Who's grading your performance during rotations?

[sailormoon]

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I am on my first rotation now, surgery, and still very confused about the grading process.
On the syllabus, it just says your clinical performance is graded based on the evaluations from attendings and residents. ( didn't say how much and from who?? even from interns??)

And, I rarely see any attendings and I am pretty sure some of them don't even know my existence, and I do roundings with different attending and residents every days. They don't really ask much questions and doesn't teach medical students, and they seem to care less about medical students actually.
Students usually work with chief residents and other residents most of time.

I just feel like I have too little interactions with attendings for them to evaluate me well, and I am concerned about this. What should I do in this case?? I am not even sure how attendings are going to grade my performance because they barely work with students.

I wanna hear from any residents or attendings, or anyone who knows about the grading process
Thanks

 

[operaman]

It's different everywhere, even within the same department. As a rule, everyone is watching you and evaluating you at all times. The residents will likely evaluate you and most good attendings will ask the upper levels how the students are performing in addition to their own observations.

That said, you need to get in there and start getting to know them. Ask good questions (if it can be answered with a google search, an anatomy atlas, or by reading a recent progress note, it's a bad question), be interested. If they're always busy, make an appointment with them to sit down and talk about the rotation and a career in surgery. I have found these conversations to be great opportunities to get to know them and start building relationships. Ask if you can go to their clinic and see/present some patients.

 

[DermViser]

I am on my first rotation now, surgery, and still very confused about the grading process.
On the syllabus, it just says your clinical performance is graded based on the evaluations from attendings and residents. ( didn't say how much and from who?? even from interns??)

And, I rarely see any attendings and I am pretty sure some of them don't even know my existence, and I do roundings with different attending and residents every days. They don't really ask much questions and doesn't teach medical students, and they seem to care less about medical students actually.
Students usually work with chief residents and other residents most of time.

I just feel like I have too little interactions with attendings for them to evaluate me well, and I am concerned about this. What should I do in this case?? I am not even sure how attendings are going to grade my performance because they barely work with students.

I wanna hear from any residents or attendings, or anyone who knows about the grading process
Thanks

All of them: intern, resident, and attendings. The attendings will likely ask the residents and interns about you and incorporate it into their evaluation. Attendings will likely grade you based on your presentations to them as well as your ability to answer pimp questions.

 

[SouthernSurgeon]

The practical logistics of it will vary from school to school. At some places, only the attendings will formally grade you - but they will almost always seek out the input of the residents. Other schools, the residents get to formally participate in the grades as well.

Bottom line is you should assume in your interactions that everyone will be evaluating you.

Also - I never understand when students say they never see the attendings on a surgery rotation. Are you not going to the OR? I saw way more of my attendings on surgery, since I was spending literally hours a day elbows to elbows with them, than on any other service (where the attending usually checked in for rounds and then d/c'ed themselves for the remainder of the day).

 

[sailormoon]

I am doing some subspecialty surgery rotation which involves a lot of post-op care rather than actual operations. I go to OR like 3-4 times a week and so far I've never worked with the same attending more than once. I tried to introduce myself and thank them every time, but even in the OR, they are kinda busy teaching residents and doing the surgery, and I often feel like talking to them for just 2-3 min before the operation is not adequate to leave good impression about me on them.

 

[Kaustikos]

Also - I never understand when students say they never see the attendings on a surgery rotation. Are you not going to the OR? I saw way more of my attendings on surgery, since I was spending literally hours a day elbows to elbows with them, than on any other service (where the attending usually checked in for rounds and then d/c'ed themselves for the remainder of the day).

My adult neurosurgery rotation I rarely saw the attending. He maybe came in to see how procedures were going with the fellow/residents. At the VA, the attending only has to "be there" and not even scrubbed in, so that meant they weren't there either. So, yeah, it can happen. It's rare, but it does happen to some extent. However, you do have clinic in which the attending IS there, so you don't always miss out.

 

[Law2Doc]

I am on my first rotation now, surgery, and still very confused about the grading process.
On the syllabus, it just says your clinical performance is graded based on the evaluations from attendings and residents. ( didn't say how much and from who?? even from interns??)

And, I rarely see any attendings and I am pretty sure some of them don't even know my existence, and I do roundings with different attending and residents every days. They don't really ask much questions and doesn't teach medical students, and they seem to care less about medical students actually.
Students usually work with chief residents and other residents most of time.

I just feel like I have too little interactions with attendings for them to evaluate me well, and I am concerned about this. What should I do in this case?? I am not even sure how attendings are going to grade my performance because they barely work with students.

I wanna hear from any residents or attendings, or anyone who knows about the grading process
Thanks

Usually the attendings grade with substantial imput frm the residents. If the attending doesnt have his own impresion and the residents don't think much of you you'll do poorly. If the residents think highly of you usually do fine. Just work hard and study hard.

 

[Winged Scapula]

My adult neurosurgery rotation I rarely saw the attending. He maybe came in to see how procedures were going with the fellow/residents. At the VA, the attending only has to "be there" and not even scrubbed in, so that meant they weren't there either. So, yeah, it can happen. It's rare, but it does happen to some extent. However, you do have clinic in which the attending IS there, so you don't always miss out.

This still amazes me.

During my residency, the subspecialties would run multiple rooms, with the attendings walking back and forth between them during the cases. Never in GS; one room per attending, even if they weren't scrubbed in the whole time, they were in the room. Some scrub nurses wouldn't even allow you to start the case unless they'd seen the attending; not sure how the subspecialties got away with it. In this day and age of increased oversight and litigation, I'm amazed that this happens. I understand that the attending only needs to be there for the "critical portion of the case" but this sounds ludicrous to me and its not like I'm doing brain surgery.

 

[SouthernSurgeon]

This still amazes me.

During my residency, the subspecialties would run multiple rooms, with the attendings walking back and forth between them during the cases. Never in GS; one room per attending, even if they weren't scrubbed in the whole time, they were in the room. Some scrub nurses wouldn't even allow you to start the case unless they'd seen the attending; not sure how the subspecialties got away with it. In this day and age of increased oversight and litigation, I'm amazed that this happens. I understand that the attending only needs to be there for the "critical portion of the case" but this sounds ludicrous to me and its not like I'm doing brain surgery.

Even just since I've arrived at my institution, the regulatory requirements have increased drastically.

If you tried to do a time-out and start a case without an attending physically in the room, you could potentially get fired.

From what I've heard through the grapevine some of the subspecialties still do get away with some of this stuff, but it's largely due to the discretion of their longtime circulators/scrubs - which I'd not exactly want to count on when S**t hits the fan...

Our VA it is firm policy now that attending must be physically in house to wheel the patient back to the room, and in the room to start the case. My intern year the rule was that chiefs could start cases independently but that has changed.

 

[Winged Scapula]

I suspect its also financial.

The subspecialties, especially Ortho, bring in a lot of money, so the attendings are encouraged to run more than 1 room. GS brings in money, but not as much, so I suspect administration looks the other way when and where they can.

 

[VisionaryTics]

It's probably because the subspecialty residents are so much higher quality than the dreck that GS uses to fill its ranks. Less oversight necessary.

😉

 

[SouthernSurgeon]

It's probably because the subspecialty residents are so much higher quality than the dreck that GS uses to fill its ranks. Less oversight necessary.

😉

Get back to checking your boxes, intern!

 

[Winged Scapula]

Get back to checking your boxes, intern!

I'd like to make some crack about mandatory nap time here; too bad the IOM backed off on that recommendation,

 

[mimelim]

I am doing some subspecialty surgery rotation which involves a lot of post-op care rather than actual operations. I go to OR like 3-4 times a week and so far I've never worked with the same attending more than once. I tried to introduce myself and thank them every time, but even in the OR, they are kinda busy teaching residents and doing the surgery, and I often feel like talking to them for just 2-3 min before the operation is not adequate to leave good impression about me on them.

Hint: It isn't all about you leaving a "good impression about me".

Be the best MS3 on the service. Function as an intern. Leave the grading to them and focus on getting something out of your rotation.

 

[DermViser]

It's probably because the subspecialty residents are so much higher quality than the dreck that GS uses to fill its ranks. Less oversight necessary.

😉

As evidenced by their average board scores (kidding, kidding, seriously). On a side note, it's always funny the power we give Step 1 - it's like a natural male enhancement drug for med students.

 

[DermViser]

Hint: It isn't all about you leaving a "good impression about me".

Be the best MS3 on the service. Function as an intern. Leave the grading to them and focus on getting something out of your rotation.

The ones who try to "leave a good impression" are usually the ones who are the most annoying. And in Surgery, that can be a death sentence to your grade.

 

[notbobtrustme]

Hint: It isn't all about you leaving a "good impression about me".

Be the best MS3 on the service. Function as an intern. Leave the grading to them and focus on getting something out of your rotation.

function as an intern? the ****'s that even mean? place non-existent orders in an EMR system you don't have access to? write notes no one really gives 2 ****s about. yaokay buddy.

To the OP: As an M3, you show up, you know your place and you don't overstep your bounds. That's how you get good evals. Shine when asked to, otherwise, shut your fool mouth. This isn't the first time they've seen a med student (and if it is, you pretty much get an A for knowing what a bicep is, so kudos to you). They know the game, they know how evals work and the people who eval you will know what you did.

Also, crush the shelf.

 

[SouthernSurgeon]

function as an intern? the ****'s that even mean? place non-existent orders in an EMR system you don't have access to? write notes no one really gives 2 ****s about. yaokay buddy.

To the OP: As an M3, you show up, you know your place and you don't overstep your bounds. That's how you get good evals. Shine when asked to, otherwise, shut your fool mouth. This isn't the first time they've seen a med student (and if it is, you pretty much get an A for knowing what a bicep is, so kudos to you). They know the game, they know how evals work and the people who eval you will know what you did.

Also, crush the shelf.

Mimelim's advice was good

 

[Kaustikos]

This still amazes me.

During my residency, the subspecialties would run multiple rooms, with the attendings walking back and forth between them during the cases. Never in GS; one room per attending, even if they weren't scrubbed in the whole time, they were in the room. Some scrub nurses wouldn't even allow you to start the case unless they'd seen the attending; not sure how the subspecialties got away with it. In this day and age of increased oversight and litigation, I'm amazed that this happens. I understand that the attending only needs to be there for the "critical portion of the case" but this sounds ludicrous to me and its not like I'm doing brain surgery.

Yeah,
I never understood it, either. Some attendings will be there, but just watch while they're unscrubbed and make comments/suggestions. Truth be told; that's how I was first assist the night before my neurosurgery exam doing an epidermal hematoma evacuation. That's also the first time I ever saw a plastic surgeon in the OR...

Our VA it is firm policy now that attending must be physically in house to wheel the patient back to the room, and in the room to start the case. My intern year the rule was that chiefs could start cases independently but that has changed.

"Physically in house" is the loosest policy on the planet... or that's what I've found out.

function as an intern? the ****'s that even mean? place non-existent orders in an EMR system you don't have access to? write notes no one really gives 2 ****s about. yaokay buddy.

To the OP: As an M3, you show up, you know your place and you don't overstep your bounds. That's how you get good evals. Shine when asked to, otherwise, shut your fool mouth. This isn't the first time they've seen a med student (and if it is, you pretty much get an A for knowing what a bicep is, so kudos to you). They know the game, they know how evals work and the people who eval you will know what you did.

Also, crush the shelf.

Uh... function as an intern could mean several things -
Have an appropriate/realistic plan for your patient
Be able to handle tasks asked of you in a timely manner
Be able to interview a patient in a timely manner
Have a good knowledge base of putting orders into EMR
Write/present good SOAPs.

If you can handle doing that, you'll shine. I'll also add that being familiar w/ your patient plays a factor on service, too. So, it's possible and you should honestly be able to function like an intern by fourth year. Or you better get ready before your Sub-I

 

[SouthernSurgeon]

Yeah,
I never understood it, either. Some attendings will be there, but just watch while they're unscrubbed and make comments/suggestions. Truth be told; that's how I was first assist the night before my neurosurgery exam doing an epidermal hematoma evacuation. That's also the first time I ever saw a plastic surgeon in the OR...



"Physically in house" is the loosest policy on the planet... or that's what I've found out.



Uh... function as an intern could mean several things -
Have an appropriate/realistic plan for your patient
Be able to handle tasks asked of you in a timely manner
Be able to interview a patient in a timely manner
Have a good knowledge base of putting orders into EMR
Write/present good SOAPs.

If you can handle doing that, you'll shine. I'll also add that being familiar w/ your patient plays a factor on service, too. So, it's possible and you should honestly be able to function like an intern by fourth year. Or you better get ready before your Sub-I

That's just to wheel the patient back to the OR. It means, in practical execution, that the attending has to pop their head into preop and greet the patient before anesthesia will head back.

The standards for the timeout/incision are stricter.

The bottom line is that if you force the attending to be in the room the whole time, it takes an exceptionally patient surgeon to sit in the corner and let residents have autonomy and struggle.

These policies that increase attending supervision on the whole are a good thing for patient care, but they have drastically impacted surgical training

 

[Kaustikos]

That's just to wheel the patient back to the OR. It means, in practical execution, that the attending has to pop their head into preop and greet the patient before anesthesia will head back.

The standards for the timeout/incision are stricter.

The bottom line is that if you force the attending to be in the room the whole time, it takes an exceptionally patient surgeon to sit in the corner and let residents have autonomy and struggle.

These policies that increase attending supervision on the whole are a good thing for patient care, but they have drastically impacted surgical training

No disagreement here. Though... if you go to a remote location like we have here in Indiana, then you find that there are only Attendings and no residents/interns. Maybe a PA. But it's just you, the attending and the scrub nurse. Not to mention the anesthesiologists that let you learn how to place central lines properly...Hence why I'd take a community program > academic program.

 

[Armadillos]

I think 'the function as an intern' bit is such a myth, its completely impossible to recreate that unless you have a system where the medstudent is the one getting paged by the pharmacist, the one getting paged by the nurse, the one getting the angry call from the radiology tech telling you that you ordered the wrong thing, etc, etc.

Being a MS3 is being an investigative journalist more than anything, your not making decisions, your finding out what decisions others have already made and making your best approximation at what decisions others will make in the future.

 

[SouthernSurgeon]

I think 'the function as an intern' bit is such a myth, its completely impossible to recreate that unless you have a system where the medstudent is the one getting paged by the pharmacist, the one getting paged by the nurse, the one getting the angry call from the radiology tech telling you that you ordered the wrong thing, etc, etc.

Being a MS3 is being an investigative journalist more than anything, your not making decisions, your finding out what decisions others have already made and making your best approximation at what decisions others will make in the future.

A lot of it is a mindset. It is something to aspire to. Are you truly going to replace an intern and do all their work? Of course not.

But somehow some students find a way to get **** done, and take initiative. It does not go unnoticed.

 

[SouthernSurgeon]

Hence why I'd take a community program > academic program.

Eh. I think there are advantages and disadvantages to both types of programs. I said it in another thread a while ago but I have yet to see this mythical public hospital/community hospital trained med student/intern who is a procedural bada** and can do anything on day one.

I think the procedural learning aspect of medical school has unfortunately been largely given away. Even the interns we have who come from a notoriously experience-heavy med school are idiots on day one, for lack of a better term (I was one too, so I don't mean that in a condescending way). All residency programs these days have to assume they are starting from square one with a new trainee.

 

[Armadillos]

A lot of it is a mindset. It is something to aspire to. Are you truly going to replace an intern and do all their work? Of course not.

But somehow some students find a way to get **** done, and take initiative. It does not go unnoticed.

I agree completely, thats being a medstudent. Not "functioning as an intern".

 

[SouthernSurgeon]

I agree completely, thats being a medstudent. Not "functioning as an intern".

If it were, then more students would understand that and do it.

You guys are needlessly nitpicking @mimelim 's point. We do in fact understand the difference between a resident and a medical student.

But it's a mindset issue. For whatever reason a lot of students devalue their own role on the team. Aspiring to "function as an intern" means aspiring to contribute meaningfully to the team and to patient care.

There are logistic and institutional hurdles that get in students' way of "functioning as an intern"...but the best medical students manage to narrow that gap. They often know more about the service than the interns do. They find little things they can do to help the team. They update the chief on daily events. They actually write down to do boxes on rounds and follow up on them. They run the list with the interns. They chase down lab results and radiology reports. They do all this without asking what needs to be done.

 

[Kaustikos]

Eh. I think there are advantages and disadvantages to both types of programs. I said it in another thread a while ago but I have yet to see this mythical public hospital/community hospital trained med student/intern who is a procedural bada** and can do anything on day one.

I think the procedural learning aspect of medical school has unfortunately been largely given away. Even the interns we have who come from a notoriously experience-heavy med school are idiots on day one, for lack of a better term (I was one too, so I don't mean that in a condescending way). All residency programs these days have to assume they are starting from square one with a new trainee.

I agree. And I'm not talking about being a procedural badass.... or I didn't mean to imply it. I'm saying it's been a blessing to be in a place where I'm learning how to do this on so many occasions so that I'm fairly comfortable with the process/procedure. I'm not expecting to be great, but I'd at least like to have some familiarity with it. I also want more exposure to basic/widely done procedures instead of the rare ones. True, I got to see every congenital heart disease on the planet at Riley, but it didn't mean much since I'm not doing peds CT.
So, yeah, I know I'll look like an idiot. I expect it. I'm just trying to not look like a complete 100% idiot. Just... 50%?

We do in fact understand the difference between a resident and a medical student.

But it's a mindset issue. For whatever reason a lot of students devalue their own role on the team. Aspiring to "function as an intern" means aspiring to contribute meaningfully to the team and to patient care.

Yeah, I agree. I always kind of assume it's completely okay for me to be wrong while I'm in med school. I just say "I'd rather be wrong and know why than be wrong later". And agreed with the latter; it's what I try to do on rotations. But I do have a certain limit/point to my patience/tolerance and it showed during OB. If you're not letting me be in the room to deliver babies, or even deliver babies or telling me to just sit there... I'm just not going to give a **** and go study.

 

[mimelim]

function as an intern? the ****'s that even mean? place non-existent orders in an EMR system you don't have access to? write notes no one really gives 2 ****s about. yaokay buddy.

To the OP: As an M3, you show up, you know your place and you don't overstep your bounds. That's how you get good evals. Shine when asked to, otherwise, shut your fool mouth. This isn't the first time they've seen a med student (and if it is, you pretty much get an A for knowing what a bicep is, so kudos to you). They know the game, they know how evals work and the people who eval you will know what you did.

Also, crush the shelf.

http://forums.studentdoctor.net/thr...etent-fool-on-rotations.988111/#post-13752337

I have maybe a hundred medical students work with me in some sort of capacity each year. You think that placing orders or writing notes is what being an intern is about? Really? Then again, you think being an MS3's job is to sit in the corner and be quiet. MS3 and beyond is in large part about taking ownership of your education. Reading when you have to, asking things when you have to, and learning things as you do them. Yes, students are getting the short end of the stick when it comes to different aspects of their eduction. There are far less procedures to go around. There are far less scut oriented things that they can do at most places. That is not what being an MS3 is about. Being an MS3 is about learning how to function in a hospital environment. It is about learning how to really do an H&P. It is about learning how to create a differential. It is about learning how to work as a part of a team. It is obvious when you work with dozens of students who is working, who is learning, who is sitting quietly in the corner doing nothing and who disappears.

I think 'the function as an intern' bit is such a myth, its completely impossible to recreate that unless you have a system where the medstudent is the one getting paged by the pharmacist, the one getting paged by the nurse, the one getting the angry call from the radiology tech telling you that you ordered the wrong thing, etc, etc.

Being a MS3 is being an investigative journalist more than anything, your not making decisions, your finding out what decisions others have already made and making your best approximation at what decisions others will make in the future.

I carried the team pager as an MS4. Which again isn't the point. You don't need to do that to learn to function as an intern. This isn't about service. This is about education. The point was, take ownership of your education. Start your journey at learning the art of practicing medicine and surviving in the hospital. Don't focus on "leaving a good impression" and buy your residents coffee so that they "like" you.

 

[SouthernSurgeon]

I have maybe a hundred medical students work with me in some sort of capacity each year

This is actually a really key point.

I feel like a lot of times the studs here devalue residents' advice.

Over my going on five years as a resident, I have worked with literally hundreds of students. More than any poster's entire medical school class.

I work with them on the wards, I teach them in lectures, I give their oral exams.

I also have a growing cohort that I consider friends and whom I have helped mentor through their applications in surgery. These are generally people who have excelled and were bada** students and who are now residents at MGH, WashU, U Wash, U Wisconsin, to name a few among other great programs.

Residents do, occasionally, know a thing or two about this whole game.

 

[Kaustikos]

http://forums.studentdoctor.net/thr...etent-fool-on-rotations.988111/#post-13752337

I have maybe a hundred medical students work with me in some sort of capacity each year. You think that placing orders or writing notes is what being an intern is about? Really? Then again, you think being an MS3's job is to sit in the corner and be quiet. MS3 and beyond is in large part about taking ownership of your education. Reading when you have to, asking things when you have to, and learning things as you do them. Yes, students are getting the short end of the stick when it comes to different aspects of their eduction. There are far less procedures to go around. There are far less scut oriented things that they can do at most places. That is not what being an MS3 is about. Being an MS3 is about learning how to function in a hospital environment. It is about learning how to really do an H&P. It is about learning how to create a differential. It is about learning how to work as a part of a team. It is obvious when you work with dozens of students who is working, who is learning, who is sitting quietly in the corner doing nothing and who disappears.

Yeah,
I don't know how people manage a hundred. We have 200ish and I can only imagine how you guys deal with us. You have to sit there and filter through us week by week. I'm still happy my attendings/residents/interns remember me (in a positive way).

I can attest to the latter. I didn't mind doing things if I knew it helped the team function progressively. If I'm scrubbed in on a procedure for a pediatrics case, I have no problem doing nothing since it's micro-surgery... only because I can practice my jokes (jk- but not really). So long as you remember I'm there, which a lot of attendings/residents do do. They point things out/answer questions/etc. Or having me check on patients/nurse inquiries/etc. Hell, I'll drive your damn car (if it's a sports car). I think that's what really makes me love surgery more; I see the teamwork day-in, day-out and it's pretty ****ing cool to see these procedures played out like it's nothing.

I carried the team pager as an MS4. Which again isn't the point. You don't need to do that to learn to function as an intern. This isn't about service. This is about education. The point was, take ownership of your education. Start your journey at learning the art of practicing medicine and surviving in the hospital. Don't focus on "leaving a good impression" and buy your residents coffee so that they "like" you.

Yeah,
I bought coffee for my team on some occasion but only in a "Yeah, I think we all need caffeine". One fellow was like "You know, bribing isn't how you get good evals". Before I could bite my tongue; "Yeah, I'm makin' it rain with that $2.67!" I mean... really. If I bought you a Rolex, then yes, you should raise an eyebrow. But only because our attending might be missing a Rolex.

 

[Kaustikos]

This is actually a really key point.

I feel like a lot of times the studs here devalue residents' advice.

Over my going on five years as a resident, I have worked with literally hundreds of students. More than any poster's entire medical school class.

I work with them on the wards, I teach them in lectures, I give their oral exams.

I also have a growing cohort that I consider friends and whom I have helped mentor through their applications in surgery. These are generally people who have excelled and were bada** students and who are now residents at MGH, WashU, U Wash, U Wisconsin, to name a few among other great programs.

Residents do, occasionally, know a thing or two about this whole game.

Truth be told, on my surgery rotation, I didn't really pay much attention to my attending evaluations as much as the residents/interns. They were the ones I worked with 99% of the time so I would always talk with them when I had a chance to get advice on how I can be better. They were rarely wrong. Everything they said helped. Though, the most important conversation I had was at the end of Gen Surgery with my attending. The short end of it - he made me swoon.
Not to say I'm biased; but I've generally gotten better advice from Surgeons... Only because they taught me how to present as quick as possible/to the point.

 

[giantswing]

The best thing you can do in third year is keep your ears open and your trap shut. When you get pimped, answer it correctly but dont spout off everything you know, because they will keep pimping you till you dont know the answer.

 

[Kaustikos]

The best thing you can do in third year is keep your ears open and your trap shut. When you get pimped, answer it correctly but dont spout off everything you know, because they will keep pimping you till you dont know the answer.

Yeah,
I gave up trying on my last two weeks in heme onc. In pimp questions. He'd ask me stats on cancer which I was okay with until I saw him asking residents and interns way more interesting questions about pathology and drugs.
Also its hilarious how easily the tides can turn in pimping from answering questions to looking like an arrogant prick. Word to the wise: if they say you're wrong, just smile and nod. Even if you know 150% you're right. They ask what 2+2 is and they say you're wrong with 4....don't bother.

 

[DermViser]

Yeah,
I gave up trying on my last two weeks in heme onc. In pimp questions. He'd ask me stats on cancer which I was okay with until I saw him asking residents and interns way more interesting questions about pathology and drugs.
Also its hilarious how easily the tides can turn in pimping from answering questions to looking like an arrogant prick. Word to the wise: if they say you're wrong, just smile and nod. Even if you know 150% you're right. They ask what 2+2 is and they say you're wrong with 4....don't bother.

Sad, but true. Not worth it.

 

[mimelim]

Sad, but true. Not worth it.

And for the love of God, don't bring in an article the next day and shove it in their face and tell them that they are wrong. It won't end well.

 

[Kaustikos]

And for the love of God, don't bring in an article the next day and shove it in their face and tell them that they are wrong. It won't end well.

OMG. Hahahahahaha
Oh man
I just
Oh man.

I would only do that if I gave no ****s and was quitting. Like one of those scenes in a movie where you walk away like a badass. I'd have doves flying, a long coat flowing and explosions. While "Bulls on Parade" by rage against the machine played.

 

[DermViser]

And for the love of God, don't bring in an article the next day and shove it in their face and tell them that they are wrong. It won't end well.

I know a guy who brought in the big Robbins textbook to prove to an attending about the #1 risk factor for a particular disease. Definitely did not end well. Could have been worse, I guess, could have brought in First Aid (yes, we had one of those).

 

[Kaustikos]

I know a guy who brought in the big Robbins textbook to prove to an attending about the #1 risk factor for a particular disease. Definitely did not end well. Could have been worse, I guess, could have brought in First Aid (yes, we had one of those).

I personally reference wikipedia. If that doesn't work, I've heard 4chan/reddit is the definitive source of information for medicine.

 

[DermViser]

And for the love of God, don't bring in an article the next day and shove it in their face and tell them that they are wrong. It won't end well.

Someone actually did that? Did the attending fly off the handle or just do it quietly on his/her evaluation?

 

[giantswing]

I heard of a third year who told an attending "if you had read my note from yesterday you'd know that"...

 

[DermViser]

I heard of a third year who told an attending "if you had read my note from yesterday you'd know that"...

Wow. Just, wow. Unbelievable. I don't care how "sleep-deprived" you think you are as a third year, you kindly repeat yourself and move on.

 

[Psai]

I heard of a third year who told an attending "if you had read my note from yesterday you'd know that"...

Okay maybe I'm not doing so bad after all

 

[mimelim]

Someone actually did that? Did the attending fly off the handle or just do it quietly on his/her evaluation?

I've seen it twice. First time was a fellow MS3 telling a consulting attending (general surgeon) that they should do a NOTES procedure instead of the standard open because it was better for the patient and proceeded to lecture them on how minimally invasive procedures were God's gift to human kind. The surgeon asked if the MS3 could do a NOTES procedure, they said, "No" and the surgeon replied, "Neither can I, now go away."

Then last year an MS3 told a trauma attending that they were "managing the fluids wrong" and then produced some old trauma guidelines from their white coat. The attending's head damn near exploded. Luckily one of the chiefs jumped in and told them to read the latest in military/trauma literature and make sure to note who the authors were (last author, the attending being told they were "managing the fluids wrong").

 

[DermViser]

I've seen it twice. First time was a fellow MS3 telling a consulting attending (general surgeon) that they should do a NOTES procedure instead of the standard open because it was better for the patient and proceeded to lecture them on how minimally invasive procedures were God's gift to human kind. The surgeon asked if the MS3 could do a NOTES procedure, they said, "No" and the surgeon replied, "Neither can I, now go away."

Then last year an MS3 told a trauma attending that they were "managing the fluids wrong" and then produced some old trauma guidelines from their white coat. The attending's head damn near exploded. Luckily one of the chiefs jumped in and told them to read the latest in military/trauma literature and make sure to note who the authors were (last author, the attending being told they were "managing the fluids wrong").

And this is why we can't have nice things.

 

[Psai]

I've seen it twice. First time was a fellow MS3 telling a consulting attending (general surgeon) that they should do a NOTES procedure instead of the standard open because it was better for the patient and proceeded to lecture them on how minimally invasive procedures were God's gift to human kind. The surgeon asked if the MS3 could do a NOTES procedure, they said, "No" and the surgeon replied, "Neither can I, now go away."

Then last year an MS3 told a trauma attending that they were "managing the fluids wrong" and then produced some old trauma guidelines from their white coat. The attending's head damn near exploded. Luckily one of the chiefs jumped in and told them to read the latest in military/trauma literature and make sure to note who the authors were (last author, the attending being told they were "managing the fluids wrong").

Man I'm just happy when the attending acknowledges my existence

 

[notbobtrustme]

Man I'm just happy when the attending acknowledges my existence

yessir and nosir are about as much I'd venture to say when in the operating room.

 

[operaman]

Geez, I must have had some crazy idyllic outlier of an experience on surgery.

 

[PL198]

How f*cking stupid do you have to be to pull some of this crap ? I'm sorry but if someone is dumb enough(yes I absolutely this action reflects on their intelligence) to not realize that trying to one up the attending as an ms3 is a horrible idea, then they deserve to be kicked out of school. Seriously I've never heard of a dumber thing.

 

[mimelim]

How f*cking stupid do you have to be to pull some of this crap ? I'm sorry but if someone is dumb enough(yes I absolutely this action reflects on their intelligence) to not realize that trying to one up the attending as an ms3 is a horrible idea, then they deserve to be kicked out of school. Seriously I've never heard of a dumber thing.

Go to pre-allo, read a dozen or so threads and extrapolate forward 4 years. Not hard to imagine anymore...

 

[PL198]

Go to pre-allo, read a dozen or so threads and extrapolate forward 4 years. Not hard to imagine anymore...

I feel like majorities of those people won't get into school though. I feel like getting in requires a decent amount of understanding how to work the system. For someone to do that, I'd probably say that would require a behavioral disorder or being a complete idiot, in which case idk how they'd get in in the first place, or get through the first 2 years.