Dr. Cox, while I appreciate the sentiment, and agree in general about "6, 8, 12" week clerkships with respect to future career goals, I have to respectfully say I find your comment a bit disingenuous. It's not that way everywhere? OK, I'm willing to concede that in the most abstract and general use of that phrase, "not that way everywhere" you may be correct. I would love to find that place, if for nothing else to satiate my curiosity, much the same way I would if I had a chance to see a white buffalo, because what I experienced is not some sort of isolated incident. You've seen the posts on here on SDN - the same stuff every cycle, every year, different schools and different services, yet always the same crap. This was the same experience of my father over 30 years ago, and all of his contemporaries tell the same stories irrespective of school or place of training. So what gives?
I dunno...I've seen just as many people complain when I post about how horrible my residency was...they say, "its that way in the Northeast/academic programs/only general surgery" etc and that I'm painting a picture of surgery that doesn't exist everywhere. I guess I can't win for losing...either I'm being disingenuous or I'm painting too black of a picture.
The fact is that neither you and I have trained at anymore than a couple of places so cannot be experts on what surgery is like everywhere. And as much as I complained about my own residency program, it was not because of the surgeon's personalities there (save for one or two) but rather the system and design of the residency. I know for a fact, that my ex-SO and friends have trained at programs that were much "kinder and gentler" and having rotated at some of these for electives, I believe what they told me.
So, its not meant to be disingenuous, but rather a realization that surgery doesn't have to be how you and I experienced it.
I can also attest to the strong team ethic I also experienced. As a matter of fact, it was for this reason that we violated work hours - you don't want to sign out work that belonged to your team. So if that meant the Chief was making new patient lists or calling in consults, so be it...whatever it took to get everyone home as early as possible. That doesn't mean I haven't seen Chief residents refuse to do "intern work" but that attitude was highly discouraged at my program, so it wasn't often that I saw it. From my vantage point the medicine program was much more likely to sign out at 5:00 on the dot, even if there was work left to do. That to me, doesn't say team effort but rather "me first".
This isn't meant to be seen as an attack (which would be really, really "bad form" to attack any administrator), so I hope I've caused no offense.
Of course you haven't. This shouldn't be about insulting each other and it should be more about trying to understand each other's view point. I've met some horrible personalties in surgery, to be sure, but I've also met some real PITAs in other fields as well. I think the "surgical personality" tends to be more impatient and to the point and if someone is more of a "Type B" person, they may perceive this as malignant, arrogant or rude. And it probably is sometimes, but I would like to think its not meant to be.
NB: "attacking an administrator" gets you the same warning as if I was a regular citizen. So don't spare me on that account!
I am merely trying to point out what I see as the REAL problem - which may not even be seen as a "problem" by those who are comfortable with said culture. I have a good friend who got on great in general surgery because he like the culture. So, I think it is only fair to say it exists, it always has, and it probably always will. Some of us don't play well within that system. The way I see it, things will continue as they always have until people like you decide it needs to change. Maybe my son will find the surgical environment much less hostile?
I agree that a surgical culture exists and there does need to be some changes. For example, surgeons have no one to blame but themselves when they complain about work hour restrictions. But it was the surgical mentality of "this is not important to me" or "they'll never do it to us" that got them into such a predicament.
Surgeons tend to focus on their work and not other things...fortunately, some of the ostriches are pulling their heads out of the sand and trying to understand and fix reimbursement issues, turf war issues, work hour restrictions and training issues, etc. So perhaps your son will find surgery a kinder and gentler experience than you and I. I doubt it will ever be as touchy-feely as other fields, but that's because of the people who are drawn to it. But I cannot help but feel that the influence of more women, more people interested in lifestyle and the acceptance of different types of people into the field will have a positive impact.
Which is too bad because I came to medical school to be surgeon. Sour grapes? I'll cop to some of that. I just think its just sad - I would have been a kickbutt surgeon - and my main reason for not wanting surgery, the culture. What a kick in nads, huh?
What's really sad is that you might have found a program without as much of the culture you depise. These tend to exist mostly in community programs where you find people less interested in their own egos and more about just having fun, getting work done and playing well with others. Even the anesthesiologists will tell you that the surgeons in PP and at community places are much easier to get along with.
Maybe its sour grapes on my part as well...I was fairly disgusted with what I could call "IM culture" during medical school. I could not understand the "one-upmanship" for minutiae and most gallingly, leaving stuff until the next day (one patient who stands out needed a pleurocentesis. For several days, it was left to the end of the day and then put off until the next day. Sure the patient was ok, but he would have been better if someone had been willing to stay late and do it). And the incessant and lengthy rounding really just took the "fun" out of medicine for me.
So, no worries...I"m not insulted and would hope you aren't either. I do honestly believe that while my residency program would win no awards in lacking the typical surgical culture, that those programs do exist and that not every surgeon is an arrogant prick. We might seem like it, but really we're teddy bears in scrubs.
