bad evaluations - anyone else shocked by them?

[maiko82]

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[Winged Scapula]

Sometimes you don't see it coming.

Do yourself a favor, if you have any friends or confidants in the program, ask them about this specific attending.

The "functions at the level of an M-3" comment reminds me of something similar I got from a Vascular Surgery attending. As an intern, he commented that I functioned at the level of a 4th year medical student. I was appalled and upset as all my other evals had been decent.

Then I started asking around. The Vascular fellow called this attending "the Cheshire Cat" - he will smile at you and praise you, all the while stabbing you in the back. The next year, an intern, who had been a medical student at that school and had become a good friend of mine, was also reviewed by this attending. His eval? "X functioned at the level of a 3rd year medical student." She told me not to feel so bad, since I was at 4th year medical student level.

But the point was that there are some attendings that will skewer you, and never give you input along the way. Its unfair but it happens. More importantly though, your faculty is likely to know who does this routinely. We had surgery attendings who gave everyone great evals and some who gave everyone ****ty ones. If this is an off-service rotation for you, it may be that your faculty doesn't even care what this SOB has to say about you.

So try not to let it bring you down. I'll bet that this attending has bad things to say about almost everyone if you ask around. If you want to know more, try approaching him and asking:

1) if I was doing so poorly why didn't I get any mid-rotation feedback. Faculty is *supposed* to provide this to prevent residents and students from not having a chance to improve.

2) what specifically were the problems and how you improve your performance, and become a better physician?

While it may not change his eval, on the off chance that you did function poorly, it will give you more insight and make future rotations, on all services, better.

 

[Frugal Traveler]

Around every bend, someone is going to tell you that you suck or aren't good no matter what your talents. I would try to glean whatever lessons you can learn from the evaluation because sometimes people do offer valid criticism and we want to deny it. In your case, it sounds like you were blistered, and I do not know how much you could glean from such an evaluation. I would ask the attending how you could improve and to justify the comments politely (was it your efficiency, assessment/plan, confidence level)?

In the future, I would try to get feedback from the attending(s) you work with at some mid-point (just like in medical school). I've seen even a chief resident do this with the attending, which illustrates the point that no matter how much experience one accumulates, you can still learn to improve and be better. We all have our weakness!


Best wishes

 

[Acherona]

I did an ID rotation as an MS4. After the first day the attending started telling me how I was a terrible student and should watch out because I might fail the rotation. He was very aggressive and abusive with me. I went right away to the rotation director because this was my last requirement for med school and he was like oh yeah that attending has a personality disorder, and let me switch to another service. As an MS3, one month I'd be told I didn't know how to generate a differential to save my life, or my knowledge was poor, and the next month my differentials were amazing, my knowledge was superior...basically it's all BS. Many times I had no idea what was coming good or bad. Evals are based on either personality or very limited contact/information and are pretty useless most of the time esp since ppl are forced to complete them and make something up if they have nothing to say. If you're getting the exact same comment more than a couple times there's probably some truth to it, otherwise just ignore it and do your job.

 

[RegularNihilist]

The "functions at the level of an M-3" comment reminds me of something similar I got from a Vascular Surgery attending. As an intern, he commented that I functioned at the level of a 4th year medical student. I was appalled and upset as all my other evals had been decent.

I am glad you were subjected to such a low-life scum. I am not gonna rationalize and claim it did you any good, but it might just have done everybody in contact with you a great favor. Imagine you having no experience giving you a platform to build sympathy with those subjected to abuse of superiors. I'd bet you would have turned into one of those very intelligent, arrogant and authoritarian scumbags commonly encountered on the top of the medical food chain. Maybe you'll still reach the top, and if you do, somebody should send a "thank you" note to all the abusive persons you have had to put up with.

 

[DarthNeurology]

I am glad you were subjected to such a low-life scum. I am not gonna rationalize and claim it did you any good, but it might just have done everybody in contact with you a great favor. Imagine you having no experience giving you a platform to build sympathy with those subjected to abuse of superiors. I'd bet you would have turned into one of those very intelligent, arrogant and authoritarian scumbags commonly encountered on the top of the medical food chain. Maybe you'll still reach the top, and if you do, somebody should send a "thank you" note to all the abusive persons you have had to put up with.

I think that abuse begets abuse. Meaning that being mean and abusive to people just makes them mean and abusive. It's like being in the army and your drill sargeant yells at you nonstop, when you're the drill sargeant you will yell at everybody too.

Believe me, I was around *a lot* of abusive people in medical school, and it breaks your heart and changes your personality in abnormal ways. Take anyone who has been really abused and they would more likely than others want to really give it to subordinates when they are an attending.

Same thing with arrogant attendings, one guy who emotionally and even physically abused me blabbed about how much attendings hated him. This guy was a real low life who got his thrills by being *very* mean and controlling to medical students. I think he just passed away, but nonetheless I would like to dig up his body, clone him, and kill all of his clones (joke for dramatic flare).

Abuse sucks, it doesn't make nice people at all. Attendings who were abused think that abuse and harassment is No Big Deal. If an attending actually had a relatively good residency and medical school experience, then why would they start abusing people?

Just like a patient who has a seizure and it is often said that seizures begets seizures, same thing with abuse. The really malignant and abusive places produce malignant residents and attendings.

I don't think that Winged is "better" as a person for getting an unfair evaluation. What does this say? Its says that the evaluation of medical students has a lot of bias, is not fair at times, and that there are backstabbers in medicine who feel entitled to write whatever they want in an evaluation. Not a rosy picture. Just a depressing part of medicine that saps people's strength and time when they should be worrying about treating patients.

How would you like to be a very sick patient in the hospital and find out that the attending taking care of you was "feuding" with the residents and students?? I have seen patients in outpatient clinics have to put up with abusive attendings who complain about residents/students in front of them all the while their clinic visit misses important things and everything is put off until next time. Abuse does impact patient care to one extent or another.

Something tells me that Winged would be a "nice" or even "nicer" attending it she was treated with more respect as a student/resident. Face it, if the system is intent on emotionally breaking you, then sure thing a crappier product is produced by schools and residency programs.

While we all want good constructive feedback, residency programs and medical schools need to realize that attendings don't teach as well as they used to, the best attendings I have seen all retired over five years ago. Present day attendings sort of assume that students and residents will teach themselves and residency training and clerkships are not as rigorous as they once were. Not being able to present patients is a lack of experience more than anything else. Being assertive and seeing as many patients as possible helps some.

 

[RegularNihilist]

Great post. I understand what you are saying, and maybe you are right, but I believe that I am as well, for a subset of the student population.

People in general have sympathy and act nice to ppl they can associate with. If you are a fatso, you would be less inclined to resort to stupid notions like "free will" and poor strength of will, to explain obesity. You might not feel an urge to explain how stupid the patient is, that can't lose a few pounds, and the same goes for smoking. If you have suffered from hypochondria, and maybe throw in some anxiety + adjustment disorder as well, you might gain some insight in the emotions of others going through the same, and thus feel that you are making a difference by choosing your words wisely, and being less accusive, when talking to similar patients.

Maybe there is a difference in having been abused, and then having received good/great evals as well. I would suspect that somebody who have survived the rollercoaster, and is pleased with life in general, would be less occupied with showing the world how miserable she is herself, by paying it back.

Another thing to consider, is that medicine is an area littered with ambitious people, and among these fellas, you are likely to encounter a lot of individuals that are textbook examples of nice, lovable narcissists. They will definitely not be any nicer to people in general, merely by being buttered by their attendings. If anything, they will just grow more arrogant, more despicable, more condescending. I'd rather see these guys fail, and fall down in that black hole of their narcissistic depression, lol. (Ooops, I guess that kinda gives support to your theory. ) 😀

 

[DarthNeurology]

Great post. I understand what you are saying, and maybe you are right, but I believe that I am as well, for a subset of the student population.

People in general have sympathy and act nice to ppl they can associate with.

Maybe there is a difference in having been abused, and then having received good/great evals as well.

Interesting points, however, I would argue that being abused and receiving great evals aren't two mutually exclusive concepts.

For example, I did a SICU rotation and other surgery rotations and was asked, and willing did, go beyond the call of duty. For an elective I showed up around 4 am (not 6 AM like I supposed to) because I felt obligated to help the surgical interns who probably couldn't make it in internal medicine if they headed that route, and then stayed until 7:30 pm at night. I took a lot of abuse, but helped cover a dozen SICU patients and learned to do a-lines and even ordered ABGs on patients I felt were going down hill. Was I abused? Yes, in that we had to do more than your average medical student, including moving deceased patients and doing scutwork while being verbally abused. However, I got a great eval.

On other rotations you get heavily abused and get a very bad eval. On such rotations you should take the eval with a grain of salt, especially in the case of the attendings like the one that Winged described where they have everybody in their sights. If the attending is a jerk then that is likely the source of the bad eval. It is like those high minded movie critics who slam the major blockbusters that come out. They do it because it elevates them to a higher level.

Heck, Ebert gave E.T. a bad review and the company that makes the M & M's candies didn't want them associated with some wrinkled old outer space alien with a glow stick for a finger so they had to go with Reese Pieces . . . and I think that little movie did OK. Same thing with evals, an attending can say how bad a resident is, but other attendings may love their work and they could go on to be respected in their field. I think a lot of attendings get a power trip by giving really sarcastic and mean evals with little basis in reality.

If you are on a rotation where aren't being harassed daily and abused, and get a poor eval then you need to revaluate and figure out what you did wrong. Hopefully you will improve each day regardless of evals and progress in your education. If you are being abused by an attending who, *wink*, yells at everybody and treats people like cow manure do you really think you can sift through the pile of poo to figure out what went wrong? What went wrong is that the sadistic attending wasn't hugged enough by his mom so he likes to urinate on students, bully patients, and avoid decent behavior like the plague. Insteading of paying $30,000 a year for the privilege of working in a hospital as a "student" and getting enlightening evals from attendings who are figuring out how to get out of medicine while playing mind games with residents, I should have bought a box of fortune cookies to evaluate my clinical skills as at least the person who writes the predictions on those little pieces of paper put more than half a minutes worth of thought into it. Eventually some kicked around medical student is going to hang himself/herself to escape the harassment and abuse, and sure enough some attending at his school will criticize him for not properly hanging himself if his rope breaks. I thought about doing this myself on a tree near the front steps of my school, with a nasty note taped to my chest about how much I hated the abuse, but I knew that invariably somebody from the schools' administration would point out a typo in the note and conclude that I wasn't serious about the whole thing even though my corpse would be hanging outside their window. I am surprised that when I go into a restaurant some sadistic attending doesn't watch what I'm ordering and then tell me what a crappy selection I made. I was depressed on one Valentine's Day (without an S.O.) and I was sitting in this food court in this mall and this SOB professor from medical school and his wife comes up to ask me what the hell I am doing not studying and then walks away. Somebody needs to tell these people that constant dribble of criticisms that flow out of their mouths is as meaningless as when I take a piss on a plant outside. Attendings who harass medical students should have to perform an "oral debridment" on festering surgical wounds, meaning that they get their face in there and lick it all up. Some attendings should be good at this as many are lifeless leaches with no lives of their own who subside by destroying whatever happiness medical students and residents can find in their lives. I'd love to visit some of the attendings who abused me years later, and tell them how piss poor of a job they are doing keeping their yards clean, then I would report them to the city for thousands of dollars in fines for not having their grass cut to the proper length, after this I would get the city council's permission to install a traffic camera on my car's hood and follow them when drove so that each day I could hand them hundreds of dollars in parking tickets and traffic violations, then I would show up at their funerals and give an uninvited speech to their families about how they treated students and residents like crap and how this must mean that they are in a much warmer place right now.

I can see what you are saying about some medical students being "narcissistic", but then again if you are heading into the medical profession you should be confident that you can become a great doctor. Most medical students are, and should be, confident in what they are doing. I think some attendings mistake this for narcissism and feel that it is important to break down medical students who are confident or even just happy. I have seen this happen and some attendings *want* students to have a hard time emotionally dealing with their personality disorder.

Thing is that this produces tons of medical students who are *less* confident in their abilities. I think this is a bad thing. It used to be that medical students weren't shown their grades in classes until they graduated, or something like that. It was done for a reason, and that reason was that it isn't good to "doctor bash" and destroy the confidence of medical students.

The medical profession has become much more automated and less humanized over the past decade, the result is that attendings and residents have more time to treat their subordinates like whipping boys and girls.

 

[notinkansas]

I got several evaluations that were subopitmal. Nobody ever talked to me about the problems before the rotation was over. Some of them graded me below my peers for things that don't matter... like seeming tired all the time, or not liking my voice (that last one was a major WTF moment)

On the other hand, I had an equal number of very glowing evaluations.

I think it's very common in medicine to get surprise bad evaluation. It's helpful to make subtle inquires about the attending involved. For example, one vascular surgery attending, turns out, never gave a good evaluation to a female..

Unless your PD tells you that you risk being held back, I wouldn't worry about it too much. Look for things that are valid to try to improve. And realize you can't please everybody

 

[NotAProgDirector]

I hate to be the party pooper here, but perhaps the OP's performance in the ED really was sub-par. They admitted up front that their first rotation didn't go well. It's possible that they did equally poorly in the ED. The problem would then not be that some attending was a jerk and just gave them an unfair, low evaluation, but instead that the evaluation accurately reflected their work performance but that they did not receive effective feedback during the rotation. This is a common problem in residency programs, and in the ED specifically:

1. The OP is likely a visiting intern in the ED (i.e. may not be in an ED residency). IN that case, the ED staff may not feel it is their problem to deal with this, simply let the person skate by, then fail them.

2. In the ED residents do not usually work with a single faculty. INstead, they rotate around on shifts with multiple faculty. It is difficult to give feedback to someone when you only work with them for 8-12 hours.

3. In the ED, workload is often defined by the individual. You "sign up" for cases, and you can do so for as many or as few as you want. Some sign up for very few, do a good job with them, but are then failed for not pulling their weight.

4. Sometimes cases are handed out by triage. In that case, a poor performer can be given all of the easy cases, and then potentially failed because of an inability to handle the occasional complex case.

5. Many faculty are uncomfortable giving serious contructive feedback. In addition if a resident is very far behind the curve, many faculty feel there is "no good way to start". In those cases, I usually hear "the 3rd year student is better than this intern". I just heard that this AM (luckily not one of my stellar interns, but one rotating from another program)

6. Some residents, when given feedback, do not pick up on the fact that the feedback that they are getting is negative. For example, I told a med student once that I was "concerned about their ability to present a case coherently on rounds" and that they needed to "focus on the basics, get the story together" and that I would reassess them tomorrow. The next day, similar disaster on rounds. I spoke to the intern the next day and asked them "please tell me what I told you yesterday and what it meant" and he said "You said I was doing a fine job, and if I make my presentations better I'll get an honors grade." So, I tried feedback again, this time saying: "Your current performance will earn you a grade of fail." That got through. The point is, I tried to be nice / soft / caring when delivering the feedback, and the student completely missed the seriousness of the issue. Perhaps that was my fault, but most people would have seen my disappointment with their performance the first time.

 

[DarthNeurology]

The problem would then not be that some attending was a jerk and just gave them an unfair, low evaluation, but instead that the evaluation accurately reflected their work performance but that they did not receive effective feedback during the rotation. This is a common problem in residency programs. . .

In addition if a resident is very far behind the curve, many faculty feel there is "no good way to start". In those cases, I usually hear "the 3rd year student is better than this intern".

The problem with presenting cases is that every service has their own ways to present cases, from IM to Ob/Gyn to Peds. Personally I have always felt that ER cases are the easiest to present, quick HPI, Med Hx, . . . invariably the ED attending stops you when he or she feels that they have heard enough.

Most med students will get creamed on a new service for presenting patients in a manner unlike what their attendings wanted.

If nobody cares to help you learn how to present patients then you won't pick up the style of the ED or whatever and perhaps get a failing grade, however, this isn't based on a lack of clinical skills or communication abilities, IMHO, just that attendings sometimes take a couple weeks off from teaching and then feel they have to "fail" their students.

While APD appears to do a lot of good things education wise, there is nothing more disheartening that hearring an attending just say "Your presentation style sucks, make it better or else I will fail you." Please, where are the specifics. By the time someone finishes a couple years of residency, presenting patients should be old hat.

One attending I had trouble presenting with told me how to present, I wrote it down, and used that format, but it still wasn't what he wanted as he changed the format later on. In the end he was just annoyed with me, . . . if attendings get annoyed with you then the code for that is "your presentation style sucks."

Look at APD's student who was apparently to thick headed to change presentation styles, not very flattering for the student. I think most, if not all students want to learn to present properly, and just telling someone to change their presentation style without saying what is wrong is not good teaching IMHO. This is why ALL teaching on the wards is piss poor, you would learn more reading a journal article than trying to learn the intricacies of presenting to an attending you will never work with again, but of course we all have to play this game of learning how to please certain attendings.

In the end you need to choose a style that is coherent and consistent for yourself. Presenting is best learned, IMHO, by watching residents do it, and early on it can be a hard skill to learn, whereas later if you build up a super big fund of knowledge then it is a breeze.

It is a big problem when attendings refer to student's presentations as "disasters" on the wards, this seems overly hysterical, most students do OK presenting and have all the information but need to reorganize it and learn what is pertinent and what isn't. In the end attendings are a little to entitled when it comes to having students present cases to them in a certain way that the students may have to unlearn for the next rotation. It is like telling the king what happened outside the castle and the king gets all pissed off as the servant (student) isn't telling them the details in the manner that is most pleasing to them.

I think in the future we will all have iPads and simply look at a printed version of the patient's chart, not much presenting, but more reading and reviewing. Oral communication is good for quick assessments and changes in management, but presenting a whole patient? Medicine is still stuck in the middle ages.

 

[Winged Scapula]

I am glad you were subjected to such a low-life scum. I am not gonna rationalize and claim it did you any good, but it might just have done everybody in contact with you a great favor. Imagine you having no experience giving you a platform to build sympathy with those subjected to abuse of superiors. I'd bet you would have turned into one of those very intelligent, arrogant and authoritarian scumbags commonly encountered on the top of the medical food chain. Maybe you'll still reach the top, and if you do, somebody should send a "thank you" note to all the abusive persons you have had to put up with.

I don't think that Winged is "better" as a person for getting an unfair evaluation. What does this say? Its says that the evaluation of medical students has a lot of bias, is not fair at times, and that there are backstabbers in medicine who feel entitled to write whatever they want in an evaluation. Not a rosy picture. Just a depressing part of medicine that saps people's strength and time when they should be worrying about treating patients.

Something tells me that Winged would be a "nice" or even "nicer" attending it she was treated with more respect as a student/resident. Face it, if the system is intent on emotionally breaking you, then sure thing a crappier product is produced by schools and residency programs.

Maybe there is a difference in having been abused, and then having received good/great evals as well. I would suspect that somebody who have survived the rollercoaster, and is pleased with life in general, would be less occupied with showing the world how miserable she is herself, by paying it back.

I'm not sure how this became about me. My point to the OP is that many of us receive unfavorable evaluations along the way; usually (at least for those of us who complete residency) mixed in with great and average evals. Was the OP deserving of his evaluation? I, nor anyone else, has any way of knowing, although I did miss that he did poorly his first month as an intern as well (which may indicate a pattern of behavior). I simply wanted to point out that there are some attendings who are well known to dole out unfavorable evals - mind you, in my case, this was the same rotation in which the Chief of Vascular Surgery gave me a largely positive eval (with a few, "you could improve on X" comments as well). Perhaps I am wrong in the OP's case and his performance really was subpar, but I do not believe that every resident that gets a single poor eval is deserving of such.

Furthermore, I find it rather amusing that two posters, one recently a member 🙄, discussing what I am really like in person. Rest assured I am happy with my life and that I have certainly reached a level of professional success, despite being a nice guy. Yes, some attendings in my residency program were less than pleasant; there was daily humiliation on some rotations, and after 2003, daily work hour violations. Did it make me "less nice"? I doubt it. I had the relative advantage of attending medical school and residency well after personality is believed to be fully formed. I might have emerged depressed, and looking a little worse for the wear, but most of my friends would not say that my personality has changed. Several SDN members who know me IRL and have rotated with me as students or residents, can also attest to that.

In terms of abuse begetting abuse, that is certainly true in some situations. However, being raised in a very traditional military home (ie, unavailable critical father, distant, narcissistic mother), joining a sorority during college and then doing a general surgery residency, I can tell that you some of us, come through those experiences not with a need to abuse others, but rather empathy and the ability to break those patterns.

It would also do the users a world of good to not assume their program is representative of such programs around the country or world. Darth clearly had a negative surgery experience and it has colored his feelings about the field and its practitioners. I know those programs exist. However, I had a negative Pediatrics experience during medical school - but it didn't color my feelings about Pediatricians or the field wholesale. For some reason I see SDN users broadbrush their experiences into those of all students and residents. Probably normal, but it should be recognized for what it is...a sometimes inappropriate extrapolation of experiences.

Perhaps the comments above weren't meant to be personal, but they came off as implying that I am "occupied with showing the world how miserable am" and unpleasant to be around. There is no role for such comments directed at individuals here. I can think of several SDN users much more prone to such occupations than I.

 

[DarthNeurology]

I'm not sure how this became about me.

Furthermore, I find it rather amusing that two posters, one recently a member 🙄, discussing what I am really like in person. Rest assured I am happy with my life and that I have certainly reached a level of professional success, despite being a nice guy.

I can tell that you some of us, come through those experiences not with a need to abuse others, but rather empathy and the ability to break those patterns.

Darth clearly had a negative surgery experience and it has colored his feelings about the field and its practitioners.

My surgery experience was actually pretty good in the SICU although I was abused, I got a good evaluation which pleased me because I was able to *serve* the surgery service and residents. I don't mind being abused for a good reason. At least I understand surgeons and the stresses they are under. I would do my SICU rotation again even if yelled at and made to work extra hours as it was a good learning experience and I was *used*, just like that commercial for the yellow pages. I DO respect surgeons and probably would have done a general surgery residency if I could have. . . I even bought swartz just for an elective and read some of it in addition to other surgical books so i'm not adverse to surgery.

My Ob/Gyn experience sucked as I was abused and got a bad eval but most importantly I was made to feel like I wasn't helping out even though I tried very hard to do so. Some residents loved the extra help but if you piss off the clerkship director you are screwed.

I think that Winged understands my point as while some people can rise above abuse, there is a viscious cycle that must be broken. Parents who were abused themselves as children are more likely to become abusers of their own children when they grow up. Sure, some of us can rise above the abuse, but personality is a lot more plastic and flexible than psychologists have believed over the years, there may be subconscious effects related to abuse as well. Children who grow up being abused believe that abuse is "normal." Same thing with abused residents and medical students who subconsciously learn that abuse and harassments of medical students is normal.

I don't need to imagine what Winged is like in person as I saw her giving a talk to students once, WAY too fast talker Winged, but overall seemed like a chipper person and very in love with surgery. Didn't mean to make this whole thread all about you . . .

 

[Winged Scapula]

I don't need to imagine what Winged is like in person as I saw her giving a talk to students once, WAY too fast talker Winged, but overall seemed like a chipper person and very in love with surgery. Didn't mean to make this whole thread all about you . . .

Really? PM me about that, as I have never been told previously I talk too fast and I don't recall giving a student lecture recently. Sure it was me? 😕

If it was, I'll take your advice to try and slow down. And yes, perhaps I confused your Ob-Gyn with your Surgery experience.

 

[dragonfly99]

OP, sorry that you got a bad evaluation.
I think that in these cases you do have to take it with a grain of salt. There is definitely a lot of subjectivity in evaluations.

Sometimes the bad evaluation means that they just don't like your style of presentation. Often they will interpret this as a general lack of knowledge or not being organized, if you aren't presenting the patient like the attending(s) wanted. We all know that there is much more to patient care than some 5 minute oral presentation, but that is what attendings see of you when you are an intern, so it becomes very important.

I do think it would be helpful to ask around (if you can do so safely... i.e. to another intern or PGY2 you can trust not to blab) and see if this particular attending just gives a lot of bad evaluations. If so,then the problem may not be on your end.

If you can stomach it, it may be helpful to go back and talk with either the attending for your 1st month and/or a couple of the ER attendings who seem fairly friendly and just see what feedback they have for you. Some of it may be unwarranted but you are likely to get some helpful advice as well. At the least, you force them into the position that they have to give you specific feedback, and then if your program director brings up any of these issues later, you can come back to him and say that you went back and spoke w/the attendings because you wanted to get constructive feedback so you can improve.

And don't get too discouraged...it's only a couple of months into intern year. Things will probably start getting easier before you know it...but don't slack off yet. Just work really hard the next couple of months and try to kiss up a bit to the attending(s) you work with, and see if that helps.

 

[ozzidoc]

Really? PM me about that, as I have never been told previously I talk too fast 😕

Speaking quickly is an Australian thing 😉

 

[Winged Scapula]

Speaking quickly is an Australian thing 😉

Perhaps, but it turns out it *wasn't* me that Darth saw giving a lecture.

 

[Moonglow]

Perhaps, but it turns out it *wasn't* me that Darth saw giving a lecture.

Being thought of as a "chipper person" tipped you off that Darth identified another surgeon? 😀

 

[Winged Scapula]

Being thought of as a "chipper person" tipped you off that Darth identified another surgeon? 😀

😀

Ha ha...no, that made me think it *was* me, as I am often described as chipper (except when I'm not).

No, it was the location and date of the talk; a place I've never been and at a time before I moved to town.

 

[sluggo]

Let me tell you what is important in medicine:
1. Integrity
2. Compassion for your patients
3. Work ethic
4. Knowledge
5. Clinical judgment

Focus as hard as you can on these 5 things. Evaluations are important to the extent that they guide your focus on these 5 things. The rest is background noise.

 

[psychforme]

2. Compassion for your patients

I wish more people would focus on this instead of focusing on "Compassion for your wallet."

 

[maceo]

Sometimes you don't see it coming.

Do yourself a favor, if you have any friends or confidants in the program, ask them about this specific attending.

The "functions at the level of an M-3" comment reminds me of something similar I got from a Vascular Surgery attending. As an intern, he commented that I functioned at the level of a 4th year medical student. I was appalled and upset as all my other evals had been decent.

Then I started asking around. The Vascular fellow called this attending "the Cheshire Cat" - he will smile at you and praise you, all the while stabbing you in the back. The next year, an intern, who had been a medical student at that school and had become a good friend of mine, was also reviewed by this attending. His eval? "X functioned at the level of a 3rd year medical student." She told me not to feel so bad, since I was at 4th year medical student level.

But the point was that there are some attendings that will skewer you, and never give you input along the way. Its unfair but it happens. More importantly though, your faculty is likely to know who does this routinely. We had surgery attendings who gave everyone great evals and some who gave everyone ****ty ones. If this is an off-service rotation for you, it may be that your faculty doesn't even care what this SOB has to say about you.

So try not to let it bring you down. I'll bet that this attending has bad things to say about almost everyone if you ask around. If you want to know more, try approaching him and asking:

1) if I was doing so poorly why didn't I get any mid-rotation feedback. Faculty is *supposed* to provide this to prevent residents and students from not having a chance to improve.

2) what specifically were the problems and how you improve your performance, and become a better physician?

While it may not change his eval, on the off chance that you did function poorly, it will give you more insight and make future rotations, on all services, better.

i agree when i was a third year medical student on neurology for four weeks. the third week the attending saw me late at night and said you are doing a great great job and shook my hand. Then come evaluation time he literally hosed me to the poinnt i almost failed the rotation.

 

[RegularNihilist]

I wish more people would focus on this instead of focusing on "Compassion for your wallet."

If ppl see a doc regularly that has a focus on her wallet that compromises the focus on the patient, then they are stupid, and don't deserve anything else.

There is a very sickening notion that doctors ought to be martyrs in some sense, or for some dubious reason, choose options that are not the most lucrative ones. If I am crucified for arguing with a superior about the best treatment for a patient, then it is highly rational to just don't care, and go with the option that proves least likely to result in loss of right to practice medicine. This is how the world works, and you fools attribute the responsibility of a change to individuals. Consequently, I love to see you punished with bad care for it. Change has to come from another system that results in a new game. Change dependent on individual crucifying is sickening, according to my subjective sympathies.