Anyone else hate their clerkship?

[SGuttenberg]

There is zero orginzation and no supervision. When you go to where you are assigned there is nobody there to tell you what to do. When you ask residents what to do they ignore you or brush you off. They give vauge responses and avoid making eye contact with you. If you ask them anything even simple things like asking to observe a required procedure they just get pissed off and ignore you harder. It's like their lives are so hard and you are just the biggest burden in the world to them. It's not like teaching med students is part of their responsibilites or anything... Sometimes residents and attendings will give conflicting instructions. One says to put notes in the chart, then another will yell at you saying don't put med student notes in the charts show it to him instead, then yet another yells at you for not having put your notes in the chart for him to review.

Then nurses/techs/office staff roll eyes and huff at you for invading "their" space despite voluntarily working at a teaching institution. I stand, I never use a computer or chart unless nobody has touched it for a few minutes and the area is clear and nobody looks like they'll need it. I never use their pens, i stand in corners out of the way, and barely say anything to anyone and they still act like I am a huge annoyance. BTW I tried the being friendly and saying hi/making small talk route and that failed even harder than the silence/avoidance route.

All I want to do is the bare minimum and get the hell out of there, but if you leave the floor even when absolutely nothing is going on somehow the resident/attending gestapo rats you out to the clerkship supervisor. I love that I pay thousands of dollars to my school and I get zero instruction and have to waste almost all my awake time and get barely anytime to study. I would learn so much better on my own reading books and watching videos than dealing with this crap.

Anybody elese in this boat or do I just attend a very crappy medical school? Is anyone actually enjoying third year?

NOTE: I do attend a very bad medical school considering our piss poor step 1 performance.

---

Members don't see this ad.

 

[VoiceofReason]

sounds like you have a crappy medical school -- but even though my clerkships are well organized i still hate them cause i give not one **** about the core rotations!

 

[drizzt3117]

I'm enjoying 3rd year so far, and I'm on one of the rotations I thought I'd like the least, managing patients is a nice change from shadowing.

 

[BigRedder]

If you're trolling:
Well done.

If you're not trolling:
That sounds like a crappy situation, and it shouldn't be the norm. Perhaps if you showed a willingness to do more than "the bare minimum and get the hell out of there," you might find people more receptive to you. Just a thought.

 

[C5toC9]

i suggest trying to become interested in the people you work with on a non-work level

 

[coldweatherblue]

sounds like a pretty typical rotation.. third year so far is much much better than studying for boards imo though..

that said, I've noticed that nurses at teaching institutions have no obligation to treat med students with the respect and dignity naturally befitting a living, breathing human being. Every day I am as polite and professional as possible while asking for charts, overnight events, and issues related to patient care, and much of the time students are treated in a way that in other situations would be unacceptable, but in medicine are allowed due to the political atmosphere of hospital administration. very typical interaction: it's 7:30am, I'm pre-rounding on a patient post-call after being in the hospital for 24+ hours straight, and a nurse who is making $$$$$$$, who started her shift 30 mins ago insults the entire profession of medicine and tells me I need glasses because I didn't anticipate the random cubbyhole where she buried the chart, then proceeds to roll her eyes and walk away without listening when I ask if the patient had any acute overnight events.

it's not really a problem because I waited tables for 6+ years full-time so i'm used to being treated like **** but to be honest I did not expect such consistent animosity.

 

[Knicks]

sounds like a pretty typical rotation.. third year so far is much much better than studying for boards imo though..

that said, I've noticed that nurses at teaching institutions have no obligation to treat med students with the respect and dignity naturally befitting a living, breathing human being. Every day I am as polite and professional as possible while asking for charts, overnight events, and issues related to patient care, and much of the time students are treated in a way that in other situations would be unacceptable, but in medicine are allowed due to the political atmosphere of hospital administration. very typical interaction: it's 7:30am, I'm pre-rounding on a patient post-call after being in the hospital for 24+ hours straight, and a nurse who is making $$$$$$$, who started her shift 30 mins ago insults the entire profession of medicine and tells me I need glasses because I didn't anticipate the random cubbyhole where she buried the chart, then proceeds to roll her eyes and walk away without listening when I ask if the patient had any acute overnight events.

it's not really a problem because I waited tables for 6+ years full-time so i'm used to being treated like **** but to be honest I did not expect such consistent animosity.

Disgusting.

 

[SGuttenberg]

I guess its just a crappy situation then. I'd like to hear what a more typical clerkship experience is like.

 

[vir0n]

Here is the deal: you are a 3rd year medical student that has been at it for 3 weeks. Nurse has been at it for 20 years. You honestly think she is going to take the time out of her morning to give you, Mr./Miss. 3rd year an update on a patient that you are NOT TECHNICALLY taking care of? What would you do if you were in the reverse situation?

Yes, I agree, it sucks. It would be a lot better if they could just put on a face and take 5 mins out of their day to help you out. It, being the real world, doesn't work like that. Respect is earned, not given. You're a 3rd year medical student...nothing is lower on the pole than you right now. Earn your keep, be a team player and for f**k's sake, don't take things personally. They hate all medical students equally...you aren't the first nor will you be the last. You are not special.

 

[ShyRem]

Ok, here's the deal. You ARE the lowest on the totem pole. Now that being said, there is no excuse to treat you like a pile of poop. HOWEVER, if you want them to treat you nicely, give you information they really don't have to give you (remember it's yet ANOTHER person they are spewing information to and they're pretty darn busy already), then you have to play nice. BE NICE. Smile. Say hi. If they're grumpy, apologize for their bad day even if it's not your fault. It is amazing what these people will do for you if you just make an effort. Even something as small as helping with a slide transfer can really put you a couple points in the nurses' favor. And yes, I still do that if I have a few minutes and am close. And they appreciate it.

This will follow you even later. Now that I'm a resident I get the supreme joy of calling consult folks on weekends to tell them I'm asking for a consult. Now generally they hate that crap. They're grumpy. It's their weekend. Their time off. I don't blame them. So far I'm batting about .800 on them actually thanking me for calling them about the consult on the weekend, even making small talk, jokes, etc. And the other residents stare at me open mouthed while I'm having an (oh, heavens) actual conversation with the attending who I called at home. And they remember me later, smile and say hello, ask how my day is going, give me a little verbal update on the patient... and it makes the day and care go a bit easier. Does it take a couple extra minutes? perhaps. But the lack of aggravation is SO WORTH IT.

 

[mTOR]

Ok, here's the deal. You ARE the lowest on the totem pole. Now that being said, there is no excuse to treat you like a pile of poop. HOWEVER, if you want them to treat you nicely, give you information they really don't have to give you (remember it's yet ANOTHER person they are spewing information to and they're pretty darn busy already), then you have to play nice. BE NICE. Smile. Say hi. If they're grumpy, apologize for their bad day even if it's not your fault. It is amazing what these people will do for you if you just make an effort. Even something as small as helping with a slide transfer can really put you a couple points in the nurses' favor. And yes, I still do that if I have a few minutes and am close. And they appreciate it.

All you had to say was "kiss ass" and you could've saved yourself a whole paragraph

OP, Third year sucks. The core rotations suck. Most aspects of medical education suck. Convince yourself being a fake shell of happiness is normal, or suffer.

Patient contact-heavy specialties are filled with tired bitter people. In general, the more power patient's have (or the greater the threat of litigation) or the poorer the lifestyle, the more ornery the faculty, the more hostile the residents, the worse the specialty and educational experience (see OB/GYN). Rads, gas, and path -- where the sane people reside

 

[NAGNAM]

All you had to say was "kiss ass" and you could've saved yourself a whole paragraph

OP, Third year sucks. The core rotations suck. Most aspects of medical education suck. Convince yourself being a fake shell of happiness is normal, or suffer.

Patient contact-heavy specialties are filled with tired bitter people. In general, the more power patient's have (or the greater the threat of litigation) or the poorer the lifestyle, the more ornery the faculty, the more hostile the residents, the worse the specialty and educational experience (see OB/GYN). Rads, gas, and path -- where the sane people reside

Make this your bible and act accordingly.

 

[jackieMD2007]

I don't think that third year clerkships sucked at all.

But I don't consider myself entitled to:
1-interrupt other people's work
2-demand that people give me direction when they are doing other things

The first few weeks, RELAX. Do the best you can. In the real world (try to imagine) different supervisors (read attendings) like things done different ways. That is simply the way it is. Do your best to remember the way different residents like things done. Make it easy for them.

Follow them around and watch what they do. How do they organize their morning? What jobs do they have to do in order to actually get patients taken care of? What do their notes say? What do they say to the people on the other end of the phone? Are they effective? Are they not? Are they the kind of doctor you want to be?

You can learn a lot by watching other people work, especially in the beginning (you just started third year)...they are teaching you by simply being there and doing their job.

Your resident team, especially the interns--are new too. Everyone is figuring out their team and assignment and hierarchy just like you. And you are in the unique position of not having to actually be responsible for anything!

....And thank goodness, because you'll realize really fast that despite your stellar boards performance, your pathology grades and your mother's love--if a patient is coding or has a terrible CHF exacerbation or has a mental status change you're sort of unsure what to do and even if you know what to do you don't know how to get it done, find the RN, get the supplies, etc.

So sit back, settle into third year, work on studying your patient cases and practice questions and keep your eyes and ears open.

ShyRem is right--be nice. This doesn't mean kiss ass like someone else said--residents (and your subi's) see through that. If you're not an overly perky person don't try to do that. Be a professional, mature version of yourself. And polite.

 

[McGillGrad]

I guess its just a crappy situation then. I'd like to hear what a more typical clerkship experience is like.

A typical 3rd year rotation is working in a team with a couple residents and ghost-like attending. They should be assigning you a couple patients to you per day to take H&Ps and write SOAP notes...and present. The residents and attendings should be teaching you along the way by simply explaining why they 'ask this' or 'test that' and somehow relate that to your basic science education. You should also have some lectures set up once or twice a week on topics related to bread/butter cases.

 

[psipsina]

The nurse thing seems pretty typical. When I get a particularly ornery one I try to stay polite and generally say something like "I understand there just aren't enough computer stations to go around, thank you so much for sharing with me". I also try to make jokes about being a clueless medstudent and act like I'm looking for them to teach me the ropes. There are still some that will just be rude but I smile and move on. In one situation that got particularly out of control I had a nurse report me to her supervisor for being rude to her (irony, she was being NASTY and I was really not) but the fact that I've always been super nice and smily and made chitchat saved my tush because the nursing supervisor believed me.

Clinical rotations are mostly about the social game. Its about being a team player, always seeming eager but never obnoxious, giving the illusion that you care even when you really really don't and never losing your cool regardless of what others are doing around you. At the bottom of the totem pole standing up for yourself often looks "entitled" so you have to be super savvy and choose your battles. I just don't engage the ancillary staff if they're starting up, I figure its only a matter of years until they can't speak to me like that anymore so I still win.

 

[vicinihil]

rotations here are good but the problem is that students don't really have a "defined" role. The hospital here is pretty good and nationally ranked so you have a lot of good faculty. But because the hospital is a quality hospital, they are cautious about students putting in orders or just F'ing things up. It's a bit of a pain in the butt to think that you're not really participating in patient care and not making a difference. I lose motivation with the latter fact. Anyone else feel like they'd be a lot more excited about rotations if you actually made a difference?

 

[badasshairday]

rotations here are good but the problem is that students don't really have a "defined" role. The hospital here is pretty good and nationally ranked so you have a lot of good faculty. But because the hospital is a quality hospital, they are cautious about students putting in orders or just F'ing things up. It's a bit of a pain in the butt to think that you're not really participating in patient care and not making a difference. I lose motivation with the latter fact. Anyone else feel like they'd be a lot more excited about rotations if you actually made a difference?

I think that is just the nature of the 3rd year. We are learning the ropes, making mistakes, learning what questions to ask and the next steps of management. We are a blank slate. By 4th year, you WILL make a difference. As a Sub-I, you have real responsibility and ability to make a difference. And you know what, even as a 3rd year, you do make a difference, maybe not in the way of the attending or resident. But there are definitely things that are important. Part of this is rotation/attending/hospital/clinic specific.

 

[colbgw02]

All you had to say was "kiss ass" and you could've saved yourself a whole paragraph

OP, Third year sucks. The core rotations suck. Most aspects of medical education suck. Convince yourself being a fake shell of happiness is normal, or suffer.

Patient contact-heavy specialties are filled with tired bitter people. In general, the more power patient's have (or the greater the threat of litigation) or the poorer the lifestyle, the more ornery the faculty, the more hostile the residents, the worse the specialty and educational experience (see OB/GYN). Rads, gas, and path -- where the sane people reside

Well said. All of this stuff about being a team player, yada, yada, yada, is only true to a point. Most of the time when nurses or interns treat medical students like crap it's just a power play. They have it; you don't. Most attempts to rationalize it as something else is just a way of convincing yourself that you're not crazy for putting yourself through all this.

Sure, there are a few students who don't know their role, step out of line, and come off as being arrogant, but those people are the exception. For all of you that are having a tough time, just put one foot in front of the other. Years from now, you'll be amused at all the crap you took from people who, in retrospect, didn't know their ***end from their elbow. If you weren't willing to put up with delayed gratification, then you wouldn't have made it this far.

 

[Deferoxamine]

Oh man. This was the initial transformation into 3rd year (where the 2nd year kiddies are let out of their pen and onto the floors, a volatile pool of medical jargon, new residents, and mandatory attendance) that I was spared from last year because my first block was outpatient medicine.

OP and other new 3rd years - chill out. Smile. If you're feeling tired or crabby, force the smile anyways. You just have to.

Also, I sense some frustration could be at the realization that there isn't much in the course of your day that serves as a fair basis for people grading you - this hits everyone at different times. So realize that you're very likely not going to get H on your first rotation - a few do, but most won't. Those that do are either literally the very very top students in your class, or got it by dumb luck where the stars just happened to align and they got all the easy-grading attendings and residents (don't worry - it'll even out later). This means you shouldn't give yourself an ulcer right now when an attending or resident tries to correct you. So bust your ass on the floors as much as possible and study up for the exams to ensure a B or a HP or whatever other funky alphabet soup grading system your school uses.

Other than that, just take it in and try to enjoy yourself - after all, this IS why you came to medical school, right?

 

[FadingPromise]

Clinical rotations are mostly about the social game. Its about being a team player, always seeming eager but never obnoxious, giving the illusion that you care even when you really really don't and never losing your cool regardless of what others are doing around you. At the bottom of the totem pole standing up for yourself often looks "entitled" so you have to be super savvy and choose your battles. I just don't engage the ancillary staff if they're starting up, I figure its only a matter of years until they can't speak to me like that anymore so I still win.

I think this was the best way to summarize the topic. Thanks for the well iterated summary.

 

[SGuttenberg]

On the plus side I'm learning to get by with the support staff and to just deal with the jerks.

On the negative side I'm still not learning anything. If you beg, plead and stalk residents they MAY let you observe procedures, but if you ask questions or try to learn how to do them they are pretty unsupportive. I keep asking for things to do and the residents still brush me off. I can only try so much before crossing over into being just annoying. To make matters worse my classmates try to be gunners and jump in and steal residents attention to get procedures/instruction and make me look even worse. For some ******ed reason only one student can get a procedure or see a patient at a time.

I am getting massacred on evals for the dreaded "appears uninterested" but man this is torture for the shy and introverted. I've gotten no other feedback but a cursory "looks/sounds fine" on my notes and presentations. Nobody has gotten anything but mediocre evals and all of us are pretty upset with the general lack of quality of the rotation. I do go to a pretty bad medical school and this particular rotation is notorious for terrible teaching/motivation from the residents and the attendings are barely visable. I really hope our school gets put on suspension next time they're up for accreditation.

I feel like if I had 3 weeks to study I could do OK on the subject exam and go on but I am at the hospital/clinics all day and I have a hard time studying anywhere but home. If I had a week with models and videos I could learn all the procedures I would need.

The moral is study hard in college, ace your MCAT and pad out your resume so you don't have to go to a crappy medical school.

 

[McGillGrad]

I wouldn't worry too much. Your 260+ step I score will make it all okay in the end.

On the plus side I'm learning to get by with the support staff and to just deal with the jerks.

On the negative side I'm still not learning anything. If you beg, plead and stalk residents they MAY let you observe procedures, but if you ask questions or try to learn how to do them they are pretty unsupportive. I keep asking for things to do and the residents still brush me off. I can only try so much before crossing over into being just annoying. To make matters worse my classmates try to be gunners and jump in and steal residents attention to get procedures/instruction and make me look even worse. For some ******ed reason only one student can get a procedure or see a patient at a time.

I am getting massacred on evals for the dreaded "appears uninterested" but man this is torture for the shy and introverted. I've gotten no other feedback but a cursory "looks/sounds fine" on my notes and presentations. Nobody has gotten anything but mediocre evals and all of us are pretty upset with the general lack of quality of the rotation. I do go to a pretty bad medical school and this particular rotation is notorious for terrible teaching/motivation from the residents and the attendings are barely visable. I really hope our school gets put on suspension next time they're up for accreditation.

I feel like if I had 3 weeks to study I could do OK on the subject exam and go on but I am at the hospital/clinics all day and I have a hard time studying anywhere but home. If I had a week with models and videos I could learn all the procedures I would need.

The moral is study hard in college, ace your MCAT and pad out your resume so you don't have to go to a crappy medical school.

 

[C5toC9]

haha