Is the plastics intern really necessary?

October 16, 2007 at 1:13 am | Posted in internship | Leave a comment

So. There are two PGY2 neurosurgery openings for 2008. One of them is an expansion, and the other appears to be an early dropout (someone matched there for 2008, and the program isn’t adding a new position).

And the earliest I can get in to see my program director to discuss my plans for next year is the end of October. It’s very frustrating, because I don’t want to apply without her support.

Neither of these programs is a place I applied to last year. And since I scoured every source of information I could find about every program in the U.S. before deciding where to apply, that actually means something. In both cases, it wasn’t so much that I’d heard anything negative, just that they were missing something I really wanted in a program, and I wasn’t aware of any compensatory strength in some other area of importance to me.

Of course, it could very well have one, and there’s just not enough information out there for me to have heard about it.

Really I’d prefer to stay here, but I don’t see any of these guys leaving, either voluntarily or involuntarily. And I’m not reapplying through the match because a) I can’t afford it, b) my vacation month isn’t until the spring and c) I can’t afford it. Also I have my Harborview neurosurgery month during the most active 4 weeks of interview season. And of course, right now I’m lolling around on plastics for two solid months, which is a nice break but of limited usefulness to me in finding a spot for next year.

All in all, very frustrating.

Also I feel like I’m not getting much out of this rotation. The division just hired a PA, and so most teaching efforts are being directed toward teaching her, and there aren’t enough cases for both of us to be scrubbed in and helping. Or actually, there are plenty of cases, just not enough OR time for the division to be running them simultaneously so we can both be involved. So she gets priority, because she’ll be a permanent part of the service, and theoretically will be teaching subsequent interns. There’s often not even room for us all to be scrubbed. This is billed as one of the “operative” rotations for interns, but frankly I operated more when I was on trauma.

And there’s clinic three days a week, so whenever there are cases and clinic going on at the same time, my job is to be in clinic. But even in clinic, it seems like I’m there mostly to help carry the dictation load. In every other respect, the service is micromanaged by the senior. Which may simply be his style. However, I don’t like having to redo my work over matters of personal preference. So now I just wait for him to tell me exactly what he wants, because if I try to anticipate what he wants, whatever I did, he’ll want something different. That’s the problem with micromanagement: it discourages initiative.

So my scutwork is being micromanaged, and my reward for doing the scut well and efficiently on this service is being done to a large extent by a PA, who currently can’t function in any non-operative capacity without asking a ton of questions of whoever happens to be nearby (usually me). And who arrives after me every day and goes home before me. I’ve been nice about it so far, but the bottom line is that the service doesn’t need an intern, and it doesn’t seem like the intern is going to get much out of it either.