add time to the case, especially if you do a lot of interrupted suturing with pop-off needles.

I have a few left-handed residents. They manage just fine and are quite good.

 

[Crayola227]

So don't lock them?

alot of the time you really need to. I don't like suturing with them unlocked. Just more awkward and a tough more difficult to unlock that's all.

They do make left-handed needle drivers and there are some tools that are only righty and others that come in both flavors. Attendings can usually specify to the department and for a case certain equipment they prefer like some left handed tools.

 

[Crayola227]

The scrub nurse locks the needle driver after loading the needle.

I guess a left handed surgeon could load all his/her own needles, but that would add time to the case, especially if you do a lot of interrupted suturing with pop-off needles.

I have a few left-handed residents. They manage just fine and are quite good.

If you let the nurses know they have no problem loading them for a leftie.

 

[NWwildcat2013]

Silver lining and one thing I'm trying to take away from this is the medical management. Surgeons REALLY know their stuff (general surgery especially) and I'm learning a ton.


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[Crayola227]

You get used to it. You just use your thenar eminence to sort of snag it and pull it to unlock it rather than the natural right handed push move.

When suturing for myself (e.g. on a running suture or anastomosis) I typically don't ever lock the needle driver, but I don't think most righties do either, at least not for delicate tissue?

I don't ever think about it at this point. It just becomes natural.



No, there really aren't. About the only time locking the needle driver is needed is if you are going through fascia with a big needle, or if you are throwing a suture that is under a high degree of tension, which usually begs the question of why you are throwing a suture under that much tension to begin with.

One of our CT surgeons has a lefty tray with needle drivers. I got to use it once and it ironically just felt backward to me after years of using the regular instruments.

another lefty!!

I was speaking from the point of view of someone who rarely throws a stitch
the way you describe is exactly right, and in my experience how awkward/time consuming to unlocking just has to do with how practiced you are
always hurt my thenar eminence a bit after a few stitches but whatever

the only stitching I would do is on skin or subQ
I just find that if I'm clutching the needle as hard as I usually do I almost always end up locking it, and TBH I feel "better" doing it that way like I have better grip/more control
I think the more you do it the less you "cling" to the needle drivers like life savers, so for me any of what I said vs what you said has depended on how practiced I was at the time

my EM rotation was I was doing a way better job than outpt IM clinic just for how often you do stuff

 

[Seroquel]

OP, I came into surgery dreading it and knowing it would be horrible. For the first few weeks it definitely was. I kept getting yelled at by the scrub nurses and one of my residents bad-mouthed me in front of the attending. But I switched services and it was fantastic through the end. I ended up absolutely LOVING the experience and my residents and attendings were my favorite the entire year. What made the difference for me was that I finally got to connect with the patients. I like talking to people and one day I decided to just have my own "student rounds" after lunch and before afternoon cases. I got to know them better and their procedures and I gained a newfound interest and immense respect for surgery. I highly recommend trying to find the silver lining in all of your rotations this year. The other thing I would say is try not to look uninterested. I unfortunately am very expressive so it was obvious how I felt but I tried my best to hide it. And I actually did become more interested as time went on. This was the only rotation where it seemed like people got offended if you said you weren't interested in surgery so be careful.

 

[Amygdarya]

The three main things I've learned about clinical rotations so far (halfway through my core rotations):
1) At least for me, my clerkship experiences depend almost entirely on the people I work with, from attendings to fellow students on my team. I'm really fine with busy work and long hours, as long as people are nice. Conversely, interpersonal issues can make even the easiest rotation hell.
Corollary to the OP's question: persevere, things may well change for the better once you switch teams.
2) Find attendings and residents who teach and don't leave their side. Help them (your residents specifically) by doing necessary things nobody wants to do (like writing notes, getting records from other places etc), thus freeing up time to teach you more. It may also be a good idea to get more face time with fewer residents/attendings rather than the other way around, since the more they know you the more they let you do (especially true on surgery).
3) A good attitude and willingness to help can go a long way.

 

[psychhopefull2016]

I am with you. I despised surgery rotation. It was my first rotation and I considered quitting medical school (very glad I did not, it got so much better). I had a very malignant team and was not in a good place emotionally by the end. My hours were often 4am-8pm. BUT I did learn a few very important things:

1) I can survive pretty much anything. While I did not learn much by way of surgical skill I learned a lot of survival skill for long hours and difficult teams. I think this will serve me well for rotations I don't like in residency.

2) I learned when to call a surgeon. Aka the only "surgical skill" I could ever need as a psychiatrist

 

[NWwildcat2013]

I am with you. I despised surgery rotation. It was my first rotation and I considered quitting medical school (very glad I did not, it got so much better). I had a very malignant team and was not in a good place emotionally by the end. My hours were often 4am-8pm. BUT I did learn a few very important things:

1) I can survive pretty much anything. While I did not learn much by way of surgical skill I learned a lot of survival skill for long hours and difficult teams. I think this will serve me well for rotations I don't like in residency.

2) I learned when to call a surgeon. Aka the only "surgical skill" I could ever need as a psychiatrist

Almost identical situation to mine. Similar hours and team vibe. I wake up to a rush of hot anxiety in my stomach every morning.

At this point I take it one day at a time. Actually, I take it one surgery or episode of rounding at a time.

Sounds like I'm definitely not the first student to feel like this so I'm hoping to find enough time to pass the shelf like many before me.


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[psychhopefull2016]

Almost identical situation to mine. Similar hours and team vibe. I wake up to a rush of hot anxiety in my stomach every morning.

At this point I take it one day at a time. Actually, I take it one surgery or episode of rounding at a time.

Sounds like I'm definitely not the first student to feel like this so I'm hoping to find enough time to pass the shelf like many before me.


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You can pass! I was in the high 60s on the shelf and got a "pass" in the rotation. I went on to get HP or honors in the rest of them. You will find something you love and be much happier on other things. Or be like me an buy yourself a celebratory end of surgery pet. (Maybe not if you don't have pet care help)

 

[JustPlainBill]

Even though you despise surgery and will likely never see the inside of a surgical suite again in this lifetime, there are some takeaway points to this rotation that can help you anywhere --

1) Learn the indicators of a post-op infection
2) Figure out by observation what the wound healing process looks like -- is that thing that was closed yesterday getting better or worse?
3) What antibiotics do they use prophylactically and why? Is it different for CT surgery?
4) What are the different suture materials and why/when do you use them. Think ahead -- you're now a resident moonlighting at an urgent care facility and someone walks in who's just almost amputated their finger slicing an avocado -- how the hell do I suture that thing and what is the expected course? What are the things that could go wrong?
5) Fluids -- what are my considerations there? Is D5NS always the right choice? and what's the proper rate post op wise?
6) ambulation -- when/how/why?
7) how do you do simple vs other types of sutures and when do you use them? Can you get some supervised practice?
7.5) Will anesthesia let you practice intubating?
8) what's different about suturing a face/eyebrow vs palm of the hand vs upper arm vs scalp vs toe?
9) How do you do digital blocks/nerve blocks?
10) Now this is a little off the wall --- you're in outpatient clinic after graduating residency happily enjoying never setting foot inside a freakin' hospital again with those alpha-male, driven, surgeons with a God-complex --- when you hear a thump, scream and commotion down the hallway that leads to your exam rooms -- being the curious chap (or chapette) that you are, you go look and there's a gathering crowd of MAs and others -- you calmly walk over, munching your cherry Nutrigrain bar to see what's up --- and there's a 68 y/o grandma who tripped and went headfirst into your crash cart that's strategically placed in a small hallway off the main one -- with blood flowing from the head wound and a nasty gash on the upper arm that seems to be pulsating as it runs down into her antecubital fossa --- being the quick thinking physician, you recognize it as an arterial bleed --- recalling your joyous time in surgery, you think back to some of your cases where a bleeder got away from everyone, channel the calm/collected surgeon who acting quickly and efficiently and apply direct pressure to the wound --- what are your best ways to react to stuff like that -- uncontrolled bleeding, etc. that you may be able to learn from surgical attendings/residents?

You can learn from every situation -- sucks to do it when you're tired and takes extra motivation, but it can be done ---

By the way, those are questions I wish I would have had the guts to ask my attending surgeon -- but I didn't know what I didn't know and what I would need once I was out -- so I missed the chance......he was a really nice guy and good teacher --- but I guess he thought I knew all of it or would get it as an intern ----

No warranties expressed or implied, your mileage may vary, car driven by a professional driver on a closed course......

 

[cabinbuilder]

Even though you despise surgery and will likely never see the inside of a surgical suite again in this lifetime, there are some takeaway points to this rotation that can help you anywhere --

1) Learn the indicators of a post-op infection
2) Figure out by observation what the wound healing process looks like -- is that thing that was closed yesterday getting better or worse?
3) What antibiotics do they use prophylactically and why? Is it different for CT surgery?
4) What are the different suture materials and why/when do you use them. Think ahead -- you're now a resident moonlighting at an urgent care facility and someone walks in who's just almost amputated their finger slicing an avocado -- how the hell do I suture that thing and what is the expected course? What are the things that could go wrong?
5) Fluids -- what are my considerations there? Is D5NS always the right choice? and what's the proper rate post op wise?
6) ambulation -- when/how/why?
7) how do you do simple vs other types of sutures and when do you use them? Can you get some supervised practice?
7.5) Will anesthesia let you practice intubating?
8) what's different about suturing a face/eyebrow vs palm of the hand vs upper arm vs scalp vs toe?
9) How do you do digital blocks/nerve blocks?
10) Now this is a little off the wall --- you're in outpatient clinic after graduating residency happily enjoying never setting foot inside a freakin' hospital again with those alpha-male, driven, surgeons with a God-complex --- when you hear a thump, scream and commotion down the hallway that leads to your exam rooms -- being the curious chap (or chapette) that you are, you go look and there's a gathering crowd of MAs and others -- you calmly walk over, munching your cherry Nutrigrain bar to see what's up --- and there's a 68 y/o grandma who tripped and went headfirst into your crash cart that's strategically placed in a small hallway off the main one -- with blood flowing from the head wound and a nasty gash on the upper arm that seems to be pulsating as it runs down into her antecubital fossa --- being the quick thinking physician, you recognize it as an arterial bleed --- recalling your joyous time in surgery, you think back to some of your cases where a bleeder got away from everyone, channel the calm/collected surgeon who acting quickly and efficiently and apply direct pressure to the wound --- what are your best ways to react to stuff like that -- uncontrolled bleeding, etc. that you may be able to learn from surgical attendings/residents?

You can learn from every situation -- sucks to do it when you're tired and takes extra motivation, but it can be done ---

By the way, those are questions I wish I would have had the guts to ask my attending surgeon -- but I didn't know what I didn't know and what I would need once I was out -- so I missed the chance......he was a really nice guy and good teacher --- but I guess he thought I knew all of it or would get it as an intern ----

No warranties expressed or implied, your mileage may vary, car driven by a professional driver on a closed course......

This is probably the best post I have seen in a while. Take it from someone who wished he had learned more when he had the chance. Once you get out there really isn't that guy in the office next to you who can teach you what you didn't learn. Look at what type of doctor you want to be, say PEDS for example. You will still need to know how to suture that kid who just cut his hand on the knife. The OR may not be your love but learn from surgery clinic what can be done in the office because you never know when you are going to need those skills as Bill said with wounds and infections. Which suture do you use? Can you do a double layer closure if you have to? Etc.

 

[JustPlainBill]

This is probably the best post I have seen in a while. Take it from someone who wished he had learned more when he had the chance. Once you get out there really isn't that guy in the office next to you who can teach you what you didn't learn. Look at what type of doctor you want to be, say PEDS for example. You will still need to know how to suture that kid who just cut his hand on the knife. The OR may not be your love but learn from surgery clinic what can be done in the office because you never know when you are going to need those skills as Bill said with wounds and infections. Which suture do you use? Can you do a double layer closure if you have to? Etc.

Thank you @cabinbuilder for the natural recognition of my genius.....no need for applause, just throw money -- preferably dollar bills, folded lengthwise....😉

 

[cabinbuilder]

Thank you @cabinbuilder for the natural recognition of my genius.....no need for applause, just throw money -- preferably dollar bills, folded lengthwise....😉

Yah, yah, yah. The pesdestal is not very high to say the least. Just keep calling me when you get stuck. 😍 Always wise to have a "go to" person when you have questions. Trust me I have a long list of fellow doctors on speed dial.

 

[JustPlainBill]

Yah, yah, yah. The pesdestal is not very high to say the least. Just keep calling me when you get stuck. 😍 Always wise to have a "go to" person when you have questions. Trust me I have a long list of fellow doctors on speed dial.

Yes, my dear, you have bailed my nasty self out of many a situation and I am appreciative .... and it is nice to have someone who will honestly tell you whether or not you made the right call when your bosses are griping that you didn't due to revenue.....

 

[cabinbuilder]

Yes, my dear, you have bailed my nasty self out of many a situation and I am appreciative .... and it is nice to have someone who will honestly tell you whether or not you made the right call when your bosses are griping that you didn't due to revenue.....

Any time. Happy to be your phone wife.

 

[JustPlainBill]

Any time. Happy to be your phone wife.

Mmmm, just how I like 'em....intelligent and sassy.....😉

 

[URHere]

I also passionately hated my surgery rotation back when I was an MS3. The saving grace for me was that my site was very flexible in terms of who they let me work with, and which settings they let me work in.

Do you have a set schedule in terms of preceptors and cases that you need to scrub in for? If not, is there any way you could arrange to spend more time in clinic or swap some of your normal day sessions for overnights when you would be dealing with more interesting trauma cases? Trauma was the one thing I liked about surgery, and as weird as it sounds, those night shifts were a lifesaver for me.

 

[NWwildcat2013]

I also passionately hated my surgery rotation back when I was an MS3. The saving grace for me was that my site was very flexible in terms of who they let me work with, and which settings they let me work in.

Do you have a set schedule in terms of preceptors and cases that you need to scrub in for? If not, is there any way you could arrange to spend more time in clinic or swap some of your normal day sessions for overnights when you would be dealing with more interesting trauma cases? Trauma was the one thing I liked about surgery, and as weird as it sounds, those night shifts were a lifesaver for me.

Unfortunately it is a pretty rigid schedule.

 

[byaaaaaaah23]

Just gotta take it one day at a time. Plan something fun for the weekend after your shelf and just focus on getting through to that. You will make it through.

 

[EmergDoc2B]

As for faking interest, I wouldn't. Enjoy the parts you enjoy and be honest about them. The parts you dont enjoy be honest as well. I went into my surgery rotation knowing I wanted to do EM. When asked I was very honest about that and scared my attendings would ignore me. They didnt instead they tailored their talks with me in terms of what an EM intern needs to know about ______. They also busted my balls regularly about my choice and not going into surgery. I think in the end they appreciated the honesty and that I busted my tail knowing I wasnt interested in gen surg. my 2cents.

 

[bannie22]

99% of medicine is faking it. and you will do well to continue to fake it until you are an attending. and if you are in academics, or in any form of non rural private group practice, you might be faking it for life.

 

[NWwildcat2013]

99% of medicine is faking it. and you will do well to continue to fake it until you are an attending. and if you are in academics, or in any form of non rural private group practice, you might be faking it for life.

Ill fake positive emotions to patients because that's part of the job if that's what you mean. Can't let your negative emotions or a bad day spill over into the exam room.

Presumably I'll find a specialty where I don't have to fake an interest to my peers and attendings so I don't quite agree with your post. I'm pretty pessimistic and it takes a lot for me to see the sunny side but even I think most people can find a specialty that they like more days than not as long as they don't let money, prestige, or others expectations guide them.


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[NWwildcat2013]

One thing I can't get over in surgery is how weirdly militaristic it is. Aside from the yelling and public humiliation I find it very strange when residents deferentially call an attending "Sir". It really makes me cringe. The hierarchy also seems more rigid and the chain of command is more linear which I don't think makes for a good learning environment. I'm talking from the perspective of a medical student trying to learn and not a resident going through a day. I never feel like I can ask questions past my intern who doesn't have time for them anyway.

I also refuse to participate in the circus during rounds which involves med students tripping over each other to grab gloves and fiddle with drains and dressings to look engaged. If you didn't do that during prerounds then you aren't doing your job and if you did but are inquisitively peering at the same 20cc of serosanguinous output that you JUST SAW in order to appear active then I have no words other than "Have fun". I won't do it. The OR is full of that too. I've been told to do so many things in the OR before, during, and after surgery that just gets in the way of nurses and anesthesia or is redundant. When I stopped doing them after other staff told me it's easier if I don't or redundant then I have been scolded by residents for slacking. Sometimes I just laugh in my head at how a surgery rotation is like navigating a minefield.

I'm predicting some "then it's on you to find the best way to be helpful" response but let me say that I tried that but my residents likely don't see it and all they see is me not doing the thing they told me to do. Surgery, more than anything else I have rotated through, seems to appreciate being busy for the sake of being busy.

It's a strange culture and I'm just keeping my head down as others have suggested.


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[akwho]

One thing I can't get over in surgery is how weirdly militaristic it is. Aside from the yelling and public humiliation I find it very strange when residents deferentially call an attending "Sir". It really makes me cringe. The hierarchy also seems more rigid and the chain of command is more linear which I don't think makes for a good learning environment. I'm talking from the perspective of a medical student trying to learn and not a resident going through a day. I never feel like I can ask questions past my intern who doesn't have time for them anyway.

I also refuse to participate in the circus during rounds which involves med students tripping over each other to grab gloves and fiddle with drains and dressings to look engaged. If you didn't do that during prerounds then you aren't doing your job and if you did but are inquisitively peering at the same 20cc of serosanguinous output that you JUST SAW in order to appear active then I have no words other than "Have fun". I won't do it. The OR is full of that too. I've been told to do so many things in the OR before, during, and after surgery that just gets in the way of nurses and anesthesia or is redundant. When I stopped doing them after other staff told me it's easier if I don't or redundant then I have been scolded by residents for slacking. Sometimes I just laugh in my head at how a surgery rotation is like navigating a minefield.

I'm predicting some "then it's on you to find the best way to be helpful" response but let me say that I tried that but my residents likely don't see it and all they see is me not doing the thing they told me to do. Surgery, more than anything else I have rotated through, seems to appreciate being busy for the sake of being busy.

It's a strange culture and I'm just keeping my head down as others have suggested.


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You're not going to be a surgeon and that's just fine. The world needs all types of healers, but I would hate to see you miss out on some of the most important lessons surgery has to teach because you are having a bad experience. A surgical team that is a well oiled machine is a wonder to behold. Bandage changes can be a beautiful ballet where every team member anticipates the next step which are carried out in rapid procession. You are completely missing the plot if you think rounds are a time to look busy. Rounds are a time as a medical student to show that you "get it." Every minute your team saves on rounds is a minute your team can spend teaching you later. Every minute you waste on rounds, is a minute less of teaching, learning or operating.

It is the same principal in the OR, anticipate, anticipate, anticipate. Have the nurses show you how to do something the first couple times, and the whole rest of the rotation you are an useful part of the surgical team for that step in the process. It is just fine if you slow things down in the beginning, that is expected. If you are slowing things down on week six it looks like you just don't get it, or worse you don't care. If either of those are the case you are wasting your seniors time, which is the one thing they don't put up with in surgery. If you are wasting your seniors time don't expect to have an enjoyable surgical clerkship experience or a good clerkship grade.

Respect is important in surgery. Your seniors are walking you through cases, sharing knowledge hard won that you will use to make your patient's lives better. When you see an attending surgeon come in and save a patient's life who would have died in your hands, you will realize that calling them sir or ma'am doesn't begin to pay back the debt of respect owed for their knowledge, capability to teach and to heal. The same is true in medicine, but the feeling is perhaps less visceral due to the nature of the work.

Most important lessons from your surgical rotation: Respect your seniors knowledge it will save your patient's lives and preserve their health, be efficient, anticipate, anticipate, anticipate, and teamwork.

 

[EmergDoc2B]

99% of medicine is faking it. and you will do well to continue to fake it until you are an attending. and if you are in academics, or in any form of non rural private group practice, you might be faking it for life.

respectfully disagree.