Ok, I just got this e-mail from a prof at my school, tell me what you think....

Sounds about right.

Markemus said:

"I just came across this passage, from Healing Beyond the Body, by Larry
Dossey, MD. By way of supporting my position about medical education, I
can't resist sending it to you!


"At one major medical school, 80 percent of seniors reported being
abused during their training, and more than two-thirds stated that at
least one of the episodes was of 'major importance and very upsetting.'
Sixteen percent of the students surveyed said the abuse would 'always
affect them.' In another survey of third-year medical students, the
perception of mistreatment (particularly verbal abuse and 'unfair
tactics') was pervasive. Three-fourths of the students reported having
become more cynical about academic life and the medical profession as a
result of these episodes. Two-thirds felt they were worse off than their
peers in other professions. More than one-third considered dropping out
of medical school, and one-fourth would have chosen a different
profession had they known in advance about the extent of the
mistreatment they would experience. Another study of medical student
abuse indicates that the effects of mistreatment are not trivial but are
associated with measurable psychopathological consequences.

These problems are not restricted to the United States. …(A)n estimated
18 percent to 25 percent of newly qualified British physicians never
enter medical practice, or leave medicine shortly after qualifying.""

Ok, so this is a total load of crap right? I can't immagine a culture at any medical even closely related to what is portrayed in this e-mail.

Thanks,
MarKeMuS

Click to expand...

So, I'm only an M1 here, so I can't talk from expereince but more so from what I've heard. The mistreatment is VERY common, but I personally think that there should be a rigorous path that is far from pampering. I'm not condoning these acts, but I'm saying that the harshness helps toughen the doctors-to-be and reduces their errors. Kinda like the military.

One thing that bothers me is the idea of students who "would have gone into a different field had they known BLAH about medicine." As someone who was just premed less than a year ago, I felt like I had to be very educated about what was ahead of me, if not to avoid wasting my life/money in medicine, than to be able to answer questions in interviews, and to convey that I know what I'm getting into. So, how could these med students have made it into med school without knowing what it was like? Many SDNers complain after getting into medschool (a few drop out) but they were on SDN to hear the horror stories when they were pre-meds.... did they think it was all a joke?

I just noticed that I didn't answer your questions. No, it's NOT a load of crap. from what I hear 3rd and 4th year is full of "humbling" experinces. For me to shadow a surgeon as an M1, I have to be "humbled by nurses" and according to the orthopod I'm about to shadow, this "humbling" consists of NURSES YELLING at me to scare me from doing anything wrong in the OR (like contaminate it somehow)....

it's a rite of passage, and I'm looking forward to experincing every minute of it until I cross that stage in 2011!

Without more description of what was meant by abuse or mistreatment, it is impossible to comment on that statement. Truth of the matter is you will probably get yelled at or lectured for screwing up at some point. You will get your ego bruised and feel like an idiot at times. You will be working with people who haven't slept for 30 hours and they will often treat you the way you'd expect someone who hasn't slept for 30 hours might. You need to develop a thick skin, and may need to learn how to work with difficult people. It isn't really all that different than other professional career paths.

WiscDoc said:

I just noticed that I didn't answer your questions. No, it's NOT a load of crap. from what I hear 3rd and 4th year is full of "humbling" experinces. For me to shadow a surgeon as an M1, I have to be "humbled by nurses" and according to the orthopod I'm about to shadow, this "humbling" consists of NURSES YELLING at me to scare me from doing anything wrong in the OR (like contaminate it somehow)....

it's a rite of passage, and I'm looking forward to experincing every minute of it until I cross that stage in 2011!

Click to expand...

Nurses will yell at you if you want to go in and round on a patient before they think the patient should wake up. (I'm sorry I went in at 5:55 instead of 6, but I've got 10 C-sections to see!) They'll also yell at you for afternoon rounds for just checking a patient in the NeuroICU. Ugh. I like nice nurses. So far, most have been extremely nice to me, and probably saved my butt more than once by being like, "So, this attending likes to ask about this in particular..." But I've been yelled at a few times just for doing what I'm supposed to.

Ashers said:

Nurses will yell at you if you want to go in and round on a patient before they think the patient should wake up. (I'm sorry I went in at 5:55 instead of 6, but I've got 10 C-sections to see!) They'll also yell at you for afternoon rounds for just checking a patient in the NeuroICU. Ugh. I like nice nurses. So far, most have been extremely nice to me, and probably saved my butt more than once by being like, "So, this attending likes to ask about this in particular..." But I've been yelled at a few times just for doing what I'm supposed to.

Click to expand...

I was actually talking about like a planned out session, kind of like training before I'm allowed into the OR (since I'm only an M1). It's like an act that is supposed to ensure that I won't be stupid enough to do something stupid... the way the surgeon described it was "I almost crapped myself when I had my humbling session back when I was in med school."

I agree that nurses can be a great source when you are the lost med student that knows nothing!

WiscDoc said:

So, I'm only an M1 here, so I can't talk from expereince but more so from what I've heard. The mistreatment is VERY common, but I personally think that there should be a rigorous path that is far from pampering. I'm not condoning these acts, but I'm saying that the harshness helps toughen the doctors-to-be and reduces their errors. Kinda like the military.

Click to expand...

Harshness has no role in helping to prevent errors. All harshness or abuse do is make the recipient focus on avoiding yelling/screaming/throwing of items in the future, not on what they did incorrectly to "deserve" the treatment and how to avoid that in the future. Constructive criticism goes a lot further in preventing future errors.

An example directly from the wards:
Attending A (a subspecialist) finds fault with everything the interns do. Inevitably if you have one of her patients you will be yelled at on a daily basis and be told how lacking in basic medical knowledge you are. Interns respond by shutting down, brushing off her criticism, and doing the bare minimum for her patients. Interns very little about her (complex) field.

Attending B (also a subspecialist) always notices the interns' weaknesses when it comes to managing his patients. He responds to these weaknesses by asking for time to address the interns as a group during teaching rounds, by meeting individually with the interns who have his patients to go over their notes and the daily plan, and by encouraging questions, even if they come at times that aren't convenient to him. As a result, the interns know how to manage his patients and don't worry about calling him if they have important questions. His patients are managed well on the floor because of this.

SoCuteMD said:

Harshness has no role in helping to prevent errors. All harshness or abuse do is make the recipient focus on avoiding yelling/screaming/throwing of items in the future, not on what they did incorrectly to "deserve" the treatment and how to avoid that in the future. Constructive criticism goes a lot further in preventing future errors.

An example directly from the wards:
Attending A (a subspecialist) finds fault with everything the interns do. Inevitably if you have one of her patients you will be yelled at on a daily basis and be told how lacking in basic medical knowledge you are. Interns respond by shutting down, brushing off her criticism, and doing the bare minimum for her patients. Interns very little about her (complex) field.

Attending B (also a subspecialist) always notices the interns' weaknesses when it comes to managing his patients. He responds to these weaknesses by asking for time to address the interns as a group during teaching rounds, by meeting individually with the interns who have his patients to go over their notes and the daily plan, and by encouraging questions, even if they come at times that aren't convenient to him. As a result, the interns know how to manage his patients and don't worry about calling him if they have important questions. His patients are managed well on the floor because of this.

Click to expand...

I agree that there are multiple methods of dealing with situations. On a day-to-day basis, as an attending, you are the teacher of the interns/students/residents and should have a "teaching plan" that goes beyond yelling. What I am saying is that trainees are not being "abused" if the attending gets out of line once in a while. I don't think attendings should be mean all the time, but tough love can be rewarding!

Well, on the bright side, I'm through 2 months of internal medicine and 1.5 months through general surgery, and have gotten nothing even close to abuse.

I had to laugh a bit at the nurse comments. During vascular surgery, we would round at 5:30 or 6am, so I would be there to pre-round at 5ish usually. An ICU nurse made the comment that "students just don't care about the patients. They just arrive earlier and earlier and the patient can't get any sleep." I told her that I certainly wouldn't be there at 5am if i didn't have to. Like I get up at 4am for fun.

akpete said:

An ICU nurse made the comment that "students just don't care about the patients. They just arrive earlier and earlier and the patient can't get any sleep." I told her that I certainly wouldn't be there at 5am if i didn't have to. Like I get up at 4am for fun.

Click to expand...

LOL. Truth of the matter is that med students serve an important function of already having woken up the patients at 5-6 so that when the team rounds at 7, all the patients are already wide awake, and the higher ups don't come off as the bad guys. A hospital is a bad place to try and get any rest. Which is good, because the goal is to get folks up and out whenever possible.

20. Have you personally been mistreated during medical school?
Percent Percent Percent Percent Percent
'03 '04 '05 '06 '07
Yes 15.0 13.5 12.7 12.2 14.7
No 85.0 86.5 87.3 87.8 85.3


http://www.aamc.org/data/gq/allschoolsreports/2007.pdf

mistreatment starts on page 37 of the file.

so it looks like about 15 percent of med students, over the past 5 years, report they were mistreated during med school.

WiscDoc said:

So, I'm only an M1 here, so I can't talk from expereince but more so from what I've heard. The mistreatment is VERY common, but I personally think that there should be a rigorous path that is far from pampering. I'm not condoning these acts, but I'm saying that the harshness helps toughen the doctors-to-be and reduces their errors. Kinda like the military.

One thing that bothers me is the idea of students who "would have gone into a different field had they known BLAH about medicine." As someone who was just premed less than a year ago, I felt like I had to be very educated about what was ahead of me, if not to avoid wasting my life/money in medicine, than to be able to answer questions in interviews, and to convey that I know what I'm getting into. So, how could these med students have made it into med school without knowing what it was like? Many SDNers complain after getting into medschool (a few drop out) but they were on SDN to hear the horror stories when they were pre-meds.... did they think it was all a joke?

Click to expand...

Exactly.

I was surrounded by many people (including family members) who told me what medical school was like, but, as the saying goes, "You have to see it to believe it." For someone who hasn't ever really had a hard time with academics, medical school can be quite a culture shock. After all, it wouldn't be the first time that someone said that something was hard and it turned out to be a cake walk.

Also, as you progress through the years, you'll see that it's not always about how smart you are but how well you get along with people, how well you can compartmentalize your social/home life from your work life, and how much you can look at your friends who graduated undergrad with you making $$$$ working <40 hrs/wk while you rack up the student loans and become more and more sleep-deprived. That last one takes a little getting used to.

You can't know everything about medical school before you start medical school no matter how many people you shadow. You don't know what is going to bother you. I remember one of my classmates, after his first rotation, realizing he didn't like dealing with patients! Obviously he'd shadowed before med school but shadowing as an undergrad and trying to perform a DRE on a schizophrenic off his meds at 3 am are two different things!

As prior military, I will tell you that there is a difference between mistreatment and "tough love". I've experienced both and will tell you that mistreatment begets more mistreatment and leads to resentment and backstabbing, not better doctors.

To answer the OP, I guess I've had what could be called mistreatment once or twice, but nothing I'd cry about or note on a survey.

chaser08 said:

As prior military, I will tell you that there is a difference between mistreatment and "tough love". I've experienced both and will tell you that mistreatment begets more mistreatment and leads to resentment and backstabbing, not better doctors.

To answer the OP, I guess I've had what could be called mistreatment once or twice, but nothing I'd cry about or note on a survey.

Click to expand...

My dad was in the Navy before med school. He said that there were several situations he faced in med school, that if he hadn't become used to having people yell at him, or whatever, with him being a jr. officer, he would've had a hard time.

He told me that before I started med school, but I worked in a hospital as a phleb, and I had the other phlebotomists mad at me for not drawing as well as they, and I'd come home crying.

Ashers said:

My dad was in the Navy before med school. He said that there were several situations he faced in med school, that if he hadn't become used to having people yell at him, or whatever, with him being a jr. officer, he would've had a hard time.

He told me that before I started med school, but I worked in a hospital as a phleb, and I had the other phlebotomists mad at me for not drawing as well as they, and I'd come home crying.

Click to expand...

I was a phleb too, and experienced nothing like that. Those other phlebs were complete dinguses and if they treated me like that I would have told them to **** off.

NCF145 said:

I was a phleb too, and experienced nothing like that. Those other phlebs were complete dinguses and if they treated me like that I would have told them to **** off.

Click to expand...

I get majorly stressed out from just the thought of drawing blood, even if a person has great veins. Not that I'll miss, but I just remember them all getting mad at me, complaining about my lack of skills (partially due to a lack of training on their part), and complaining and gossiping about me in Tagalog (one of the lab techs told me about it -- I had wondered what all the conversations with "...Ashers..." were about).

In the ER, if I couldn't get a draw because the patient was really hard, MDs and RNs would help me, so I wouldn't go back and get yelled at. I hated that job.

3 thoughts on "abuse" from an M4.

1. It happens alot, and should be officially discouraged with sanctions, dismissals etc when it becomes a pattern.

2. While the "powers that be" should battle the systems that allow abuse of medical students, medical students themselves should be tough. Residencies are looking for tough applicants. I'm not saying you should allow yourself to be pushed around, but you should do your best to remain cool, professional, and unflappable.

3. I took alot of "abuse" as an M3, as an M4 I don't put up with it. Just the other day an attending started belittling me on an extremely trivial point. I interrupted her, corrected her, and asked if she had any other questions. She backed down. Not trying to brag, just encouraging other students to push back when it is appropriate.

surebreC said:

dude, stfu. You are an M1, you don't know what the "humbling" entails, and you don't know whether it will help you are not. Actually, as an M1, at the beginning of M1 year, you know approximately jacksquat - so do everyone a favor and shut your trap.

Click to expand...

You sound like you just came out of Room 572 in the East Building. Is that old kook still wandering the halls looking for me?

Do me a favor, tell him I took his advice and went to Hell - if he wants me, he can find me there.
Seems like a more fitting place to hear Act 5 of his "Why you're an idiot" monologue anyway....

I think what the e-mail refers to is that medical education has traditionally been an environment of fear and intimidation. Thank Dr. Cox on scrubs. The problem with this is that 1) Intimidation might not always be the best teaching tool and 2) The cycle perpetuates itself b/c students tend to emulate their mentors so you produce more Dr. Coxs. Given that doctors are supposed to compassionate and personable, it's not good for the education system to be producing Dr. Coxs.

An example for my own experience. At my school we have medical skills once a week. Before hand we're given a reading assignment on the skills. It's pretty hard to learn physical skills exactly from a book. However, we have instructors who test us the skill cold turkey when we walk in the door and if we're uncertain about it they yell at us for not having done the reading. While the experience helps us thicken our skin it doesn't really help us learn the skills as well as when the instructor demonstrates the skill and allows us to practice it before testing.

WiscDoc said:

What I am saying is that trainees are not being "abused" if the attending gets out of line once in a while. I don't think attendings should be mean all the time, but tough love can be rewarding!

Click to expand...

For some reason, I don't think having surgical instruments thrown at you in the OR or being told to "f*** yourself and do us all a favor and jump off the roof" by an attending are tough love. But if you want to endure that proudly until you graduate in 2011, all the more power to you.

Ashers said:

Nurses will yell at you if you want to go in and round on a patient before they think the patient should wake up. (I'm sorry I went in at 5:55 instead of 6, but I've got 10 C-sections to see!) They'll also yell at you for afternoon rounds for just checking a patient in the NeuroICU. Ugh. I like nice nurses. So far, most have been extremely nice to me, and probably saved my butt more than once by being like, "So, this attending likes to ask about this in particular..." But I've been yelled at a few times just for doing what I'm supposed to.

Click to expand...

I've been preparing for this by moving in with my girlfriend. By the time rotations roll around I assume I'll be immune to all types of abuse.

Markemus said:

Another study of medical student
abuse indicates that the effects of mistreatment are not trivial but are
associated with measurable psychopathological consequences.

Click to expand...

LOL! Holy S#$%.

Law2Doc said:

Without more description of what was meant by abuse or mistreatment, it is impossible to comment on that statement. Truth of the matter is you will probably get yelled at or lectured for screwing up at some point. You will get your ego bruised and feel like an idiot at times. You will be working with people who haven't slept for 30 hours and they will often treat you the way you'd expect someone who hasn't slept for 30 hours might. You need to develop a thick skin, and may need to learn how to work with difficult people. It isn't really all that different than other professional career paths.

Click to expand...

No the abuse that you get on the wards is people telling you that you are doing a good job and then turning around and saying something else about you to the course director who later calls you in his office and tells you that you are underperforming.... and when you try to get back on the wards people once again tell you what a wonderful job you are doing... its more about people playing with your mind than anything else..medicine is a mind game.

Law2Doc said:

Without more description of what was meant by abuse or mistreatment, it is impossible to comment on that statement. Truth of the matter is you will probably get yelled at or lectured for screwing up at some point. You will get your ego bruised and feel like an idiot at times. You will be working with people who haven't slept for 30 hours and they will often treat you the way you'd expect someone who hasn't slept for 30 hours might. You need to develop a thick skin, and may need to learn how to work with difficult people. It isn't really all that different than other professional career paths.

Click to expand...

I doubt Podiatry and Pharmacy students are getting treated like the OP
and the study mentioned.
So I don't agree that its no different than other professional career paths.

surebreC said:

dude, stfu. You are an M1, you don't know what the "humbling" entails, and you don't know whether it will help you are not. Actually, as an M1, at the beginning of M1 year, you know approximately jacksquat - so do everyone a favor and shut your trap.

Click to expand...

I never really claimed to know much of anything, so what I DO know is really irrelevant. I was just passing along what an orthopedist told me about the process. So you are right, I don't know what humbling entails, but you are wrong, conveying what an attending told me may do some good (as opposed to shutting my trap). As for my opinion, I was just its annoying how med students complain of stuff such as "we have to study all the time" or "attending was mean to me on a rotation." Maybe its because I never took being in medical school for granted to remind myself of how badly I wanted to do this.

P.S. And you know everything as that much more experinced M2?

Honestly, no one put a gun to your head and said
"you better go to med school". That's why I really
just dont get some people.

Re3iRtH said:

Honestly, no one put a gun to your head and said
"you better go to med school". That's why I really
just dont get some people.

Click to expand...

Thank you... that's what I'm talking about!

surebreC said:

Yeah, get back to me on how you aren't taking it for granted when you're studying for Step I. Again, its easy to take such a high and mighty stance when you've been in medschool all of a month.

Click to expand...

I am sorry that your bitter about your experience, but I am TRYING to remain optomistic about mine. When I was pre-med being in med school was like a dream, and I still view it as a privelage. I know MOST (you included) view it that way too, and that these boards are a good means of venting. I appreciate that you have been through more than I have (still don't appreciate the attack though). If it makes any difference, I started school in May, so I have been in med school for about 6 months. I am not trying to be high and mighty, I just get irritated by people who complain about the little details like actually having to spend more than 2 hours a day studying. It's like come on, we knew we had that coming, didn't we? Anyways, good luck with the rest of your med school years! I think we are supposed to look back at these years and laugh. We'll see

surebreC said:

Well, to be perfectly honest, nobody gives a crap what some attending who've you've never shadowed but plan on shadowing told you about getting "humbled" being a positive experience. It's the equivalent of "my friend's brother's sister told me..."

And yeah, I'm an M2 and haven't been on the wards yet aside from the stuff we do M1/M2 years (of course, I have been here a tad longer than your month of medschool and we do have presentations which sometimes involve being called "stupid"). However, I am not the one making claims about how great getting berated is.

Click to expand...

Haha... sorry had to respond to that, just because you don't doesn't mean that nobody else does. Unless all of a sudden YOU are "nobody." That's really not nice to say about yourself. If it makes you feel any better, I think you are somebody!

surebreC said:

Yeah, what's your point? If I went to medschool and the school decided that giving us all electric shock collars that they could activate when we got a question wrong would make us better students, would you argue "hey, what are you complaining about, no one forced you to go to medschool"? Just being the status quo doesn't make something right nor does it mean it is a good teaching tool.

Click to expand...

Well sorry to say, but if you don't like you med school's teaching practices,
there isnt much you can do about it now. And I'm sure someone along the
line told you that med school is a b*tch. This doesn't have to include
just having to study a lot. Some people actually enjoy studying quite
a lot. No one likes to be put down, but I've heard about how med students
are scut monkeys even before I considered medicine.

WiscDoc said:

I am not trying to be high and mighty, I just get irritated by people who complain about the little details like actually having to spend more than 2 hours a day studying. It's like come on, we knew we had that coming, didn't we?

Click to expand...

Did we know that we had these things coming?

- medical student referred to regularly as "girl" on rounds

- medical student asked to take attending's car to the mechanic

- medical student publicly referred to as "p*ssy", "jacka$$", and "******"

How about these?

- medical student instructed to purchase lunch for residents with their own money

- medical student has attending grab her breast in the middle of the hospital

- medical student told by preceptor to leave the operating room and never scrub into another surgery in that hospital

Or these?

- resident has hands routinely slapped in the OR

- attending throws tray across room during case

- medical student punched in the arm hard enough to leave a bruise after giving wrong lab value on rounds



You are an MS1. You are impressed with your accomplishments, and you should be. But do not think that a couple medical school classes makes you some kind of authority on what is and is not appropriate, and what makes a physician "tough".

I hope everyone realizes the source of this passage is on par with the colon cleansing guy and magical Jesus water infomercials they run on television at 4am. I know it's slightly out of context but the numbers quoted in the passage sound bejiggered to fit the author's case and agenda, namely selling for profit his ideas on combating disease via the powers of herbs, prayer, positive thinking, etc. For example, I refuse to believe a quarter of British med graduates drop out of the profession because of abuse. Not that abuse doesn't occur in the medical educational system (it obviously does), but like others posted I don't think it's grossly more or less than many other professions so I take it in stride.

i am done with training. I will say that all the abuses and the hoop jumping and the back stabbing and all the silly evaluations are all not needed to produce competent doctors. all that stuff makes me a worse doctor because i am most bitter. I remember being TORTURED huge on the wards. It was like you have to read peoples minds. Everybody ignores you when you are around but the 20 minutes you decide to go take care of something personal, you are written up like "nobody can ever find him". The people were all abrasive, no manners, refuse to teach(it was like if they didnt like you they would keep things from you), talk behind your back... out to get you. it was unbelievable.. most horrendous experience The worst of it is you HAD to take it and live with it. and it went on and on and on.

Tired said:

Did we know that we had these things coming?

- medical student referred to regularly as "girl" on rounds

- medical student asked to take attending's car to the mechanic

- medical student publicly referred to as "p*ssy", "jacka$$", and "******"

How about these?

- medical student instructed to purchase lunch for residents with their own money

- medical student has attending grab her breast in the middle of the hospital

- medical student told by preceptor to leave the operating room and never scrub into another surgery in that hospital

Or these?

- resident has hands routinely slapped in the OR

- attending throws tray across room during case

- medical student punched in the arm hard enough to leave a bruise after giving wrong lab value on rounds

Click to expand...

Can't half of those things be considered sexual/physical harassment in a legal sense (especially the more physical things)? Events like these have been beaten into me as being "unprofessional" and "suable" during orientation and professionalism lectures (ugh). I know that the clinical years aren't supposed to be a breeze, but at the same time, there's a certain line you have to draw between being the intern bitch and unwarranted degrading behavior.

Just wanted to thank the upper classmen for sharing their experiences. Just to be clear, I was NOT trying to down play the hardships that med school entails, or belittle what B.S. you had to undergo on the wards. I never heard for such stories at my school, as Slide mentioned, some of these issues are suable... but maybe our upper classmen are trying not to scars away, or maybe Wisconsin is just too boring for action (in a good way this time, I guess).

Slide said:

Can't half of those things be considered sexual/physical harassment in a legal sense (especially the more physical things)? Events like these have been beaten into me as being "unprofessional" and "suable" during orientation and professionalism lectures (ugh). I know that the clinical years aren't supposed to be a breeze, but at the same time, there's a certain line you have to draw between being the intern bitch and unwarranted degrading behavior.

Click to expand...

Yes they are, but you'll still find medical students who will gladly put up with them because "I've got to pay my dues!".

Although Tired's examples have surely happened (I know 2 or 3 of them that have happened at my institution!) I think most medical students would realize thosre are unacceptable behavior and report the physician. Although it's notoriously hard for anything bad to happen to an attending based on a med student complaint, if the behavior is blatant enough, retribution can occur. (Once again, someone did complain about one of the infractions on Tireds list when it occured at our hospital. The attending was punished...not as much as he should have been but action was taken.)

The real hard stuff to deal with is the borderline stuff. Attending makes a borderline inappropriate comment to a student, not enough to report him but still inappropriate. Attending/Resident asks the student to fetch something for him that he forgot on the other side of the hospital. Of course it's wrong to do, but it's probably easier for you just to do it than complain about it. The attending who chews you out in surgery for a mistake you made. You understand that you were wrong, but it's starting to head into abuse territory.

PeepshowJohnny said:

Yes they are, but you'll still find medical students who will gladly put up with them because "I've got to pay my dues!".

Although Tired's examples have surely happened (I know 2 or 3 of them that have happened at my institution!) I think most medical students would realize thosre are unacceptable behavior and report the physician. Although it's notoriously hard for anything bad to happen to an attending based on a med student complaint, if the behavior is blatant enough, retribution can occur. (Once again, someone did complain about one of the infractions on Tireds list when it occured at our hospital. The attending was punished...not as much as he should have been but action was taken.)

The real hard stuff to deal with is the borderline stuff. Attending makes a borderline inappropriate comment to a student, not enough to report him but still inappropriate. Attending/Resident asks the student to fetch something for him that he forgot on the other side of the hospital. Of course it's wrong to do, but it's probably easier for you just to do it than complain about it. The attending who chews you out in surgery for a mistake you made. You understand that you were wrong, but it's starting to head into abuse territory.

Click to expand...

Yeah, I don't really have a really big issue about doing things like fetching someone's stuff, or being lectured/chewed out for making a big mistake (happened to me a lot in college during my workstudy job). It's the stuff that would require me to sacrifice my dignity as a person (like being subjected to physical abuse) or being abused just due to my race. Well the bright side is that there is a higherup that supposedly might deal with the problem. I know in the Hollywood industry such practices as Tired described are common towards interns, and unfortunately there really is nothing that can be done about it in that industry.

AmoryBlaine said:

3 thoughts on "abuse" from an M4.

1. It happens alot, and should be officially discouraged with sanctions, dismissals etc when it becomes a pattern.

2. While the "powers that be" should battle the systems that allow abuse of medical students, medical students themselves should be tough. Residencies are looking for tough applicants. I'm not saying you should allow yourself to be pushed around, but you should do your best to remain cool, professional, and unflappable.

3. I took alot of "abuse" as an M3, as an M4 I don't put up with it. Just the other day an attending started belittling me on an extremely trivial point. I interrupted her, corrected her, and asked if she had any other questions. She backed down. Not trying to brag, just encouraging other students to push back when it is appropriate.

Click to expand...

In that case, consider yourself lucky. At my institution, they will destroy you for talking back to an attending, or for that matter even an intern, regardless of the circumstances.

They will document whatever mistakes you make during the month (and all med students make at least some mistakes). Your evaluation at the end of the month will be several pages long, trumping up whatever mistakes you made and making no mention of actually relevant facts like "X showed up to work on time every day and did all that was asked of him". You'll get failing scores all the way down, and they'll check off the box saying that you need extra evaluation (basically that you need to repeat the clerkship).

And of course it'll all show up anonymously one day when you go to check your scores on E-value, so you may not even know who did it.

Of course you get to evaluate them, but they don't give a damn what medical students say. Also, if you happen to fail and you're made to come back to that department, you don't want to work for somebody that you wrote a nasty evaluation about the first time around because they'll take it out on you this time. So on your end, you have to give everybody good evaluation and pretend there are no problems. If you complain, the university perceives you as a troublemaker and will summon you before a committee.

Then again, I've rotated with DO students who bring a checklist in everyday. So long as the attending checks off that they worked for the day, they pass their rotations. Another DO student I worked with had an evaluation form that had to be filled out in his presence by the attending (no secret evaluating/backstabbing bull****). I much rather prefer this. Maybe the DO's are on to something that we could learn from.

Some of the interns will definitely "Scut you out"!!! " MS-III is definitely a transitional year. Expect anything from appreciation to humiliation depending upon your intern and residents. Most of the attendings won't even bother learning your name during the rotation. But you will have fun too. The hardest thing to get used to is the exhaustion and mental fatigue as well as the decreased tolerance for mistakes during rounds. Wait until you give the lab alues for the wrong patient when presenting a case on one of your patients, then you will see intimidation.

WiscDoc said:

I just noticed that I didn't answer your questions. No, it's NOT a load of crap. from what I hear 3rd and 4th year is full of "humbling" experinces. For me to shadow a surgeon as an M1, I have to be "humbled by nurses" and according to the orthopod I'm about to shadow, this "humbling" consists of NURSES YELLING at me to scare me from doing anything wrong in the OR (like contaminate it somehow)....

it's a rite of passage, and I'm looking forward to experincing every minute of it until I cross that stage in 2011!

Click to expand...

Having NURSES yelling at you is a minor annoyance. Let us know how you feel after your attending, the guy you were hoping to get a letter from because you are applying to his specialty, belittles you and lets his residents use you as a verbal punching bag. I've seen it happen; thankfully not to me.