Cancer Research, Statistics, and Treatment

RESIDENT CORNER
Year
: 2021  |  Volume : 4  |  Issue : 2  |  Page : 350--351

The intimidating experience of becoming a surgeon


Saneya Pandrowala 
 Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Correspondence Address:
Saneya Pandrowala
Flat-402, Sonas Tower, Parel, Mumbai - 400 012, Maharashtra
India




How to cite this article:
Pandrowala S. The intimidating experience of becoming a surgeon.Cancer Res Stat Treat 2021;4:350-351


How to cite this URL:
Pandrowala S. The intimidating experience of becoming a surgeon. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Dec 4 ];4:350-351
Available from: https://www.crstonline.com/text.asp?2021/4/2/350/320165


Full Text



My first experience of observing a surgery was as a second-year medical student during a Whipple procedure. I watched the entire procedure intently without understanding most of it. When I left the theater, the dopamine surge in my brain was very rewarding and gratifying even though I had not contributed to the surgery in any way. That is when I decided that I wanted to be a surgeon. However, surgery is not the same as any other medical field and becoming a surgeon is a unique experience. Intimidation is deeply rooted in the pillars of surgical training. Some even believe that an individual will perform better “under the gun.” [1] However, considering that even a small mistake when performing a surgery can put a life at risk, this might be a small price to pay. During the journey from being a medical student to a surgeon, one might feel intimidated on many levels and at various instances. This may partly be due to the god complex or the aura surrounding surgeons, which gives them the title of the most arrogant members of the medical fraternity (I disagree, we are actually a delightful bunch of people).[2] Medical students have a stereotype of surgeons as self-confident and intimidating individuals and the surgical culture as competitive, masculine, and requiring sacrifices.[3]

So, what does intimidation really mean? The dictionary definition reads, “frightening someone to be able to persuade them to do something that you want them to do.” A career in surgery requires one to learn from the experts, and believe me, that is not an easy task. It is essential at times to inculcate some fear to positively affect the outcomes. If my boss expects me to perform a procedure in a certain way, any deviation is not going to be appreciated. That is because a defined protocol has been set to minimize complications and maximize patient safety. Questioning yourself might help to bring out the best in you but that is not the only outcome it can lead to. However, I am unaware of another way to engrave in a person's mind the importance of even the tiniest step while operating. Nonetheless, there is a thin line between intimidation and harassment, which no one can determine. There is no way to tell the difference, and we do not know how intimidation affects a trainee as everyone has a different emotional reaction to a given situation. It could linger in a person's mind and affect their mental health and perception of themselves. This occupational stress is found to be directly related to mental health problems and burnout.[4],[5]

I do not know if intimidation is the only way of surgical education as it might cause people to hold themselves back in certain situations and they may even start feeling that they do not belong to this field of medicine. It is interesting how over the years this has become a rite of passage. Residents tend to see this as good intent, as it is ultimately meant to maximize patient safety, and that is what we are all here for. Although the goal is to become the best possible surgeon, the process of attaining this goal in such a time-bound heated environment takes a heavy toll on a surgical resident's social and emotional well-being. Surgery, being a demanding and adrenaline-rush-filled field, generally leaves no space for building up a personal life or more so maintaining it. Maintaining the image of a confident and competitive surgeon does not allow one to ask for help. We do not really know how much of a toll this takes until it ultimately reaches burnout.

Perhaps, we need to use a tailored teaching approach rather than using the basket approach of intimidation and learning. Every individual is different and needs to be spoken to and taught accordingly. That is how we will bring ”precision learning” into medicine. Perhaps, it is a time for all of us to ponder over this.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Musselman LJ, MacRae HM, Reznick RK, Lingard LA. 'You learn better under the gun': Intimidation and harassment in surgical education. Med Educ 2005;39:926-34.
2Logghe HJ, Rouse T, Beekley A, Aggarwal R. The evolving surgeon image. AMA J Ethics 2018;20:492-500.
3Hill EJ, Bowman KA, Stalmeijer RE, Solomon Y, Dornan T. Can I cut it? Medical students' perceptions of surgeons and surgical careers. Am J Surg 2014;208:860-7.
4Gerada C, Jones R. Surgeons and mental illness: A hidden problem? BMJ 2014:348:g2764.
5Noronha J, Malik A, Bindhulakshmi P, Karimundackal G. Oncology Residency - A burning issue, results of a questionnaire-based survey on psychological well-being of oncology residents. Indian J Surg Oncol 2020;11:387-93.