Intern year is terrible

[X.O.]

Going close to the 6 month mark of a surgical prelim year and I feel that that they're taken their pound of flesh and then some.

My chief was "perturbed" that my fellow intern and I always crack jokes on how much we want to off ourselves on rounds every morning.

Sigh another 6 months of abuse and indentured servitude.

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[El Dooderino]

Going close to the 6 month mark of a surgical prelim year and I feel that that they're taken their pound of flesh and then some.

My chief was "perturbed" that my fellow intern and I always crack jokes on how much we want to off ourselves on rounds every morning.

Sigh another 6 months of abuse and indentured servitude.

who woulda thunk it

 

[gutonc]

who woulda thunk it

I'm as shocked as you are. A miserable surg prelim year? Not sure I've ever heard of such a thing.

 

[Doctor4Life1769]

pretty sure it's a vent thread
dude's doing radiology so he's got it made
where's this prelim surg at?

 

[El Dooderino]

pretty sure it's a vent thread
dude's doing radiology so he's got it made
where's this prelim surg at?

If he's doing rads that means he at least has decent numbers, not sure what the logic of doing a prelim surg year is if he wasn't expecting to get his ass kicked

 

[gutonc]

If he's doing rads that means he at least has decent numbers, not sure what the logic of doing a prelim surg year is if he wasn't expecting to get his ass kicked

I've run into this recently as well. A few surg prelims going in to Rads or Rad Onc. When I asked why not an IM prelim year, every one of them said "I hate rounding." I'm not a big fan of endless IM rounds either (although I didn't actually have that experience in my IM program), I can't imagine hating them so much you wanted to throw away a perfectly good year on a surgery prelim.

But different strokes I guess.

 

[jdh71]

I've run into this recently as well. A few surg prelims going in to Rads or Rad Onc. When I asked why not an IM prelim year, every one of them said "I hate rounding." I'm not a big fan of endless IM rounds either (although I didn't actually have that experience in my IM program), I can't imagine hating them so much you wanted to throw away a perfectly good year on a surgery prelim.

But different strokes I guess.

rounds in place of . . . abuse and less sleep . . . hmmmm . . . sounds like a DEAL to me!

 

[2012mdc]

I've run into this recently as well. A few surg prelims going in to Rads or Rad Onc. When I asked why not an IM prelim year, every one of them said "I hate rounding." I'm not a big fan of endless IM rounds either (although I didn't actually have that experience in my IM program), I can't imagine hating them so much you wanted to throw away a perfectly good year on a surgery prelim.

But different strokes I guess.

One of my interns on my surg rotation had matched derm and was doing a prelim surg yr. Don't remember if a he had a reason for not doing a prelim med but he said he didn't want to do TY b/c he thought it was a glorified 3rd year and he hated OB.

I can understand hating long rounds but not more than the terrible hours in surg

 

[badasshairday]

People who are going into rads and are certain they want to go into IR are doing surgical internships.

OP is just venting.

Goodluck OP. Half way done, the home stretch starts now.

 

[X.O.]

This is the most frickin miserable year of life and I'm counting the time I spent a year in the Korean army and my time as a bulge bracket Ibanking analyst. Im near the end of 4 consecutive weeks of nightfloat and this is the most inhumane torture Ive been through. I would club a baby seal right now if I didn't have to answer another page from a nurse ever again.

Anyone that chooses to do categorical surgery has to have a hole in their head and Im at a community program so it could be even worse at a real academic program. If its believable, the medicine interns at my hospital have it way worse than I do. That's saying alot.

My only advice is to avoid doing intern year at a NYC hospital. NYC Fing sucks.

 

[2012mdc]

People who are going into rads and are certain they want to go into IR are doing surgical internships.

OP is just venting.

Goodluck OP. Half way done, the home stretch starts now.

I guess it depends on the prelim year. Where I did my Surg rotation prelims barely got into the OR if at all. I don't think the exposure to surgical management is worth that extra abuse.

I can't imagine a prelim surg yr vs a prelim med yr will give one that much of a upper hand 5 yrs down the line

 

[gutonc]

This is the most frickin miserable year of life and I'm counting the time I spent a year in the Korean army and my time as a bulge bracket Ibanking analyst. Im near the end of 4 consecutive weeks of nightfloat and this is the most inhumane torture Ive been through. I would club a baby seal right now if I didn't have to answer another page from a nurse ever again.

Anyone that chooses to do categorical surgery has to have a hole in their head and Im at a community program so it could be even worse at a real academic program. If its believable, the medicine interns at my hospital have it way worse than I do. That's saying alot.

My only advice is to avoid doing intern year at a NYC hospital. NYC Fing sucks.

Lenox Hill...no doubt in my mind.

 

[enhanced]

People who are going into rads and are certain they want to go into IR are doing surgical internships.

OP is just venting.

Goodluck OP. Half way done, the home stretch starts now.

WOW this could not be further from the truth... there are many people (including myself and a number of my co-residents) who are pretty set on IR and did not even consider a surgical internship.

I realize people do surgical internships out of need or family/spousal situation (i.e. location) but unless you're planning on ultimately going into an actual surgical field you should not even consider it as other than a backup. I just wanted to make sure rads/IR applicants didn't get the wrong idea.

For all of us doing a clinical intern year you should always apply, and rank accordingly, TY>prelim medicine>surgery... also it's worth biting the bullet to do a miserable month of say ambulatory or OB or family med to get 4 months of elective in return.

 

[Smurfette]

Interesting. The rads kids who wanted to do IR did a surg prelim year at my institution...and it paid off for them in that:

1. they got procedure experience
2. we would let them participate with IR procedures on surgical patients when they were interns (assuming they weren't too busy or their co-intern would cover for a short time).
3. They are the 'go-to' people for the interesting cases in IR---surgery residents would seek them out, devise a plan, and they'd get the case over some of the other fellows down there. They much preferred the surgical patients needing something done over the IVC filter/PermCath/tube checks that the medicine teams pushed their way.
4. The experience of thinking along the surgery point-of-view was helpful in some of the problem solving/complex cases they got. I know the IR attendings in particular found this helpful and appreciated it.
5. As a surgery prelim, they got experience with vascular surgery and transplant which are significant users of IR techniques

I think it is likely institution dependent--while a surgery prelim year is not something most rads residents want to do their first year, it could be advantageous to some. I know that those (future IR guys) who did it did not regret it in the least and in general would rather do surgery any day than medicine rounds and clinic....but if you are just thinking strongly of IR but are open to multiple options, it may not be the option for you.

Also, we had a dedicated IR track rads residency program---the surg prelim year was encouraged by the program (and the surg dept was happy to give them a spot for a year...they were always great interns, and they tried to give them rotations that utilized rads and IR more).

 

[badasshairday]

Interesting. The rads kids who wanted to do IR did a surg prelim year at my institution...and it paid off for them in that:

1. they got procedure experience
2. we would let them participate with IR procedures on surgical patients when they were interns (assuming they weren't too busy or their co-intern would cover for a short time).
3. They are the 'go-to' people for the interesting cases in IR---surgery residents would seek them out, devise a plan, and they'd get the case over some of the other fellows down there. They much preferred the surgical patients needing something done over the IVC filter/PermCath/tube checks that the medicine teams pushed their way.
4. The experience of thinking along the surgery point-of-view was helpful in some of the problem solving/complex cases they got. I know the IR attendings in particular found this helpful and appreciated it.
5. As a surgery prelim, they got experience with vascular surgery and transplant which are significant users of IR techniques

I think it is likely institution dependent--while a surgery prelim year is not something most rads residents want to do their first year, it could be advantageous to some. I know that those (future IR guys) who did it did not regret it in the least and in general would rather do surgery any day than medicine rounds and clinic....but if you are just thinking strongly of IR but are open to multiple options, it may not be the option for you.

Also, we had a dedicated IR track rads residency program---the surg prelim year was encouraged by the program (and the surg dept was happy to give them a spot for a year...they were always great interns, and they tried to give them rotations that utilized rads and IR more).

I have had a similar experience talking to rads interns, residents, attendings. IR is a specialty in transition right now.

 

[LADoc00]

I'm as shocked as you are. A miserable surg prelim year? Not sure I've ever heard of such a thing.

reminds me of Casablanca
I'm shocked, shocked to find that gambling is going on in here!
...Your winnings, sir.

 

[enhanced]

Interesting. The rads kids who wanted to do IR did a surg prelim year at my institution...and it paid off for them in that:

1. they got procedure experience
2. we would let them participate with IR procedures on surgical patients when they were interns (assuming they weren't too busy or their co-intern would cover for a short time).
3. They are the 'go-to' people for the interesting cases in IR---surgery residents would seek them out, devise a plan, and they'd get the case over some of the other fellows down there. They much preferred the surgical patients needing something done over the IVC filter/PermCath/tube checks that the medicine teams pushed their way.
4. The experience of thinking along the surgery point-of-view was helpful in some of the problem solving/complex cases they got. I know the IR attendings in particular found this helpful and appreciated it.
5. As a surgery prelim, they got experience with vascular surgery and transplant which are significant users of IR techniques

I think it is likely institution dependent--while a surgery prelim year is not something most rads residents want to do their first year, it could be advantageous to some. I know that those (future IR guys) who did it did not regret it in the least and in general would rather do surgery any day than medicine rounds and clinic....but if you are just thinking strongly of IR but are open to multiple options, it may not be the option for you.

Also, we had a dedicated IR track rads residency program---the surg prelim year was encouraged by the program (and the surg dept was happy to give them a spot for a year...they were always great interns, and they tried to give them rotations that utilized rads and IR more).

I think these are some excellent points, but as far as I can tell the advantages you mention likely only exist in an ideal (possibly theoretical) surgical internship.

My experience is certainly more limited than yours, but from working with surgery prelims (on our PGY1 gen surg rotation) as well as speaking with surgical interns I know at/from med school -- as well as my own surgery rotation during intern year -- i can tell you there is little to no time for procedures as you spend nearly all of your time managing surgery patients on the floor. The OR time/procedures that are available are generally reserved to senior surgery residents then categorical surgery interns (as they should be... it's their field). As for IR procedures, I suppose if you (a). have the time (unlikely) and (b). there are no radiology fellows and/or IR fellows around, you could assist the interventionalist, but these opportunities would likely be few and far between. Furthermore, there's no reason your colleagues wouldn't let you do this as a TY/medicine prelim also interested in IR. For example, I put in more central lines during our ICU rotation than one of the surgery prelims I worked with had all year (zero). This wasn't b/c I had to either, as many of my co-interns did no procedures, it was b/c I wanted to and had the time.

As Smurfette mentions, your actual internship is institution dependent, but I just can't imagine any prelim surgery program that offers enough of these opportunities to offset the significant cost of doing this year over a TY, at least in my mind. Also, you can use your elective time during a TY to do a rads or IR rotation at an ACGME accredited program, which obviously would be the most beneficial.

 

[badasshairday]

I think these are some excellent points, but as far as I can tell the advantages you mention likely only exist in an ideal (possibly theoretical) surgical internship.

My experience is certainly more limited than yours, but from working with surgery prelims (on our PGY1 gen surg rotation) as well as speaking with surgical interns I know at/from med school -- as well as my own surgery rotation during intern year -- i can tell you there is little to no time for procedures as you spend nearly all of your time managing surgery patients on the floor. The OR time/procedures that are available are generally reserved to senior surgery residents then categorical surgery interns (as they should be... it's their field). As for IR procedures, I suppose if you (a). have the time (unlikely) and (b). there are no radiology fellows and/or IR fellows around, you could assist the interventionalist, but these opportunities would likely be few and far between. Furthermore, there's no reason your colleagues wouldn't let you do this as a TY/medicine prelim also interested in IR. For example, I put in more central lines during our ICU rotation than one of the surgery prelims I worked with had all year (zero). This wasn't b/c I had to either, as many of my co-interns did no procedures, it was b/c I wanted to and had the time.

As Smurfette mentions, your actual internship is institution dependent, but I just can't imagine any prelim surgery program that offers enough of these opportunities to offset the significant cost of doing this year over a TY, at least in my mind. Also, you can use your elective time during a TY to do a rads or IR rotation at an ACGME accredited program, which obviously would be the most beneficial.

Makes sense. You guys both have good points. I guess it is about finding a good surgical prelim program. Or it might not be worth it to be totally scutted out. But even if you are scutted it, it could be helpful in that you know basic wound management and some technical exposure that you would miss out in a TY or prelim medicine year.

 

[badasshairday]

I think these are some excellent points, but as far as I can tell the advantages you mention likely only exist in an ideal (possibly theoretical) surgical internship.

My experience is certainly more limited than yours, but from working with surgery prelims (on our PGY1 gen surg rotation) as well as speaking with surgical interns I know at/from med school -- as well as my own surgery rotation during intern year -- i can tell you there is little to no time for procedures as you spend nearly all of your time managing surgery patients on the floor. The OR time/procedures that are available are generally reserved to senior surgery residents then categorical surgery interns (as they should be... it's their field). As for IR procedures, I suppose if you (a). have the time (unlikely) and (b). there are no radiology fellows and/or IR fellows around, you could assist the interventionalist, but these opportunities would likely be few and far between. Furthermore, there's no reason your colleagues wouldn't let you do this as a TY/medicine prelim also interested in IR. For example, I put in more central lines during our ICU rotation than one of the surgery prelims I worked with had all year (zero). This wasn't b/c I had to either, as many of my co-interns did no procedures, it was b/c I wanted to and had the time.

As Smurfette mentions, your actual internship is institution dependent, but I just can't imagine any prelim surgery program that offers enough of these opportunities to offset the significant cost of doing this year over a TY, at least in my mind. Also, you can use your elective time during a TY to do a rads or IR rotation at an ACGME accredited program, which obviously would be the most beneficial.

Makes sense. You guys both have good points.

I guess it is about finding a good surgical prelim program. Or it might not be worth it to be totally scutted out. But even if you are scutted it, it could be helpful in that you know basic wound management and some technical exposure that you would not see in a TY or prelim medicine year. And I am just bringing this point up in terms of somebody interested in IR, as they now admitting priviledges and having some clinic time similar to a surgical subspecialty. If you are going into diagnostic rads, you are MUCH better off at a TY year or at worst a prelim med year. Doing a surgical prelim for a diagnostics guys would be worthless.

 

[Momentum70]

While we are venting, I looked over at my co intern who is also a prelim while rounding today post call. She made a motion of slitting her wrists. I responded with the class gun to head. That about sums up how we feel about our halfway point. Oh joy, only 5 more months of q4 call.

 

[2012mdc]

Makes sense. You guys both have good points.

I guess it is about finding a good surgical prelim program. Or it might not be worth it to be totally scutted out. But even if you are scutted it, it could be helpful in that you know basic wound management and some technical exposure that you would not see in a TY or prelim medicine year. And I am just bringing this point up in terms of somebody interested in IR, as they now admitting priviledges and having some clinic time similar to a surgical subspecialty. If you are going into diagnostic rads, you are MUCH better off at a TY year or at worst a prelim med year. Doing a surgical prelim for a diagnostics guys would be worthless.

Wouldn't a TY with a few surgery months and elective time (for IR, vasc surg etc) be better? Don't have the rough schedule all year but still get the exposure? Or does the full year of surg really make a difference?

 

[badasshairday]

Wouldn't a TY with a few surgery months and elective time (for IR, vasc surg etc) be better? Don't have the rough schedule all year but still get the exposure? Or does the full year of surg really make a difference?

I'm trying to figure that out.

 

[JustPlainBill]

While we are venting, I looked over at my co intern who is also a prelim while rounding today post call. She made a motion of slitting her wrists. I responded with the class gun to head. That about sums up how we feel about our halfway point. Oh joy, only 5 more months of q4 call.

Called a friend from medical school last night who was a year ahead of me -- asked if it was normal to feel like quitting at this point -- she responded that it's abnormal not to feel that way --- I've noticed a certain increase in her DGAF level as a second year ---should've just read this thread ---

Yeah, it really sucks right about now --- I'm just waitin for any form of teaching to be done --- you know, that impartation of knowledge and clinical experience in an actual example at the bedside where nuances and considerations of this particular case are used as teaching points to increase the fund of medical knowledge that's done in a normal tone of voice between two professionals of different levels of experience --- not the screaming,"I can't believe you are not recording BOTH weights and I/Os in a patient with ascites in your daily notes!!! "I don't know" is not an answer" in the halls in front of nurses, patients, patient's families and your peers......or "Since you're too stupid to read the English language, I thought I'd call and spell out my treatment plan since you consulted my service"......

And then these people have the audacity to say they want us to refer patient's back into this particular hospital system after we graduate -- subtext - we need more patient's for our specialists.....I'm thinking of using graduation from a program in this hospital system as a litmus test for whether or not I send a patient to a particular specialist or not --- if you graduated from here -- no way in hell....

 

[jdh71]

For all of us doing a clinical intern year you should always apply, and rank accordingly, TY>prelim medicine>surgery... also it's worth biting the bullet to do a miserable month of say ambulatory or OB or family med to get 4 months of elective in return.

Gah.

I ****ing HATE to hear this attitude in a 'tern.

Mean I totally don't buy the whole "oh surgery internship is the only way to go if you want to do IR", which is stupid. The isolated times when you might be involved little or even more in IR things during internship do not really translate into all sorts of "extra experience" . . . there's a reason radiology is 4 years after internship and normally an extra year or or two of fellowship. So I'm ok with trying not to kill yourself, because the reasoning here doesn't really pan out when you look at it. "Hey we were going to insist on a IR fellowship, but I see here you did a surgical pre-lim!" But going TY so you can work a few hours a day for 4 months is some of the weakest ****ing sauce I've ever heard.

Does my and others work ethic, tolerance for long hours, and want to be a real doctor make me/us better than you? I think so. What?

 

[Labslave]

Does my and others work ethic, tolerance for long hours, and want to be a real doctor make me/us better than you? I think so. What?

Some people have a hard time motivating themselves to be miserable for no long-term career benefit. Period.

That being said, I've told many people on the interview trail this year as I've been giving tours that the culture of a program is infinitely more important than the number of hours worked. I would personally prefer to work long hours and be respected during this time rather than being treated like $hit working 40 hrs./week.

 

[DukeNukem]

Four months? All my top TY ranks have me doing a few hours a day for 5-6 months.

jdh71 can think he's a better person than me all he wants. I won't care what he thinks when I'm off skiing... Or any other time, really.

 

[jdh71]

Four months? All my top TY ranks have me doing a few hours a day for 5-6 months.

jdh71 can think he's a better person than me all he wants. I won't care what he thinks when I'm off skiing... Or any other time, really.

cared enough to post a reply, mentioning me specifically

 

[Llenroc]

I've run into this recently as well. A few surg prelims going in to Rads or Rad Onc. When I asked why not an IM prelim year, every one of them said "I hate rounding." I'm not a big fan of endless IM rounds either (although I didn't actually have that experience in my IM program), I can't imagine hating them so much you wanted to throw away a perfectly good year on a surgery prelim.

But different strokes I guess.

Stupidest thing I ever heard was "I hate rounding, therefore I prefer surgery to medicine." I've done 4 surgery rotations all at different hospitals. Every single one involved more rounding than was the case on a medicine rotation. You come in early at 5 or 6 and pre-round. Then you round with your team before the surgeries. Then in the evening before you go home, the attending will round on the patients. Often times, there are 2-3 different attendings and each will want to round separately on their own patients which makes it even more painful.

Typical medicine rotation you come in at 7, pre round. 9-10 is teaching time. 10-12 are rounds. Then you're done with rounding. I've been doing clinical medicine for 5 years now, and I've never rounded in the evening or multiple times on any medicine/pediatric/etc. rotation, except under the most rare of circumstances.

 

[Labslave]

cared enough to post a reply, mentioning me specifically

Sad to see that you've become nothing more than a troll.

 

[jdh71]

Sad to see that you've become nothing more than a troll.

I'm sad to see you clearly have no clue what you are talking about

 

[2012mdc]

Stupidest thing I ever heard was "I hate rounding, therefore I prefer surgery to medicine." I've done 4 surgery rotations all at different hospitals. Every single one involved more rounding than was the case on a medicine rotation. You come in early at 5 or 6 and pre-round. Then you round with your team before the surgeries. Then in the evening before you go home, the attending will round on the patients. Often times, there are 2-3 different attendings and each will want to round separately on their own patients which makes it even more painful.

Typical medicine rotation you come in at 7, pre round. 9-10 is teaching time. 10-12 are rounds. Then you're done with rounding. I've been doing clinical medicine for 5 years now, and I've never rounded in the evening or multiple times on any medicine/pediatric/etc. rotation, except under the most rare of circumstances.

Well you've had the fortunate experience. On Surgery we pre rounded before 6 and then rounds were 6-7. A few times after clinic we stopped by to see a consult with the attending but we never really rounded after 7. Most of the time we rounded with the chief and not the attending. If the attendings wanted to round they would come and join us, they didn't want to round post-clinic or post-OR either.

On Medicine we pre round before 8. Morning report 8-9. Rounds 9/930 - 12. I've been fortunate compared to my classmates as I've never rounded after noon conference. Some of them have rounded 9-12 and then for another few hours in the afternoon.

My experience is obviously much more limited than yours but maybe it reflects the majority of the experiences across the country

 

[gutonc]

Well you've had the fortunate experience. On Surgery we pre rounded before 6 and then rounds were 6-7. A few times after clinic we stopped by to see a consult with the attending but we never really rounded after 7. Most of the time we rounded with the chief and not the attending. If the attendings wanted to round they would come and join us, they didn't want to round post-clinic or post-OR either.

On Medicine we pre round before 8. Morning report 8-9. Rounds 9/930 - 12. I've been fortunate compared to my classmates as I've never rounded after noon conference. Some of them have rounded 9-12 and then for another few hours in the afternoon.

My experience is obviously much more limited than yours but maybe it reflects the majority of the experiences across the country

I'm with Llenroc. On my surgery rotations, med students would "pre-pre-round" to get vitals and I/Os and quick exam, sometimes with the interns, then "pre-round" with the junior/senior and maybe the Chief, then "round" with the attending. Then "work round" with the intern or junior, then off to the OR, then post-op rounds with either the Chief or the attending (where I'm am now, the attendings round but in med school they rarely appeared after they were done in the OR).

Even on my worst months as an IM resident I would never round for more than 2-3 hours. With one notable attending exception (who was part-time and also on staff at another hospital that didn't have overnight call so always forgot that we had to get out the door by 1 or 2 and wouldn't show up for post-call rounds until 10 or 11 sometimes), post-call rounds were usually done for the team in under 2 hours and the attendings would generally then take the med students back on longer teaching rounds, leaving the residents/interns alone to get work done.

Doing a surg prelim year "because you hate rounding" is just crazy talk. Lots of other good reasons not to do IM prelim, but that's a really bad one.

 

[jake2]

I did a gen surg prelim at a large tertiary care hospital before going into radiology this year. It was in fact the worst period of continuous pain I've experienced yet. I'm planning on going into IR, so I still have to see whether it will pan out as having been useful.

I will say this though, we work pretty hard by radiology standards at the program I'm at now, and my co-residents complain every now and then. After going through a gen surg prelim, every day seems like a glorious gift so I may well be the happiest person in the joint.

 

[Llenroc]

Well you've had the fortunate experience. On Surgery we pre rounded before 6 and then rounds were 6-7. A few times after clinic we stopped by to see a consult with the attending but we never really rounded after 7. Most of the time we rounded with the chief and not the attending. If the attendings wanted to round they would come and join us, they didn't want to round post-clinic or post-OR either.

LMAO. That's because you're a medical student. They send the students to the OR during the day. Meanwhile, the other residents will staff inpatients with the attendings in the afternoon or evening. That is typical, based upon having worked in a lot more hospitals, in a lot more cities than you have.

 

[2012mdc]

LMAO. That's because you're a medical student. They send the students to the OR during the day. Meanwhile, the other residents will staff inpatients with the attendings in the afternoon or evening. That is typical, based upon having worked in a lot more hospitals, in a lot more cities than you have.

Ok I stand corrected about how it is overall across the country

I guess my program is the exception not the rule. We were rarely sent home before the residents (save the chief) and they was very little rounding done after the morning. On OR days, the students who were not scrubbed in on a case would help the prelims take care of stuff on the floors or just chill with them in the lounge. On clinic days we left with them after clinic.

So there are programs where prelim surg interns round considerably less than prelim med interns.

I personally don't think that's enough to make me choose a prelim surg year though

 

[dilated]

LMAO. That's because you're a medical student. They send the students to the OR during the day. Meanwhile, the other residents will staff inpatients with the attendings in the afternoon or evening. That is typical, based upon having worked in a lot more hospitals, in a lot more cities than you have.

"Staffing" inpatients means talking to the attending about them, usually over the phone. It's uncommon to physically round with surgical attendings unless the service has a designated "attending teaching rounds" or it's a really light service with only a few patients. Maybe that was more common years ago or something, but it's not super common now so I would be a little more cautious when you talk about what's "typical" in surgery programs.

 

[95439]

x

 

[X.O.]

Ive got fewer than 80 days left but I'm seriously contemplating suicide every day. I can see how surgical residency can turn the most upbeat person into a basketcase SOB. Sometimes I dream of running my car into a pole so I dont have go in and get tortured again.

Ive got no doubt in my mind that my program would abuse the crap out of me if work hours weren't in place and even then I have to fudge on my work hours or risk getting a beatdown from the PD and chief for entering in my real work hours. It's all a farce.

Just finished a month where I was debriding 2-3 sacral decubs every other day. Really nasty necrotic decubs on immensely fat people. I wish I could scrub my mind with lysol.

Its going to be painful to the very last day.

 

[drblueshades]

Ive got fewer than 80 days left but I'm seriously contemplating suicide every day. I can see how surgical residency can turn the most upbeat person into a basketcase SOB. Sometimes I dream of running my car into a pole so I dont have go in and get tortured again.

Ive got no doubt in my mind that my program would abuse the crap out of me if work hours weren't in place and even then I have to fudge on my work hours or risk getting a beatdown from the PD and chief for entering in my real work hours. It's all a farce.

Just finished a month where I was debriding 2-3 sacral decubs every other day. Really nasty necrotic decubs on immensely fat people. I wish I could scrub my mind with lysol.

Its going to be painful to the very last day.

Sorry to hear how horrible this year has been for you. To state the obvious, I hope you seek help if you're thinking about hurting yourself. I'm only an MS4, but a number of my intern friends have told me they've benefited from speaking with a psychiatrist about PGY-1-related depression and other issues. Can't speak for your program, but are actually psychiatrists at our medical center who will bend over backwards to accommodate a crazy intern/resident schedule.

 

[hot sauce]

Ive got fewer than 80 days left but I'm seriously contemplating suicide every day. I can see how surgical residency can turn the most upbeat person into a basketcase SOB. Sometimes I dream of running my car into a pole so I dont have go in and get tortured again.

I'm sorry to hear you are having such a horrible intern year. As stated by the other poster if you are having SI please get help.

 

[Law2Doc]

...
My experience is certainly more limited than yours, but from working with surgery prelims (on our PGY1 gen surg rotation) as well as speaking with surgical interns I know at/from med school -- as well as my own surgery rotation during intern year -- i can tell you there is little to no time for procedures as you spend nearly all of your time managing surgery patients on the floor. The OR time/procedures that are available are generally reserved to senior surgery residents then categorical surgery interns (as they should be... it's their field). ..l.

Whether you get to the OR as a prelim is totally program dependent. The big academic centers rarely let interns (prelim or categorical) into the OR, while the smaller community hospitals may be doing more operations than residents such that everybody makes it into the OR (even at times when they are scheduled to be doing floorwork) several times a week. The more senior and categoricals get first dibs on the coolest stuff, of course.

 

[Law2Doc]

...
That being said, I've told many people on the interview trail this year as I've been giving tours that the culture of a program is infinitely more important than the number of hours worked. ...

Absolutely true. I've been places where the IM residents were constantly depressed and unhappy and talking about being abused and averaged 60-70 hours/week, while the surgeons all joked around and ribbed each other all day most days, while (on paper) averaging 80. It's all about culture. A good group of people who like to joke around and have each other's backs beats getting out of work a few hours earlier but hating every minute of it. This is something few med students realize when picking residencies, but I suspect if you do a good job of debriefing folks who recently completed intern year, you might be able to get a better picture.

Hours do not equal malignancy. Culture and composition of the residency and their director/chairman is what can equal malignancy. If you talk to enough people you will realize that you can have a 50 hour/week TY be the worst year of your life and a prelim surgery internship which barely stays in compliance with the 80 hour work week be the best.

 

[Labslave]

Absolutely true. I've been places where the IM residents were constantly depressed and unhappy and talking about being abused and averaged 60-70 hours/week, while the surgeons all joked around and ribbed each other all day most days, while (on paper) averaging 80. It's all about culture. A good group of people who like to joke around and have each other's backs beats getting out of work a few hours earlier but hating every minute of it. This is something few med students realize when picking residencies, but I suspect if you do a good job of debriefing folks who recently completed intern year, you might be able to get a better picture.

Hours do not equal malignancy. Culture and composition of the residency and their director/chairman is what can equal malignancy. If you talk to enough people you will realize that you can have a 50 hour/week TY be the worst year of your life and a prelim surgery internship which barely stays in compliance with the 80 hour work week be the best.

Great advice that should be mandatory reading for M4s prior to creating rank lists.

 

[Neuronix]

If you talk to enough people you will realize that you can have a 50 hour/week TY be the worst year of your life and a prelim surgery internship which barely stays in compliance with the 80 hour work week be the best.

I have talked to a lot of people who are going into, are in, and who have done TYs and never once heard a specific example of this often mentioned, but in theory only cush but miserable TY. The only nightmare scenario I have heard specifically is people being hoodwinked into thinking their TY or prelim IM would be 50 hours a week and then it turning into an 80+ hour/week scutfest.

 

[JustPlainBill]

Absolutely true. I've been places where the IM residents were constantly depressed and unhappy and talking about being abused and averaged 60-70 hours/week, while the surgeons all joked around and ribbed each other all day most days, while (on paper) averaging 80. It's all about culture. A good group of people who like to joke around and have each other's backs beats getting out of work a few hours earlier but hating every minute of it. This is something few med students realize when picking residencies, but I suspect if you do a good job of debriefing folks who recently completed intern year, you might be able to get a better picture.

Hours do not equal malignancy. Culture and composition of the residency and their director/chairman is what can equal malignancy. If you talk to enough people you will realize that you can have a 50 hour/week TY be the worst year of your life and a prelim surgery internship which barely stays in compliance with the 80 hour work week be the best.

RTFO -- always, always be suspicious of a program that won't let you alone with interns......no matter the effin' excuse....or that hides the interns....

 

[Jwax]

Doing a surg prelim year "because you hate rounding" is just crazy talk. Lots of other good reasons not to do IM prelim, but that's a really bad one.

Let me re-phrase that to what they really mean. When someone picks surgery over medicine, it isn't rounding that we hate... it's spending 30 minutes rounding on one person.... or spending 30 minutes (or an hour) at 2am discussing a differential when it is abso*fing*lutely obvious the patient is having yet another recurrent COPB exacerbation. Spending ~5-15 minutes rounding on each patient in the wards, with a bit more for ICU pts >>>>>> the time spent on medicine patients. Surgical rounds are great; they're quick, informative, and to the point (except in a trauma icu, then they tend to drag... but for good reason, and I kind of love the TICU so there's that). Medicine rounds made me want to die.

Ive got fewer than 80 days left but I'm seriously contemplating suicide every day. I can see how surgical residency can turn the most upbeat person into a basketcase SOB. Sometimes I dream of running my car into a pole so I dont have go in and get tortured again.

Ive got no doubt in my mind that my program would abuse the crap out of me if work hours weren't in place and even then I have to fudge on my work hours or risk getting a beatdown from the PD and chief for entering in my real work hours. It's all a farce.

Just finished a month where I was debriding 2-3 sacral decubs every other day. Really nasty necrotic decubs on immensely fat people. I wish I could scrub my mind with lysol.

Its going to be painful to the very last day.

Hmm maybe I should get a preemptive psychiatrist so I can have easy access to anti-depressants come November - January of intern year as a categorical surgical 'tern.

 

[Doctor4Life1769]

Better find a psychiatrist outside of your residency program!!!!

 

[badasshairday]

hopefully the OP made it through internship alive.

 

[Law2Doc]

hopefully the OP made it through internship alive.

No doubt he did, only to learn that the ACGME changed the rules for interns such that now the second year is the worst one in residency and he has to pick up the slack for those shorter call shifts the interns now do.

 

[DrBowtie]

No doubt he did, only to learn that the ACGME changed the rules for interns such that now the second year is the worst one in residency and he has to pick up the slack for those shorter call shifts the interns now do.

He's doing Rads so he's probably too busy enjoying his 50 hour work week to post. That and has his face buried in Brant & Helms.