Best clinical / Hands on Residencies?

[Guest]

Anybody know where can they run two rooms still? Seems like its a dying breed.

[Guest]

(04-08-2022, 08:55 AM)Guest Wrote: Anybody know where can they run two rooms still? Seems like its a dying breed.

I don't think it's necessarily a dying breed, I was only exposed to three programs during the last interview cycle- Barrow, Mayo, Carolinas, all three had some attendings running two rooms. Might just seem like that due to where I've been though.

[Guest]

In my experience, it’s more typical than not for spine surgeons to run multiple rooms at the same time, even at east coast programs. Cranial I’ve mostly seen for emergent cases or simple cortical tumors. I don’t think it’s as rare as ppl on this site make it seem. Also not sure why ppl think Mayo, BNI, and Carolina’s are the only places to train. Carolinas hasn’t even graduated any residents? Strange

[Guest]

fuck you all. none of you fuckers care one bit about patient safety. i hope that one day you need a surgeon, and an inexperienced resident operates on you without an attending, and fucks you up real bad--just as how all of you paralyze and kill patients for the sake of your ego, er... i mean "autonomy". fuck you

[Guest]

(04-08-2022, 02:44 PM)Guest Wrote: fuck you all. none of you fuckers care one bit about patient safety. i hope that one day you need a surgeon, and an inexperienced resident operates on you without an attending, and fucks you up real bad--just as how all of you paralyze and kill patients for the sake of your ego, er... i mean "autonomy". fuck you

??? I mean when a surgeon is running 2 rooms, it’s gonna be a senior resident as primary and a junior as assist in each room so hardly an inexperienced resident. Attendings will come in for critical portions, but ya I don’t think it affects patient safety if they aren’t in the room during closing or something.

[Guest]

Yeah we all know residents that have fucked up patients when the attending was not in the room.

[Guest]

So much anger from people who do not understand how operating concurrently works... No attending attempts 2 big whacks with only PGY2 coverage. Most programs guarantee one room to be staffed by a senior/chief resident or fellow. Attendings also prioritize their room case mix such that the critical portions of each room are balanced. For example, tumor attending may have a pituitary room w/ ENT opening/closing with a junior and a meningioma with a senior resident. Same thing for spine attending running an ALIF and large posterior whack room. Also, attendings now all have back-up surgeons.

Moreover, residents at operative powerhouses are NOT handed automatic autonomy their 1st day of PGY2.

Resident autonomy is incremental and earned individually with each attending after you demonstrate ability and safety. The days when the attending is not in the room for critical portion of a big case are basically gone. Any clipping of a moderately complex aneurysm, 3-column correction, or tumor resection adjacent cranial nerves will have the attending at least in room.

Opening/closing are not challenging. You could teach a motivated monkey to do either (most residencies have). Graded autonomy in these 2 areas should be expected at every competent residency program. Besides, the most challenging aspects of neurosurgery occur way before skin incision. The art of neurosurgery lies in the decision making i.e. if/when to operate and what surgery to do if any.

[Guest]

That person unfortunately has no idea what they're talking about, and is likely incompetent and simply displacing their frustrations on others. The poster above is correct. No one untrained is doing surgery unsupervised. What the better programs allow you to do is *give you the opportunity* to learn these skills early, demonstrate you can do them safely under supervision, and then maximize your training by getting more repetitions.

By far the more dangerous and likely scenario is folks graduating from observership residencies after watching for 7 years, selling themselves as a "fully trained surgeon", and then finally being able to do the case as an attending. Unfortunately at that point, you rarely have back up and patients are much more likely to suffer.

[Guest]

The above is true. As an attending you need good senior resident and fellow support to run multiple rooms. Each senior person leads said case and juniors will assist in those rooms. Overall allows for good autonomy at all levels. Smaller programs without fellows and is 1-2/yr cohort the number of rooms running is less important, and in general autonomy shouldn’t be compromised as residents are dispersed in their respective rotations/services, ideally leaving you as the junior alone with the more senior person in a case. Overall I wouldn’t worry too much about this for applicants unless it is a truly slow/low volume program with only handful of “good” cases a week.

[Guest]

(04-08-2022, 06:53 PM)Guest Wrote: That person unfortunately has no idea what they're talking about, and is likely incompetent and simply displacing their frustrations on others. The poster above is correct. No one untrained is doing surgery unsupervised. What the better programs allow you to do is *give you the opportunity* to learn these skills early, demonstrate you can do them safely under supervision, and then maximize your training by getting more repetitions.

By far the more dangerous and likely scenario is folks graduating from observership residencies after watching for 7 years, selling themselves as a "fully trained surgeon", and then finally being able to do the case as an attending. Unfortunately at that point, you rarely have back up and patients are much more likely to suffer.

+1 on this