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Burned by the system, sparked by surgery: a resident’s odyssey

Paz De la Torre, MD
Physician
March 11, 2024
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“Medicine is a form of art.” Those are the words my grandfather told me as I embarked on my journey through medical school. Medicine resembles literature; we, physicians, enter into people’s lives, and we become part of their life tales. The way we do our work influences how these stories are told. Some tales speak of loss and sorrow, while others resonate with healing and joy. It’s akin to sculpture, my preferred analogy, as we refine our skills to repair and mold the human form with our hands. This is why I chose general surgery – to restore and reshape damaged bodies, contributing to the well-being of my patients.

Years have passed since the days I wrote the later paragraph trying to express in words my desire to be a surgeon. Yet, the purpose behind such letters remains elusive to me. Write about yourself, someone said, two or three paragraphs are enough somebody else said, still wondering what the purpose is and what is the right way to write a personal statement.

The experience of being a resident in the health care system presents a perplexing paradox. It’s disheartening to realize that my thoughts, preferences, beliefs, and values are often overlooked. Instead, I’m simply regarded as just another “resident” with the same responsibilities as those before me: writing notes, assisting in surgeries, performing dressing changes, and discharging patients. The demanding schedule demands working strenuous 12-hour days, six days a week, leaving little room for anything else, yet maintaining high ABSITE scores and conducting research remains imperative. Unfortunately, there’s insufficient infrastructure, time, or support to adequately fulfill these obligations.

All these come to my mind as I revisit my old personal statement. I question myself about my priorities and my old and new dreams, but I am drowning in a cycle of endless work, fatigue, and emotional strain. Health care and medical education are a vicious cycle of mistreatment, disguised with empty choirs trying to show empathy, caring, and interest in residents as individuals when we are often reduced to mere statistics, USMLE scores, number of papers, electives, ABSITE scores, shelf scores, but, regardless please write a personal statement.

Please be short, but not overly, be direct, but not too much, be sincere but not too cocky or emotional, be charming but yet not flirtatious, showcasing achievements without being monotonous, as they already have your CV. Tell them what they want to hear, tell them you want to be an important academic surgeon doesn’t matter if you want something different.

Reflecting on my journey, three years of residency and two years as house staff, I find myself distant from the person portrayed in my earlier personal statement. Nevertheless, there is a bold paragraph that I can’t quite recall if I dared to include in my final draft: Since my goal with this statement is to provide you with a complete and honest description of myself, I would like to give you three reasons why you may not hire me:

I am going to ask a lot of questions. I am eager to learn and do things better. If I believe there is a better way to do something, I will openly, honestly, and constructively present my point of view.

I will be relentless with myself. I will push myself to give my best, and I expect the same from the people working around me.

I care about my patients, their health, and their lives. I will give them the best care possible, and sometimes, I am going to grieve if something goes wrong with them.

The system resists critical thinking, proactivity, and leadership in change because the established norms of medical education resist transformation. It avoids questions, discourages engagement, and prefers the simplicity of numbers and silence.

Paz De la Torre is a surgery resident.

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