Hi
I am in a difficult situation and would like some advice. I am in a preliminary medicine year position, but would like to stay in medicine. I want to approach my program director for this, but am nervous since my first month's evaluation isn't really good. It says things like "had some difficulty with during this month. Needs to take more of a leadership role with her patients and more proactive in decision-making". I really love medicine and I have done all my duties as a resident. I feel lost as to how to approach my program director about this.

Don't despair. I wouldn't approach the PD now. Wait a couple of months, hopefully until you get some better evaluations. Don't despair. I also got a not good evaluation my first month of internship, but I ended up as a cardiology fellow, so you never know. Sometimes it's just hard to get used to new people and a new hospital, new computers, etc. Also, some attendings will just decide to dislike you (or some residents will...). Others will like you for no apparent reason, or are just easier graders. HOWEVER, I would swallow your pride and I would call up your attending from this past month, and just hear him/her out, ask for 5 minutes to discuss what he thinks went wrong on your last evaluation. Some of the criticisms might be inaccurate, but it's always good to know what people are saying about you, and what they are basing that on. There is probably both some truth and some inaccuracy in what he/she said in the evaluation. Sometimes attendings don't notice the hard work we are doing...they see us only an hour or so a day, and get a very superficial impression of what is going on. However, by talking with the attending you could get some good insights. Just don't take it too personal - take it with a grain of salt but try to absorb any helpful/constructive criticism. Then if your PD mentions the bad evaluation, you can say "Oh yes Mr PD I really love internal medicine and I love this program, I love taking care of patients and I was disappointed in my evaluation, so I already talked to Mr Attending So and So to get specific feedback about how I can improve, since I am definitely dedicated to being the best internist I can be!"

First of all, i dont think that eval is necessarily "bad". I think most interns are kind of like what the eval described in their first month. You'll get the hang of things as the rotations go on.

Secondly, I agree with dragonfly that now is not the time to approach the PD regarding staying on as a PGY2, not because of your eval though, but because the PD will likely make this decision based on how you do throughout intern year, and there is just not enough information about that after just one month under your belt. Also, there will be a question of how are you sure you want to stay as a medicine resident. Towards the end of the year you will have more to support your decision, and the fact that you still like medicine despite the hardships you've had to endure intern year will also reassure your PD. Thus, I guarantee that if you talk about this with your PD now, all you are going to hear is "it depends on how you do this year" or "we'll see". So around Feb, March, April is when I'd recommend having this talk with your PD.

good luck!

Don't get discouraged. You may receive some good advice if you also approach your chief residents when you're ready. Try to get to know everyone first.

Hi
I am in a difficult situation and would like some advice. I am in a preliminary medicine year position, but would like to stay in medicine. I want to approach my program director for this, but am nervous since my first month's evaluation isn't really good. It says things like "had some difficulty with during this month. Needs to take more of a leadership role with her patients and more proactive in decision-making". I really love medicine and I have done all my duties as a resident. I feel lost as to how to approach my program director about this.

I think if you go to talk to your PD then he/she may suspect that you are coming seeking advice about your poor evaluation, and might be put off that you want to discuss a promotion to a categorical year. Not necessarily bad, but sounds "off" to me if I was the PD. While you may "love" medicine and "do all your duties", what resident doesn't?

Not to be mean, but if I was the PD it sounds like you were/are planning to apply for a categorical position at your home program and want to counter your poor evaluation with comments about how much you like the field.

I think you should wait until you get a great evaluation, otherwise you are the problem resident who didn't address their poor eval with the PD but wants to be reassured that they will be promoted. Again, not to be mean but it doesn't sound right for someone just on the job 1-2 months who has a poor eval to be talking about doing the categorical residency at this institution. If all your evals are poor like this then you would probably not get a categorical spot at this program and it would be embarassing to ask. I think that deep down you want reassurance that this one poor eval hasn't torpedoed your chances at this program, something which the PD can't give you as he/she doesn't know you yet.

OK palmolive, I don't think it was really necessary to flame the OP, though I suppose you have a point.
For the record, I don't think it's true that all residents love medicine and work their butts off...they don't. I've been at 2 supposedly top 20 or so medical centers and I've seen some nondedicated and/or lazy residents. Most work hard, but some don't. Some who don't get away with it by having a winning personality, plus being a good test taker. And don't think I'm ragging on good test takers 'cause I'm jealous, because I'm one of those good test takers.... I think that loving medicine does matter and would probably matter to the PD if he/she believes the OP means it, but I agree now isn't a great time to approach the PD.