I knew returning to surgery residency would be difficult and challenging. It’s not like I forgot the long hours, the (often) annoying consults, the personalities of different physicians and nurses, and the typical hospital drama. I knew that my free time would significantly shrink from the days when I was pursuing a Masters in Public Health. I knew things would be different.
But no matter how much you think an experience will turn out, the reality is significantly different from what you envision. Sometimes for the worse and sometimes for the better. It’s been three months so far, and over all the experience has left me with mixed feelings.
When I left residency, I was a third year resident – just starting to run a service as the “chief” and yet still dealing with surgical consults on overnight call. On my return, I’ve been propelled into the world of a fourth year resident, the “chief” on each service (ours happen to be trauma surgery and pediatric surgery at our main hospital, and general/vascular surgery at a community hospital). As a third year resident, I often found myself running the service and delegating tasks to an intern during the day and fielding phone calls and calling the chief resident and attending on call during the evenings. It was a career split between ultimate responsibility during days and coverage during nights.
But that’s all changed now. Ultimate responsibility prevails both during the day and at night, although there is always an attending for backup. But for a type A control freak, I sometimes (read: almost always) find it difficult to delegate away all tasks and hope/pray/believe that those tasks will be accomplished on my patients. Overseeing others is incredibly difficult, further compounded by the fact that their mistakes are ultimately my mistakes. I haven’t bothered to ask, but I can only imagine that the interns on service with me get annoyed with my mostly hands-on but occasionally hands-off approach. In addition to clinical responsibilities, surgery, and patient care, teaching occupies a portion of the day as well. In my mind, intern year is about learning how to actually be a physician as opposed to acting like one – and teaching interns how to “be” a physician is significantly harder than teaching medical students how to act like one. Furthermore, teaching second and third year residents how to manage surgical consults can be incredibly challenging when you’ve been “out of the game” for two years.
That said, it hasn’t all been unnerving. Returning to the operating room has been wonderful, although these days I’m not operating much on my current service. I’m no longer the first call for consults; to not be the first person woken up in the middle of the night because a patient in the ER has abdominal pain is basically a gift from baby Jesus. Rejoining the surgery residency “family” on a full time basis has been great too – one’s co-residents do become very good friends considering how much time we all spend together. And I’ve been blown away by how many people have said things like “glad to have you back” or “we missed you” – certainly a good feeling.
I’d be lying if I said I didn’t miss my MPH days – the freedom and the free time. The time to sit and read, to write, to blog, and to work out. Friends and family ask how I can give that all up for a grueling work life/schedule. And try as I might to explain it, there’s really nothing out there that is equivalent to performing a tracheoesophageal fistula repair on a one day old infant or doing a latissimus dorsi flap to reconstruct a woman’s breast after breast cancer surgery. To everyone else, these are just words…