3rd year competition

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HereWeGo21

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Has anyone dealt with competition against other students in 3rd year? I'm definitely detecting some.

For one, this one girl always stays late, like two hours past when her shift ends. Like, I've heard about "arriving early and staying late", but I'm not sure if she's in the right here. Sure, if you're asked to admit a new patient near the end of your shift, you absolutely admit the patient, and stay as late as you need to finish your note. But I'm more just talking about staying late for no reason. It's like she thinks it will make her look better, so she does it. I'm not even sure that's the case, because if I was an attending, I'd be like, "Why are you still here?" And sometimes they do. But it also makes me wonder if I should stay late too. Like, after my shift I don't just go home; I go to the library to study. But I could stay on the floor all night if I thought it would get me a better grade. I just don't know if it will.

Also, competition happens for which patients we get. There was a cool patient, for example, and the attendings gave him to me. But then I spent a few days shadowing on another floor. The day before, she declared that she was gonna "pick up" my patient, as in follow him and write notes on him, cuz I'd be gone a few days. I guess not completely unreasonable, but still kinda stoking tension. Another time, I clearly said I wanted a given patient. She "misheard me", and so picked up that same patient, because she "thought" I had said I wanted a different one. Could have been true, but still kinda sketchy. This time I actually pushed back a little and made sure I still got that original patient.

Anyone else experience things like this? What do? Try not to get wrapped up in it I suppose? Do you think grades are actually made or broken by jockeying like this, or no?

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togaedere

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I'm a fourth year. I had noticed things like this so any team I'm on I've been very clear and proactive about everyone on the team doing much the same thing -- leaving at the same time, taking breaks at the same time or if that's not feasible all taking the same length of break. I also had tried to see what everyone wanted to go into. If we were on surgery for example (I have no interest in surgery), and one of the fellow students wanted to do surgery, then we would all be clear that that student's interest was highlighted. Maybe I'm too hippie dippy but I just thought being proactive and transparent about everyone's intentions helped to mitigate the pressure to be competitive.

I have a friend at school who was formerly a PharmD, and a really good one. Naturally she knows tons about medications, dosing, fluids, etc. It makes her stand out on rounds. Apparently one of our classmates yelled at her once for presumably showing off her knowledge, as he perceived it made him look bad as a result. It's this bs mentality that I can't stand, and gets in the way of patient care. I was on service with her, and the attending noticed she was answering all the drug questions. He asked if she was a PharmD. She said yes. Afterwards she apologized to us saying she hates it when attendings find out because of how other students react. Luckily the three of us (the other students) were more focused on what she brought to the team.

My point is that I do know it gets rough and confusing for students. I go to a big school, so it can be kind of hard to figure out how to differentiate yourself without making other people look bad as a result. But it's possible. What's worked for me is to just be cool with other people's talents, and to be really open about arrival time, departure time, having a really clear method for distributing patients and work, etc. I did well third year so I don't think I was harmed in the process either.

Edit: oh and to answer your question about grades-- I think most attendings are pretty aware of the student who is doing things just for a grade and those who do things cus it's the right thing to do. People are busy so they might not catch everything, but for the most part I do believe that attendings and residents are fairly savvy.


Has anyone dealt with competition against other students in 3rd year? I'm definitely detecting some.

For one, this one girl always stays late, like two hours past when her shift ends. Like, I've heard about "arriving early and staying late", but I'm not sure if she's in the right here. Sure, if you're asked to admit a new patient near the end of your shift, you absolutely admit the patient, and stay as late as you need to finish your note. But I'm more just talking about staying late for no reason. It's like she thinks it will make her look better, so she does it. I'm not even sure that's the case, because if I was an attending, I'd be like, "Why are you still here?" And sometimes they do. But it also makes me wonder if I should stay late too. Like, after my shift I don't just go home; I go to the library to study. But I could stay on the floor all night if I thought it would get me a better grade. I just don't know if it will.

Also, competition happens for which patients we get. There was a cool patient, for example, and the attendings gave him to me. But then I spent a few days shadowing on another floor. The day before, she declared that she was gonna "pick up" my patient, as in follow him and write notes on him, cuz I'd be gone a few days. I guess not completely unreasonable, but still kinda stoking tension. Another time, I clearly said I wanted a given patient. She "misheard me", and so picked up that same patient, because she "thought" I had said I wanted a different one. Could have been true, but still kinda sketchy. This time I actually pushed back a little and made sure I still got that original patient.

Anyone else experience things like this? What do? Try not to get wrapped up in it I suppose? Do you think grades are actually made or broken by jockeying like this, or no?
 

HereWeGo21

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I'm a fourth year. I had noticed things like this so any team I'm on I've been very clear and proactive about everyone on the team doing much the same thing -- leaving at the same time, taking breaks at the same time or if that's not feasible all taking the same length of break. I also had tried to see what everyone wanted to go into. If we were on surgery for example (I have no interest in surgery), and one of the fellow students wanted to do surgery, then we would all be clear that that student's interest was highlighted. Maybe I'm too hippie dippy but I just thought being proactive and transparent about everyone's intentions helped to mitigate the pressure to be competitive.

I have a friend at school who was formerly a PharmD, and a really good one. Naturally she knows tons about medications, dosing, fluids, etc. It makes her stand out on rounds. Apparently one of our classmates yelled at her once for presumably showing off her knowledge, as he perceived it made him look bad as a result. It's this bs mentality that I can't stand, and gets in the way of patient care. I was on service with her, and the attending noticed she was answering all the drug questions. He asked if she was a PharmD. She said yes. Afterwards she apologized to us saying she hates it when attendings find out because of how other students react. Luckily the three of us (the other students) were more focused on what she brought to the team.

My point is that I do know it gets rough and confusing for students. I go to a big school, so it can be kind of hard to figure out how to differentiate yourself without making other people look bad as a result. But it's possible. What's worked for me is to just be cool with other people's talents, and to be really open about arrival time, departure time, having a really clear method for distributing patients and work, etc. I did well third year so I don't think I was harmed in the process either.

Edit: oh and to answer your question about grades-- I think most attendings are pretty aware of the student who is doing things just for a grade and those who do things cus it's the right thing to do. People are busy so they might not catch everything, but for the most part I do believe that attendings and residents are fairly savvy.

OK, thank you for your reply.
So you're saying that I should actually suggest we all leave at the same time?
That seems a bit authoritarian for me to tell her to leave when I do (on time). Not to mention that it would bring the whole competition thing into the light, which would be somewhat uncomfortable.
 
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HelpPleaseMD

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med school problems. what she did is not entirely unreasonable. she wanted to follow/learn/help out on the more complex patients when you were gone.
I see that as proactive.
 

togaedere

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I'm just saying what's worked for me and the teams I've been on. My personality is not really authoritarian at all so in practice it may work out differently than what it seems like written out.

In my experience it's been better to talk it out with fellow students about fairness and equity as soon as possible. I've found that it actually takes some pressure off the drive to be competitive (and makes everyone look better in the long run, because everyone's working as a team). I don't know what your relationship is like with your classmate, but if it's at all possible to talk with her I suggest you probably should. She's honestly probably just nervous about giving a good impression and not trying to harm you directly. I do not think suggesting to her that you both leave at the same time is unreasonable. How she responds is yet to be determined. The emphasis being on suggestion, she's still free to leave whenever she wants. But I'm saying she may not know what her staying 2 hours later looks like. (And your superiors probably notice as well, possibly not positively for her).

Someone else may have a different response. But that's what's worked for me. I can honestly say it's worked, too. I got honors in all rotations but one and developed good relationships with my classmates.

Edit: I do agree that it's possible she's putting in extra time because she's interested in that specialty. Still I think my answer is the same -- talk to her. Figure out what she's looking to do and see if there's a way you can both get what you're looking for out of the rotation without harming each other or putting pressure on the other to stay unnecessarily.

OK, thank you for your reply.
So you're saying that I should actually suggest we all leave at the same time?
That seems a bit authoritarian for me to tell her to leave when I do (on time). Not to mention that it would bring the whole competition thing into the light, which would be somewhat uncomfortable.
 
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cyanide12345678

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Has anyone dealt with competition against other students in 3rd year? I'm definitely detecting some.

For one, this one girl always stays late, like two hours past when her shift ends. Like, I've heard about "arriving early and staying late", but I'm not sure if she's in the right here. Sure, if you're asked to admit a new patient near the end of your shift, you absolutely admit the patient, and stay as late as you need to finish your note. But I'm more just talking about staying late for no reason. It's like she thinks it will make her look better, so she does it. I'm not even sure that's the case, because if I was an attending, I'd be like, "Why are you still here?" And sometimes they do. But it also makes me wonder if I should stay late too. Like, after my shift I don't just go home; I go to the library to study. But I could stay on the floor all night if I thought it would get me a better grade. I just don't know if it will.

Also, competition happens for which patients we get. There was a cool patient, for example, and the attendings gave him to me. But then I spent a few days shadowing on another floor. The day before, she declared that she was gonna "pick up" my patient, as in follow him and write notes on him, cuz I'd be gone a few days. I guess not completely unreasonable, but still kinda stoking tension. Another time, I clearly said I wanted a given patient. She "misheard me", and so picked up that same patient, because she "thought" I had said I wanted a different one. Could have been true, but still kinda sketchy. This time I actually pushed back a little and made sure I still got that original patient.

Anyone else experience things like this? What do? Try not to get wrapped up in it I suppose? Do you think grades are actually made or broken by jockeying like this, or no?


It was amusing when a gunner himself blamed me for gunning on one rotation. The attending had asked the medical students to do a presentation on a topic. Apparently my bringing a paper on the topic was me gunning. All the med students were given a topic, the other two didn't remember that the attending gave them a topic to present, hence apparently I was a gunner for being prepared to talk lol. But that's the only time through medical school someone has said that I was making someone else look bad.

Other than that one isolated experience, med school gunning isn't too bad. And I go at a school with a reputation for gunners (I think its a false reputation but oh well). Some people are just inherently talented and better lol. Lets just accept we're not necessarily the best at everything. While I myself am a top quartile student at a top med school, but there have been students who have absolutely blown me away with their skills. It's not like they are trying to gun anyone, some people are just inherently more enthusiastic about learning than I can ever be lol. I remember a student on my first ever medicine rotation, she was just ridiculously talented. She tackled social issues almost as well as a social worker. None of what she did came from trying to gun, the girl was just so ridiculously enthusiastic. Infact, during my "feedback" session with my attending, I went out of the way to tell the attending that this particular student was probably one of the best I've seen. She obviously agreed. She herself had been blown away. It didn't mean that I was a crappy med student. I ended up honoring the rotation eventually myself, so realistically when someone else looks good, it usually doesn't make the other person look bad. But lets face it...if someone works harder, studies more, has greater knowledge (like the pharmD example above), then realistically that person honestly does deserve a better grade than a average student. But staying 2 hrs over end of shift when you're not doing ****, that does sound worthless to me.
 

cyanide12345678

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Also, you do make it sound like it's shift work. Since I'm going into ED, and have done a bunch of ED shifts, I'll tell you it's kind of weird staying late after shift. The only two times I've done it was when I was suturing up complex lacs. I don't even think a conversation is worth it with her. I mean you can ask her something on the line of "hey did you get to see anything cool when you stayed after shift. I wonder if it's worth it for me to stay a bit longer". That will help you gauge whether she's actually staying for added educational value vs staying for brownie points with attendings. But I think asking someone else to do less isn't cool, some people genuinely might enjoy it and get a lot out of it. People learn differently. And if her staying 2 hrs after shift for brownie points is an anomaly, the attendings will know, and it will not be a bad mark on you if you left at end of shift like everyone else.
 
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togaedere

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Yeah, I mean I guess I should be clear that I'm not advocating for her to be pressured to leave earlier, nor should OP be pressured to stay late. The way you said it seems to be the best way to put it -- "hey did you see any cool stuff?" What I was trying to convey was that OP needed to gauge classmate's motivations in some way, and not just stay late if it wasn't going to be worthwhile for them.

Also, you do make it sound like it's shift work. Since I'm going into ED, and have done a bunch of ED shifts, I'll tell you it's kind of weird staying late after shift. The only two times I've done it was when I was suturing up complex lacs. I don't even think a conversation is worth it with her. I mean you can ask her something on the line of "hey did you get to see anything cool when you stayed after shift. I wonder if it's worth it for me to stay a bit longer". That will help you gauge whether she's actually staying for added educational value vs staying for brownie points with attendings. But I think asking someone else to do less isn't cool, some people genuinely might enjoy it and get a lot out of it. People learn differently. And if her staying 2 hrs after shift for brownie points is an anomaly, the attendings will know, and it will not be a bad mark on you if you left at end of shift like everyone else.
 

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