Do basically all med. students go through the blues or depression?

[NYgirl2]

Pretty much all I know have gone through that. The feeling of the lack of life, being buried in books, lack of sleep, constant studying, seeing everyone around them getting married, and us still focusing on school...

Does everyone go through this at some point? How long did it last?

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[pillowhead]

Pretty much all I know have gone through that. The feeling of the lack of life, being buried in books, lack of sleep, constant studying, seeing everyone around them getting married, and us still focusing on school...

Does everyone go through this at some point? How long did it last?

I think certainly everyone has periods of the blues, esp. on particularly hard rotations, when they're sleep-deprived even more than usual, after a horrendous call or after a mistake or error has been made (or perceived to have been made). The stresses of medicine are such that it's almost inevitable in my opinion. But these periods don't usually are more situationally related and tend to resolve after the situation resolves in a few days.

However, depression, which by definition is more prolonged, is probably more prevalent than in the general population but I wouldn't say that most (as in the majority) or students and residents experience true depression.

I consider the blues to be more situation dependent, i.e. something bad happens and then you feel bad (and bad things are always happening in residency) while depression occurs even when external events are going okay (being on a no-call elective getting plenty of sleep while working with nice people and still feeling awful day after day).

 

[Dr. V]

No, matter of fact medical school is a breeze compared to residency. You have loads of time in medical school in comparison to residency.

If you are having depression you need to see someone about that. Most medical schools have free psych and it is confidential.

Now if you are asking do most medical students have bad days and get into bad moods then the answer is yes. That's just part of life, any life.

If you are having issues though don't hesitate to go see someone. That's what the program is there for.

 

[gasnewby]

what year are you?

 

[Winged Scapula]

I was MUCH happier in medical school than residency.

There was much more free time, more sleep, less derogating comments from faculty, and despite the fact that I was in Australia, I actually saw MORE of my family than I did when I was in residency (and had no time off).

 

[dingozlife]

yeah i agree at times i go through cycles of feeling those blues regarding: "my friends are all moving forward in life with marriages, careers, making money, buying houses, traveling, free weekends, etc." i was more so that way first year, then 15% better 2nd year, then 3rd yr i got 85% better in not thinking more than i should. I admit i was bitter wen some friend couples compare and say our lives are smooth sailing and we didnt even go to college and bringing in six figures doing sales and finances 9-6pm jobs, have a house, change cars, new plasma tvs. sometimes they would say by the time you could afford a 50" plasma tv, we're already moved onto bigger/better toys. btw im a guy so thats why more focused on toys lol
anyhow i look back and dont regret sticking through it, cuz im having the time of my life doing rotations, always something new, stories to tell at happy hrs, when everyone else supposedly moved forward in their lives, I feel like my life has just started afresh, the feeling is priceless.

 

[Blade28]

Agreed that med school was much less stressful than residency.

Now, you have to deal with a multitude of factors: the added pressure and competitiveness of fellow residents; continuous beat downs by attendings/fellows/chiefs/senior residents; brutal hours and lack of sleep; frustrating interactions with nurses/other hospital staff; the less-than-enjoyable experience of dealing with bureaucratic red tape.

And then there's the whole "taking-care-of-patients-so-they-don't-get-sick-or-die" thing.

 

[NYgirl2]

what year are you?

M3

 

[NYgirl2]

No, matter of fact medical school is a breeze compared to residency. You have loads of time in medical school in comparison to residency.

If you are having depression you need to see someone about that. Most medical schools have free psych and it is confidential.

Now if you are asking do most medical students have bad days and get into bad moods then the answer is yes. That's just part of life, any life.

If you are having issues though don't hesitate to go see someone. That's what the program is there for.

No, I do get the blues, but I'm not having true depression by any means (which I know is different), I was just wondering if med. students get more so than others due to our hectic load.

 

[buckley]

med school is an incredibly tough time, and the funny thing is you cant really pinpoint what's making it so tough. Of course the academic demands are there, but it's usually the mix, like a parent suddenly having an MI or a bad break-up, all-in-all while you watch your highschool classmates earning a living while you are still highlighting...hahahaha! we used to joke that medical school is prolonged adolescence or puberty years the second time around. it has a way of making you feel insecure, insignifiant and totally immature. being told by a patient whom you cannot insert an IV line on that you are a worthless doctor--ooh! that really hurts, considering you've been working your ass off so he can get better. yup, it's tough. someone once told me you need some masochistic streak in you to survive medical school. and to think the "reward" is an even more strenuous environment called residency! hahaha...but at the end of the day if medicine is really what you want to practice, you will get through. just make sure you cast your own net of wonderful supporters who seem to know you so well that they knock on your dorm room with a cake on hand, and it's not your birthday

 

[Winged Scapula]

No, I do get the blues, but I'm not having true depression by any means (which I know is different), I was just wondering if med. students get more so than others due to our hectic load.

I'm not sure that its medical school per se which makes people depressed, but that there is a higher rate of depression amongst the high functioning, intellectual crowd that attends medical school. You may find the same rates of depressive disorders in law school, PhD programs, etc.

So couple a baseline tendency with long hours, frustrating experiences and watching your friends with much less education buying houses, getting married, starting families, etc. its not suprising taht many medical students would suffer at least the "blues" if not full blown clinical depression.

 

[Winged Scapula]

we used to joke that medical school is prolonged adolescence or puberty years the second time around. it has a way of making you feel insecure, insignifiant and totally immature.

I used to joke about that too and I really think there's something to it. I first noticed it when I was in grad school and had residents as roommates. Despite being in their late 20s (I was a few years younger) these guys acted like the guys I'd gone to college with.

My perception was that people who had spent a long period of time studying and not had the "typical" college experiences tended to make up for it later in life. So these guys were still dating 18 yo girls, staying out all night getting drunk, etc. and pretty much acted like 20 yos. Except they were 28, 29, 30, etc.

Of course, you could make the case that they dated 18 yo girls because they could, but when I inquired why educated men were dating uneducated women, the response wasn't "because we can" but rather "because they are impressed by us being doctors".

 

[dingozlife]

28, 29 y/o residents behaving like college frat boys, thats something rewarding to look forward to when i finish med school, lol

 

[Llenroc]

I guess it depends what residency you're going into. In Physical Medicine & Rehab., you hardly ever work more than 45 hours a week.

 

[DOCNY81]

I'm not sure that its medical school per se which makes people depressed, but that there is a higher rate of depression amongst the high functioning, intellectual crowd that attends medical school. You may find the same rates of depressive disorders in law school, PhD programs, etc.

So couple a baseline tendency with long hours, frustrating experiences and watching your friends with much less education buying houses, getting married, starting families, etc. its not suprising taht many medical students would suffer at least the "blues" if not full blown clinical depression.

I wonder if anyone studied the depression rate among the match applicants... ?

 

[Tired]

I used to joke about that too and I really think there's something to it. I first noticed it when I was in grad school and had residents as roommates. Despite being in their late 20s (I was a few years younger) these guys acted like the guys I'd gone to college with.

I prefer the explanation from House of God. Highly stressful situations result in reverting to more juvenille behaviors to cope.

 

[Blade28]

I prefer the explanation from House of God. Highly stressful situations result in reverting to more juvenille behaviors to cope.

Agreed!

 

[chrisisinnocent]

I'm not sure that its medical school per se which makes people depressed, but that there is a higher rate of depression amongst the high functioning, intellectual crowd that attends medical school. You may find the same rates of depressive disorders in law school, PhD programs, etc.

So couple a baseline tendency with long hours, frustrating experiences and watching your friends with much less education buying houses, getting married, starting families, etc. its not suprising taht many medical students would suffer at least the "blues" if not full blown clinical depression.

I think that the sleep deprivation and disruption of circadian rhythms has a lot to do with depression/blues amongst residents. Sleep deprivation is the most reliable way to make someone experience psychotic episodes and the kind of low grade chronic sleep deprivation one experiences in residency seems like the perfect trigger to push someone into depression.

 

[Winged Scapula]

I think that the sleep deprivation and disruption of circadian rhythms has a lot to do with depression/blues amongst residents. Sleep deprivation is the most reliable way to make someone experience psychotic episodes and the kind of low grade chronic sleep deprivation one experiences in residency seems like the perfect trigger to push someone into depression.

I don't doubt that chronic sleep dep makes depression worse but would argue that you see high rates of depression amongst other groups in society without it. I tend to think, as for most things, its a multitude of factors contributing to it.

 

[titanjones]

mine lasted most of 3rd year. 4th year tho is grrrreat

 

[GoodMonkey]

just wait until about 7 months into internship.

 

[BlackSails]

I was MUCH happier in medical school than residency.

There was much more free time, more sleep, less derogating comments from faculty, and despite the fact that I was in Australia, I actually saw MORE of my family than I did when I was in residency (and had no time off).

Are you happier as an attending than you were as a med student?

 

[Kubed]

The really cruel part about all of this is that in medicine, every one seems to say that it only gets worse. Than means that whatever part you're experiencing, it's the worst you've had to deal with. It gets pretty depressing to hear residents and attendings talk about how great med school was and how it only goes downhill from there. What's sad is they have the benefit experience and are right.

VA IM this month for me. +1, it's a slow service, only 40 or so on the floor. -1, 7 hospitalists who need to get their daily dose of pimping in. 12 hours of "you paid good money to go to med school and you can't even answer that question?" ... ugh, knowing that this is "light" and it gets much, much worse.... it's never too late for law school right?

 

[Winged Scapula]

Are you happier as an attending than you were as a med student?

No.

I'm enjoying it but the level of stress is much much greater and it weighs on me sometimes.

 

[Ypo.]

An intern told me today that third year sucked worse than intern year. Another resident told me that third year sucks slightly less than intern year. However this was coming from an ER and anesthesiology resident, respectively. I think hands down residency is harder than being a student (duh).

I will say that medical school has a unique suckiness in that you don't have a well defined role, you are pretty much useless no matter how hard you try, interns get all the cool cases over you, and YOU ARE PAYING to be treated this way. I don't think there is a better way to feel like an ass other than to tattoo "fool" on your forehead.

I will take internship and hard work over this. I frigging HATE third year.

Every rotation I start out hopeful, eager to please. I progress somewhat like this:

-->-->(x 10)--> (x10)---->-->--> (realizing that no one pays attention to what I do anyways)-->.

I've learned the art of looking interested or at least neutral when I am in fact dying of boredom. And that is the greatest thing I have learned this year, and the tool I use most often.

 

[DJ LACTULOSE]

at least you don't have a shelf exam every 2 months during intern year. i think that's what makes med 3 terrible. it wouldn't be so bad if you could just relax once you get home.

 

[Blade28]

I will say that medical school has a unique suckiness in that you don't have a well defined role, you are pretty much useless no matter how hard you try, interns get all the cool cases over you, and YOU ARE PAYING to be treated this way. I don't think there is a better way to feel like an ass other than to tattoo "fool" on your forehead.

I will take internship and hard work over this. I frigging HATE third year.

What you've said is true. But once you're a resident, there's a whole 'nother type of pain waiting for you.

I always say, as you advance in level, the pain doesn't lessen...it just changes.

at least you don't have a shelf exam every 2 months during intern year. i think that's what makes med 3 terrible. it wouldn't be so bad if you could just relax once you get home.

But almost everyone has a yearly in-service exam. So that keeps you studying every day.

 

[smq123]

I will say that medical school has a unique suckiness in that you don't have a well defined role, you are pretty much useless no matter how hard you try, interns get all the cool cases over you, and YOU ARE PAYING to be treated this way. I don't think there is a better way to feel like an ass other than to tattoo "fool" on your forehead.

Really? The interns get the cool cases? That's not the case at my school - in fact, this is the part that worries me slightly about intern year.

On surgery, I scrubbed in on every whipple and every distal pancreatectomy that was done on my service. The intern, however, was in the SICU running the floor.

On OB nightfloat, I got to hang out and watch a bunch of stat c-sections - including a really interesting case where a woman had "twins": 1 normal fetus + 1 hydatiform mole "twin". (Yes, it does look like a "bunch of grapes," but the vesicles aren't attached to each other, which I found disappointing. It looks more like a collection of beads, rather than grapes.) Where was the intern? - running the labor floor.

I do agree, though that on some services you don't have a defined role, at least for the first few days.

Every rotation I start out hopeful, eager to please. I progress somewhat like this:
-->-->(x 10)

Hahaha - I can relate, but my progression is a little different:

> > (I finally understand how the service is being run!!) > > (I really hated leaving OB/gyn and leaving surgery - I had a great time on OB, and I absolutely loved my surgery rotation. Sigh.)

I run hot and cold on third year. Some days are better than others. I wonder how intern year will stack up....

 

[Blade28]

Really? The interns get the cool cases? That's not the case at my school - in fact, this is the part that worries me slightly about intern year.

So are you finally switching from OB/GYN to G Surg then?

 

[smq123]

So are you finally switching from OB/GYN to G Surg then?

No...maybe...I don't know.

Gah! You're making my existential crisis worse....:cry:

Expect a PM in the next day or so. (sigh)

 

[Blade28]

No...maybe...I don't know.

Gah! You're making my existential crisis worse....:cry:

You'll figure it out!

PM/email me if you want to talk, OK?

 

[smq123]

PM/email me if you want to talk, OK?

Oh, trust me - I will. Quite soon.

 

[Ypo.]

Really? The interns get the cool cases? That's not the case at my school - in fact, this is the part that worries me slightly about intern year.

On surgery, I scrubbed in on every whipple and every distal pancreatectomy that was done on my service. The intern, however, was in the SICU running the floor.

On OB nightfloat, I got to hang out and watch a bunch of stat c-sections - including a really interesting case where a woman had "twins": 1 normal fetus + 1 hydatiform mole "twin". (Yes, it does look like a "bunch of grapes," but the vesicles aren't attached to each other, which I found disappointing. It looks more like a collection of beads, rather than grapes.) Where was the intern? - running the labor floor.

I do agree, though that on some services you don't have a defined role, at least for the first few days.

Here it's the 2nd or third year residents who run the floors. I don't think they would let an intern actually try to coordinate a floor when they still don't really know how to manage their own patients completely.

I have hit or miss days as well. Today got dissed by a nurse, pimped brutally by an attending during a C-section. But he took time to show me anatomy, so it was cool.

Hahaha - I can relate, but my progression is a little different:

.

Yeah, I should have thrown in a few more party hats at the end of the rotation.



And I should add; I saw the same attending (who pimped me) ream out the residents (and I do mean ream, for something that wasn't a big deal at all). They were all complaining about it afterwards. To work that hard and have your attending come down on you for something so minor really blows. Worse than my petty little complaints.

 

[Ypo.]

What you've said is true. But once you're a resident, there's a whole 'nother type of pain waiting for you.

I always say, as you advance in level, the pain doesn't lessen...it just changes.

But hopefully the skin continues to grow thicker. I have developed a rough callus several millimeters thick since the beginning of the year. Not quite thick enough yet.

 

[Blade28]

But hopefully the skin continues to grow thicker. I have developed a rough callus several millimeters thick since the beginning of the year. Not quite thick enough yet.

The skin thickens at the same rate that the barbs worsen, unfortunately.

 

[gutonc]

I've learned the art of looking interested or at least neutral when I am in fact dying of boredom. And that is the greatest thing I have learned this year, and the tool I use most often.

Try to keep that going. I used to have that skill but now, as an IM R2, you can actually hear my eyes roll back in my head when I'm dying of boredom. I long ago gave up pretending to care about things I'm not interested in. I do my work, provide good patient care, and secretly dream of stabbing attendings who drone on about the joy of managing diabetes or how interesting renal disease is.

If it's not big and growing out of control in the middle of an organ you really kind of need, I'm not interested. The best day I had last month (in the ER) was the day I got to tell a guy that the cough he had (and that his PCP told him was just a URI) was stage IV lung cancer. Finally, something I can give a **** about.

 

[gutonc]

Originally Posted by DJ LACTULOSE View Post
at least you don't have a shelf exam every 2 months during intern year. i think that's what makes med 3 terrible. it wouldn't be so bad if you could just relax once you get home.

But almost everyone has a yearly in-service exam. So that keeps you studying every day.

True, but the difference is that the ITEs tend to be more up-to-date (at least the IM one was) than the shelf exams are.

The problem w/ being a 3rd year is that you have to study everything twice. Once, to learn that specialty as it was practiced 5 years ago, in order to pass the shelf exam and a second time, to learn it as it's practiced today, in order to answer pimp questions on rounds. At least once you get to residency you only have to really worry about the current state of your specialty...and you can ignore all the other specialties completely once you're done w/ Step 3.

ps...this is post 666 for me...I wish it were more evil.

 

[SocialistMD]

I will say that medical school has a unique suckiness in that you don't have a well defined role, you are pretty much useless no matter how hard you try, interns get all the cool cases over you, and YOU ARE PAYING to be treated this way. I don't think there is a better way to feel like an ass other than to tattoo "fool" on your forehead.

Really? The interns get the cool cases? That's not the case at my school - in fact, this is the part that worries me slightly about intern year.

On surgery, I scrubbed in on every whipple and every distal pancreatectomy that was done on my service. The intern, however, was in the SICU running the floor.

smq123, I think the confusion comes from the fact that you guys are talking about different things. It sounds like Ypo. wanted to do the case, not simply watch. Either that, or Ypo. was talking about interesting patients on medical services instead of the CHF exacerbation.

From a surgical perspective, I think expectations make a difference. As a medical student, you shouldn't expect to get to do cases, merely scrub in on them while the residents do them. If you get a bone, great, but you aren't there to learn to operate, the intern is, so the case should go to him/her.

 

[smq123]

From a surgical perspective, I think expectations make a difference. As a medical student, you shouldn't expect to get to do cases, merely scrub in on them while the residents do them. If you get a bone, great, but you aren't there to learn to operate, the intern is, so the case should go to him/her.

No, I agree - there's no way that an MS3 should expect to operate before the intern. Any residency program that allows that is pretty terrible, and learning how to operate isn't really the purpose of a med school rotation, anyway.

In my case, the intern did a lot more than I did, but I got to see more stuff than she did. That makes sense - you wouldn't want an MS3 taking care of SICU patients or seeing consults by herself. But it still made me feel kind of bad for the intern.

The way the service worked was that, for a Whipple, the intern would open and do the open chole with the chief. Then, after they set up the Bookwalter, the attending would come in and do the rest of the Whipple with the chief, and the intern would leave the OR to attend to the patients in the unit or on the floor. The intern would then come back at the end of the case to suture the patient closed. The student works the suction for the entire case - so you see more of the case as the student, but you usually don't do anything beyond suctioning bile/blood and helping the intern to close. So I guess it evens out - particularly on that special day when the attending walked the intern through the D-J anastomosis.

 

[smq123]

Actually, I disagree. I think med students should be operating much more than the interns. Our job is to run the floor. Letting the med students operate is a way to interest them in the field, and weed out those who find out they don't really like the OR.

When you say "operate," what exactly do you mean? Do you mean suctioning and retracting, or do you mean actually using the bovie, suturing, anastomosing, etc.?

Letting the med students operate, to me, doesn't seem like it would weed out people who really shouldn't be in general surgery. I think that there are a ton of third year med students who want to "do cool stuff," but don't want to do any work on the floors, don't want to see SICU patients, and don't want to take weekend trauma call. By letting them do a lot of cool stuff in the OR, I think it gives them a slightly slanted view of what a gen surg residency is like.

Practically every med student that I've talked to loved being in the OR, and loved doing "cool stuff" and fun procedures. But do I think that every med student that I've talked to ought to be a surgeon? Not really.

I think that third year med students should be allowed to see a lot of cool stuff in the OR. But letting them actually do procedures (over the intern) doesn't necessarily give them a very accurate view of what to expect in a gen surg residency. And while I do understand that the intern's role is to run the floor/SICU, I think that inviting the med student to help take down a gall bladder (over the intern) isn't really fair to the intern, either.

R2 year is when you should really get going in the OR. Internship is a throwaway year from an operative perspective.

But it seems like intern year would be a good time to get interns practicing one-handed ties, suturing, using the bovie, and becoming more comfortable with the basics of operating (i.e. visualizing tissue planes, how to open skin correctly, setting up retractors like the Bookwalter, prepping patients, etc.)

EDIT: I just realized the humor of this. The intern is saying that the MS3 should be more involved in the OR, while the MS3 is saying that interns should be allowed to do more in the OR. You'd think it'd be the opposite.

 

[Blade28]

Practically every med student that I've talked to loved being in the OR, and loved doing "cool stuff" and fun procedures. But do I think that every med student that I've talked to ought to be a surgeon? Not really.

While I agree with much of what Tired said, I agree with the above quote.

A large majority of med students love going to the OR, provided they're getting to do stuff. They like to get "their hands dirty." They like scrubbing into OR cases, and they like to assist with bedside procedures.

But most of those med students won't go into surgery. It's the lifestyle and culture that scares them away.

 

[Ypo.]

smq123, I think the confusion comes from the fact that you guys are talking about different things. It sounds like Ypo. wanted to do the case, not simply watch. Either that, or Ypo. was talking about interesting patients on medical services instead of the CHF exacerbation.

Oh, I don't expect to be able to operate of course. But they do let us suture from time to time.

But if there is an intern there, I get to do less. That's just how it works. I understand why it is that way, I just wish I could do more. On my OB-Gyn rotation, the interns do all the low-risk c-sections and handle all the low risk patients. I have scrubbed in on more complicated surgeries, but usually there is an intern there as second, learning how to handle it even if they don't do the whole surgery. I'm pretty content doing what they'll let me do (blotting, cutting sutures, stapling, holding retractors). I love being scrubbed in on the surgeries, it's fun.

But actually I've been hanging out with this intern this week who is really cool. He actually makes sure that I can do more on his cases. I really appreciate it. But even so, since I've been assigned all his patients, there are usually two doctors for the delivery; him and the attending. And the attending will always have him do the delivery, suturing, because he needs to learn it more than I do. There are other times when it's just me and an attending, and if they know me, they let me do a whole lot more. When I was on family, for example, I got to catch babies and suture perineal tears.

It was the same on peds. They got to do all the spinal taps, circs.

 

[Ypo.]

Actually, I disagree. I think med students should be operating much more than the interns. Our job is to run the floor. Letting the med students operate is a way to interest them in the field, and weed out those who find out they don't really like the OR.

I agree with you on letting the students do more. I tell you, nothing makes me happier than being engaged.

But it sounds like Ob-Gyn is different than gen surgery. The interns here do 5 months of OB, and they have to do a certain number of c-sections and other surgeries.

 

[Ypo.]

By letting them do a lot of cool stuff in the OR, I think it gives them a slightly slanted view of what a gen surg residency is like.

Sure it does! But that's the point; residency/intern year SUCK. You just have to find doing something you love enough to make it worthwhile. For some, doing surgeries makes up for all the other scut work.

And I think that many medical students, when they get interested in a field, try to do a sub-i or at least function as much like an intern as they can while they are on the rotation. At least that's what I try to do.

 

[smq123]

But it sounds like Ob-Gyn is different than gen surgery.

Yeah, they're different - in many more ways then you may currently know....

Actually, what's surprised me is how different gen surg can be from other specialties. In ENT, for instance, it seems like they get the interns and PGY-2s operating a LOT more than they do in gen surg. By PGY-3, they're doing a lot of simpler operations absolutely independently, and some moderately complex surgeries mostly by themselves. The difference is pretty interesting.

Personally, I hate the floors. Surgery without the OR is a sh*thole, and expecting students to want to go into the field without letting them into the OR would be a foolish recruiting tool.

And really, there are a lot of students out there who hate the OR. They hate standing up that long, they hate being sterile, the hate the personalities.

I guess we've had different experiences then, because many students I encounter don't like operating.

Well, I wouldn't advocate NEVER letting med students into the OR - after all, that's the point of a rotation. But I think that they don't need extensive, daily exposure to know if they like the OR or not. Like you said, we must have had very different experiences - because most med students I know LOVE procedures and love getting into the OR. One or two days in the OR is usually enough to get them hooked. But most of them should not be surgeons.

Sure it does! But that's the point; residency/intern year SUCK. You just have to find doing something you love enough to make it worthwhile. For some, doing surgeries makes up for all the other scut work.

And I think that many medical students, when they get interested in a field, try to do a sub-i or at least function as much like an intern as they can while they are on the rotation. At least that's what I try to do.

Of course - the chance to go into the OR makes up for all the other crap. But, like I said before, I think that most students need only a limited amount of exposure to the OR before they know whether or not they like it (i.e. by watching laparoscopic procedures, but they don't necessarily have to scrub in on these).

In my case, after two days on gyn, I knew that I liked being in the OR and that I'd, at least, enjoy my surgery rotation - which turned out to be the case.

 

[Ypo.]

Of course - the chance to go into the OR makes up for all the other crap. But, like I said before, I think that most students need only a limited amount of exposure to the OR before they know whether or not they like it (i.e. by watching laparoscopic procedures, but they don't necessarily have to scrub in on these).

In my case, after two days on gyn, I knew that I liked being in the OR and that I'd, at least, enjoy my surgery rotation - which turned out to be the case.

I haven't seen any laparoscopic surgery yet, so I can't comment. I do know that there was a world of difference between observing a c-section (i've done that about 5 times) and scrubbing in on them.


I wonder why intern year of gen surgery is so different. Maybe they need you guys to do all the scut work. Anyways, Ob/Gyn is like primary care and surgery packed into four years, so maybe they can't afford to wait a year.

Do gen surgery interns get more ER consults than in the other residency years?

 

[smq123]

I wonder why intern year of gen surgery is so different. Maybe they need you guys to do all the scut work. Anyways, Ob/Gyn is like primary care and surgery packed into four years, so maybe they can't afford to wait a year.

Do gen surgery interns get more ER consults than in the other residency years?

The patients on gen surg are much sicker than the patients on gyn. They require more care, generally, so they need interns and juniors to actually take care of them. The patients on gyn feel like crap the day after surgery, but they can usually take care of themselves.

The most demanding patient on gyn had post-op ileus and needed an NG tube.

The most demanding patient on my gen surg rotation was obtundant and needed to be rushed to CVIR to have a biloma drained. He also needed to have a PICC line placed, an appropriate TPN formula calculated, strict I&Os, and twice daily chem 7s - plus his CBC looked a little iffy, so they had to keep an eye on that. He was also persistently tachycardic (~130 bpm) and his blood pressure would take these frightening spikes into 180/140 territory.

Taking care of gyn patients on the floor, and then taking care of SICU patients, is like two different worlds.

Plus, the general surgery/trauma surgery service list tends to be a lot longer than the gyn service list. On gyn, the list rarely spread over into a 2nd page. On trauma surgery, if you can get the list down to under 4 pages, it's a minor miracle.

 

[Blade28]

Do gen surgery interns get more ER consults than in the other residency years?

At many programs you won't start seeing consults on your own until your PGY-2 year. As an intern, usually there's enough scut going on to keep you busy.

 

[smq123]

Actually, I disagree. I think med students should be operating much more than the interns. Our job is to run the floor. Letting the med students operate is a way to interest them in the field, and weed out those who find out they don't really like the OR.

I found this old post from a whole year ago - I was looking for something else, and stumbled upon it. It made me laugh out loud.

As an MS3, my residents and faculty made it very clear that perioperative management was the focus of learning in my clerkship. Sure, everyone wants to go to the OR all the time, but perioperative management is as (or more) important to the patient than the actual surgical procedure.

In addition, assuming you (the OP) are interested in surgery, the majority of your intern year will be spent on the wards rounding, rather than doing procedures in the OR. The MS3 clerkship and MS4 sub-i's can potentially be an excellent source of preparation for your your first year, if you take the time to learn what you need to know.

During my 4th year sub-i's, no resident or Staff ever complimented me on my surgical technique (which obviously sucks as a student), but they I did get really good feedback about how well I knew my patients and give good input on treatment plans. I believe this contributed mightily to my matching at my first choice program.

http://forums.studentdoctor.net/showpost.php?p=4589984&postcount=22

It was from a thread about wanting to skip "boring" AM rounds on surgery. What you said in that post is EXACTLY what I was trying to say with my posts - except you said it a lot more eloquently and succinctly than I did.

 

[smq123]

But if there is an intern there, I get to do less. That's just how it works. I understand why it is that way, I just wish I could do more.

When you get to your surgery rotation, you'll find that OB/gyn and surgery are different. The interns on gen surg have more floor work to do, and are not in the OR as much. So, if you're looking forward to stuff to do, that'll be your chance. (Provided that there are no surgical PAs at your program....)