I hate constantly being evaluated every single day..stupid medicine

[alisepeep]

I am so over this med school concept of constantly being evaluated. The worst is on clinical rotations. Right now I am on a rotation in which a new attending grades you every single day. Clearly these attendings all have different personalities. So some of my evaluations say im a spectacular student and others say I am below average, just goes to show how rediculous this whole evaluation thing is. I am the same student from day to day yet some attendings love me and others hate me. It's so subjective its ridiclous, and its realy hard to have your personality stack up with every attending. Can't wait for this constant evaluation process ot be over..

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[Doctor Bob]

Noted

 

[Modeselektor]

I am so over this med school concept of constantly being evaluated. The worst is on clinical rotations. Right now I am on a rotation in which a new attending grades you every single day. Clearly these attendings all have different personalities. So some of my evaluations say im a spectacular student and others say I am below average, just goes to show how rediculous this whole evaluation thing is. I am the same student from day to day yet some attendings love me and others hate me. It's so subjective its ridiclous, and its realy hard to have your personality stack up with every attending. Can't wait for this constant evaluation process ot be over..

Yeah, then you can replace the word attending w/ patient and med school w/ RateMDs.

 

[DermViser]

I am so over this med school concept of constantly being evaluated. The worst is on clinical rotations. Right now I am on a rotation in which a new attending grades you every single day. Clearly these attendings all have different personalities. So some of my evaluations say im a spectacular student and others say I am below average, just goes to show how rediculous this whole evaluation thing is. I am the same student from day to day yet some attendings love me and others hate me. It's so subjective its ridiclous, and its realy hard to have your personality stack up with every attending. Can't wait for this constant evaluation process ot be over..

You're joking right? It's never really over. What do you think happens in residency where you have different attendings during the month, and you get 360 evaluations from people who aren't even attendings?

 

[jakeislove]

Coming up with creative, constructive, or ego-sparing ways to describe typical students is probably boring for them, too.

 

[pdxhopeful]

I know this is easier said than done, but I'm wondering if you'd benefit from getting a better read on what different attendings are looking for, either from their comments, residents' comments, reactions to other students' presentations, etc. allowing you to tailor your presentations (eg. develop a quick one for the attending who really just wants to know if the patient is better or worse, and gets annoyed if you take more then 2 min.). Let that subjectivity - pain though it is - work for you.

 

[Doctor Bob]

Coming up with creative, constructive, or ego-sparing ways to describe typical students is probably boring for them, too.

Haha... oh yea. This is true.
As much as I want to write "this student was average, had an average level of knowledge, completed his/her paperwork adequately, and generally blended into the paint on the wall during rounds" I feel as though I shouldn't. Because heaven forbid people be judged as average. Students see that as the touch of death. So I have to find ways to highlight the 1 or 2 above average things they did during the month/week/day and downplay the other 99% of the time.

 

[Smokemont]

Haha... oh yea. This is true.
As much as I want to write "this student was average, had an average level of knowledge, completed his/her paperwork adequately, and generally blended into the paint on the wall during rounds" I feel as though I shouldn't. Because heaven forbid people be judged as average. Students see that as the touch of death. So I have to find ways to highlight the 1 or 2 above average things they did during the month/week/day and downplay the other 99% of the time.

We appreciate your effort.

 

[mimelim]

Funny, the better students don't seem to have this problem as much. Trying being a better student?

 

[Nasrudin]

Residency evaluation is orders of magnitude more palatable. 1. you actually have a job. 2. your impact on workflow is measurable--whatever you can't do somebody else has to. And online rating systems are not pivotal in your career as I understand them.

It's not just students that are ridiculous about the disdain of averageness, its the people evaluating them. You know those d!ckheads that have been evaluating other people so long that they imagine they're gods. You know...old @ss attendings. Those people who select students for interviews.

Stop blaming the kids trying to survive the game. You can't remember what it's like to play it. If you ever knew with your trained in the carter administration @ss when a handshake between fraternity brothers meant you got the job.

 

[jakeislove]

Residency evaluation is orders of magnitude more palatable. 1. you actually have a job. 2. your impact on workflow is measurable--whatever you can't do somebody else has to. And online rating systems are not pivotal in your career as I understand them.

It's not just students that are ridiculous about the disdain of averageness, its the people evaluating them. You know those d!ckheads that have been evaluating other people so long that they imagine they're gods. You know...old @ss attendings. Those people who select students for interviews.

Stop blaming the kids trying to survive the game. You can't remember what it's like to play it. If you ever knew with your trained in the carter administration @ss when a handshake between fraternity brothers meant you got the job.

Is the educational value of evaluations lost at this point?

In theory, the feedback is supposed to help us improve.

 

[alisepeep]

Funny, the better students don't seem to have this problem as much. Trying being a better student?

You're kidding me right?
Some of the top students i know have more of this problem than the average student that knows how to kiss someone's ass. I am not an ass kisser i show up and do my job and i should not be penalized for my dislike of sucking up. I've seen people who have failed several courses show up on rotations and suck up to the attendings like no other, bringing presents, coffee every morning, etc. While some students who truly know the material and love working with others are being marked down because they refuse to suck up..its a messed up system.

 

[Kaustikos]

You're kidding me right?
Some of the top students i know have more of this problem than the average student that knows how to kiss someone's ass. I am not an ass kisser i show up and do my job and i should not be penalized for my dislike of sucking up. I've seen people who have failed several courses show up on rotations and suck up to the attendings like no other, bringing presents, coffee every morning, etc. While some students who truly know the material and love working with others are being marked down because they refuse to suck up..its a messed up system.

Yes, he was kidding. Not entirely but somewhat.
Your argument is a strawmans attempt at best. We all know it sucks but there's no need to generalize to your extreme. OP needs to learn how to tailor yourself to other people. And I don't mean sucking up.

 

[Nasrudin]

I agree. When outsized and overpowered by an enemy. You have to learn a different sort of Kung Fu to survive. Something fast, adaptive, smooth, deft. And silent.

If you are rigid. And fixed in one mental position. You'll get crushed.

It's their licence you operate under.

The quickest, least painful way through the day and you getting home or wherever else you want to be is not achieved by letting them know what you really think--ie that their capricious whims on your style of presentation are as inconsequential as gnat farts in the scheme of providing better care for patients.

Don't disdain the survivalist's ethic. It won't serve you. Learn to appreciate it as art.

 

[evilbooyaa]

You're kidding me right?
Some of the top students i know have more of this problem than the average student that knows how to kiss someone's ass. I am not an ass kisser i show up and do my job and i should not be penalized for my dislike of sucking up. I've seen people who have failed several courses show up on rotations and suck up to the attendings like no other, bringing presents, coffee every morning, etc. While some students who truly know the material and love working with others are being marked down because they refuse to suck up..its a messed up system.

And you know those others are getting honors? Failing courses in pre-clinical doesn't mean you are incapable of doing well on rotations.

You really just have to accept it, and change it when you're in a position to do so (like when you're an attending).

 

[Jabbed]

Just think of clerkship evaluations as a teaser trailer for Press Ganey screwing you over for the rest of your life.

 

[mimelim]

You're kidding me right?
Some of the top students i know have more of this problem than the average student that knows how to kiss someone's ass. I am not an ass kisser i show up and do my job and i should not be penalized for my dislike of sucking up. I've seen people who have failed several courses show up on rotations and suck up to the attendings like no other, bringing presents, coffee every morning, etc. While some students who truly know the material and love working with others are being marked down because they refuse to suck up..its a messed up system.

Little known fact, residents and attendings are stupid and can't see through transparent ass kissing.

 

[Nasrudin]

Little known fact, residents and attendings are stupid and can't see through transparent ass kissing.

That's probably correct actually. Making someone feel respected, appreciated, and focusing your receptive attention on them, is a subtle but powerful form of persuasion. If that person feels good around you by these means then that will most certainly affect their opinion of you. Whether or not this is laying of lips on ass, is just a question of metaphor and emphasis.

This is how the game is played correctly, however it is conceived. And it is effective.

 

[cartoondoc]

I think that the constant judging and evaluation during medical school is a lot harder than what you go through during residency and post training. When you are a resident, you're not constantly getting graded. Or if you do get a grade, it doesn't matter most of the time unless you really screw up.

So hang in there.

 

[DermViser]

I think that the constant judging and evaluation during medical school is a lot harder than what you go through during residency and post training. When you are a resident, you're not constantly getting graded. Or if you do get a grade, it doesn't matter most of the time unless you really screw up.

So hang in there.

You're not being "graded" per say, but you are being evaluated month to month. What sucks is your responsibilities are greater than when you're a student.

 

[DermViser]

Little known fact, residents and attendings are stupid and can't see through transparent ass kissing.

Really? I guess it depends on the person.

 

[mimelim]

Really? I guess it depends on the person.

Sarcasm++

 

[DermViser]

Sarcasm++

Darn it. Should have known.

 

[laconfidential]

I think that the constant judging and evaluation during medical school is a lot harder than what you go through during residency and post training. When you are a resident, you're not constantly getting graded. Or if you do get a grade, it doesn't matter most of the time unless you really screw up.

So hang in there.

Oh boy are you wrong on that front.

You are constantly evaluated as a resident. By attendings, your senior, your fellow, even from time to time nurses and pharmacists will be asked to eval you. And then naturally you get evaluated by your program director twice a year.

If your evals are not up to par, I promise you hear about it. And it's a lot harder to argue your competence without a shelf exam to back you up.

 

[Nasrudin]

Oh boy are you wrong on that front.

You are constantly evaluated as a resident. By attendings, your senior, your fellow, even from time to time nurses and pharmacists will be asked to eval you. And then naturally you get evaluated by your program director twice a year.

If your evals are not up to par, I promise you hear about it. And it's a lot harder to argue your competence without a shelf exam to back you up.

Hmmm. Maybe it varies. Also, I don't think evaluation is as bad when you have a job. I suspect the only people who have trouble with residency evals are people who can't do their job or are not good with people.

These are minimum standards to me. And I don't have issue with being evaluated along these lines.

Whereas being a clerk is being a figment of someone else's imagination. And why aren't you the perfect whateverthef@ck on that particular day for that particular person. Just fodder for narcissistic personalities.

I am quite confident that working hard to do my job and playing nice with people will ensure my contract renewal and support of my PD in my future career. Evals schmeevals. As long as I'm within the wide boundaries of a functioning resident.

But...my program is not malignant. Were that the case...then yes...it would be worse than 3rd year. But that's rare. At least in my specialty.

 

[Perrotfish]

Oh boy are you wrong on that front.

You are constantly evaluated as a resident. By attendings, your senior, your fellow, even from time to time nurses and pharmacists will be asked to eval you. And then naturally you get evaluated by your program director twice a year.

If your evals are not up to par, I promise you hear about it. And it's a lot harder to argue your competence without a shelf exam to back you up.

Residency and MS3 evals each suck in their own separate ways, and a few common ways as well.

Both sets of evals suck because they're the most random performance assessments you will ever get in your life. What other job assesses you monthly/weekly, based on the experience of multiple bosses who work with you only for a few days each? I've had more than 50 separate attendings in a single rotation, and even on an average rotation I'll always have at least 4 separate people evaluating me. You can't adapt to a bosses quirks over the course of 14 hours or even 14 days, its just random chance whether your personality matches the quirks he/she already has.

Resident evals also suck because they are never, ever positive. There are no grades, raises, or promotions in residency, so everything is basically pass/fail. That's good, because it somewhat mitigates the randomness of them and lets you focus on the comments more as a tool for self improvement than as a career destroying judgement. However the attendings known that as well as you do, and therefore the common experience for most of the residents I've met is that their feedback is either bluntly negative, or more commonly a **** sandwich of good and bad. There's nothing quite like finishing another month of 80 (really 100) hour work weeks and having your boss send you a long list of your inadequacies to thank you.

MS3 evals are at least occasionally glowing, however they suck because they're almost completely random, much more so than resident evals, and yet the grades you receive can determine the course of your career. As most MS3s don't have a real job to do, you're graded on how much you entertain your attendings, how believable your fake smile is, the crispness of your fake patient presentations, and most of all how your attending/resident feels the day they write the eval. At the end of three years of residency I feel like I have no more than the weakest grasp on what my medical students can do, and I would question the insight of anyone who thinks they can do better. Isn't this the best possible way to figure out who gets to be an ENT and who doesn't?

All in all I would say that, while all our lives suck, MS3s have is worse. At least when I'm evaluated as a resident I an feel reasonably confident that someone's pissy mood that day won't derail my career.

 

[DermViser]

Haha... oh yea. This is true.
As much as I want to write "this student was average, had an average level of knowledge, completed his/her paperwork adequately, and generally blended into the paint on the wall during rounds" I feel as though I shouldn't. Because heaven forbid people be judged as average. Students see that as the touch of death. So I have to find ways to highlight the 1 or 2 above average things they did during the month/week/day and downplay the other 99% of the time.

Yup, and it is the exact reason why the MSPE has become a useless document. Every PD knows that the "Pass" actually means average if not below-average.

 

[DermViser]

Funny, the better students don't seem to have this problem as much. Trying being a better student?

You mean the harder working students who don't complain, help their intern, work on their presentations, know everything about their patients (considering how few they are seeing), etc. actually do better grade wise? Color me shocked.

 

[DermViser]

You're kidding me right?
Some of the top students i know have more of this problem than the average student that knows how to kiss someone's ass. I am not an ass kisser i show up and do my job and i should not be penalized for my dislike of sucking up. I've seen people who have failed several courses show up on rotations and suck up to the attendings like no other, bringing presents, coffee every morning, etc. While some students who truly know the material and love working with others are being marked down because they refuse to suck up..its a messed up system.

Kissing up doesn't do anything to improve your grade. It looks desperate. Residents can see right thru it esp. if you do it wrong: like telling the prelim IM resident that you want to go into Internal Medicine, as if that should mean something.

 

[cabinbuilder]

I am so over this med school concept of constantly being evaluated. The worst is on clinical rotations. Right now I am on a rotation in which a new attending grades you every single day. Clearly these attendings all have different personalities. So some of my evaluations say im a spectacular student and others say I am below average, just goes to show how rediculous this whole evaluation thing is. I am the same student from day to day yet some attendings love me and others hate me. It's so subjective its ridiclous, and its realy hard to have your personality stack up with every attending. Can't wait for this constant evaluation process ot be over..

OMG, hated rotations EVERY SINGLE DAY. It was worse that I was older than most of the attendings. Ugh. Totally sucked. Your goal is to GET THROUGH. DON'T PISS ANYONE OFF. Get through residency and be the doctor you want to be. I agree, it's hateful and TOO SUBJECTIVE.

 

[Doctor Bob]

Yup, and it is the exact reason why the MSPE has become a useless document. Every PD knows that the "Pass" actually means average if not below-average.

It's not entirely useless. Some MSPEs show a class distribution. It'll show the individual student's grade in each class, along with the grade distribution for the entire class. So if a person gets honors, but 90% of the class also got honors, then it means the grade is inflated. If this person got a pass, and everyone else got honors... the grade is still inflated but it raises eyebrows as to why this person is an outlier. And so on and so forth through the other permutations.

 

[DermViser]

It's not entirely useless. Some MSPEs show a class distribution. It'll show the individual student's grade in each class, along with the grade distribution for the entire class. So if a person gets honors, but 90% of the class also got honors, then it means the grade is inflated. If this person got a pass, and everyone else got honors... the grade is still inflated but it raises eyebrows as to why this person is an outlier. And so on and so forth through the other permutations.

You're assuming a PD is going to sit and go thru each and every MSPE coming up with the permutations.

 

[Doctor Bob]

You're assuming a PD is going to sit and go thru each and every MSPE coming up with the permutations.

Well, not all of them. But I would. Took me a few hours to go through the stack and just get a sense of where the applicants fell on the bell curve in their class, and how the respective school graded their students in general.

It didn't take me nearly as long as it did to do a pubmed search of all of the articles people claimed to have published. But it gave me good discussion material when people came to interview.

I wouldn't expect the PD to do all of this... but that's why there are APDs

 

[Nasrudin]

What we call buttkissing is simply a lack of social intelligence. Whereas the person who is appropriate, interested, fun, hardworking, earnest, and the rest of these sorts of behaviors is simply the more skillful player of the same game. But to imagine there's this one type of obvious manipulation that is universally distasteful or none at all is underestimating the skill involved as a lot of it is second nature to a lot of us.

To imagine that attendings are above manipulation or are above petty grievances, tastes, proclivities, and idiosyncracies is absurd. Sure hardwork is an essential component. But as Mark Twain says: Give a man a reputation as an early riser and he can sleep till noon. What that means for the clerk is that you can work hard and you may or may not be rewarded. Be thought of as working hard and you can take it easy.

Because that hospitalist who rounds for a couple of hours and bails gives not the f@ck necessary to know the difference. And the hardworking fool who plows into the evening hustling for interns might not earn a penny of praise for his efforts. And be graded instead on moments of stagetime. By those who's arrogance makes them perfect only in assessing their own random fancies and mistaking that for perception.

 

[Apoplexy__]

gives not the f@ck necessary

I feel like I need to be sipping fine spirits in an armchair while reading your posts

 

[madchemist89]

Because that hospitalist who rounds for a couple for hours and bailes gives not the f@ck necessary to know the difference. And the hardworking fool who plows into the evening hustling for interns might not earn a penny of praise for his efforts. And be graded instead on moments of stagetime. By those who's arrogance makes them perfect only in assessing their own random fancies and mistaking that for perception.

Sad, but true.

 

[mimelim]

You're assuming a PD is going to sit and go thru each and every MSPE coming up with the permutations.

We go through the MSPEs pretty closely. Granted, we only have two spots per year and don't have a huge pool to go through, but the MSPE is pretty important.

 

[DermViser]

We go through the MSPEs pretty closely. Granted, we only have two spots per year and don't have a huge pool to go through, but the MSPE is pretty important.

I guess it depends on how many spots you have. There are specialties that send out interviews long before they've even gotten to look at the MSPE and only flip thru the MSPE on the day of the interview.

 

[mimelim]

I guess it depends on how many spots you have. There are specialties that send out interviews long before they've even gotten to look at the MSPE and only flip thru the MSPE on the day of the interview.

Ya, I never understood sending invites before the MSPE came out. I want to know what people say about people when they aren't writing a LOR.

 

[mimelim]

I'm going to have to work with our incoming interns for 3 years. If they have any ward deficiencies, my best bet of finding it is going to be in the MSPE. Bad intern = mimelim doing more work

 

[Armadillos]

This is one of those those where I can undoubtedly say it gets better (at least temporarily), I remember throughout MS3 I thought I hated to hospital, but really I just hated being constantly under the microscope, even though all my evals were good. MS4 I had some pretty demanding rotations where I had a surprising amount of autonomy compared to MS3, but my stress levels where much, much lower because I was not worrying about every tiny thing that could end up in an eval.

 

[DermViser]

Ya, I never understood sending invites before the MSPE came out. I want to know what people say about people when they aren't writing a LOR.

IM and FM tends to do this more. I don't know whether General Surgery does this. Either way, it doesn't make sense to dole out an interview based on an ERAS app with only board scores without going thru the MSPE, have them fly out to an interview, and then to see a red flag on their MSPE which would have affected your decision to give out the interview in the first place. Unless if you think a board score is a good surrogate, and in that case, you deserve the residents you get.

 

[Mad Jack]

You're going to love your hospital performance evaluations and Press Gainey surveys...

 

[DermViser]

This is one of those those where I can undoubtedly say it gets better (at least temporarily), I remember throughout MS3 I thought I hated to hospital, but really I just hated being constantly under the microscope, even though all my evals were good. MS4 I had some pretty demanding rotations where I had a surprising amount of autonomy compared to MS3, but my stress levels where much, much lower because I was not worrying about every tiny thing that could end up in an eval.

That's bc your MSPE is closed to being updated as well as class rank. You're virtually protected in M4, unlike M3.

 

[KnuxNole]

Sometimes the MSPE can mask ward inefficiencies. Especially since quite a lot of attendings like to put comments as one sentence, or two words...and so for IM, you might see someone getting Honors with comments of "good student, pleasure to work with", but missed out on the lack of several things that they didn't bother to mention. Also, for a lot of places, the "negative comments" are never placed on the Dean's letter, and given to students on the side for education purposes.

 

[DermViser]

Sometimes the MSPE can mask ward inefficiencies. Especially since quite a lot of attendings like to put comments as one sentence, or two words...and so for IM, you might see someone getting Honors with comments of "good student, pleasure to work with", but missed out on the lack of several things that they didn't bother to mention. Also, for a lot of places, the "negative comments" are never placed on the Dean's letter, and given to students on the side for education purposes.

Yes, the formative comments section.

 

[ThoracicGuy]

Yeah, then you can replace the word attending w/ patient and med school w/ RateMDs.

You mean Press-Ganey. You have to score the highest number or you might as well fail. You're left to the whims of patients that maybe you refused to give a pain script to who is drug seeking or the patient that is mad at you because you are ten minutes late seeing them... It's a wonderful world!

 

[Kaustikos]

Ya, I never understood sending invites before the MSPE came out. I want to know what people say about people when they aren't writing a LOR.

So give me my invite already


Jk. I'm totally joking.

I do agree with you, though.

 

[SouthernSurgeon]

Ya, I never understood sending invites before the MSPE came out. I want to know what people say about people when they aren't writing a LOR.

Until recently the MSPE didn't come out til Nov 1. So I think a lot of programs feel comfortable with their selection process without it as a result.

 

[DermViser]

So give me my invite already


Jk. I'm totally joking.

I do agree with you, though.

That's more common with IM and FM. I doubt Gen Surgery does it as much. I think Mimelim is saying he wants to read the MSPE before giving out an interview since it's not an LOR but a letter of evaluation.