Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How Murphy’s law applies to medical students

Bradley Lander
Education
April 23, 2015
Share
Tweet
Share

shutterstock_210504655

If the analogy between medical training and a fraternity is true, then medical students are the pledges.

For many, the most grueling part of this pledge process is the third year surgery rotation where the modified Murphy’s Law is applicable almost daily: Anything a medical student can do wrong, a medical student will do wrong.

In a fraternity, pledges can do no right. Correctly answered questions are criticized for being said too slowly or without conviction. Several correctly answered questions in a row are almost certainly followed by harder and more esoteric questions until the senior questioner stumps the junior trainee.

The same goes for the surgery clerkship.

Attending surgeon: “Which part of the intestine are we holding?”

Me: “Uhh … the small intestine?”

Attending surgeon: “Good. What is this yellow material attached to it?

Me: “Uhh … the mesentery.”

Attending surgeon: “Good. What is the name for this specific little piece of fat (that looks identical to everything else)?”

Me: “Uhh …”

Even the smartest student will be tested to his or her limits. On this occasion, my limit happened to be the ileocecal fat pad of Treves.

In a fraternity, pledges have menial responsibilities such as alphabetizing anything alphabetizable cleaning the bathroom and organizing bookshelves. During the surgery clerkship, medical students are responsible for similarly minor tasks. The tasks are important enough to make the student feel included in the case but subjective enough to be criticized.

Even the most basic skills, such as cutting string or ripping tape, become unusually difficult in this pressured setting. The timeline of a standard operation typically goes as follows:

1. Me: “Hi Mr. Smith, my name is Brad Lander. I’m a medical student on the surgery team helping with your operation today.” Mr. Smith: “You’re just going to be watching right?”

ADVERTISEMENT

2. After wheeling the bed to the operating room and seemingly bumping into every corner en route, I dance around the room trying not to contaminate anything already sterile.

3. I go to scrub and then while putting the gown on, my fingers seem to get stuck in the gloves. Everytime.

4. The operation begins. The surgeon begins to quiz me. I am averaging about 70 percent correct answers. Not bad for basketball. Not good for surgery.

5. I use the retracting device to expose the abdomen for the surgeon to see. “You’ve got to pull harder, don’t give up on us now,” the surgeon says.

6. The surgeon stitches the tissue together and instructs me to cut the suture. I do. “You left it too long,” he says.

7. The surgeon stitches more tissue together and instructs me to cut the suture. I do. “You left it too short,” he says.

8. As the surgeon cauterizes the tissue, I earnestly use the suction tube to suck the rising smoke out of the field of view (and smell). The surgeon notes: “Your instrument is blocking my view.”

9. We begin to close the skin at the end of the operation. “Here, Brad, you suture this small 1 cm incision.” It’s my first time suturing, and I immediately develop an essential tremor. I somehow leave the patient with 2 cm of cosmetic imperfection.

10. We finish the operation. I can sense the surgeon’s impatience, so I hurriedly bring the bed in from the hallway to transfer the patient from the operating table. The anesthesiologist glares at me: “The patient is still intubated.”

Despite being a victim of Murphy’s Law repeatedly during the case, my attention shifts. I realize that we just removed a grapefruit-sized mass from a patient’s abdomen. Cosmetically, he looks much better. His confidence in his appearance will increase, and his pain should subside within the next few days. In the span of a few hours, we substantially improved the quality of this patient’s life — a reality that I know matters much more than whether I correctly answered the intraoperative questions directed to me.

The similarities between the surgical clerkship and the fraternity pledge process become more apparent at their conclusions.

In fact, the shared experiences during fraternity pledging serve as a bond for the brothers long after we are inducted as full members. We reminisce on our assigned tasks and can laugh at them retrospectively. We know that all of our predecessors completed the same process and all those who follow will do the same. We earned our way with no shortcuts.

Similarly, the third-year surgical clerkship is a shared experience among physicians, regardless of whether surgery is our ultimate career path. I recently spoke with two of my uncles about my experience, one is a pediatrician, and the other is an ophthalmologist.

They both asked me, “So, did you cut the suture too long or too short?”

Bradley Lander is a medical student.

Nagel Photography / Shutterstock.com

Prev

Sorry, but I’m not part of the ancillary staff. I’m a physician.

April 23, 2015 Kevin 24
…
Next

A brief history of the EHR

April 23, 2015 Kevin 12
…

Tagged as: Medical school, Surgery

Post navigation

< Previous Post
Sorry, but I’m not part of the ancillary staff. I’m a physician.
Next Post >
A brief history of the EHR

ADVERTISEMENT

More in Education

  • Why medical student debt is killing primary care in America

    Alexander Camp
  • Why the pre-med path is pushing future doctors to the brink

    Jordan Williamson, MEd
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: Why the NRMP’s SOAP process is broken

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Bridging the rural surgical care gap with rotating health care teams

    Ankit Jain
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How Murphy’s law applies to medical students
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...