Attending hates you because of future field?

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Jamers

Jamers

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I am on a Cardiology rotation right now and on the first day the attending asked me what I was interested in going into. After I told him Emergency medicine he launched into this 20 minute long tirade about how EM docs "base all their clinical decisions on a list without thinking. They don't know the difference between the various tests they order and the [he] is surprised anyone actually survives a trip to the ED." Anyways, now he is hardcore about every pimp question; asking more and more questions the more I get things right. Once I don't know something he responds with, "you are going to turn out to be just like one of those no brained ED doctors and just order every test under the book aren't you?" I pretty much can't win.

I am not really looking for any sort of guidance about how to deal with this as I am sure I can last another three weeks but I was wondering if anyone else has experienced this type of hatred based simply on their future plans?
 
Never had that problem. I always sidestepped the specialty question. E.g. Oh I'm still not sure I'm considering (their specialty) but I didn't mind (last rotation). It sometimes backfires and they spend the entire rotation trying to swing me over to their side but it's better than the alternative.
 
Maybe you could say something like "I am the one that's going to keep your MI pt alive until you show up" 😀

I always told attendings what I wanted to do & then took whatever abuse they threw at me. Smart.....No, Fun...Hell yeah !!
 
I made the mistake of mentioning I was going into dermatology during a 3rd year rotation. I've since learned the correct answer is now always, "I'm not sure. I hope I find the answer soon."

Heck, I even caught a little flak for mentioning it as a 4th year student.
 
It's unfortunate and unprofessional, but it also happens very frequently.

So far I've gone with the "I'm really not sure what I want to go into...trying to figure it out" throwaway line. Now that I've made up my mind, I'm going to test the waters on my next rotation by just saying it...we'll see how it goes.
 
asmallchild said:
I made the mistake of mentioning I was going into dermatology during a 3rd year rotation. I've since learned the correct answer is now always, "I'm not sure. I hope I find the answer soon."

Heck, I even caught a little flak for mentioning it as a 4th year student.
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Weird. My class has already selected their M4 schedule and picked faculty advisers, so if you have NO idea what you're doing for residency, you're starting to lag behind the game.

That attending sounds like a huge d-bag, but there's really nothing you can do about it. I did a rotation in the ER, and it's definitely tough to figure out what's going on there, because you don't have a lot of time, but you do have a lot of patients.
 
Ask him how nice it is to only have to worry about one organ system. What a punk.
 
Silence is a very strong weapon most people don't like to use. When u are quiet, insecure people around you get worried.
 
Take whatever they're complaining about, smile and say "that's exactly what I like about it". As someone going into Peds, all I ever heard from adult attendings and classmates was "I hate kids" or "loved the kids, couldn't stand the parents"...pretty easy to flip those, but I did have a couple other gems during the year.
 
I always say "I'm not sure yet. I'm learning so much more about myself with each rotation". The attendings usually don't mind this and spare the "lecture" 🙂
 
I'm still honest with people about what I want to do, and it's something that generates some negativity (psych), but I don't like lying .I also think the whole I don't thing doesn't fly so well at this point in the year because you should have developed some preferences by this point. So the guy's a dick, but whatever. At this point, I'd just blow it off and maybe make some self-deprecating jokes about being a "dumb ER doc."
 
Jamers said:
I am on a Cardiology rotation right now and on the first day the attending asked me what I was interested in going into. After I told him Emergency medicine he launched into this 20 minute long tirade about how EM docs "base all their clinical decisions on a list without thinking. They don't know the difference between the various tests they order and the [he] is surprised anyone actually survives a trip to the ED." Anyways, now he is hardcore about every pimp question; asking more and more questions the more I get things right. Once I don't know something he responds with, "you are going to turn out to be just like one of those no brained ED doctors and just order every test under the book aren't you?" I pretty much can't win.

I am not really looking for any sort of guidance about how to deal with this as I am sure I can last another three weeks but I was wondering if anyone else has experienced this type of hatred based simply on their future plans?
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So , you re looking to vent? Good Im glad you can vent. You wont find any hatred from me. I lurk alot and when I post its usually not looked at me saying anything particularly significant.

Pimp questions are just that questions. He cant fail you for saying "I dont know the answer." As long as you are respectful in what you are doing he cant fail you.

Every time he goes into an ER tirade just tell him that you ll make sure to keep those things in mind so you dont become an ER doc that he detests. Or just change the subject (respectfully)
 
My specialty choice changed over the year, but I never felt guilty over revealing what I was leaning towards. Oddly enough, I got reinforcement for my choice of psych in the strangest places - surgeons, EM physicians, neurologists. Everyone talked about how they sometimes wished they had gone in psych instead.

As for your attending, maybe there's a wee bit of projection/reaction formation at work. In any case, I've found that the best way to slide past these black holes of cheer is to ask why they chose to go into their own fields and act as if you're paying rapt attention to their answer. These people like nothing more than an opportunity to talk about how great they are, and you're about to give it to them, good and hard. They'll write about how wonderful of a listener you are and how you're always eager to learn (from them) in your evals. Then, eviscerate them on your evals after the rotation ends. :meanie:
 
I think almost everyone who has ever said what they were planning on doing has caught some flak for it by attendings/residents. The fact is that medicine is a veritable pissing contest...surgeons look down on anesthesiologists, internists make fun of surgeons, everyone hates on radiologists/dermatologists/psychiatrists. It gets annoying.

Don't worry about your attending. He's probably just upset he gets called by EM docs for an MI in the middle of the night and then has to work the next day while the EM doc goes home at 7am and gets to sleep all day. Jealousy takes many forms.
 
There's a few possibilities here. Maybe the attending is just trying awkwardly to make a joke and doesn't know how to let it go. Maybe he is just that unprofessional.

One thing that I would definitely do is speak to whoever is in charge of the rotation (sub-i director) or at least one of the chief residents on the IM service. If someone who is in a position to evaluate you is belittling you like that then the work environment is hostile and you are paying too much money t to put up with that. Your eventual grade may be helped if you approach someone you can trust and say, "look this guy really isn't even giving me a chance."

Specialty bashing is the most juvenile form of interaction in the hospital. It cuts across all fields and actually emergency residents tend to be among the worst perpetrators (while simultaneously being the most sensitive).

The lesson you should take is not just to react to this individual situation but to refrain from talking about "those idiot X residents" a few years down the road.
 
OP, I have a different take on this situation than you and most of the other posters. It may be that your attending doesn't actually hate you. Instead, he could be trying to give you an indirect compliment, albeit not going about it as kindly as he could. In other words, maybe he thinks you are "too good" to be an EM doc. He might want to convince you to do IM instead, and that's why he keeps harping on how awful EM docs are and testing you to get you hooked on learning more medicine. I've had attendings do that kind of thing to me, especially on medicine rotations. I have no desire whatsoever to go into any kind of medicine anything. But several internists have been pretty horrified when I say I am thinking about anesthesiology, and some insist rather strongly that I should go into medicine. The medicine people just don't see anesthesia as a patient care-oriented specialty, and they think I should do something that involves patient care as they conceive of it. Even though it's annoying to have attendings act like this, I think that most attendings would pretty much just ignore you if they actually disliked you. So, your attending probably wouldn't waste his time trying to convert you from the "dark side" if he didn't think you were worth the effort. 🙂
 
QofQuimica said:
OP, I have a different take on this situation than you and most of the other posters. It may be that your attending doesn't actually hate you. Instead, he could be trying to give you an indirect compliment, albeit not going about it as kindly as he could. In other words, maybe he thinks you are "too good" to be an EM doc. He might want to convince you to do IM instead, and that's why he keeps harping on how awful EM docs are and testing you to get you hooked on learning more medicine. I've had attendings do that kind of thing to me, especially on medicine rotations. I have no desire whatsoever to go into any kind of medicine anything. But several internists have been pretty horrified when I say I am thinking about anesthesiology, and some insist rather strongly that I should go into medicine. The medicine people just don't see anesthesia as a patient care-oriented specialty, and they think I should do something that involves patient care as they conceive of it. Even though it's annoying to have attendings act like this, I think that most attendings would pretty much just ignore you if they actually disliked you. So, your attending probably wouldn't waste his time trying to convert you from the "dark side" if he didn't think you were worth the effort. 🙂
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That was my reaction/interpretation as well.

He may think you could "do better" or perhaps is trying to encourage you to think deeper by debasing your choice. Such remarks aren't always born of dislike for the student, although it is indeed annoying.

I got tons of it on Psych and Peds as a student going into surgery.
 
Jamers said:
. . . long tirade about how EM docs "base all their clinical decisions on a list without thinking. They don't know the difference between the various tests they order and the [he] is surprised anyone actually survives a trip to the ED." Anyways, now he is hardcore about every pimp question; asking more and more questions the more I get things right. Once I don't know something he responds with, "you are going to turn out to be just like one of those no brained ED doctors and just order every test under the book aren't you?"
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I would just treat it as small talk meaning that you could just ask him more about bad experiences with ER doctors. Attendings don't really regulate half of what comes out of their mouth on rounds, I would just say in a casual tone that I don't want to be an ER doctor who just "orders every test under the book (err sun?)". I would just focus on trying to be a good "internist" on the internal medicine rotation. Same rules for everything else, just look interested when pimp and ask good questions, it might not be that you want to do ER that he is targeting you, it might be he likes to target some students randomly and poke fun at them or maybe he thought you didn't look interested in IM and wanted to see what you wanted to do , i.e. ER . . . either way I wouldn't clam up and take the "silent" approach, be more responsive if anything.

Some attendings don't like to hear that medical students are planning on going into specialty x, because they feel that the student is not interested in their specialty, generally when you are on a service they want students to "act" like they want to go into the specialty EVEN if you say you don't want to do it.

The Unwritten Deal of Third Year is that you take all sort of abuse as a student and pretend it doesn't happen, you pretend you want to do internal medicine and in exchange your attendings may pretend that they tolerate you and we all participate in the big lie.

Really it doesn't matter *what* specialty you say you want to go into, many students have been on rotation x and wanting to do specialty x only to get more hazing. I liked all the medical work in all my rotations, but the personalities in many were very problematic, and I don't have an acting degree, but really that is what is required to pretend that the barbs don't hurt. In the end it is hazing, you have to endure a certain amount humiliation/harassment at each institution, which varies a remarkable amount. At some hospitals you may have a rough first day, . . . at others the pain lasts the whole rotation.

This attending may actually have wished that he did ER or maybe at least wish he didn't have to interact with ER physicians, and wants medical students to just be worried about passing IM and not to be planning their careers under his nose. At some places medical students are referred to as "wedges" because a wedge is a simple mechanical tool good for keeping a door open and other menial things and shouldn't be talking about their "career plans". Wedges don't have fancy career plans, they are wedges.

ER is more competitive than IM and the attending may have been put off by that. Maybe it would be like a surgical intern saying on the first week that they want to do CT surgery after their surgical residency, possible, but makes you look like you think you are somehow "better" than others.

This posts falls under my first rule of surviving in medicine, mainly that "everybody hates everybody else in the hospital underneath a plethora of fascades."
 
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QofQuimica said:
OP, I have a different take on this situation than you and most of the other posters. It may be that your attending doesn't actually hate you. Instead, he could be trying to give you an indirect compliment, albeit not going about it as kindly as he could. In other words, maybe he thinks you are "too good" to be an EM doc. He might want to convince you to do IM instead, and that's why he keeps harping on how awful EM docs are and testing you to get you hooked on learning more medicine. I've had attendings do that kind of thing to me, especially on medicine rotations. I have no desire whatsoever to go into any kind of medicine anything. But several internists have been pretty horrified when I say I am thinking about anesthesiology, and some insist rather strongly that I should go into medicine. The medicine people just don't see anesthesia as a patient care-oriented specialty, and they think I should do something that involves patient care as they conceive of it. Even though it's annoying to have attendings act like this, I think that most attendings would pretty much just ignore you if they actually disliked you. So, your attending probably wouldn't waste his time trying to convert you from the "dark side" if he didn't think you were worth the effort. 🙂
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Well, I think you should go into Ob/Gyn and become my woman doctor.
 
Uhhhh... reads to me that the IM attending doesn't like EM docs. Few do.
 
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MrBurns10 said:
Well, I think you should go into Ob/Gyn and become my woman doctor.
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You know, Burnsie, I wouldn't even consider doing something as odious as OB/gyn for anyone else but you. Oh, and you do have to name your first-born child after me in return. If it's a guy, you can call him Quentin. If it's a girl, naturally you must name her Quintessa. 😀
 
QofQuimica said:
You know, Burnsie, I wouldn't even consider doing something as odious as OB/gyn for anyone else but you. Oh, and you do have to name your first-born child after me in return. If it's a guy, you can call him Quentin. If it's a girl, naturally you must name her Quintessa. 😀
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You know, you automatically have 50% naming rights considering it's your child. Don't act like that night never happened 😡
 
I got the same 'tude from my ophtho rotation just recently. The attending is well-known for his disdain for ER docs, and frequently will say 'I bet you'd order a CT scan for that, huh. You know it's unnecessary."

I've gone through every off-service rotation in residency asking the attending one thing: is this something I can handle without calling a consult? When should I call you in? Living life in the ED is working in the fishbowl. Everyone looks in and makes their comments.

Every off-service attending has their old chestnut about how ER doc 'didn't complete the workup before calling' or 'ordered every test known to man.' You can't win.

When I ask - "So what do you want me to know, in terms of being an ER doc?" They're happy to tell you. Sometimes it's crap, but most of the time they discuss what, as a consultant, they want to hear when you call them on the phone. When you start calling consults, the more of 'their' language you can speak the smoother the consult goes. If you have the couple of steps of what the consider a good workup started, you get less attitude and more cooperation.
 
tkim said:
When I ask - "So what do you want me to know, in terms of being an ER doc?" They're happy to tell you. Sometimes it's crap, but most of the time they discuss what, as a consultant, they want to hear when you call them on the phone. When you start calling consults, the more of 'their' language you can speak the smoother the consult goes. If you have the couple of steps of what the consider a good workup started, you get less attitude and more cooperation.
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I think that's a great way to look at it. I think you're more likely to get along with the doc if you're able to communicate to him that you want to use what you learn on his rotation to become a better emergency doc.
 
Winged Scapula said:
That was my reaction/interpretation as well...
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It's not limited to specific medical fields. I want to do research and be a physician. The PhDs tell me I'll do bad science because I won't have enough training. The clinicians tell me "I hope you don't work on some protein" and "you don't need to do research because EM's not all that competitive"

That last one came from a FP attending. :laugh:

More seriously, I would take nothing anyone says as personal. Everyone has their own axe to grind, and few in the medical profession seems to have any respect for colleagues in other fields. This goes double for people 'lower on the totem pole" like 3rd years. Have a vision of where you want to go, and don't let angry, biased, and narrow opinions shake you from it.
 
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Jamers said:
I am on a Cardiology rotation right now and on the first day the attending asked me what I was interested in going into. After I told him Emergency medicine he launched into this 20 minute long tirade about how EM docs "base all their clinical decisions on a list without thinking. They don't know the difference between the various tests they order and the [he] is surprised anyone actually survives a trip to the ED." Anyways, now he is hardcore about every pimp question; asking more and more questions the more I get things right. Once I don't know something he responds with, "you are going to turn out to be just like one of those no brained ED doctors and just order every test under the book aren't you?" I pretty much can't win.

I am not really looking for any sort of guidance about how to deal with this as I am sure I can last another three weeks but I was wondering if anyone else has experienced this type of hatred based simply on their future plans?
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Jamers I have a hard time imagining anyone disliking you. Tell him your from PHilly and that should be the end of it. You could always try the total kiss butt approach and say "As a cardiologist, what do you think I could do better as an ER physician, or what things do you expect out of me as an ER physician before you see the patient"

THen you put the onus on him to actually identify or give you examples of what he thinks can improve. I don't know don't let it get you down!
 
I thank everyone for their responses. I normally am honest with docs when they ask what I am interested in. At this stage, I figure it is kind of odd to "not" know what I want to go into. Anyways, this was the first time it backfired in my face. The first two and half weeks of this rotation were hell. I was constantly told, daily, that I would kill all of patients like those "ED docs" if I didn't know the answer to all of his questions. I was belittled in front of his staff and made out to be an idiot in front of anyone that was around. This all changed when he expressed attitude towards a patient; he told the patient, a college professor, that they were "ignorant beyond belief." The patient went to the docs bosses and since then, he has laid off me. He also shared with me a few facts that may explain why he is this way: he failed his step 1 boards and wanted to be a surgeon but couldn't Match into a program. Thanks again everyone.
 
Ahhh...that explains a lot. Nothing worse than someone who is bitter about not doing what he really wanted to do. Taking it out on others makes him somehow feel better about his own failures in life. I find it a little odd he would admit this to you, but ok...

He's an ass (apparently to you and patients). I wouldn't give him another thought.
 
Winged Scapula said:
Ahhh...that explains a lot. Nothing worse than someone who is bitter about not doing what he really wanted to do. Taking it out on others makes him somehow feel better about his own failures in life. I find it a little odd he would admit this to you, but ok...

He's an ass (apparently to you and patients). I wouldn't give him another thought.
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After the patient complained about him he told me and I talked to him about it and made him "feel better" I guess. That was when he opened up about failing his boards, ect. I was just as surprised as you are and didn't really know how to reply except with oh...really? I guess it does explain a lot though doesn't it? Thanks again for all the replies.
 
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Jamers said:
He also shared with me a few facts that may explain why he is this way: he failed his step 1 boards and wanted to be a surgeon but couldn't Match into a program.
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Wonder if he knows that today the average surgery and medicine step I are within a few points of each other. Also cardiology is one of the most difficult fellowships to land after IM. Also the lifestyle is much better, even though the ED makes his life hell by forcing him actually do some work.
 
Jamers said:
I was belittled in front of his staff and made out to be an idiot in front of anyone that was around. This all changed when he expressed attitude towards a patient; he told the patient, a college professor, that they were "ignorant beyond belief." The patient went to the docs bosses and since then, he has laid off me. He also shared with me a few facts that may explain why he is this way: he failed his step 1 boards and wanted to be a surgeon but couldn't Match into a program. Thanks again everyone.
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That is really interesting hearing the "true story" behind the anger. I sort of thought he was jealous of you as you have open career options and maybe since some people view ER as more competitive or better than IM. I think he was projecting saying ER docs "kill people" as he failed Step 1 and was relagated to IM, which he didn't want to do.

I think a lot of such attacks on medical students by physicians are rooted in such feelings of their own deficiencies, not that ER physicians "kill people."
 
TUCAnSam said:
Wonder if he knows that today the average surgery and medicine step I are within a few points of each other. Also cardiology is one of the most difficult fellowships to land after IM. Also the lifestyle is much better, even though the ED makes his life hell by forcing him actually do some work.
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The grass is always greener on the other side, but he *failed* step 1, . . . that could really decrease your chances of doing surgery, but IM not so much
 
DarthNeurology said:
The grass is always greener on the other side, but he *failed* step 1, . . . that could really decrease your chances of doing surgery, but IM not so much
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Hey, out of curiosity, how do attendings react to a student expressing interest in neurology? I'm trying to think of any potential bad stereotypes... hopefully there aren't too many! 😉
 
DarthNeurology said:
That is really interesting hearing the "true story" behind the anger...I think a lot of such attacks on medical students by physicians are rooted in such feelings of their own deficiencies, not that ER physicians "kill people."
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As I'm interested in EM, I also get a lot of "oh you must not care about your patients" and "you'll be shoving your problem patient on to me so you can go golfing."

This was said by an ortho attending who later complained to everyone that his Saturday tee-time was cancelled by an emergent case. :laugh:

NRMP shows step scores for IM ~ GSurg ~ EM (mean and std dev), so everyone's just about as smart as each other. But even if they weren't, attendings and residents should stop this crap. I agree that almost everyone who participates in talking-down has either some personal history/issue or they doesn't know how to convey pride in their field like a grown-up.
 
I have learned never to tell an attending that you want to do radiology . . . especially a family practice doctor . . . I regretted saying that for the rest of my six week rotation. Now I just say, oh, I'm not sure what I want to do.
 
sunshinedoc said:
I have learned never to tell an attending that you want to do radiology . . . especially a family practice doctor . . . I regretted saying that for the rest of my six week rotation. Now I just say, oh, I'm not sure what I want to do.
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I didn't tell anyone either until my last 2 weeks of the year...and then I realized why. I was sitting around in clinic with the peds residents and I told one of them what I wanted to do (after being asked), and he goes "Oh, that's cool...though I dunno, I went to medical school to be, like, a real doctor."

Every time I'm asked what I want to go into, I'm embarassed to answer. It's like I always have to justify to other people why I want to go into the field. It's a shame, but you just learn to deal with it.
 
Everyone experiences this.

I can think of several reasons we see this in the hospital- first, most of us like what we are doing or we would not be doing it and therefore, it is naturally the coolest field of medicine and cannot understand those who would want to practice anything else. In this instance, it is a compliment. Then, there is a small minority who hate what they are doing and are jealous of others either in the field that they wanted to go into or those going into fields that are more lifestyle friendly than their current chosen field. Everyone thinks differently and each field has its own distinct personality.

If you are going into neuro, you can dumped on by surgery, surgery by medicine and pathology, psych, family med and EM by what seems like everyone, internal medicine by EM, surgery, GI etc., then anesthesia by surgery and round and round.

I have been told by non-EM physicians that I am "too smart" to be an EM doc and then usually get regalled with a laundry list of stories about how some EP screwed up and did not diagnose an extremely rare condition and only focused on ruling out the life threatening possibilities 🙂idea: sort of the point of emergency medicine but I digress). Forget missing the forest for the tree- they missed the leaf on the 12th branch on the right side of the 5th tree in the middle. Or I hear about how we are unable to think and simply shotgun the lab and imaging, irradiating our patients to no end, and letting the tests dictate our diagnosis. However, if you hold off on getting that CT scan and want to rely on the ultrasound (Or heaven forbid, your physical exam skills) for a hot appy, sometimes you get told no- the surgeon wants the CT scan.

It can be undoubtedly frustrating. I took the approach in third year that I was leaning toward EM but had an open mind and found things that I liked about every rotation (actually true:laugh:). I would also ask if you could have an emegency medicine physician know one thing to better help the patient, what would it be? How can I better package the patient for your service? The non-EM attending/resident usually appreciates this approach and decreases the EM bashing (at least in my presence).
 
sunshinedoc said:
I have learned never to tell an attending that you want to do radiology . . . especially a family practice doctor . . . I regretted saying that for the rest of my six week rotation. Now I just say, oh, I'm not sure what I want to do.
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Never had a problem telling my attendings I wanted to do radiology. They saw how genuinely excited I was about rads. I looked at every film and got plenty of stat reads by visiting the reading room and knowing all of the radiologists. My medicine attendings had me present on relevant radiological aspects of the diseases we were encountering.

Be interested in your current rotation for the learning experience even if it's not the field you're going into. I think attendings understand that not everyone is going to go into their specialty.

Sometimes you just won't be able to win and it's best to stay quiet.
 
vtucci said:
Everyone experiences this.

I can think of several reasons we see this in the hospital- first, most of us like what we are doing or we would not be doing it and therefore, it is naturally the coolest field of medicine and cannot understand those who would want to practice anything else. In this instance, it is a compliment. Then, there is a small minority who hate what they are doing and are jealous of others either in the field that they wanted to go into or those going into fields that are more lifestyle friendly than their current chosen field. Everyone thinks differently and each field has its own distinct personality.

If you are going into neuro, you can dumped on by surgery, surgery by medicine and pathology, psych, family med and EM by what seems like everyone, internal medicine by EM, surgery, GI etc., then anesthesia by surgery and round and round.

I have been told by non-EM physicians that I am "too smart" to be an EM doc and then usually get regalled with a laundry list of stories about how some EP screwed up and did not diagnose an extremely rare condition and only focused on ruling out the life threatening possibilities 🙂idea: sort of the point of emergency medicine but I digress). Forget missing the forest for the tree- they missed the leaf on the 12th branch on the right side of the 5th tree in the middle. Or I hear about how we are unable to think and simply shotgun the lab and imaging, irradiating our patients to no end, and letting the tests dictate our diagnosis. However, if you hold off on getting that CT scan and want to rely on the ultrasound (Or heaven forbid, your physical exam skills) for a hot appy, sometimes you get told no- the surgeon wants the CT scan.

It can be undoubtedly frustrating. I took the approach in third year that I was leaning toward EM but had an open mind and found things that I liked about every rotation (actually true:laugh:). I would also ask if you could have an emegency medicine physician know one thing to better help the patient, what would it be? How can I better package the patient for your service? The non-EM attending/resident usually appreciates this approach and decreases the EM bashing (at least in my presence).
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I 100% agree with everything you said here. Trying to explain to a non-EM physician about why you want to get the CT scan instead of the US is next to impossible. They seem to forget that people are coming into the ED because of...*gasp* an Emergency! Sure, most of what you find is nothing threatening but you will be damned to all hell if you miss something simply because you didn't want to order the test. I guess this is what creates the mentality that ED docs base all decisions on tests and not on clinical knowledge which is, of course, 100% bogus. I do find it funny that everyone seems to dislike ED docs. I will never forget what one ED physician told me while on rotation: (waiting on the phone for another doc to pick up) "We are the only doctors that, when we call another doc, get treated like we are five years old. The will keep us on the phone for 15 minutes and then talk down to us about all of our decisions. Really, we are pretty much the bitch of the hospital."

I have used the same method of asking physicians how they feel I can be a better future ED doc. Up until this rotation it actually worked out very well. One physician actually called me on my cell phone after I had finished the rotation because he had an interesting "emergency" case.
 
MrBurns10 said:
I didn't tell anyone either until my last 2 weeks of the year...and then I realized why. I was sitting around in clinic with the peds residents and I told one of them what I wanted to do (after being asked), and he goes "Oh, that's cool...though I dunno, I went to medical school to be, like, a real doctor."

Every time I'm asked what I want to go into, I'm embarassed to answer. It's like I always have to justify to other people why I want to go into the field. It's a shame, but you just learn to deal with it.
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That is the exact same type of response I have received. Apparently wanting to do radiology means that I am either antisocial and hate people or just lazy and greedy . . . I am almost done with third year and really don't care if anyone has a problem with my future plans. Like you said, you just learn to deal with it.
 
OP, you more or less have at least two choices when faced with a rotation in a specialty that's not on your short list: Sidestep with the "not 100% sure yet response & making sure to keep an open mind" or be relatively open/honest/diplomatic and yet risk calling the attending's baby "not worthy." I suspect you may be right; you may be screwed now; at least you'll know better next rotation. Be careful what you say unless you are willing to experience a virtual kick to your lower half for being real; not pretty, but survivable. I've heard some otherwise amazing attendings make some infantile comments when a student expresses preference for a specialty X when that's not the attending's specialty ....
 
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unsung said:
Hey, out of curiosity, how do attendings react to a student expressing interest in neurology? I'm trying to think of any potential bad stereotypes... hopefully there aren't too many! 😉
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A common stereotype about neurologists is that they do nothing for the patient - i.e., they spend a lot of time and money diagnosing a problem that they likely won't be able to fix. I just finished my ER rotation, and got a little bit of good-natured ribbing after I told my attendings I was going into neurology. I just participate in the joking and make fun of myself. "I could never do ER because you can fix way too much stuff too quickly". After all, there is a nugget of truth in the stereotype about neurology, though I think neurological treatments have been advancing by leaps and bounds and will represent the most exciting cutting-edge stuff in medicine in the coming years/decades.
 
MrBurns10 said:
I didn't tell anyone either until my last 2 weeks of the year...and then I realized why. I was sitting around in clinic with the peds residents and I told one of them what I wanted to do (after being asked), and he goes "Oh, that's cool...though I dunno, I went to medical school to be, like, a real doctor."

Every time I'm asked what I want to go into, I'm embarassed to answer. It's like I always have to justify to other people why I want to go into the field. It's a shame, but you just learn to deal with it.
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I've had a similar reaction to radiology. In fact, I ran into my preceptor (an IM hospitalist) a few months back, and he asked me what I was planning on specializing in. After I told him, he gave me a 10-minute lecture basically telling me how disappointed he is that I'm didn't choose IM, described it as "wasted potential," and said that he hoped I wasn't choosing it for money or lifestyle. That was a kick in the stomach.

The weird reactions to radiology don't really bother me anymore. I matched and they can't suck the joy out of it. 😉
 
vtucci said:
It can be undoubtedly frustrating. I took the approach in third year that I was leaning toward EM but had an open mind and found things that I liked about every rotation (actually true:laugh:). I would also ask if you could have an emegency medicine physician know one thing to better help the patient, what would it be? How can I better package the patient for your service? The non-EM attending/resident usually appreciates this approach and decreases the EM bashing (at least in my presence).
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This is pretty much my plan, since it is pretty much the truth. I'm pretty sure I won't be dissuaded from EM, but I don't intend to completely make up my mind until I've gotten through most of my rotations 3rd (next) year. I think the best thing about knowing you want to do EM is that almost every rotation has applicable knowledge for your career. I intend to use this to my advantage, so I'll say something like, "I'm pretty sure I want to go into emergency medicine, but I won't close any doors until third year is over. Besides, if I do stick with EM, I'll see patients that fall under [x specialty] so often that I'm excited to learn how to apply knowledge from [x specialty] to my future career." Or something more or less eloquent than that (depending on sleep to coffee ratio).
 
why have i gotten the impression from SDN that every Attending is Hitlers clone?
 
Rogue Synapse said:
A common stereotype about neurologists is that they do nothing for the patient - i.e., they spend a lot of time and money diagnosing a problem that they likely won't be able to fix. I just finished my ER rotation, and got a little bit of good-natured ribbing after I told my attendings I was going into neurology. I just participate in the joking and make fun of myself. "I could never do ER because you can fix way too much stuff too quickly". After all, there is a nugget of truth in the stereotype about neurology, though I think neurological treatments have been advancing by leaps and bounds and will represent the most exciting cutting-edge stuff in medicine in the coming years/decades.
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Going into EM and I generally had the same feeling about neuro that you describe until I'm doing my neuro rotation now. I got to administer tPa and a total hemiparesis with facial droop, upgoing Babinski, and dead reflexes completely reversed itself within 1-2 minutes 🙂 I realize I got in a lucky case, but the neurologist attending told me, "Who says we can't do anything for the patient😉"
 
I have been honest with wanting to do EM to all my attendings. I have surprisingly gotten compliments for being honest and not giving the answer they all know are lies ("I'm not sure yet" or "still deciding" etc). I also followed up that I wanted to learn what I can do before calling them or what I can do to make their job easier. They liked that perspective (or they at least pretended to like it). They would also send me to the ED for consults knowing my interest was there, then teach me things about the patients and what I could have done differently. I really haven't had the completely negative attitudes yet.
 
Yeah, the responses weren't great when I said radiology during fourth year rotations. Usually if I qualified it with interventional radiology (which is true) I got a "o never mind, that's okay then". Or if I said I'm doing it cause I like physics, suddenly I chose rads for noble reasons apparently. I like to think it's because if you're strange enough to like physics, then you're obviously a little crazy and can't really be blamed for your life choices. 😀

Honestly, 99% of the time I didn't bother and just said radiology and smiled contently. Judge me all you want, I'll be in the reading room with a cup of cocoa and playing video games in the IR suite soon enough. Good luck with that 2 AM pneumonia admit. 😉
 
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I am just finishing my 3rd year & have been Rads the whole time, and endured a lot of the usual comments. Sometimes I wish I would've said the ole "I'm not sure, I'm still trying to find my true passion". If I had to do it all over again I would probably do it the same way. I would feel bad 'tapdancing' around the question & get other docs all excited that I might go into that field. I get worried that they might see right through me, I'm a terrible tapdancer.
 
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