A letter to my intern

[lipstikisntfood]

Dear Intern:

For some bizarre reason, you appear to think that I am your secretary. Ahem. I AM NOT YOUR SECRETARY. The difference between us is that I am paying to learn, whereas you are being paid to do scut. Therefore, you must answer your own pager, do your own paperwork, check your own daily schedule, fetch and carry your own instruments, and manage your own lunch. If you would like my help with a task that directly contributes to patient care, try saying please and/or thank you.

And, while the lines of communication are wide open, I suggest that you get over yourself. You're arrogant enough to be an attending right now, but you have a few more years of training to endure before you can make everyone around you miserable.

Sincerely,

Your Medical Student

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[SLUser11]

Dear Intern:

For some bizarre reason, you appear to think that I am your secretary. Ahem. I AM NOT YOUR SECRETARY. The difference between us is that I am paying to learn, whereas you are being paid to do scut. Therefore, you must answer your own pager, do your own paperwork, check your own daily schedule, fetch and carry your own instruments, and manage your own lunch. If you would like my help with a task that directly contributes to patient care, try saying please and/or thank you.

And, while the lines of communication are wide open, I suggest that you get over yourself. You're arrogant enough to be an attending right now, but you have a few more years of training to endure before you can make everyone around you miserable.

Sincerely,

Your Medical Student

Just remember how bad that guy or girl (it's a girl right?) sucks, and it will prevent you from being like that as an intern.

The worst part about that type of unhealthy learning environment is that it is self-propagating. Most residents that are @sses are at least partially emulating the residents they encountered in med school.....

 

[SLUser11]

Just remember how bad that guy or girl (it's a girl right?) sucks, and it will prevent you from being like that as an intern.

The worst part about that type of unhealthy learning environment is that it is self-propagating. Most residents that are @sses are at least partially emulating the residents they encountered in med school.....

This is a thread that embodies what happens to students who don't learn their lesson from jack@ss residents:

D-Bag goes on a power trip

If only that type of attitude would get attacked in real life the way it did here on SDN, maybe the system would change a little (old Telemachus, a relatively active poster in the past, never posted again after this thread, having been completely owned).


Sorry for drudging up the past...but your "Letter to my intern" title brought out a fond memory...

 

[Law2Doc]

Dear Intern:

For some bizarre reason, you appear to think that I am your secretary. Ahem. I AM NOT YOUR SECRETARY. The difference between us is that I am paying to learn, whereas you are being paid to do scut. Therefore, you must answer your own pager, do your own paperwork, check your own daily schedule, fetch and carry your own instruments, and manage your own lunch. If you would like my help with a task that directly contributes to patient care, try saying please and/or thank you.

And, while the lines of communication are wide open, I suggest that you get over yourself. You're arrogant enough to be an attending right now, but you have a few more years of training to endure before you can make everyone around you miserable.

Sincerely,

Your Medical Student

While I agree that in a perfect world, most of what you might do will contribute to patient care and learning, the truth of the matter is that to a large degree a med student's job is to help the interns/residents. And so that means doing menial things, because honestly med students don't know all that many other ways of being useful. You shouldn't really be asked to get coffee or lunch or anything, but answering pagers, playing caddy for medical equipment, chasing down medical records and other such paperwork are certainly not something you can object to. In return, you hopefully get to see and do some stuff more medicine related. That's the way it's supposed to work. Not meaning to be rude, but reading your post I wasn't exactly sure who should really be getting over themselves.

 

[Scaredshizzles]

While I agree that in a perfect world, most of what you might do will contribute to patient care and learning, the truth of the matter is that to a large degree a med student's job is to help the interns/residents. And so that means doing menial things, because honestly med students don't know all that many other ways of being useful. You shouldn't really be asked to get coffee or lunch or anything, but answering pagers, playing caddy for medical equipment, chasing down medical records and other such paperwork are certainly not something you can object to. In return, you hopefully get to see and do some stuff more medicine related. That's the way it's supposed to work. Not meaning to be rude, but reading your post I wasn't exactly sure who should really be getting over themselves.

No wonder why so many incompetent doctors get pumped out if that is what you spend your day doing as a student...I can see why the interns wind up being so useless and stressed.

 

[Law2Doc]

No wonder why so many incompetent doctors get pumped out if that is what you spend your day doing as a student...I can see why the interns wind up being so useless and stressed.

It's part of the job. You do scut, and maintain your place in the hierarchy. But all the while watching and listening and learning. Works the same way in most professions, actually. And it actually doesn't generate incompetent doctors. More often than not, the opposite.

I'm not sure what you are imagining you should be doing as a student. The first two years of med school teach you a lot of foundation, but very little that is helpful on the wards. So you spend your third year as the intern's sherpa, hoping to get to do some cool stuff along the way, ie hoping some table scraps fall off the table. The greatest physicians in history all apprenticed this way.

Interns are useless and stressed because they are barely removed from med school, not given the greatest hours for sleep, and yet suddenly are responsible for people's lives. And on top of this, the department expects them to give some teaching to med students "in their spare time". Some handle the task better than others.

 

[Scaredshizzles]

It's part of the job. You do scut, and maintain your place in the hierarchy. But all the while watching and listening and learning. Works the same way in most professions, actually. And it actually doesn't generate incompetent doctors. More often than not, the opposite.

I'm not sure what you are imagining you should be doing as a student. The first two years of med school teach you a lot of foundation, but very little that is helpful on the wards. So you spend your third year as the intern's sherpa, hoping to get to do some cool stuff along the way, ie hoping some table scraps fall off the table. The greatest physicians in history all apprenticed this way.

Interns are useless and stressed because they are barely removed from med school, not given the greatest hours for sleep, and yet suddenly are responsible for people's lives. And on top of this, the department expects them to give some teaching to med students "in their spare time". Some handle the task better than others.

How many other apprenticeships do you pay 35 grand a year in to train....sure some of them you work for no pay, but nothing like this. Now obviously the housestaff isn't getting the money, nor or the attendings because they don't get paid much either....but if you pay that much money you should expect to actually get a chance to observe what is going on as opposed to being in a MR office by yourself for hours tracking down a chart or spending hours trying to get in contact with someone over the phone. And what do you really learn from an intern anyway? 80% of what they do gets overturned by some arrogant attending who wants it done his way...and granted, his way is usually a better choice than the intern's way. Don't see the need to do much scut for the interns. I know some students go out of their way to do that stuff hoping somehow they will impress someone by looking like a hard worker, but that's simply not how you learn much of anything....The majority of your time should be spent with patients in order to learn how disease present in the real world....sometime should be spent listening to rounds and seeing how patients are being managed, just because that helps you memorize that stuff, even though it is just protocol that can be found in a textbook....and then a lot of time should still be spent studying texts... It's a good idea to do some scut just to prepare you for what you need to do when you are a house officer, but it's silly to offer yourself up to do it like I see so many of my ambitious classmates doing.

 

[Law2Doc]

How many other apprenticeships do you pay 35 grand a year in to train....sure some of them you work for no pay, but nothing like this. Now obviously the housestaff isn't getting the money, nor or the attendings because they don't get paid much either....but if you pay that much money you should expect to actually get a chance to observe what is going on as opposed to being in a MR office by yourself for hours tracking down a chart or spending hours trying to get in contact with someone over the phone. And what do you really learn from an intern anyway? 80% of what they do gets overturned by some arrogant attending who wants it done his way...and granted, his way is usually a better choice than the intern's way. Don't see the need to do much scut for the interns. I know some students go out of their way to do that stuff hoping somehow they will impress someone by looking like a hard worker, but that's simply not how you learn much of anything....The majority of your time should be spent with patients in order to learn how disease present in the real world....sometime should be spent listening to rounds and seeing how patients are being managed, just because that helps you memorize that stuff, even though it is just protocol that can be found in a textbook....and then a lot of time should still be spent studying texts... It's a good idea to do some scut just to prepare you for what you need to do when you are a house officer, but it's silly to offer yourself up to do it like I see so many of my ambitious classmates doing.

It's about give and take. You do a good job helping out the interns and residents and in return you often get to do (or at least see) some more legit stuff. That's pretty much the way it has worked for many many decades and at most schools. But your "job" during these rotation years is to help out the interns/residents. Your "ambitious classmates" get this -- you can't hold it against them that they are playing the game well. The notion "I paid a lot of money for this" so I should only get to do cool stuff is going to fall on deaf ears -- the attendings and residents and interns were all in your boat years earlier; they did their share of scut.
This is kind of the "air of entitlement" you see physicians complaining about in various news articles about the current generation of med students. It won't serve you well.

 

[GoofyDoc]

Don't see the need to do much scut for the interns. I know some students go out of their way to do that stuff hoping somehow they will impress someone by looking like a hard worker, but that's simply not how you learn much of anything

Actually, I would say these types of students are real team players (and I'm not talking about the obvious phony suck-ups). This is a big part of the learning process because as a clerk, you're learning how to be an intern.

The majority of your time should be spent with patients in order to learn how disease present in the real world....sometime should be spent listening to rounds and seeing how patients are being managed, just because that helps you memorize that stuff, even though it is just protocol that can be found in a textbook....and then a lot of time should still be spent studying texts... It's a good idea to do some scut just to prepare you for what you need to do when you are a house officer, but it's silly to offer yourself up to do it like I see so many of my ambitious classmates doing.

Ideally, you should be following 2-3 patients (or more depending on how large the service is) and reading up on their condition when you have time. The clinical years are a lot more than just learning about disease, esp on your core rotations. If all you do is look at patients and read, how different is that from your preclinical ECM course? Don't just do "some" scut. If you're in a scut-heavy place, offer to do as much as you can. Become a pro now so you don't waste half your day as an intern on these things. Getting medical records, calling pharmacies, being a social worker, these are all part of our reality so better get used to it now. Of course, if the intern has plenty of time to do this stuff and is just shoving it all on you so he/she can have it easy, that's another story. Getting food for interns is also uncalled for, unless they are completely overwhelmed and ask you as a favor (and not a frequent thing). The best teams are those who help each other out, whether it's the junior helping the senior or vice-versa. When you interview for residency, they'll care more about how you function in a team than about how much of Harrison's you know.

 

[Melanie]

When you feel like part of the team, you'll do any scut the residents/interns hand down to you, because you feel appreciated and truly like you are accomplishing something - even if it is hunting down a chart or calling the pharmacy.

The problem and frustration comes when you're treated like you don't exist by the interns/residents. I know they're stressed, but doing scut and not feeling like part of the team (which is mostly the case - at my institution anyway) is annoying.

There are times when doing scut truly interferes with learning though. I have been asked many, many times by interns/residents to pick up patients who, were generating more paperwork - instead of following "boring" patients who generated less paperwork. Continuity and watching what happens with my patients is the best way that I learn on the wards. I should be encouraged to pick up more complicated patients, but not just because it makes the lives of the residents easier.

I don't think that the OP has an overblown sense of "entitlement" at all. It's just really irritating to be ignored and scutted out all the time.

 

[Baditude]

I think most of us MsIII's wouldn't mind doing things for the interns etc if they just asked instead of ordering/demanding it be done. How hard is it to say could you please........ for me because I am busy/tired etc. I have no problem with that. In return please take the time to tell me why you are doing/ordering xyz so in the future I will be able to understand the process you went through to decide on that as the needed treatment/test etc. I don't expect to be doing difficult procedures as an MSIII but I would like to master some of the more basic procedures even if it means shadowing and learning from the nurses. You as an intern have a lot to teach but you are also trying to learn to so make it easy on both of us and "ask" when you need help and send us to someone who can teach us when you are too busy.

 

[Blade28]

to the last two posts. Great examples of how both residents and med students alike can work together to make the team function better as a whole.

Often, the culprit is bad communication.

 

[Law2Doc]

I think most of us MsIII's wouldn't mind doing things for the interns etc if they just asked instead of ordering/demanding it be done. How hard is it to say could you please.

I agree with this. But part of the problem is that intern is a lot of these folks first jobs, or at least first supervisory jobs. It's very unnatural to suddenly go from student to being in charge of people, with virtually no teaching or instruction on the matter and for most, it takes several months to years to get into a good pattern (which unfortunately may be longer than many clerkships). I know in law I was probably a lousy boss to the paralegals and secretaries until I had a better feel for how to manage people most effectively.

Similarly, quite a few med students have never been in the ratrace and don't have a good sense of how to be a good "employee", where their place in the hierarchy is, etc. You go through med school treated like you are the future of the profession, and it's hard to transition to the fact that all you are actually useful for is to be some intern's gopher. It's well and nice to say "I'm paying 35k for this experience" and so I want a good show, but the system doesn't work like this -- clerkship is not for your entertainment or enjoyment, it is for you to prove you can work well with residents and attendings in whatever scut they throw at you, all the while keeping up to date on various patient issues and reading up on topics. It is, in a very true sense, an apprenticeship. You work hard at the mundate scut so hopefully you get taught and involved in the more interesting stuff.

 

[Melanie]

I agree with this. But part of the problem is that intern is a lot of these folks first jobs, or at least first supervisory jobs. It's very unnatural to suddenly go from student to being in charge of people, with virtually no teaching or instruction on the matter and for most, it takes several months to years to get into a good pattern (which unfortunately may be longer than many clerkships). I know in law I was probably a lousy boss to the paralegals and secretaries until I had a better feel for how to manage people most effectively.

Similarly, quite a few med students have never been in the ratrace and don't have a good sense of how to be a good "employee", where their place in the hierarchy is, etc.

Law2doc,

I think you're exactly right! That really is what goes on in a lot of cases where there is tension between students and residents. Maybe someone somewhere is medical school needs to mention this. It would be really helpful to have some course/lecture series on how to motivate and be a good manager.

Great post!

 

[Baditude]

Being an older student who worked for too many years with the public before going back to school I forgot how many of these kids have never been employed before much less a "boss". I know it took me a bit to get used to being in charge of a group of employees and with that experience behind me I know how I want to be treated in my future rotations. Unfortunately maybe many of these young interns have only experienced how they were treated and not how real people in the work place operate.
I can honestly say I will do just about anything I am asked to but it chaps my behind to be ordered to do something that is not technically in my job description. I am a very easy person to get along with if you treat me with the same respect you want me to give you! We are all human and we all make mistakes.

 

[Law2Doc]

I can honestly say I will do just about anything I am asked to but it chaps my behind to be ordered to do something that is not technically in my job description.

Agreed. But considering "helping out the interns and residents" is the job description of a med student, at most schools, your behind can stay unchapped. As a med student at pretty much every school you will be asked to answer pagers, to chase down medical records and pharmacy info, to do paperwork and other scut, along with the stuff you may actually want to do. The interns didn't make this up -- they probably just do a poor job of delegating it nicely.

 

[fakin' the funk]

While I agree that in a perfect world, most of what you might do will contribute to patient care and learning, the truth of the matter is that to a large degree a med student's job is to help the interns/residents. And so that means doing menial things, because honestly med students don't know all that many other ways of being useful. You shouldn't really be asked to get coffee or lunch or anything, but answering pagers, playing caddy for medical equipment, chasing down medical records and other such paperwork are certainly not something you can object to. In return, you hopefully get to see and do some stuff more medicine related. That's the way it's supposed to work. Not meaning to be rude, but reading your post I wasn't exactly sure who should really be getting over themselves.

good laugh man.

I just love how, no matter what the objectionable things the OP says they're forced to do (which should by all rights NOT be their job as an MS3), some gunner somewhere will reply and say "suck it up." It never fails here on SDN.

 

[fakin' the funk]

I agree with this. But part of the problem is that intern is a lot of these folks first jobs, or at least first supervisory jobs. It's very unnatural to suddenly go from student to being in charge of people, with virtually no teaching or instruction on the matter and for most, it takes several months to years to get into a good pattern

Now, THIS is an EXCELLENT point. THIS is why some interns take all freaking day to do a relatively small number of menial tasks while others have it knocked out by 10am.

 

[fakin' the funk]

But considering "helping out the interns and residents" is the job description of a med student

Is it? I, for one, disagree.

 

[Law2Doc]

good laugh man.

I just love how, no matter what the objectionable things the OP says they're forced to do (which should by all rights NOT be their job as an MS3), some gunner somewhere will reply and say "suck it up." It never fails here on SDN.

Honestly, what did the OP say s/he was forced to do that a million other 3rd year med students haven't been asked to do routinely over the last 50 years. The OP pretty much DESCRIBED the role of a 3rd year at most schools I am aware of, and was complaining about it being this one intern's fault. Sorry but scut is the role. You absolutely are going to be expected to chase down records, talk to doctors offices and pharmacies, do some paperwork, carry equipment and run and check on things. You don't really know enough to be of much use otherwise. And I think you need a new dictionary if you think I'm a gunner. Please.

 

[Law2Doc]

Is it? I, for one, disagree.

I've heard this from a number of attendings and department heads. You work hard, help out the interns/residents, and try to learn something. Considering they think this is the med student's role, it probably is.

 

[DrThom]

Is it? I, for one, disagree.

So what is your definition of what a med student is suppose to do?

I always thought the med student is considered part of the patient care team. Being a team player sometimes encompasses doing some scut work because it is work that had to get done. Doing some scut while learning the required material is just part of the role.

That being said, I concur that asking med students to get food or other personal requests is crossing the line.

 

[AUdacious]

When you are so busy that you dont have time to eat, a medical student bringing you food is like winning the lottery. You are so thankful - that small act will not be overlooked or forgotten. While I agree that it is not your "job" to get food, I think some of you should check your ego at the door. You do your best to help the people you work with out. If things go smoothly, everyone "looks good" (which is apparently all some of you are worried about) and you have more down time for discussions/teaching. People talk - you get reputations, good or bad. While interns do not physically write the eval at most places, you better belive that they have a strong influence on them. The attending always asks me what I think about my students and I always go out of my way for the ones work hard and do the small things that make my life a little better too.

 

[surrender903]

That being said, I concur that asking med students to get food or other personal requests is crossing the line.

ill pretty much do anything you ask me to do, but if you ask me to get you lunch you better be paying.

 

[DrThom]

ill pretty much do anything you ask me to do, but if you ask me to get you lunch you better be paying.

That's true....I shouldn't of used the food example because I'm not above getting my resident some food (and have before) but stuff like getting dry cleaning from the hospital cleaning service is a little much.

I also agree that if I'm going to get you food a)it better be on your tab and b)I'll be less bitter about it if you say I can pick a little something up for myself while I'm at it.

 

[AUdacious]

Who are these people? Do people really ask you to get their dry cleaning?

 

[DrThom]

Who are these people? Do people really ask you to get their dry cleaning?

Not anymore...apparently this used to be a problem at my school but something happened and now the residents are terrified to ask the students to do almost any scut work at all. I wonder how they threatened them...

 

[Blade28]

Who are these people? Do people really ask you to get their dry cleaning?

I've had to do that when I was a med student.

 

[Ypo.]

But considering "helping out the interns and residents" is the job description of a med student

No, that's not right. Our "job" (if you can call it that seeing as how we're paying money to be there) is to learn without slowing the team down. Part of that is learning how to work with the team-how to function like an intern. But in general, I'd say our educational process is very loosely outlined in third and fourth year. I've also never heard from any intern or resident or attending that my job is to 'help' them. Instead I've heard that my job is to learn how to come up with a reasonable differential, narrow it down, and then know the next beginning steps in treatment. Honoring means showing up early, working with enthusiasm and being pleasant to others, and taking initiative in learning.


To add to that, I've had attendings/residents ask me to do small things (grab a patient's chart, make a copy of labs for the patient, get the nurse) but I've never had them do it to abuse. I don't mind doing favors at all, but if you think that being a persona assistant is your job as a medical student, then you are completely missing out on your educational experience. I should add one caveat that your job does entail learning how to take care of the patient. So, if by doing that (practicing skills that you will need as a doctor) you end up 'helping' the intern or the attending, more power to you. But the focus should be on learning and patient care, and not on sucking up and being a human doormat.

 

[JackBauERfan]

as a medical student, 3rd year especially I think the best way to learn how to be a good doctor is carry 2-3 patients (remember someone HAS to write a real note over yours at this stage, most likely the intern), and read something about them; as well as study for your clerkship test. You will learn a lot more during your intern year, so its really just to get your feet wet in muliple specialties and kind of figure out what field you want to go into. Many times the choices you make will depend on the people you interact with on these rotations (attendings, residents/interns); whether this is the right reason or not to go into a field doesnt' matter I think cause thats what you're going to judge it by.

I think to avoid this, try to think of if you would like to work with the particular patient type that you encounter.

Other than that, picking up charts, films, moving patients, getting social service folks to get a patient out are all things that NEED to be done by someone, whether its the intern, attending, or med student and to be a good team everyone has to pull their weight. I definitely dont think getting coffee, food is right for the medical student, or pretty much anyone to do besides the person that wants the food. I remember getting coffee for folks sometimes, but at that time it wasnt' that big of a deal cause that particular person helped me out before.

so in short, ANYTHING that involves doing something in the hospital for the patient should be fair game for anyone, and any kind of food getting is not right in my books haha.

 

[beasleys]

No, that's not right. Our "job" (if you can call it that seeing as how we're paying money to be there) is to learn without slowing the team down.

But it is not the job of the resident to teach, yes? They are there to learn too. You can blame the attendings then if you are not learning but not the residents, I think. In fact if the residents totally ignore you that should be OK if you want to be technical.

 

[Baditude]

I don't mind picking up food or even dry cleaning if I am asked nicely when I can see it will help out my intern/resident/attending etc. I will mind if I am ordered to when it is clear it is being done so because of a power trip. I am very easy to get along with and I enjoy being part of a team and I fully expect "to earn my place" on that team but nobody deserves to be treated like crap simply because they are low man on the totem pole.

 

[Blade28]

I don't mind picking up food or even dry cleaning if I am asked nicely when I can see it will help out my intern/resident/attending etc. I will mind if I am ordered to when it is clear it is being done so because of a power trip. I am very easy to get along with and I enjoy being part of a team and I fully expect "to earn my place" on that team but nobody deserves to be treated like crap simply because they are low man on the totem pole.

Despite your ironic screen name, your post shows a tremendous positive attitude. I wish I had med students like you.

 

[Law2Doc]

I don't mind picking up food or even dry cleaning if I am asked nicely when I can see it will help out my intern/resident/attending etc. I will mind if I am ordered to when it is clear it is being done so because of a power trip. I am very easy to get along with and I enjoy being part of a team and I fully expect "to earn my place" on that team but nobody deserves to be treated like crap simply because they are low man on the totem pole.

I agree that food and dry cleaning cross the line. This is rarely asked of med students anyhow. But the other 80% of the things the OP was complaining about (answering pagers, carrying equipment, paperwork, schedules) are totally within the realm of scut a med student should expect to do. Let's not get carried away about drycleaning (something the OP wasn't even complaining about).

 

[fakin' the funk]

No, that's not right. Our "job" (if you can call it that seeing as how we're paying money to be there) is to learn without slowing the team down....Instead I've heard that my job is to learn how to come up with a reasonable differential, narrow it down, and then know the next beginning steps in treatment...I don't mind doing favors at all, but if you think that being a persona assistant is your job as a medical student, then you are completely missing out on your educational experience. I should add one caveat that your job does entail learning how to take care of the patient. So, if by doing that (practicing skills that you will need as a doctor) you end up 'helping' the intern or the attending, more power to you. But the focus should be on learning and patient care, and not on sucking up and being a human doormat.

great post!

 

[Scaredshizzles]

I agree that food and dry cleaning cross the line. This is rarely asked of med students anyhow. But the other 80% of the things the OP was complaining about (answering pagers, carrying equipment, paperwork, schedules) are totally within the realm of scut a med student should expect to do. Let's not get carried away about drycleaning (something the OP wasn't even complaining about).

Let's face it, as a med student none of what we say is taken seriously and so really we have no impact on our patients, so the idea of doing for your patients, including being their social worker, goes out the window imo... Our primary responsibility should be to our future patients and not really to our current patients...And to be good to our future patients, we need to learn how to recognize disease patterns and to recognize how patients respond to different treatment protocols, and yes part of it is recognizing how patients cope and their social needs...but then actually being their social worker or whatever should never be part of our responsibility, there should be paid staff for that, and there are, they just happen to be lazy themselves. Our energies should really be focused on the aforementioned, and that is what will help us be good doctor's in the future. I'm not saying not to be considerate to other staff and to patients, I'm just saying it is dumb to have "students" burn themselves out doing menial labor....Learning is a task that requires a lot of mental energy of you want to be very discerning and keen and learn everything; doing all that scut just results in your becoming a half-arsed student....You might be able to memorize enough clinical pearls in a review book to do well on a shelf, but that's not learning....rote memorization is basically the same as scut work.....And you might get far in the medical profession by being a great team player, but you will make no contribution or positive change to the art and practice of medicine and to your patients....You'll follow the same flawed protocols as the residents you scutted for used.

 

[Law2Doc]

And you might get far in the medical profession by being a great team player, but you will make no contribution or positive change to the art and practice of medicine and to your patients....You'll follow the same flawed protocols as the residents you scutted for used.

Which is why I described it as an apprenticeship. You play underling to the residents, and in return they hopefully teach you some stuff and let you see some things. And then you take their place for the next set of med students. It may seem flawed, but it actually generates a pretty impressive quality product, bearing in mind that paperwork and scut is a BIG part of medicine these days, and becoming efficient in this aspect of the practice, although not exciting, is going to serve you well.

But bottom line, the point of med school rotations is certainly to learn, but also partly to make a good impression about how you work in a hierarchical team setting, something folks who have never worked for a living may be sorely lacking, yet something critically important in a profession such as medicine. You are being subjectively evaluated by the folks you are working with as a huge part of your grade, which is why you need to see helping out the intern and residents as your job. Protesting and suggesting that you should be doing other stuff because you are paying for this experience is going to fall on deaf ears because everyone in the game was at your stage once.

 

[Tired]

This is a thread that embodies what happens to students who don't learn their lesson from jack@ss residents:

D-Bag goes on a power trip

I remember that. It was a great thread! That dude was a total douche.

I thought the title of this thread was pretty funny too. I mean, if I don't listen to you when you talk, what makes you think I'll read a letter you wrote to me?

 

[Baditude]

Blade..... Maybe our paths will cross along the way! I imagine you recognize the work your students put in to help the team run smooth and also recognize their desire for learning along the way.
We as students do need to spend the majority of our time learning the art of medicine and describing it as an apprenticeship is an excellent comparison. When one is learning any trade it is a steep learning curve and it takes a unique person to be able to balance the need and desire to learn quickly and to be actual help to the team during the day it also takes a unique person to teach those skills to those behind them. Anyone who states it is an easy job to teach has never spent much time doing it. Teaching is a skill that not many really excel at. When a person has no experience working with people in the public all of a sudden goes from student to student and teacher that can be overwhelming. When that persons role model of teaching was angry/ mean/ or simply did a poor job how can we expect any different in the new "teacher".
I guess this is my rambling way of saying if we as students don't like how we were treated by our interns (teachers) then we should work that much harder to not pass that attitude on when we become the teacher. The cycle has to stop somewhere so why not with you.
If we all do our jobs whatever they may be to the best of our abilities we will get to where we need to be hopefully with only a few bumps in the road along the way.
Best of luck to all of you in the next few rough years!
Happy holidays everyone.

 

[OrnotMajestic]

Everytime I get on SDN now, I become increasingly grateful for my experiences so far at my school. Sure, I've only been an MSIII since July, but I've yet to do one single ounce of unwanted "scut". Have I looked up lab values for residents/attendings? Of course. But every bit of "scut" that I've done has been part of a learning experience. Get lab values = "what do you think is going on here? What should we do here? What should we order?". Fetch the supply cart? Why sure! That means I get to do the paracentesis, I get to remove the toenail, I get to do a skin shaving for biopsy. I've fetched food once, but the resident bought my meal as well, and they had been up for 24+ hours so I didn't mind so much.

My experience so far has been a positive one. As said above, the best way to learn is to carry 2-3 patients on my own. Sure, the resident has to see the patient too, and write the orders...but if you work hard and stay on top of things, they start to trust you. Up to and including just writing addendums on your notes, and filling out the orders that you ask for.

So far I've only run into one or two "power trip" interns/residents, and I never worked with them. Why? The other residents hated him/her, warned me about them, and said "stick with me, I'll teach you stuff". Then again, maybe I'm a poor example, because I still think it's awesome that I get to check blood pressures and do venous blood draws.

I think though, that this "job description of an MSIII" is less of an actual as it is a matter of degrees. The intern I'm working with may ask me to check labs and imaging on my patient for them while they D/C three others to save time, and I don't consider that scut. Why? Because I know my intern isn't treating me as free labor, but asking me to help out the team. It's quite easy to imagine, though, an a-hole intern saying "call for lab values and fetch me a sammich, cause that's what med students do". So before we all get worked up about what our "job" is...perhaps it's just as said above...we are there to learn and be part of the team. Nothing really should be above or below anyone. (my current attending is known for picking up food for us while we are on call, doing his own "scut" work, and even doing some of ours)

 

[Baditude]

OrnotMajestic- I can only hope the rest of my experiences will be just like yours! It seems we have the same idea of what our role/place on the team is. I am grateful for the time to practice even routine things like reading labs, taking vitals etc because it just makes me more proficient at it and it all will help me on Step 2 CS and CK exams.

 

[OrnotMajestic]

OrnotMajestic- I can only hope the rest of my experiences will be just like yours! It seems we have the same idea of what our role/place on the team is. I am grateful for the time to practice even routine things like reading labs, taking vitals etc because it just makes me more proficient at it and it all will help me on Step 2 CS and CK exams.

I was actually a bit worried about my third year after hearing horror stories (IRL and on here) about power-tripping interns, screaming attendings, sitting in the corner and doing nothing (ie "DON'T TOUCH THE PATIENT MED STUDENT! JUST WATCH!!")...but I've found this to be the most rewarding year since starting school! I do indeed hope the rest of your experiences are similar to mine, as I think it will do nothing but help us to become a better clinicians.

Glad to see others think the way I do. Hell, I admit to know nothing on the wards, so I try to turn even fetching labwork into some sort of learning experience. Then again, I have attendings that are cool as hell, and pretty much treat me like an intern. If this keeps up, I think I'll be a mite-bit less scared come intern year!

 

[Blade28]

I guess this is my rambling way of saying if we as students don't like how we were treated by our interns (teachers) then we should work that much harder to not pass that attitude on when we become the teacher. The cycle has to stop somewhere so why not with you.

I completely agree!

I was often beat-down by my residents when I was a med student, so am determined not to act similarly now that I'm a resident myself.

 

[Law2Doc]

...but I've yet to do one single ounce of unwanted "scut". Have I looked up lab values for residents/attendings? Of course. But every bit of "scut" that I've done has been part of a learning experience. Get lab values = "what do you think is going on here? What should we do here? What should we order?". Fetch the supply cart? Why sure! That means I get to do the paracentesis, I get to remove the toenail, I get to do a skin shaving for biopsy. I've fetched food once, but the resident bought my meal as well, and they had been up for 24+ hours so I didn't mind so much. ... The intern I'm working with may ask me to check labs and imaging on my patient for them while they D/C three others to save time, and I don't consider that scut. Why? Because I know my intern isn't treating me as free labor, but asking me to help out the team.

Basically sounds like from your post you are being asked to do about the same things as the OP, but just have the right attitude about it. Part of that is going to be related to the intern's inexperience working with "employees", and much of it is the prior med student's inexperience working in a hierarchy. You do scut. There's usually a reason and a good intern should share that with you and keep you in the loop. But not every intern is going to have the right attitude or experience, and what you do in med school is about as much exposure or training you get in terms of how to work with med student underlings before you are thrust into it in residency. So best if as a med student you have the right attitude, know that yours is a scut-filled job, and just try to make yourself useful. If you learn how not to be an intern by watching a bad one, I suppose that's valuable learning too.

 

[chicamedica]

You know, when i was a med student i actually hated it when my interns were so worried about "not scutting me out" that they wouldn't let me do anything. Medicine was my first rotation of MS3 and seriously, I needed to do those little things to learn the ropes, because even the smallest tasks showed me how the floors worked. Learning this was made harder when the "nice" interns my first medicine month would say "nah, you dont have to do that. . .it's scut". I also felt very left out when they would be like that. The 2nd month, my intern wasnt as nice, and I learned so much more.

As an intern, I like to involve my med students as much as possible. They write the notes, we do orders together, we write the discharge summary together (if they're beginners. . .but i'm a picky writer too). If there's a procedure, we go to the supply closet together and get the needed supplies. They help out in the procedure, or watch depending on what it is. If i'm in the middle of it and i run out of a material, sure i might ask the med student to get me another one. When I was a med student, I absolutely happy to do so for a resident who invited me watch or participate in a learning activity. And if I wasn't invited I would invite myself and involve myself by doing whatever i could to not just be "furniture" there, even if it meant scut.

You can learn valuable things from doing scut, even if it means just learning where things are kept, what materials you need, how a medical team functions. You do not want to be learning these things for the first time as an intern. You'll have other things to worry about, so scut has to be second nature by then.

 

[OrnotMajestic]

Basically sounds like from your post you are being asked to do about the same things as the OP, but just have the right attitude about it. Part of that is going to be related to the intern's inexperience working with "employees", and much of it is the prior med student's inexperience working in a hierarchy. You do scut. There's usually a reason and a good intern should share that with you and keep you in the loop. But not every intern is going to have the right attitude or experience, and what you do in med school is about as much exposure or training you get in terms of how to work with med student underlings before you are thrust into it in residency. So best if as a med student you have the right attitude, know that yours is a scut-filled job, and just try to make yourself useful. If you learn how not to be an intern by watching a bad one, I suppose that's valuable learning too.

I guess scut is subjective, since I don't think I really get "scutted", even though I do what many consider "scut" work. This probably stems from the fact that, so far, even my attendings do "scut" for the team.

 

[Blade28]

Basically sounds like from your post you are being asked to do about the same things as the OP, but just have the right attitude about it. Part of that is going to be related to the intern's inexperience working with "employees", and much of it is the prior med student's inexperience working in a hierarchy. You do scut. There's usually a reason and a good intern should share that with you and keep you in the loop. But not every intern is going to have the right attitude or experience, and what you do in med school is about as much exposure or training you get in terms of how to work with med student underlings before you are thrust into it in residency. So best if as a med student you have the right attitude, know that yours is a scut-filled job, and just try to make yourself useful. If you learn how not to be an intern by watching a bad one, I suppose that's valuable learning too.

Great post.

We need to all remember that a positive attitude (and strong work ethic) is so under-rated.

 

[Scaredshizzles]

Great post.

We need to all remember that a positive attitude (and strong work ethic) is so under-rated.

Agreed on the positive attitude, disagree on the work ethic part because most people said to have a work ethic tend to waste their time doing worthless stuff for the sake of being told they have a good work ethic. Not impressed.

 

[Blade28]

Agreed on the positive attitude, disagree on the work ethic part because most people said to have a work ethic tend to waste their time doing worthless stuff for the sake of being told they have a good work ethic. Not impressed.

Well I agree that grinding away on pointless work is just futile. You need a combination of strong work ethic with the judgment to know what's important to focus on. Time management and prioritization are key!

 

[filter07]

Medical students are there to learn. They should learn not only how to diagnose a disease, but also how to take care of patients and work with various members of the team.

I think a lot of primadonna medical students have the attitude that if every single moment of their clinical day isn't spent filling their head with First Aid factoids, they are getting cheated out of their education.

What these type of med students fail to realize is that medicine is a SERVICE profession. Part of clinical rotations is learning how to serve. Physicians don't just diagnose patients. They do WHATEVER is necessary to give these patients the best care. Sometimes that means staying late to do paperwork. Sometimes that means doing the job of some nurses (starting IV lines, hanging a bag of fluids, wheeling someone down to radiology). At times we have to do the job of social workers, counselors, etc. Medical students with a "not my job" attitude in healthcare should fix that mentality soon or decide not to deal with patients. Physicians have the ultimate responsibility for patients so it's OUR job to do things when other people don't do their jobs. Sure I could say, "It's not my job to clean this guy's bedpan." But if you truly care about patients, you will be humble and do whatever is needed to do what's best for them.

So the next time someone asks you to return a page because they are scrubbed in in the OR, or write down some vitals in the morning because they are writing orders, try to remember that you are learning how to be a team player and being flexible enough to do whatever it takes for your patients. Take it also as an opportunity to find out whether patient care is really for you, because if this type of work just gets you angry and pissed off, you should not be taking care of patients and should be working on Wall Street.

Finally, if someone asks you to get coffee because they don't want to miss ESPN on TV, have some enough self-esteem to tell them to screw off. But when it's appropriate, do try to help the team.

Lecture over.