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Hey all - I haven't seen this discussed elsewhere, thought it would be nice to hear from people with positive experiences.
I was able to do my home Sub-I during 3rd year, leaving me open for an away rotation in July. Anyone have any tips on finding the balance of being a stellar Sub-I, while not butting heads with the interns who are just as green to the program?
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This is a good question and a tough one because often interns will sap tasks that at other times might be given to a subi. The biggest this is to be patient and deferential. Do not upstage an intern unless asked a question directly for example. Interns can often be the most social as theyre more used to med students than doctors, but in general I would focus on spending time with senior residents and helping with their duties as interns will be grateful for help but need to learn to do it themselves and frankly dont tend to have much influence with the match.
Interns and junior residents are often overworked and stressed. Finding activities to occupy a sub I or supervising their work takes mite effort for them than working solo.
If you know how to be helpful but also give residents space when appropriate you will be well thought of. You don't want to be an annoying "in your face" sub I. Also don't want to be passive and clueless. Striking the balance is the name of the game
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The advise I always give to SubIs is to hang with the more senior residents. Chiefs are often busy, as are the juniors and interns. The mid-level and seniors are usually the best to scrub with. They often have more leeway with the attendings and will be at the very least opening and closing by themselves if not doing most of the case. And so you can scrub with them and get a good amount of experience assisting or even being talked through opening or closing a case. At the very least thats what I've tended to do with SubIs or med students that have rotated through my program. Towards the end of the day, check in with the juniors to make sure you cant help see a consult or help out in some way. The only real downside to having fresh interns is that you may not get to do that many procedures or EVDs etc. Otherwise there should be plenty of work to go around for SubIs.
I'm a junior resident now. But I remember specifically when doing my sub I's that I found it most exciting/educational to do call with junior residents as opposed to more senior residents (if that given program has senior residents take in house call) [however I do agree that day-time is best to cover elective cases with senior residents who are more likely to let you do more in the OR]
On call, senior residents with their increased confidence and independence often just quickly dealt with all issues that arose in a second nature sort of fashion without having to think through it. And so those call nights ended up being the most uneventful. Finding work for me to do would actually slow things down for an efficient senior resident
The juniors are still working on how to triage, and think through even common issues. I found that they tended to talk out loud their reasoning and justify their decisions and were more grateful for my help and novice second opinion on things.
Your Sub-I experience will have a lot to do with the procedures and culture at the program. So hanging with a certain group or doing certain things is not necessarily under your control. Be hard working, eager to help and above all humble. Main goal of your Sub-I should be to see if this is a good fit for you. Pay special attention to interactions among and between residents, attending, chair, staff, etc. Another goal for you is to increase your chance of matching at the program. Study and pick a couple of attending whose work or status interest you and ask them to scrub in on their surgeries as often as you can. Be prepared to answer questions and also engage with them and ask them questions. Try and get a meeting with the chair and/or the PD if possible. Be visible to the PD & the chair.
