I'm on rotation and I'm noticing that residents are avoiding vascular and maybe thoracic cases. Is that common among other residency programs. I would think that these more involved/challenging cases would be the type of experience that residents are looking for.
What cases do residents tend to avoid?
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do the cases have the same surgeons involved? usually is more that than avoiding a chance to be in the OR.
Sometimes those cases are complex and involve 2 attendings... or just one attending who doesn't feel there's much they can let the resident do. As a result, residents realize it's a waste of their time.
Also keep in mind that, unless you're going into thoracic or vascular, those cases are mostly irrelevant and won't be done in a real world general surgery practice.
Also keep in mind that, unless you're going into thoracic or vascular, those cases are mostly irrelevant and won't be done in a real world general surgery practice.
D
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As an anesthesia resident, I don't have the ability to avoid any type of case... because I have no direct say in what cases I'm assigned. Is this different elsewhere?
As a surgical resident I avoid the following cases if I can scrub a different one instead.
1) Where the attending is in over their head. This is rare, but I don't want to be named in the inevitable lawsuit.
2) Where there are fellows or senior residents scrubbed in ahead of me. I won't get to operate.
3) Routine boring cases, especially if a more interesting one is going on next door.
4) Cases where I will retract the entire time and not be able to see what is going on (standing on the opposite side of a pelvis case retracting).
5) Where the attending is overly handsy or is a jerk, both of which will lead to an unpleasant operating experience.
Truthfully though I pretty much go where I'm told. Rare to get the option which case to scrub.
1) Where the attending is in over their head. This is rare, but I don't want to be named in the inevitable lawsuit.
2) Where there are fellows or senior residents scrubbed in ahead of me. I won't get to operate.
3) Routine boring cases, especially if a more interesting one is going on next door.
4) Cases where I will retract the entire time and not be able to see what is going on (standing on the opposite side of a pelvis case retracting).
5) Where the attending is overly handsy or is a jerk, both of which will lead to an unpleasant operating experience.
Truthfully though I pretty much go where I'm told. Rare to get the option which case to scrub.
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All of the below quote is completely correct.
I will add that at least for my program, there was a bit more leeway as you became a senior/Chief. That being said, all the cases still need to get covered and upper levels were expected to be in appropriate cases. (I was at a program where juniors operated early and often and depending on the service that could mean being the only resident in the case).
Also, I (and everyone else) would avoid cases with a particular attending who was a total b***h. She preferred to use First Assists instead of residents anyway, so if we left her cases uncovered it wasn’t a big deal most of the time. But that is a very specific situation that is uncommon in most academic settings.
I will add that at least for my program, there was a bit more leeway as you became a senior/Chief. That being said, all the cases still need to get covered and upper levels were expected to be in appropriate cases. (I was at a program where juniors operated early and often and depending on the service that could mean being the only resident in the case).
Also, I (and everyone else) would avoid cases with a particular attending who was a total b***h. She preferred to use First Assists instead of residents anyway, so if we left her cases uncovered it wasn’t a big deal most of the time. But that is a very specific situation that is uncommon in most academic settings.
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After intern year and especially as a third year (peds) resident, I actively avoided the child abuse and child sexual abuse cases in our ED. I usually guided the interns to those with the "well, I'm not going to be available to testify when this inevitably makes it to court and I'm out of state in a PICU fellowship...it'd probably be best if you saw this one" style argument.
Also avoided the 4am presentation of a toddler with "Fever" when I could, because invariably it'd be the mom who had dragged the toddler and the three other siblings to the ED in the middle of the night for a fever that started 90 minutes prior. You wer lucky if they had actually checked a temperature with a thermometer other than just saying "he felt warm". And of course they never gave Tylenol because they "wanted to make sure you doctors would believe me that he had a fever". I got in trouble with one attending by telling one mom that it was probably just a virus, but couldn't definitively rule out that he was going to get septic shock and die.
Also avoided the 4am presentation of a toddler with "Fever" when I could, because invariably it'd be the mom who had dragged the toddler and the three other siblings to the ED in the middle of the night for a fever that started 90 minutes prior. You wer lucky if they had actually checked a temperature with a thermometer other than just saying "he felt warm". And of course they never gave Tylenol because they "wanted to make sure you doctors would believe me that he had a fever". I got in trouble with one attending by telling one mom that it was probably just a virus, but couldn't definitively rule out that he was going to get septic shock and die.
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