Annoyed with ER resident

Started by ocean11
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ocean11

ocean11

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Man! I work hard, I do all the scut work thats asked of me with a smile on my face and when it comes time to do my evaluations (we do one or two per shift) the ER resident that I worked the most with gave me two 3/5's (equaling all together 20/25) for my 'medical knowledge' I felt like saying 'yeah biatch.... I'm only a third year without IM clerkship, I don't know as much as you' I don't think I'm stupid, I did well on boards and classes in general... I just thought it was kind of mean to expect med students to know as much as a chief resident!!! 🙁

Oh well.... luckily I had another eval which gave me 23/25, a much nicer resident (she was from IM) LOL....... anyhow anyone else have similar experiences... were you work SO hard but still get a luke warm eval! ?!?!?!? I hate it! I may as well slack off and still get a B.....
 
ocean11 said:
Man! I work hard, I do all the scut work thats asked of me with a smile on my face and when it comes time to do my evaluations (we do one or two per shift) the ER resident that I worked the most with gave me two 3/5's (equaling all together 20/25) for my 'medical knowledge' I felt like saying 'yeah biatch.... I'm only a third year without IM clerkship, I don't know as much as you' I don't think I'm stupid, I did well on boards and classes in general... I just thought it was kind of mean to expect med students to know as much as a chief resident!!! 🙁

Oh well.... luckily I had another eval which gave me 23/25, a much nicer resident (she was from IM) LOL....... anyhow anyone else have similar experiences... were you work SO hard but still get a luke warm eval! ?!?!?!? I hate it! I may as well slack off and still get a B.....
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Everybody has those experiences. They're a part of med school. Get over it and move on.
 
ER residents are a bunch of a-holes anyway. Who cares what they have to say.
 
ocean11 said:
Man! I work hard, I do all the scut work thats asked of me with a smile on my face and when it comes time to do my evaluations (we do one or two per shift) the ER resident that I worked the most with gave me two 3/5's (equaling all together 20/25) for my 'medical knowledge' I felt like saying 'yeah biatch.... I'm only a third year without IM clerkship, I don't know as much as you' I don't think I'm stupid, I did well on boards and classes in general... I just thought it was kind of mean to expect med students to know as much as a chief resident!!! 🙁

Oh well.... luckily I had another eval which gave me 23/25, a much nicer resident (she was from IM) LOL....... anyhow anyone else have similar experiences... were you work SO hard but still get a luke warm eval! ?!?!?!? I hate it! I may as well slack off and still get a B.....
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Let me break this down-
You admit to not yet having IM, but question a 60% on your eval for 'medical knowledge'.

Why are you on an EM rotation prior to your cores being complete? This seems like a disservice to you.
In the states, most EM rotations and electives require completion of the basics prior to the ED. Is this different in Canada, or are you in the US?

Any other issues with the ED resident?
 
Our school has a required 3rd year EM clerkship that is part of our core clerkships. When you do what clerkships depends on what overall track you managed to get through our lottery system. Unless you do EM last, you will probably will not have done all of medicine, surgery, OB, peds, or psych. That's just the way it is. I don't think this is a disservice, as it is probably one of the most enjoyed rotations of 3rd year at our school.

In all honesty though, you shouldn't expect to get all 5/5 of 10/10 on medical knowledge in your 3rd year, cuz you really don't know much. Basic and clinical knowledge are two completely different realms. It's just the reality of medicine. Also, it's one EM shift of 16. Not everyone is going to give you a great eval, but if you work with the same resident, you have an opportunity to show improvement. That's just kinda how it is in EM, as opposed to IM where you are evaluated over the course of a full month. Don't worry about it too much and stop stressing out about 1 evaluation.
 
Dr. Will said:
Our school has a required 3rd year EM clerkship that is part of our core clerkships. When you do what clerkships depends on what overall track you managed to get through our lottery system. Unless you do EM last, you will probably will not have done all of medicine, surgery, OB, peds, or psych. .
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Good to know. Thanks.
 
I had a similar experience on 1 of my em electives.
I had 2 preceptors, a doc and a pa. the pa was really more of a family medicine type as opposed to an em type so I spent the vast majority of my time with the doc in main doing much more interesting procedures and seeing much sicker pts.....I got a GREAT eval from the doc( they said if I went to medschool they would be very interested in me coming back there as an em resident).
the pa gave me a c- based on a very small # of pts/procedures I did with her on the first day of the rotation-the only day I spent with her.
her reasoning? I didn't "embrace the pa role" and should have spent more time doing basic cases( this despite the fact that I had already done a trauma surgery rotation and another community hospital based em rotation).
I ended up with a b+ for the rotation( 89.4%) having done well on the rotation exam.this was my only final grade of b in the entire program.kind of ironic. a future em pa who honored every course and rotation accept 1 em rotation.
I don't regret my decision to spend time with the em doc. there was no set schedule of who I was suppoed to be with on which day so I just sought out the best learning experience for where I was at that point, and that definitely was not in fast track taking care of minor pts with a family medicine pa.
 
ocean11 said:
the ER resident that I worked the most with gave me two 3/5's (equaling all together 20/25) for my 'medical knowledge' I felt like saying 'yeah biatch.... I'm only a third year without IM clerkship, I don't know as much as you' I don't think I'm stupid, I did well on boards and classes in general... I just thought it was kind of mean to expect med students to know as much as a chief resident!!! 🙁
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Wait, so you think you should have gotten a high score on "medical knowledge" despite the fact that you don't know a whole lot? What would have been an appropriate outcome, a 'pity' 25/25?
 
Tired said:
Wait, so you think you should have gotten a high score on "medical knowledge" despite the fact that you don't know a whole lot? What would have been an appropriate outcome, a 'pity' 25/25?
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Despite not knowing as much as an intern on EVALUATIONS we should compared to our fellow THIRD year medical student not attendings or senior residents. I think an appropriate outcome would have been 23/25 ANYHOW here's the update peeeps..... I got a few great evaluations in the following two weeks, so I still think I have a shot at doing decently on this rotation, but you never know... I'll let you all know as soon as I get my grade back!
 
ocean11 said:
Despite not knowing as much as an intern on EVALUATIONS we should compared to our fellow THIRD year medical student not attendings or senior residents. I think an appropriate outcome would have been 23/25 ANYHOW here's the update peeeps..... I got a few great evaluations in the following two weeks, so I still think I have a shot at doing decently on this rotation, but you never know... I'll let you all know as soon as I get my grade back!
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Hey Ocean, just a tip from someone who's walked the road you're walking on. I think you should really stop worrying about your evals. They are completely subjective and you will drive yourself completely crazy if you buy into that. Concentrate on reading and learning for the shelf exams, cuz that is something you can control. As for the evals, just go in and work hard, be interested, ask questions, etc. The more you stress about them, the more it shows and throws you off your game. Just focus on the parts you can control.
 
ocean11 said:
Man! I work hard, I do all the scut work thats asked of me with a smile on my face and when it comes time to do my evaluations (we do one or two per shift) the ER resident that I worked the most with gave me two 3/5's (equaling all together 20/25) for my 'medical knowledge' I felt like saying 'yeah biatch.... I'm only a third year without IM clerkship, I don't know as much as you' I don't think I'm stupid, I did well on boards and classes in general... I just thought it was kind of mean to expect med students to know as much as a chief resident!!! 🙁

Oh well.... luckily I had another eval which gave me 23/25, a much nicer resident (she was from IM) LOL....... anyhow anyone else have similar experiences... were you work SO hard but still get a luke warm eval! ?!?!?!? I hate it! I may as well slack off and still get a B.....
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20/25? Isn't that the same an 80 percent? A "B"? Come on now. "B" is a pretty good grade for medical school. I would have loved to get a B in everything.

Don't obsess over it. He didn't call you stupid, he just observed that you didn't know a lot. God forbid we are all ever evaluated completely subjectively. Most of us wouldn't make it.
 
ocean11 said:
Despite not knowing as much as an intern on EVALUATIONS we should compared to our fellow THIRD year medical student not attendings or senior residents. I think an appropriate outcome would have been 23/25 ANYHOW here's the update peeeps..... I got a few great evaluations in the following two weeks, so I still think I have a shot at doing decently on this rotation, but you never know... I'll let you all know as soon as I get my grade back!
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Why do they have a 25 point scale if nobody should ever get below a 23? maybe it should be a 3 point scale.
 
Dr. Will said:
Hey Ocean, just a tip from someone who's walked the road you're walking on. I think you should really stop worrying about your evals. They are completely subjective and you will drive yourself completely crazy if you buy into that. Concentrate on reading and learning for the shelf exams, cuz that is something you can control. As for the evals, just go in and work hard, be interested, ask questions, etc. The more you stress about them, the more it shows and throws you off your game. Just focus on the parts you can control.
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As one of the above-mentioned dingus Emergency Medicine residents and speaking just for myself, you don't have to ask a lot of questions or even pretend to be interested if you aren't. I am not so in love with my awesome intern power that I can't tell when my ass is being kissed. Not everybody likes Emergency Medicine. Many people absolutely hate it with a passion only equalled by that of Kevin for Bittney and they shouldn't be penalized for having more self-respect than to lie about it. So the few medical students I evaluated got the evaluations I think they deserved based on what they knew and did, not on how gung ho they were for the specialty. I know perefctly well that a couple of them hated it but they still sucked it up.

It's not that I don't like having my ass kissed, you understand, just that I don't think I deserve it yet.
 
Dr. Will said:
Hey Ocean, just a tip from someone who's walked the road you're walking on. I think you should really stop worrying about your evals. They are completely subjective and you will drive yourself completely crazy if you buy into that. Concentrate on reading and learning for the shelf exams, cuz that is something you can control. As for the evals, just go in and work hard, be interested, ask questions, etc. The more you stress about them, the more it shows and throws you off your game. Just focus on the parts you can control.
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I second that!
 
Panda Bear said:
As one of the above-mentioned dingus Emergency Medicine residents and speaking just for myself, you don't have to ask a lot of questions or even pretend to be interested if you aren't. I am not so in love with my awesome intern power that I can't tell when my ass is being kissed. Not everybody likes Emergency Medicine. Many people absolutely hate it with a passion only equalled by that of Kevin for Bittney and they shouldn't be penalized for having more self-respect than to lie about it. So the few medical students I evaluated got the evaluations I think they deserved based on what they knew and did, not on how gung ho they were for the specialty. I know perefctly well that a couple of them hated it but they still sucked it up.

It's not that I don't like having my ass kissed, you understand, just that I don't think I deserve it yet.
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Hey I agree with you. But I don't think showing interest and ass kissing are necessarily the same thing. It is for some...and it's transparent for these people. I, for one, am against ass kissing in any form...but during my rotations, I showed interest in what was going on even if I had no desire to be a part of that particular field again. It was either this or complain of boredom. I rather try and learn something that will help me for the shelf exam. As for the question asking, I meant ask questions if you have them, not for the sake of asking them. That to me is annoying as all hell.

And while this all may not be necessary for you, there are far too many people out there, residents and attendings, that this is true for. It's not right, but it exists.
 
ocean11 said:
Despite not knowing as much as an intern on EVALUATIONS we should compared to our fellow THIRD year medical student not attendings or senior residents. I think an appropriate outcome would have been 23/25 ANYHOW here's the update peeeps..... I got a few great evaluations in the following two weeks, so I still think I have a shot at doing decently on this rotation, but you never know... I'll let you all know as soon as I get my grade back!
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Concentrate on being hot if you don't care about EM. Seriously, as other people have mentioned, it will be subjective no matter what you do. Some people give great grades for suckups, others ding people. With EM, you don't work with the same person every day, so you can't gradually learn what they want and don't want.
A "B" won't kill you, we promise.
 
IbnSina said:
Concentrate on being hot if you don't care about EM. Seriously, as other people have mentioned, it will be subjective no matter what you do. Some people give great grades for suckups, others ding people. With EM, you don't work with the same person every day, so you can't gradually learn what they want and don't want.
A "B" won't kill you, we promise.
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I agree, but I think a B will kill me if I want to get in to Emergency Medicine which I'm semi-considering right now. Anyhow, I got another Eval today: 21/25 whatever.... I got a few perfects over the last few days, so i'm not too stressed out. We'll see... either way I'll tell you guys what I got at the end of this whole ordeal. Today I stayed an extra two hours to get to watch a NG tube procedure, it was interesting!!!! 1 more week then family practice, yey! 😉
 
ocean11 said:
I agree, but I think a B will kill me if I want to get in to Emergency Medicine which I'm semi-considering right now. Anyhow, I got another Eval today: 21/25 whatever.... I got a few perfects over the last few days, so i'm not too stressed out. We'll see... either way I'll tell you guys what I got at the end of this whole ordeal. Today I stayed an extra two hours to get to watch a NG tube procedure, it was interesting!!!! 1 more week then family practice, yey! 😉
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People are giving you sound advice and yet you don't listen. A B in your 3rd year EM clerkship will not prevent you from going into EM. Worry about the exams for EM and FM because no matter what your evals are, if you don't get A's on your exams, you will not get an A for the clerkship.
 
Ok, regarding the "grading" of students and residents.

The "goal" is not to give everyone 100%, but rather allow for areas to show improvement. I would imagine a 3/5 is considered average. Well, I would also imagine this particular resident never grades a 5/5 as that would be 'no room for improvement' or essentially 'perfect'. It is a useless score and has no value, except for those who seek the highest cumulative score for whatever reason. Well, it really means very very little when applying to residencies (which I am sure you are primarily concerned with). The point of a grade is to simply show areas where improvement could be made, and as you pointed out, perhaps if you had a IM rotation first you would have scored better...so who's at fault?

I grade all of the residents at my institution, and NO ONE gets a 10/10. I have handed out a handful of 9's. This actually puts value to the 10...those who score ten, do so deservedly.
 
ocean11 said:
I agree, but I think a B will kill me if I want to get in to Emergency Medicine which I'm semi-considering right now. Anyhow, I got another Eval today: 21/25 whatever.... I got a few perfects over the last few days, so i'm not too stressed out. We'll see... either way I'll tell you guys what I got at the end of this whole ordeal. Today I stayed an extra two hours to get to watch a NG tube procedure, it was interesting!!!! 1 more week then family practice, yey! 😉
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Honestly, getting a B in a third year rotation isn't that bad. As long as you get out there during fourth year and show some people at other schools (meaning away rotations) that you have learned more and are a better student than your grades suggest, all is well. Besides, if they ask a question (and from my interviews, nobody really asks questions about your application) about it, you have a perfect excuse, saying that you hadn't taken IM, so you didn't have a good base. As long as your evals state that you show interest, lacking clinical knowledge isn't your fault at this point. Now, it will be your fault during 4th year, and for any problems with Step and/or Comlex exams.
 
I agree with Wagner.

Just as he (she), I am an attending now in an EM residency. I see tons of students (mostly M4s interested in EM), our EM residents, and IM/Surgery interns/residents....

When I was a senior resident, a paltry one year ago, I used to give everyone "5's" (Which are the equivalent of your 25/25). Then, our PD said to us, "You guys are doing them a disservice. Do you really think all the medical students you are working with deserve a 100% PERFECT score? The AVERAGE student should get an AVERAGE score, being a 3, and the above average student a 4, and only the superstellar students get a 5" I thought about it, and since then have really changed my opinion.

Where I'm at, the students have a 1-10 grading scale option. I sit down and tell them all, prior to me filling it out (which I do in front of them), the above paragraph. The average medical student (and I tell them I was the average medical student) deserves a 4-6. A lot of my students end up getting 4's-6's. No one has ever gotten a ten (that I can recall).

Its absolutely USELESS for a medical student to get "all 10s" if they didn't deserve it. Wouldn't you rather have a TRUE evaluation and let you know how you TRULY compare to your colleagues? I know superficially, as a medical student, I wouldn't, because it would "be so harmful to my application." Philosophically and deep down I am sure we all really want candid HONEST and true evaluations of ourselves. That's what I give.

If you are an M3 and you get a 10/10 or a 25/25, you better have really knocked the socks off on me and are at the very top of your class. Otherwise, you dont' deserve it.

Q
 
I imagine that the frustration comes in when there is no standarization. If I perform the exact same as another medical student, but DrQuinn gives me a 5 because I am average, and DrCheery gives the other medical student an 8, at the end of the year, even though we performed identically, I will suffer.

I think a better way to do it would be to tally all of DrQuinn's evals and report that I was in the 65th percentile OF HIS EVALUATIONS, and all of DrCheery's evals and report that the other student was also in the 65th percentile. That would at least be a more accurate assessment.

Just my thoughts.
 
This has hurt me a lot in my career, as those of you who read a certain blog that I'm not supposed to plug too heavily know, but I have never cared either way about evaluations. And I'm talking not caring to the point of not even being interested in reading them.

Unless I'm screwing up or not doing what I'm supposed to be doing, I have a profound indifference to what people think about me, especially residents. It just doesn't matter. What am I going to read that I don't already know?

"OB/Gyn: Student is on time and does everything asked of him willingly and with good humor but seemed uninterested in assisting in any more vaginal deliveries than was required to pass the rotation."

"General Surgery: Student Doctor Bear did everything asked of him but was singularly unenthusiastic about holding a retractor for six hours. He does not seem to enjoy call and never seems to either know or care about the answers to the random trivia question I ask him just to keep him on his toes."

I have my faults but a lack of self-knowledge isn't one of them.
 
DrQuinn said:
Where I'm at, the students have a 1-10 grading scale option. I sit down and tell them all, prior to me filling it out (which I do in front of them), the above paragraph. The average medical student (and I tell them I was the average medical student) deserves a 4-6. A lot of my students end up getting 4's-6's. No one has ever gotten a ten (that I can recall).

Q
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The problem lies in the fact that (at least at my school) a 40-60% is an "F". If you think the average student should fail the rotation then great. But if you think the average student is a B or C student, then they should all get 7-8. Average does not equal F.
 
ocean11 said:
I agree, but I think a B will kill me if I want to get in to Emergency Medicine which I'm semi-considering right now. Anyhow, I got another Eval today: 21/25 whatever.... I got a few perfects over the last few days, so i'm not too stressed out. We'll see... either way I'll tell you guys what I got at the end of this whole ordeal. Today I stayed an extra two hours to get to watch a NG tube procedure, it was interesting!!!! 1 more week then family practice, yey! 😉
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Sorry that this happened to you. Unfortunately, it is a part of 3rd and 4th year. My E-Med rotation was the pits. I never worked with the same resident or attending twice. It is going to be really interesting to see what type of grade that I get out of this. Thank goodness I am not going into E-Med!

You're a third year, so you have time to improve your application should you get a B in EM (which isn't that bad). Do some E-Med electives early in your fourth year and do the best that you can in the rest of your clerkships. Try to get good letters of recommendation. I think that most residency programs know that grading can be very subjective and as long as you don't have a lot of negative comments about your clinical performance, you should be okay! Talk with your advisor and get their input as to what they recommend that you do to get into a good EM program! Good luck!
 
DrQuinn said:
I agree with Wagner.

Just as he (she), I am an attending now in an EM residency. I see tons of students (mostly M4s interested in EM), our EM residents, and IM/Surgery interns/residents....

When I was a senior resident, a paltry one year ago, I used to give everyone "5's" (Which are the equivalent of your 25/25). Then, our PD said to us, "You guys are doing them a disservice. Do you really think all the medical students you are working with deserve a 100% PERFECT score? The AVERAGE student should get an AVERAGE score, being a 3, and the above average student a 4, and only the superstellar students get a 5" I thought about it, and since then have really changed my opinion.

Where I'm at, the students have a 1-10 grading scale option. I sit down and tell them all, prior to me filling it out (which I do in front of them), the above paragraph. The average medical student (and I tell them I was the average medical student) deserves a 4-6. A lot of my students end up getting 4's-6's. No one has ever gotten a ten (that I can recall).

Its absolutely USELESS for a medical student to get "all 10s" if they didn't deserve it. Wouldn't you rather have a TRUE evaluation and let you know how you TRULY compare to your colleagues? I know superficially, as a medical student, I wouldn't, because it would "be so harmful to my application." Philosophically and deep down I am sure we all really want candid HONEST and true evaluations of ourselves. That's what I give.

If you are an M3 and you get a 10/10 or a 25/25, you better have really knocked the socks off on me and are at the very top of your class. Otherwise, you dont' deserve it.

Q
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First, I agree with big Navy guy's response. At my med school, the average student deserves (on a scale of 1-10) a score of 7 or 8, b/c i honestly feel that an average med student is not a 4-6.

Second, the PD shouldn't be telling people how to grade...and why is he working the system against his own students? kind of kidding...but not really.

Third, you bring up a really good point Dr. Quinn. The other part of this that you didn't address is that, yes, you may be grading in the most "ideal" fashion, but the majority of other attendings are not. Therefore you put average and above average students at a disadvantage by grading them with a biased toward the low end of the scale, whereas another attending would grade them better if put in your shoes.

My philosophy is to grade everyone well unless they don't truly deserve it. My standards for a 7 are that they show up and they are interested and respectful. Bad students get the 4s and 5s...those who have poor knowledge base, no motivation, no respect and poor clinical skills. If you do something that violates school policy/honor code that is really serious, you'll get 1-3 (never happened). Excellent students get the 9s and 10s (excellent = obviously superior to classmates past and present in terms of knowledge, clinical skills, motivation and personality).

Don't be afraid to give a 10...you're obviously not afraid to give a 4.
 
To the OP, did you make it known to your resident that you wanted to go into EM? You'd be surprised at how differently they will treat you and even evaluate you based on this information.
 
scootad. said:
To the OP, did you make it known to your resident that you wanted to go into EM? You'd be surprised at how differently they will treat you and even evaluate you based on this information.
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yes I made it known, although I'm not so certain I want to go into it anymore... I'm at a 'crossroads' in my life... I like too many things... I"m b/w Neurology/Internal Medicine and Emergency medicine as well as Dermatology... sucks eh? oh well... anyhow TONIGHT IS MY LAST shift! from midnight to 8am.... whew... family practice starts on Monday... I hope the attendings there are nice!

Let you all know my grade once I get it 🙂
 
Panda Bear said:
"OB/Gyn: Student is on time and does everything asked of him willingly and with good humor but seemed uninterested in assisting in any more vaginal deliveries than was required to pass the rotation."
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It's a national phenomenon! I just got my OB/Gyn evals back and got one that was nearly the same, word for word. Minus "good humor" and "vaginal."
 
lord_jeebus said:
It's a national phenomenon! I just got my OB/Gyn evals back and got one that was nearly the same, word for word. Minus "good humor" and "vaginal."
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It's not just Ob/Gyn. When I was on FP, I made the mistake of admitting to an interest in Surgery. Every eval had, "Is not all that interested in Primary Care."

When I'm an attending, I'm going to write evals that say, "Student is interested in Primary Care, and therefore is required to receive a lower grade on this rotation."
 
Tired said:
It's not just Ob/Gyn. When I was on FP, I made the mistake of admitting to an interest in Surgery. Every eval had, "Is not all that interested in Primary Care."

When I'm an attending, I'm going to write evals that say, "Student is interested in Primary Care, and therefore is required to receive a lower grade on this rotation."
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They must get tired of writing "Student is not interested in primary care." At my medical school they had a stamp for that to save time.
 
DrQuinn said:
I agree with Wagner.

Just as he (she), I am an attending now in an EM residency. I see tons of students (mostly M4s interested in EM), our EM residents, and IM/Surgery interns/residents....

When I was a senior resident, a paltry one year ago, I used to give everyone "5's" (Which are the equivalent of your 25/25). Then, our PD said to us, "You guys are doing them a disservice. Do you really think all the medical students you are working with deserve a 100% PERFECT score? The AVERAGE student should get an AVERAGE score, being a 3, and the above average student a 4, and only the superstellar students get a 5" I thought about it, and since then have really changed my opinion.

Where I'm at, the students have a 1-10 grading scale option. I sit down and tell them all, prior to me filling it out (which I do in front of them), the above paragraph. The average medical student (and I tell them I was the average medical student) deserves a 4-6. A lot of my students end up getting 4's-6's. No one has ever gotten a ten (that I can recall).

Its absolutely USELESS for a medical student to get "all 10s" if they didn't deserve it. Wouldn't you rather have a TRUE evaluation and let you know how you TRULY compare to your colleagues? I know superficially, as a medical student, I wouldn't, because it would "be so harmful to my application." Philosophically and deep down I am sure we all really want candid HONEST and true evaluations of ourselves. That's what I give.

If you are an M3 and you get a 10/10 or a 25/25, you better have really knocked the socks off on me and are at the very top of your class. Otherwise, you dont' deserve it.

Q
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Interesting! The Surgery rotation at my school kind of fixed this problem by having a narrative eval sheet. So instead of circling "5/5" for medical knowledge they have to circle "full textbook knowledge combined with up to date grasp of relevant literature and current issues." It has supposedly cut down some on the number of "straight 5" evals.
 
BigNavyPedsGuy said:
The problem lies in the fact that (at least at my school) a 40-60% is an "F". If you think the average student should fail the rotation then great. But if you think the average student is a B or C student, then they should all get 7-8. Average does not equal F.
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We use our own evaluations, and, no, a 4-6 on a scale of 1-10 is not failing. Two different scales, people. If a "5" out of 10 is "average", and a 60% (out of 100, obviously) is failing, then they are two different scales.

Hence, I am not afraid to give people 4-6's on evaluation.

And I sit down and TELL each and every student how and why I grade the way I do, so there is no confusion.

Often times I do hear the plea "I didn't get a 10?!?!?! I'm going to fail my rotation!" This is the exact reason why I do my evals the way I do. I wish all my fellow colleagues gave evaluations like I do. I absolutely hate it when teh attending says "Oh I'll fill it out, thanks." And then when teh student leaves, they just circle all tens, write no constructive criticism, and put it in the evaluation box. This gives NO feedback to teh student whatsoever.

Are we in medical school to learn medicine, or to just pass? Wouldn't you like to know really how you are doing, instead of just being on cruise control for four years?

Q
 
QuinnB said:
Third, you bring up a really good point Dr. Quinn. The other part of this that you didn't address is that, yes, you may be grading in the most "ideal" fashion, but the majority of other attendings are not. Therefore you put average and above average students at a disadvantage by grading them with a biased toward the low end of the scale, whereas another attending would grade them better if put in your shoes.
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Someone's gotta stop the madness somehow. If I just conform to what everyone else is doing, then no one learns a thing and we all think we are 10/10 medical students who have no flaws and are "far and above the average medical student." To be fair, I have only given one failing grade, and that was to a medical student who was nearly finished with his M3 year. Every attending that had worked with him before I did said horrible things about him. In fact, there were even funny emails going aound about this medical student. Even his peers thought he was horrible. I sat down adn talked with him (longer than all my other evaluations) for about 10 minutes after his shift. I told him, to paraphrase, "you need to pick up teh slack, you have really fallen behind the curve and need to get your act together." The next shfit I worked with him, he was like a new medical student, and actually performed better than most. After that shift, he said "thank you so much for your talk." NO ONE HAD EVER talked to him about his performance, and he told me he "just kept getting good grades."

That's why I do what I do. You went into this to learn medicine, not to just "fly by" and get to graduation. When you get to applying to residencies, you'll see that your rotation grades, unless you perform poorly in all the rotations or fail a bunch, doesn't make much of a difference. Its your LORs and board scores that carry the most weight. And I would never give a LOR if I didn't think the student truly deserved it (and I would never write negaive comments on a LOR, I just woudln't write a "super strong one").


Q
 
DrQuinn said:
I told him, to paraphrase, "you need to pick up teh slack, you have really fallen behind the curve and need to get your act together." The next shfit I worked with him, he was like a new medical student, and actually performed better than most. After that shift, he said "thank you so much for your talk." NO ONE HAD EVER talked to him about his performance, and he told me he "just kept getting good grades."
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I'm really impressed that you did that, because at least at my school, it almost never happens. Although there are certainly some students who are simply slacking, there is also a substantial contingent who simply don't know what they are supposed to be doing. Working on the wards is not intuitive at first, and for those more 'quiet' students who don't actively seek out feedback, there are very few residents who will correct them except in the most eggregious circumstances. Frequently it seems like residents and attendings will silently "put up" with poor med student work using the rationale that, "Well, I only have to deal with them for a few weeks." Then on their end unit eval, the student bears the brunt of their previously unspoken frustration, and is confused and frustrated.

I believe that most students want to do a good job, and not simply to receive a good grade. Students want to be valuable to the team, if only in small ways. Although hearing negative feedback will invariably sting, most of us would prefer to hear it early so that we can correct it, rather than at the end of the rotation when we cannot.
 
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