Why should I care?

[mdb3006]

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Say, hypothetically, I matched into my desired program which has the unfortunate requirement of a prelim year. And say, again hypothetically, I decided to do a surgery year. Aside from having my name attached to everything I do, if an attending or senior resident decides to bitch me out (often without provocation) why should I care? I should qualify this by saying that I work hard and have done well in surgery, and generally enjoy it. Nor would I disregard advice, instruction, or criticism from anyone without first giving its inherent value close consideration. But I know that many of the personalities in the OR are there because they are far too dysfunctional to be allowed daily contact with the general population. Short fuses, hair triggers, bipolar disorder, great. I can deal with it and not allow it to interfere with the quality of care I give my patients, but on a personal level, why should I hold my tongue and not tell an irrational, undermedicated senior to lick my nuts? Do I really have anything to lose? Can this impact the rest of my career somehow (assume my advanced program is in a different state)?

 

[Danger Man]

Say, hypothetically, I matched into my desired program which has the unfortunate requirement of a prelim year. And say, again hypothetically, I decided to do a surgery year. Aside from having my name attached to everything I do, if an attending or senior resident decides to bitch me out (often without provocation) why should I care? I should qualify this by saying that I work hard and have done well in surgery, and generally enjoy it. Nor would I disregard advice, instruction, or criticism from anyone without first giving its inherent value close consideration. But I know that many of the personalities in the OR are there because they are far too dysfunctional to be allowed daily contact with the general population. Short fuses, hair triggers, bipolar disorder, great. I can deal with it and not allow it to interfere with the quality of care I give my patients, but on a personal level, why should I hold my tongue and not tell an irrational, undermedicated senior to lick my nuts? Do I really have anything to lose? Can this impact the rest of my career somehow (assume my advanced program is in a different state)?

That is an interesting, albeit, hypothetical situation. Let's say, hypothetically that this situation is really occuring. Perhaps, these folks just have an axe to grind with you because they do not like you, are bitter that you are able to jump ship from their pitiful specialty in just one year, or they do not like the car that you drive. However, holding your tongue is good practice and you must realize (?) that you cannot fight every battle with every a-hole that you come across in medicine (that would be a job that is >80 hrs a week). There are a-holes in your specialty as well so I think that you should look at this time as valuable training for the rest of your career. We all know that medicine is a very small world and that surgery resident who you called a bleepin' a-hole may hyptothetically have a friend at institution X who is best friends with an attending who is going to be your mentor. Get the picture? However, I do not condone allowing someone--attending or otherwise--to be abusive and there are appropriate ways of dealing with that situation. Just my 2 cent.

 

[mdb3006]

That is an interesting, albeit, hypothetical situation. Let's say, hypothetically that this situation is really occuring. Perhaps, these folks just have an axe to grind with you because they do not like you, are bitter that you are able to jump ship from their pitiful specialty in just one year, or they do not like the car that you drive. However, holding your tongue is good practice and you must realize (?) that you cannot fight every battle with every a-hole that you come across in medicine (that would be a job that is >80 hrs a week). There are a-holes in your specialty as well so I think that you should look at this time as valuable training for the rest of your career. We all know that medicine is a very small world and that surgery resident who you called an bleepin' a-hole may hyptothetically have a friend at institution X who is best friends with an attending who is going to be your mentor. Get the picture? However, I do not condone allowing someone--attending or otherwise--to be abusive and there are appropriate ways of dealing with that situation. Just my 2 cent.

It's not occurring for me...yet, but it will. There's a certain amount of contempt for the prelims that must originate from the aforementioned ship jump. So, as a-holes are an inevitability as is my departure in 1 year, do I really need to show restraint, or is it just the path of least resistance? And I wouldn't have chosen to do a surgery year if I hadn't wanted to work hard, and hopefully, gain some valuable knowledge and experience. I think I still may be able to do this while not genuflecting and scraping to the whim of the senior. And what's not to like about a 1984 Lebaron GTC convertible? Next you're going to tell me it isn't cool to blast White Snake in my 1984 Lebaron GTC convertible when sitting at stop lights. Whatever.

 

[Von Hohenheim]

What's to be gained? You've endured it quietly and obediently for a whole year. I don't see how losing your composure now that "you're safe" is going to make up for that. Just keep your temper, finish the year and move on.

 

[8744]

You do not have to hold your tounge. On the other hand telling your boss to "lick your nuts" is highly unproffesional and whether you are justified our not will get you reprimanded or fired pretty quicky, even from a prelimnary year.

This stuff does get around, by the way. You will get a reputaion as being a trouble-maker and this will hurt you later. If you get fired I believe you will lose your residency spot. Just be forceful, forward, and honest with everybody. Look them in the eye and talk to them as equals and you will have no problems.

And be professional. I have politely suggested to several upper-level residents that they would look pretty silly trying to explain to their boss some of their toolish behavior. If you are timid you will get abused.

Still, you have to expect some good natured ribbing and well-deserved sarcasm in residency. Don't be hyper-sensitive. The chief of surgery might yell at you but his failed marriage, drug-abusing kids, and bad personality are punishment enough.

 

[3dtp]

It's not occurring for me...yet, but it will. There's a certain amount of contempt for the prelims that must originate from the aforementioned ship jump. So, as a-holes are an inevitability as is my departure in 1 year, do I really need to show restraint, or is it just the path of least resistance? And I wouldn't have chosen to do a surgery year if I hadn't wanted to work hard, and hopefully, gain some valuable knowledge and experience. I think I still may be able to do this while not genuflecting and scraping to the whim of the senior. And what's not to like about a 1984 Lebaron GTC convertible? Next you're going to tell me it isn't cool to blast White Snake in my 1984 Lebaron GTC convertible when sitting at stop lights. Whatever.

There is danger in dealing with these folks. First, they can make your life miserable with call, weekend schedules, shifts, and other evil things. This is easy.

Second, at some point, you will apply to hospitals for credentials or to states for licenses. These stubby sticks will have the opportunity to ding your record in such a way that you will have to forever explain it. That you can explain it will get you by them, but having a "problem residency" flag on a credentials document will give you headaches you don't need.

Third, in a highly malignant program, they can lie, distort or worse. If they succeed, you are out of business, potentially forever. Once you are in in a program, especially if it's a malignant program, you can be severely burned.

Tread very lightly my friend, they hold all the cards and carry a very, very high voltage cattle prod, which some programs won't hesitate to use. Trust me, you do not want to be the one they make an example of. I once thought like you did. PM me for details.

 

[dinosaurcrumpet]

Look them in the eye and talk to them as equals and you will have no problems.

Just talk to your superiors as equals? Wah ha ha. That right there is the secret to achieving a lifetime of crappy evals?

 

[mdb3006]

There is danger in dealing with these folks. First, they can make your life miserable with call, weekend schedules, shifts, and other evil things. This is easy.

Second, at some point, you will apply to hospitals for credentials or to states for licenses. These stubby sticks will have the opportunity to ding your record in such a way that you will have to forever explain it. That you can explain it will get you by them, but having a "problem residency" flag on a credentials document will give you headaches you don't need.

Third, in a highly malignant program, they can lie, distort or worse. If they succeed, you are out of business, potentially forever. Once you are in in a program, especially if it's a malignant program, you can be severely burned.

Tread very lightly my friend, they hold all the cards and carry a very, very high voltage cattle prod, which some programs won't hesitate to use. Trust me, you do not want to be the one they make an example of. I once thought like you did. PM me for details.

That really does answer my question. Whether or not it can follow me. Thanks.

 

[mdb3006]

You do not have to hold your tounge. On the other hand telling your boss to "lick your nuts" is highly unproffesional and whether you are justified our not will get you reprimanded or fired pretty quicky, even from a prelimnary year.

This stuff does get around, by the way. You will get a reputaion as being a trouble-maker and this will hurt you later. If you get fired I believe you will lose your residency spot. Just be forceful, forward, and honest with everybody. Look them in the eye and talk to them as equals and you will have no problems.

And be professional. I have politely suggested to several upper-level residents that they would look pretty silly trying to explain to their boss some of their toolish behavior. If you are timid you will get abused.

Still, you have to expect some good natured ribbing and well-deserved sarcasm in residency. Don't be hyper-sensitive. The chief of surgery might yell at you but his failed marriage, drug-abusing kids, and bad personality are punishment enough.

Yeah, I figured "lick my nuts" is unproffessional. Thanks. That would have been the point. An unprofessional response to an unprofessional professional.

 

[irrka]

Just talk to your superiors as equals? Wah ha ha. That right there is the secret to achieving a lifetime of crappy evals?

yeah but you can still be totally frank and make their being an ass into a joke, but so they know they're being an ass. wow that was a convoluted sentence.

 

[njbmd]

Say, hypothetically, I matched into my desired program which has the unfortunate requirement of a prelim year. And say, again hypothetically, I decided to do a surgery year. Aside from having my name attached to everything I do, if an attending or senior resident decides to bitch me out (often without provocation) why should I care? I should qualify this by saying that I work hard and have done well in surgery, and generally enjoy it. Nor would I disregard advice, instruction, or criticism from anyone without first giving its inherent value close consideration. But I know that many of the personalities in the OR are there because they are far too dysfunctional to be allowed daily contact with the general population. Short fuses, hair triggers, bipolar disorder, great. I can deal with it and not allow it to interfere with the quality of care I give my patients, but on a personal level, why should I hold my tongue and not tell an irrational, undermedicated senior to lick my nuts? Do I really have anything to lose? Can this impact the rest of my career somehow (assume my advanced program is in a different state)?

Hi there,
You need to learn the fine art of diplomacy which entails telling these unruly folks to "go to h--l and make them enjoy the trip. It's so much better for you in the long run than your "scorched earth approach". You never know where you will wind up in the long run and who you will wind up with. People in the medical field move around quite a bit and are frequently related to each other. Additionally, they have phones and mouths and use them so hold your tougue, do what you have to do and move on with grace and civility.

njbmd 🙂

 

[mdb3006]

Hi there,
You need to learn the fine art of diplomacy which entails telling these unruly folks to "go to h--l and make them enjoy the trip. It's so much better for you in the long run than your "scorched earth approach". You never know where you will wind up in the long run and who you will wind up with. People in the medical field move around quite a bit and are frequently related to each other. Additionally, they have phones and mouths and use them so hold your tougue, do what you have to do and move on with grace and civility.

njbmd 🙂

Diplomacy has been the theme for the last four years. And I suppose as long as my self-preserving instincts continue to function, it will likely continue. I had thought that the potential existed for repercussions, I just wasn't sure how detrimental they might be. Sounds like the consensus is, regardless of how unofficial they might be, they can be severe. Sarcasm and dry wit will have to suffice. Thanks for the advice.

 

[DarksideAllstar]

Diplomacy has been the theme for the last four years. And I suppose as long as my self-preserving instincts continue to function, it will likely continue. I had thought that the potential existed for repercussions, I just wasn't sure how detrimental they might be. Sounds like the consensus is, regardless of how unofficial they might be, they can be severe. Sarcasm and dry wit will have to suffice. Thanks for the advice.

Yeah, you sarcastic bastard. Just watch out for the one with the BMW X5.

 

[8744]

There is danger in dealing with these folks. First, they can make your life miserable with call, weekend schedules, shifts, and other evil things. This is easy.

Second, at some point, you will apply to hospitals for credentials or to states for licenses. These stubby sticks will have the opportunity to ding your record in such a way that you will have to forever explain it. That you can explain it will get you by them, but having a "problem residency" flag on a credentials document will give you headaches you don't need.

Third, in a highly malignant program, they can lie, distort or worse. If they succeed, you are out of business, potentially forever. Once you are in in a program, especially if it's a malignant program, you can be severely burned.

Tread very lightly my friend, they hold all the cards and carry a very, very high voltage cattle prod, which some programs won't hesitate to use. Trust me, you do not want to be the one they make an example of. I once thought like you did. PM me for details.

So true. So true. Academic medical centers are beauracratic viper's nests. Sure, they make all that happy happy kumbayah talk during your intern orientation about how much they love you and how valuable yer' little opinion is to them but step out of line and the full weight of the thought police will come kicking in your door.

Can you fight them? Sure you can. And you can even win. When I was a conservative student activist at the University of Vermont back in the early nineties I used to regularly hold the extremely liberal administraton (or the part of it I was involved with) in check. But then I had the time and the legal backing (yes, there are some conservative lawyers in Vermont) to put up a fight.

You will get hauled up before some institutional diversity commitee or some harrasment task force and they will railroad you. It won't help that you will have actually told somebody to "lick your nuts." I'm sure whatever you do will be construed as homophobic, bigoted, misogynistic, or intolerant. It also won't help that you have a full-time job and are surrouded by other residents who are too intimidated to testify on your behalf against your abusive attending.

Better to let it go. Suck it up and count the days when you can work for yourself or for a small group far away from academia.

 

[mdb3006]

Yeah, you sarcastic bastard. Just watch out for the one with the BMW X5.

I think it's an X3. And you should talk.

 

[Qafas]

I agree with those who think that diplomacy and tact are the way to go in such situations. It is one thing if someone is being downright abusive; nobody should have to put up with that. But, even in that case, there are proper ways of handling things. Doing something stupid will only hurt your position. For all the rest of the little crap that goes on in every hospital and every program, just suck it up. As mentioned by others, medicine is a smaller community than you and I might believe. And a tarnished record, whether you deserve it or not, is very difficult to shake.
It is no surprise that large academic programs are much more prone to such problems than smaller community ones. That there is the reason why I steered clear of Univ programs and am heading to a community hospital to do my training.

 

[Laryngospasm]

Say, hypothetically, I matched into my desired program which has the unfortunate requirement of a prelim year. And say, again hypothetically, I decided to do a surgery year. Aside from having my name attached to everything I do, if an attending or senior resident decides to bitch me out (often without provocation) why should I care? I should qualify this by saying that I work hard and have done well in surgery, and generally enjoy it. Nor would I disregard advice, instruction, or criticism from anyone without first giving its inherent value close consideration. But I know that many of the personalities in the OR are there because they are far too dysfunctional to be allowed daily contact with the general population. Short fuses, hair triggers, bipolar disorder, great. I can deal with it and not allow it to interfere with the quality of care I give my patients, but on a personal level, why should I hold my tongue and not tell an irrational, undermedicated senior to lick my nuts? Do I really have anything to lose? Can this impact the rest of my career somehow (assume my advanced program is in a different state)?

They can refuse to give you credit for the year or part of the year , and you will wish you had just kept quiet at that point, choose your battles wisely.

 

[Dr_Frank_II]

I am only a pre-med, but my father is a physician and told me a story about a colleague...He is currently in the process of leaving a hospital after 20/25 years. He made some disparaging remarks about an administrator at the hospital, and the administrator found out. As he is iin the process of leaving and looking to site refrences, the worst thing that can happen now is that when someone calls this hospital (where he was for most of his professional career) that the best recommendation they will give is "Yeah, he worked here!" Beyond the whole recommendation scenario, you never want to burn your bridges. Like others have said, you may one day look to go into a private practice or academic setting and they see that you trained at XYZ. Someone calls up his old friends, or someone that he knows from someone else to see if he knows you. The last thing you want is this "unprofessional professional" to do is say, "I knew that little arrogant @$$ when he was a PGY1, worst I've ever had!" Its only a little while longer. Good luck

 

[DrNick2006]

Professional professionals will see your behavior too, or at leaset hear about it and judge you for it. Your best bet is to let the little stuff go and with a real problem go to whomever is above this person or in charge of maintaining a positive work enviroment and file a complaint, then call a lawyer if it gets out of hand. YOur Professional behavior will then be an asset.

Or you can develope an elaborate plan to entrap them in the illusion of having an affair and drug addiction, then extort them.