Surgery residency is nearly twice as long as that of any other specialty: Five years, compared to three for medicine, pediatrics, and ER. (Neurosurgery is seven, radiology and anesthesiology five total.) This leads to some interesting relationships between junior and senior residents, and between specialties.

For example, as a second-year resident, I am as far behind my fifth-year chief as a medical student is to a senior medicine resident. They’re polite enough to treat the juniors as colleagues, though not equals, but the knowledge gap between us is as wide as between me and a second-year medical student. The more I consider this gap, the more amazed I am at their tolerance for my shortcomings.

With medicine and ER residents, it works the other way. The doctors who were medicine and ER interns with me are now considered “seniors” in their program, and can have a team of two or three interns and a couple of medical students to run on their own. Next year, while I’m only halfway through, they’ll be finishing, choosing fellowships or going through job offers.

We have a couple new ER and medicine attendings this year, who graduated from residency here in June. This means that when they were interns, our surgery chiefs were already second year residents. Understandably, though not always defensibly, this leads to a somewhat cavalier approach by the surgery chiefs to the junior attendings. The ones who are from this program are usually old friends, and things go smoothly. The young attendings from other programs, though, have their work cut out to prove themselves.

The neurosurgery senior residents, for another side of the coin, get general respect on all hands. The best ones, both trauma and ER will take their word for it, without insisting on calling the attending before acting.