Bad shift on away rotation?

[MsFutureDoc123]

Hi everyone!

I recently finished an EM away rotation and overall I think I did well, many of the attendings and residents gave me good comments and my mid-clerkship feedback was positive! However, on one of the last shifts I did before I finished the rotation, I had a really rough shift. This attending pimped like crazy and was very nit-picky during my presentations. When I asked for feedback after the shift, he told me I basically had to work on everything. My histories, physical exam, differentials. While there were certainly points he made on things I can improve on and I want to learn from this, I'm worried about what kind of evaluation he left me with. Is it normal for students to have a bad shift like this? I feel like we are expected to always be the best we can be on away rotations but is it normal to have some days that just don't go well? Thanks in advance!

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[surely]

Hi everyone!

I recently finished an EM away rotation and overall I think I did well, many of the attendings and residents gave me good comments and my mid-clerkship feedback was positive! However, on one of the last shifts I did before I finished the rotation, I had a really rough shift. This attending pimped like crazy and was very nit-picky during my presentations. When I asked for feedback after the shift, he told me I basically had to work on everything. My histories, physical exam, differentials. While there were certainly points he made on things I can improve on and I want to learn from this, I'm worried about what kind of evaluation he left me with. Is it normal for students to have a bad shift like this? I feel like we are expected to always be the best we can be on away rotations but is it normal to have some days that just don't go well? Thanks in advance!

It happens! Don't stress. If that person pimps extensively, they do it to everyone, and the people reading the evaluations to decide what to write in your SLOE will know that evaluator's reputation. One shift won't ruin your career. Hell, matching at the worst program in the country (whatever that means) wouldn't ruin your career. Even not matching may just be a big speedbump, as much as my heart goes out to anyone in that position.

Still wish I could have read my SLOEs, at least after matching!

 

[Birdstrike]

Hi everyone!

I recently finished an EM away rotation and overall I think I did well, many of the attendings and residents gave me good comments and my mid-clerkship feedback was positive! However, on one of the last shifts I did before I finished the rotation, I had a really rough shift. This attending pimped like crazy and was very nit-picky during my presentations. When I asked for feedback after the shift, he told me I basically had to work on everything. My histories, physical exam, differentials. While there were certainly points he made on things I can improve on and I want to learn from this, I'm worried about what kind of evaluation he left me with. Is it normal for students to have a bad shift like this? I feel like we are expected to always be the best we can be on away rotations but is it normal to have some days that just don't go well? Thanks in advance!

It sounds to me like the attending knew it was probably one of the last, if not the last shift he or she was going to work with you, and therefore just blasted you with everything he thinks you need to work on, since he might not get to work with you again. Some will do that. I also see why it would be a little overwhelming. But honestly, I wouldn't stress it too much if you're early in your career. Feedback in person sometimes is more useful than on a sheet of paper you might get a month later, which you'd largely ignore after you've already moved on. Take what portions of the feedback you feel were useful, learn from it and move on. You might be surprised and find out this guy gave you one of your best evaluations. But if he gives you a crappy evaluation, there's a very honest and easy way to counter it. "At that stage in my learning, this attending made some valid points about skills I needed to improve. That's because I had a lot to learn. I learned immensely from that feedback and I feel I'm much better off and have learned a lot from the experience." No one expects you to know everything in medical school and residency, just that you're constantly learning.

I had some very significant weak points early on. Everyone dose. And sometimes some of the attendings you think are most harsh at the time, in retrospect, may have taught you the most. That being said, some attendings are just jerks and teach you primarily about their personality disorders. This guy may have napalmed every other student/resident before you, but that doesn't mean anyone's going to admit it. Which one of these this attending is, an excellent but blunt teacher or simply a jerk, I don't know. It'll become obvious to you, in time. Regardless, it sounds like this attending achieved his goal with this technique: He got your attention.

Bottom line: You survived the month. Your career moves on. And you're one rotation smarter than you were before you started and are most likely doing much better than you think you are. Soldier on.

 

[OnlyOneZlatan]

Hi everyone!

I recently finished an EM away rotation and overall I think I did well, many of the attendings and residents gave me good comments and my mid-clerkship feedback was positive! However, on one of the last shifts I did before I finished the rotation, I had a really rough shift. This attending pimped like crazy and was very nit-picky during my presentations. When I asked for feedback after the shift, he told me I basically had to work on everything. My histories, physical exam, differentials. While there were certainly points he made on things I can improve on and I want to learn from this, I'm worried about what kind of evaluation he left me with. Is it normal for students to have a bad shift like this? I feel like we are expected to always be the best we can be on away rotations but is it normal to have some days that just don't go well? Thanks in advance!

Lol how did we go from having a single bad shift to mentions of not matching? It's one bad shift. Not all attendings are good educators and can pick up on social cues or even understand how to properly provide feedback or manage their baseline terrible demeanor. Maybe it was just them and like previously mentioned, the ones that put together the dept SLOE will probably know the reputation of that attending... But I say all this under the assumption that you're a normal human being and are self-aware, things that we cannot always say about humans in medicine.

 

[Vandalia]

This may be more of an old man's ramblings that a direct response to the original post, but it is worth telling.

During my time in the military, I worked for a general who nitpicked everything I did. Finally, I had enough and went to him and asked if I should be reassigned since he didn't like any of my work. He said, "Sit down. Listen. The reason I am so hard on you is I think you have potential, if I didn't I would completely ignore you."

If you are doing an away rotation, it is tough to interpret the environment and people's motivation. But if someone is taking the time to tell you what needs to improve, at least they are taking an interest in you. I would be far more worried about an attending who didn't say anything, in my opinion, they are simply writing you off.

So if it at least theoretically possible that criticism is a very good thing.

 

[GonnaBeADoc2222]

I had a shift like this during an away rotation at a historically "amazing" program (really, just resting on their laurels from like 30 years ago). Made me feel like s**t. Was worried about evals, grade, SLOE, etc. Thank god I didn't match there. Matched at a far better place.

 

[boomshaketheroom]

This may be more of an old man's ramblings that a direct response to the original post, but it is worth telling.

During my time in the military, I worked for a general who nitpicked everything I did. Finally, I had enough and went to him and asked if I should be reassigned since he didn't like any of my work. He said, "Sit down. Listen. The reason I am so hard on you is I think you have potential, if I didn't I would completely ignore you."

If you are doing an away rotation, it is tough to interpret the environment and people's motivation. But if someone is taking the time to tell you what needs to improve, at least they are taking an interest in you. I would be far more worried about an attending who didn't say anything, in my opinion, they are simply writing you off.

So if it at least theoretically possible that criticism is a very good thing.

Also a sub-plot in an episode of community 😀

But I agree. If that attending thought you (OP) were bad/had no potential I don't think he would waste his time with pimping or in-depth feedback. No one can know everything as a med student. I bet they care more if you seemed like you wanted to be there and were easy to work with.

I had a couple rough shifts during my aways, didn't seem to hurt me in the end.

 

[WilcoWorld]

Vandalia is spot on.

I rarely bother giving critical feedback to med students that aren't good enough to match with us.

 

[LaceyMD]

Hi everyone!

I recently finished an EM away rotation and overall I think I did well, many of the attendings and residents gave me good comments and my mid-clerkship feedback was positive! However, on one of the last shifts I did before I finished the rotation, I had a really rough shift. This attending pimped like crazy and was very nit-picky during my presentations. When I asked for feedback after the shift, he told me I basically had to work on everything. My histories, physical exam, differentials. While there were certainly points he made on things I can improve on and I want to learn from this, I'm worried about what kind of evaluation he left me with. Is it normal for students to have a bad shift like this? I feel like we are expected to always be the best we can be on away rotations but is it normal to have some days that just don't go well? Thanks in advance!

Sounds exactly like the experience I had on my shift a few nights ago. The way I'm choosing to look at it is this - we all have difficult shifts for one reason or another. Maybe your attending was having a bad day, maybe you were, maybe that's just the way he is with students. Overall, if you've had a good experience on the rotation and the rest of your feedback was positive, then a negative evaluation in a stack of positives would likely be viewed as an outlier.

But I definitely feel you on the pressure to be "on" all of the time - it's tough!

 

[Keladry]

Had a horrendous shift with one of the APDs on my away, went home and cried, worried about effects on SLOEs/matching. Don't think it was even mentioned in my SLOE (def never came up during interviews) since it was just the 1 time so they looked at my overall evals and wrote the SLOE accordingly. Matched at my #1. So it happens, and it sucks, and it will not torpedo your chances or ruin your SLOE - that's why they're usually written as a department.

 

[gamerEMdoc]

There are attendings that are easy on students and praise even the worst students. And there are attendings that are hard on every single student no matter how good they are. That’s going to happen no matter where you go. I think students sometimes freak out after working with the tough ones, but also sometimes over estimate how they did based on a few shifts with the easy ones.

Id pay attention to the overall feedback you get (if any) by whoever does the grading because they are the ones who see everyones evals and know the entire story.

Also, I totally agree with the notion that being hard on someone doesnt always mean you are doing poorly. If a student impresses me, I generally push them harder than others.

 

[southerndoc]

I also push students harder and question/critique more if I'm interested in them. If I have no interest in them matching with us, I generally will let them just do their own thing without any feedback or questioning at all.