PRINCETON, NJ – When neurosurgery residents at Princeton University Hospital discovered they had a reputation among the medical students as being friendly and nice, they took immediate action.  “I was horrified when I heard what they were saying about us,” says Dr. John Blake, a PGY-6 resident.  “It’s obviously not okay for a serious and grueling surgical service to be labeled as ‘the nice guys of the hospital.'”

An emergency meeting was arranged to start damage control and status reinstatement.  Program director, Dr. Bob Lange started the meeting by describing the good ol’ days “when you could see the fear in medical students’ eyes and they stuttered when introducing themselves.”  The residents came up with a multidisciplinary staged plan to change the service reputation.  “You need everyone from the OR nurses to the cafeteria staff to hear that we are a tough group of residents,” explains Dr. Blake.

“That way when a medical student says he starts neurosurgery next week, even the strangers in the vicinity give him a look of pity and someone mutters under their breath ‘those guys are hardcore’ as if they had been personally beaten.”  Brainstorming was somewhat stunted by the reality that the group was in fact generally nice and wasn’t interested in being frankly mean.  They also agreed that their efforts needed to come off as believable.

The groundbreaking intervention took place last week in the surgeon lounge.  The on-service medical student, already in on the mission in order to strengthen his chances of matching in neurosurgery, was loudly ordered to go see a new fictitious consult and be back in the lounge in 4 minutes.  He ran off and returned 13 minutes later.  Chief residents Dr. Plerbeck and Dr. Weiss were ready for him when he returned.

A penlight was directed into his eyes and a list thrown at his body.  “This is sub-par work!” yelled Dr. Weiss as Dr. Plerbeck went on a expletive-filled rant about neurosurgery being a fast moving and efficient critical assessment specialty. The junior resident nearby joined in from across the lounge by shaking his head with a look of disappointment and shame.  The chief residents stormed off to their cases leaving the medical student to walk to the locker room with his head hung low.

The incident had reasonable success, with hospital chatter about the event for several days.  “Now that stage one is complete, we can move on to the next intervention, which is physically pinning down medical students and punching them,” says Dr. Lange, “but this is a long process.  Real change takes time.”