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I just read this entire thread, incredibly interesting and informative! Thank you so much!!
Surgical intern answering questions tonight (part II)
- Thread starter mimelim
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Mimelim, what happens when you get sick? I mean a small head cold/fever..
Are you encouraged to work through it?
I have a feeling you would refuse to miss anything more than a couple of days so as not to sacrifice your training.
Are you encouraged to work through it?
I have a feeling you would refuse to miss anything more than a couple of days so as not to sacrifice your training.
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I can't believe mimelim did a Q&A thread and I never noticed. Thank you for updating, it was all very interesting and useful.
K
KlondikeDelight
Does where I go to medical school matter as long as it is a US MD school? I'm thinking about going to a school that is unranked instead of a private school because of money but I am not sure if that will affect my residency. I would like to get into the best residency in the county and I don't know how much of a factor my medical school is in that process. I do know that I have to crush Step 1 and 2 though!
No, it won't matter, in the sense that you can do any specialty from any school. Top ranked schools (generally, but not always) tend to have more research opportunities and the like, and often attract intelligent, motivated people. So their alums tend to often match in competitive specialties and good programs. If you rock USMLE, do well on clerkships and have lots of research the sky is the limit.
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I have never missed a day of work because of being sick. Small head colds, sniffles, I've worked through. Ibuprofen, Tylenol, fluids, etc have done the trick for me. My senior once sent me home "early" (4pm) instead of waiting for signout because I "looked miserable". I've been lucky that I haven't been really sick. Other residents have and you work around it. If you have a fever, you aren't coming into the hospital. If you have anything that would be seen as remotely contagious, they will send you home. "They" being the hospital. Patients complain about sick looking workers. But, it is a fine line. Just because you don't come in, doesn't mean the workload changes and virtually no service at the hospital has extra residents lying round to pick up the slack which means that every day you are out someone else is pulling your weight. When it has happened, we find coverage, we help each other out, but if it looks like someone is trying to pull a fast one, you bet that people notice and get pissy in a hurry. If I had the flu, yes, I would stay at home and it would suck. But, it happens, part of life 😛.
Does what school you go to as long as it is US MD? Depends who you are and what you are going into. For the vast majority of applicants (95%+) it matters zero. What school you are at is one of the last things that people care about when ranking people for residency. Where you will hear it discussed is in highly competitive specialties (Plastics, Derm, ENT) and then at very very competitive programs within other less competitive specialties (CHOP, Boston Children's, Texas Children's etc for peds). In those situations every edge counts for something. @TheThirdLevel 's point is well taken. Good schools have good opportunities, but so do big state schools and the like. Who you are and how much you maximize your opportunities matters way more than what school you go to.
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Another question, who is in your avatar?
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Another question, I watch a lot of Grey's Anatomy and I love it. On the show, every single surgical attending wears a personalized scrub cap. I have watched a lot of surgeries on YouTube, and it seems like this is simply not the case. Anecdotally, I saw a surgeon at the hospital where I volunteer at wearing an LSU scrub cap.
Finally, Mimelim, what would be on your personalized scrub cap?
Finally, Mimelim, what would be on your personalized scrub cap?
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I see a lot more scrub nurses and techs with personalized gear than docs...same as on the floor where the docs tend to have pretty standard scrubs but the nurses often play around with it more. It also depends on the hospital - some of them don't allow outside scrubs or caps. The most recent one I worked at had converted to this policy only in the past several years, so most of the nurses (and a sporadic few of the surgeons) who found themselves with cool caps and nowhere to wear them compromised - they wear their fancy caps, and then they put the see-through mesh bouffant caps on top to comply with regs. It diminishes the effect of the caps, but you can still see the design!
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Deleted due to hurt feelings.
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Does it take a certain personality to be a surgeon? I conceivably could have the dexterity to do it, but I feel I'd be very, well, nervous.
I feel like one has to be very detached to be able to do it - in the lab I work at, if I haven't injected a squirming rat (of all things) in a while, I usually feel pretty anxious.
I feel like one has to be very detached to be able to do it - in the lab I work at, if I haven't injected a squirming rat (of all things) in a while, I usually feel pretty anxious.
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Wow, this is an incredibly condescending and bizarre post. I hope you end up in a nurse-free specialty, for the nurses' sakes. You should probably learn to mask that attitude, or have fun being run ragged intern year.
The point of the rule is to reduce contamination. Now, whether or not it achieves anything on that front is a topic worth debating. But nobody earns the right to increase contamination. You can contest the rule by saying "there is little evidence that it accomplishes what you say," but not "MDs should wear caps even if it is bad for patients, because ego."
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Was ready to take a nap but then read through this entire thread, your daily schedule, and now I feel guilty for even considering sleeping for 30 minutes 🙁
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Tell me about it. Mimelim's solution to making up for sick days: Just don't get sick.
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He speaks the truth. I did a surgical internship and the only day I ever missed was when there was an outbreak of Norwalk virus in the hospital. When public health found out that I was throwing up in the call room, I got sent home as part of a mass quarantine of the surgical residents. The OR had to halt all elective cases for a day as a result. For any other occasion, you can get a friendly nurse to put in an IV and bolus 1-2 liters of fluid before returning to work.
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This is interesting indeed, because I see so many surgeons in the hospital just walking around all day with the cap on (disposable usually) and mask around the neck. I doubt they switch it out between each surgery. It seems to me that this only serves to prevent hair/dandruff and pathogens in the mouth from contaminating the sterile field. Also to protect the surgeon from inadvertently inhaling particles/pathogens.
I do wonder though if you pick up random things on the outsides of caps and masks just walking around the hospital. But then again I don't believe the caps or masks are sterile in the first place.
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Right. I personally think a lot of the scrub materials are more show than impact...consider this piece, for example, on wearing facemasks:
http://www.medpagetoday.com/InfectiousDisease/InfectionControl/16278
where they state that "Really, the surgeon might as well wear nothing on their face," but that likely "Patients would not accept a surgeon who doesn't wear a mask because they are so ingrained as a symbol of a safe surgical environment"
(I looked this up after reading through the discussion on a Google Glass surgery broadcast where the surgeon did not use a mask, was heavily criticized, and rebutted saying that at his hospital, they often don't bother because it doesn't contribute.)
Perhaps the cap itself is helpful to prevent hair or dandruff falling, but it's definitely not sterile to begin with (your head is not part of the sterile zone) and that isn't considered an issue, so I'm not sure why it needs to be washed in hospital systems or disposable.
Same with the scrubs - people wear them on the floors, and even when policy dictates otherwise, from home. So why require hospital-issue scrubs other than promoting an image of uniformity/team?
All of the above are reasonable arguments against a 'no personal scrubs' policy...'he earned it for being a surgeon, let the nurses follow the rules because who cares about them' is not.
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A vascular surgeon. If I took a selfie in the OR I'd use my own image 😛.
I normally wear the disposable scrub caps. I own two personalized scrub caps, one that all the IVS residents have from a conference that we hosted (hospital name/department on it, nice fabric) and the other one is just flat black. I don't really have much desire to have much else. To be honest, the disposable ones are much more convenient. And most people, right or wrong, don't change out their scrub cap when they walk out of the OR. I definitely do it if I have to run to the ICU/floor from a case. Mask is always exchanged, but it isn't common practice as far as I've seen.
One of our cats was sick last week and I had a harder time (in terms of anxiety) giving her injections than opening someone's chest in the ER. Some of it is squirming, discomfort with feline anatomy, etc. Nerves are normal and to a certain extent, good. They stop you from doing something that you aren't prepared to do. But, that is where good mentors come in. That is where your training program matters. A lot of that anxiety disappears with understanding. The rest disappears with practice.
I think that certain personalities gravitate toward surgery. I don't think that any particular personality is required or would be detrimental, especially with a lot of the true 'malignant' old ways being snuffed out.
As @southernIM says, you need to consider something outside of medicine. The vast majority of residencies require time periods where you will not sleep 8 hours every night.
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He said that in a different thread a while ago. Creepy how you remembered it. I think your both talking out of your you know what, as there are other things I'm sure I've said that rubbed you two confederates the wrong way. Nice try though.
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Uh, she said it in THIS thread 2 posts ago.
It's seeming less creepy conspiracy and more 'why does this keep being said to you?'
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Oops, I've got southern on ignore list due to 1950's attitude. Haha! I guess southerns obsession with my sleep preferences is what's really creepy. I've talked to many docs where I volunteer and read posts here and 8-9 hours is doable as long as you can make sacrifices elsewhere. Not all of us are married with 1.85 kids, or care to have a social life. Mmkay?
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Sure, as an attending.
It's not the 'prioritizing sleep' that seems like such an issue as the utter inflexibility with which it is stated. The last time I went into the hospital, the resident had been there since the morning before...not sure how you plan to guarantee 8hrs of sleep while at the hospital for 24 straight hours (which does happen). I'm sure you'll manage, but you will likely have to bend a little and compromise here and there in order to do so
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This is the only thread I've read today, and I read through the whole thing. Up until just now I thought mimelim had some weird obsession with saying "Tis" and everyone else in the thread started playing along out of respect.
Well played, SDN admins.
Well played, SDN admins.
Thank you for the reply . 🙂
What do you mean by these 'ways' (like, residency hours)? 🙂
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Omg - it all makes sense now! I was so confused aha #sneaky
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Lol, I was going to ask why a poster had 5 Tis in the post and then I remembered SDN plays some tricks from time to time. I had to goggle what Tis means too.
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There are very few residencies that you will be able to sleep more than 8 hours a night every night. Surgery, IM, Peds, surgical subspecialties and anything that requires a pre-lim surgery/IM year will have some sort of call and/or system where you will be pressed for sleep. This isn't about making sacrifices elsewhere. This is about the fact that sometimes you work 16 hours straight and need to be back at the hospital at 6am the next day.
A little bit of 'tough luck', but realistically, there is some sort of vascular work being done in most of the major cities. You may have to go to a nearby institution, which you should be doing anyways for your aways and this is a good excuse for an introduction. Most people are not held back by the school that they went to, but I certainly can imagine that if you went to a school that was relatively isolated that it would be much more difficult to match at some of the powerhouse research heavy residencies. At the end of the day, just realize that while research is important for a lot of faculty, it is certainly not among the top 3 most important and is noticeably absent from many strong applicants from this cycle.
No. There are plenty of residents that have children during residency. It is hard. You will not have as much time as people who are doing other things. It will require sacrifice on many different fronts, but it is doable, if that is what you want. It is definitely harder for women. No question. But, doable. Surgery is far more difficult than other specialties, but for instance, in our OB/Gyn program, half of the residents either have kids or are planning to during residency.
In general, people don't shadow residents/fellows. I have someone from SDN doing research with me right now (along with a couple of other pre-meds/med students).
Malignant means something different now than it used to. Residency hours are what they are. You need to put in the time to gain the knowledge and skills to become a good physician. I'm talking about the brow beating, instrument throwing, temper tantrums, etc.
I have read 1984. And no I haven't thought that to myself before, lol. Usually it is Whitesnake... "Here I go again on my own"
@mimelim thanks for doing this. I am in the process of beginning to apply to med school, and I have a question about residency in other specialties. I have been using FREIDA to look at average hours per week by specialty. General Surgery and Internal Medicine are up there around 80, and some like PM&R are around 43. I am thinking about trying to choose a specialty that is on the lower end of the spectrum in terms of hours/week (just for personal reasons)
So I wanted to ask, do you notice differences like this among other residents in the hospital? Do residents in other fields seem to have substantially more free time? 5am - 7pm every day seems very taxing. I understand that all fields of medicine are taxing, but I'm assuming (based on the numbers I'm seeing) that certain residencies, like yours, are more time consuming than others. Thank you
So I wanted to ask, do you notice differences like this among other residents in the hospital? Do residents in other fields seem to have substantially more free time? 5am - 7pm every day seems very taxing. I understand that all fields of medicine are taxing, but I'm assuming (based on the numbers I'm seeing) that certain residencies, like yours, are more time consuming than others. Thank you
Really helpful answers. Thank you!
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I feel like this says a lot about you as a person. Maybe I'm not cut out for surgery because I'm not singing that until after I get some caffeine in me...
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It is definitely true that other specialties are going to work more balanced hours, even in residency. For instance, I'm told that our anesthesia residents are in the hospital ~55-60 hours per week, as are the EM residents. Also, it is worth noting that different programs will be very different in terms of hours, even within a given specialty. Probably less true for surgery, but definitely true for IM, neurology, etc.
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I haven't heard about this year, but last year there were 6 jobs for every graduating vascular fellow/resident. Our fellows at multiple offers all over the place and essentially picked exactly where they want to go. Things can always change, but I'm confident in the training that I'm getting and have been rather productive in the research realm. I don't think I will be disappointed.
