Surviving surgery with aspiring plastics people

[ostomy plug]

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I thought I'd be in like company taking surgery first, and not have to deal with gooners and classmates who are hardcore surg types. Well, now that board scores are out, some people's true colors are coming out as well. How do I do well, when other team members are stopping just short of blowing residents in hospital bathrooms on rounds. It seems like the curve will be higher now, and being moderately interested in surgery, I feel like my evals are going to be poor vs. peers, rather than stand on their own. It hasn't taken me long to realize third year is like Big Brother. Any advice?

Post count is related to my desire to remain anonymous, by necessity.

 

[Tired]

Presumably you're not a gunner type, because otherwise you wouldn't be worried about how to compete with them. I assume then, that you're not lying to your residents and telling them how much you want to do surgery for a career.

If that's true, you have three choices:

1) Show up, read, be competent, and try not to upstage your classmates. This will either result in an average grade while your colleagues get high marks. Or, as sometimes happens, your mellow attitude and non-competitive behavior will be viewed more favorably than your classmates' gunner behavior, and you will get an unexpectedly high score.

2) Tell them you don't really like surgery and aren't that interested in it, but read a ton at home and work extra hard, blowing your classmates out of the water. When your residents know you don't want to do their specialty, but you are a better student than those who do, you look extra impressive, and can count on a very high grade.

3) Show up, don't read too much, don't work that hard, let your classmates win the game. You'll still pass, you won't feel all that stressed out, and you won't have to work too hard.

 

[NPR]

I thought I'd be in like company taking surgery first, and not have to deal with gooners and classmates who are hardcore surg types. Well, now that board scores are out, some people's true colors are coming out as well. How do I do well, when other team members are stopping just short of blowing residents in hospital bathrooms on rounds. It seems like the curve will be higher now, and being moderately interested in surgery, I feel like my evals are going to be poor vs. peers, rather than stand on their own. It hasn't taken me long to realize third year is like Big Brother. Any advice?

Post count is related to my desire to remain anonymous, by necessity.

I'd say you have to one-up them.

Don't stop short. Go all the way.

👍

 

[blabbyblab]

Just do your best and don't worry about the other people in your class.

lol

 

[persia]

Dude! welcome to third year. I have seen this on all of my rotations - including psych! There will always be someone who is trying to score the highest and if they can do it at your expense - like, by trying to make you look bad - then they will that as well.

Third year sux big time, what can I say. What faith I had in my fellow colleagues got washed down the toilet.

What Tired said seems like the most reasonable answer. I have tried to act the same despite different gunners, etc and mostly I think it depends on the residents and attendings. Some people have been awesome and would see through this BS, and then the student/s looked ridiculous. Often tho, residents DO like this behavior and will collude in the insanity. Then, it can feel terrible to be on a team were the residents seem to adore these students and you are left like Cinderella, washing the floor while everyone else is at the Ball. Or, whatever. You know what I mean.

In the end, it's kind of all BS. How can you predict the future, in terms of your eval. Decide what kind of person you want to be and then just try and be true that. Even if you come out an 'average' student on this rotation you can still do other surgical rotations later and do well then. Third year is not the make or break of your whole life. Currying favor and buying residents lunch, or licking their feet is not the true test of what kind of physician you will be. It just means that you are good at BS'ing people. People either liked to be BS'd or not, and we can't control that. In the end we are all judged on our character. If we are a$$holes that will come back to us one way or another.

 

[MSHell]

2) Tell them you don't really like surgery and aren't that interested in it, but read a ton at home and work extra hard, blowing your classmates out of the water. When your residents know you don't want to do their specialty, but you are a better student than those who do, you look extra impressive, and can count on a very high grade.

This is surprisingly effective. I'm not going to be a surgeon. Not ever. When asked what specialty I was interested in, I mentioned path (I'm not sure yet, though). I thought that would backfire. Instead there was shock and awe that I could recognize both tibia and fibula on an x-ray (this was ortho).

 

[Law2Doc]

This is surprisingly effective. I'm not going to be a surgeon. Not ever. When asked what specialty I was interested in, I mentioned path (I'm not sure yet, though). I thought that would backfire. Instead there was shock and awe that I could recognize both tibia and fibula on an x-ray (this was ortho).

This is extremely resident/attending dependent, I'm afraid. While I believe in being honest and not telling each specialty that you are interested in what they do, there are absolutely surgeons who, once they hear you aren't interested in surgery, lose all interest in teaching you or showing you anything cool. Folks like to pigeon-hole. If they hear you want to be a pathologist, you won't get to scrub in, but they might call you over to take a look at what they and your classmates cut out of a patient. So it's often best early in the year to give a laundry list of things you are considering, leaning towards, rather than have a specific field. Folks will be okay if you are still struggling with the decision, and it may actually give them an incentive to teach you more. Toward the end of third year it's harder to straddle the fence though and you'll need to pick something.

In terms of competing with classmates, the bottom line is that if you want to keep pace, you are going to have to read up on things without being assigned them, be gung ho excited to do every lousy piece of scut tossed your way, and show up early to get numbers to help out residents without necessarilly being asked. You don't upstage your classmates, but you need to keep pace. If they are reading up on stuff and know the answer to every pimp question, you need to get your knowledge base to that level too. Basically, if you can't beat them, join them.

If you actually want to go into a field you are rotating in, bear in mind that attending face time is everything. If they know who you are and that you are excited about their field, that can pay dividends.

 

[Ypo.]

If you don't want to go into surgery, I'd say just do your job efficiently and don't stress.

If those other students do want to go into surgery, chances are they are just trying to do the best they can and not necessarily trying to show you up.

Anyways, don't stress. Your time to shine will come if you read every day and concentrate on getting a good education.

 

[Droopy Snoopy]

I'd say you have to one-up them.

Don't stop short. Go all the way.

👍

No no no, that's not the progression. It's bj, then bj plus reach-around prostate stimulation. If you go straight to home they'll think you're a slut and have no respect for you.

 

[ostomy plug]

I guess i just had underestimated how sickening this type of behavior is to watch. Especially since you could put a laundry list of threads about teammates here on SDN bringing articles to rounds, asking q's in a way that is sure to increase the workload, going well past the cursory ask once if there is anything we can do then leave method, gooning you on rounds or in teaching sessions, etc.

I guess it will be like this on most rotations, but I'd like to think most teammates have more integrity. Sadly, I think that may not be the case.

 

[MSHell]

This is extremely resident/attending dependent, I'm afraid. While I believe in being honest and not telling each specialty that you are interested in what they do, there are absolutely surgeons who, once they hear you aren't interested in surgery, lose all interest in teaching you or showing you anything cool. Folks like to pigeon-hole. If they hear you want to be a pathologist, you won't get to scrub in, but they might call you over to take a look at what they and your classmates cut out of a patient. So it's often best early in the year to give a laundry list of things you are considering, leaning towards, rather than have a specific field. Folks will be okay if you are still struggling with the decision, and it may actually give them an incentive to teach you more. Toward the end of third year it's harder to straddle the fence though and you'll need to pick something....

I agree, it is variable. I did say that I was considering pathology, nothing definite. In this case, this hospital, I said this across several surgery services and I wasn't taught differently or treated differently at all. Some of the nurses laughed, but the residents shut them up.

 

[UCLAstudent]

This is extremely resident/attending dependent, I'm afraid. While I believe in being honest and not telling each specialty that you are interested in what they do, there are absolutely surgeons who, once they hear you aren't interested in surgery, lose all interest in teaching you or showing you anything cool.

Agreed. My roommate, who ended the year with surgery, was scrubbed into a surgery when the attending asked what field she was going into. Since it was the end of the year, she figured it was "safe" to tell him that she's going into pediatric. After an uncomfortable 10-second pause, the attending blurts out, "Wrong answer!!" 😱

 

[Tippmann]

There are dangers of "taking the higher road."

I did that all year. Finished with one honors and the rest high passes.

Doing the "honorable" thing is probably going to cost me dearly in applying for a highly competitive field.

 

[DrDre311]

It's all in what you want and what you're willing to do to get it. Let me quote a great and visionary man: "The **** I don't got be the **** I gotta take."

Want honors? Take it. Or cruise along...nothing wrong with that. You'll pass and be fine if you're not completely ******ed or lazy. But if you want to be a stud, sometimes you have to outgun the gunners or just find a different way to stand out.

Another great line: "I got bustas, hos, and police watchin' me" (in which case the bustas, hos, and police are the nurses, your classmates, and your residents--in any order you choose).

 

[jdh71]

 

[persia]

I don't get the little French dog. 😕

Listen, I would an a$$hole too, if I only knew how to do it without having to come home and live with myself. Plus, my short lived attempts at it were a disaster and I quickly learned that life is better lived by trying to be a decent person and not by trying to screw as many people as you can.

The simplest reason is also that by behaving like that, it often seems to cause more problems than it solves. I have never found being an aggressive b'stard to be a successful way of moving through life.

[This is a touchy subject and clearly I have very strong feelings about it! 😡]

 

[jdh71]

I don't get the little French dog. 😕

If I have to explain, you won't understand 😀

EDIT:

[YOUTUBE]http://www.youtube.com/watch?v=QR7-2MxNL7Y[/YOUTUBE]

 

[persia]

Sweet! 👍

 

[LadyWolverine]

You should be comfortable enough around your classmates to tell the gunner of the group that he/she is being a DB. I'd bet that half the time, they don't even realize they are being a DB.

No point in trying to out-DB the DB, if you can knock the DB down a few rungs. Save yourself some work and a few shreds of dignity.

 

[sestamibi]

You should be comfortable enough around your classmates to tell the gunner of the group that he/she is being a DB. I'd bet that half the time, they don't even realize they are being a DB.

No point in trying to out-DB the DB, if you can knock the DB down a few rungs. Save yourself some work and a few shreds of dignity.

Of course, the very definition of a DB is someone who is told he/she is a DB to their face and yet, will continue their DB ways in an attempt to out-DB their original DB ways.

 

[LadyWolverine]

Of course, the very definition of a DB is someone who is told he/she is a DB to their face and yet, will continue their DB ways in an attempt to out-DB their original DB ways.

This is true. I meant to say the "clueless DB," meaning a rather overeager individual who isn't a DB at heart, but who, when made highly excitable, exhibits certain DBish tendencies.

Hopefully, the majority of your classmates are these types. If not, I'm sorry man.

 

[lankysudanese]

to the OP:
dont let the fact that you are rotating with plastic-bound classmates threaten you. I took surgery in a quarter where I was the only one who wasn't going into a speciality involving a scaplel (everybody else either wanted to do either direct plastics, neurosurg, urology, ENT or general surg). I told every attending/fellow/resident that asked me about career aspirations the exact same answer ("Internal Medicine and then Infectious Diseases"). Some made smart comments and some tried talking me into surgery. But as long as I knew my s**t inside out (when it came to surgical conditions, indications and procedures) and did not suck up to anybody, I knew that I would be happy with whatever grade that I got.
Weirdly enough, I got Honors in the rotation, which was most likely due to getting the highest score on the midterm test, shelf exam and the standardized patient exam. And the icing on the cake is that every attending (and 2 of the fellows) made a comment that I would make a great surgeon and that I "would undoubtedly make just as great contribution in internal medicine". (Should make for great deans letter, hopefully)

So study your ass off and don't worry about the gunners and what they're up to. Take advantage of the opportunity of not being expected to perform, and blow everybody out of the water.

 

[AmoryBlaine]

Only thing you can do is just keep trucking and be yourself. If the plastics folk start being ****ty (scooping cases etc) then it will be time for a little sit-down on the order of, "hey I know this is what you guys want to do but we need to work out a system where we do things reasonably equally."

 

[DrDre311]

Why all the hatin on plastics? I never felt the need to outgun people. Just made sure I did my work, was pleasant to be around, and knew everything I could. I had classmates who didn't realize I was going into plastics until after interviews started. Plus, integrated plastics residents tend to be a rare breed. We're more like ortho residents than anything else--except we care about technique--in terms of personality (pretty laid back).

Plastics is filled with so many smart/knowledgeable people that nobody feels the need to be a hardass; it's just that all your co-residents know everything and the environment pushes you just to keep up. No GS-style hardasses for the most part. We'll let you be lazy, and won't punish you on the eval for it, but you're not getting a good letter unless you impress somebody--and we don't like a-hole gunners, either. It's a fine line to walk.

 

[jdh71]

Why all the hatin on plastics? I never felt the need to outgun people. Just made sure I did my work, was pleasant to be around, and knew everything I could. I had classmates who didn't realize I was going into plastics until after interviews started. Plus, integrated plastics residents tend to be a rare breed. We're more like ortho residents than anything else--except we care about technique--in terms of personality (pretty laid back).

Plastics is filled with so many smart/knowledgeable people that nobody feels the need to be a hardass; it's just that all your co-residents know everything and the environment pushes you just to keep up. No GS-style hardasses for the most part. We'll let you be lazy, and won't punish you on the eval for it, but you're not getting a good letter unless you impress somebody--and we don't like a-hole gunners, either. It's a fine line to walk.

I agree with the above.

People who MATCH into plastics tend to be pretty chill, but the OP is talking about people who want to do plastics . . . you know, the asshats that are not going to match, but are going to make your life ridiculous with their douchebaggery

 

[McMD]

I agree with the above.

People who MATCH into plastics tend to be pretty chill, but the OP is talking about people who want to do plastics . . . you know, the asshats that are not going to match, but are going to make your life ridiculous with their douchebaggery

I would definitely agree with this...the people who match into plastics are actually pretty cool people and usually no-one knows they even want it until interviews or match day. However, the gunners who are DBs and just tell everyone they want to go into plastics because it's one of the most competitive specialties, and you know they just want to do it FOR that reason!!!...they are usually the ***holes who don't care about the next person.

 

[ostomy plug]

I agree with the above.

People who MATCH into plastics tend to be pretty chill, but the OP is talking about people who want to do plastics . . . you know, the asshats that are not going to match, but are going to make your life ridiculous with their douchebaggery

This is exactly the sentiment I was after. And plastics is just the de facto uber-competitive surg specialty, so no hatin at all. Ironically, I've been prodded about my budding technical skills potentially fitting in there. Sadly, I don't think my grades or scores will. But yeah, meant more the classmates that REALLY want the LOR or whatever rather than the personalities of most residents I've met.