“What’s the difference between God and a surgeon? God doesn’t think He’s a surgeon.”1 Jokes like these are very commonplace; they poke fun at the notion that surgeons are arrogant, overconfident, and mean.
As a fourth year medical student going into general surgery, I have been told by my classmates, residents, and attendings that I am “too nice” to go into surgery. I would awkwardly laugh it off, not showing my frustration and confusion. Why does everyone think surgeons are mean? Surely, people can’t take one bad experience and blanket it onto an entire group of people? Internally, I would immediately get defensive—it doesn’t feel good when people insult your colleagues and friends, especially without any basis. My experiences with surgical residents and attendings have been extremely positive, and this was a contributing factor to me deciding to pursue a surgical career. After a couple of these comments, I vowed to make every effort I could to shatter this negative stereotype of all surgeons being mean—not only to minimize this unfair view of myself and my colleagues, but also to prevent aspiring medical students from being scared or hesitant to pursue surgery.
Every medical specialty has some sort of “stereotype” about them. These are usually made from one medical professional to the other, in good fun. However, it seems the stereotype that surgeons are mean and arrogant is more serious, and is engrained in the minds of medical students, residents, and attendings from all specialties. It is so serious that I have had M1s to M3s ask me, “Is it true that most everyone is mean? I’m interested in surgery but maybe I should start thinking about something else.” One internal medicine attending told me, “It’s a shame you’re going into surgery and not medicine. Your personality is great.” These kind of remarks illustrated to me that there is a deeply rooted stigma in our field.
Medical students throughout the years have fueled this stereotype by exchanging “horror” stories from their surgery clerkships. Outright abusive behavior towards medical students has greatly declined, however, so why does this stereotype still exist? From discussion with my fellow medical students, it appears that surgeons are more likely than other specialists to be rude, scold students, or pay little to no attention to them. While I disagree with this, it seems the story of a few has become the story of the many. The negative stories about surgeon interactions have been propagated throughout the medical community, making surgery the most notorious specialty. People don’t need to have a bad experience anymore—it’s assumed, unless proven otherwise, that surgical residents and attending are unfriendly and mean.
My Experiences as a Medical Student
The experiences, mentorship, teaching, friendship, and advice I received from my surgery residents and attendings were great. In fact, these positive experiences were part of the reason I decided to pursue surgery.
I spent most of the time on my surgery rotations with my residents. My favorite residents were the ones who included me as part of the team and gave me work to do or patients to follow so that I could be involved. As I progressed throughout my clerkship and then my electives and sub-internships, I appreciated that the residents would hold me responsible for certain patients or tasks. It showed me that they trusted me and were willing to share the responsibility and privilege of taking care of patients with me. By making sure I was invested in my patients, they furthered my education, improved my clinical skills, and expanded my knowledge of disease management.
Another reason I appreciated my residents was because of how interactive they were in the operating room. The awesomeness of the OR was what originally attracted me to surgery. From closing port sites and lacerations and placing PEGs to driving the camera during a laparoscopic case, being involved in the OR gave me the ultimate sense of accomplishment and happiness. Having residents that wanted, and expected, me to participate in the OR made me feel much more comfortable as a learner—I knew that I could ask about different anatomical structures and parts of the procedures, and that they would help me work on my suturing technique and give me the honest truth about how my skills were progressing.
The surgery residents I worked with were also great teachers. Even amidst their crazy number of consults and OR cases, they would find time to teach me something. Whether it was a more formal lecture about colorectal cancer during some down time, a quick quiz on the workup and indications for a cholecystectomy before a case, or a “What Do You Do Next” about a trauma situation during lunch, they always tried to find something to teach me about. They ensured that my days on the floors, in the OR, or in the clinic were always supplemented with didactics.
The most important thing that my residents did for me was be friendly. We would sit together for team breakfast and lunch and talk about family, weekend plans, and our cute dogs. They would invite me along for a midnight snack during trauma calls and swipe their badge for me at the cafeteria because they had enough stipend left. They created a comfortable learning environment for me, which encouraged me to ask more and learn more. I wasn’t treated like “an annoying med student.” Instead, I was treated as a colleague and friend. I never dreaded going into work the next day because I knew I would be working with a great team.
Attendings illustrate the result of years of dedication, learning, and hard work. I am continually in awe of my surgical attendings and strive to emulate them. The attendings I admired and learned from the most were the ones who treated me similarly to my favorite residents: by including me as part of the team, giving me responsibility, teaching, and treating me like a colleague and friend.
My surgery attendings always made an effort to learn my name, ask what I was interested in, and involve me in patient care. During complex cases, like transanal pull-throughs for Hirschsprung’s or Whipples, they would point out important anatomy and describe the various steps of the procedures. They would expect me to read before each case and know about the patients, and ask relevant “pimp” questions during the case to reinforce the reading I had done. My attendings would answer any questions I had and give me the opportunity to work on suturing, tying, and other skills while giving me constructive criticism on ways to improve.
Some of the most valuable lessons my attendings taught me was ways to handle failure and disappointment. They were honest and candid about the obstacles they faced throughout their careers, whether that be enduring a rough call schedule for years on end, having a complication from a case, deciding when to start a family, or really tough patient deaths. Each attending had his or her own wisdom to impart on me, and I am grateful that they were willing to share it.
Ways to Smash the Stereotype
At all hospitals and on all services, I have had such a great surgical experience as a medical student. I get infinitely frustrated when people tell me, “you’re too nice to be a surgeon” and “surgeons are mean.” There are always a couple bad apples in the bushel (as there are in every specialty and career path). As a future surgeon, I am going to make sure that my medical students, residents, colleagues, ancillary staff, and patients know that surgeons are some of the most dedicated, caring, and encouraging people in the medical field. The field of surgery is truly amazing and surgeons work immensely hard to earn the privilege of operating on the human body. My residents and attendings have so much devotion to their patients and truly care about making the world a better place—it’s time that we, as surgeons, smash the stereotype that surgeons are mean and shed light on the true nature of surgeons.
When I am a resident and an attending, there are a few pearls I will try my hardest to follow in order to lessen the stereotype. These are based off the positive experiences I’ve had and my conversations with other students about the best learning environments.
- Acknowledge the student and get them involved: learn the name of the student and use it often, find out what they would like to gain from the rotation or experience, and give them clinical responsibilities appropriate for their level
- Be open to answering questions, teaching, and giving advice
- Don’t be rude to other specialists and ancillary staff: whether in the OR, seeing a consult, working in a research lab, in a multidisciplinary meeting, during a trauma… we may feel tired, overwhelmed, and frustrated, but need to always make an effort to be respectful and kind
- Show your human side, bring your personality out at work: we aren’t robots!
- Provide mentorship for those who are earlier in their career and need guidance and support: if you do not have enough time to be a formal mentor, you can still provide valuable bits of information to those trying to start or extend their careers
- Tweet, Instagram, email, text, blog, write: when I joined the surgery twitter world, I was shocked at the amount of welcome and support I received; social media is a great way to find/give mentorship and encourage people to succeed
- More surgical residents and attendings need to win teaching awards
- Be open to working with premed and high school students
- Encourage your surgical colleagues and hold them to a high standard: don’t sit back and let a colleague mistreat or be rude to a student or staff member
- Be aware that there are always impressionable people watching you
- Illustrate how great you are through your patient interactions: our ultimate goal is to provide the best care for our patients
- Remember that it is a privilege to be a surgeon and advertise how awesome it is!
- Surgeon Jokes Never Go Out Of Style! The Happy Hospitalist. https://thehappyhospitalist.blogspot.com/2010/08/surgeon-joke-of-day.html. Published August 2010. Accessed April 14, 2018.