Bizarre Medical Student

[Redpancreas]

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Update: Called into meeting with clerkship director of the medical student rotation and my associate PD during working hours. I was super scared and was very tight-lipped initially. As the conversation progressed, it was clear that they were not worried about anything I did, but were seeking to find any information I had and offered at one point we want to know if there are any issues. I shared everything I had. The student is still not back on rotations per a colleague whose rotation he was supposed to be on. I no longer have regrets.

 

[Matthew9Thirtyfive]

Update: Called into meeting with clerkship director of the medical student rotation and my associate PD during working hours. I was super scared and was very tight-lipped initially. As the conversation progressed, it was clear that they were not worried about anything I did, but were seeking to find any information I had and offered at one point we want to know if there are any issues. I shared everything I had. The student is still not back on rotations per a colleague whose rotation he was supposed to be on. I no longer have regrets.

You did the right thing. That guy was a dead or injured patient waiting to happen.

 

[Goro]

Update: Called into meeting with clerkship director of the medical student rotation and my associate PD during working hours. I was super scared and was very tight-lipped initially. As the conversation progressed, it was clear that they were not worried about anything I did, but were seeking to find any information I had and offered at one point we want to know if there are any issues. I shared everything I had. The student is still not back on rotations per a colleague whose rotation he was supposed to be on. I no longer have regrets.

It sounds like someone got a suspension, or is on rotation elsewhere so that his clinical faculty could keep a closer eye on him.

If said student was a problem student with a warning that further nonsense would lead to a dismissal, then dismissal is also a possibility.

 

[ArteryStudyPainting]

Guy sounds like the kinda guy who would aggressively take the tube from anesthesia in a trauma and then try to back up his reasoning some-how.

 

[Lawpy]

Guy sounds like the kinda guy who would aggressively take the tube from anesthesia in a trauma and then try to back up his reasoning show-how.

This gives me nightmares

 

[fluorescent colors]

OP like you know I am sure, you should forward your concerns over to whoever is concerned with Medical student education. Also, you should beware of inadvertently doxxing yourself given the specifics surrounding these situations, and how recent they are.

You could bring it up in a non confrontational way with the student first. If he doesn't change, bring it up with the clerkship director of the rotation that you are currently on.

 

[ArteryStudyPainting]

This gives me nightmares

"I noticed you weren't holding the tube correctly!"

 

[flasheroonie]

Some students need feedback on their behavior. I hope he got some from someone responsible for his education.

 

[Ganon]

Guy sounds like the kinda guy who would aggressively take the tube from anesthesia in a trauma and then try to back up his reasoning show-how.

wh....what

 

[junky372]

Now... here is a side effect of this thread - it got me really worried about my rotations in the future. What if I do something in good faith and someone up the chain will not like it and "report" it?

I wouldn't worry about good faith mistakes. After 4 months of rotations, I've definitely made a few - residents and attendings do not expect you to be perfect. As long as you make it clear that you're trying to do what's in the best interest of the patient and the team, taking appropriate amounts of responsibility as a learner, and are a trustworthy reporter of information (e.g. don't lie, don't fib if you didn't ask about something that they're interested in, and accurately report objective findings) then you'll be fine. Otherwise, don't try to take titles you don't have, don't contradict your team/consultants, and let your team deliver important news (e.g. cancer screening results, major diagnoses) if possible, though this may be institution/specialty/attending specific.

I've had patients tell me one thing and then tell the intern/resident/attending something wildly different - that's to be expected and just about every one of your supervisors have had that happen to them when they were students/trainees.

 

[7331poas]

You know what really pisses admin off? When a problem student flies under the radar until right before graduation because no one had the guts to say anything.

Admins dont care about poorly preforming medical students. They only case about the "risk management" of having a visibly poor medical student walking around harming patients.

 

[Goro]

Admins dont care about poorly preforming medical students. They only case about the "risk management" of having a visibly poor medical student walking around harming patients.

Maybe at your school, but at mine, we do not want students to end up having 2-4 years of debt and not being able to be doctors. So we invest a lot of effort into making them adequately performing students.

At the same time, students who are unteachable in rotations, or are chronically unprofessional we jettison. It's not a perfect process. Our all time worst student is a PGY3 now, probably killing patients somewhere on the East Coast.

 

[Med Ed]

Admins dont care about poorly preforming medical students. They only case about the "risk management" of having a visibly poor medical student walking around harming patients.

We usually don't admit them if they come poorly preformed.

 

[7331poas]

Maybe at your school, but at mine, we do not want students to end up having 2-4 years of debt and not being able to be doctors. So we invest a lot of effort into making them adequately performing students.

At the same time, students who are unteachable in rotations, or are chronically unprofessional we jettison. It's not a perfect process. Our all time worst student is a PGY3 now, probably killing patients somewhere on the East Coast.

We usually don't admit them if they come poorly preformed.

They will become doctors. They slip through with passes and land in a low competitive specialty. The school scrubs the MSPE to look good, a common practice among medical schools these days. We have a student just like the OP at our school.

 

[Lawpy]

Wait was there an update to the situation?

 

[Goro]

Wait was there an update to the situation?

Student has apparently been pulled off all rotations. Not a good sign.

 

[deleted50541]

Maybe at your school, but at mine, we do not want students to end up having 2-4 years of debt and not being able to be doctors. So we invest a lot of effort into making them adequately performing students.

It was the same at mine. My school made a lot of effort to help those students who were struggling including assigning them a faculty member for one-on-one remediation during the pre-clinical years. Most of the washouts occurred during those first two years and it was rare to have major issues arise by third year.

Out of about 140 students in my class, roughly 10% ultimately did not graduate. The majority of those folks struggled with pre-clinical work and did not progress to the final two years. Others realized medicine wasn't right for them and chose a different career. One woman even made it to fourth year, but ultimately decided medicine wasn't for her, along with other personal reasons for leaving.

 

[Redpancreas]

Update: Student dismissed. A few years ago I would have said that's a bit harsh but I've seen more discipline for far less and frankly this dude seemed to be causing problems all over the place. We seldom get a chance to make real differences even in medicine. Feels great to know me speaking up probably screwed up someone's life and this negative act probably outweighs any good I may have done for my patients this year. I just don't know what's right or wrong anymore.

 

[Osteosaur]

Update: Student dismissed. A few years ago I would have said that's a bit harsh but I've seen more discipline for far less and frankly this dude seemed to be causing problems all over the place. We seldom get a chance to make real differences even in medicine. Feels great to know me speaking up probably screwed up someone's life and this negative act probably outweighs any good I may have done for my patients this year. I just don't know what's right or wrong anymore.

I am super curious if it's just the one incident (the consult), simply a lot of bad behavior adding up, or if something else happened...

 

[Lawpy]

Update: Student dismissed. A few years ago I would have said that's a bit harsh but I've seen more discipline for far less and frankly this dude seemed to be causing problems all over the place. We seldom get a chance to make real differences even in medicine. Feels great to know me speaking up probably screwed up someone's life and this negative act probably outweighs any good I may have done for my patients this year. I just don't know what's right or wrong anymore.

Wow! Well good on your program and school for taking that move.

You did the right thing.

 

[wholeheartedly]

I am super curious if it's just the one incident (the consult), simply a lot of bad behavior adding up, or if something else happened...

in my experience there’s usually at lot more to the story than any one individual is aware of.

 

[Lawpy]

I am super curious if it's just the one incident (the consult), simply a lot of bad behavior adding up, or if something else happened...

Iirc there were like 3 instances presented in this thread alone + probably others too. It's very very likely a pattern of increasingly problematic behavior that compelled the school to take this action. OP did the correct and necessary thing of speaking up and this is 100% not his fault.

 

[Redpancreas]

I am super curious if it's just the one incident (the consult), simply a lot of bad behavior adding up, or if something else happened...

Apparently my thing was one thing, but there were other things immediately afterwards and looking back there were apparently some other things. He wasn't harming a patient literally but like IDK, it was just weird. I don't even see the reason behind it. For some issues with unprofessionalism I get it. If you're late you don't respect others time and prioritize other things like sleeping in. For this, I don't know why he felt the need to talk crap about residents/attending physicians to patients behind our backs, tells patients their dogs needed to be euthanized without even so much as asking (the average medical student will ask 100X before having that discussion), or get in the way with consultant politics.

 

[deleted50541]

Update: Student dismissed. A few years ago I would have said that's a bit harsh but I've seen more discipline for far less and frankly this dude seemed to be causing problems all over the place. We seldom get a chance to make real differences even in medicine. Feels great to know me speaking up probably screwed up someone's life and this negative act probably outweighs any good I may have done for my patients this year. I just don't know what's right or wrong anymore.

Dismissed how? From the rotation or from school?

Sounds like a case was building against him for a while. You did the right thing. Medicine is a team sport and this guy did not understand the rules.

 

[Mass Effect]

Update: Student dismissed. A few years ago I would have said that's a bit harsh but I've seen more discipline for far less and frankly this dude seemed to be causing problems all over the place. We seldom get a chance to make real differences even in medicine. Feels great to know me speaking up probably screwed up someone's life and this negative act probably outweighs any good I may have done for my patients this year. I just don't know what's right or wrong anymore.

You did the right thing. You never know what's in a student's background. Your complaint may have been the straw that broke the camel's back and if that's the case, then maybe the student deserved to be out. Or maybe something happened after your complaint.

 

[Matthew9Thirtyfive]

Feels great to know me speaking up probably screwed up someone's life and this negative act probably outweighs any good I may have done for my patients this year. I just don't know what's right or wrong anymore.

What? Dude you did the right thing. That guy was going to hurt people. You might have prevented another Christopher Duntsch for all we know. What you did is what we’re supposed to do. I know it sounds hippy dippy, but that’s the pact we have with patients. That we’ll police ourselves.

 

[Redpancreas]

What? Dude you did the right thing. That guy was going to hurt people. You might have prevented another Christopher Duntsch for all we know. What you did is what we’re supposed to do. I know it sounds hippy dippy, but that’s the pact we have with patients. That we’ll police ourselves.

What? Dude you did the right thing. That guy was going to hurt people. You might have prevented another Christopher Duntsch for all we know. What you did is what we’re supposed to do. I know it sounds hippy dippy, but that’s the pact we have with patients. That we’ll police ourselves.

Yeah I know that’s the right answer and I’ll try to convince myself that in the long term that I was saving some patient but was I? What harm could have actually come to patients? I feel bad for his dad. I saw a note he wrote from another hospital and it was actually quite good.

 

[Ganon]

What a saga

 

[mrbreakfast]

What harm could have actually come to patients?

I think this student's dismissal was not a preventative measure for now, but for two years from now. Overconfidence as a resident leads to patients dying. The scariest junior residents to work with aren't the dumb ones, they're the ones who think they can't make a mistake and don't double check anything a more senior physician. This student is already demonstrating recklessness as an M3; it'll only get worse.

If it's any consolation, the student was probably not dismissed due to your report. Your report was probably slid somewhere in the middle of the large file of a student who was already on thin ice. The single student who was involuntarily dismissed from my med school class was dismissed after repeated formal warnings over several years, including being held back a year, without a change in the student's attitude.

 

[Matthew9Thirtyfive]

What harm could have actually come to patients?

Um, death. This is a Christopher Duntsch in the making. He might not have been able to hurt people now, but he absolutely could have—and very well may have—hurt people in the future. This reluctance we feel to get people in trouble is how they get pushed through. We are supposed to police ourselves to protect patients from bad doctors. It only works if we do what you did.

 

[spottedpothos]

Um, death. This is a Christopher Duntsch in the making. He might not have been able to hurt people now, but he absolutely could have—and very well may have—hurt people in the future. This reluctance we feel to get people in trouble is how they get pushed through. We are supposed to police ourselves to protect patients from bad doctors. It only works if we do what you did.

Well said.

 

[Mad Jack]

I mean he’s telling patients their dogs will have to be euthanized and making inappropriate calls to consultants and incorrect info to patients. That’s grossly inappropriate. You’d probably fail a rotation here for doing that.

100% would fail a student for doing stuff like this. He's upsetting patients and disrupting care, and generally being a legitimate nuisance to the service and patients

 

[Mad Jack]

Now... here is a side effect of this thread - it got me really worried about my rotations in the future. What if I do something in good faith and someone up the chain will not like it and "report" it?

I've reported and failed zero students and have worked with at least a hundred at this point. Even the weird ones it's just like, eh, that guy's a little weird and has his quirks but whatever, you do you my guy. I've never had someone tell my patient that they were going to euthanize their dog, that's just psychopathic, and I've never had a student try to bump up procedures that they have no clue how to schedule or perform, which is just asinine.

 

[Osteosaur]

I've reported and failed zero students and have worked with at least a hundred at this point. Even the weird ones it's just like, eh, that guy's a little weird and has his quirks but whatever, you do you my guy. I've never had someone tell my patient that they were going to euthanize their dog, that's just psychopathic, and I've never had a student try to bump up procedures that they have no clue how to schedule or perform, which is just asinine.

Have the students you've had to fail typically been like this? Actively insubordinate, or being upsetting to patients? What else has warranted it?

Just crazy to me someone would make it this far acting this way.

 

[Mad Jack]

Have the students you've had to fail typically been like this? Actively insubordinate, or being upsetting to patients? What else has warranted it?

Just crazy to me someone would make it this far acting this way.

Read again, my dude. I've never failed a student, because I'd imagine anyone so far out of line was stopped by the meat grinder prior to meeting me

 

[FutureInternist]

Maybe at your school, but at mine, we do not want students to end up having 2-4 years of debt and not being able to be doctors. So we invest a lot of effort into making them adequately performing students.

At the same time, students who are unteachable in rotations, or are chronically unprofessional we jettison. It's not a perfect process. Our all time worst student is a PGY3 now, probably killing patients somewhere on the East Coast.

I have a list of people from medical school all the way up to current colleagues to whom I would never refer a pt.

I actually give a typed up list of rules to students…. And # 1 rule is “Don’t lie”

 

[LunaOri]

Yeah I know that’s the right answer and I’ll try to convince myself that in the long term that I was saving some patient but was I? What harm could have actually come to patients? I feel bad for his dad. I saw a note he wrote from another hospital and it was actually quite good.

I would bet any amount that you only saw the “tip of the iceberg” and there was a whole heck of a lot more problems that led to his dismissal.

 

[NotAProgDirector]

You did the right thing. You should lose no sleep over this.

And, had you not done anything, it is very likely the same result would have happened. Sounds like lots of behavior issues all around. But regardless, you did the right thing.

And it's not like this kid's life is over. They can go and have another career in another field.

 

[Angus Avagadro]

I would bet any amount that you only saw the “tip of the iceberg” and there was a whole heck of a lot more problems that led to his dismissal.

We graduated a guy like that. Always on the edge, multiple complaints. Quite bright, but no filter. Patients, nurses, attending and other med students complained about him. Went to a university affiliate residency, and was asked to.leave. Last I heard was working as a prison Doc. We should have done the right thing. Prisoners deserve better.

 

[mrbreakfast]

Just crazy to me someone would make it this far acting this way.

Lots of residents/attendings don't *really* review students. Honestly, it's hard to pay close attention to more than 1-2 students at a time when you have so much else to do.

I've never failed any students but almost failed a sub-I last year for poor performance. In lower-quality med schools (like the one I went to) people slip through the cracks, however, and it can really happen anywhere. Especially among residents, questionable stuff can often go unreported.

 

[operaman]

Oh wow! Props to the school for cutting this guy loose!

I would also add to the voices in support of reporting this student: remember that dismissal in most places goes through a committee of faculty and other students. These folks got to see the whole file and they decided to show this guy the door. And they did this despite his father being a physician connected with the school, right? Yeah, the reports in this thread were definitely the tip of the iceberg and probably preceded by umpteen written warnings.

Not everyone gets to be a doctor. It’s not all objective and multiple choice tests and eventually real humans have to sign off. And as I’ve learned after going through licensing and credentialing 7 times in the last couple years - they have to keep signing off for the rest of your career.

 

[Lynx zwo drei vier]

I am super curious if it's just the one incident (the consult), simply a lot of bad behavior adding up, or if something else happened...

I'd guess that there've been other problems, and that they were pretty egregious. The misdeeds that OP described sounded so bad that I can't imagine them being de novo behaviors. And in any case, schools will give students who struggle, but are trying in good faith, ample chances to redeem themselves.