Surgery seems awesome, being a student on surgery sucks

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intubesteak

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Current M3 on surgery rotation, was considering some of the surgical subspecialties prior to my rotation. Have seen some really awesome things and felt like I could really fall in love with surgery. However, my experience as a student has not been very enjoyable. I typically feel useless and in the way (which is completely true to be fair). Also do not enjoy getting barked at in the OR, getting gunned by various students gunning for surgery, and the amount of pointless busy work without learning (ie making the list at 5am). I'm sure that I am in the majority of students with these feelings, but I would love to hear how this affected people's decision to go into surgery (particularly subspecialties). I can definitely imagine myself as an attending but also feel like I might not fit well into the harsh culture. Thoughts?
 
Not a surgical resident but I had a similar experience. I liked surgery itself but did not feel like I was a good fit amongst the residents (whereas definitely fit for IM). You probably could still end up liking it. Attendings probably will still yell at you in the OR and you’ll still have to do crap work at 5 am etc. But you’ll probably get to do more in the OR then as well
 
OrthoTraumaMD said:
All of us have felt that way, even up to and including residency. Ya gotta earn those scrubs 😉


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At what point did you decide it was worth it? So far I have enjoyed just about every rotation and I have the grades and stuff to do anything at this point. I've heard the "if you can live without the OR" deal but I have not fully subscribed to that lol.
 
What surgical subspecialties are you considering? Most of them seem to have a “nicer” culture than gen surg, however, you’ll find harsh people in any field. I am pursuing one myself and while I wasn’t a huge fan of gen surg itself, I still enjoyed my rotation. That being said, it’s not unusual for people who are going into surgery to not like the clerkship. It’s also pretty common for cases to be really boring to watch as a student. Unfortunately, there is only so much that med students can do in surgery, so being “pimped” on anatomy is a common way to get you involved in a case.

I’m not going to pretend that students aren’t treated like **** at times, but in my experience, students took things way too personally. It’s not uncommon for residents or attendings to give you instructions in a curt manner during a case. They don’t do it that way because they hate you/they’re all so mean, etc etc - they just want a certain thing done NOW. Obviously, there are better ways to communicate, but learning to not take stuff like this to heart is going to be more helpful in the short-term.


intubesteak said:
....I typically feel useless and in the way (which is completely true to be fair). Also do not enjoy getting barked at in the OR, getting gunned by various students gunning for surgery, and the amount of pointless busy work without learning (ie making the list at 5am).
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Helping your intern make the list and get numbers in the morning is a great way for med students to be helpful during your surgery clerkship. I agree that it’s a mindless, non-educational task, but doing small things like this can be really useful for getting better evals (or just making you a nicer person to work with). OTOH, education is obviously the first priority for med students and “scut” shouldn’t get in the way of it.

Lastly, having to deal with gunners on rotations really sucks. Hopefully your residents will notice if they’re acting really malicious :/
 
A surgery sub/acting-internship may help to shed some light if you're on the fence. While I felt like I was just seen as an annoyance during my rotation, during my AI I felt more like a part of the team and was able to actually participate in the care of patients. It also seemed like residents treated me differently as an acting intern then during my rotation. While I didn't get much OR time during my AI (my goal was to get my intern in there as much as possible while I manned his pager), the time scrubbed in seemed higher quality (no reason to scrub in unless you're going to participate as there's plenty to take of on the floor). The attendings mostly just ignored me but at least I wasn't barked at or pimped like my fellow med students in their rotation.
As OrthoTraumaMD alluded to, there definitely is a hierarchy in surgery. The path up the food chain is rough but the experience on my AI suggested to me that I might be able to survive the worst year of it without completely hating life. And it's motivating to see how much better the senior residents are than the juniors and the attendings over the seniors. Makes me excited to move up the ranks and be like them.

Plus I can't stand three to four hours of rounding...
 
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Dont take this the wrong way, but as a freshly minted M3, there isn't a whole lot you are qualified to do. Once again, at the bottom of the food chain. It is VERY frustrating. Pay attention, dont make the same mistake twice, offer to help wherever you can. At $1,800 an hour, they can't let you put in a stitch, admire it, put in another, admire it, ...you get the picture. Hang around with your resident as much as you can. You'll learn more and get to do more. Best wishes and good luck!
 
Just Call Me Doc said:
A surgery sub/acting-internship may help to shed some light if you're on the fence. While I felt like I was just seen as an annoyance during my rotation, during my AI I felt more like a part of the team and was able to actually participate in the care of patients. It also seemed like residents treated me differently as an acting intern then during my rotation. While I didn't get much OR time during my AI (my goal was to get my intern in there as much as possible while I manned his pager), the time scrubbed in seemed higher quality (no reason to scrub in unless you're going to participate as there's plenty to take of on the floor). The attendings mostly just ignored me but at least I wasn't barked at or pimped like my fellow med students in their rotation.
As OrthoTraumaMD alluded to, there definitely is a hierarchy in surgery. The path up the food chain is rough but the experience on my AI suggested to me that I might be able to survive the worst year of it without completely hating life. And it's motivating to see how much better the senior residents are than the juniors and the attendings over the seniors. Makes me excited to move up the ranks and be like them.

Plus I can't stand three to four hours of rounding...
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I think you're right. On my last rotation, the intern (brand new) honestly needed my help and I really took ownership and enjoyed the process. We have an AI on this rotation as well, so there are probably too many cooks in the kitchen for a relatively slow service. If I continue to enjoy what I see happening in the OR, I will probably pursue an AI early in 4th year and sort things out.
 
Angus Avagadro said:
Dont take this the wrong way, but as a freshly minted M3, there isn't a whole lot you are qualified to do. Once again, at the bottom of the food chain. It is VERY frustrating. Pay attention, dont make the same mistake twice, offer to help wherever you can. At $1,800 an hour, they can't let you put in a stitch, admire it, put in another, admire it, ...you get the picture. Hang around with your resident as much as you can. You'll learn more and get to do more. Best wishes and good luck!
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Totally makes sense. We have been sent off to study more often than I would like, as I would much rather be going on consults and learning on the floor. Plus there has not been many opportunities for questions or any teaching yet. Next week I will be a little more assertive in pursuing this kind of thing without being annoying. My fear is that this rotation will pass me by too quickly and I won't be able to make my mind up, when there are other specialties that I know much better and would be happy doing as well. Thanks for the advice!
 
You could always make friends with the peds/FM residents where you do your surgery residency. Fresh baked cookies to pick you up when you're down yo
 
On my last week of Gen Surg right now, I can honestly say that I learn more stuff from my residents than my attendings. However, a good part of me wishes that my rotation is done at a rural hospital with a community surgeon so that I am first assist on everything. Closing the lap ports is cool for my first couple of days. However, the process of slowly being allowed to do small tasks based on seniority is straight up garbage.

Surgery has so much potential to be a great rotation at all levels. The turtle speed at progress is very frustrating.
 
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Black Coffee 24/7 said:
On my last week of Gen Surg right now, I can honestly say that I learn more stuff from my residents than my attendings. However, a good part of me wishes that my rotation is done at a rural hospital with a community surgeon so that I am first assist on everything. Closing the lap ports is cool for my first couple of days. However, the process of slowly being allowed to do small tasks based on seniority is straight up garbage.

Surgery has so much potential to be a great rotation at all levels. The turtle speed at progress is very frustrating.
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Is this specific to surgery or would you recommend trying to get rotation sites at community hospitals for as many core rotations as possible?
 
Lawper said:
Is this specific to surgery or would you recommend trying to get rotation sites at community hospitals for as many core rotations as possible?
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That’s my exp at a teaching hospital in Gen Surg. I learn a few stuff that’s helpful on boards from my weekly didactic sessions.

However, I’m pretty much an independent learner, so that I’m pretty sure that I would learn the materials eventually from my outside resources and clinic days assuming that I’m proactive in my learning.

However, the hand on exp in the OR is straight up bull. I’m pretty satisfied with my exp but I would be so much happier at a rural hospital doing first assist in eveything.

The academic and clinical work are easy in my opinion if you are proactive in your learning. However, the hand on exp can’t be from anywhere except the OR. As a medical student, your OR exp will blow ball at a teaching hospital.
 
I'm not interested in surgery but in conjunction with what black coffee said, I can confirm that the experience at a rural hospital is MUCH better and less malignant, depending on where you go. I did part of my surgery rotation at a rural hospital approved by my school and was first assist on most things. I learned a ton, and my attendings were very nice and invested in my learning. They made me feel like a (somewhat) useful part of the team. If your school lets you rotate at a rural site 3rd year or has a rural site requirement I would for sure try to do a surgery rotation or elective there. Just my 2 cents
 
OrthoTraumaMD said:
All of us have felt that way, even up to and including residency. Ya gotta earn those scrubs 😉


Sent from my iPhone using SDN mobile
Click to expand...

As someone going into a procedural fellowship of IM I agree. I get lots of hands on time doing coronary cases but PCIs and structural cases are reserved primarily for the advanced fellows. There’s a reason for it. I appreciate this a lot more doing relatively invasive procedures.

I think personality fit matters a lot more than people give credit. Sorry, but there is a stereotype which fits amongst most surgical specialties (and non surgical specialties). Ortho = gym going bro’s/sis’s, EM = excessively social and outdoorsy, etc. I think trying to fit into that mold if you don’t inherently feel that way can be isolating and stressful which makes the experience suck.
 
intubesteak said:
Current M3 on surgery rotation, was considering some of the surgical subspecialties prior to my rotation. Have seen some really awesome things and felt like I could really fall in love with surgery. However, my experience as a student has not been very enjoyable. I typically feel useless and in the way (which is completely true to be fair). Also do not enjoy getting barked at in the OR, getting gunned by various students gunning for surgery, and the amount of pointless busy work without learning (ie making the list at 5am). I'm sure that I am in the majority of students with these feelings, but I would love to hear how this affected people's decision to go into surgery (particularly subspecialties). I can definitely imagine myself as an attending but also feel like I might not fit well into the harsh culture. Thoughts?
Click to expand...
The residents you work with, especially those in surgery, are generally smart enough to pick out the gunners and socially inept. Just work hard.
 
@IMreshopeful
I agree with you, up to a point. I feel like you can change certain aspects of your personality to fit the job. I was, and still am, a video game playing, Renaissance faire going, sports hating nerd. But the core of orthopedics speaks to my soul, so I learned how to talk shop, and how to interact with people whom I would have never been friends with in school.


Sent from my iPhone using SDN mobile
 
Black Coffee 24/7 said:
On my last week of Gen Surg right now, I can honestly say that I learn more stuff from my residents than my attendings. However, a good part of me wishes that my rotation is done at a rural hospital with a community surgeon so that I am first assist on everything. Closing the lap ports is cool for my first couple of days. However, the process of slowly being allowed to do small tasks based on seniority is straight up garbage.

Surgery has so much potential to be a great rotation at all levels. The turtle speed at progress is very frustrating.
Click to expand...

If you actually want to GO into surgery, like as a career, this is a horrible idea. Surgery at a community site without residents is NOTHING like it is wherever you will do residency. People that don't, either for MS3 or Sub-I do a rotation at a place with residents with the hierarchy are much more likely to be miserable and/or quit surgery before completion. You need to expect that you will be in a hierarchy wherever you go for residency, and if you don't have that exposure as a medical student, it can end poorly.

If you don't want to go into surgery, then yeah go nuts pick the chillest rotation.
 
evilbooyaa said:
If you actually want to GO into surgery, like as a career, this is a horrible idea. Surgery at a community site without residents is NOTHING like it is wherever you will do residency. People that don't, either for MS3 or Sub-I do a rotation at a place with residents with the hierarchy are much more likely to be miserable and/or quit surgery before completion. You need to expect that you will be in a hierarchy wherever you go for residency, and if you don't have that exposure as a medical student, it can end poorly.

If you don't want to go into surgery, then yeah go nuts pick the chillest rotation.
Click to expand...

Even though I don't want to do surgery, it wasn't about having the "chillest" rotation for me. Yeah there were no residents, but it was actually one of the least chill rotations I had all year. I got to learn a lot which is what I wanted. The attending expects a lot out of you, much like a resident, so you feel useful. Random 8pm OR case added to the schedule? I'd go in. Attending wants me to check in on a patient for him late at night? I'd go in (my school put me up right next to the hospital). My rural experience gave me waaay more of a hands on/firsthand experience than I would have gotten elsewhere. There aren't many opportunities during 3rd year to do that before you decide on a specialty. Also, surgery is 10 weeks at my school and my rural experience was only 3 weeks of that, so I still got the experience everyone else had and joined in on the frustration.
 
Had an awesome day and got to first assist on several cases, completely unexpected and amazing! I have a lot to think about. Expect another "help me decide" thread in the near future...
 
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