Can anyone do surgery?

[EChipouras]

Is surgery a specialty that anyone can go into if they have sufficient dedication and good motor skills; or is it only for people who are exceptionally apt at manipulating tools,etc. with their hands?

On a related note, do surgeons ever get worried that they have all their 'eggs in one basket' in the sense that if something happens to their hands and/or motor skills (through trauma and/or aging/disease) then their career as a surgeon is over? How often does this happen?

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[SLUser11]

Is surgery a specialty that anyone can go into if they have sufficient dedication and good motor skills; or is it only for people who are exceptionally apt at manipulating tools,etc. with their hands?

On a related note, do surgeons ever get worried that they have all their 'eggs in one basket' in the sense that if something happens to their hands and/or motor skills (through trauma and/or aging/disease) then their career as a surgeon is over? How often does this happen?

Everybody knows a surgeon or knows a story about a surgeon that loses fingers or even a whole hand, and usually it doesn't completely end their practice, although it can severely limit it, based on the extent of injury.

As for me, after a year of residency, and seeing normal people come in with severed fingers from wood-work, I personally wouldn't get anywhere near a table saw. Not everyone shares my fear of amputation, and as one of my colorectal attendings states it, "That's what good disability insurance is for...."

 

[Blade28]

The common, romantic misconception is that only those blessed with gifted hands can eventually become a surgeon.

In reality, as long as you don't have a terrible intention tremor, most surgical skills can be taught. With enough practice, most people can become proficient technicians. (Of course there's much more to becoming an accomplished surgeon than just what takes place in the OR - pre-op and post-op care, deciding when and when not to operate, etc.)

I've seen people with decent resting tremors who still have sufficient dexterity. I will argue that delicate tasks - such as vascular anastomoses in Vascular, Plastics or Cardiac - may weed out some surgical residents, but in general, anyone can do it.

I agree with SLUser11 that I wouldn't use a table/jig saw anymore. (I used to, when I took shop back in junior high school.) I'm still young and relatively fearless, and take unnecessary risks (driving fast, lifting weights without gloves, etc.) and have to remind myself to take care of my hands.

 

[Playmakur42]

.

 

[Blade28]

What's wrong with lifting weights w/o gloves? I figured the calluses might even add a (very) small degree of protection from needle sticks.

I've heard it's dangerous for a number of reasons - bruises, slippage, calluses, etc.

Similarly, I play a lot of guitar and have built up calluses on my left hand's fingertips, which I guess may theoretically decrease some sensitivity. But I don't care.

 

[Castro Viejo]

Is surgery a specialty that anyone can go into if they have sufficient dedication and good motor skills; or is it only for people who are exceptionally apt at manipulating tools,etc. with their hands?

On a related note, do surgeons ever get worried that they have all their 'eggs in one basket' in the sense that if something happens to their hands and/or motor skills (through trauma and/or aging/disease) then their career as a surgeon is over? How often does this happen?

I think the technical aspects of performing an operation can be learned and taught to just about anyone, as others have noted. My Chiefs used to say all the time, "You can train a monkey to operate." Certainly this monkey has learned a thing or two over the last 4 1/3 years.

Seriously, though, just because you're great with your hands and can do anything with them (like put the little screw back into the little hole on the hinge of your eyeglases with your fingers!) doesn't mean you'll make a great surgeon.

There's a way of thinking that goes along with being a surgeon that is unique and separate from the rest of medicine and physicians in general. There's also an attitude and a lifestyle that goes along with being a surgeon that the non-operative types don't seem to understand.

If you can truly accept the idea of being a surgeon as part of your life on a daily basis at every moment of the day or night, and not just when you're "on duty," then you can probably do this. If you can't and feel that your other obligations in life will always get in the way of taking care of your patients, pre or postoperatively, then find another area of medicine. Too many interns I meet today come to surgery with the expectation of 80 hours per week and that's it. They're not working one minute more.

While I think the extension of the 80 hour work week to envelope surgery has made it much easier to get through a program, it's created lazy surgeons. When I was an R1 and R2 we were expected to stay post call and scrub until 5 or 6PM. We were also expected to come in on Saturdays when our Chairman rounded. Now, the interns aren't allowed to stay post to work. They have to go home and do God-knows-what. Some even refuse to come in on Saturdays for Chairman rounds. It's unreal sometimes how even during my lifetime in a residency program things have changed.

Case in point: I got home about an hour ago because I was having a God-awful time doing an LAR (by the way, did I mention I'm not crazy about bowel surgery and especially LARs?) when the R3 paged me to ask if I could "find someone else" to assist the attending on an ex-lap going on in another room for free air because he was on-call tomorrow and "didn't want to get home too late." WTF? I would've KILLED in my R3 year to do something like that, and this guy was asking if I could assign it to "someone else?"

I won't share with you the feelings I communicated to him as those are personal (and rated well above the accepted PG-13 standard here) but suffice it to say I was disappointed. But his request is not unusual at this or at other places, so I'm told. It's just a different time and people were suckered into a career they thought would be 9 to 5 with weekends off because of the ACGME's la-la-land insistence that work hours for surgeons be limited to 80 hours.

And now someone told me the ACGME is targeting SIXTY hours per week! Are you kidding me?

So can anyone do surgery? Absolutely not. Only those with the necessary manual skills (no terrible tremors) and the dedication to their patients and profession can become surgeons. The rest of them can become dermatologists (Or "MOHS surgeons").

 

[RinaBe]

There's a way of thinking that goes along with being a surgeon that is unique and separate from the rest of medicine and physicians in general. There's also an attitude and a lifestyle that goes along with being a surgeon that the non-operative types don't seem to understand.

Can you elaborate on this? What kinds of traits make for a good surgeon? What is the surgeon attitude? How is the surgical approach to problems different from that in other fields of medicine?

 

[RinaBe]

Also, what are MOHS surgeons?

 

[smq123]

While I think the extension of the 80 hour work week to envelope surgery has made it much easier to get through a program, it's created lazy surgeons.

It's not just surgeons - my sister (who did internal med) would agree. She was astounded at how readily interns used the 80 hour week rule to get out of basic floor work. When my sister was a senior resident, an intern shoved a partially-completed consult form into my sister's hand, and said (over her shoulder), "He's down in the ER. I didn't finish working him up because I have to leave at 1 PM or else I'm going over 80 hours." My sister was so amazed she couldn't even move for a few seconds.

Can you elaborate on this? What kinds of traits make for a good surgeon? What is the surgeon attitude? How is the surgical approach to problems different from that in other fields of medicine?

If you get a chance, read the intro to "Surgical recall." They talk about features of the "dream" surgery student. (Or at least they used to - I don't know if they still do.) Basically - don't complain, don't whine, don't cop an attitude to your superiors, and don't take things too personally.

Also, what are MOHS surgeons?

One last feature of a good surgery student - look things up for yourself. (http://en.wikipedia.org/wiki/Mohs_surgery)

 

[Blade28]

One last feature of a good surgery student - look things up for yourself.

Ah, if only 99% of SDN (especially the pre-meds) could follow this rule...our work would be a lot easier!

 

[Castro Viejo]

It's not just surgeons - my sister (who did internal med) would agree. She was astounded at how readily interns used the 80 hour week rule to get out of basic floor work. When my sister was a senior resident, an intern shoved a partially-completed consult form into my sister's hand, and said (over her shoulder), "He's down in the ER. I didn't finish working him up because I have to leave at 1 PM or else I'm going over 80 hours." My sister was so amazed she couldn't even move for a few seconds.

That's just pathetic and disgusting for a physician.

Honestly I'm not all that surprised when an internal medicine resident does it (it's not a knock on the medical guys, but culture is culture and medicine has that sort of laid-backness about it that allows this kind of thing), but it's still disappointing to hear about.

At my institution, the medicine department has "MARs," the Medical Admitting Resident who is stationed down in the ED for a 12-hour shift. During those 12 hours they are allowed to admit no more than 16 patients or something. Anything over 16 the Chief Medical Resident or the Hospitalist or the next shift's on-call resident would have to be called in early.

Now, if I were the guy doing the 16th admission and there's a 17th one, I don't know how I could look my attending or Chief Resident in the eye and say, "Sorry, man, it's over my limit for the day" and hand him a list of new admissions. I also don't know how I can call in someone -- in the middle of the night sometimes -- to come in to start their day early.

Tired doctors may make stupid mistakes and sometimes it'll cost the life of an unsuspecting patient, but what about lazy doctors? Aren't they just as much of a threat?

What about the surgeons we're training today who watch the clock when they schedule cases? What if this emergency case comes in at 5PM? Dead gut with septic shock requiring massive volume and pressors and stuff? I've had attendings tell me, when I covered the ED as a consult resident, "Uh, yeah, I think the patient needs more volume resuscitation so give him 1L an hour and I'll be in around 5AM to do the case. Make sure the SICU knows about him. Oh, and don't forget the IV Heparin." It was 8PM when the patient came in.

I had to call my Chief Resident who then called the attending and they took him to the OR within an hour or two thankfully.

But isn't this the kind of thinking and attitude toward patient care that the ACGME is sort of allowing? Aren't residents being lead down the wrong path in thinking that the surgical workweek is limited to 80 hours in the real world? And who will take care of the lazy surgeon's patients when the clock strikes 5PM or the number of work hours logged for that week breaks 80?

For those of you guys here contemplating a career in surgery, be sure you understand the commitment and time it requires to be a good surgeon. Anyone can cut corners, and maybe you'll get away with it. But everytime you do you're putting someone else at risk and you're helping to erode what's left of the little bit of trust the public has in its physicians ans surgeons.

For whatever reason the ACS seems to be okay with this whole 80 hour thing. I guess anything to fill the ranks, huh?

 

[doc02]

My sister was so amazed she couldn't even move for a few seconds.

Sweet, I shall take complete advantage of her while she is paralyzed.

 

[RinaBe]

Thanks for your responses. I thought MOHS was a special term/inside joke here on SDN, so I didn't look it up elsewhere.

So what people seem to be saying is that operating is a learned skill. What it takes to be a surgeon involves the ability to work hard, take criticism, and dedicate yourself even at the final hour. That's cool with me.

Perhaps my initial question was too broad, so I'll ask two specific questions and maybe you can help me with some more information:

1. Given the nature of your work, do you guys find that surgeons are more visual learners than other types of physicians?

2. Are most surgeons naturally talkative types of people, or do you also have more reserved colleagues who also make for excellent surgeons?

Any other kind of anecdotal advice or observations about the makings of a good surgeon? I'll try to check out a copy of Surgical Recall too. Thanks everyone.

 

[Blade28]

You learn to be outspoken in surgery - the quiet, shy types don't exactly tend to do well.

In addition, what patient wants a shy, self-conscious, stammering surgeon? Gotta portray confidence, assertiveness, and calm.

If you're asking what I think you're asking (between the lines), just wait until your MS-III General Surgery rotation and see if you like it - no need to worry about whether or not you "fit the mold."

 

[smq123]

2. Are most surgeons naturally talkative types of people, or do you also have more reserved colleagues who also make for excellent surgeons?

Just from the perspective of a med student - being a really talkative person can be a detriment on a surgery rotation. I have known students who tried to make small talk with the residents during slow parts of the operations, or asked a lot of questions (partly to show the residents that they were reading at night, but also to fill in the silence). On the student evals, the residents wrote stuff like "Does not know when to shut up," "Could not stay quiet at crucial moments in the case." Don't be shy and a pushover, but don't talk the resident's ear off either!

Quite a few surgeons are actually very friendly (and funny) people. But there's no reason why being quiet and reserved is necessarily a bad thing for a surgeon. As long as you can effectively communicate with patients and with colleagues - you should be okay.

What it takes to be a surgeon involves the ability to work hard, take criticism, and dedicate yourself even at the final hour. That's cool with me.

Any other kind of anecdotal advice or observations about the makings of a good surgeon?

Just do well on the rotation and see if you really like being in the OR, I would guess.... Lots of people start out wanting to do surgery, and end up hating it.

Make sure that the things that you mentioned really are "cool with you." I've heard students talk about how much they want to do surgery, and how they love being in the OR. But they don't like staying in the hospital for more than 12 hours, refuse to come in and help round on weekends, and stand around chatting with other students while the poor resident frantically does paperwork, answers pages, and writes out prescriptions. Or they INSIST on going down to the cafeteria and getting a full breakfast after rounds (even though the pre-op area is already overflowing). And then they complain because they didn't get Honors on that rotation.

 

[Castro Viejo]

1. Given the nature of your work, do you guys find that surgeons are more visual learners than other types of physicians?

2. Are most surgeons naturally talkative types of people, or do you also have more reserved colleagues who also make for excellent surgeons?

I don't think surgeons are any more visual in learning type than other physicians. Unless you mean "reading," and the stereotype goes that surgeons don't read much. Given what the American Board of Surgery wants you to know, it's impossible not to read.

Surgeons, as Blade pointed out, tend to be externally more confident. The saying, "often wrong but never in doubt" fits us well I think. And that kind of tenacity is something you need in the operating room, during a trauma resuscitation, and anywhere where your decision making will mean the patient lives or dies. It kind of sucks sometimes, but that's the nature of surgery. I've watched surgeons who get confused, who can't separate the forest from the trees, and generally can't commit. That's damn scary.

But then there are surgeons who seem to be great at decision making in different theaters of combat. One trauma/critical care attending I know is great in the SICU and has command of everything when the fit hits the shan, but throw him in the middle of the OR with an emergency case and it's usually the resident who has to smack some sense into him to get anything done. Oh, and he has terrible tremors... Just terrible. To the point where if he were to throw a stitch into bowel, he'll likely tear a hole into it. I mean really bad.

 

[smq123]

Now, if I were the guy doing the 16th admission and there's a 17th one, I don't know how I could look my attending or Chief Resident in the eye and say, "Sorry, man, it's over my limit for the day" and hand him a list of new admissions. I also don't know how I can call in someone -- in the middle of the night sometimes -- to come in to start their day early.

Tired doctors may make stupid mistakes and sometimes it'll cost the life of an unsuspecting patient, but what about lazy doctors? Aren't they just as much of a threat?

That is scary. I can't imagine people doing that with a good conscience. My sister did internal med, like I said before (she is a critical care attending now), but she doesn't fit the "laid back" internal med stereotype. (Otherwise she wouldn't work in the CCU, I guess.) She'd rip her resident a new one if he did that. Heck, if she found out that I did something like that, she'd rip ME a new one.

 

[Castro Viejo]

Just from the perspective of a med student - being a really talkative person can be a detriment on a surgery rotation. I have known students who tried to make small talk with the residents during slow parts of the operations, or asked a lot of questions (partly to show the residents that they were reading at night, but also to fill in the silence). On the student evals, the residents wrote stuff like "Does not know when to shut up," "Could not stay quiet at crucial moments in the case." Don't be shy and a pushover, but don't talk the resident's ear off either!

I can understand the med students' need to fill in the gaps of silence with some kind of conversation just to pass the time, but it's sometimes at the worst moment. For the most part if I'm in the OR doing something with my attending, or the attending is somewhere present, for me to carry on a conversation with a med student makes it seem like my focus isn't on the operation, and that'll upset the attending and his trust in me will be reduced. Even if it's related to the operation, conversation in the OR should be between the attending and the resident, or the Chief Resident and his assistant.

Take the hint: if the resident is busy with something or visibly flustered, it's probably not the right time to start talking. If everyone is sitting around blabbing about something and you've verified there's absolutely no work to do, then come by, sit back with us, and we'll be more than happy to shoot the stuff with you. When things get a little haywire, then you should be running around trying to help get things done to facilitate whatever thing we're trying to do.

The surgery rotation is a cakewalk if you know how to be a good intern. It'll be terrible if you try and soften the surgeons you work with -- especially the cranky Chief Resident.

 

[Blade28]

That is scary. I can't imagine people doing that with a good conscience. My sister did internal med, like I said before (she is a critical care attending now), but she doesn't fit the "laid back" internal med stereotype. (Otherwise she wouldn't work in the CCU, I guess.) She'd rip her resident a new one if he did that. Heck, if she found out that I did something like that, she'd rip ME a new one.

An internist is very different from an intensivist, which is what your sister is. Their personalities tend to be VERY different.

I forgot to add the expression that Castro Viejo pointed out in his excellent post - "sometimes wrong, never in doubt."

I'm not saying surgeons can't be nice and friendly and have great bedside manner (because I like to think of myself as quite kind), but a certain deal of confidence/assertiveness is required, IMHO.

 

[Blade28]

I've heard students talk about how much they want to do surgery, and how they love being in the OR. But they don't like staying in the hospital for more than 12 hours, refuse to come in and help round on weekends, and stand around chatting with other students while the poor resident frantically does paperwork, answers pages, and writes out prescriptions. Or they INSIST on going down to the cafeteria and getting a full breakfast after rounds (even though the pre-op area is already overflowing). And then they complain because they didn't get Honors on that rotation.

The majority of med students like the "technical" aspect of surgery - suturing/cutting/tying in the OR, assisting with central lines/chest tubes, etc. But the question is, do you like it enough to deal with the lifestyle/culture?

 

[Winged Scapula]

A certain amount of confidence and decisiveness is necessary to be a surgeon. Interestingly, outside of the OR and office, I am sometimes stymied by the choices in life...where to eat dinner, what to eat, what color towels to put in my new bathroom, etc. For those things I prefer someone to tell me what to do (*sometimes*).

Many surgeons are quite and reserved and perhaps even shy, but to be successful you have to be confident and decisive. Many are extroverts, talkative types who like jokes and loud music in the OR. I fit the latter category, and although I've been told many times that I'm "too nice to be a surgeon", I still embody many of the necessary elements of the surgical mentality. As nice and caring as I am, I still have pretty high standards for those I work with and I will tell you if you don't live up to those standards. On second thought, I will not tell you...at least not initially; you have to really piss me off before I say something.

I like students who are talkative as long as the talk isn't designed to show me what they read the night before or doesn't come at an obtrusive time. I once worked with a resident, a PGY-2, who wouldn't shut up. The patient would be bleeding out and she'd be chatting with the scrub nurse about her weekend. One attending once told her to STFU because he'd simply had enough. Talking is ok, knowing when to talk and what to say is the art.

I'm as lazy as the next person, but like the others here I fear about the mentality that surgery is shift work. Has everyone simply decided that the ACGME duty hour principles mandates an 80 hour limit? The principle is an AVERAGE of 80 hours. You do not turn into a pumpkin on hour 80.

Like Castro, I cannot fathom how someone could leave and not finish their work, or to hand it over to someone else. I'm as guilty as the next one of pissing and moaning when I'd get a page 5 minutes before I was planning on going home, but I couldn't see passing it off to the next guy, just because he was taking over in 5 minutes. It just isn't the way I was taught.

Finally, as others have noted, surgery sounds cool and it sounds like it would be tolerable. But you'd be suprised at those who think they'd enjoy it and find that they cannot wait to go home at the end of the day. Its easy to say, "sure I don't mind staying late, or coming in early," but when faced with family crisis or a job you don't like or maybe even a new love interest (that you want to be at home with), its very hard to do. As Blade notes, almost every one likes the OR and the technical stuff, but very very many people cannot deal with the lifestyle, the personalities, the culture and mentality and the BS.

 

[Blade28]

Interestingly, outside of the OR and office, I am sometimes stymied by the choices in life...where to eat dinner, what to eat, what color towels to put in my new bathroom, etc. For those things I prefer someone to tell me what to do (*sometimes*).
...
I fit the latter category, and although I've been told many times that I'm "too nice to be a surgeon", I still embody many of the necessary elements of the surgical mentality.

(1) Ah, that explains a lot.

(2) Funny, I've also been told the exact same thing - that I'm "too nice to be a surgeon." I plan on being a different breed - the kind that actually sits and talks to patients from time to time!

I should add that I've also seen some ridiculous behavior regarding the 80-hour workweek. A recent example is a new intern who left a discharge summary and dictation HALF-FINISHED because the clock struck 12 noon. Absolutely ridiculous.

 

[Winged Scapula]

(1) Ah, that explains a lot.

What? Like why I'm still single?

 

[Castro Viejo]

I like students who are talkative as long as the talk isn't designed to show me what they read the night before or doesn't come at an obtrusive time. I once worked with a resident, a PGY-2, who wouldn't shut up. The patient would be bleeding out and she'd be chatting with the scrub nurse about her weekend. One attending once told her to STFU because he'd simply had enough. Talking is ok, knowing when to talk and what to say is the art.

Oooooo!!! I know her! I know her!

She IS annoying! My PD told her to STFU too. I think it was more like, "Shut up. Just S-T-F-U. AKYFMS."

Surprisingly, to this day, she STILL thinks she left here on a positive note and everyone loves her. Psycho.

 

[Blade28]

What? Like why I'm still single?

Nah, just goes with my theory of you coming home being exhausted from acting the "bad guy" at work! Maybe you are too nice, at heart, to be a surgeon.

 

[doc02]

Interestingly, outside of the OR and office, I am sometimes stymied by the choices in life...where to eat dinner, what to eat, what color towels to put in my new bathroom, etc. For those things I prefer someone to tell me what to do

That's not that surprising. The natural order of things is for men to tell women what to do.

 

[Winged Scapula]

That's not that surprising. The natural order of things is for men to tell women what to do.

Ok, so what color towels should I get for the guest bathroom?

 

[Winged Scapula]

Nah, just goes with my theory of you coming home being exhausted from acting the "bad guy" at work!

You have a theory about my home life? Do tell, do tell!

Maybe you are too nice, at heart, to be a surgeon.

Perhaps, but its too late now!

 

[Winged Scapula]

Oooooo!!! I know her! I know her!

Yes you do.

She IS annoying! My PD told her to STFU too. I think it was more like, "Shut up. Just S-T-F-U. AKYFMS."

Surprisingly, to this day, she STILL thinks she left here on a positive note and everyone loves her. Psycho.

Goes along with the narcissistic personality disorder. Wonder how many she's alienated in her fellowship program already?

 

[doc02]

Ok, so what color towels should I get for the guest bathroom?

Blue. Any other questions?

 

[Playmakur42]

.

 

[Winged Scapula]

Blue.

Thanks. I got black and cream with a cool design...on sale.

Any other questions?

Should I get an LCD or plasma tv?

Blackberry vs Moto Q?

Is a Dyson worth the money?

Where can I find non-standard size director chair covers?

Is premium gas *really* required or is that just a scam?

 

[Castro Viejo]

Goes along with the narcissistic personality disorder. Wonder how many she's alienated in her fellowship program already?

I've been seeing her around town more and more often recently.

Either it's not very busy or they've told her not to come to work anymore.

 

[doc02]

Thanks. I got black and cream with a cool design...on sale.

Black towels? Oh, sorry, I thought you wanted a suggestion that would make your bathroom look good, not ugly. Next time, be clearer.

Also: Plasma; who cares; no, but it'll look better than your ugly towels; suture together some of your ugly towels; it's a scam

 

[Winged Scapula]

Black towels? Oh, sorry, I thought you wanted a suggestion that would make your bathroom look good, not ugly. Next time, be clearer.

Blue? C'mon if any man doesn't choose as his favorite color as blue (or maybe brown), I'll eat my words. My towels aren't black, they're black and cream and very cute:

Also: Plasma; who cares; no, but it'll look better than your ugly towels; suture together some of your ugly towels; it's a scam

I dunno...I have two very old tvs (not even cable ready, I have to use an RF modulator and explain to the cable guys what that is), so wanted something new, but wasn't sure of the benefits of plasma vs LCD. But thanks for your help, my pretty towels would make a nice wall hanging!

 

[Winged Scapula]

I've been seeing her around town more and more often recently.

Either it's not very busy or they've told her not to come to work anymore.

While I can certainly imagine the latter, I think she has family in the NY or Norther NJ area, so she's probably coming back to see them.

You're actually running into her on the street?

 

[doc02]

Blue? C'mon if any man doesn't choose as his favorite color as blue (or maybe brown), I'll eat my words.

Right, that's why blue is correct and everything else is wrong.

My towels aren't black, they're black and cream and very cute

If you paid $8 for them, you overpaid. Also ...$8 for a SET of towels? Why don't you just hang a roll of Bounty up on the wall?

I dunno...I have two very old tvs (not even cable ready, I have to use an RF modulator and explain to the cable guys what that is), so wanted something new, but wasn't sure of the benefits of plasma vs LCD. But thanks for your help, my pretty towels would make a nice wall hanging!

Plasma is much more expensive but it has better black contrast (so the colors are considered more correct) and doesn't suffer from the blurring effect that LCDs have when they show fast motion. LCDs don't get "burn in," which plasmas do (if you watch the same channel continuously, their logo will burn in after a while, for example) and are less expensive. If you're getting a smaller screen (30"-40"), go for LCD. If you're going for a giant one, get plasma but be prepared to shell out at least a few thousand for it. Then hang it over the towels in your bathroom so that I can stop puking.

 

[Winged Scapula]

Right, that's why blue is correct and everything else is wrong.

Oh yeah, I forgot...you're right.

If you paid $8 for them, you overpaid. Also ...$8 for a SET of towels? Why don't you just hang a roll of Bounty up on the wall?

Hah...have you purchased towels in awhile? 8$ is for the hand towel. The bath towels were $12, hand towels $8 and I think the wash cloth was $7. The rug was $24 and the shower curtain $25. Add $20 for the soap dispenser and toothbrush holder and you have $116 for the supplies.

Bounty towels are undoubtedly cheaper but not nearly as cute. But perhaps if I hung those up, I would have less guests.

Plasma is much more expensive but it has better black contrast (so the colors are considered more correct) and doesn't suffer from the blurring effect that LCDs have when they show fast motion. LCDs don't get "burn in," which plasmas do (if you watch the same channel continuously, their logo will burn in after a while, for example) and are less expensive. If you're getting a smaller screen (30"-40"), go for LCD. If you're going for a giant one, get plasma but be prepared to shell out at least a few thousand for it. Then hang it over the towels in your bathroom so that I can stop puking.

Being female I do tend to watch a channel a bit longer than most males, given their channel surfing habits. Also being female I cannot see having a tv the size of a small nation. So maybe LCD would be better.

Thanks...now what about that premium gas. Do I really need it for my car?

 

[Playmakur42]

.

 

[DoctaJay]

Speaking of what it takes to be a surgeon; I've been kind of miffed by all the stories of malignant surgeons with their malignant personalities. All of the surgeons that I shadowed that encouraged me to pursue surgery have been the nicest guys I've ever met. They don't seem to loose their temper, they didn't mind teaching the poor college student (me) following them around, and I didn't even hear profanity laced outbursts. Maybe I'll run into it more during my 3rd year, but my experiences so far have been pretty picturesque.

 

[Blade28]

That's not that surprising. The natural order of things is for men to tell women what to do.

Yeah, I'm the same way.

Should I get an LCD or plasma tv?

Blackberry vs Moto Q?

Is a Dyson worth the money?

Where can I find non-standard size director chair covers?

Is premium gas *really* required or is that just a scam?

LCD. Depends how many emails you get. No way. No idea. And only if your car manual states that it's necessary.

 

[smq123]

Speaking of what it takes to be a surgeon; I've been kind of miffed by all the stories of malignant surgeons with their malignant personalities. All of the surgeons that I shadowed that encouraged me to pursue surgery have been the nicest guys I've ever met. They don't seem to loose their temper, they didn't mind teaching the poor college student (me) following them around, and I didn't even hear profanity laced outbursts. Maybe I'll run into it more during my 3rd year, but my experiences so far have been pretty picturesque.

Doctors were SOOO nice to me when I was an MS-1 and MS-2 shadowing them around for a day. The exact same doctors have snapped at me now that I am an MS-3.

A lot of doctors and residents are incredibly nice to students before the rotation starts or after it ends. There's something about the whole "I have to evaluate you and you have to evaluate me" dynamic that sours that relationship very quickly. As a pre-med, I suspect that the surgeons had no expectations of you and that you were not expected to evaluate them. As an MS-3, the situation is very different, so the way that you get treated is different.

A lot of surgeons ARE nice, but I also wouldn't expect to be treated the same way as a 3rd year med student as you were treated as a pre-med.

 

[DoctaJay]

lol, sounds like Dr. Jekel and Mr. Hyde. I'm not looking forward to it ...

 

[Winged Scapula]

It does change. The surgeons I worked with during medical school were encouraging of me, supportive of my goals and fun to be around. Somehow I got the idea that all surgeons were like that!

Things changed during residency...I soon realized that not everyone was as easy to get along with as my med school professors.

 

[Castro Viejo]

While I can certainly imagine the latter, I think she has family in the NY or Norther NJ area, so she's probably coming back to see them.

You're actually running into her on the street?

Yeah, I know. It spooks me out to see the vultures circling overhead whenever she's nearby.

 

[doc02]

Oh yeah, I forgot...you're right.

I already knew that.

 

[RinaBe]

It does change. The surgeons I worked with during medical school were encouraging of me, supportive of my goals and fun to be around. Somehow I got the idea that all surgeons were like that!

Things changed during residency...I soon realized that not everyone was as easy to get along with as my med school professors.

I've also had realy positive experiences with the surgical department at my school. It's why I'm suddenly asking all of these q's on the board, as prior to that, surgery was the last thing I would have considered doing.

I did find a link to the Surgical Recall book mentioned earlier by smq. Here it is for those who are interested: http://books.google.com/books?id=aDwEEAlKvNAC&dq=surgical+recall&pg=PP1&ots=2Gmj_mXumD&sig=deFDTTFGwWM-DyP6NQuRXhaNVBg&prev=http://www.google.com/search%3Fclient%3Dsafari%26rls%3Den%26q%3Dsurgical%2Brecall%26ie%3DUTF-8%26oe%3DUTF-8&sa=X&oi=print&ct=title&cad=one-book-with-thumbnail#PPP1,M1

 

[Castro Viejo]

I've also had realy positive experiences with the surgical department at my school. It's why I'm suddenly asking all of these q's on the board, as prior to that, surgery was the last thing I would have considered doing.

Even medical school has changed to benefit the clock-watching bunch interested in surgery.

When I was in med school the surgical rotation was really busy. We took call every third night. Stayed post call. Was called on by the house staff to do everything and anything that felt appropriate (putting in central lines, chest tubes, etc.). All this and we had a shelf exam (is that what they're still called) at the end along with an oral.

NOW the med students from the same school (affiliated with my community program) take call once per week, and almost all elect for a Thursday night call to get a three day weekend with Friday off, aren't allowed to do scut work, aren't allowed to do lines, insert tubes, and they've scrapped the oral.

No wonder General Surgery more popular today. Everyone thinks it's a cakewalk based on some lousy third-year rotation.

Hopefully the subinternships still retain that bit of torture that I remember...

 

[smq123]

Even medical school has changed to benefit the clock-watching bunch interested in surgery.

When I was in med school the surgical rotation was really busy. We took call every third night. Stayed post call. Was called on by the house staff to do everything and anything that felt appropriate (putting in central lines, chest tubes, etc.). All this and we had a shelf exam (is that what they're still called) at the end along with an oral.

NOW the med students from the same school (affiliated with my community program) take call once per week, and almost all elect for a Thursday night call to get a three day weekend with Friday off, aren't allowed to do scut work, aren't allowed to do lines, insert tubes, and they've scrapped the oral.

No wonder General Surgery more popular today. Everyone thinks it's a cakewalk based on some lousy third-year rotation.

Take heart. Many of the students who rotate through your hospital have probably requested to rotate their BECAUSE they have no interest in surgery, and heard that that rotation site is easy.

At my school, you can rotate through the VA - where there is NO call at all, and you're often done by 5. (Plus, on Fridays you are done by 11, so you can make it back to Philadelphia in time for mandatory didactics.) Most of the people who choose to do their rotation at that site are people who would never go into surgery, even if they were paid double the usual resident salary.

Or, you can rotate through the University hospital, in which you are q3-q4, and are often done by 7, after starting at 5 AM. Most of the people who rotate through the University hospital are people who are really interested in surgery and are hoping to get a good LOR from somebody there.

Everyone who wants to do surgery is strenuously advised to do a sub-I at our University hospital, in addition to (possibly) a sub-I at another hospital.

No oral exam here either - just an OSCE and the shelf.

 

[smq123]

No wonder General Surgery more popular today. Everyone thinks it's a cakewalk based on some lousy third-year rotation.

I think Gen surg is more popular today because of Grey's Anatomy. I'm not kidding.

I wonder how many people want to specialize in "Diagnostic Medicine" after watching House.