I’ve been thinking: the surgery in-training exam is really like a recitation of legends, orally recounted histories, not too closely related to facts, that define our community.
The test runs through a long series of stories, which are so familiar to surgeons and surgeons-in-training, that we only have to mention a few words of the story, to have the whole thing immediately recognized and understood.
These are some of the legends: gallbladder cancer, incidentally discovered after lap chole, invading through the lamina propria (snap answer: resect a surrounding rim of normal liver tissue); projectile vomiting in a 4wk old male (pyloric stenosis, hypokalemic hypochloremic metabolic alkalosis); medullary thyroid cancer (MEN 2; check for pheochromocytoma before resecting); knee pain and blue toes in a 50-yr old smoker (popliteal aneurysm; resect and bypass, and check for a contralateral aneurysm and AAA); mesenteric thickening after total colectomy for FAP (desmoid tumor; chemo only, no surgery).
That isn’t even English, and it certainly bears little relationship to what we actually see and do; but those are the legends that we all recognize. In that light, the ABSITE is an exercise in intergenerational transfer of epic tales. . . like the Iliad and Beowulf and Hansel and Gretel. . . That’s my explanation for the high incidence of rare diseases, the lack of correlation between what we practice in real life, and the right answer on the test, and the way the residents go around for a week afterward trading key words and comparing answers. This is our oral tradition.
March 31, 2010 at 9:51 pm
I enjoyed this post, and I’m eagerly awaiting the next one. You write a great blog.
Studying for USMLE step 1 – seems like stories and stereotypes are the way to remember everything!
April 24, 2010 at 7:47 pm
http://punditkitchen.com/2010/04/23/political-pictures-car-accident-socialist-fire-departments/
Let’s privatize fire departments as well!
You say you are against Obamacare. I daresay I hope you are aware that the reason all of Europe is laughing at you and Americans like you is because you do not realize how bad you have it; you also seem to fail to realize that what has been passed does not even remotely resemble a socialist healthcare system. I love your blog, and I am enthralled by the writings of your surgeries, however your knowledge regarding the true nature of government programs seems to be rather severely lacking.
April 28, 2010 at 7:43 pm
As a newbie a few years behind you a similar career path….I wanted to let you know that I have missed your posts. My fear is that you’re getting a workout on your respective service/rotation–I hope that’s not the case.
Anyway, hang in there with whatever you’re doing. You may not need it, but I always thinks it nice to know someone (even a random someone) is rooting for you.
May 2, 2010 at 1:52 am
[…] Cut on the Dotted Line – absite as myth I’ve been thinking: the surgery in-training exam is really like a recitation of legends, orally recounted histories, not too closely related to facts, that define our community. […]
May 21, 2010 at 4:35 pm
Enjoying your blog. I am applying to Surgical Tech school in Tyler, TX in the spring but am doing lots of lurking on related sites and studying already. It is an obsession. I can’t seem to stay away from it.
I am a Christian as well and I hear lots of negative things about workplace behavior and language. I am hoping to maintain a good example in the OR no matter what everyone else is doing. Your story from 2007 about the ST and circulator not paying attention and being completely unprepared is appalling! I believe you should do EVERY job as if you were doing it for God…whether you are sweeping the floor or performing surgery.
May 27, 2010 at 1:09 am
Sadly, you seem to have stopped blogging, just as things were getting really interesting (in terms of the kinds of cases you were getting to work on). I keep hoping to see you back, but almost 4 months out, it looks unlikely, which is truly a loss for all your readers.
May 28, 2010 at 9:57 am
I miss you too! I hope you’re okay.
July 14, 2010 at 10:20 am
It seems that the majority of people come across a situation when you are taught something and you learn it yourself, too, but when it comes to real life, it turns out you know very little what it’s all about and this is called gaining some experience. Quite a hard way to get it, isn’t it?
September 13, 2010 at 9:47 am
Wondering how you are. Well, I hope.
March 4, 2011 at 9:54 pm
Because of these traditions I am proud that I am a doctor. But you do have a point that it lacks correlation in real life. Great blog.
March 19, 2011 at 2:59 am
very pleased to find this site.I wanted to thank you for this great read!
March 19, 2011 at 3:01 am
Hey i am newbie here just want to say your post is really impressive.
April 1, 2011 at 5:58 pm
Thwadi maa da phudda maran comment post ku nahi karn dinday
April 1, 2011 at 6:00 pm
das inch da lun thwadi chhoti kuri di phuddi day anddr.
September 17, 2014 at 4:42 pm
very impressive information, some great information
November 15, 2015 at 8:39 pm
This is very interesting I wonder did the blog posts now stop for some reason ?
September 7, 2016 at 2:35 am
I wonder how a rhinoplasty surgeon would do it…
January 17, 2017 at 1:48 pm
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