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Funny. Because my osce had a situation where I delivered bad news.
Which is a completely reasonable thing to practice in an OSCE
Funny. Because my osce had a situation where I delivered bad news.
Funny. Because my osce had a situation where I delivered bad news.
Yes, of course, on an OSCE bc you'll be doing it as a resident or more often as an attending.Funny. Because my osce had a situation where I delivered bad news.
That is the exact purpose of an OSCE. Not sure what you are trying to say.
You think that students are penalized for being proactive? For starters, it is illogical. Why would somewhere that doesn't teach or is an otherwise ****ty training location make a difference? It doesn't all of a sudden make sense that someone is being helpful and insightful, and people's thoughts are, "lets punish him!" I understand that every training site is going to be different. I don't think what people value when it comes to the basics changes. People aren't going to value not showing up, or yelling at patients just because it is a bad training spot. This is the exact same thing.
You think that students are penalized for being proactive? For starters, it is illogical. Why would somewhere that doesn't teach or is an otherwise ****ty training location make a difference? It doesn't all of a sudden make sense that someone is being helpful and insightful, and people's thoughts are, "lets punish him!" I understand that every training site is going to be different. I don't think what people value when it comes to the basics changes. People aren't going to value not showing up, or yelling at patients just because it is a bad training spot. This is the exact same thing.
Mimelim, I think your opinion is slightly off-kilter, since it is clear that you have no issue with students being proactive, as they put in central lines and stuff at your institution.
Couple of issues.
#1 You think that physicians out there agree with the statement, "Being proactive is a negative quality in a student"? Is that what you are saying?
#2 Putting central lines in has nothing to do with a student being proactive. Trying to connect the two is illogical.
Possibly not 'proactive', but 'over-eager' (even if the student is performing well otherwise, as opposed to all your examples where he can't do basic MS3 tasks), for sure. What is the real difference between those two words besides the opinion of the person behind them? We're getting into semantics now, but that's what the differences are.
The fact that you are OK with students taking procedural steps on their rotation makes you, IMO, significantly less likely to consider a student 'over-eager', especially if that student is capable in his basic MS3 tasks.
Just my 2 cents, and obviously you are more than welcome to disagree.
Possibly not 'proactive', but 'over-eager' (even if the student is performing well otherwise, as opposed to all your examples where he can't do basic MS3 tasks), for sure. What is the real difference between those two words besides the opinion of the person behind them? We're getting into semantics now, but that's what the differences are.
The fact that you are OK with students taking procedural steps on their rotation makes you, IMO, significantly less likely to consider a student 'over-eager', especially if that student is capable in his basic MS3 tasks.
Just my 2 cents, and obviously you are more than welcome to disagree.
So if a student is already capable in basic MS3 tasks, you think he should turn down an opportunity to place a central line so that he doesn't come off as "overeager"? Yeah no. You can ask to perform or help with a procedure in a non-entitled way, completely understanding that the answer can be "no," and understanding and respecting your boundaries. It's an opportunity to learn, and you should take every opportunity offered to you, especially if your resident likes to teach.
Are you not permitted to perform procedures at your institution? It depends on the attending here, but procedures like line placement, catheterization, LPs, joint aspirations, etc are not unheard of on rotations (we were actually expected to log an LP on pediatrics but I never got the chance).
The fact that you are OK with students taking procedural steps on their rotation makes you, IMO, significantly less likely to consider a student 'over-eager', especially if that student is capable in his basic MS3 tasks.
I don't really see where the procedure thing fits into your argument. Letting a med student perform a procedure under supervision has nothing to do with whether or not students are being proactive.
If @mimelim was okay with students putting in central lines unsupervised and without being told to, that would maybe fall under the blanket of "overeager/proactive/whatever word we're using today"
I'd let a med student put in a central line under the right circumstances. Unfortunately usually I have an intern who still needs to learn how to do it, so their educational needs win. C'est la vie.
How it fits is that someone like mimelim is not going to be one of the attendings we are talking about who wants med students to be more seen quietly in the background, not mucking up the team's flow, rather than up front, grabbing patients, forming and presenting plans, asking to do procedures, etc.
I have never encountered an attending who considers "fly on the wall" the key to success as a medical student.
It's certainly not the advice I'd give to a medical student looking to succeed.
Like mimelim, I've worked with hundreds of medical students. I've written hundreds of clerkship evaluations. I've read hundreds of LORs. I cannot ever recall an instance where a student being engaged and proactive was brought up in a negative connotation. I can recall tons of times where it was highlighted as a positive trait.
Did you never have an attending that did not teach, was an ass, and did the entire case instead of guiding you through a procedure? It's basically the same principle.
I think among the very basic qualities of medical students that residents and attendings value, being engaged and proactive is among, if not the, most common.
I will continue to give the advice to be proactive to every student I work with or mentor.
I would never give the advice to sit back and stay out of the way.
Do I accept that there are true dinguses out there who have no interest in teaching? Of course. But I also think, from my experience both as a student and a resident working with myriad faculty in different departments, that they are extremely rare. So giving students advice to cater to the whims of a capricious minority of dinguses is not going to be helpful to most students.
Honestly, I'm just confused that neither of you can even begin to believe that there are preceptors that run things differently. What about in residency? Did you never have an attending that did not teach, was an ass, and did the entire case instead of guiding you through a procedure? It's basically the same principle.
I agree with everything you said. I think being an enthusiastic, proactive med student is a great quality and generally appreciated. The people on the other side of the argument have just probably experienced the rare poor teachers a little more often than you did/have and are cautious.
And I would argue that the people arguing that students being proactive is seen negatively don't know what they are talking about.
Poor teachers != "proactive is bad"
If a student claims, "They don't like me because I'm proactive" that student is full of it, whether they realize it or not. And, in my experience, they know it and are being defensive.
And what you fail to see is from MS-3 onwards the way residents/attendings see it, matters. You will be evaluated here on out based on what someone thinks of you. The time for your performance to ONLY be evaluated by a multiple choice exam is over.I don't think there's anything further to argue. You guys see it one way as residents, and some of the med students see it another way.
Yeah, there is this thing called life-long learning. Medical students should know this by now. No one is going to spoon-feed you knowledge (not you).This has nothing to do with being proactive.
We all agree, there are surgeons who are asses. There are a lot of preceptors that don't teach.
Sorry, but proactive = positive. And that is universal. Logic on our side, overwhelming experience on our side. Game, Set, Match.
And what you fail to see is from MS-3 onwards the way residents/attendings see it, matters. You will be evaluated here on out based on what someone thinks of you. The time for your performance to ONLY be evaluated by a multiple choice exam is over.
Yeah, there is this thing called life-long learning. Medical students should know this by now. No one is going to spoon-feed you knowledge (not you).
Your preceptor is not your bish. You're a rotator. It's not worth knowing your name bc you'll be gone next month.We aren't talking about being spoon fed. There is a marked difference between a preceptor pimping you and telling you this is important, go look it up later (which is teaching though not lecture-style spoonfeeding), and not even engaging the student - there were definitely preceptors I had that did not give three ****s what my name was, what I knew, or what I could do. Much less care about teaching.
Yes, bc who better to evaluate your medical student friends fairly, than a fellow medical student classmate rather than the resident who sees them everyday on rotation.I finished M3 with honors in everything except family med. I have a pretty good grasp of how the game is played. That doesn't mean I am unable to see that other students have been, in my mind, unfairly judged.
Your preceptor is not your bish. You're a rotator. It's not worth knowing your name bc you'll be gone next month.
Mainly bc you're not dating your preceptor. his job is not to find out your life story and this isn't the classroom. Grow up.Therein lies the difference between us - what kind of a ****ty human being thinks like that?
Mainly bc you're not dating your preceptor. his job is not to find out your life story and this isn't the classroom. Grow up.
Didn't say it was "normal" whatever that is for each individual. What I am saying is you are ridiculously entitled for a medical student. In a normal workplace, you stay a lot longer than a month. In the MS-3 year, you are rotating amongst different clerkships: IM, Peds, Surgery, OB-Gyn, Neuro, Family Med, Psych. Don't expect an attending or an intern/resident, whom you are likely slowing them down, to drop everything to get to know and teach you like you're on the Love Connection.I pity you that you think that's normal. In the workplace you learn the names of people you work with for a couple days much less an entire month. Grow up? Be more of a condescending ass. Often wrong, never in doubt.
Therein lies the difference between us - what kind of a ****ty human being thinks like that?
I pity you that you think that's normal. In the workplace you learn the names of people you work with for a couple days much less an entire month. Grow up? Be more of a condescending ass. Often wrong, never in doubt.
Didn't say it was "normal" whatever that is for each individual. What I am saying is you are ridiculously entitled for a medical student. In a normal workplace, you stay a lot longer than a month. In the MS-3 year, you are rotating amongst different clerkships: IM, Peds, Surgery, OB-Gyn, Neuro, Family Med, Psych. Don't expect an attending or an intern/resident, whom you are likely slowing them down, to drop everything to get to know and teach you like you're on the Love Connection.
The expression, often wrong, never in doubt, ironically enough applies to you here.
It makes you a ****ty human being for not knowing someone's name? Sorry, but most preceptors are working, hard. Most medical students (in my opinion, wrongfully) are expecting to be spoon fed and don't take an active role in their education. If you are going to function as a shadow, people aren't going to remember your name. If you think that proactivity is bad (lol) and interact with people accordingly, nobody is going to bother learning your name. What is the point? This is no different in any other profession that moves as fast pace as we do. It is NOT unique to medicine. It is purely a function of what people value and I'm sorry, but some entitled kid following you around is very low on most people's lists.
Entitled for expecting a teacher to know my name. Just listen to yourself. Now it's just a generic term you throw around. I learn the names of people I meet for one night at a party. It takes active disinterest to ignore someone you work with for 12 hours a day for a month. Your attitude is disgusting.
I was a consultant for 3 years before medical school. I worked with people for 1-2 months all the time before rotating teams. I'm still in contact with most of the people I worked with. What jobs have you worked? You clearly have no idea what an actual job entails.
I never said proactivity is bad, I said it had potential to be interpreted in a negative light. Too busy to teach is a funny explanation. Frankly, if you're not capable of teaching while taking care of clinical duties, maybe you should leave academia.
I agree that people should not be spoon fed, but not learning a ******* name is ridiculous.
We see this quite a bit when we ask at interviews, "what are you interested in?" and someone says, "academic medicine because I want to teach".
My problem with this conversation is that I don't get a sense that you know much about clinical medicine or the wards.
#1 Virtually no attending works that closely with medical students. When they do work with people closely, they learn names, universally. Even if they are terrible human beings, if they are spending time with someone or working with them, they learn names because that is how you effectively communicate with people.
#2 Your attending is not your teacher. They may teach, but they are an attending. They are NOT a 'teacher'. They are a hybrid of boss, professor, teacher, etc. To expect every person that teaches to know your name is just silly. There are many professors in undergrad who don't know all their student's names because of class size or other reason. Attendings are no different. If you are of some sort of consequence on the rotation, good or bad, your name gets learned.
#3 Like many medical students are under the impression that academia means teaching. I'm sorry, but if you spent any time in a university, you would know that this is simply not true. Saying, "Frankly, if you're not capable of teaching while taking care of clinical duties, maybe you should leave academia." shows a fundamental lack of understanding of how academics work. We see this quite a bit when we ask at interviews, "what are you interested in?" and someone says, "academic medicine because I want to teach".
Maybe at your institution. I got to know all my attendings, even non-surgical ones that knew I had no interest in their field. And that's all I was saying. Obviously, if you never work with a student you can't be expected to remember them. Which is a different situation than DV had brought up, in my opinion.
And sure, maybe I dont know what clinical medicine or the wards are. I'm just a M4 done with subIs. Maybe I'll learn what it is at some point during residency. But I didnt have attendings that ignored me, and they all learned my name, and for the most part they all tried to teach somehow. It's always been a good culture that I've been in and what you and DV describe sounds like an incredibly ****ty environment to learn in.
I'm saying that those ****ty attendings, if they exists, are such a minuscule fraction of the preceptor population, it is a far better guess that the issue is with the student, not the attending if they complain about being penalized for being proactive. My faculty were fantastic. They sure as **** knew my name if it mattered. When it didn't, they didn't.
It never hurt me if they didn't remember my name. I don't even know how you can when you have so many students rotating multiple times. But when they remember me and talk to me, it's nice.I'm saying that those ****ty attendings, if they exists, are such a minuscule fraction of the preceptor population, it is a far better guess that the issue is with the student, not the attending if they complain about being penalized for being proactive. My faculty were fantastic. They sure as **** knew my name if it mattered. When it didn't, they didn't.