bruh

I'm very happy to hear that you almost never experience days where people are in a bad mood or on edge, but that has not been my experience or my colleagues who I am close to. I am not exaggerating when I say at least twice a week I encounter a miserable OR atmosphere. I'm not a whiny soft little kid to think any time someone is being direct they're being jerks. I think some people get acclimated to the assholes in the OR. Even I think I'm getting used to it. Also, I see the staff surgeons sometimes befriend the tough nurses so they can be on their side and not deal with their BS. I've also seen complete denial and shrugs from those who are toxic themselves. If you asked the moronic jerk whether they think there is toxicity in the workplace they'd just look at you with disgust and tell you "what?? no, I have no idea what you're talking about". I have had friends of mine bring up these issues to their senior residents or staff and were fully dismissed as hearsay/false news. My point is it's not a good idea to downplay the fact that there is a lot of toxicity, unhealthy, unkind behaviour in surgery. Maybe I'm living in a different reality, which I might be because I did most of my surgery and sub surgery rotations in a level 1 trauma centre with notoriously intense staff. But my experience is absolutely real - for me and many of my classmates toxicity in surgery has not been rare at all. But you are in Mac, which I have heard has really good healthy culture even in surgery, so it's possible that there truly is a huge divide in our experiences.

I use minoxidil and had the exact same problem as some of you. Hair looked oily and even more thin and bald when I applied the minoxidil. What I did was use it after work and again before bed. Also at times, I only used it once and it still did the trick. I don't even use finasteride lol. After about 4 months I grew enough hair on my head that I was cool with using it in the morning because even with it looking oily it looked great lol So just do it after work for now, then once you see results you should be able to do it in the morning because it'll look fine. Also, on surgical rotations you are wearing a scrub cap anyways so you can use it in the morning too. Also on weekends you can use it in the morning too. Let me know if you have any more questions!

I definitely may have had a bias as someone interested in an intense surgical specialty. Also, I did most of my rotations in notoriously busy level 1 trauma sites known to have very intense environments. Those factors definitely played a huge part in my perception of the field, which is definitely disappointing because it makes me question my choices. Maybe training in other cities, or different sites is different, but how am I going to get exposure to that unless I commit my elective time to those experiences? I will say, however, that my experience in peds, psych, and IM was vastly different. There is so much more kindness and positivity in those specialties than you find in surgery.

While I agree it is very important to have thick skin and ignore all the negativity, that one loud angry voice is the one that fosters a negative environment not just for the med student but everyone involved in the OR, including the staff surgeon. The other day I was in the OR, and while watching the surgery and not doing much, I figured I'd just reflect on the atmosphere. The circulating nurse was a truly terrifying presence. Every other nurse was a slave running around, nodding and bowing to her while getting yelled at and spoke to like they're lesser human beings. The residents got sighs and eye rolls from her, and the staff surgeon got passive aggressive comments. Everyone was tense, everyone spoke and moved in calculated ways, thinking if they will be punished for it. What a miserable environment... I just wanted to break out of character for a moment and ask the nurse "why do you have so much anger and resentment? Why do you have such a persistent frown on your face? have you never experienced love and kindness in your life?". Granted, this only happened in that OR and the rest of the days were more positive experiences. But the job as a surgeon is already tough, the hours are already long and there is already so much you're responsible for. The only thing we do have a control of is our attitude, manners, and the way we treat other people. It's disappointing to see so much toxicity in our field, and all we do is stay "strong and have thick skin" when in reality I don't think that make us any happier in life - I'm not surprised to see that many strong, resilient residents are unhappy in surgery.

I've heard the military training analogy and can now really appreciate how it truly feels to experience it. At least in military training the bonds you develop with your peers are unmatched to any other field, or so I've heard. To me, the worst outcome of all of this is that competent, amazing people who want to become surgeons are choosing to not pursue it because of the toxic culture. I know of many of my classmates who gave up on surgery solely because of this and now they're in a limbo of uncertainty about what to do with their life, or have chosen lifestyle specialties over their career ambitions because they lost the passion they had when they started medicine - sadly I may be one of those people come CaRMS time.

I'm an MS4 who just finished clerkship. I've wanted to apply to a very competitive specialty since the beginning of med school but I'm having serious doubts about that now. I used to frequent premed101 a lot as a premed and really appreciated some of the advice and help I got on here. I owe a lot of my knowledge during my premed journey to the likes of rmorelan and others who kept me informed. So, I wanted to return the favour in some form to the rest of you premeds. I want to share a few things that I wish I had known before I started medical school. I'll preface that this post may come off cynical, negative, or resentful but that truly isn't my intention to paint that picture. I just want to inform you in the most truthful and honest way before you get yourself into this field. PART 1: Your AGE does matter As someone who started med school in their late 20s, I was constantly told that age doesn't matter, and I should do the career that makes me the happiest. There is truth to that, because I still am happy I chose medicine and I wouldn't trade it for anything else. But, age DOES matter. I'm going to start residency in my early-30s and I always wanted to pursue a competitive surgical specialty. But my priorities in life are changing. Do I really want to spend the next 6-8 years of my life working 80+ hours a week making less than $10 per hours with 300K of debt? Do I really want to sacrifice the valuable time I spend with my family, friends, and self-care for a job? This is something that you will start to to think about even if you don't right now - because your priorities in life will change as you age, and you need to develop the insight now to predict your later priorities. That kid in you who really wanted to be a top-notch surgeon is gonna want to settle down at some point, focus on family, friends, and kids. If you're interested in family medicine, then age really doesn't matter. FM residency is only 2 years (3 in a few years!) and warrants you a good lifestyle. PART 2: You will work harder than ever, and that's the easy part. The TOXIC CULTURE is the hard part. I'll preface this point with the fact that I received outstanding or exceeds expectations evaluations on all of my clerkship rotations. So, working hard wasn't something I struggled with, and trust me you'll learn what working hard really is. You'll do 26h call shifts with no sleep every 4 days on some of your rotations. At my university, the culture is doing 1 in 3 26h call shifts if you really want to pursue the specialty. But that's really the easy part. All you have to do is guzzle down coffee like a junkie, stay awake, don't complain, and do your task. What has really surprised me isn't the work expectations, but the toxic culture and environment I'm immersed in. One of the best things I heard in all of clerkship was from an OB resident who told me "Medicine is a shit funnel. Shit rains down from the top, and you can either pass it down like a funnel, or you can be an umbrella and stop it". I've resonated with that statement so many times. The unfortunate truth is that you will always encounter shit funnels through your training. Sometimes, it's the nurse who's only enjoyment in life is belittling med students. Sometimes, it's the staff physician who had it really rough as a resident so they can't bare seeing you happy. I guess I've just learned that I value kindness more than I thought I would. You will experience kindness too, but unfortunately it's the unkind moments you'll remember more. I do think that the culture is slowly shifting in medicine. Most current residents and new attendings are kind, and truly are part of the change in the system. I hope that in the coming years, we will see the culture in medicine truly change for the better. PART 3: Academic medicine will paint a POOR REALITY of medicine for you You will spend most of your time in medicine in academic sites with academic physicians. This is inclusive of medical school and residency. This is even more pronounced if you are in a large metropolitan city like Toronto. You will live a reality that is niche, specific, and wholly different from all the different realities that exist in the field of medicine. Most people will not pursue academic medicine, and that is something that you don't really take in because you don't even know what community medicine is like. My best advice is to maximize your community medicine experience. The best decision I made in medical school was doing as many community sites as possible, and they have been some of the best experiences for me. Academic medicine is important too because it exposes you to more complex and difficult presentations, level 1 traumas, and superb teaching and research opportunities. Those are important too, but it comes with the caveat of often being more intense, busy, and alienating for med students. When you work in academic sites, you will get to do less as a medical student/junior resident and are more often the observer than doer. This also lends itself to a less welcoming environment for med students. You will see cool cases for sure, but all you can do is observe and learn, which is cool but likely inconsequential because most graduates don't do academic medicine anyways. My point is that med school didn't really show me what I want to do with my actual career. It made it confusing for picking a specialty because my experiences were specific to the sites I did my rotations in. You'll notice this when your classmates start having such vastly different experiences depending on the sites they were at. PART 4: You will discover your TRUE IDENTITY in medicine This is probably the most meaningful thing I learned in medical school. I have personally developed more than I ever had during my time in med school. The intensity of med school, the vast career options available to you, and the constantly changing environment continuously makes you re-evaluate your identity. You will make great friends in med school and develop close bonds. You will start focusing on other parts of your identity that you never even appreciated were part of you until med school. Suddenly, your only dream of just being a doctor becomes a lot more nuanced. You will realize how valuable your time with your family, friends, and yourself is. This applies to most people. For some people, they discover that medicine is really all that they dreamed up to be. Their passion of being a physician and treating patients becomes reinforced. They study, work, and research harder than everyone else, and don't need as much emphasis on other aspects of their social life. Those people will become neurosurgeons and cardiac surgeons. This is not something that you really take in until later. Most people start medicine tantalizing themselves with the idea of becoming some world-renowned doctor then they learn how much they value other parts of their identity - this applied to me and many many of my friends in medicine. BOTTOM LINE: All of the above will both help and confuse you in CHOOSING A SPECIALTY to pursue The bottom line is that you will develop personally through medical school. You will experience so many things. Some you enjoy, some you loathe. You will make some amazing connections, but also some hurtful ones. These experiences will help narrow down how you want to live the rest of your life, but they will also confuse you if you're passionate about medicine AND your personal life. Residency is long, and for the surgical specialties, there is always stories of people who drop out, transfer, or are unhappy throughout. So, yes, there is a light at the end of this tunnel, but sometimes the tunnel is too dark and too long to be worth it. Don't think that just because you're a strong, resilient person, you are immune to the rigours of medicine. There are a lot of resilient, brilliant people in medicine, and all of us get tested in this journey. If you think that you will be happy as a family physician, then you likely won't have as much of a quarter-life crisis as the ones who want surgical specialties. You just have to get through med school and a short residency which will warrant you a more relaxed and comfortable life. However, if you are someone like me who has always wanted to be a surgeon, your values and ideals will be challenged greatly, and you should know this now so that you are prepared for what lies ahead. Overall, I do not regret pursuing medicine, and wouldn't have it any other way. There are beautiful moments when I get to help a patient and make a difference. I just wish I knew more and was prepared for what lied ahead.

I wouldn't talk about an abusive relationship. As much as you wish the reviewers to be unbiased and free of stigma, we can't be sure of that. Abusive relationships are sensitive areas, and usually involve complexities that someone without knowing you personally would have a difficult time truly understanding the experience. I'm really sorry you went through this, but speaking about your experience with your baby cousin would be meaningful and safe (from stigma).

As stated above: - do an elective at U of T with one of the big name IM committee members. - Get in touch with IM residents ASAP to set up connection, shadowing, research - If you are not too far from Toronto, try to set up shadowing with residents/committee members before 3rd year starts. You won't have time to travel to Toronto for shadowing in 3rd year (except maybe during christmas/march break). - Maximize your research and show passion. Submit some abstract, present at some conferences - again make connections with UofT IM docs

I urge you to dig deeper into the details regarding the record of this. Is the record not being on the transcript unique to just you? If the faculty has somehow rescinded the violation in some way then you may be right to not disclose this. It is odd for an academic integrity violation to not be on your record, so I think the truth is that it IS on your record as a student but just not on your transcript, which would make sense. This would definitely be something that could hurt your chances, but won't outright screen you out. Everyone is capable of mistakes and if an honest, mature reflection and lesson was learned through the experience, then there may be sympathy.

That's most specialties anyways. ENT, Ophtho, Urology all work on the same organ. Other ortho specialties are even more repetitive, like arthroplasty and foot/ankle. NSx and Plastics have more variety, however.

Even with 2 fellowships, Ortho would be 7 years. I know many ortho surgeons who did not do 8-10 years of residency. Also, I am doing the USMLEs this summer to prepare for possible move to the US for fellowships/jobs. So, I don't think it'll be as bad as you've painted it. Vascular, NSx, and CSx are pretty much gauranteed 8-10 years, however. I'll check out urology. I think it's a great specialty. I just don't know if I want to be a penis doctor for the rest of my life haha.

After 2 years of medical school, I have finally narrowed down my interest to a surgical specialty, and one that uses cool tech. Last week, I scrubbed in for a TLIF spine surgery with the Stryker protocol. It was the most exciting day of medical school for me. It was like a video game - they had the entire vertebral column mapped onto a 3D CT scan and the software would navigate the surgeon in screw placements by using the landmarks on the monitor. When the surgeon landmarked the wrong spots he'd get a red X and when he'd get the right spots he would get the green checkmark. Then he put the screws in a specific part of the lamina of the vertebrae using the 3D map. My mind was blown, and I realized that I would enjoy doing this for the rest of my life. I felt a sense of comfort too because I know I would be good at that kind of surgery. Now my question is, where does this lead me to? This was an ortho spine surgeon, so I am assuming ortho is tech heavy? Are there other operations that use cool stuff? I shadowed some joint replacement surgeries but didn't see any virtual tools. I have heard that vascular surgery, neurosurgery, and cardiac surgery are also very tech savvy. But I cannot imagine doing 7+ years of residency and dealing with bad outcomes and unhappy patients for the rest of my life. So, can someone help me find a specialty that is tech heavy but also not for the complete masochist?

Thank you. So, is that master’s embedded in the 6 year residency, or would it be 6 + 1? The reason I’m asking is because I see most programs indicate one year is dedicated to “academic enrichment” so I don’t know if that means it’s meant to give you a grad degree or not. Your third point is the one that stands out the most to me actually. All of the cardiac surgeons I know completed 8-10 year residencies with masters or PhD and fellowships. I have a hard time seeing myself being satisfied in that predicament. I would literally be 40 by that time LOL. I find cardiac surgery incredibly fascinating but I also feel like I just want to get the residency done so I can do surgery instead of years of research. If I could do it in 6-7 years I would be more inclined, but I fear that it’s not the right “fit” for me if I have that mentality. I don’t know if that makes sense. I guess one thing I want to mention is I am open, and in fact considering working in the US either way. I have always been very open to relocating and embrace it actually. This is why I feel like maybe it would be possible to do CS residency in 6-7 years and get a job after? It sounds very wishful, I know. But if that’s a possibility, I might be okay with it. Also, it’s not like other surgical residencies are forgiving. Ortho residents do multiple fellowships and end up with 6-8 years - same with NSx, plastics, and GenSx. Too early to tell right now, but one thing I am sure about is I am going into surgery. I just don’t want 10+ years of residency.

I have a couple of questions regarding cardiac surgery residency. It seems that research is a part of most cardiac surgery residencies, but I can’t tell if this is because it’s expected by the program or the interest of the resident themselves. Is it pretty much required to complete a masters or PhD in residency? My 2nd question is: how long is a CS residency with a masters? PhD? I’m looking into the specialty, but it is already the longest residency at 6 years and with the implied expectation of doing either a masters or PhD, that sounds like a 7-9 year residency, possibly longer with fellowships. I’d really appreciate some insight.

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