Incompetent Intern

Medstudentquest · Oct 30, 2007

What to do? I'm currently on a rotation where the intern is very incompetent. We basically have to do all the work of the resident and he's always asking us to do his work. He makes frequent mistakes, the attendings hate him, and the other residents also dislike him. He's frequently late, spends all day doing who knows what, but at the end of the day, notes that have not been written by the students are pretty much left unwritten, patients orders have not been made, and so forth. He basically makes us do all the work and whatever we don't do, it's left undone pretty much. The senior is aware of how bad the intern is, as are other residents and attendings. One of the residents today even told us that we should not be working as hard as we are and that they all know how incompetent this intern is. It's come to the point where nurses ask us the students about the orders, discharge planning, and so forth. I mean I think I am pretty darn good in the clinical field, but I don't believe as a student I should be making all the decisions. What should my best plan of action be? Although I don't want to get him in trouble, I also don't want to have to leave the hospital at 6pm every day. I feel so frustrated!

PeepshowJohnny · Oct 30, 2007

I'd go to the clerkship director. If they won't switch you to another intern to follow, they'll hopefully at least keep other students from having to suffer through working with this joker.

Tired · Oct 30, 2007

Medstudentquest said:
I mean I think I am pretty darn good in the clinical field, but I don't believe as a student I should be making all the decisions. What should my best plan of action be?

The PC answer: As a student you should not be called upon to do as much as you are doing. You could talk to the attendings or your clerkship director about your concerns.

The better answer: Take over his job as much as possible, without violating the law against practicing medicine without a license. Your patients need you to be on the ball, since their nominal doctor obviously isn't. It will also make your residents appreciative of your efforts, which is the surest way to get a great eval. Don't forget that in a year-and-a-half you will be the doc on service.

It's technically correct to say, "It's not my job" but do you really want to put off all responsibility until the very last day before you get your MD?

Medstudentquest · Oct 30, 2007

Tired said:
The PC answer: As a student you should not be called upon to do as much as you are doing. You could talk to the attendings or your clerkship director about your concerns.

The better answer: Take over his job as much as possible, without violating the law against practicing medicine without a license. Your patients need you to be on the ball, since their nominal doctor obviously isn't. It will also make your residents appreciative of your efforts, which is the surest way to get a great eval. Don't forget that in a year-and-a-half you will be the doc on service.

It's technically correct to say, "It's not my job" but do you really want to put off all responsibility until the very last day before you get your MD?

I don't mind working hard and taking care of patients, but I am a student after all and I can make mistakes! Also I shouldn't be the one having to come up with plans, talking to nurses about orders, etc. That is the job of the intern. I find it scary that "I" need to come up with plans!! Also, interns don't evaluate us at all. The whole point of a rotation is to learn. At this point, I'm not really learning anything, I'm just doing the job of the intern. I find it scary that this intern is even on the team! Shouldn't the intern know more than a student? He asks us about things and what do and so forth. I mean I will be done with this rotation in a few weeks, but I find it scary that this person is practicing. He didn't match, he scrambled and doesn't even have a position for next year yet. It's scary to think this person has an MD.

Tired · Oct 30, 2007

Medstudentquest said:
I don't mind working hard and taking care of patients, but I am a student after all and I can make mistakes! Also I shouldn't be the one having to come up with plans, talking to nurses about orders, etc. That is the job of the intern. I find it scary that "I" need to come up with plans!! Also, interns don't evaluate us at all. The whole point of a rotation is to learn. At this point, I'm not really learning anything, I'm just doing the job of the intern. I find it scary that this intern is even on the team! Shouldn't the intern know more than a student? He asks us about things and what do and so forth. I mean I will be done with this rotation in a few weeks, but I find it scary that this person is practicing. He didn't match, he scrambled and doesn't even have a position for next year yet. It's scary to think this person has an MD.

I'm not trying to rip on you, so please don't take it that way. I've been in your shoes, and it sucks, I know. But I want to point out a couple things:

"I'm a student after all and I can make mistakes!"
- so can your intern, and apparently he is
- just because you are the most junior doesn't mean you are the most incompetent

"I shouldn't be the one having to come up with plans, talking to nurses about orders, etc. That is the job of the intern."
- actually not true, it's everyone's job on the team, it's just that since your intern is the low-man on the totem pole, he gets stuck doing it
- I will tell you that I routinely have my med students communicate plans to nursing, and I expect them to be able to formulate a coherent plan

"Also, interns don't evaluate us at all."
- No, but your residents do, and you better believe they are watching you like a hawk, as they are doing with your intern
- My point was that the more responsibility you take on, the less stress you place on your residents because they don't have to do the intern's job, and they will love you for it

"The whole point of a rotation is to learn."
- Only partially true: the whole point of a rotation is to learn to function as a house officer, which is part learning clinical medicine and part job training
- You ignore the job training at your own peril; even the smartest med students can make crappy house officers if they didn't take the time to learn to function as an intern while still students

"It's scary to think this person has an MD"
- Yes, it is, now watch over your patients and make sure he doesn't inadvertently kill them

Tired · Oct 30, 2007

All I'm trying to say is that, yes, you can talk to people in authority and stay in the background and go home early if you want. No one will blame you for it or hold it against you.

But if you really want to take care of your patients (and yes, they are yours) then sometimes you have to step up, get outside your comfort zone, and overextend yourself a little. It is scary, but if take the time get your residents (or intern) to cosign all your orders before you have nursing do it, and limit your communication with the nurses to what you know is the plan, you will be fine. Pretty soon that will be your whole job, so you might as well learn what you can now.

fakin' the funk · Oct 31, 2007

Medstudentquest said:
What to do? I'm currently on a rotation where the intern is very incompetent. We basically have to do all the work of the resident and he's always asking us to do his work. He makes frequent mistakes, the attendings hate him, and the other residents also dislike him. He's frequently late, spends all day doing who knows what, but at the end of the day, notes that have not been written by the students are pretty much left unwritten, patients orders have not been made, and so forth. He basically makes us do all the work and whatever we don't do, it's left undone pretty much. The senior is aware of how bad the intern is, as are other residents and attendings. One of the residents today even told us that we should not be working as hard as we are and that they all know how incompetent this intern is. It's come to the point where nurses ask us the students about the orders, discharge planning, and so forth. I mean I think I am pretty darn good in the clinical field, but I don't believe as a student I should be making all the decisions. What should my best plan of action be? Although I don't want to get him in trouble, I also don't want to have to leave the hospital at 6pm every day. I feel so frustrated!

grow a pair and use the opportunity to learn about how to manage pts

MeowMix · Oct 31, 2007

I can't believe an MS3 is complaining about the opportunity to see patients and take responsibility, formulate plans, and have someone actually care what their opinion is. With minimal consequences if you screw up (your resident and attending get the consequences since no one expects you to know what to do). This is an amazing learning opportunity. Take advantage of it.

surprisedgirl · Oct 31, 2007

MeowMix said:
I can't believe an MS3 is complaining about the opportunity to see patients and take responsibility, formulate plans, and have someone actually care what their opinion is. With minimal consequences if you screw up (your resident and attending get the consequences since no one expects you to know what to do). This is an amazing learning opportunity. Take advantage of it.

agreed i would LOVE it

arthrodisiac · Oct 31, 2007

Medstudentquest said:
What to do? I'm currently on a rotation where the intern is very incompetent. quote]

funniest thing i've read on sdn.....ever.

Medstudentquest · Oct 31, 2007

surprisedgirl said:
agreed i would LOVE it

There is absolutely no reason why medical students should bear the whole responsibility of managing all 25 patients on a team with no help from the intern. The senior on the team despises the intern, as do the rest of the residents in the program. Incompetency is incompetency. I doubt you would want to get in at the hospital at 6am and leave at 7pm every day and do the whole job of the intern. I constantly even have to correct the intern's mistakes and at times even stick up for him because he gets ripped on so much and told how incompetent he is by the seniors and attendings. It is irresponsible and ridiculous that an intern can't act as such. Further they are thinking of kicking him out of the prelim altogether and since he didn't match in the first place and has no spot for PGY-2, the PD in the program is unwilling to let him match in the program next year altogether.

Medstudentquest · Oct 31, 2007

fakin' the funk said:
grow a pair and use the opportunity to learn about how to manage pts

Do you manage 25 patients on your team? I doubt it. Do you have an intern who does anything on your team? I hope so. Learn to give constructive advice.

smq123 · Oct 31, 2007

Medstudentquest said:
There is absolutely no reason why medical students should bear the whole responsibility of managing all 25 patients on a team with no help from the intern.

How about this reason - there are still sick people in the hospital who need someone to take care of them. Right now, that "someone" is a third year med student. And these people are actually sick, and some could die from lack of care - these aren't standardized patients.

Is that a good enough reason for you?

Medstudentquest said:
The senior on the team despises the intern, as do the rest of the residents in the program. Incompetency is incompetency.

I constantly even have to correct the intern's mistakes and at times even stick up for him because he gets ripped on so much and told how incompetent he is by the seniors and attendings.

If the senior and the attendings know that this intern is so crappy, why do you waste your breath and time sticking up for him? It's not like your input is going to change their minds or anything. If they dislike him, they dislike him, regardless of what you have to say.

Medstudentquest said:
I doubt you would want to get in at the hospital at 6am and leave at 7pm every day and do the whole job of the intern.

Actually - I don't know if I'd mind working from 6AM - 7PM, if it meant that I actually got to do STUFF. I hated being in the hospital from 8 AM to 3 PM, and realizing that I did nothing all day except sit in a corner and try not to get yelled at. (Or else sit in a corner and swallow my rising resentment at being ignored by the resident for 7 hours.)

As MeowMix said - someone ACTUALLY wants to hear your opinion! You actually matter!! Revel in it, because this will not happen on other rotations. (Seriously - on my last rotation, the only thing that the resident said to me was, "Oh, you're still here? What's your name again?")

Medstudentquest said:
Do you manage 25 patients on your team? I doubt it.

a) Do you manage all 25 patients by yourself? I doubt it.

b) I realize that your original post was meant to vent. And that's fine. But this is starting to cross the line into whining. And I think that, as 3rd year med students, getting out of the habit of whining about stuff that is beyond our control is a good idea.

I'm truly sorry for you that your intern sucks. (Actually, I'm even sorrier for the patients on your service.) And, yes, you're being put in a position with more responsibility than 3rd years usually get, which I agree - that's scary. But the patients need help. All you can do at this point is realize that your intern is incompetent, suck it up, and try to help out the patients as much as you possibly can.

Tired · Oct 31, 2007

Medstudentquest said:
I doubt you would want to get in at the hospital at 6am and leave at 7pm every day and do the whole job of the intern.

This is the second time you've mentioned these hours. Hate to tell you, that's not particularly bad. Three of my four months so far as an intern have been 4am-7pm or later plus call.

And not to belabor the obvious, but in short order, you will "get in at the hospital at 6am and leave at 7pm every day and do the whole job of the intern" because you will be the intern.

A-non-y-mous · Nov 1, 2007

Tired said:
This is the second time you've mentioned these hours. Hate to tell you, that's not particularly bad. Three of my four months so far as an intern have been 4am-7pm or later plus call.

And not to belabor the obvious, but in short order, you will "get in at the hospital at 6am and leave at 7pm every day and do the whole job of the intern" because you will be the intern.

How about developing some empathy???

You don't have a shelf exam looming over your head that probably more than half your grade. You probably don't have to form a 10 page write up due before your attending arrives. You also probably don't have to go impress people with articles that theya ren't going to read anyway.

So you wake up at 4 work till 7 pm....when is the time to study?? Interact with family? At least when you go home your time is yours. For students, they still have other school related responsibilites.

It's unfair to become an intern when you aren't supposed to be. That's point of being an MS3, having someone to guide you through the medical management of patients..... I would understand your argument if this was an MS4 we're talking about. Or even an MS3 late in the year...but come on.

Tired · Nov 1, 2007

A-non-y-mous said:
You don't have a shelf exam looming over your head that probably more than half your grade. You probably don't have to form a 10 page write up due before your attending arrives. You also probably don't have to go impress people with articles that theya ren't going to read anyway.

So you wake up at 4 work till 7 pm....when is the time to study?? Interact with family? At least when you go home your time is yours. For students, they still have other school related responsibilites.

Are you serious? I just finished Step 3, and I actually had to take vacation time to get it done. I have two posters coming up for a conference in December that I still haven't started on. My inservice training exam (OITE) is in four weeks and I have about 700 questions I need to get through before then. And I have to constantly keep looking stuff up, not because I have a stupid Shelf exam to study for, but because I actually have to manage diseases that I only have a vague understanding of. My family is supportive, but my wife is saying she wants another baby now, and seriously, I guess I could get to know my next child in a couple years . . .

You didn't really think internship was just showing up to rounds in the morning, did you?

A-non-y-mous said:
It's unfair to become an intern when you aren't supposed to be. That's point of being an MS3, having someone to guide you through the medical management of patients..... I would understand your argument if this was an MS4 we're talking about. Or even an MS3 late in the year...but come on.

Yeah yeah, unfair. Life is so unfair.

Like I said before, you can duck and cover in the corner if you want, and probably no one will hold it against you. Or you can grow a pair, take some responsibility that's offered to you, and try to improve the lot of your patients. Which kind of med student would you prefer to have wake you up at 5am every day?

Blade28 · Nov 1, 2007

A-non-y-mous said:
How about developing some empathy???

You don't have a shelf exam looming over your head that probably more than half your grade. You probably don't have to form a 10 page write up due before your attending arrives. You also probably don't have to go impress people with articles that theya ren't going to read anyway.

While I sympathize with the plight of the overworked med student, don't forget that Tired's already been through it all. He's gone through the brutal hell of the MS-III year, and is now slaving along in an Ortho residency. I doubt he's forgotten what it's like to be a junior med student.

Anka · Nov 1, 2007

The only moral course of action for you is to step up and take care of your patients (cause guess what, doc, you're it). Quit whining about it and do your job. Listen to Tired and Blade -- they know what they're talking about and are giving you the tough love that someone should have given you while you were still in diapers. This isn't about empathy and holding hands and singing Kumbaya. This is about making sure you take the best care you know how of patients who are actually sick and depending on you.

Yeah, I know it's unpopular now a days to expect med students to do work. There's all this PC BS about how MS3's are not there to do the interns job, they're there to learn. But as an MS4 who was there only a short year ago, I can tell you I learned the most on rotations where I was doing the interns job (or as much as I could handle). And to do that I woke up earlier and stayed later than an intern would have had to, 'cause that's how long it took me to get it done. And I still studied for the shelf.

As far as ten page write ups and little talks that are useless to start with, just stop doing them. My guess is it won't hurt your grade if you're doing as much as you say you are. The big picture is simple -- you need to protect your patients first, your team second, find time to study third (and with the hours you're working, you really do have plenty of time to study; you probably just need to learn how to study when you're tired), and worry about your grade and those absurd things which are useless anyway last.

Big picture is, at every point in your career you're going to have to face a completely unreasonable set of demands and be held to a very high standard on all of them, and the only way to stay sane is to develop a strong internal sense of what is important and what is BS, and do the important things first. This is true not just in medicine, but in any high performance field.

And don't even get me started on what I think about people on this thread claiming that somehow the shelf exam exempts you from your moral responsibility to provide excellent care for your patients.

Best,
Anka

Top Gun · Nov 1, 2007

Look, your intern is clearly incompetent. The $hit has hit the fan, so now you're it. You are now the one responsible for the patients. Yes, its scary, but its also a better learning opportunity than you would normally get as an MS3. I mean, you get more say in making decisions and you have more opportunities to do procedures. Think of how well you will be prepared once you actually become an intern. You also now have an opportunity to really shine on your evals.

plastikosmd · Nov 1, 2007

great opportunity i agree, had the same thing happen to me...became the intern as an MS3, eval at the end..

"was indistinguishable from a service resident, even though he was an MS3, out-worked and performed our intern....honors"

fakin' the funk · Nov 1, 2007

smq123 said:
a) Do you manage all 25 patients by yourself? I doubt it.

b) I realize that your original post was meant to vent. And that's fine. But this is starting to cross the line into whining. And I think that, as 3rd year med students, getting out of the habit of whining about stuff that is beyond our control is a good idea.

For (a) to be true, the OP's intern would actually have to have 25 patients. No way! Where I was at, interns were capped at 10.

And the point about whining in (b) is well taken - a good chunk of the posts in this forum are whiny or otherwise misdirected ("I have a difficult and complex problem with my clerkship, why don't I go ask a bunch of overachieving strangers?") I stand by my original advice, which is either to grow a pair/suck it up OR possibly do something about it - asking on SDN doesn't do a whole lot eh?

Tired · Nov 1, 2007

fakin' the funk said:
For (a) to be true, the OP's intern would actually have to have 25 patients. No way! Where I was at, interns were capped at 10.

I'm going to guess that your rotation with a cap was Internal Medicine, and the rotation with 25 patients was Surgery.

My record so far was 21 patients, all mine. No caps.

surrender903 · Nov 1, 2007

im sure ill get lambasted for this, but didnt we sign up to learn to be doctors voluntarily?

the information you will learn from managing patients yourself is incomparable to just book knowledge. its nice that you can name 11 signs of SLE, but man to take care of patients and really step up to the plate with the ability to CYA and say "but the intern was supposed to do this" as your excuse (i dont agree with having excuses, but to each his own), relish in that ability NOW because we wont have that luxury once we are doctors.

pagemmapants · Nov 1, 2007

Medstudentquest said:
I doubt you would want to get in at the hospital at 6am and leave at 7pm every day.

After a 92 hour week on thoracic surg where I didn't once leave the OR before 8:00pm. . .

I'd love to. 😀 Sign me up.

Blade28 · Nov 1, 2007

Tired said:
I'm going to guess that your rotation with a cap was Internal Medicine, and the rotation with 25 patients was Surgery.

My record so far was 21 patients, all mine. No caps.

My record was 50 patients - 46 on the floor, 4 in the step-down unit. This was July 2006, trauma service at our busy level 1 trauma center.

Medstudentquest · Nov 2, 2007

Tired said:
This is the second time you've mentioned these hours. Hate to tell you, that's not particularly bad. Three of my four months so far as an intern have been 4am-7pm or later plus call.

And not to belabor the obvious, but in short order, you will "get in at the hospital at 6am and leave at 7pm every day and do the whole job of the intern" because you will be the intern.

I'm not an intern, I'm a medical student. Those hours for an intern are reasonable, but not for a medical student.

Medstudentquest · Nov 2, 2007

A-non-y-mous said:
How about developing some empathy???

You don't have a shelf exam looming over your head that probably more than half your grade. You probably don't have to form a 10 page write up due before your attending arrives. You also probably don't have to go impress people with articles that theya ren't going to read anyway.

So you wake up at 4 work till 7 pm....when is the time to study?? Interact with family? At least when you go home your time is yours. For students, they still have other school related responsibilites.

It's unfair to become an intern when you aren't supposed to be. That's point of being an MS3, having someone to guide you through the medical management of patients..... I would understand your argument if this was an MS4 we're talking about. Or even an MS3 late in the year...but come on.

That is my point right on. I don't mind working hard, but I am an MS3, not an intern. The whole point of rotations is to learn and to be guided over what to do and how to manage patients.

Medstudentquest · Nov 2, 2007

fakin' the funk said:
For (a) to be true, the OP's intern would actually have to have 25 patients. No way! Where I was at, interns were capped at 10.

And the point about whining in (b) is well taken - a good chunk of the posts in this forum are whiny or otherwise misdirected ("I have a difficult and complex problem with my clerkship, why don't I go ask a bunch of overachieving strangers?") I stand by my original advice, which is either to grow a pair/suck it up OR possibly do something about it - asking on SDN doesn't do a whole lot eh?

Well you are incorrect my friend. Our patient list is 25 patients long, and there are only 2 residents on the team. Intern "handles" all the patients.

surrender903 · Nov 2, 2007

Medstudentquest said:
I'm not an intern, I'm a medical student. Those hours for an intern are reasonable, but not for a medical student.

you re kidding me right? *blinks eyes* 👎

smq123 · Nov 2, 2007

Medstudentquest said:
I'm not an intern, I'm a medical student. Those hours for an intern are reasonable, but not for a medical student.

Medstudentquest said:
I don't mind working hard, but I am an MS3, not an intern.

No, really? You're only an MS3? I didn't know. It's only the 15th time you've mentioned it in this darn thread!

SHUT UP, grow a pair, and HELP YOUR PATIENTS. Does your life suck? Sure. Does it suck even more that your patients don't have an actual MD/DO taking care of them, and instead are forced to receive care from a whiny MS3 who loudly complains about the lack of an intern? YES.

Your patients are sick. They need you. Suck it up, accept it for the learning experience that it is, and help them out.

Medstudentquest said:
Those hours for an intern are reasonable, but not for a medical student.

Have you done your Ob/gyn rotation yet?? Nightfloat on L&D is usually from 5:30 PM to 8 AM - and yes, these were student hours. I usually ran into my resident when I reported for work, and I would leave the hospital with them.

You have some pretty cushy expectations for third year.

Medstudentquest said:
That is my point right on. I don't mind working hard, but I am an MS3, not an intern. The whole point of rotations is to learn and to be guided over what to do and how to manage patients.

The whole point of rotations is to learn how to function as a semi-useful member of the healthcare team.

If the "whole point" of rotations was to teach you how to manage patients, you could just stay at home and read textbooks. Or just shadow a doctor for a while. But none of these things teach you how to be a good intern.

Medstudentquest said:
Well you are incorrect my friend. Our patient list is 25 patients long, and there are only 2 residents on the team. Intern "handles" all the patients.

So the other resident on the team isn't carrying any patients? The other resident doesn't give you advice or help you out at all?

Medstudentquest · Nov 2, 2007

smq123 said:
No, really? You're only an MS3? I didn't know. It's only the 15th time you've mentioned it in this darn thread!

SHUT UP, grow a pair, and HELP YOUR PATIENTS. Does your life suck? Sure. Does it suck even more that your patients don't have an actual MD/DO taking care of them, and instead are forced to receive care from a whiny MS3 who loudly complains about the lack of an intern? YES.

Your patients are sick. They need you. Suck it up, accept it for the learning experience that it is, and help them out.

Have you done your Ob/gyn rotation yet?? Nightfloat on L&D is usually from 5:30 PM to 8 AM - and yes, these were student hours. I usually ran into my resident when I reported for work, and I would leave the hospital with them.

You have some pretty cushy expectations for third year.

The whole point of rotations is to learn how to function as a semi-useful member of the healthcare team.

If the "whole point" of rotations was to teach you how to manage patients, you could just stay at home and read textbooks. Or just shadow a doctor for a while. But none of these things teach you how to be a good intern.

So the other resident on the team isn't carrying any patients? The other resident doesn't give you advice or help you out at all?

Yes I have done OB and I won't even go there about my feelings on OB. I was q3 for OB. Nevertheless, no, the intern doesn't do anything because he doesn't know! He asks us if we have seen the patients and what to do. It's like I'm in the twighlight zone!

MeowMix · Nov 2, 2007

Medstudentquest said:
I don't mind working hard, but I am an MS3, not an intern. The whole point of rotations is to learn and to be guided over what to do and how to manage patients.

I am sorry to break it to you that the quality and nature of teaching on rotations is pretty much never what it "should" be. This intern (and most others) is simply not going to be capable of teaching you what you want to learn. You will have to figure out how to learn without guidance. Reading, asking residents and attendings, watching what others do, talking to fellow students; all of these work well. It is often inefficient, but it's necessary.

I worked long, long hours on most of my MS3 rotations. On IM, I prerounded at 6 am (earlier if I had a lot of pts) and rarely left the hospital before 7 pm even on non-call nights. On surgery I worked 6 a.m. - midnight or later, pretty much 7 days a week. All of this was OPTIONAL, but I learned so much from it. My reading time during the day or at night was spent trying to figure out what was going on with specific patients. I studied for shelf exams on 1-2 days at the end of each rotation, because I was too tired to do it during the real rotation. "Time to interact with family" got postponed. But when I took Step 2, what I remembered over and over was what I saw with real patients, and what we did with them.

You are in a situation where you can do no wrong. It is not your responsibility to carry all the patients; it's your resident and intern and attending's. So you pick out 2 or 4 or 6 or 8 or however many patients and do a great job with them, take full responsibility even though you don't have to. Be clear with your supervisors that the others are not your patients but you expect to pick up and be able to carry more pts eventually. This will work better than ineffectually trying to carry 25 pts, which you are not ready to do. You have a CHOICE here, so do not get all resentful. People expect you to know your limits and ask for help when you need it.

In my experience, you are wasting time trying to impress people by pulling articles. Spend your time on patient care instead.

Finally, instead of vilifying the incompetent intern, why not figure out how to work as a team and get the job done together. Then you will have someone else who thinks you are fantastic, and you will have proven to the whole team that you know how to handle a difficult personnel situation.

smq123 · Nov 2, 2007

Medstudentquest said:
Yes I have done OB and I won't even go there about my feelings on OB. I was q3 for OB. Nevertheless, no, the intern doesn't do anything because he doesn't know! He asks us if we have seen the patients and what to do. It's like I'm in the twighlight zone!

There are 2 residents on the team, you said.

What is the other resident doing? Are both of your residents incompetent?

If you've done OB, then you should know that 4 AM - 7 PM are not totally unreasonable hours, even for a student. They're not fun hours - I admit that - but lots of students (even third years) work those kinds of hours.

fakin' the funk · Nov 2, 2007

Medstudentquest said:
That is my point right on. I don't mind working hard, but I am an MS3, not an intern. The whole point of rotations is to learn and to be guided over what to do and how to manage patients.

Look, if you're not gonna listen to what anyone had for comments/suggestions for you, then why post in the first place? Perhaps...to whine?

Medstudentquest · Nov 2, 2007

smq123 said:
There are 2 residents on the team, you said.

What is the other resident doing? Are both of your residents incompetent?

If you've done OB, then you should know that 4 AM - 7 PM are not totally unreasonable hours, even for a student. They're not fun hours - I admit that - but lots of students (even third years) work those kinds of hours.

No, the other resident is very good but he is super busy taking care of a ton of things. I don't know any medical student who works 4ma-7pm.

Medstudentquest · Nov 2, 2007

fakin' the funk said:
Look, if you're not gonna listen to what anyone had for comments/suggestions for you, then why post in the first place? Perhaps...to whine?

Not about whinning. It's about a reality that is inappropriate and should not occur in hospitals. It's dangerous for patients and a liability for the hospital.

Hallm_7 · Nov 2, 2007

When your intern looks bad, take advantage of the opportunity and show your senior and attending how good you are. An intern that doesn't come up with plans leaves the door wide open for the student to mention plans during rounds. Act like this is your sub-I except during third year.

smq123 · Nov 2, 2007

Medstudentquest said:
No, the other resident is very good but he is super busy taking care of a ton of things. I don't know any medical student who works 4ma-7pm.

Medstudentquest said:
That is my point right on. I don't mind working hard, but I am an MS3, not an intern. The whole point of rotations is to learn and to be guided over what to do and how to manage patients.

Wait.

I just re-read some of your previous posts.

You were doing rotations since last spring. Which means that (unlike many of the other MS3s who have posted here already), you've been an MS3 (or some equivalent) for ~ 7 months now.

And you're still complaining about how "patient care is not your responsibility?" How many of the clinical decision-making should be done by the intern, and not by you?

I thought that you were just a new third year (like me), and scared. And yeah, when you're 3 months into third year, that much responsibility is scary, and you're allowed to vent a little. (Not much, but a little.) But now, I'm just thinking that you enjoy whining.

Dude. Grow up.

smq123 · Nov 2, 2007

Medstudentquest said:
Not about whinning. It's about a reality that is inappropriate and should not occur in hospitals. It's dangerous for patients and a liability for the hospital.

If you're so concerned about patients, why not just try and give them the best care that you can? And why did you spend so many posts talking about how "this is not expected of a third year"?

surrender903 · Nov 2, 2007

*facepalm*

Top Gun · Nov 2, 2007

Medstudentquest said:
Not about whinning. It's about a reality that is inappropriate and should not occur in hospitals. It's dangerous for patients and a liability for the hospital.

You are not listening. Everyone on this thread has been telling you how to make the best of this particular hand that you were dealt. You've been told how its a great learning opportunity, how its great practice for when you become the intern, and how its a chance for you to shine on evals.

We have already established that your intern is incompetent. So what can you do about it? Nothing. So now its time for you to quit complaining, step up to the plate, and take care of your patients.

Tired · Nov 3, 2007

I guess this is a matter of perspective and probably the culture of the institution that you train at. Where I came from, we went through 6 different affiliated hospitals, and the expectation of what the MS3 did ranged quite substantially depending on the service and location. Some places we functioned nearly independently, while others we were expected to be seen but not heard. Our school though, made it clear from the outset that we were expected to conduct ourselves like physicians, and function as one as much as our staff and residents allowed. There were a variety of requirements each department was expected to follow regarding students (mandatory time for conferences, post-call hours, etc) but the total hours we worked in a week were not among them. Anyone with the foolishness to say something like, "Those hours are appopriate for an intern, but not a student" was quickly corrected.

Obviously the OP comes from a different environment.

I would still maintain that it will be difficult to transition from a situation of pure hand-holding to independent function as an intern, without some kind of intermediate phase.

ladynice · Nov 3, 2007

Tired said:
This is the second time you've mentioned these hours. Hate to tell you, that's not particularly bad. Three of my four months so far as an intern have been 4am-7pm or later plus call.

when do you write all these thousands of posts?

doc02 · Nov 3, 2007

Woah, an entire thread all about me. I'm flattered. OP: GET BACK TO WORK!! Mwah ha ha ha ha.

Blade28 · Nov 3, 2007

ladynice said:
when do you write all these thousands of posts?

About 10 posts a day, averaged over the past 10 months or so, will do it.

Winged Scapula · Nov 3, 2007

ladynice said:
when do you write all these thousands of posts?

There is a fair bit of sitting around on your arse in surgery, so its fairly easy with a fast connection to log on and post a few times each day or so.

colbgw02 · Nov 4, 2007

Medstudentquest said:
Not about whinning. It's about a reality that is inappropriate and should not occur in hospitals. It's dangerous for patients and a liability for the hospital.

Dude, all medical education is a liability for the patients, the hospitals, everybody. Obviously, patients, as a whole, would be better off if their care were handled solely by experienced, attending, board-certified physicians with years of experience.

You came here to get advice about dealing with an incompetent intern. You've got it. All this business about patient load, too many hours in-house, and worrying about a shelf exam sounds exactly like what it is - whining.

Tired · Nov 4, 2007

Kimberli Cox said:
There is a fair bit of sitting around on your arse in surgery, so its fairly easy with a fast connection to log on and post a few times each day or so.

I carry a Blackberry, and post on rounds. Attendings bore me, and after a few days on service they realize there's no point in trying to pimp me, so I have plenty of time to look at SDN while they prattle on about patients.

Also, I do most of my procedures one-handed, so I can usually type out the shorter posts in the middle of doing central lines, dressing changes, etc.

Sometimes I have the scrub nurse take dictation during cases.

doc02 · Nov 5, 2007

Tired said:
Also, I do most of my procedures one-handed

Indeed.

Long Dong · Nov 5, 2007

Tired said:
I carry a Blackberry, and post on rounds. Attendings bore me, and after a few days on service they realize there's no point in trying to pimp me, so I have plenty of time to look at SDN while they prattle on about patients.

Also, I do most of my procedures one-handed, so I can usually type out the shorter posts in the middle of doing central lines, dressing changes, etc.

Sometimes I have the scrub nurse take dictation during cases.

You military guys are such rock stars. :horns:

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