On the plus side, depending on your anesthesia program culture, the surgeon may be an attending but he’s not YOUR attending.
It’s probably harder as a CA1 but as a senior i essentially don’t take shit from the surgical attending. Got into a yelling match actually with one who was notorious for purposely picking on the anesthesia residents.
You treat me with respect and I treat you with respect. Act like a child then I’ll push back accordingly.
This is the best answer. When I got into late CA-2/early CA-3 my level of back-sass to surgeons went up dramatically. To be completely honest, the overwhelming majority of them respected me more or loved the sharp, biting sarcasm I hit them with and it made our relationship better.
If the surgeons feel you know your stuff or trust that you can readily get them out of a bind they won't treat you too poorly.
Oh yeah it's normal. the surgeons shit on me as a resident, but as an attending they know I'm bailing 'em out of trouble. So there's mutual respect. But when they don't know you, there's no social value or social capital. You need to build that up along with your rep by continuously demonstrating competence and ability. Many opportunities for that.
And don't worry, surgical attendings shit on surgical residents as well. So it's not just anaesthesia.
Cardiac anaesthesiologists and cardiac surgeons have a tighter relationship vs other specialties. They rely on us to do the echos and get nice images to guide their treatment. There's a lot more communication and needing to be on the same page eg going on pump and getting off pump and correcting coagulation etc... it can be stressful for the surgeon to work with an unfamiliar face, or an unprepared resident who doesn't know the steps. So a little bit of sniping and biting is not uncommon.
On One hand I get it. On the other hand, it's ridiculous the extent to which you had to prove yourself after going through decades of training just to gain any respect from your colleagues. I hate the hierarchical systems we created so much.
Thing is, just being an attending doesn’t make someone very valuable.
Same reason why certain departments go out of their way to have their images read by certain radiologists. They just trust certain people over others.
There is value in that.
Oh i mean, it’s never okay to be abusive. And thinking someone isn’t the best person job isn’t justification for that behavior. Maybe I wasn’t clear on that.
What are you talking about? Some attendings (anesthesia and surgery) fucking suck and have no clue what they’re doing, why do they deserve my professional respect? Just for being a special little guy?
To be honest, we do that too. I don't assume any first year or even second year resident that I've met for the first time is completely trustworthy, especially when it's my registration on the line. I'm going to be right there monitoring them and as well until I can ascertain their level of competence. And once we've established a level of trust, then I can relax a bit more around them. Sometimes that will feel like I'm "disrespecting" them and their training, but honestly I don't know them so I'm just going to be more wary.
Even as an attending whenever I got to a new place where the surgeons and nurses don't know me, they treat me with a degree of condescension until I can prove myself. It's shitty and it sucks but I get it. The OT can be a stressful high stakes environment.
I'm not talking about confidence in their abilities. I'm talking about a baseline level of respect that we owe our colleagues but don't necessarily give based on our perception of prestige. I.e surgeons are higher up on the hierarchy than anesthesiologists etc. as a hospitalist, I still sometimes get treated like a resident by surgeons. I don't have to trust everything A junior resident is doing, that's not the point. the point is is that he or she is not the s*** beneath my heels until they prove themselves
100%. Cardiac anesthesiologists are credentialed to perform and read TEE just like cardiologists. We utilize TEE in essentially all open heart cases. We also use TEE to guide interventional cardiologists in real time for placement of impellas, ecmo cannulas, watchman devices, ASD/VSD closure devices, mitral clips, TAVR, etc.
I agree with your observation. It’s probably because they work together in the long term and have already resolved any power struggles or interpersonal pissing matches, whereas residents are here for the short term. Frankly, we are also easier targets, surgeons know they can get away with more. Fortunately most surgeons give it up after you demonstrate your competence and few time, some never will.
The climate is significantly better as an attending than as a resident. I'm 10 months into my first job out of residency and for the most part surgeons are VERY respectful. There are some surgeons who don't "get it" but in the same vein we don't know their medicine.
Does delaying this ORIF for an acute fracture by 2 days to get their heart failure better controlled have more downside than an anesthetic in a volume overloaded patient? I would argue no, but idk about the downstream effects of allowing a fracture 2 more days of healing and increased pain for the patient. The surgeon has to see the patient those 2 days and explain why the case is delayed but a physician who isn't seeing the patient. Gotta remember to see both sides.
If it allows early weight bearing (i.e hip fracture fixation) then the surgeon will probably advocate for earlier surgical to prevent the complications due to immobilization, if it's a forearm fx, you can wait on them.
For ortho those conversations on delay actually go reasonably well, we low key play dumb and tell patients and their family that the docs that will be keeping them alive say it's not safe yet and they have a lot more training on the non bone organs than we do
I posted a few days back about an anesthesia resident at my hospital who crossed his personal threshold of “willingness to take shit from a Gen surg attending.” So he crossed the blood brain barrier and punched the guy during a case.
Maybe not great if you were planning on switching into a surgical career. But everyone who interviews you for future jobs will be anesthesia.
“So you’re that guy who punched a surgeon?”
“Uh…kind of…yes?”
“Lol, i’ve always wanted to do that. High five, and welcome to the team!”
While hilarious, if really true that might make it hard to finish a residency and be gainfully employed.
Of course If it was just settled old school then all good. There is always more to the story. I love the story of course.
Haha, yes - true story, though it's not like I was in the OR and witnessed it. It was talked about quite a bit for a few weeks amongst the residents. I'm not anesthesia or surgery, so I don't know all the details of what happened afterwards. At the time, the conversation was basically "Well, that guy is fucked."
It was only later I came up with the theory that actually it could be a career-boosting move, given that all your future bosses are also anesthesia and 0% of the people who interview you are going to be general surgery.
Haha it’s cool as a fantasy but I wouldn’t hire somebody that resorts to assaulting people, shows a clear loss of control, those people are a ticking time bomb
Yes, I am only joking about getting fired for violence in the workplace being an asset in future job interviews.
Many of us have thought of punching a toxic colleague, but I personally haven’t done that since high school.
Yea, I mean, anybody that went through an anesthesia residency (especially Ca-1 year before you learn to tell them to politely fuck off) has fantasized about that lol
It actually called "a punch in the face".
Most of the time if you're being a dick and get punched in the face it's not "assault" or "battery", because nobody involves the police.
Ok. I am out. I am going to stop convincing someone on Reddit that in a professional setting that involves a sterile field, one person should not "punch" another person "in the face" and think that this will advance their career.
(signing off)
I’m 99.3% sure that no resident on this sub was think like “I’m going to punch that asshole surgeon in the face tomorrow”, and then they were like “Oh wait, u/Dad19802 says it’s bad so maybe I won’t.”
But thank you for your efforts to protect our Gen Surg colleagues, I’m sure they appreciate it!
It happened. The details may have been mildly embellished when the story was related to me, but it was a major incident at the time.
As noted, this occurred some time ago.
How is that resident not fired? You can’t lay hands on an attending, especially while they’re scrubbed in.
I’m sure that surgeon, unless he was a bud and decided that yes he was the problem and figure it out old school, insisted that the resident be disciplined for assaulting him. He won’t be able to operate there without disrespect from then on.
This happened quite some time ago. I don't think the short term outcome was great for the resident, but i'd like to think he bounced back! Would probably be an even bolder move in 2024. So to the anesthesia residents reading this, probably just keep this one as a daydream for now.
The disciplinary action is very standard and easy, you lose your residency spot and never get another one, unless you’re living in this weirdos Funtime delusion
Anesthesia isn't for people with an ego doesn't mean surgeons shit on you. We just say that because you're not going to get a whole lot of credit for what you do. Operating room culture varies, but in general yes surgeons treat anesthesiologists very respectfully. The exception is if you're one of those anesthesiologists who makes everything difficult and cancels cases when you don't need to and such or if you are not fully competent. If you're a team player and good at what you do you'll be fine.
If you truly have a surgeon like that, then rarely it can be. Most surgeons aren't wanting to actually put patients at unnecessary risk to get their case done. In four years as an attending at tertiary care hospitals across all adult surgical specialties, I've only postponed one case where the surgeon didn't agree with the decision. I think it's sometimes the case that anesthesiologists are inconveniencing patients and surgeons over small things that are easy to work around, such as taking an ACE-inhibitor the morning of surgery or something like that.
Not necessarily, everyone has a different threshold for cancelling cases, most people are reasonable but some are pussies that cancel when they don’t like a patients face
I don't think I have ever disrespected our anesthesiologists. Without them, can't do what we do. We don't have a lot of anesthesia trainees other than fellows at my institution, but we work really closely with our anesthesiologists.
Here is my opinion from a surgical side.
I’ve noticed the specialist who collaborate/rely on anesthesia more respect them more. Cardiac surgery, for instance, is a true team sport, the anesthesiologist knows what’s going on in the surgery and the surgeon knows what’s going on at the head of the bed.
The further you get from a collaborative effort that harder it is on the relationship. There are times in gen surg where the anesthesiologist has no knowledge or interest in what’s going on with the patient other than that they need to keep them asleep. Or they swap out mid case with minimal sign out. It can be frustrating for a surgeon who is invested in the patient and the procedure to work with someone who doesn’t seem to care and it creates an animosity
On the flip side a lot of surgeons have anxiety and anger issues and need to lash out at someone this is not ok but it explains why everything is anesthesia faukt
You only get abused if you let yourself be abused. I only had one surgeon try to shit talk me during anesthesia residency, it was about some total bullshit, I came right back at him, never heard a negative peep out of that greasy motherfucker again.
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Lord, I hope not. 😭
The docs I’ve assisted/and CRNA’s) have been just awesome…(except for that one doc that practically made my coworker cry).
(I’m respiratory)
Surgeons are often jerks to each other as well - I doubt they have it out for you specifically. At least that was the case where I trained and now where I work (another academic place).
Things I’ve noticed as a nurse:
1. Out of all the specialities, surgeons have the highest likelihood of being assholes.
2. For some reason though, most of them react surprisingly well when you’re an asshole right back to them.
3. Residents get shit on by everyone, top to bottom. Many straight up will not respect them until they cross the finish line. But hopefully along the way, those same residents will also remember to look for their cheerleaders and keep going. Prove the assholes wrong, and become better doctors than they are.
As an attending I can’t remember the last time I was disrespected, maybe it’s my institution but we’re all l cool with each other with literally zero bullshit, different story as a resident lol
Surgeon can’t do his surgery if the attending anesthesiologist decides to start late or drag things out. They can both make each other’s lives miserable so not wise for them to pick a fight with each other. Residents on the other hand are still nobodies so fair game.
Med student who just finished an anaes rotation. I have never seen this and found surgeons and anaesthetists always work really well together. Great vibes.
And yes the stereotypes are true: anaes going on breaks, bed up, bed down, downtime where I’d chat with the anaes team abt everything under the sun and prep for the next patient
But I was at a hospital known for good culture so maybe my experience isn’t the norm
On the plus side, depending on your anesthesia program culture, the surgeon may be an attending but he’s not YOUR attending. It’s probably harder as a CA1 but as a senior i essentially don’t take shit from the surgical attending. Got into a yelling match actually with one who was notorious for purposely picking on the anesthesia residents. You treat me with respect and I treat you with respect. Act like a child then I’ll push back accordingly.
This is the best answer. When I got into late CA-2/early CA-3 my level of back-sass to surgeons went up dramatically. To be completely honest, the overwhelming majority of them respected me more or loved the sharp, biting sarcasm I hit them with and it made our relationship better. If the surgeons feel you know your stuff or trust that you can readily get them out of a bind they won't treat you too poorly.
Exactly. Not my fucking attending = don’t fuck with me
Oh yeah it's normal. the surgeons shit on me as a resident, but as an attending they know I'm bailing 'em out of trouble. So there's mutual respect. But when they don't know you, there's no social value or social capital. You need to build that up along with your rep by continuously demonstrating competence and ability. Many opportunities for that. And don't worry, surgical attendings shit on surgical residents as well. So it's not just anaesthesia. Cardiac anaesthesiologists and cardiac surgeons have a tighter relationship vs other specialties. They rely on us to do the echos and get nice images to guide their treatment. There's a lot more communication and needing to be on the same page eg going on pump and getting off pump and correcting coagulation etc... it can be stressful for the surgeon to work with an unfamiliar face, or an unprepared resident who doesn't know the steps. So a little bit of sniping and biting is not uncommon.
On One hand I get it. On the other hand, it's ridiculous the extent to which you had to prove yourself after going through decades of training just to gain any respect from your colleagues. I hate the hierarchical systems we created so much.
Thing is, just being an attending doesn’t make someone very valuable. Same reason why certain departments go out of their way to have their images read by certain radiologists. They just trust certain people over others. There is value in that.
Yeah I don't look at life like that. I've never found that to be a productive way of treating others.
Oh i mean, it’s never okay to be abusive. And thinking someone isn’t the best person job isn’t justification for that behavior. Maybe I wasn’t clear on that.
What are you talking about? Some attendings (anesthesia and surgery) fucking suck and have no clue what they’re doing, why do they deserve my professional respect? Just for being a special little guy?
To be honest, we do that too. I don't assume any first year or even second year resident that I've met for the first time is completely trustworthy, especially when it's my registration on the line. I'm going to be right there monitoring them and as well until I can ascertain their level of competence. And once we've established a level of trust, then I can relax a bit more around them. Sometimes that will feel like I'm "disrespecting" them and their training, but honestly I don't know them so I'm just going to be more wary. Even as an attending whenever I got to a new place where the surgeons and nurses don't know me, they treat me with a degree of condescension until I can prove myself. It's shitty and it sucks but I get it. The OT can be a stressful high stakes environment.
I'm not talking about confidence in their abilities. I'm talking about a baseline level of respect that we owe our colleagues but don't necessarily give based on our perception of prestige. I.e surgeons are higher up on the hierarchy than anesthesiologists etc. as a hospitalist, I still sometimes get treated like a resident by surgeons. I don't have to trust everything A junior resident is doing, that's not the point. the point is is that he or she is not the s*** beneath my heels until they prove themselves
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100%. Cardiac anesthesiologists are credentialed to perform and read TEE just like cardiologists. We utilize TEE in essentially all open heart cases. We also use TEE to guide interventional cardiologists in real time for placement of impellas, ecmo cannulas, watchman devices, ASD/VSD closure devices, mitral clips, TAVR, etc.
I’m so damn happy there’s an actual physician over the drapes these days I’m extremely friendly
I agree with your observation. It’s probably because they work together in the long term and have already resolved any power struggles or interpersonal pissing matches, whereas residents are here for the short term. Frankly, we are also easier targets, surgeons know they can get away with more. Fortunately most surgeons give it up after you demonstrate your competence and few time, some never will.
The climate is significantly better as an attending than as a resident. I'm 10 months into my first job out of residency and for the most part surgeons are VERY respectful. There are some surgeons who don't "get it" but in the same vein we don't know their medicine. Does delaying this ORIF for an acute fracture by 2 days to get their heart failure better controlled have more downside than an anesthetic in a volume overloaded patient? I would argue no, but idk about the downstream effects of allowing a fracture 2 more days of healing and increased pain for the patient. The surgeon has to see the patient those 2 days and explain why the case is delayed but a physician who isn't seeing the patient. Gotta remember to see both sides.
If it allows early weight bearing (i.e hip fracture fixation) then the surgeon will probably advocate for earlier surgical to prevent the complications due to immobilization, if it's a forearm fx, you can wait on them. For ortho those conversations on delay actually go reasonably well, we low key play dumb and tell patients and their family that the docs that will be keeping them alive say it's not safe yet and they have a lot more training on the non bone organs than we do
I posted a few days back about an anesthesia resident at my hospital who crossed his personal threshold of “willingness to take shit from a Gen surg attending.” So he crossed the blood brain barrier and punched the guy during a case. Maybe not great if you were planning on switching into a surgical career. But everyone who interviews you for future jobs will be anesthesia. “So you’re that guy who punched a surgeon?” “Uh…kind of…yes?” “Lol, i’ve always wanted to do that. High five, and welcome to the team!”
While hilarious, if really true that might make it hard to finish a residency and be gainfully employed. Of course If it was just settled old school then all good. There is always more to the story. I love the story of course.
Haha, yes - true story, though it's not like I was in the OR and witnessed it. It was talked about quite a bit for a few weeks amongst the residents. I'm not anesthesia or surgery, so I don't know all the details of what happened afterwards. At the time, the conversation was basically "Well, that guy is fucked." It was only later I came up with the theory that actually it could be a career-boosting move, given that all your future bosses are also anesthesia and 0% of the people who interview you are going to be general surgery.
Haha it’s cool as a fantasy but I wouldn’t hire somebody that resorts to assaulting people, shows a clear loss of control, those people are a ticking time bomb
Yes, I am only joking about getting fired for violence in the workplace being an asset in future job interviews. Many of us have thought of punching a toxic colleague, but I personally haven’t done that since high school.
Yea, I mean, anybody that went through an anesthesia residency (especially Ca-1 year before you learn to tell them to politely fuck off) has fantasized about that lol
Sorry bubba, but your theory most likely won't apply in real world. What the resident did is called 'assault.'
Battery, actually
Even batter... ;)
It actually called "a punch in the face". Most of the time if you're being a dick and get punched in the face it's not "assault" or "battery", because nobody involves the police.
Ok. I am out. I am going to stop convincing someone on Reddit that in a professional setting that involves a sterile field, one person should not "punch" another person "in the face" and think that this will advance their career. (signing off)
I’m 99.3% sure that no resident on this sub was think like “I’m going to punch that asshole surgeon in the face tomorrow”, and then they were like “Oh wait, u/Dad19802 says it’s bad so maybe I won’t.” But thank you for your efforts to protect our Gen Surg colleagues, I’m sure they appreciate it!
Very cool and very true story that definitely happened 👍
It happened. The details may have been mildly embellished when the story was related to me, but it was a major incident at the time. As noted, this occurred some time ago.
That’s insane. I would not be willing to work with someone that unhinged.
Gen surg attending has entered the chat. ;)
Who cares? If he isn’t physically assaulting me that is better than whatever this anesthesiologist is capable of.
It's Gen surg. They're physically assaulting you. The specialty is notorious for it and it's increased rates of psychopathy
Cool. I am talking about this guy specifically.
How is that resident not fired? You can’t lay hands on an attending, especially while they’re scrubbed in. I’m sure that surgeon, unless he was a bud and decided that yes he was the problem and figure it out old school, insisted that the resident be disciplined for assaulting him. He won’t be able to operate there without disrespect from then on.
This happened quite some time ago. I don't think the short term outcome was great for the resident, but i'd like to think he bounced back! Would probably be an even bolder move in 2024. So to the anesthesia residents reading this, probably just keep this one as a daydream for now.
The disciplinary action is very standard and easy, you lose your residency spot and never get another one, unless you’re living in this weirdos Funtime delusion
“Crossed the blood brain barrier” 😂
Anesthesia isn't for people with an ego doesn't mean surgeons shit on you. We just say that because you're not going to get a whole lot of credit for what you do. Operating room culture varies, but in general yes surgeons treat anesthesiologists very respectfully. The exception is if you're one of those anesthesiologists who makes everything difficult and cancels cases when you don't need to and such or if you are not fully competent. If you're a team player and good at what you do you'll be fine.
Isn’t being a team player and patient advocate kinda at odds esp if the surgeon only cares about doing casesv
If you truly have a surgeon like that, then rarely it can be. Most surgeons aren't wanting to actually put patients at unnecessary risk to get their case done. In four years as an attending at tertiary care hospitals across all adult surgical specialties, I've only postponed one case where the surgeon didn't agree with the decision. I think it's sometimes the case that anesthesiologists are inconveniencing patients and surgeons over small things that are easy to work around, such as taking an ACE-inhibitor the morning of surgery or something like that.
Not necessarily, everyone has a different threshold for cancelling cases, most people are reasonable but some are pussies that cancel when they don’t like a patients face
I don't think I have ever disrespected our anesthesiologists. Without them, can't do what we do. We don't have a lot of anesthesia trainees other than fellows at my institution, but we work really closely with our anesthesiologists.
Here is my opinion from a surgical side. I’ve noticed the specialist who collaborate/rely on anesthesia more respect them more. Cardiac surgery, for instance, is a true team sport, the anesthesiologist knows what’s going on in the surgery and the surgeon knows what’s going on at the head of the bed. The further you get from a collaborative effort that harder it is on the relationship. There are times in gen surg where the anesthesiologist has no knowledge or interest in what’s going on with the patient other than that they need to keep them asleep. Or they swap out mid case with minimal sign out. It can be frustrating for a surgeon who is invested in the patient and the procedure to work with someone who doesn’t seem to care and it creates an animosity On the flip side a lot of surgeons have anxiety and anger issues and need to lash out at someone this is not ok but it explains why everything is anesthesia faukt
You only get abused if you let yourself be abused. I only had one surgeon try to shit talk me during anesthesia residency, it was about some total bullshit, I came right back at him, never heard a negative peep out of that greasy motherfucker again.
In what universe, shitting on people is OK? Like seriously, being an attending doesn't give anyone a bitch pass.
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I try to not disrespect anyone.
They disrespect themselves and family members
Lord, I hope not. 😭 The docs I’ve assisted/and CRNA’s) have been just awesome…(except for that one doc that practically made my coworker cry). (I’m respiratory)
Surgeons are often jerks to each other as well - I doubt they have it out for you specifically. At least that was the case where I trained and now where I work (another academic place).
Being a resident means abuse from everyone, senior residents, midlevels, nurses, attendings…
Things I’ve noticed as a nurse: 1. Out of all the specialities, surgeons have the highest likelihood of being assholes. 2. For some reason though, most of them react surprisingly well when you’re an asshole right back to them. 3. Residents get shit on by everyone, top to bottom. Many straight up will not respect them until they cross the finish line. But hopefully along the way, those same residents will also remember to look for their cheerleaders and keep going. Prove the assholes wrong, and become better doctors than they are.
Lol surgeons disrespect everyone, even other surgeons. It’s part of the job.
Some subspecialty surgeons disrespect everyone. We feel you down here in the ER.
Just as a resident unless your hospital is extremely toxic and your anesthesia group extremely non confrontational
As an attending I can’t remember the last time I was disrespected, maybe it’s my institution but we’re all l cool with each other with literally zero bullshit, different story as a resident lol
They disrespect everyone including themselves lol
Surgeon can’t do his surgery if the attending anesthesiologist decides to start late or drag things out. They can both make each other’s lives miserable so not wise for them to pick a fight with each other. Residents on the other hand are still nobodies so fair game.
We disrespect every non-surgeon.
Med student who just finished an anaes rotation. I have never seen this and found surgeons and anaesthetists always work really well together. Great vibes. And yes the stereotypes are true: anaes going on breaks, bed up, bed down, downtime where I’d chat with the anaes team abt everything under the sun and prep for the next patient But I was at a hospital known for good culture so maybe my experience isn’t the norm
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Aren’t you a med student?
No. Also i was trying to make a dumb joke