Dear all, I need an honest appraisal:

I am almost committed to neurosurgery. I have very good grades, a strong step 1, lots of research experience with publications, etc. On paper, I should be a strong applicant. The problem is that I’m rather absent-minded.

I probably leave at least one thing I need (keys, wallet, ID card, lunch, cell phone, etc) at home more days than I remember to take everything. I will go to a store and come out only to realize I forgot to buy what I went in there for. I may look for the milk in the fridge, only to realize I left it in the trunk after buying it last night. I lose things constantly – am on my 3rd flash drive, among other items like hats, sunglasses, etc, that regularly sprout legs and disappear. I’m also rather unobservant. I have been ticketed for completely not noticing a stop sign, and may be oblivious to some new item in the house if it is not pointed out to me. I may fail to notice my alarm is set for PM, etc, etc.

As much as I am convinced I would love neurosurgery, I also don’t want to set myself up for failure. Nor do I want to unnecessarily put patients’ lives at risk. If I can’t keep simple day-to-day things straight, how will I remember to do all the intricate parts of brain surgery correctly and in the right order, while not forgetting to order and check any number of important labs, etc, for a dozen+ ICU patients whose wellbeing depends on my attentiveness?

Maybe I’m just being overly self-critical or paranoid, but I’d rather figure out if I’m in the wrong career before I start, rather than struggling through years of residency only to get fired for incompetence or stupidity, or worse, for inadvertently harming or killing a patient via what could be interpreted as gross negligence.

You may understand why I am hesitant to discuss this with my advisors. If I’m not the only absent minded person out there, how do you make sure you avoid making stupid life-threatening mistakes in the hospital?  I can make lists, but of course, that only works if you remember to write things down, remember to check it, and don’t lose the list! Also, there are no lists to check items off during surgery… If I am alone in being so absent-minded, and the field would be safer without me, I’d rather know now than later.

Thanks in advance for your honest appraisal.

hmmm, sounds like me. i typically cant remember what i did yesterday and things ive done in the morning seem so long ago when i think about them in the evening. not sure how i made it this far haha

I’m not sure any of us can give you a good answer on that subject.  Most people who are absent-minded are really only that way about mundane things, whereas academically and intellectually they perform very reliably.  If you’ve ever held a job with real or significant responsibility, your work as a physician will more likely resemble your performance in that arena, rather than your performance at the mundane tasks of daily living.  If you haven’t, you will find out over the course of 3rd year and in your sub-I’s if this kind of forgetfulness is also pervasive in your work.

Having said that, I would guess from your self-description that it is not.  In general, you can use academic attentiveness as a proxy for attentiveness at work.  It’s a very imperfect proxy for overall performance, but for the purposes of your question it will probably serve well enough.  Clearly you pay enough attention to things like test dates, details of the concepts you’re asked to learn, and details of the questions used to assess your learning.  Research requires great attentiveness to details, and you seem to have performed OK in that arena.  So you probably don’t have much to worry about.

Maybe neurology would be better for you. Seriously..

I am not absent minded yet I make lists daily of things I need to do.  I wake up from a cold sleep on call wondering if I actually put in an order or checked a patient and call the floor.  I get up and reevaluate a patient I am sure nothing would change on, just to prove my minds eye wrong.

Surely, based on your suggestion you think you have the cerebral power to make a mental list of these mundane, inconsequential things and it hasn’t, yet, caught up with you.  But, honestly, residency is a hard process.  You forget.  You forget and sometimes people get hurt.  I have seen it happen.

I guess what I’m saying is if you think you’re too smart, too smart to check, double check, and then maybe wake up at 4 AM and check again, maybe something less acute than neurosurgery is for you.

I struggled with the same questions before I decided on NS.  On more than one occasion, after destroying an O-Chem test back in undergrad, I’d come back to my car to find my keys still in the ignition.  In first year of MS1 I would annihilate the gross practicals then come home to an open garage door.

In third year I learned to make lots of lists, take lots of notes, then repeatedly check my list whenever I had a free moment.  The key is to remember where you put your list.

I’ve the absent minded prof syndrome too. 

It’s important that you can lock in when it’s important.  I think a lot of people in neurosurgery have the same fault.  When you are a third/fourth year a lot of talk is about if you can prioritize things.  I’m forgetful because I’m thinking about other things all day, things I care about, which amazingly doesn’t appear to be whether I have my car keys before I lock the car.  The question isn’t if your absent minded, but why and how you are absent minded.  It may just take sometime getting used to being hyper vigilant about keeping your to do list with you at all times.

You should call that girl you have in mind tonight

This is also typical of ADD (not saying you have it necessarily). There are plenty of physicians and surgeons (even chairmen) with ADD who are successful. Medication can be extremely helpful.

A significant fraction of the surgeons I know (me included) are pretty absent minded when it comes to non-medical things such as their own phone number, atm codes, etc.

Well, according to an email this morning, there will be at least one more absent-minded neurosurgery resident on the floors of some unsuspecting hospital later this year… and this one carries a formal diagnosis of ADHD, inattentive type (previously known as ADD). I personally know highly-regarded residents in other specialties, and successful physicians with the diagnosis. Where I had my evaluation, they said they tend to get one or two referrals each year for interns/residents who obviously did well academically but are not holding things together on the wards. (So yes, it can affect your performance as a resident) I’m trying Adderall, which, I think is helpful, though not perfect - maybe still looking for the best dose. Not sure yet how the side-effects, including increased tremor will affect me in the OR. I think awareness of this condition is important, as it does seem to be relatively prevalent among our peers. While the pros and cons of meds can be debated, I think awareness is definitely the first step toward ensuring appropriate compensatory measures are in place. Some say that ADD can actually be an advantage by allowing you to hyperfocus on the task at hand, but I still make enough stupid mistakes on exams and leave enough important things out of my exams / presentations to be skeptical. I guess I am cautiously optimistic that things will go OK, but will certainly be practicing my hypervigilance looking after sick patients. Maybe next time you go to pour juice instead of milk on your cereal, after realizing you have the wrong shoes on, consider signing up for an evaluation. With student health insurance, the >$1000 evaluation is often free, and you may find yourself more in control understanding better why you are looking at the keys in the ignition through that locked door. Congrats to all who matched. Strength and courage to those who didn’t.

@ absent-minded-professor: hope you are no more having trouble with daily chores.. if you still do, simply appreciating deeply how much time you lose (the time you could have used in reading your favorite article or book or doing research work) by your forgetting nature can improve you a lot. Note that the so-called-mundane things are necessary for our proper and efficient functioning in this so-called-organized world. i know i came to this post too late, hope this would at least help someone!!