Classmates you would not refer your family member to?

[Ypo.]

There are people in my class I would not want a family member to see/would not refer a patient to.

I'm sure this happens when you are practicing; you hear about bad experiences from your patients, so you stop referring to so and so.


And before filling out the poll, remember this is not a popularity contest; it doesn't matter if you don't like the person-just if they are ethical, studious, work hard, care for their patient's wellbeing, etc...

P.S. you may fill out multiple options.

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[ChiefToma]

I have to say- at least in my small group of about 24 ( we are in a distributed program in Victoria BC, Canada- based out of the University of British Columbia), I would have no problems sending a family member to any one of my classmates.

 

[ladynice]

The people who are the quickest to find faults in others are usually the most borderline students I've come across. Usually they suffer from fibromyalgia and rant about unempathic doctors and everything you do is proof that you will be a "bad doctor". Also the system and the tests are hardwired to work against them and to promote "bad doctors" who only can read and have no empathy *insert some example of some doctor who didn't prescribe vicodin for their fibromyalgia*.

 

[DrThom]

I wanted to check the option "No, not because they aren't smart but because they have no interpersonal skills and are frequently insulting" but it wasn't there...

 

[Tired]

The people who are the quickest to find faults in others are usually the most borderline students I've come across. Usually they suffer from fibromyalgia and rant about unempathic doctors and everything you do is proof that you will be a "bad doctor". Also the system and the tests are hardwired to work against them and to promote "bad doctors" who only can read and have no empathy *insert some example of some doctor who didn't prescribe vicodin for their fibromyalgia*.

So there's no one in your class you think is too stupid to be a good doctor?

 

[Ypo.]

I wanted to check the option "No, not because they aren't smart but because they have no interpersonal skills and are frequently insulting" but it wasn't there...

Frequently insulting to patients? I know a lot of people who are frequently insulting, but usually they are able to put a different face forward to patients.

At any rate, just check option three or four; don't care/lazy. I think being rude is just a lazy way of avoiding having to use your manners.

 

[Blade28]

Absolutely there were classmates of mine I wouldn't have referred my family members to see, even though I often liked said classmates as friends.

 

[Anka]

A related question (but shut me down if I'm highjacking your thread) -- do you think med schools should be more liberal in failing people who are extremely bad? Maybe not "I wouldn't let this guy see my family" but more "I wouldn't send my worst enemy to see this guy". Should medical schools act as gatekeepers?

Anka

 

[Blondbondgirl]

I think American schools (compared to Germany, which pretty much takes people only based on grades) already weeds out a lot of people who don't belong...

Anka, good question! I have certainly met some docs that I wish had gone into research... (because they are mean) and as far as dumb people go... It's just an international problem , IMHO

 

[Law2Doc]

A related question (but shut me down if I'm highjacking your thread) -- do you think med schools should be more liberal in failing people who are extremely bad? Maybe not "I wouldn't let this guy see my family" but more "I wouldn't send my worst enemy to see this guy". Should medical schools act as gatekeepers?

Anka

As blondbondgirl points out, the admissions criteria are so strict precisely so that schools don't have to later fail people out. In other countries where folks are let in based on grades, they fail people out in droves. Here, something like 95% of all freshman premeds don't remain premed by the time they graduate college, and thereafter those folks who remain are put through a variety of weed out criteria, ranging from their numerical stats, essays, clinical experience, LORs, to the interview, and even then don't accept half the folks who apply, many of whom have fairly decent credentials. Because they do all this, they are playing gatekeeper, and the folks who actually get into med school are fairly cherry-picked. A few won't pan out, but the system is good enough that 90+% will make decent doctors. Thus fail outs in US schools are quite rare -- all the cuts were made before folks got here.


However there is a lot of arrogance in medicine, so I have no doubt that lots of folks think less of some of their classmates. But judged against the norm (not another med student's self expectations) most people coming out of US med school are pretty darn good.

 

[MSHell]

...In other countries where folks are let in based on grades, they fail people out in droves...

Unfortunately, a dumb people make it through those systems too. It is a universal problem.

 

[Law2Doc]

Unfortunately, a dumb people make it through those systems too. It is a universal problem.

I'm not sure it's a problem at all. When people talk about healthcare shortcomings I've never heard of doctors being too stupid anywhere in the top 10.

 

[SkylineMD]

I would say all of the above reasons for why not to send a family member to see some classmates. The few individuals i can think of each fall under one or two of the categories. For the most part, I would say I would only send my family members to some of the most capable students in my class and that only comprises about 10-15%. About 60-70% will probably make fine doctors but of course its family and I would want someone who would be meticulous in taking care of them.

 

[Acherona]

I wanted to check the option "No, not because they aren't smart but because they have no interpersonal skills and are frequently insulting" but it wasn't there...

I second this. The term "weirdos" comes to mind.

 

[AwesomO]

Based solely on competence I would hesitate sending my family to about 30-50% of my class. There are about 5% I wouldn't even let treat my family for a simple URI.

 

[Ypo.]

I'm not sure it's a problem at all. When people talk about healthcare shortcomings I've never heard of doctors being too stupid anywhere in the top 10.

I'm not the smartest cookie in the box, but I know classmates who are on their third try of trying to pass step 1; these are native English speakers, who have failed courses multiple times, and who would have almost certainly been weeded out from European schools. Oddly enough, most of these students I would still refer to simply because they are hardworking, ethical, and because I believe they would refer to a specialist if they felt over their heads. However, in terms of being "smart", I would not call them smart or good diagnosticians. Perhaps that will come with more time and experience. On the other hand, I have met a lot of attendings who clearly never got past the memorize and apply, rather than using deductive reasoning.

I also think that medical schools should start using research experience as a requirement to get into med school, or during med school, because the lack of understanding of research and statistics is appalling in my class.

 

[PeepshowJohnny]

There are people in my class who I would never refer family, friends, acquaintances to as well. My big issue with these people is that they just don't "Get it". Guy in my class, convinced he's going to be a radiologist. No one can talk him out of it. The thing is, he fails tests left and right, has no clinical judgment skills, and has no common sense. And he doesn't see any problem with this. He excuses his performance sometimes on "not needing to know this with what I want to do" and the other half on the instructor (preclinical) or his evaluator (clinical).

The way I see it, if he finishes med school (by no means guaranteed) he's either going to
A) Attempt to match into radiology and fail to match
or
B) Be forced into matching into a less competitive specialty (IM, Peds, Family)

If he does B, he's just not going to do a good job because his ego would be so bruised and he's just got godawful clinical skills.

 

[Law2Doc]

Based solely on competence I would hesitate sending my family to about 30-50% of my class. There are about 5% I wouldn't even let treat my family for a simple URI.

Bear in mind that half the physicians out there in the real world were in the bottom half of their med school class, and many weren't even at as good a med school as wherever you are at. So odds are quite good that your family members already see physicians who are the equivalent or less competent then these classmates. And probably are quite happy with them. (I certainly got an eye opener when talking to my internist recently and hearing about how he failed this course and that course during med school). Even worse, the most competent students frequently go into the referral specialties where they see the fewest patients (eg derm, optho, rads), whereas the folks who have to take primary care spots commensurate with their scores tend to become the internists, FPs, pediatricians -- the ones who will actually see the most patients, including your family members. So I wouldn't be so quick to give up on that last 5% -- Someone in your family probably already goes to a doctor out there in the real world who was a worse student at a "worse" med school. Food for thought.

 

[Law2Doc]

I also think that medical schools should start using research experience as a requirement to get into med school, or during med school, because the lack of understanding of research and statistics is appalling in my class.

I like this idea. But medicine as a profession has come to realize it is less of a science than a service profession, and so I don't see this happening. Truth of the matter is that only a fraction of the profession will do any research, and the current demand for physicians is greatest in the primary care fields which don't do nearly as much. Most physicians won't end up working at academic settings, won't be participating in clinical trials, and won't ever have to use statistics beyond trying to understand a JAMA article they are reading. More useful would be to drop the physics prereq and make everyone take a year of Spanish.

 

[MSHell]

Law2Doc, but that's was the whole point about the research requirement (I'm not the one who brought it up but I agree nonetheless). I know most won't go into research or academics but it is important to know enough about research and stats to be able to read and understand the medical literature out there.

I've never done any research and because of this, I know that I have no clue what I'm looking at. But at least I know I have this problem. I plan on doing some research this year or next just to see what it entails, not because I plan on becoming a researcher. Publish or perish is really not for me.

And spanish is a good to know. I did that instead

 

[Ypo.]

Law2Doc, but that's was the whole point about the research requirement (I'm not the one who brought it up but I agree nonetheless). I know most won't go into research or academics but it is important to know enough about research and stats to be able to read and understand the medical literature out there.

I've never done any research and because of this, I know that I have no clue what I'm looking at. But at least I know I have this problem. I plan on doing some research this year or next just to see what it entails, not because I plan on becoming a researcher. Publish or perish is really not for me.

And spanish is a good to know. I did that instead

Yep, that's what I was getting at. I'm doing Spanish as well.

At least I took a fair amount of statistics and epidemiology. I feel I can critically analyze papers pretty well.

 

[AwesomO]

Bear in mind that half the physicians out there in the real world were in the bottom half of their med school class, and many weren't even at as good a med school as wherever you are at. So odds are quite good that your family members already see physicians who are the equivalent or less competent then these classmates. And probably are quite happy with them. (I certainly got an eye opener when talking to my internist recently and hearing about how he failed this course and that course during med school). Even worse, the most competent students frequently go into the referral specialties where they see the fewest patients (eg derm, optho, rads), whereas the folks who have to take primary care spots commensurate with their scores tend to become the internists, FPs, pediatricians -- the ones who will actually see the most patients, including your family members. So I wouldn't be so quick to give up on that last 5% -- Someone in your family probably already goes to a doctor out there in the real world who was a worse student at a "worse" med school. Food for thought.

I don't base their competence on class rank or board scores. In fact I have no idea where most of these classmates rank although I would wager most do ok with some even in the top 10%. Their ability to memorize power point slides and kiss up to attendings isn't what worries me. What worries me is lack of interpersonal skills, poor history taking, lack of critical thinking, and some who just honestly do not care about the patient.

Looking back 30-50% is probably too large a number. As for that last 5% though, I'm not yielding on that. Again not based on class rank or exams.

 

[Jesus DO]

At my school, there are 149 students. As of yesterday, my class rank was 142. I feel very sad reading through this thread, but I do confess that you guys do make several good points

I have a sign on my desk that has a Latin quote on it - Diligentia maximum etiam mediocris ingeni subsidium. It means something like: Mediocre people must rely of dilligence.

 

[Orthodoc40]

As blondbondgirl points out, the admissions criteria are so strict precisely so that schools don't have to later fail people out. In other countries where folks are let in based on grades, they fail people out in droves. Here, something like 95% of all freshman premeds don't remain premed by the time they graduate college, and thereafter those folks who remain are put through a variety of weed out criteria, ranging from their numerical stats, essays, clinical experience, LORs, to the interview, and even then don't accept half the folks who apply, many of whom have fairly decent credentials. Because they do all this, they are playing gatekeeper, and the folks who actually get into med school are fairly cherry-picked. A few won't pan out, but the system is good enough that 90+% will make decent doctors. Thus fail outs in US schools are quite rare -- all the cuts were made before folks got here.


However there is a lot of arrogance in medicine, so I have no doubt that lots of folks think less of some of their classmates. But judged against the norm (not another med student's self expectations) most people coming out of US med school are pretty darn good.

Here if any body gets the boot, it's for a behavioural issue - not academic. Bad judgement, poor professionalism, cheating...

 

[fuzzyerin]

You may be surprised how some of these people turn out once residents - one of the biggest slackers in my class (one of my drinking friends who I swore I'd never refer a patient to) is 6 months from being a medicine chief resident, is well published, and well liked by patients/attendings/med students alike. Knowing him as a student, I did a double take when we caught up at a wedding recently.

You really don't know how people are going to do until they are truly in the situation of being able to make decisions. Some excellent MSIIIs will suck as residents and vice-versa.

 

[persia]

Diligentia maximum etiam mediocris ingeni subsidium.

Diligence is a very great help even to a mediocre intelligence.----Seneca


(Thank you, Google. )


To Jesus DO, you sound like a nice person who will have alot to contribute to his/her clinical practice. Keep the faith and trust in yourself and your ability to learn and do well as you move along in your education. Compare yourself to yourself and just try and be the best person you can be. Forget all the temporary BS and don't compare yourself to people you don't even know all the facts about. That person who sounds like they know it all and are 'perfect,' might be trying to compensate for deep insecurities. Just keep the focus on yourself and you will do fine. The best docs doubt themselves and question themselves when they feel they are struggling. Likely, they also weigh all the evidence and ask questions when unsure of a diagnosis. Do you want a physician who is instantly sure of an answer and cannot be swayed from that? or someone who takes his/her time and asks more questions and confers with colleagues before making a judgment.

 

[Anka]

Do you want a physician who is instantly sure of an answer and cannot be swayed from that? or someone who takes his/her time and asks more questions and confers with colleagues before making a judgment.

In my experience, it is the most mediocre people who have the hardest time asking for help in real life. They are most likely to possess delusions of equality, and insist that their opinion is as good as anyone else's.

That said, Jesus DO, class rank does not a bad (or good) doctor make. There's a lot more to it, and part of it is figuring out where you fit in. The particular classmates that come to mind when I think of people I wouldn't refer someone to are some of the more highly ranked people in my class -- they either lack common sense, work ethic, or ethics in general.

So, don't get all freaked out... there's a reason you do a 3-7 year residency. We all doubt ourselves at some point. It can be a healthy thing -- it can motivate us to work harder or find better solutions to the problems we are having; it can cause us to find fields that take advantage of our weaknesses as well as our strengths. But too much is destructive. There is just no way at this point you know where you stand as a physician, and by reading too much into your class rank you risk selling yourself short.

Anka