Halfway through my third year, my rotation comments mostly boil down to "Avivace is a pleasant student who plays well with others and acts like a responsible adult". At first I wasn't too concerned, since those are definitely things I would look for when evaluating someone I might work with someday, but now I'm starting to wonder if I need to do something different. I recently learned that these comments are included in the dean's letter and the sample the school provided made it sound like a good evaluation comment should reference how you cured cancer during your IM rotation, where I was just focused on learning how to diagnose and treat (and navigate the EMR and the hospital itself).
What qualities do residency directors actually look for in these comments, if anything? Should I be concerned? Will good grades (A's and A-'s) and board scores help mitigate any damage from the lack of superlatives or comments describing how, as a third year student, I astonished the attendings with my brilliance? It's not that I wouldn't love to do that, but it does seem unlikely.
You have no control over subjective comments. Focus on honoring the shelf and learning how to tie management to pathophysiology. Also learn how to present and write SOAP notes. That’s it.
Things people like:
-Keeping it simple. Its better to say too little and be prompted for more. Don’t be bear boned and come off as clueless for presentations, but too much detail bores people (whether it’s presentations, talking to residents, etc). The reason I say this is because after two years of medical science and patient skills activities where they are taught to ask everything from travel history to palpate the thyroid , students tend to say more. Think of it as a test where you have to saying the relevant gets you points, but the irrelevant makes you lose points. Don’t play the “let me include XYZ” in case it’s important.
-Pimp questions are not meant to test your knowledge, but to humble you. If you don’t know something and they tell you, show genuine gratitude.
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Some things that make people upset:
-Any vibe you give them to display intelligence or even imply you can do something that’s their job turns residents off. Like cool dude, if they worked the
same ours as us and had no responsibility, they’d have time review and rattle off the differential for a headache too.
-Trying hard with your words, but not actions.
Residents are the accountants of work done in the hospital. They know exactly what you did for the patient so when you act super interested/enthusiastic, but dip without seeing your patient, they’ll understand you’re just after their validation and will lose respect for you.
-Getting in their way. Sometimes residents don’t even bother to hide the fact that they don’t need you there...but unfortunately the reality is they still expect you there. It’s a respect thing...Unfortunately this means you need to basically be the son who sits next to his dad for 4 hours doing nothing, but handing him a tool every once in a while. If you really need to study, you can try the standard “anything else I can do” line which I recommend. Otherwise, have patience and maybe they’ll teach you something later, but who knows if it’ll be useful. Sucky situation to be in tbh.
-Asking needless questions or questions at inopportune times. While some residents are nicer than others, they’re not your encyclopedia and they know when you ask questions you already know the answer to.
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Some things you can do to impress attendings:
-Try to have a plan ready. The best way is to look at a resident note and see what they did for their plan yesterday and use their suggestions as a template in coming up with a new plan. Warfarin on today? Can he eat? Does a service have to be called? Does he need any labs or can we stop any labs? Try to run it by the resident. Also, be ready to answer why you did certain aspects of your plan because attendings are wary of people who take shortcuts.
-Know details like that the patient has a daughter in college or something you can tell the attending (DON’T FORCE IT) that they can then use to develop rapport with the patient. I know all that seems lost in busy ritual of rounding, but attendings appreciate it.
