Correct Your Intern?

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Elysium

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I was in the hospital a few days ago and overheard an MS3 correcting an intern (they're on the same team) about a specific test they were doing one way at one hospital but did differently at the academic hospital the medical school is at (the other one is the community hospital). The third year just would not let it go, and insisted the intern was wrong (and this intern basically operates at an R2 level and isn't often wrong). Finally the intern told the third year to look it up.

The question: do you guys often correct your interns? Would you do something toolish like give a pedantic lecture on some esoteric topic to your superiors or do you just let it go? What if you know they're wrong? Do your superiors deserve respect because you've been training in clinical medicine for 4-5 months tops and they've already graduated, or do you think that your knowledge might sometimes trump theirs? I find the hubris of medical training fascinating - and I'm not being facetious. I'd like to hear the stories. There must be something out there.

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if the life of the patient was at risk and I knew 100% sure that the intern was incorrect I would talk to him ALONE and explained the situation.

But never I would do it in front of an attending.
 
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It's happened on more than one occasion. The only reason I pick up on it is because of my pharmacy training. When I was just the PharmD on the team, they would usually do what I suggested, but as a medical student they will usually give me a lecture on why I'm wrong. Then, if it's an issue of appropriate patient care, I find some way to get the attending to "teach" us all about it without letting on that there's been a disagreement between myself and the intern. That way the intern saves face and the right thing still gets done. If it's not that kind of issue, I just shrug it off and mentally note that the intern doesn't know the limits of his knowledge.
 
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I was "corrected" a few times by my medical students (I put corrected in quotes because their correction was wrong) as a SECOND YEAR this year, and it kind of pissed me off. I know that I can be wrong sometimes, and I don't mind if a medical student, nurse, whoever, corrects me if I am wrong. But when I have ordered a test a million times for something, and then the medical student tells me that is the wrong test to order, it's kind of irritating. It's amazing the spectrum of third year students that come out of med schools....some just kind of absorb everything around them, and then others act like they are already attendings. It's an interesting thing to watch.

When I was a medical student and I thought something a resident said was wrong, I would ask the intern/resident/whoever in private. I would usually phrase it as a question..."you ordered such and such test, but couldn't this one be ordered too?" or something to that effect.
 
I agree that it's annoying to be corrected by someone junior to you. Which is why, when I'm certain of my facts, I ask the attending the explain, instead of insisting that I'm right. Usually the attending will say the same thing as me, but with more authority and a clearer explanation.

If I'm uncertain, I usually do ask in private. However, if I get an explanation that doesn't make sense (which often happens, since housestaff don't have much practice with teaching), I will still ask the attending for an explanation. However in that instance, I make it clear that the intern has explained the correct thing to do, and I just didn't understand.

And you're right, people who come through medical school have a host of different backgrounds. So you won't always be right, just because you're more senior.
 
If I am 100% beyond a shadow of a doubt sure, I'll mention it in private in a tactful, non-demeaning way...usually phrased as a question. There's no way in hell I'd "correct" someone above me in front of the attending unless it was a life and death issue. I feel that those who have already walked a mile in our shoes by enduring four years of med school and [x] many years of residency are at least worthy of some respect and common decency. After all, I'll be in the same position (hopefully) soon enough.
 
I tend to give the seniors the benefit of the doubt. If something seems wildly wrong I pretend I'm stupid and ask why are you doing such and such. Usually the answer is logical or something I knew but conveniently forgot (that happens too often). Only once did I get a totally nonsensical reply and had to argue with the resident. Still it wasn't just any resident I'd known the dude since undergrad and it was in private. Sadly, not all med students know to pick their battles.

On my first rotation I was the leader and every morning I'd get the scut list (resite IV's, take bloods, culture swabs etc.) for all the patients on the ward. I remember one morning after I had briefed all the med students, one guy came back to me and asked why we were doing X test on his patient. I can't remember what test it was, it wasn't very common but at the same time it wasn't a reason to get your panties in a bunch. I tried to explain to him why they might want it, but he insisted that it made no sense -- very forcefully too. When he decided to tell me that "Maybe you wrote down the wrong thing because this is foolishness" I told him to check the intern if he had a problem.

You wouldn't believe what this dude did. Instead of asking the intern politely in private, the dude picked up the phone at the nurse's station, paged her and then flatly told her he's not doing it because it's a pointless test...in front of all the nurses. I almost choked. Not surprisingly it didn't end well, as it turned out the intern was only doing as the attending had ordered and (as I later heard for the other students) the attending had explained the purpose of the test on the ward round that morning. Now I had missed the ward round but the guy was there for the whole thing. Man they slaughtered him. He got told off by the intern, we all had to sit through a lecture on "ward ettiquette and professionalism" and I heard he was hauled over the coals by the attending later that day who made him apologize to the intern in front of everyone at the next ward round. So, word to the wise, correct if you must but don't be a know-it-all prick.
 
I feel that those who have already walked a mile in our shoes by enduring four years of med school and [x] many years of residency are at least worthy of some respect and common decency. After all, I'll be in the same position (hopefully) soon enough.

I, for one, hope that the people junior to me WILL challenge me when they know I'm incorrect, and not just let it go because I've endured more educational pain than they have. And I don't care who they do it in front of. The heirarchy should be respected, yes, but not at the expense of patient care.
 
I have corrected my interns before, but in as tasteful of a way as possible. This is not a hierarchy issue, but more of a mutual respect for other people issue. I didn't really take it too far, even if I knew the answer because at the end of the day it doesn't really matter and nobody on our service was making single decisions that dramatically affected a patient's outcome w/o discussing it w/ the senior and attending and making sure we knew what we were talking about. Petty discussions on lab values or this test vs that test were not really worth it. Usually we ended up looking whatever the question was up together.

The big mistake I made was correcting my senior on something, even though it was in private. It was a cards issue and apparently he's applying to a cards fellowship this year. He was flat out wrong, and eventually realized it, but couldn't handle it. It reflected in my eval. :mad:
 
I was in the hospital a few days ago and overheard an MS3 correcting an intern (they're on the same team) about a specific test they were doing one way at one hospital but did differently at the academic hospital the medical school is at (the other one is the community hospital). The third year just would not let it go, and insisted the intern was wrong (and this intern basically operates at an R2 level and isn't often wrong). Finally the intern told the third year to look it up.

The question: do you guys often correct your interns? Would you do something toolish like give a pedantic lecture on some esoteric topic to your superiors or do you just let it go? What if you know they're wrong? Do your superiors deserve respect because you've been training in clinical medicine for 4-5 months tops and they've already graduated, or do you think that your knowledge might sometimes trump theirs? I find the hubris of medical training fascinating - and I'm not being facetious. I'd like to hear the stories. There must be something out there.

This reminds me of that episode of Family Guy where Peter gets snobbish after watching reruns of Frasier.

Lois: How is the meatloaf?

Peter: I find it rather shallow and pedantic.

:laugh:
 
The big mistake I made was correcting my senior on something, even though it was in private. It was a cards issue and apparently he's applying to a cards fellowship this year. He was flat out wrong, and eventually realized it, but couldn't handle it. It reflected in my eval. :mad:

Heh heh. Yeah, something similar happened to me on surgery, although I wasn't even correcting anyone. I went with the chief resident to see a patient with a partial SBO obviously starting at the G-tube insertion site. He asked me to look at the KUB and tell him what I saw, and I said exactly that, and asked whether it was possible that the G-tube insertion had caused it. He snapped at me, "that's a known complication of G-tube placement." Turns out he was the surgeon who had done it (which I had not known at the time I asked or I'd have been a little more diplomatic).

He ripped me to shreds on my eval, which the chiefs write and the attendings just sign, and did so despite good reports from the interns and no complaints from anyone else on the team. Edit: fortunately, on paper my eval wasn't nearly as bad as the report I got from the intern who was in the room when they discussed us.

So I made a mental note not to apply there for residency. If they'll let the chiefs screw over students without recourse, then it's only fair if they have to deal with the chiefs also screwing the program out of decent applicants.
 
Unless I know that the patient is being placed at risk by a mistake, a situation I have yet to encounter, I just keep my mouth shut. What's the point of making an issue of it? If an unnecessary lab test is ordered, what's the big deal? Most of the lab tests we order are probably unnecessary. Why pick on the one lab test out of a million? It's not worth making waves or embarrassing anybody.

It's not my job to educate my superiors, even if I was competant to do it which I am not.
 
I have corrected my interns before, but in as tasteful of a way as possible. This is not a hierarchy issue, but more of a mutual respect for other people issue. I didn't really take it too far, even if I knew the answer because at the end of the day it doesn't really matter and nobody on our service was making single decisions that dramatically affected a patient's outcome w/o discussing it w/ the senior and attending and making sure we knew what we were talking about. Petty discussions on lab values or this test vs that test were not really worth it. Usually we ended up looking whatever the question was up together.

The big mistake I made was correcting my senior on something, even though it was in private. It was a cards issue and apparently he's applying to a cards fellowship this year. He was flat out wrong, and eventually realized it, but couldn't handle it. It reflected in my eval. :mad:

I would have given you a crappy evaluation. As if being an intern isn't difficult enough without getting correction from a medical student. You also have no business taking the senior resident aside and correcting him on anything unless he's going to hurt a patient. If you do correct him, there is no need argue with him if he doesn't agree with you. You did your duty. You made your point. He probably knew he was wrong but you gave him no leeway to save face. Browbeating him about it is just another way of saying. "I'm right and you're wrong, nyah, nyah, nyah."

Just a little wisdom. You don't have to be right all the time. It is OK to not correct people and let them beleive things which are not true. This might fall under category of "picking your battles."
 
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An MS4 was presenting a patient with knee pain to me and he went through the whole story, etc, and I asked him, "does the pain keep the pt awake at night?" and the MS4's like, "you know, I didn't ask that question, but yeah, that's a good question to ask!" almost like he was praising me for coming up with the idea to ask that question. I said, "yeah, it IS a good question! You'd think I graduated med school or something!"

Oh how the tables turn. :D
 
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An MS4 was presenting a patient with knee pain to me and he went through the whole story, etc, and I asked him, "does the pain keep the pt awake at night?" and the MS4's like, "you know, I didn't ask that question, but yeah, that's a good question to ask!" almost like he was praising me for coming up with the idea to ask that question. I said, "yeah, it IS a good question! You'd think I graduated med school or something!"

Oh how the tables turn. :D

:laugh:

This happens to me all the time too.

My favorite was when I told the med student I was going to order an echo on the patient we were following, and she was like, "Why?" I explained why, and she said, "Okay, I'll buy that." WTF? Like I had to convince her that the echo was necessary...
 
The lesson to be learned for interns is speak with authority and know wtf you're talking about or else don't say anything at all, and if you don't have the answer tell the student to pull some chapters and articles on the subject and you'll rap about it over coffee. :D
 
The lesson to be learned for interns is speak with authority and know wtf you're talking about or else don't say anything at all, and if you don't have the answer tell the student to pull some chapters and articles on the subject and you'll rap about it over coffee. :D

That is excellent advice. I had a patient with San Fillipo syndrome the other day and my most excellent medical student kept his mouth shut until I turned to him and said, "I have no earthly clue what the hell that is. Have you ever heard of it?"

He had, of course, and gave me brief summary.

And I never ask medical students to pull articles on anything. Why make life more difficult. If they're interested they'll look it up on their own and if I'm interested I'll do likewise.
 
I am beginning to realize this, as well. We have some excellent departments, and a few that are well, not ones that I would apply to. I think Samoa's approach is a healthy way of looking at the situation. I also think Samoa's experience as the pharmD on the team, and then being the med student is very interesting. Same person, different perception. Thanks for mentioning that. :thumbup:
 
LovelyRita said:
and the MS4's like, "you know, I didn't ask that question, but yeah, that's a good question to ask!" almost like he was praising me for coming up with the idea to ask that question.
My favorite was when I told the med student I was going to order an echo on the patient we were following, and she was like, "Why?" I explained why, and she said, "Okay, I'll buy that." WTF? Like I had to convince her that the echo was necessary...
Wow, aren't you guys a little uptight. The first response sounds to me like the student just acknowledging that he had missed something that might have been important/useful. The second is an acknowledgement that you had answered her question. (I've often said "I'll buy that" in casual conversation, just to indicate "I understand" or "I agree".)

Do you microanalyze everyone else's sentences the way you do those of your medical students?
 
...you just gotta be there. In my case, I really didn't take it too personally and I responded in my joking/sarcastic tone....I dunno....I mean who cares if they question me or others in my position, I just think some people are so clueless that they would question the Chairman of Surgery if given the opportunity. On the flipside, I have no problems with 'questioning' things, etc, because it opens up a great opportunity for learning and discussion. But God forbid people respect each other's positions, ya know?
 
Yeah, whe I read that I wondered if people have been getting the wrong signal from me. I completely respect my superiors and bow to their knowledge, but I also speak casually and joke around sometimes... :scared:

Wow, aren't you guys a little uptight. The first response sounds to me like the student just acknowledging that he had missed something that might have been important/useful. The second is an acknowledgement that you had answered her question. (I've often said "I'll buy that" in casual conversation, just to indicate "I understand" or "I agree".)

Do you microanalyze everyone else's sentences the way you do those of your medical students?
 
And in my case, the med student had copped an attitude with me before, so maybe I did overanalyze it. She was basically questioning everything I said about that admission...and it was getting really annoying.
 
I would have given you a crappy evaluation. As if being an intern isn't difficult enough without getting correction from a medical student. You also have no business taking the senior resident aside and correcting him on anything unless he's going to hurt a patient. If you do correct him, there is no need argue with him if he doesn't agree with you. You did your duty. You made your point. He probably knew he was wrong but you gave him no leeway to save face. Browbeating him about it is just another way of saying. "I'm right and you're wrong, nyah, nyah, nyah."

Just a little wisdom. You don't have to be right all the time. It is OK to not correct people and let them beleive things which are not true. This might fall under category of "picking your battles."

Actually I didn't argue with my senior about the issue and I didn't take him aside; when I said in "private" I meant that we were the only two people in our team's conference room discussing our pt. I just made the point. He looked it up the next day, went forward w/ what I had mentioned and didn't say anything until the eval. It was a pretty benign interaction that apparently pissed him off.

Generally, the opinions of medical students are pretty well respected at my school and most interns actually enjoy teaching, learning, etc...w/ medical students. To be honest after 7 months of rotations, I haven't come across a single intern who was upset or insulted by me contributing to a discussion regarding a patient's care, even if I corrected them. You're right, being an intern is really tough and that's why having someone around who's willing to get your back, not stab it when you're not looking, can be valuable. Even if they're "just a med student."

Just a little wisdom. You don't have to assume you know everything all of the time.

Battle picked.
 
I would have given you a crappy evaluation. As if being an intern isn't difficult enough without getting correction from a medical student. You also have no business taking the senior resident aside and correcting him on anything unless he's going to hurt a patient. If you do correct him, there is no need argue with him if he doesn't agree with you. You did your duty. You made your point. He probably knew he was wrong but you gave him no leeway to save face. Browbeating him about it is just another way of saying. "I'm right and you're wrong, nyah, nyah, nyah."

Just a little wisdom. You don't have to be right all the time. It is OK to not correct people and let them beleive things which are not true. This might fall under category of "picking your battles."

What kind of a petty penis gobbler would hand out a bad eval just because his fragile ego couldn't handle being corrected by a med student? Oh wait...

It is true that there are tactful ways of dispensing knowledge, but we're all fallible and have gaps in our knowledge. Check your ego at the door.
 
What kind of a petty penis gobbler would hand out a bad eval just because his fragile ego couldn't handle being corrected by a med student? Oh wait...

It is true that there are tactful ways of dispensing knowledge, but we're all fallible and have gaps in our knowledge. Check your ego at the door.


Not too much stands out between medical students one way or another except for personality and social skills. Some are smarter but not that much smarter. Most work pretty hard and do what's expected of them. Somebody who is correcting their residents, especially in public, has some personality and maturity problems.

Wait until you're a new intern. Trust me. No matter how smart you felt as a fourth year medical student you are going to feel like everybody and their brother knows more than you about everything. Not a good feeling, I assure you but you will grow out of it. I'm a PGY-2 and I think I have a pretty good handle on things but it wasn't like that this time last year.

As for checking your ego at the door, it obviously only works one way if a medical student gets bent out of shape because his resident doesn't like being corrected.

Just a by-the-way, as an intern or resident you will be corrected by everybody from the charge nurse to the respiratory therapists. It's just part of the learning process. How you are corrected or how comfortable people will feel steering you in the right direction (or even if they will do it) depends on your personality. You have to be open to criticism but at the same time decisive enough to make a decision based on what you know. The medical student may know a few isolated facts better than you but generally speaking (generally you understand) a medical student doesn't know dick about patient care which is why even the top medical students (like the ones I met at Duke) are kind of lost for the first few months of intern year. This is why it is so annoying to be corrected by one of them.

Like I said, you can be right but it doesn't mean you have to make an issue out of it or call attention to it. Part of being on a team is knowing this. By no means should you stand silent if the health or safety of the patient is being jeapordized but if it's something idiotic like ordering an unneccessary test then let it go.

Not to mention that when you correct your resident it generally makes you look like bad all around and you will probably get bad evaluations from everybody in your chain of command.

Your job is not to dispense knowledge to your residents. They get knowledge dispensed to them by everybody and most are sick of it to varying degrees. What they really want dispensed to them is some time off.
 
And in my case, the med student had copped an attitude with me before, so maybe I did overanalyze it. She was basically questioning everything I said about that admission...and it was getting really annoying.


It's easy to be a critic when you're not responsible. Kind of like my brother and his wife who have no children of their own but have scads of good advice about raising children.
 
Insightful post, and I agree with much of what you have to say. I'm sure I'll agree even more vigorously as an intern. A med student -- you're right -- knows exactly diddly stool about patient care. And I won't really know what it's like until I've been saddled with the responsibility of patient care and being constantly barraged by everyone from techs to nurses to attendings telling me how to do things the right way. I got an inkling of this as a sub-I, but again, you're right, it's not the same thing at all. Like you, I keep my mouth shut during rounds because 1) I hate rounds and 2) if I'm curious enough about something, I look it up later. Keeping my mouth shut also means that I never bother correcting anyone unless it has direct consequences on someone's health.

And let's face it, the majority of med students are pretty annoying. Not that they get much better as residents or attendings. Still, I think it's pretty crappy to ream a third year on an official eval for what is really a minor social faux pas. It's something that can screw them up for residency, and the crime hardly fits the punishment. Just my opinion.

Not too much stands out between medical students one way or another except for personality and social skills. Some are smarter but not that much smarter. Most work pretty hard and do what's expected of them. Somebody who is correcting their residents, especially in public, has some personality and maturity problems.

Wait until you're a new intern. Trust me. No matter how smart you felt as a fourth year medical student you are going to feel like everybody and their brother knows more than you about everything. Not a good feeling, I assure you but you will grow out of it. I'm a PGY-2 and I think I have a pretty good handle on things but it wasn't like that this time last year.

As for checking your ego at the door, it obviously only works one way if a medical student gets bent out of shape because his resident doesn't like being corrected.

Just a by-the-way, as an intern or resident you will be corrected by everybody from the charge nurse to the respiratory therapists. It's just part of the learning process. How you are corrected or how comfortable people will feel steering you in the right direction (or even if they will do it) depends on your personality. You have to be open to criticism but at the same time decisive enough to make a decision based on what you know. The medical student may know a few isolated facts better than you but generally speaking (generally you understand) a medical student doesn't know dick about patient care which is why even the top medical students (like the ones I met at Duke) are kind of lost for the first few months of intern year. This is why it is so annoying to be corrected by one of them.

Like I said, you can be right but it doesn't mean you have to make an issue out of it or call attention to it. Part of being on a team is knowing this. By no means should you stand silent if the health or safety of the patient is being jeapordized but if it's something idiotic like ordering an unneccessary test then let it go.

Not to mention that when you correct your resident it generally makes you look like bad all around and you will probably get bad evaluations from everybody in your chain of command.

Your job is not to dispense knowledge to your residents. They get knowledge dispensed to them by everybody and most are sick of it to varying degrees. What they really want dispensed to them is some time off.
 
and the MS4's like, "you know, I didn't ask that question, but yeah, that's a good question to ask!" almost like he was praising me for coming up with the idea to ask that question.

My favorite was when I told the med student I was going to order an echo on the patient we were following, and she was like, "Why?" I explained why, and she said, "Okay, I'll buy that." WTF? Like I had to convince her that the echo was necessary...

I have to agree with tr... to me this sounds more like the students are trying to acknowledge what you're saying in a more interactive way than "uh-huh" or "ok". I guess it all depends on tone, but I wouldn't see anything arrogant here.
 
I have to agree with tr... to me this sounds more like the students are trying to acknowledge what you're saying in a more interactive way than "uh-huh" or "ok". I guess it all depends on tone, but I wouldn't see anything arrogant here.

Yeah...in just a few weeks on this one service, I have become so sick of people overanalyzing every statement everyone makes. Yes, I maybe often don't say things exactly the right way, or ask semi-stupid questions...but seriously, my intentions are always good, and I'm doing my best. Now today I get a comment that I started out seeming "intimidated." Ya think-- with everyone from the nurses to the residents jumping on every statement I make?! Sorry, just venting...bad day...and this hasn't happened to me on any other rotation or service. It's just a vicious cycle-- I know people are focusing on the way I phrase everything, so it makes me nervous, so I become even less articulate!
 
As an intern myself, I know that there are occasions that med students will know more than I do about some topic. It is ridiculous to think that I should know more than they do about EVERYTHING. However, I should know more than they do on average. Still, if you find me an intern who knows more than a med student on every single one of the thousands of topics that comprise medicine, I'll show you either a total freak of the US medical education system or Sho Yano at 20.

I have some weaknesses in my medical knowledge, and I ask to be corrected by my med students... mostly because it makes you a better intern, and I have been fortunate enough that the students I have worked with have had enough decency to do it in a friendly way. We're all working for the same cause here... patient care. Impressing the attending is not even on my list of priorities. Plus, it actually gives me a semi-subtle way of evaluating how easy it would be to get along with the student as a fellow resident, if they apply to my program :cool:

Correct away!
ttac
 
As an intern myself, I know that there are occasions that med students will know more than I do about some topic. It is ridiculous to think that I should know more than they do about EVERYTHING. However, I should know more than they do on average. Still, if you find me an intern who knows more than a med student on every single one of the thousands of topics that comprise medicine, I'll show you either a total freak of the US medical education system or Sho Yano at 20.

I have some weaknesses in my medical knowledge, and I ask to be corrected by my med students... mostly because it makes you a better intern, and I have been fortunate enough that the students I have worked with have had enough decency to do it in a friendly way. We're all working for the same cause here... patient care. Impressing the attending is not even on my list of priorities. Plus, it actually gives me a semi-subtle way of evaluating how easy it would be to get along with the student as a fellow resident, if they apply to my program :cool:

Correct away!
ttac

:thumbup: to you. I don't even try to correct interns/residents usually (if I ever do, I phrase it in the form of a question, like "would you like some betadine to put on that wound?"), but in general, having a cool and understanding intern is wonderful! I think I should have taken my resident's hint and followed the intern around more this time than the resident, who doesn't seem so happy to have me.

It would be nice if other people would realize we are all working for the same purpose. I have no reason to want to do things like make the resident/intern look bad in front of the attending...but I can ask an honest question and get a nasty look and "we're going to get to that." OK, lesson learned...

And I guess that one's understandable...but there are a lot of other times not in front of an attending when a resident seems to enjoy criticizing or mocking almost every question I ask or statement I make. I could, and often do, end up just giving in to the uncomfortable silence...I guess part of the problem could be she already recognizes that I'm uncomfortable...not that there's an easy way to fix that...
 
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ok... ?

Do you have something to add to this thread? Something to contribute to the discussion? An anecdote? An opinion? Are you looking to see if the medical education culture has changed on this topic in the 9 years since this thread was active? Did you have a similar experience you would like to share? Are you writing a paper on this topic and hoping to garner some new opinions on the matter? Did you watch a particularly humorous encounter in the hallway recently?

C'mon... give us something to work with.
 
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I corrected an intern recently.
 
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If the life of the patient was at risk and I knew 100% sure that the intern was incorrect I would say something.

Other than that, in the very rare circumstance where I have the right answer, I never correct the resident, intern, or M4 student (or even other M3 students) especially in front of attending.
 
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If the life of the patient was at risk and I knew 100% sure that the intern was incorrect I would say something.

Other than that, in the very rare circumstance where I have the right answer, I never correct the resident, intern, or M4 student (or even other M3 students) especially in front of attending.
Yeah,
Hence why I don't believe 90% of people who say they would.
Had a rads report on a patient concerning for mets to the brain and my attending/fellow mocked me saying melanoma doesn't go there. I kept my mouth shut even though I wanted to say "Even if it doesn't (which it does) what the hell kind of new growths are showing up on this patients mri?"
But I kept quiet. And then the patient passed away 3 months later from brain mets. But I don't think I could find any sort of way to avoid that from happening again. You get tossed in situations where you think you're right but majority of the time, you're not (which I'm thankful for), but I resent being in those moments where I was right (albeit very few). It's not easy.
I guess I just find that it's easy to be like "oh, I would call them out" like some people (not you, cbrons), when the reality is medical students are wrong way too many times to make that kind of judgement or call.
And you're wasting everyone's time by arguing about it during rounds. There are better ways to approach it. Like, step aside and ask why your reasoning is wrong. Be stupid. If you're wrong, they'll explain. If you're right, then the both of you will come out when the correction is made.

Sent from my One using Tapatalk
 
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Yeah,
Hence why I don't believe 90% of people who say they would.
Had a rads report on a patient concerning for mets to the brain and my attending/fellow mocked me saying melanoma doesn't go there. I kept my mouth shut even though I wanted to say "Even if it doesn't (which it does) what the hell kind of new growths are showing up on this patients mri?"
But I kept quiet. And then the patient passed away 3 months later from brain mets. But I don't think I could find any sort of way to avoid that from happening again. You get tossed in situations where you think you're right but majority of the time, you're not (which I'm thankful for), but I resent being in those moments where I was right (albeit very few). It's not easy.
I guess I just find that it's easy to be like "oh, I would call them out" like some people (not you, cbrons), when the reality is medical students are wrong way too many times to make that kind of judgement or call.
And you're wasting everyone's time by arguing about it during rounds. There are better ways to approach it. Like, step aside and ask why your reasoning is wrong. Be stupid. If you're wrong, they'll explain. If you're right, then the both of you will come out when the correction is made.

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pretty sure brain mets are most commonly lung, breast, melanoma, kidney
 
I've pointed out mistakes interns made during their presentation after rounds were over, but only if it would actually affect patient care (e.g. pt DOES have a med allergy to the rx discussed on rounds) and never in front of an attending. I've also corrected interns (and some seniors) when they pimp me on something and tell me I'm wrong, but actually they're wrong. This actually happened today. Intern asked me about the difference between PSC and PBC and one of the things I listed was anti-mito for PBC and they said "no that's PSC" and I kindly responded that I thought it was PBC whereas p-anca would be PSC. Last week a senior told me you can't use amylase ULNx3 to diagnose acute pancreatitis because it's non-specific. True that it's non-specific, but it can absolutely be used for diagnosis. These were both one-on-one situations though so that made it a little easier.

Not sure if this is a good rule, but in general I don't correct anyone unless it will affect pt care or my grade. And when I do correct people for the sake of my grade it's only when they tell me that I'm wrong when I 100% know I'm right; in that situation I'll say something to the effect of "I must have learned that wrong, I'll look it up and let you know what I find".
 
pretty sure brain mets are most commonly lung, breast, melanoma, kidney
It wasn't that it went to the brain, but where. I would've definitely been more livid if they were saying melanoma doesn't go to the brain. It dealt more with locations in the brain. Which, still happens regardless

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It depends on the situation. If the resident is making the med student do a lot of their work, then I think the med student has earned the right to correct the resident. You need to be on the med student's good side to gain their help. Plus, the med student could say bad things about you to the attending in an effort to get you fired, so definitely you want to be on their good side.
 
It depends on the situation. If the resident is making the med student do a lot of their work, then I think the med student has earned the right to correct the resident. You need to be on the med student's good side to gain their help. Plus, the med student could say bad things about you to the attending in an effort to get you fired, so definitely you want to be on their good side.


Wait, what? Can't tell if serious.
 
Wait, what? Can't tell if serious.

If you want them to write notes for you 18 hours a day, 7 days a week, you better be on their good side or they will want to go home.
 
If you want them to write notes for you 18 hours a day, 7 days a week, you better be on their good side or they will want to go home.
Excuse me while I laugh at the notion that medical students are entitled to that.
"Maybe if you gave me a welcome hug, got me coffee and my own room to take naps, I wouldn't correct you. But, here we are.... Don't you feel stupid."
And student becomes blacklisted.

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Anyone care to comment on "correcting" an attending? I've had a couple of different attendings tell me I'm wrong about stuff, and in a super condescending way, and I'm pretty sure it has affected my evals. In some instances I'm just wrong and I don't have a problem there, but occasionally I'll have just finished reading something newly published while prerounding and I'll present it on rounds and the attending would smirk as if I just told him 2+2=10. Everytime that has happened I've just let it go, but like I said it has been affecting my evals from those attendings because they think I'm an idiot. So would it be completely out of line to print out my source and show it to them?

It depends on the situation. If the resident is making the med student do a lot of their work, then I think the med student has earned the right to correct the resident. You need to be on the med student's good side to gain their help. Plus, the med student could say bad things about you to the attending in an effort to get you fired, so definitely you want to be on their good side.

Wow do I wish I had residents like you! Life would be much easier.
 
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Anyone care to comment on "correcting" an attending? I've had a couple of different attendings tell me I'm wrong about stuff, and in a super condescending way, and I'm pretty sure it has affected my evals. In some instances I'm just wrong and I don't have a problem there, but occasionally I'll have just finished reading something newly published while prerounding and I'll present it on rounds and the attending would smirk as if I just told him 2+2=10. Everytime that has happened I've just let it go, but like I said it has been affecting my evals from those attendings because they think I'm an idiot. So would it be completely out of line to print out my source and show it to them?



Wow do I wish I had residents like you! Life would be much easier.

Third year is all about keeping your head down. I used to think that attendings were gods and I've since realized that most of them know a ton about their field and not much about others. Some people keep up with the literature and can cite sources as if they were an encyclopedia and others are not that good. There are those who seem to know everything about everything and those who seem to know nothing about anything. You just have to know who to listen to. Just see your patients, write your notes and keep reading. Then when you're an attending, you will remember to treat your medical students nicely.

But think about how you would feel if some snot nosed high schooler tried to correct you about the krebs cycle right after you had biochem. You'd probably not take too kindly to that
 
Anyone care to comment on "correcting" an attending? I've had a couple of different attendings tell me I'm wrong about stuff, and in a super condescending way, and I'm pretty sure it has affected my evals. In some instances I'm just wrong and I don't have a problem there, but occasionally I'll have just finished reading something newly published while prerounding and I'll present it on rounds and the attending would smirk as if I just told him 2+2=10. Everytime that has happened I've just let it go, but like I said it has been affecting my evals from those attendings because they think I'm an idiot. So would it be completely out of line to print out my source and show it to them?

This caught my attention. I encourage my students and residents to bring in the articles they refer to when we talk so we can go over them together. Many times, the studies they bring in are either poorly designed or not actually coming to the conclusion/answering the question that they think it is. This happens a little more often with students than with residents, because learning how to critically read medical literature is something most people have to work at. It's not as simple as just doing a pubmed search. Other times, they do bring in something worthwhile that I haven't read yet (I am usually a month or two behind reading my specialty's big journals). I don't count it against them in either case- the only thing that can rub me the wrong way is if their interest is less in learning, and more in just being right.
 
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I've pointed out mistakes interns made during their presentation after rounds were over, but only if it would actually affect patient care (e.g. pt DOES have a med allergy to the rx discussed on rounds) and never in front of an attending. I've also corrected interns (and some seniors) when they pimp me on something and tell me I'm wrong, but actually they're wrong. This actually happened today. Intern asked me about the difference between PSC and PBC and one of the things I listed was anti-mito for PBC and they said "no that's PSC" and I kindly responded that I thought it was PBC whereas p-anca would be PSC. Last week a senior told me you can't use amylase ULNx3 to diagnose acute pancreatitis because it's non-specific. True that it's non-specific, but it can absolutely be used for diagnosis. These were both one-on-one situations though so that made it a little easier.

Not sure if this is a good rule, but in general I don't correct anyone unless it will affect pt care or my grade. And when I do correct people for the sake of my grade it's only when they tell me that I'm wrong when I 100% know I'm right; in that situation I'll say something to the effect of "I must have learned that wrong, I'll look it up and let you know what I find".
Why was someone pimping you on that to begin with?
 
I've pointed out mistakes interns made during their presentation after rounds were over, but only if it would actually affect patient care (e.g. pt DOES have a med allergy to the rx discussed on rounds) and never in front of an attending. I've also corrected interns (and some seniors) when they pimp me on something and tell me I'm wrong, but actually they're wrong. This actually happened today. Intern asked me about the difference between PSC and PBC and one of the things I listed was anti-mito for PBC and they said "no that's PSC" and I kindly responded that I thought it was PBC whereas p-anca would be PSC. Last week a senior told me you can't use amylase ULNx3 to diagnose acute pancreatitis because it's non-specific. True that it's non-specific, but it can absolutely be used for diagnosis. These were both one-on-one situations though so that made it a little easier.

Not sure if this is a good rule, but in general I don't correct anyone unless it will affect pt care or my grade. And when I do correct people for the sake of my grade it's only when they tell me that I'm wrong when I 100% know I'm right; in that situation I'll say something to the effect of "I must have learned that wrong, I'll look it up and let you know what I find".

When I was still fresh from step 1, I was pimping my interns on these stuff. We had a lot of fun with this; we would take turn pimping each other. I bet you can even pimp your attendings on step 1 material, and the majority will know only detailed, basic information in their field.
 
When I was still fresh from step 1, I was pimping my interns on these stuff. We had a lot of fun with this; we would take turn pimping each other. I bet you can even pimp your attendings on step 1 material, and the majority will know only detailed, basic information in their field.

You're just looking for trouble
 
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When I was still fresh from step 1, I was pimping my interns on these stuff. We had a lot of fun with this; we would take turn pimping each other. I bet you can even pimp your attendings on step 1 material, and the majority will know only detailed, basic information in their field.

Yep... most of us would fail step 1 if we had to take it right now.
But that's because the minutiae that's tested there isn't clinically relevant. It's a foundation. All you need to retain in active memory is the basic concepts.
Knowledge of which specific binding site is involved in Goodpastures doesn't help me much. For clinical practice, I know it's the basement membrane, but could really care less that it's the NC1 domain of the alpha-3 chain of type IV collagen. That's the sort of information that gets lost with time.
 
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