Co-resident not pulling weight

[throwawayacct1284749]

I'm in a residency training program and my co-resident isn't really putting forward the effort or taking initiative to do the work which needs to be done (currently being done by me). She also says a lot of things that make me (and other people) pretty uncomfortable. I'm paired up with her for the next few rotations. What should I do about this situation? The schedule has already been made in advance and I can't change it. I expect the way I'd cope with this is to just keep doing the lion's share of the work myself, and have this continue while she just coasts on my hard work. It's not like it's going unnoticed, however the fact is I'd be doing the majority of the work still. And the worst thing ever would be for her to drop out of leave the program because that would mean more work for all of the remaining residents.

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[Apollyon]

This is a very small unit of time in your life. Continue the high road. Do the work. I guarantee you that, if you see it, others do, too. No one is in a vacuum. You do you, and let her do what she does. Don't worry about her, do your part, and, in the final analysis, it will be evident. The hard part is remaining motivated and doing the work when the other person isn't. Keep that up, and you will do fine. And, you will feel fine. And you will be fine.

 

[NITRAS]

Residency in many ways is largely mental. So much of the work is just stupid. Most of it isn’t hard if your attitude is good. You are getting better training than your coresident. Kinda unclear what field you are in, but in ten years, this will just be a short part of your life, and there are going to be others you have to work with that will drive you nuts.

 

[guytakingboards]

As mentioned, all you can do is control your actions and your feelings about it. Don't let that person affect your performance or make you bitter. (easier said than done).

I don't think it'd be outta line to have a discussion with your chief or potentially PD but it'd really only be to reinforce their perception of your co-resident. ....and potentially further create a paper trail.

There's no good solution. If that person would consider dropping out over honest negative feedback, they're probably a headache you don't want to work with anyway.

 

[HemeOncHopeful19]

As a former chief, assuming you aren’t a PGY1 then I guarantee this person is already on the chiefs’ radar likely related to an inordinate amount of super detailed schedule requests, vacation demands, late charts etc. by this person.

I would just show up and work hard unless they do something totally egregious or demand extra days off. Eventually you will have your choice of jobs and colleagues.

 

[anonperson]

She also says a lot of things that make me (and other people) pretty uncomfortable.

What did she say?

 

[throwawayacct1284749]

What did she say?

She swears a lot. Calls people mofo (the word, not the abbreviation). Keeps saying that I'll be the chief resident even though it's two years away. Also, constantly compares herself to me.

 

[NotAProgDirector]

Speaking as someone in residency admin, I'd encourage you to mention it to someone. I'd come at it from the direction: "I've never worked with this person before, this behavior seems problematic and I find that their work ethic is lagging. I'm worried that maybe they may have something going on that needs help / support? Just wanted to let you know". If they are a chronic problem, this won't be any surprise to anyone. if not, maybe there is some acute issue.

Still, I'm sure this will be program dependent. The more supportive your program is, the more I would encourage you to reach out to someone.

 

[guytakingboards]

She swears a lot. Calls people mofo (the word, not the abbreviation). Keeps saying that I'll be the chief resident even though it's two years away. Also, constantly compares herself to me.

The swearing is a professionalism problem. Leave that one for someone up the chain.

The other stuff sounds like the comments of a pretty insecure person. While some comparison is natural, sounds like she’s using you as the bar for her performance which is obviously not how residency works. Hopefully the admin will explain the facts of life: i.e her residency progression is based on her progression through milestones and has nothing to do yours.

 

[akwho]

I always found it easier to work around people than work through them. Even if it's a couple rotations that's what 3-6 months max? You can do anything for 3-6 months.

One person I worked around during residency (did her intern notes/orders for her as the chief of the service in between OR cases because she wasn't competent) just got fired for good cause and is suing everyone under the sun. My name ain't gonna end up on that deposition because I'm not on the hit list.

You aren't her boss and unless patient harm is happening I don't think you have any obligation to involve yourself in the other resident's poor performance.

 

[Kaustikos]

Well,
I honestly wish I was in your shoes. My residency I had at least a quarter of my colleagues and numerous seniors that didn't do their work. I just kept my head down and powered on. It's just not worth it. You'll be done soon and move on. They'll eventually burn their own bridges when they become physicians/attendings.

 

[LADoc00]

Wow, this thread was a crazy flash of nostalgia for me. I dont know how many hours, days, weeks I spent at a bar at a sushi restaurant across the street from my training program complaining with my guy buddies about female residents not pulling their weight only to one day show up and overhear the female residents complaining about us not pulling our weight!

Life is funny like that.

 

[FalconSlice]

I'm in a residency training program and my co-resident isn't really putting forward the effort or taking initiative to do the work which needs to be done (currently being done by me). She also says a lot of things that make me (and other people) pretty uncomfortable. I'm paired up with her for the next few rotations. What should I do about this situation? The schedule has already been made in advance and I can't change it. I expect the way I'd cope with this is to just keep doing the lion's share of the work myself, and have this continue while she just coasts on my hard work. It's not like it's going unnoticed, however the fact is I'd be doing the majority of the work still. And the worst thing ever would be for her to drop out of leave the program because that would mean more work for all of the remaining residents.

I'll also mention that your co-resident is setting up terrible habits and not learning that much by not doing the work (I don't mean "knowledge base" but the equally important "learning how to literally be a good resident"). This is a much worse thing and will 100% come back to destroy her soon enough. Do your work, and, as others have mentioned, people will realize how boss you are by just keeping your head down and plowing through intern-crap. Reputations get solidified even within the first months of residency that last the life-time of said resident. You've already started forming your reputation...and it seems like she has too. Keep on keeping on, and kill it.

FS

 

[akwho]

Wow, this thread was a crazy flash of nostalgia for me. I dont know how many hours, days, weeks I spent at a bar at a sushi restaurant across the street from my training program complaining with my guy buddies about female residents not pulling their weight only to one day show up and overhear the female residents complaining about us not pulling our weight!

Life is funny like that.

I think the fact that the mentioned bad residents are female is incidental so I wouldn't draw the conclusion that the complaints about them are due to gender.

Plenty of bad residents out there of both genders to confirm whatever pre-existing biases you already have if you aren't careful to acknowledge your own biases and try to combat them the best you can. There isn't any data that I know to suggest a performance difference in residency due to gender. Although I am aware of at least two studies in the surgical fields showing women face a higher rate of attrition in residency which could be due to a wide variety of factors, not necessarily job performance related.

Gen Surg
Ortho

 

[dozitgetchahi]

I'm in a residency training program and my co-resident isn't really putting forward the effort or taking initiative to do the work which needs to be done (currently being done by me). She also says a lot of things that make me (and other people) pretty uncomfortable. I'm paired up with her for the next few rotations. What should I do about this situation? The schedule has already been made in advance and I can't change it. I expect the way I'd cope with this is to just keep doing the lion's share of the work myself, and have this continue while she just coasts on my hard work. It's not like it's going unnoticed, however the fact is I'd be doing the majority of the work still. And the worst thing ever would be for her to drop out of leave the program because that would mean more work for all of the remaining residents.

I agree with others as above - this is residency and I would keep my head down and do the work. Don’t like how that sounds? Here’s a story…

At my first job as an attending, I had two MAs for office staff. One was ok, while the other was simply the worst person I’ve ever had to work with in my career - rude, insubordinate, lazy, prone to not showing up because of nebulous “health issues”, didn’t do much work whenever she was there, spent much of the day drumming on her desk and humming tunes…you get the idea. Patients didn’t like her, the other office staff didn’t like her because they had to pick up her slack, and I certainly didn’t like dealing with her. However, management was mysteriously “ok” with her, and essentially didn’t do anything about her lack of work ethic or rude behavior.

I put up with this for about a year until I was fed up, and then I started taking my complaints up the food chain when the office manager did nothing to improve the situation. Guess what? Turns out that this awful MA was best friends with the office manager in high school, and the office manager was, in turn, really good friends with the CMO and other higher ups to whom I was complaining - so not only did the complaints do nothing, but then suddenly a hellstorm of bull**** was aimed at me by these “senior managers” who were apparently angry that I had stepped on the toes of one of their buddies. It quickly got so bad that I left the job.

Ultimately, that situation worked out great for me - my next job was much better all around - but as a resident, you don’t have the luxury of being able to leave if something like this happens. It’s quite possible that your program leadership is already aware of the situation, and is acting on it - but if they don’t do anything about this person, just remember that there could be some political reasons why that’s happening. Nepotism is surprisingly widespread in GME, and it’s not all that unusual for a trainee to be related to someone important in the department - you just may not be aware of it. Also (and I speak from experience on this too)…nobody likes a whistleblower at these institutions, regardless of how egregious the behavior is that you’re reporting. Making a stink can easily lead to the tables getting turned against you. You are at your weakest and most vulnerable as a resident or fellow. Just keep your head down. As others have said, in the future you will have much more control over who you work with, and you will be able to leave work situations if they go south. But not yet.

 

[FutureInternist]

I’m a fan of the anonymous memo as in the Pelican Brief 😏

 

[dozitgetchahi]

I’m a fan of the anonymous memo as in the Pelican Brief 😏

Eh, I’m not - mostly because I’ve seen these sorts of anonymous “letters” used to make all sorts of false accusations against people because of personal beefs etc. My opinion is that most anonymous memos/letters/whatever should immediately be placed in the shredder unless they’re accompanied by substantial, incontrovertible evidence.

 

[FutureInternist]

Eh, I’m not - mostly because I’ve seen these sorts of anonymous “letters” used to make all sorts of false accusations against people because of personal beefs etc. My opinion is that most anonymous memos/letters/whatever should immediately be placed in the shredder unless they’re accompanied by substantial, incontrovertible evidence.

I used it in school to highlight some BS that the admin was pulling, changing rules mid semester, making going to class mandatory etc and making it part of your grade.
We had some issues with attendings on rotations being completely uninterested and didn’t teach a thing but somehow kept getting students, etc.

I guess it was more to not have a target on my back, and since it was a known issue, everyone had plausible deniability.

Its hard to put your name on something when a “below average” on a completely subjective eval can F up your chances at the residency/fellowship you want.

Now as an attending, I sign everything I put out 😏

 

[Redpancreas]

I'm in a residency training program and my co-resident isn't really putting forward the effort or taking initiative to do the work which needs to be done (currently being done by me). She also says a lot of things that make me (and other people) pretty uncomfortable. I'm paired up with her for the next few rotations. What should I do about this situation? The schedule has already been made in advance and I can't change it. I expect the way I'd cope with this is to just keep doing the lion's share of the work myself, and have this continue while she just coasts on my hard work. It's not like it's going unnoticed, however the fact is I'd be doing the majority of the work still. And the worst thing ever would be for her to drop out of leave the program because that would mean more work for all of the remaining residents.

Curious to see how this panned out.

Sorry this happened OP. For future readers, in this situation I'd recommend clearly identifying your roles/responsibilities and doing your job, not theirs. Is your job to complete tasks/follow-up items on these 10 patients as an intern? OK do that. Obviously, there will be some cross-coverage items during call but it's not your job to do extra work to do or dig so you can give your night intern formal presentations on patients. If your co-resident doesn't give you a good sign out to you, your job is to write down what they say even if it doesn't make sense. If it's incomplete, don't spend time digging through the chart because then your work will suffer. If/when night float who has never worked with this person gives you grief, just state that that "I was told": and verbally say what your colleague verbalized to you. Answering nurse pages during cross coverage is more annoying because RNs don't care about our dynamics just like we don't care about theirs when something isn't chart and in those situations look into what's actually going on and use that to augment your sign out. Ex: "I was told to follow up HgB on 609, I was told it was last 8 but the nurse called me because it was 6.8 in the AM so I ordered a unit of blood because this patient is admitted for ACS", please follow up and transfuse for a goal of 8. State the facts. Don't editorialize. If the night resident becomes rude, just be amicably but then report what was said to your senior with your perspective. As an intern, it's not your job yet to be accountable for bad co-interns.

Most residents by default don't act like this resident. What you don't realize is that word travels super fast and in residency, when one mistake is made, people key in to who made that mistake. If it happens multiple times, whispering commences. If this level of incompetence you've mentioned is present, the program 1.) already knows about the behavior 2.) may even have a political reason for not escalating the situation. It's not your job to try to escalate the situation or compensate for the poorly performing resident. You're just making your life more complicated than it needs to be.

The only unfortunate thing is that if she's always working with you, the attending/senior will clue in on her crap and not see your mistakes as a problem. Short term, that can be a good thing to demonstrate contrast and that you're a good resident, but simultaneously you need to make sure you're still growing as a resident.

 

[sirspamalot]

Residency without colleagues who look out for each other is pure hell, hopefully most don't have this happen. This is the real value of doing interviews at residency programs - if this is good, everything else will fall into place. If not, it'll sucketh.

 

[Old_Mil]

I'm in a residency training program and my co-resident isn't really putting forward the effort or taking initiative to do the work which needs to be done (currently being done by me). She also says a lot of things that make me (and other people) pretty uncomfortable. I'm paired up with her for the next few rotations. What should I do about this situation? The schedule has already been made in advance and I can't change it. I expect the way I'd cope with this is to just keep doing the lion's share of the work myself, and have this continue while she just coasts on my hard work. It's not like it's going unnoticed, however the fact is I'd be doing the majority of the work still. And the worst thing ever would be for her to drop out of leave the program because that would mean more work for all of the remaining residents.

This is an excellent opportunity to learn that as a physician, nobody that you report to actually cares what you think. Keep your head down and power through.

 

[dozitgetchahi]

This is an excellent opportunity to learn that as a physician, nobody that you report to actually cares what you think. Keep your head down and power through.

Bingo. This was one of the hard learned lessons I picked up after finishing training.

The other was that “quality of care” counts way, way less in the current medical game than you might think. Are your diagnoses correct? Do you actually get patients better? Do you practice “good medicine”? Sadly, it turns out as long as you’re not overtly killing patients or doing flagrantly stupid things, nobody cares *that* much (especially in rural areas where they’re often happy just to have a doctor - any doctor - show up to work, and if that person isn’t a drunken lunatic that’s just icing on the cake). The patients will of course care about whether or not you get them better, and will gravitate towards doctors that do this more effectively, but your superiors will be surprisingly unimpressed and blasé about this. Instead, you will be judged on silly metrics like whether your notes are done in 72 hours or “patient satisfaction” scores much more than whether you help people or practice good medicine. Even if you get a lot of people doing better, you will likely get dragged into meetings because one kooky drug seeking patient thought you didn’t give them the narcotics they deserved, or something equally stupid. You will see greedy, stupid colleagues “succeed” doing dumb things for very long periods of time, often being quite successful financially in the process, and you will wonder why the medical board never goes after these kinds of people; but then you’ll see the board go vigorously after some random doctor who doesn’t seem to be doing much of anything wrong, and you’ll wonder why that’s happening.

That stuff has been one of the hardest things to swallow about medicine, honestly.

 

[sirspamalot]

You will be judged on silly metrics like whether your notes are done in 72 hours or “patient satisfaction” scores much more on whether you help people.

Don't forget completing mind numbing Homer Simpson online education homework.

 

[dozitgetchahi]

Curious to see how this panned out.

Sorry this happened OP. For future readers, in this situation I'd recommend clearly identifying your roles/responsibilities and doing your job, not theirs. Is your job to complete tasks/follow-up items on these 10 patients as an intern? OK do that. Obviously, there will be some cross-coverage items during call but it's not your job to do extra work to do or dig so you can give your night intern formal presentations on patients. If your co-resident doesn't give you a good sign out to you, your job is to write down what they say even if it doesn't make sense. If it's incomplete, don't spend time digging through the chart because then your work will suffer. If/when night float who has never worked with this person gives you grief, just state that that "I was told": and verbally say what your colleague verbalized to you. Answering nurse pages during cross coverage is more annoying because RNs don't care about our dynamics just like we don't care about theirs when something isn't chart and in those situations look into what's actually going on and use that to augment your sign out. Ex: "I was told to follow up HgB on 609, I was told it was last 8 but the nurse called me because it was 6.8 in the AM so I ordered a unit of blood because this patient is admitted for ACS", please follow up and transfuse for a goal of 8. State the facts. Don't editorialize. If the night resident becomes rude, just be amicably but then report what was said to your senior with your perspective. As an intern, it's not your job yet to be accountable for bad co-interns.

Most residents by default don't act like this resident. What you don't realize is that word travels super fast and in residency, when one mistake is made, people key in to who made that mistake. If it happens multiple times, whispering commences. If this level of incompetence you've mentioned is present, the program 1.) already knows about the behavior 2.) may even have a political reason for not escalating the situation. It's not your job to try to escalate the situation or compensate for the poorly performing resident. You're just making your life more complicated than it needs to be.

The only unfortunate thing is that if she's always working with you, the attending/senior will clue in on her crap and not see your mistakes as a problem. Short term, that can be a good thing to demonstrate contrast and that you're a good resident, but simultaneously you need to make sure you're still growing as a resident.

You raise good points, one of which is that OP could be inventing more work for herself (for whatever reason).

Another story…when I was a rheumatology fellow, I had an overzealous co-fellow who often took it upon herself to invent more work to do, out of a misguided idea that it made her look better. For instance, if you signed out to her on the consult service, one thing she loved to do was pitch a fit and say “all these notes are so bad, I have no idea what’s going on!”…and then proceed to write a fresh set of new consult notes on all the patients currently on the service, with a full HPI and everything else, so that the notes were “good enough” for her precious standards. (That wasn’t the only thing she was doing like this, either.) The worst part was that the environment of this fellowship was so toxic that the attendings loved her for doing things like this, even though all her co fellows eventually grew to hate her.

 

[sirspamalot]

Nothing like hating on the outcast. Ours was an anti-semitic low-performer who ended up, whaddya know, doing UM reviews.

On another angle: There are three kinds of UM reviewers: the retired, those who want to work at home or can't find a job locally, or the under performer who can't hack doing the job.

Prove me wrong..

 

[dozitgetchahi]

Nothing like hating on the outcast. Ours was an anti-semitic low-performer who ended up, whaddya know, doing UM reviews.

On another angle: There are three kinds of UM reviewers: the retired, those who want to work at home or can't find a job locally, or the under performer who can't hack doing the job.

Prove me wrong..

Hahahahaha - no disagreement here.

Ours was a “high performer” who had the classic kiss up/kick down mentality-she was great at kissing attendings’ asses and making herself look good, but treated her co-fellow colleagues and all support staff like complete garbage. She was very overcompetitive and never missed an opportunity to try to throw you under the bus, or otherwise take potshots at you and your skills in front of an attending.

She also had a number of weird and irritating habits. Despite being engaged to some guy living in another state, she was always talking about how this attending or another was sexy, or how she had a crush on this fellow in whatever department, etc etc. The second year she apparently had the hots for one of our (married) first year fellows, and she was always making random inappropriate comments about his ass and such.

As part of her ass kissing process, she always religiously got every member of the department a card for any and all holidays, special events, etc - but she was also very cheap and would “recycle” stationary she received previously. One Christmas, I remember she gave me an old Christmas card where she had crossed off someone else’s name and everything else and wrote in her own message.

By the end of fellowship, nobody liked her except for the attendings, who thought she was the golden girl of the department (which tells you a lot about the toxic culture we endured). She got married at the end of fellowship and invited everyone. Iirc, nobody went.

 

[sirspamalot]

Check for divorce papers lol. Sure, crazy in the head is fun. No doubt, zero. But that divorce is gonna happen or YOU will go crazy.

But as I am going to eventually be telling my teenage boys.. DO. NOT. MARRY. DO. NOT. GET. EMOTIONALLY. ATTACHED.

Think of it as fun, a great workout. Etc. Your wife won't be like this, nor should she I suppose, but feel free to indulge before you get married...just be careful. Please. For your parents sanity sake and your own... and remember.. there are no unicorns.

 

[dozitgetchahi]

Check for divorce papers lol. Sure, crazy in the head is fun. No doubt, zero. But that divorce is gonna happen or YOU will go crazy.

But as I am going to eventually be telling my teenage boys.. DO. NOT. MARRY. DO. NOT. GET. EMOTIONALLY. ATTACHED.

Think of it as fun, a great workout. Etc. Your wife won't be like this, nor should she I suppose, but feel free to indulge before you get married...just be careful. Please. For your parents sanity sake and your own... and remember.. there are no unicorns.

Lol. Exactly.

And do you know where this lovely peach of a co-fellow went? Where all manipulative, personality disordered doctors go, Pinky - academia.