Interested in surgery, please post your residency horror stories to dissuade me

[Light at end of tunnel]

Indeed, the devil is always in the details. It would be wonderfully helpful if those with some specific knowledge pertaining to the named programs would chime in...maybe in the other forum/thread or even here if admin is OKwith that.

That being said, my gut instinct is that the issues leading to probation may be related to duty hours rules. I could be 100 percent wrong though and I freely admit that.

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[OTOSwap]

5min per page for the entire shift.
nonstop trauma.
perirectal abscess to drain in ED @2am
never sleep
never eat
never go home
never see sun

Accurate post! Yes, the pages every 5 minutes (even for specialty surgery!), never sleep, never eat, 17 hour days on the regular.

 

[LucidSplash]

Indeed, the devil is always in the details. It would be wonderfully helpful if those with some specific knowledge pertaining to the named programs would chime in...maybe in the other forum/thread or even here if admin is OKwith that.

That being said, my gut instinct is that the issues leading to probation may be related to duty hours rules. I could be 100 percent wrong though and I freely admit that.

I know that for Toledo Jobst it was a combination of things: work hours, poorly structured didactics.

That being said, a program on probation is actually a program that you can be sure is now toeing the line. They are under direct scrutiny and if they don't fix their problems they will be finished. For most programs (including Toledo) it usually results in very positive changes.

 

[Light at end of tunnel]

I know that for Toledo Jobst it was a combination of things: work hours, poorly structured didactics.

That being said, a program on probation is actually a program that you can be sure is now toeing the line. They are under direct scrutiny and if they don't fix their problems they will be finished. For most programs (including Toledo) it usually results in very positive changes.

Absolutely!

Virtually 100 percent of probationary standings are eventually changed to full accreditation in good standing. Programs come and go from the list (something Ive come to see watching the list daily for about 2 weeks now).

Everyone loses if a program shuts down.

Surgical programs are under scrutiny these days bc of congressional oversight being more intense than ever with respect to duty hours. Surgery perhaps more than any specialty is a hands on field, where more hours at hospital essentially equals better skills. Residents actually WANT to stay beyond 80 hours to pick up cool cases, but that sometimes means violating the "technical" rules, while obviously adhering to the spirit of wanting to be the best surgeon one can be.

 

[MediCane2006]

This thread is raising my blood pressure......

 

[Mad Jack]

I once saw a surgeon not eat a meal for six whole hours. It was awful.

 

[Dr.LeoSpaceman]

Even my most horrific day, week or rotation on surgery isn't enough for me to contemplate the drudgery of an "average" day in other specialties.

 

[MediCane2006]

Even my most horrific day, week or rotation on surgery isn't enough for me to contemplate the drudgery of an "average" day in other specialties.

I can't imagine doing anything else. Especially now that I'm in practice and can pick and choose the cases that interest me. It's wonderful to be excited to go to work every day....

 

[MediCane2006]

I'm starting to get an itching for surgery, but according to the MS4's who have done aways, our home GS program is a cupcake compared to others.

Please share some stories you have of residency that demonstrates why the attrition rate is so high.

OK....

So, yeah. Gen Surg residency has gotten easier in the past decade but is still a physically and mentally challenging endeavor that lasts 5-7 years. You will have people lining up to tell you how hard it is, how it crushes your soul, it's abuse, blah, blah.

BUT.

If you like the adrenaline rush of figuring out how to work through a problem on your feet, in real time...
If you love the idea of practicing a skill over and over again, and getting technically proficient, and then getting incredibly good...
If you are kind of a Type A person who likes being surrounded by other competitive high achievers
If y0u relish the idea of being the leader, the quarterback, the person in the spotlight
If you're a person who enjoys personal interactions, making friends, having a "team" that you work with every day

....you may find that no other field really gives you all of that on a daily basis. Don't get me wrong, I liked a lot of fields during third year. I liked the personalities and potential for random weirdness on psych, I loved the diagnostic dilemmas on medicine, I enjoyed the skill aspect of getting good at reading films on radiology, I liked playing with the kids on peds, I loved the adrenaline rush of emergencies in ER and OB. But none of them "fit" like surgery.

(and I'm not your stereotypical "Surgeon", I'm a fairly sensitive girl who likes makeup and dressing nice and loves sleeping in and is fairly lazy most of the time).

My surgical practice right now is pretty unique, but what I love about surgery is that through choosing the right fellowships, I was able to build the exact practice that I wanted, one that combines pediatrics, adults, oncology, big cases, small cases, aesthetics and reconstruction. I got through residency by focusing on the fact that in a few short years I'd have a dream practice and basically be able to do exactly what I wanted every day, and I gotta be honest, it's pretty close to that.

Bottom line, do what you love. Don't let people scare you off. There are thousands of us who are well adjusted, happy, and love what we do. I think that's a good goal to aspire to.

 

[swoopyswoop]

OK....

My surgical practice right now is pretty unique, but what I love about surgery is that through choosing the right fellowships, I was able to build the exact practice that I wanted, one that combines pediatrics, adults, oncology, big cases, small cases, aesthetics and reconstruction. I got through residency by focusing on the fact that in a few short years I'd have a dream practice and basically be able to do exactly what I wanted every day, and I gotta be honest, it's pretty close to that.

What fellowships did you do? Plastics?

 

[MediCane2006]

What fellowships did you do? Plastics?

Yep followed by Craniofacial

 

[OTOSwap]

The goal is to get into the best "fit" program. Just because it is "surgery" can have a not so good fit with personalities and you end up miserable. I know people who loved their surgical residency and others who hated it and talked of suicide (serious).

 

[vhawk]

Without knowing the reasons for probation, it's hard to draw conclusions.

I can speak for one of the surgical programs on that list and say with confidence that it has nothing to do with it being a malignant place or work hours but is because of board pass rates, and in fact its a super benign, family-oriented place.

 

[YellowTurtle]

I can speak for one of the surgical programs on that list and say with confidence that it has nothing to do with it being a malignant place or work hours but is because of board pass rates, and in fact its a super benign, family-oriented place.

care to share which one?

 

[LucidSplash]

This memory popped up in my feed today. I shared on facebook but thought it was appropo to share here. Eight years later, no regrets.

 

[vhawk]

care to share which one?

Not particularly. If you can give me a convincing reason why it would matter to you which one specifically it was I may reconsider though.

 

[LucidSplash]

care to share which one?

Board pass rates are also published. You can try to correlate yourself.

General Surgery Residency Program Pass Rates | American Board of Surgery

 

[JoeBiden69]

I made an account specifically to respond to your "Of all the specialties, the best two at recognizing "sick vs not sick" are EM and general surgery. You never hear any stories of IM or FM finding a patient admitted to surgery on the floor for days who is basically dying and rescued by IM." bit. I can count on both hands the number of times I've been consulted on a surgery patient with vague chest pain (without even an ECG or trop being done) and having had to activate the cath lab. Never mind the dozens of patients who had to be coded and sent to our medical ICU because the general surgery residents don't understand that a pulse ox of 88% in a tachypneic patient is no bueno.

Do yourself a favor - take a walk through the SICU, then take a walk through the MICU, and ask yourself which group is "more sick". Hint: our MICU routinely takes transfers from the SICU. It's not because our RTs or nurses are that much better.

 

[LucidSplash]

I made an account specifically to respond to your "Of all the specialties, the best two at recognizing "sick vs not sick" are EM and general surgery. You never hear any stories of IM or FM finding a patient admitted to surgery on the floor for days who is basically dying and rescued by IM." bit. I can count on both hands the number of times I've been consulted on a surgery patient with vague chest pain (without even an ECG or trop being done) and having had to activate the cath lab. Never mind the dozens of patients who had to be coded and sent to our medical ICU because the general surgery residents don't understand that a pulse ox of 88% in a tachypneic patient is no bueno.

Do yourself a favor - take a walk through the SICU, then take a walk through the MICU, and ask yourself which group is "more sick". Hint: our MICU routinely takes transfers from the SICU. It's not because our RTs or nurses are that much better.

Really? Of everything on this board, that's what made you make an account and attempt to make a meaningful contribution?

Sorry you've had a bad experience with surgery residents. I agree, wherever you are, they sound subpar.

Great first post. Would read again, 10/10.

 

[Winged Scapula]

I can count on both hands the number of times I've been consulted on a surgery patient with vague chest pain (without even an ECG or trop being done) and having had to activate the cath lab. Never mind the dozens of patients who had to be coded and sent to our medical ICU because the general surgery residents don't understand that a pulse ox of 88% in a tachypneic patient is no bueno.

Sounds like your surgery residents suck.

 

[vhawk]

It's hard for me to imagine the surgery resident who neglects to get an ekg. Seems like we must order 10 unnecessary ekgs for every 1 indicated one at least.

But your overall point is well taken. We are not in as good a position to recognize how often other services save our patients as we are to recognize our saves.

 

[LucidSplash]

It's hard for me to imagine the surgery resident who neglects to get an ekg. Seems like we must order 10 unnecessary ekgs for every 1 indicated one at least.

But your overall point is well taken. We are not in as good a position to recognize how often other services save our patients as we are to recognize our saves.

I'm not certain I agree. Does your program not have you discuss complications like periop MI or unplanned intubation at M&M? We do and I can't think of a time that the criticism was we needed medicine to make the diagnosis for us.

Asking honestly. Interested in how M&M is handled elsewhere given my n only =2.

 

[vhawk]

I'm not certain I agree. Does your program not have you discuss complications like periop MI or unplanned intubation at M&M? We do and I can't think of a time that the criticism was we needed medicine to make the diagnosis for us.

Asking honestly. Interested in how M&M is handled elsewhere given my n only =2.

Yeah we do list those and discuss them sometimes. Honestly nowhere that I've been really is medicine the ones intubating urgently or anything unless a code is called on the floor, it's gonna be sicu, staffed by surgery residents.

 

[mimelim]

I made an account specifically to respond to your "Of all the specialties, the best two at recognizing "sick vs not sick" are EM and general surgery. You never hear any stories of IM or FM finding a patient admitted to surgery on the floor for days who is basically dying and rescued by IM." bit. I can count on both hands the number of times I've been consulted on a surgery patient with vague chest pain (without even an ECG or trop being done) and having had to activate the cath lab. Never mind the dozens of patients who had to be coded and sent to our medical ICU because the general surgery residents don't understand that a pulse ox of 88% in a tachypneic patient is no bueno.

Do yourself a favor - take a walk through the SICU, then take a walk through the MICU, and ask yourself which group is "more sick". Hint: our MICU routinely takes transfers from the SICU. It's not because our RTs or nurses are that much better.

The delusions are strong with this one.

 

[kjamess]

The delusions are strong with this one.

I'm sure some hyperbole in that post. But yea I've had the unfortunate experience of being on the receiving end of train wreck transfers from gsurg, or coming across them on consults, so not completely unheard of. But I'm sure it goes both ways. Although not my experience in residency, I came across terrible community IM programs during med school rotations where it wouldn't surprise me if gsurg had to commonly swoop in and save the day.

 

[agranulocytosis]

I made an account specifically to respond to your "Of all the specialties, the best two at recognizing "sick vs not sick" are EM and general surgery. You never hear any stories of IM or FM finding a patient admitted to surgery on the floor for days who is basically dying and rescued by IM." bit. I can count on both hands the number of times I've been consulted on a surgery patient with vague chest pain (without even an ECG or trop being done) and having had to activate the cath lab. Never mind the dozens of patients who had to be coded and sent to our medical ICU because the general surgery residents don't understand that a pulse ox of 88% in a tachypneic patient is no bueno.

Do yourself a favor - take a walk through the SICU, then take a walk through the MICU, and ask yourself which group is "more sick". Hint: our MICU routinely takes transfers from the SICU. It's not because our RTs or nurses are that much better.

Speaking as someone who has experience with both fields, I will say that physicians in both specialties are not immune to misses that were saved by the other. For the sake of efficiency, it's in our nature to create mental short cuts, opening us up to falling victim to things like confirmation bias, etc. The key is knowing our limitations and working as a team for the patient, not to massage our own egos and patting ourselves on the back saying "Look at what those idiots missed." What good does that serve? How can we Physicians as a whole stand up to negative changes in health care (like increasing mid-level encroachment, rising costs of malpractice, administrative control of the way we want to practice, etc) if we fail to even cooperate in patient care?

One of the best clinicians I know (an attending at my Pulm-CC fellowship) is super-capable and decisive, but will always look for something else that he may be missing. He even gets us fellows involved in his inquiry process. Most of the other attendings in the division come to him for 2nd opinions. Humble yet capable and always willing to help. Or as surgeons would say: affable, able and available.

 

[VincentAdultman]

I'm biased because my wife is a Hospitalist but they do seem to be able to recognize "sick vs not sick."

Full disclosure I'm an orthopod so I'm barely a doctor.

 

[Golding]

Wish I could talk about my residency experience without exposing myself, but boy was it a harrowing experience...

 

[TypeADissection]

I'm biased because my wife is a Hospitalist but they do seem to be able to recognize "sick vs not sick."

Full disclosure I'm an orthopod so I'm barely a doctor.

Reminds me of those videos on YouTube: ED vs Orthopedics.
ED: There is a fracture.
Orthopod: Where is the fracture?
ED: In room 12.
Orthopod: *stares at the camera and shakes head*

 

[VincentAdultman]

Reminds me of those videos on YouTube: ED vs Orthopedics.
ED: There is a fracture.
Orthopod: Where is the fracture?
ED: In room 12.
Orthopod: *stares at the camera and shakes head*

"Ay-sis-tol-ee"

 

[Jolie South]

For me, the worst times in residency were when I knew the right thing to do, but my attending disagreed and the patient had a horrible outcome. I am sure this happens in other specialties as well, but maybe the consequences aren't as severe.

There are also just those terrible call nights when you are in the OR with cases all night and just keep getting consults and your junior is a ***** and calling the attending directly without talking to you. Or nurses are actively trying to kill your desperately ill patient that you need to resuscitate so you can operate. I don't think those things happen all THAT often but definitely make you die inside a little.

At the same time, there are highs that I don't think anyone else can feel. Like seeing a patient with peritonitis, taking them for ex lap, patching a perf'd ulcer and having the patient go home in a few days.

 

[epsilonprodigy]

OK OP, you asked, so I'm going to be completely blunt and honest. You will meet people in surgery who will truly shake your faith in humanity. You will not find more depraved human beings than +/- 60% of the attendings I work with (or knew in med school, for that matter.) Surgery changes you. You have to make scary decisions on little to no information. Bowing to accept "responsibility" for **** that you had nothing to do with is seen as a sign of strength by people who have no interest in getting the background facts straight. Sometimes, though, you WILL be responsible for someone's death or injury, and that changes you. You will meet people who inflict pain on those weaker than them compulsively, and this has nothing to do with whether or not they like you. You will not find more horrible human behavior without getting into the realm of sociopathic killers or fascist dictators. To be clear, I'm not trying to be funny.

I am still a junior resident. I am confident in saying that I make a point to treat others well, and succeed >99% of the time. But to say I haven't changed would be a lie. I used to believe that people were truly good at heart. Many of my attendings and chiefs have shown me otherwise.

Believe it or not, I don't say this to dissuade you. I say this because you have to ask yourself if this is worth it to you. Despite all of this, I LOVE to operate, more than I could possibly explain. I am thrilled to go to the OR, even at 3 am when I haven't slept and my blood glucose is 40mg/dl. If you share this, maybe it's all worth it for you, too.

Someone suggested that if you want to be talked out of GS, maybe it's not for you. I beg to differ- I was like you, asking other people, "am I crazy?" But the first time I saw my attending untwist a volvulus and watched the bowel come alive before my eyes, I was hooked. To spin your statement back to you, if you find that you CAN'T be dissuaded, that's something worth listening to.

 

[TraumaLlamaMD]

I can't think of a single attending or co-resident in residency or med school I'd describe as "depraved" - sure, surgeons have a reputation for tough love, but I'd venture that most places aren't full of sociopaths out to make people miserable for fun. If I get a comment that seems harsh, it's instructional at its core rather than baselessly antagonistic. You'll encounter your fair share of hotheads and people with just plain poor social skills (and honestly, these personality types are there in other specialties too), but I can't imagine a work environment where I felt like half of my coworkers and supervisors were actively trying to cause me pain.

I don't know what the culture is like where you are, but I don't want OP or other readers to get the impression that it's at all normal for a surgery residency to be staffed by 60% evil human beings.

 

[epsilonprodigy]

Please understand that in no way did I intend to make implications about any surgeon-or person, for that matter- whom I don't know. As for the ones I do know, well- as my post implies, I haven't been too impressed with most of their conduct. There are a very small minority who are wonderful. My co-residents and I cling to these people for dear life. Without them, not only would we go completely "Lord of the Flies," but I'm convinced that none of us would learn how to operate! I only hope that I can be such a person to my residents someday.

Idid go into surgery knowing that my personality probably wasn't a match for most of those I'd encounter. But I reasoned that if my primary goal was to work with nice people, I could take back my college barista job. Nobody likes dinguses. Even dinguses don't like other dinguses. So I didn't base my decision on what I saw, and I don't regret that. It's nice to hear that this isn't "normal," I guess- although it makes me scratch my head and wonder how all these programs full of happy, well-adjusted surgeons escaped my radar, not once, but twice!


Sent from my iPhone using SDN mobile

 

[Winged Scapula]

Please understand that in no way did I intend to make implications about any surgeon-or person, for that matter- whom I don't know. As for the ones I do know, well- as my post implies, I haven't been too impressed with most of their conduct. I did go into surgery knowing that my personality probably wasn't a match for most of those I'd encounter. But I reasoned that if my primary goal was to work with nice people, I could take back my college barista job. Nobody likes dinguses. Even dinguses don't like other dinguses. So I didn't base my decision on what I saw, and I don't regret that. It's nice to hear that this isn't "normal," I guess- although it makes me scratch my head and wonder how all these programs full of happy, well-adjusted surgeons escaped my radar, not once, but twice!


Sent from my iPhone using SDN mobile

I'm not sure most residency programs (or any business) , regardless of specialty are "full of happy well adjusted people". But I agree with others: depravity would be rare. So much so that I would have to question what's really going on and if it's just that you interpret things differently than most (and hence might see it in ANY residency and ANY specialty).Do you mind giving specific examples?

I was quite open about some of the dinguses in my program although their psychopathology ran toward passive aggressive than sociopath.

The OP should know that your experience is not typical and that we spent a lot of time trying to discourage you from surgical training.

 

[Light at end of tunnel]

OK OP, you asked, so I'm going to be completely blunt and honest. You will meet people in surgery who will truly shake your faith in humanity. You will not find more depraved human beings than +/- 60% of the attendings I work with (or knew in med school, for that matter.) Surgery changes you. You have to make scary decisions on little to no information. Bowing to accept "responsibility" for **** that you had nothing to do with is seen as a sign of strength by people who have no interest in getting the background facts straight. Sometimes, though, you WILL be responsible for someone's death or injury, and that changes you. You will meet people who inflict pain on those weaker than them compulsively, and this has nothing to do with whether or not they like you. You will not find more horrible human behavior without getting into the realm of sociopathic killers or fascist dictators. To be clear, I'm not trying to be funny.

I am still a junior resident. I am confident in saying that I make a point to treat others well, and succeed >99% of the time. But to say I haven't changed would be a lie. I used to believe that people were truly good at heart. Many of my attendings and chiefs have shown me otherwise.

Believe it or not, I don't say this to dissuade you. I say this because you have to ask yourself if this is worth it to you. Despite all of this, I LOVE to operate, more than I could possibly explain. I am thrilled to go to the OR, even at 3 am when I haven't slept and my blood glucose is 40mg/dl. If you share this, maybe it's all worth it for you, too.

Someone suggested that if you want to be talked out of GS, maybe it's not for you. I beg to differ- I was like you, asking other people, "am I crazy?" But the first time I saw my attending untwist a volvulus and watched the bowel come alive before my eyes, I was hooked. To spin your statement back to you, if you find that you CAN'T be dissuaded, that's something worth listening to.

Wow

 

[deleted547339]

I'm not sure programs (or any business) are "full of happy well adjusted people". But I agree with others: depravity would be rare. So much so that I would have to question what's really going on and if it's just that you interpret things differently than most (and hence might see it in ANY residency and ANY specialty).Do you mind giving specific examples?

I was quite open about some of the dinguses in my program although their psychopathology ran toward passive aggressive than sociopath.

The OP should know that your experience is not typical and that we spent a lot of time trying to discourage you from surgical training.

Eh, I would say that I knew at least a couple borderline sociopathic surgeons (and at least one true sociopath) at the hospital at which I did residency and a few more where I'm doing fellowship. That being said, some of the surgeons at both my previous and current institution were also the nicest people in the hospital.

 

[Winged Scapula]

Eh, I would say that I knew at least a couple borderline sociopathic surgeons (and at least one true sociopath) at the hospital at which I did residency and a few more where I'm doing fellowship. That being said, some of the surgeons at both my previous and current institution were also the nicest people in the hospital.

Sure we probably all did.

But Epsilon described his medical school and residency faculty as pretty much all being that way which makes it a bit more unusual.

People in medicine are weird, surgery is not alone in that.

 

[deleted547339]

People in medicine are weird.

Truer words have never been spoken on SDN.

 

[Light at end of tunnel]

Sure we probably all did.

But Epsilon described his medical school and residency faculty as pretty much all being that way which makes it a bit more unusual.

People in medicine are weird, surgery is not alone in that.

Does medicine make people weird, or do you suppose weird people go into medicine?

 

[bashwell]

Does medicine make people weird, or do you suppose weird people go into medicine?

Yes.

 

[Buzz Me]

I thought I'd experienced terrible hours, countless attending beatdowns and a malignant program when I was a general surgery resident.

Then I started fellowship.

 

[bannie22]

I was in a Whipple as an intern with an attending and a chief resident. Didn't even staple skin (let the med student do it), and with a bookwalter retractor I was basically just an observer - I logged it as first assist even though I "technically" could have logged it as surgeon junior.

The other annoying thing about the case log system is that if a 3 walks a 1 or a 2 through a case, the 1/2 can only log it as surgeon junior if the 3 doesn't log it.

OK OP, you asked, so I'm going to be completely blunt and honest. You will meet people in surgery who will truly shake your faith in humanity. You will not find more depraved human beings than +/- 60% of the attendings I work with (or knew in med school, for that matter.) Surgery changes you. You have to make scary decisions on little to no information. Bowing to accept "responsibility" for **** that you had nothing to do with is seen as a sign of strength by people who have no interest in getting the background facts straight. Sometimes, though, you WILL be responsible for someone's death or injury, and that changes you. You will meet people who inflict pain on those weaker than them compulsively, and this has nothing to do with whether or not they like you. You will not find more horrible human behavior without getting into the realm of sociopathic killers or fascist dictators. To be clear, I'm not trying to be funny.

I am still a junior resident. I am confident in saying that I make a point to treat others well, and succeed >99% of the time. But to say I haven't changed would be a lie. I used to believe that people were truly good at heart. Many of my attendings and chiefs have shown me otherwise.

Believe it or not, I don't say this to dissuade you. I say this because you have to ask yourself if this is worth it to you. Despite all of this, I LOVE to operate, more than I could possibly explain. I am thrilled to go to the OR, even at 3 am when I haven't slept and my blood glucose is 40mg/dl. If you share this, maybe it's all worth it for you, too.

Someone suggested that if you want to be talked out of GS, maybe it's not for you. I beg to differ- I was like you, asking other people, "am I crazy?" But the first time I saw my attending untwist a volvulus and watched the bowel come alive before my eyes, I was hooked. To spin your statement back to you, if you find that you CAN'T be dissuaded, that's something worth listening to.

amazing post. absolutely true. this should be stickied.

"but to say i havent changed would be a lie"

we all know you change when ur a surgery resident. and def not for the better.
some try to stay nice. but

dont worry, you will change for the worse.

yet if u love what u do. its ok.
hey man, at least u love what u do.
i used to. maybe i dont get to do it now. hopefully sooner rather than later...