Second Looks

[Guest]

(01-28-2018, 12:30 PM)Guest Wrote: seems like a great program, and the residents seemed really cool, but being the only guy on call to cover 4 hospitals??? that sounds pretty rough

did a second at Tennessee last year, took call with one of the 2s, we almost never stopped moving - put in a bolt, EVD, and went to the OR twice

he told me that was about par for the course there

i'm tough, but those guys are hardcore

wasn't for me, glad i ended up somewhere else a little more chill haha

i will give them credit though, the 2 ran the show by himself all night, including the cases - the attending just came in, sat in the corner and signed the chart once we started closing

[Guest]

Where was the chief?

[Guest]

I better not be coming in to do subdurals as a chief

[Focus]

the chief shoukd come in for all emergent cases.

[Guest]

(01-29-2018, 04:23 PM)Focus Wrote: the chief shoukd come in for all emergent cases.

Why? If faculty has to come in anyway, and is willing to do the case with a junior, why should a chief have to come in to do their 400th subdural?

[Guest3]

(01-29-2018, 05:02 PM)Guest Wrote:

(01-29-2018, 04:23 PM)Focus Wrote: the chief shoukd come in for all emergent cases.

Why? If faculty has to come in anyway, and is willing to do the case with a junior, why should a chief have to come in to do their 400th subdural?

Definitely wouldn’t want to have you as a resident in my program.  When you get far enough along you’ll understand. For now, you don’t even know what you don’t know.

[Focus]

(01-29-2018, 05:02 PM)Guest Wrote:

(01-29-2018, 04:23 PM)Focus Wrote: the chief shoukd come in for all emergent cases.

Why? If faculty has to come in anyway, and is willing to do the case with a junior, why should a chief have to come in to do their 400th subdural?

Critical cases done in an emergent manner are the ones most likely to have errors. Chiefs bridge the gap between attending and junior resident. They are close enough to the fray to remember the things to check that a junior might not think of. Many attendings are slow to arrive, so they serve to ensure that the patient is being safely handled. The argument that any surgeon ever exceeds the learning value of any surgical case is flawed. You stop learning when you believe you have nothing left to learn from a case. Even when competent, there is the added additional learning opportunities of figuring out how one leads a novice through a surgery. Teaching is a learning opportunity in itself. Learning to run your own OR and handle your own emergencies is a critical skill.

[Guest]

I can't afford to do second looks, nor can I take time off from rotations to do so. It really sucks that certain programs almost require it.

[resident midwest]

(01-29-2018, 10:45 PM)Focus Wrote:

(01-29-2018, 05:02 PM)Guest Wrote:

(01-29-2018, 04:23 PM)Focus Wrote: the chief shoukd come in for all emergent cases.

Why? If faculty has to come in anyway, and is willing to do the case with a junior, why should a chief have to come in to do their 400th subdural?

Critical cases done in an emergent manner are the ones most likely to have errors. Chiefs bridge the gap between attending and junior resident. They are close enough to the fray to remember the things to check that a junior might not think of. Many attendings are slow to arrive, so they serve to ensure that the patient is being safely handled. The argument that any surgeon ever exceeds the learning value of any surgical case is flawed. You stop learning when you believe you have nothing left to learn from a case. Even when competent, there is the added additional learning opportunities of figuring out how one leads a novice through a surgery. Teaching is a learning opportunity in itself. Learning to run your own OR and handle your own emergencies is a critical skill.

couldn't have said it better

[Guest]

(01-30-2018, 11:57 AM)Guest Wrote: I can't afford to do second looks, nor can I take time off from rotations to do so. It really sucks that certain programs almost require it.

I strongly sympathize and agree - I have neither the time nor the money for second looks. Nevertheless, I'm not dismayed by the fact that some programs "almost require" second looks, because I think this reveals crucial information about a particular program's culture.

I'm similarly glad there are programs that: offer more interviews than they are able to conduct; include pimping as part of the interview day; and play games with postinterview communication. 

These programs tip their hands that these are not necessarily places where I want to train as a resident, and I'm tremendously grateful for this knowledge.