The 7 “Difficult” Colleagues Every Surgeon Should Know About

You already know these people. The colleague whose name on the call schedule makes your stomach tighten. The one who drains the energy from every meeting. The one who seems untouchable no matter how much chaos and drama they create. Chances are, you've worked with all seven.

No one teaches us how to navigate these relationships. Medical school doesn't cover it. Neither does residency or fellowship.

And yet, the quality of your surgical career may depend on it more than almost anything else. Your ability to recognize interpersonal dynamics and respond to them skillfully rather than reactively will shape your reputation, opportunities, leadership influence, professional fulfillment, and even your mental health.

This post is a field guide to seven colleague archetypes commonly found in surgery. More importantly, it's a guide to relating to them from a place of awareness and empowerment rather than judgment, irritation, fear, or intimidation.

Because the goal isn't to change these people. The goal is to stop giving them power over your peace.

1. Traumatized and Toxic

She's reactive, unpredictable, and wounded.

This colleague carries significant unprocessed pain from childhood, training, or both. She has built an entire professional identity around concealing it, and the effort required to maintain that facade leaks out in every interaction.

She runs hot and cold. She is OCD about the OR environment, harsh to staff, and particular to the point of paralysis. She has an ulterior motive, like protecting her leadership position or maximizing RVUs, and her decisions are driven by that motive far more than by clinical judgment or collegiality.

She is wearing a mask, and everyone can see it. The pretending is obvious. The tragedy is that underneath the mask is a person in genuine pain. But that is not your wound to heal, and it is not your responsibility to absorb her reactivity while she avoids doing so.

What drives her: Fear. Scarcity. The deep belief that if people saw who she really was, she would lose everything.

What she needs from you that you shouldn't give: Your silence, accommodation, and willingness to excuse behavior because "that's just how she is."

2. The Gaslighting Narcissist

He has one objective: career advancement.

This colleague is sophisticated. He, ironically, chairs the wellness committee. He mentors junior residents with visible enthusiasm. He tells you he's in your corner. He has cultivated a reputation for caring about patients, colleagues, and the institution, and it is entirely constructed.

His actual worldview is zero-sum. Your success is a direct threat to his. Anyone who outshines him or challenges him becomes a target. And he is skilled at using institutional weapons like sham peer review and performance improvement plans to remove those threats while maintaining complete plausible deniability.

The most dangerous thing about the Gaslighting Narcissist is that he makes you question your own perception. You leave interactions with him feeling confused, ashamed, and self-conscious. That disorientation is not accidental. It is the point.

What drives him: Fear. Scarcity. The belief that there is only so much success available and he must secure his portion by eliminating competition.

What he needs from you that you shouldn't give: Your trust, vulnerability, and the assumption that his stated intentions match his actual ones.

3. The Exploding Doormat

She will say yes to everything right up until she detonates.

This colleague is a people-pleaser to her core. She will switch call. She will add on your patient. She will cover your clinic, absorb your overflow, and say yes with a smile every single time. And she will resent you for every single yes she gives.

She is operating from a near-permanent state of overwhelm, but she cannot say no because her self-worth is bound up in being needed and agreeable. She is terrified of disappointing anyone. So she concedes and concedes, until one day, when you ask for one small thing, she loses it. Completely. Disproportionately. And you are left confused because you didn't know the account was overdrawn.

The Exploding Doormat is not malicious. She is exhausted. Her eruptions are not about you. They are the release valve of someone who has never learned that "no" is a complete sentence.

What drives her: Fear of rejection, fear of being seen as difficult, fear of not being enough.

What she needs from you that you shouldn't give: The assumption that her yes actually means yes.

4. The Needy Newbie

She has everything it takes except belief in herself.

This colleague is not incompetent. She is capable, well-trained, and clinically sound. What she lacks is self-trust. She is so deep inside imposter syndrome that she has built an entire operating framework around external validation.

She runs every mildly complex case by a senior partner. She won't operate unless she knows someone is nearby in case she needs rescue. She asks for assistance she doesn't actually need. She runs consults that don't require consultation. She is looking constantly outside herself for confirmation, permission, and reassurance instead of trusting the clinical acumen she has already earned.

Her self-concept is still trainee. She has graduated in credential but not in identity, and she is making life significantly harder than it needs to be for herself, and for the senior colleagues she orbits.

What drives her: A self-concept that hasn't caught up with her competence. Fear of being wrong. Fear of being exposed.

What she needs from you that you shouldn't give: Endless reassurance that reinforces the belief that she cannot trust herself.

5. The Credit Thief

Your work. His presentation. His name on the slide.

This colleague is often charming, well-liked by leadership, and highly visible. He has built a reputation, in part, on contributions that weren't entirely his. He presents your ideas in meetings without attribution. He co-authors without doing the work. He takes ownership of outcomes he observed from a distance.

He rarely does this overtly. It is usually subtle enough that calling it out feels petty or paranoid. That subtlety is by design. He understands that the appearance of collaboration provides excellent cover for extraction.

What drives him: A need for status that outpaces his actual output. The belief that reputation is a finite resource and he must accumulate more of it than you.

What he needs from you that you shouldn't give: Access to your ideas before they're documented or attributed, and your reluctance to advocate clearly for your own work.

6. The Benevolent Gatekeeper

She will help you just enough to keep you coming back.

This senior colleague presents as a mentor. She opens doors to cases, referrals, and the inner circle, but the doors open just far enough and no further. She is generous in ways that preserve her centrality. She needs to be needed, and she has structured her mentorship to guarantee that need is met indefinitely.

She is not malicious in an obvious way. She genuinely believes she is helping. But her help is calibrated, consciously or not, to keep you dependent on her rather than fully independent. When you begin to outgrow the relationship, she becomes subtly discouraging. The support cools. The referrals slow.

What drives her: Identity rooted in status and indispensability. A fear that if you no longer need her, you will no longer value her.

What she needs from you that you shouldn't give: The belief that her mentorship is purely altruistic, and your continued dependency as the price of access.

7. The Martyred Workaholic

He never goes home, and he wants you to know it.

This colleague measures his worth entirely in hours and volume. He was first in and will be last out. He hasn't taken a vacation in three years and will tell you so. He says yes to every add-on, committee, and request because working himself to the bone is his identity and his moral framework.

He is not malicious. But he is contagious. His constant presence, visible sacrifice, and judgment of anyone who leaves at a reasonable hour creates a culture of guilt around normal human limits. He makes boundaries feel like laziness and rest like failure.

What drives him: A self-concept built entirely on productivity. The belief that worth is earned through exhaustion.

What he needs from you that you shouldn't give: Your guilt, any attempts to keep up with him, your admiration for self-destruction.

What All Seven Have in Common

Look across these seven archetypes and you will see two things underneath every single one of them…

Scarcity mindset. The belief that there is not enough. Not enough success, recognition, safety, or worth. And that survival requires hoarding, competing, or controlling.

Fear-based decision-making. Every reactive outburst, political maneuver, passive yes and covert no, is driven by fear—of being exposed, surpassed, or seen as not enough.

This does not make their behavior acceptable. But it does make it understandable. When you can see the fear underneath the behavior, you stop taking it personally. And when you stop taking it personally, you stop being destabilized by it.

The Antidote: Three Essentials for a Resilient Surgical Career

You cannot control who you work with. You cannot always remove yourself from proximity to these archetypes. What you can control is the architecture of your own career. You can build it in a way that makes you genuinely difficult to destabilize.

There are three essentials.

1. Protect Yourself as the Asset

You are the most important instrument in your career. Not your degrees on your wall. Not your title. You. That means investing in your psychological health, self-concept, and capacity to maintain your identity when people around you are doing their best to erode it. The surgeon who knows who she is, independent of what any institution, colleague, or committee says about her, is the surgeon who cannot be broken.

2. Serve the Patients

Staying anchored in purpose is both psychological and strategic. When your primary orientation is genuine service to your patients, your decisions become clean. You are not operating from ego, politics, or the need to win. That clarity protects you from making reactive decisions and being drawn into power struggles. When you set an intention to serve, you no longer risk losing your north star in the middle of the uncontrollable chaos of the world around you.

3. Diversify Your Professional Identity

This is structural protection. The surgeon whose entire identity and income live inside one role—surgeon—has no leverage or safety net. Diversifying your identity through speaking, writing, coaching, consulting, teaching, or building an independent platform means that no single colleague, administrator, or weaponized peer review can define you or dismantle you.

The medicolegal, interpersonal, and politically motivated landmines of a surgical career are real. The colleagues in this post are real. But the strongest protection isn't becoming tougher or more guarded. It's becoming more grounded.

Build a life, identity, and support system that are larger than your job title. Build the self-awareness to recognize when you're being triggered and the courage to respond intentionally rather than reactively.

Most surgeons spend their careers frustrated because they can’t control the people around them. The wiser path is to find radical acceptance of every human you work with and then become someone who cannot be destabilized by them. “Difficult” colleagues will always be there. Your freedom comes from no longer needing them to change for you to become successful.