4th year bossing me around

[Smiths11]

I'm a 3rd year and so far having a blast. First two years were a real struggle for me and I doubted myself and my decision to go into medicine a lot; and so I can say with confidence that I am finally happy with my choice to become a doctor.

I'm also lucky that I have great residents and seniors, completely opposite of all the terrible stories I've heard of overworked residents ****ting on students.

Then there is the 4th year on our team. He's a real gunner and thinks he's my boss. Honestly I get more stressed out being around him than any of the attendings, seniors, or interns. I am not sure how to handle this situation. I know that him and my senior are pretty close as he rotated throughout her 3rd year here. So I feel it's tricky because I don't want him to give the senior an impression that I am not helping enough.

What I get irritated by is his condescending tone and constant lectures. I don't mind learning about medicine from him, but then there are little things he does where I feel he either wants to take advantage of me or just enjoys the thrill of having someone under him.

For example, he asked me the other day to take his patient lists to the shredder when I take mine out. It really wasn't a big deal since I just had to walk 30 feet, so instead of worrying about pissing the senior off by saying no to him, I just did it. He also told me to do bed checks and text him with results so he can update the system. He always "tells" me like he's my mother, to come walk with him when he has to go take care of something, and never asks.

Then he tells me how I shouldn't study during the day (even though we have plenty of time just sitting around), and that all studying should be saved for after or before work. He tells me not to bring my Step 2 book around during rounds (I just carry it around to look up things when needed quickly).

He asked me to come and take notes while he was interviewing a patient. He claimed the senior asked him to ask me, so I just took his word for it - again I feel trapped bc I really don't know what the senior wants or is thinking.

And finally in true gunner style, he over compliments me over the stupidest things, probably to throw me a bone for doing him little favors so I keep coming back. It's very condescending. For example, he complimented me for taking notes while the senior was discussing the day's cases; or when I did the bed check for him.

I honestly don't know what to do. I can stick up pretty well for myself in my personal life, but I don't know what to do here because I am the youngest member of the team and am constantly worried about pissing people off. I wouldn't mind sucking up and doing favors for the seniors or attendings but this is a damn student.

Any one here have any advice on how to deal with this? It's causing me stress. I can either: a) continue putting up with the crap, b) straight up tell him that I don't work for him and to leave me alone, c) complain to my senior, d) be passive aggressive and avoid him and helping him as much as I can, e) any other ideas?

Thanks for reading.

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[GUH]

Is your 4th year friend responsible for your grade?

I'm no expert but it honestly doesn't sound so bad. It doesn't seem like he has threatened you and he's thanked you for helping him when asked.

 

[Smiths11]

Is your 4th year friend responsible for your grade?

No.

But my 4th year super friendly with my senior. Also since I'm new to this (obv just a 3rd year), I don't know if there is or isn't any hierarchy, or to what extent, where a 3rd year works under a 4th year.

So if you're implying I shouldn't take any crap from him, what exactly is the best way to go about this?

 

[Psai]

Tell him to **** off
i wouldnt put up with that nonsense

 

[Smiths11]

Maybe I'm just slow and dumb since I've never worked before and don't understand office politics...but if I tell him to **** off, I think that would create more problems then it would solve.

Not trying to troll here, but I really don't want to start a war with him

 

[byaaaaaaah23]

How long will you be on this team/this rotation? In my experience, teams change after a few weeks at most so I would try to stick it out if I were you. Sounds like a really ****ty situation but I agree that it doesn't really sound like there's much you can do without possibly making yourself look bad to the people who are grading you.

 

[Kaustikos]

Wow. I never thought fourth years could be bad. Like, you're supposed to be acting as an intern on some services but if you're already taking advantage of/using/abusing students, then you have another thing coming.

OP, I would just let it slide. It sucks, but it doesn't like like they're making your life completely miserable or horrifying. Yes, they aren't right in their actions. But unless you want to deliberately screw him over by not doing what he asks and having it back fire on him without any repercussions on your end, I'd er on the side of caution.

Sidenote: you should definitely NOT be bringing any textbooks during rounds. Get a tablet or PDF file of your step 2 book. Otherwise, jot down what you don't know and look it up later.

 

[cbrons]

Dont bring your textbook on rounds. A Step 2 book isnt good for looking stuff up anyway.

 

[operaman]

Doesn't really sound that bad to me, honestly. Maybe not ideal and I'm sure the attitude and tone that accompany these things are the real issue, but compared to what some people face, it's basically a minor nuisance and not worth even mentioning. The advice you've listed is all good so I'm not sure what the problem there is. I get the scut work sucks a little, but it still has to be done and is honestly helpful; maybe he can learn to ask it in a way that is more collegial. I know whenever I've offered help and advice to underclassmen, I do it because I care and want both to help them and ensure they have a great experience. I'm sure I must have annoyed at least one or two of them, but I think everything I did was well-intentioned. Maybe lets give this guy the benefit of the doubt.

 

[Ebola4Breakfast]

Other than telling you not to study, which is stupid, I don't really see anything that bad. At least he's making sure the senior knows you're contributing. While that fact may be obvious to you, the senior may be too preoccupied to notice.

 

[cbrons]

Don't waste your time fighting this. Even if you win, you still lose.

 

[Kaustikos]

Doesn't really sound that bad to me, honestly. Maybe not ideal and I'm sure the attitude and tone that accompany these things are the real issue, but compared to what some people face, it's basically a minor nuisance and not worth even mentioning. The advice you've listed is all good so I'm not sure what the problem there is. I get the scut work sucks a little, but it still has to be done and is honestly helpful; maybe he can learn to ask it in a way that is more collegial. I know whenever I've offered help and advice to underclassmen, I do it because I care and want both to help them and ensure they have a great experience. I'm sure I must have annoyed at least one or two of them, but I think everything I did was well-intentioned. Maybe lets give this guy the benefit of the doubt.

Yeah,
I've seen worse from higher ups and they don't even acknowledge your contributions or refrain from helping you in general. Some literally do it to punish you and still punish you further on evaluations.

Other than telling you not to study, which is stupid, I don't really see anything that bad. At least he's making sure the senior knows you're contributing. While that fact may be obvious to you, the senior may be too preoccupied to notice.

Exactly. I don't mind scut work if the people tell their seniors about how I'm contributing.

 

[gators21]

Yes there is a hierarchy. He has one year more experience. But thats like saying there is a hierarchy between dog poop and cat poop. They are both still poo.
Don't bring a book on rounds. Look it up after. During down time is fine, but not if things need to be done
Asking you to throw something out, while you were going to anyways, isn't taking advantage of you. Its just being nice. Now if he expects you to do it everyday, than yea he's taking advantage of you.
Asking you to do bed checks should be the responsibility of the resident to delegate, but not unheard of to delegate a 4th year to do it
None of these seem like a huge deal, just more of him having more experience in getting things done
The only thing you should be pissy about is taking all the notes. You are not his scut monkey. Tell him to take his own.

 

[Fatalis]

I am surprised a 4th year actually cares that much lol!

 

[Freddie Mercury]

Sounds rough but not too bad. Maybe talk to him directly and talk about the personality clash. He might actually be trying to help you look good. Try to get his side of the story before escalating.

 

[Petypet]

Opportunity to grow thick skin and realize that in a few weeks you'll be on to different ground. It doesn't sound like that bad of a situation over the internet, and you are reacting to everything he does or says. Just do your work, be cordial, and move on.

 

[justin1390]

Yeah honestly, the last two 4th year rotations I've been on, the residents have actually split the team into resident and med student teams with the 3rd years under my charge. I basically watch out for the 3rd years, delegate tasks on patients we cover, distribute new admissions, and select their patient loads, time they go home, etc. I do care a lot as a 4th year, and they provided me the opportunity to function as a leader, which was a great opportunity. In that sense, there is always someone higher than you, and it really sucks sometimes having someone just barely your senior taking charge.

I tried to be super respectful of that when I have 4th years. So much of this feeds off the mentality of the 4th year, too. For instance, I'm generally pretty hard working and motivated, and it's crazy to see how efficient a team will get with the right morale. That said, when your work is done, you go home from my perspective. My patients are my responsibility. I won't ask you to do a thing that doesn't relate directly to your patient's care. During rounds, I'll slip you tidbits/suggestions to help you look good in front of the attending. If you have a question, I'll gladly answer it, even if I'm stressed. Afterall, we all have to start somewhere and questions means you are learning something. The residents and 3rd years and I got along super, super well. We even went out to lunch together after the rotation was done. I think what is said above is really important for a good team.

In terms of your 4th year, distance yourself from him and start reporting directly to the resident. Makes life a lot easier. Be careful and diplomatic in how you confront the situation. If asked to do something trivial, just say you're more than happy if you have time, but you are currently assisting the residents. A 4th year won't risk being called out for pulling a student away from resident tasks. On the other hand, if you are hard working but he throws a fit because you aren't doing what he wants, it makes him look incredibly foolish to the residents, who see a hard working 3rd year. Sounds like you are doing a fine job. Keep that tough skin and work hard.

 

[Skip Intro]

Any one here have any advice on how to deal with this?

You ready? This is a sure-fire way to fix this:

1) Smile at him and ignore him. If he starts to bark orders, just do this: politely turn and walk away. Be nice. Don't say a word.
2) Do not respond to his questions, dictums, mandates, comments, concerns, etc. Look away and start engaging someone else if he starts this after you do the things in (1). If he continues to want to talk to you, interject and change whatever subject he wants to talk about. Be persistent in this.
3) Go out of your way to interact with the person(s) who will be assigning your grade. And, be super nice and attentive.

Give it 2-3 days, and he'll get the picture.

He's a year "older" than you in this game. He's like an alpha dog that needs to learn that he's not actually the alpha. Not worthy of your worry/concern. And do not say anything to your intern/resident/attending. Just follow steps 1-3.

-Skip

 

[BruceWilly]

You ready? This is a sure-fire way to fix this:

1) Smile at him and ignore him. If he starts to bark orders, just do this: politely turn and walk away. Be nice. Don't say a word.
2) Do not respond to his questions, dictums, mandates, comments, concerns, etc. Look away and start engaging someone else if he starts this after you do the things in (1). If he continues to want to talk to you, interject and change whatever subject he wants to talk about. Be persistent in this.
3) Go out of your way to interact with the person(s) who will be assigning your grade. And, be super nice and attentive.

Give it 2-3 days, and he'll get the picture.

He's a year "older" than you in this game. He's like an alpha dog that needs to learn that he's not actually the alpha. Not worthy of your worry/concern. And do not say anything to your intern/resident/attending. Just follow steps 1-3.

-Skip

This, all day every day.

 

[Apoplexy__]

Honestly while reading the OP's post, I got the impression that this is an MS4 who is unaware of the way he's coming off and could just be trying to be helpful/nice and provide some structure to OP's rotation.

I'd hesitate towards taking an offensive. Politely wiggle out of things you don't want to do. Confirm with residents that orders the MS4 relays from them are in fact from them. Spend more time with the residents and interns and less with him. Minimize how nice/thankful you are when he guides and lectures you, or else he will just keep doing it.

 

[Frazier]

For example, he asked me the other day to take his patient lists to the shredder when I take mine out. It really wasn't a big deal since I just had to walk 30 feet, so instead of worrying about pissing the senior off by saying no to him, I just did it. ....

He tells me not to bring my Step 2 book around during rounds (I just carry it around to look up things when needed quickly).

And finally in true gunner style, he over compliments me over the stupidest things, probably to throw me a bone for doing him little favors so I keep coming back. It's very condescending. For example, he complimented me for taking notes while the senior was discussing the day's cases; or when I did the bed check for him.

None of these should be on your list...

He asked you to take some extra papers to the shredder when you were already going there? (Sounds like a normal person thing to do.)

He recommended you not carry a step 2 study textbook on rounds? (Sounds like he saved you from looking like a brand new ms3. It easily can give the wrong impression to your superiors and maybe your patients.) Do you hide it in your pocket?

You are upset because he shows you approval for a job well-done after you do a task? (Would you really feel better is he showed no sign of gratitude?)

Some of the other points you make sounds more legitimate.

 

[uselessmember]

Sounds like a personality clash rather than mistreatment.
Issues like these happen when students are paired together.
Ideally, MS3 should work alongside the Intern, and MS4 should report to the Senior.

If it bothers you so much, just ask the intern/resident to work/shadow directly (without complaining).
Do not resort to aggressive or even passive aggressive actions. Professionalism.

Learn that it's a part of the process of dealing with various personalities in the medical culture.
Ultimately, identify your goals of the rotation, and keep working hard to make sure you get the most out of it.

 

[Doctor Bob]

Hug it out.
When he tells you to do something, just walk up and hug him until he feels uncomfortable and squirms away.
Repeat.
The undesired behavior will stop eventually.



But seriously.
One place in which an M4 knows significantly more than an M3 is what's referred to as institutional knowledge. They know how the service works, what the upper levels prefer (staple in the upper right hand corner of the list for attending A and staple in the upper left hand corner for attending B), etc. Listen to those things and do what they say and soon it will become second nature to you and then you can pass that information along to the next person on the ladder. It's part of what keeps teaching services moving. If I had to start from scratch and teach each incoming student myself how I like my service to run, I would never get anything done.
It's August. You're still at the "you don't know what you don't know" stage of things. Sure, they might be taking advantage of your nicety from time to time, but it reads that on the balance they're helping you a lot more than you're helping them. You might not know it yet though. But when you're the 4th year you'll be a more useful cog in the wheel because you'll understand the system. And this M4 seems to be trying to teach you that.

 

[WinslowPringle]

Is the M4 on his sub-I? Some places, the sub-I is really structured like a sub-internship, so it falls under the expected responsibilities of the M4 to help 'herd' the M3. Some places it's not. I don't know that there is a right or wrong answer to how to structure it, tbh.

And I think I'm missing the egregious offenses.
1. Asks you to take his paper trash with you: normal person stuff
2. Tells you not to bring the Step 2 book. Probably trying to be helpful; some places this would be rather frowned upon, depending on how the looking up was done; attending preference.
3. Taking his notes. Not cool. But if the senior did want you to go, as well, as a learning experience it's a different story.
4. Telling you to 'walk with him'. Not cool if done rudely.
5. Over complimenting you: definitely not 'true gunner style.' True gunner style is smacking you down hard to the residents/attendings behind your back and trying to make you look bad in front of your back, too!

Really sounds like a personality conflict. Any chance you can look at it from another angle?

 

[Jlaw]

I worked in a lot of teams during 3rd year but I don't think I ever had to work closely with fellow students, even 4th years...granted we often did if we liked each others company but I usually had the option of just doing my own work. Is there any way you can just start seeing your patients on your own and spend less time with him?

You're going to work with a lot of challenging personalities over the next few years, just remind yourself its only a few weeks. This is good practice for having to deal with an attending or resident you hate haha.

I have a bit of a temper and hate dealing with A holes but I do not regret biting my lip during third year.

 

[Doctor4Life1769]

Sounds like the 4th year is acting like an intern and having the M3 engaged.

However, I think the 4th year should be having the M3 (OP) actually see the patient and do the H+P with the 4th year there to ensure things aint missed.

 

[CherryRedDracul]

Honestly while reading the OP's post, I got the impression that this is an MS4 who is unaware of the way he's coming off and could just be trying to be helpful/nice and provide some structure to OP's rotation.

I'd hesitate towards taking an offensive. Politely wiggle out of things you don't want to do. Confirm with residents that orders the MS4 relays from them are in fact from them. Spend more time with the residents and interns and less with him. Minimize how nice/thankful you are when he guides and lectures you, or else he will just keep doing it.

I'm going to agree with this. There's a good chance he doesn't realize how he's coming off to you. Have a hearty talk with him though.

 

[seminoma]

And finally in true gunner style, he over compliments me over the stupidest things, probably to throw me a bone for doing him little favors so I keep coming back. It's very condescending. For example, he complimented me for taking notes while the senior was discussing the day's cases; or when I did the bed check for him.

Just wanted to comment on this specifically. Initially I felt pretty similar in regard to those types of comments, but I'm realizing that stuff we think is easy/obvious/expected/not-compliment-worthy is often really appreciated by the rest of the team. For example the other day I made a phone call to a SNF to get the timeline on the symptoms of this possible stroke patient and the intern/senior talked about it all day long as if I had made some monumental discovery. Obviously last known well is important, but you'd think that phone call would be a basic expectation of all M3s rather than a praise-worthy thing. I'm sure your M4 feels the same way about the stuff you do for him even if he sounds condescending when he thanks you for it. The more senior members of the team know M3s are struggling (esp this early in the year) and being nice or making a big deal out of the little things we do is probably just their way of trying to make us feel like we matter.

On the other hand, maybe he is just being nice so you keep doing favors for him. Regardless, if you're doing things that need to be done you should continue to do them. It might help to keep in mind that those patient-care "favors" you're doing for the M4 are actually things that help the patient. I know it sounds contrived/idealistic, but if you're helping the patient get well then you shouldn't worry about how the rest of the team thanks (or doesn't) you for it.

Also what @Skip Intro and @kirbymiester said will probably work too. I've been doing something similar to the M4 I'm currently working with and she has basically stopped talking to me altogether. Unfortunately the other M3 on service is super nice and always engages in the M4s convo so he is being sucked into a bunch of worthless interactions.

 

[swoopyswoop]

It sounds like your M4 is asking you to help with patient tasks in a way that gets things done quicker for both of you (ie bed checks while he/she updates the list). My interns told me to delegate stuff to the M3s when I was on my sub-i. I never delegated scut, I would ask them to do things like a post-op check on a patient THEY were in the OR with or if notes needed to be done I always tried to give them patients they were familiar with / less complicated patients since it was their first rotation. One day the M3 in a really obvious way asked me if I had an M4 on my surgery rotation (I hadn't) because "I'm just wondering if it's normal for the M4 to tell the M3 to do things." She specifically said "sometimes you and the intern tell me conflicting information" - when I asked for an example, she said sometimes we tell her 3 different tasks. None of it was conflicting, we jsut wanted her to do those 3 things, in whatever order she deemed appropriate. She would also be VERY defensive when I gave her and the other M3 advice on rounding/notes/presentations. It pissed me off a lot because I was just trying to make HER look good to the residents by answering her dumb m3 questions and giving advice that I wish I had been given by a classmate when I was on my M3 rotations.

So as an M3, be grateful as hell to your M4s whenever they give you advice because they are trying to help you. If you think they're complimenting you on stupid stuff, you sound full of yourself. An M3 who knows to take notes while the senior is discussing patients is doing much better than most M3s (who usually only pay attention when their 1-2 patients are being discussed).

Yes, M4s are "above" M3s in the sense that 2 different types of poop differ compared to residents. But M4s have a LOT of knowledge about how the hospital system works, how the social environment of clinical rotations work, and are usually looking to HELP you, not hurt you. Ungrateful M3s come off as know-it-alls who think they are more useful/important/knowledgable than they are. He's not giving you scut work at all. I MUCH preferred to spend time teaching the M3 who was engaged, thankful, and positive than talking to an M3 who might look at me annoyed and tell me "she knows how to do that" when I tell her the components of a post-op check.

 

[Psai]

It sounds like your M4 is asking you to help with patient tasks in a way that gets things done quicker for both of you (ie bed checks while he/she updates the list). My interns told me to delegate stuff to the M3s when I was on my sub-i. I never delegated scut, I would ask them to do things like a post-op check on a patient THEY were in the OR with or if notes needed to be done I always tried to give them patients they were familiar with / less complicated patients since it was their first rotation. One day the M3 in a really obvious way asked me if I had an M4 on my surgery rotation (I hadn't) because "I'm just wondering if it's normal for the M4 to tell the M3 to do things." She specifically said "sometimes you and the intern tell me conflicting information" - when I asked for an example, she said sometimes we tell her 3 different tasks. None of it was conflicting, we jsut wanted her to do those 3 things, in whatever order she deemed appropriate. She would also be VERY defensive when I gave her and the other M3 advice on rounding/notes/presentations. It pissed me off a lot because I was just trying to make HER look good to the residents by answering her dumb m3 questions and giving advice that I wish I had been given by a classmate when I was on my M3 rotations.

So as an M3, be grateful as hell to your M4s whenever they give you advice because they are trying to help you. If you think they're complimenting you on stupid stuff, you sound full of yourself. An M3 who knows to take notes while the senior is discussing patients is doing much better than most M3s (who usually only pay attention when their 1-2 patients are being discussed).

Yes, M4s are "above" M3s in the sense that 2 different types of poop differ compared to residents. But M4s have a LOT of knowledge about how the hospital system works, how the social environment of clinical rotations work, and are usually looking to HELP you, not hurt you. Ungrateful M3s come off as know-it-alls who think they are more useful/important/knowledgable than they are. He's not giving you scut work at all. I MUCH preferred to spend time teaching the M3 who was engaged, thankful, and positive than talking to an M3 who might look at me annoyed and tell me "she knows how to do that" when I tell her the components of a post-op check.

Why bother wasting time on someone who doesn't want your help? Don't give it if they don't ask for it. M3 is all about going home as soon as possible to study for the shelf

 

[swoopyswoop]

lol, because despite her acting like she knows how everything works, i saved their asses more times than they're even aware of. they're not going home til the senior dismisses them and until then they can be useful if they know what to do and how to do it. but that's the point anyway - i didnt waste my time on her, i chose to spend time helping the other m3 if it was needed because i knew it would be a more enjoyable experience for everyone involved.

 

[bc65]

OP: I think the problem is you.

It sounds to me like the M4 is trying very hard to integrate you into the team and teach you how to be useful and efficient. You sound ungrateful and clueless. Perhaps the M4 is rude or condescending, but even if that's the case, you should learn to get used to it. The M4 gets grief from the intern, the intern from the 2nd year, the second year from the third year, and so on up the chain, and everyone from the attending. The attendings get grief from the department chief, insurance companies, administrators, and from their patients. Get used to it.

The worst thing the M4 could do to you would be to ignore you, which is what most seniors do. It's a lot easier and safer to ignore a student than to try to teach them. They are usually ungrateful anyway, as you demonstrated.

He's correct in telling you not to have a Step 2 book with you. You can have a pocket book relating to the appropriate specialty, but if you are seen reading a Step 2 book it makes you look uninterested in the rotation and you will be marked down accordingly.

 

[operaman]

lol, because despite her acting like she knows how everything works, i saved their asses more times than they're even aware of. they're not going home til the senior dismisses them and until then they can be useful if they know what to do and how to do it. but that's the point anyway - i didnt waste my time on her, i chose to spend time helping the other m3 if it was needed because i knew it would be a more enjoyable experience for everyone involved.

This reminds me of a quote on a music teacher's wall:

"Never try and teach a pig to sing. It will only upset you and annoy the pig."

 

[Kaustikos]

OP: I think the problem is you.

It sounds to me like the M4 is trying very hard to integrate you into the team and teach you how to be useful and efficient. You sound ungrateful and clueless. Perhaps the M4 is rude or condescending, but even if that's the case, you should learn to get used to it. The M4 gets grief from the intern, the intern from the 2nd year, the second year from the third year, and so on up the chain, and everyone from the attending. The attendings get grief from the department chief, insurance companies, administrators, and from their patients. Get used to it.

The worst thing the M4 could do to you would be to ignore you, which is what most seniors do. It's a lot easier and safer to ignore a student than to try to teach them. They are usually ungrateful anyway, as you demonstrated.

He's correct in telling you not to have a Step 2 book with you. You can have a pocket book relating to the appropriate specialty, but if you are seen reading a Step 2 book it makes you look uninterested in the rotation and you will be marked down accordingly.

Agreed.
OP could be dealing with a lot worse. The MS4 is actually telling the staff that OP is doing a good job.
Though some may disagree about not studying during the day, I actually think OP should ask the staff/residents/MS4 to give lectures or presentations.

 

[bc65]

For example, he asked me the other day to take his patient lists to the shredder when I take mine out.

I neglected to comment on this in my post above.

Really, OP? You really devoted a whole paragraph to complaining about someone asking you to do something for them which would require ZERO effort on your part? Someone who is exerting effort to teach you? You actually considered refusing this common courtesy? And this is the first thing that you thought to put in your post listing all the terrible things that he did to you?

I think that you could be the poster child for entitlement. If you get any negative evaluations this year, rest assured that you deserved them.

 

[Serous Demilune]

I neglected to comment on this in my post above.

Really, OP? You really devoted a whole paragraph to complaining about someone asking you to do something for them which would require ZERO effort on your part? Someone who is exerting effort to teach you? You actually considered refusing this common courtesy? And this is the first thing that you thought to put in your post listing all the terrible things that he did to you?

I think that you could be the poster child for entitlement. If you get any negative evaluations this year, rest assured that you deserved them.

This is some pretty inspiring empathy for your fellow man, doc.

 

[bc65]

This is some pretty inspiring empathy for your fellow man, doc.

Your sarcasm isn't lost on me, but I'm quite serious when I tell you that, yes, I'm showing great sympathy for OP by taking the time to address his/her problem. If OP adjusts their attitude, they might salvage their career. Perhaps you think OP should be getting a first place trophy for showing up, just like when they played millennial soccer? Sorry, medicine doesn't work that way.

If I were evaluating a student or resident who refused to shred someone else's papers when they were doing their own anyway, I would be sure to put that in their evaluation so that others could see what a terrible team player this student was, and to warn others what a terrible resident they would make. Remember, test scores might get you through pre-screening, but a letter that describes a student as self-centered, refuses to help seniors, lazy, petty, doesn't want to participate in patient care, not interested in the rotation ( reading about step 2 instead of helping or reading about their rotation) won't get a residency anywhere in anything. ( Meanwhile, the M4 is saying nice things about the student. Talk about biting the hand that feeds you!)

I have seen excellent advice on SDN on how to be a great 3rd year student. It often comes down to asking your seniors "how can I help make your life easier", and "how can I participate in patient care". Here is a student who wants to refuse to make their M4's life easier, at no cost to themselves, and who resents being asked to help work up patients. This student is the antithesis of a team player. They resent every opportunity to help or to participate. Indeed, I actually suspect that this is a troll, but I'm willing to play along because it's a good teaching moment for everyone else.

 

[hallowmann]

Nothing in your post sounds like they are bossing you around. You're new. You're supposed to be told what to do/advised. Try having an M4 pimp you like the Chief/Attending, then not really know the answers to the questions themselves. That's one of the many crappy experiences I've dealt with on one my M3 rotations. I smiled politely, briefly answered, and walked away as quickly as possible, because ain't nobody got time for that when you're getting 4-5 hrs of sleep a night and you have to study for a shelf. Sounds to me like your M4 was actually helping you with advice and integrating you into the team.

To be honest the residents/attendings don't care what you specifically do. They care the work gets done, so if you are a part of it getting done and they know that, even if its the most basic of tasks, that makes you look good. That's it.

Some rotations/residents are going to be awesome. Others will be crappy. Keep your head down, learn as much as you can, try to be part of the team if you can, and get home.

 

[Smiths11]

First off, thanks everyone for the replies. I read all of them.

In regards to the shredding of the paper, OF COURSE I wouldn't refuse if someone asked me to do it while I was going. But that's not exactly what happened. It was more like, out of the blue he came to me and said - "hold on to this and when you go toss your stuff out, take it with you". Kinda different then "oh are you going to the trash, mind taking this with you?" And yes, this isn't a big deal, but I was just using it as one small example to demonstrate the context of how this person has been.

Another, even more ridiculous, example is: he printed out the list of patients to hand to everyone on the team. Then gave them all to me asking me to hand them to the team when they arrive. So, we both sat in the morning lecture room waiting for the others - me holding all the papers and him on his phone texting. Not that I mind holding on to the papers, but why give me such a stupid task, when you can just do it yourself without effort? It was just condescending - I'm not his golf caddy.

On the brighter side, I've adjusted rather quickly, found my way around the politics to see what matters and what doesn't, and teamed up with a resident who is super cool. Now I just stick with her as much as possible and avoid the 4th year. As a few of you said, I learned to ignore him whenever possible.

So I'm happy to say this problem has for the most part resolved. And better yet I'll be moving on in a week anyway. Thanks for all the responses, they were much appreciated!

 

[JustPlainBill]

This is exactly the type of neurotic BS that used to drive me up the wall as a student/intern/resident --- but you're stuck and can't do anything about it -- if you try to fluff your plumage, you'll get slammed, but then you have to suck it up to work with this dork who's probably never had any responsibility in his/her life -- if you're a 3rd year, you've got 1+at least 3 more years of this BS and then you can begin to function like a normal human being again without all the prima donna attitudes --- I feel your pain -- this is NOT the military and there are no federal penalties for disobeying orders -- but within the academic hierarchy, the knives will come out and you will get screwed -- sorry, no good answers here......

 

[swoopyswoop]

lol now you're complaining that he printed out the lists and gave them to you to give to the team. aka he did something which meant you didn't have to spend time doing it, and let you look to the rest of the team like you were on top of your stuff and got the list printed for them. poor you.

 

[petyr_baelish]

Yeah honestly, the last two 4th year rotations I've been on, the residents have actually split the team into resident and med student teams with the 3rd years under my charge. I basically watch out for the 3rd years, delegate tasks on patients we cover, distribute new admissions, and select their patient loads, time they go home, etc. I do care a lot as a 4th year, and they provided me the opportunity to function as a leader, which was a great opportunity. In that sense, there is always someone higher than you, and it really sucks sometimes having someone just barely your senior taking charge.

I tried to be super respectful of that when I have 4th years. So much of this feeds off the mentality of the 4th year, too. For instance, I'm generally pretty hard working and motivated, and it's crazy to see how efficient a team will get with the right morale. That said, when your work is done, you go home from my perspective. My patients are my responsibility. I won't ask you to do a thing that doesn't relate directly to your patient's care. During rounds, I'll slip you tidbits/suggestions to help you look good in front of the attending. If you have a question, I'll gladly answer it, even if I'm stressed. Afterall, we all have to start somewhere and questions means you are learning something. The residents and 3rd years and I got along super, super well. We even went out to lunch together after the rotation was done. I think what is said above is really important for a good team.

In terms of your 4th year, distance yourself from him and start reporting directly to the resident. Makes life a lot easier. Be careful and diplomatic in how you confront the situation. If asked to do something trivial, just say you're more than happy if you have time, but you are currently assisting the residents. A 4th year won't risk being called out for pulling a student away from resident tasks. On the other hand, if you are hard working but he throws a fit because you aren't doing what he wants, it makes him look incredibly foolish to the residents, who see a hard working 3rd year. Sounds like you are doing a fine job. Keep that tough skin and work hard.

I hope I get to work under people like you in the future!

 

[seminoma]

Yeah honestly, the last two 4th year rotations I've been on, the residents have actually split the team into resident and med student teams with the 3rd years under my charge. I basically watch out for the 3rd years, delegate tasks on patients we cover, distribute new admissions, and select their patient loads, time they go home, etc. I do care a lot as a 4th year, and they provided me the opportunity to function as a leader, which was a great opportunity. In that sense, there is always someone higher than you, and it really sucks sometimes having someone just barely your senior taking charge.

I tried to be super respectful of that when I have 4th years. So much of this feeds off the mentality of the 4th year, too. For instance, I'm generally pretty hard working and motivated, and it's crazy to see how efficient a team will get with the right morale. That said, when your work is done, you go home from my perspective. My patients are my responsibility. I won't ask you to do a thing that doesn't relate directly to your patient's care. During rounds, I'll slip you tidbits/suggestions to help you look good in front of the attending. If you have a question, I'll gladly answer it, even if I'm stressed. Afterall, we all have to start somewhere and questions means you are learning something. The residents and 3rd years and I got along super, super well. We even went out to lunch together after the rotation was done. I think what is said above is really important for a good team.

In terms of your 4th year, distance yourself from him and start reporting directly to the resident. Makes life a lot easier. Be careful and diplomatic in how you confront the situation. If asked to do something trivial, just say you're more than happy if you have time, but you are currently assisting the residents. A 4th year won't risk being called out for pulling a student away from resident tasks. On the other hand, if you are hard working but he throws a fit because you aren't doing what he wants, it makes him look incredibly foolish to the residents, who see a hard working 3rd year. Sounds like you are doing a fine job. Keep that tough skin and work hard.

Wish I had M4s like you. All the M4s I've worked with are either super gunners (can't blame them) or checked out completely. I figured M4s wouldn't be checked out until later in the year.

It doesn't help that a lot of the interns/residents/attendings don't seem to differentiate between the M3s and M4s when it comes to pimping/evals.

 

[Kaustikos]

First off, thanks everyone for the replies. I read all of them.

In regards to the shredding of the paper, OF COURSE I wouldn't refuse if someone asked me to do it while I was going. But that's not exactly what happened. It was more like, out of the blue he came to me and said - "hold on to this and when you go toss your stuff out, take it with you". Kinda different then "oh are you going to the trash, mind taking this with you?" And yes, this isn't a big deal, but I was just using it as one small example to demonstrate the context of how this person has been.

Another, even more ridiculous, example is: he printed out the list of patients to hand to everyone on the team. Then gave them all to me asking me to hand them to the team when they arrive. So, we both sat in the morning lecture room waiting for the others - me holding all the papers and him on his phone texting. Not that I mind holding on to the papers, but why give me such a stupid task, when you can just do it yourself without effort? It was just condescending - I'm not his golf caddy.

On the brighter side, I've adjusted rather quickly, found my way around the politics to see what matters and what doesn't, and teamed up with a resident who is super cool. Now I just stick with her as much as possible and avoid the 4th year. As a few of you said, I learned to ignore him whenever possible.

So I'm happy to say this problem has for the most part resolved. And better yet I'll be moving on in a week anyway. Thanks for all the responses, they were much appreciated!

Jesus Christ... Get off your high horse.
You look better handing the team the morning report. Like you are on top of things. The fourth year is making you look good. Stop complaining.

I would love to have a four year who made me look good during third year. All I had was a fourth year who condescended and made me look stupid.

 

[Frazier]

Another, even more ridiculous, example is: he printed out the list of patients to hand to everyone on the team. Then gave them all to me asking me to hand them to the team when they arrive. So, we both sat in the morning lecture room waiting for the others - me holding all the papers and him on his phone texting. Not that I mind holding on to the papers, but why give me such a stupid task, when you can just do it yourself without effort? It was just condescending - I'm not his golf caddy.

On the brighter side, I've adjusted rather quickly, found my way around the politics to see what matters and what doesn't, and teamed up with a resident who is super cool. Now I just stick with her as much as possible and avoid the 4th year. As a few of you said, I learned to ignore him whenever possible.

So I'm happy to say this problem has for the most part resolved. And better yet I'll be moving on in a week anyway. Thanks for all the responses, they were much appreciated!

It sounds like you don't really understand the dynamics of how clinical years work...by the 4th year going through the hassle of printing and gathering papers -- then handing them directly over to you to hand out before anyone else arrives -- he is essentially doing all the "work" and letting your reap the benefits of looking on top of things to your superiors. ("Wow this brand new ms3 is on it, he had the reports ready to go and everything!")

What would you rather be doing? Sitting and reading your step 2 review book when your team shows up? Would that look better?

Your MS4 sounds kind of awesome...he wants you engaged, teaches, and seemingly goes out of his way to make you look good.

I can see your surgery rotation complaint now... "my MS4 shows up at 4am and puts together this list(?) thing of patient data. Then has the nerve to tell me 'don't worry come in at 5am just go straight to preround on patients before rounds start'... Then he has the gall to let me hold and hand out that stupid list he was working on to the team. In the OR he told me to be sure to read about the cases the night before and to pull my own gloves and not just let the scrub figure it out. Why should I do her job? He is such slime!"

This stuff shouldn't be sailing over your head.

You are going to have a ball with some folks you'll come across down the road lol

Edit: basically what the fella said above me.

 

[seminoma]

Another, even more ridiculous, example is: he printed out the list of patients to hand to everyone on the team. Then gave them all to me asking me to hand them to the team when they arrive. So, we both sat in the morning lecture room waiting for the others - me holding all the papers and him on his phone texting. Not that I mind holding on to the papers, but why give me such a stupid task, when you can just do it yourself without effort? It was just condescending - I'm not his golf caddy.

Sounds to me like he's helping you look like you want to help out the team.

 

[Psai]

translation of the op

i am an m3 that doesn't understand a medical student's role on the wards. the 4th year medical student takes time of his day to try to teach me things and it's incredibly irritating. i already know everything, i took step 1 less than a month ago! i didn't like it when he asked me to do things that helped out the team instead of me sitting on my ass looking at facebook all day. why should i waste my precious time looking to see if patients are still there? they're going to leave eventually jesus christ. he then advised me to stop carrying my step 2 book around so i wouldn't look like i was uninterested. i only have 11 more months to study for step 2! i have to do well to make pds like me! one day, he tried to show me how to improve my interviewing skills by letting me watch him do it. then he had the absolute gall to compliment me on the things that i'm doing well! how can i stick up for myself against this guy who seems hellbent on trying to help me out?

update: oh my god he printed out the list for the residents. but instead of taking credit for being helpful, he asked me to hand it out so it looked like i knew what i was doing. what a douche. it's not like any other medical student updates the lists and prints them out for the residents in the morning. my residents thought i was looking out for the team. he's such an idiot, he should just do it himself! i don't need to look good for my evals.