Dear ChildNeuro:
We all realize from your many posts that you have had a bad experience in the past with one or more attendings whom you believe have abused you. In describing the situation and in providing a measure of support to others who are also feeling abused, please reconsider the language you use and how it affects your argument.
In other words, consider saying "I have had attendings who were crappy teachers...and thus I understand your situation." We would all agree with that I think and recognize it as a supportive statement.
You could say "Most of my attendings were crappy teachers.....and thus I am not surprised that you have similar attendings." This would make me wonder how many attendings you've had and what your criteria was for "crappiness." We would further wonder how many patient deaths you had personally witnessed that could be related to physican error, let along "arrogance." Still, I wouldn't disagree per se because you are subjectively describing your own experience.
But, in many of your posts on a nearly daily basis, you generalize attendings and indicate that they commonly (in this quote you say "most") have abusive tendencies or are "crappy" or use similar insulting terms. Since you don't give a pubmed reference showing that the majority of attendings are crappy teachers, don't define the reason or basis for defining it that way, and we know you haven't evaluated the teaching skills of more than 50% of the attending physicians in the US, we can only assume that you are making a biased, generalized, unsupported insult. Now, like ethnic insults this type of generalization is offensive and insulting. It certainly does not help the poster you are trying to support.
Please consider the impact of your argument style and if possible, avoid insulting the majority of attendings, including me, whom you have never met.
I apologize for stating that most attendings are crappy teachers. I personally want to be an academic physician and do some really excellent teaching on the wards. I am also very dedicated when it comes to educating my patients about their illnesses. I have worked with many excellent attendings, and a majority of not so excellent attendings, and it distresses me greatly hearing experiences from students concerning attendings who either intentionally or not cause great distress in their students. The OP who started this thread appears to be somewhat distressed. I consider myself as part of the solution, I teach third years alot, and therefore yes, I feel within my rights to criticize the current state of graduate clinical education.
I do not enjoy hearing comments that it is okay to "yell" at students for their mistakes. From the point of view of someone who analyzes the effectiveness of teaching that attendings deliver I have come to the conclusion that many opportunities for teaching on the wards are lost, and the art of teaching medical students has been reduced to daily 5-minute pimp questions with little discussion of patient management. I highly value what attendings have to say about real life patient management, something which you can't get from a textbook. I do not feel that real medical student abuse adds anything to a medical students education.
As a senior medical student I routinely give lectures and explain things to third year medical students that I never had explained to me, whether it be some as simple as what an abbreviation means, to management issues in the ICU. They are always amazed, as am I that they have not been taught these things. I state these things not to elevate myself on this anonymous forum, but to point out that much of medical student's time and patience is wasted by attedings in teaching hospitals who are verbally aggressive with students, and not focused on teaching. If I can do an excellent job, why aren't attendings doing even more excellent teaching? To further elaborate, most attendings haven't received any training to be teachers, i.e. to develope educational objectives, standardized curriculum, or how to best interact with students in a teaching mode. If I was a teaching attending I would be interested in attending perhaps a one-time one week course, maybe for CME credit, on how to smoothly run a ward and teach med students and residents, alot of attendings are very awkward at teaching to put it mildly, and some take out alot of their frustrations on students. For some reason college professors and other teachers don't do this. To re-phrase my comment, I would say that, "Most attendings are not taught how to rise above the level of a crappy teacher, based on my personal experience, maybe N=75." Remember we make generalizations all the time in medicine, like most patients with diabetes have symptom X, do we really need to study 50% of diabetics to say this!?!? Many attendings look down and intellectually bully students into thinking that they don't know how to think anymore. I've had enough experience in clinical medicine to make a reasonable estimation of the poor teaching abilities of alot of attendings. While Tildy may have served on alot of commitees, that doesn't mean that he/she has a good handle on medical student abuse, especially from the perspective of a medical student.
Very bad teaching practices are alive and well in medicine and should be addressed. Attendings and residents do make generalizations about us, my fav: "Third years are the worst." Not as bad as what I said as I was one of the third years in the room at the time. Attendings can be very blunt or even abusive in comments, it would be nice if students could be so openly, a taste of their own medicine. I am sorry for Tildy feeling upset, though if a medical student is upset by an attendings comments we are expected to, "Grow some thicker skin." There are several attendings who I wish I could have properly notified them of the expected style of which disparaging comments are to be directed towards me.
I think we would agree that many things that attendings do in the context of "teaching" would cause a college or high school teacher to be fired on the spot, i.e. racial slurs, significant bullying, etc. . . Attendings probably feel their power status in the medical heirarchy decline as patients can look up diseases and treatments online and file lawsuits when there are adverse outcomes. Some attendings would be upset to give up the environment that allows them to make multiple abrassive and abusive comments to students and residents. Medical students rely on a small, but significant cadre of attendings to teach them well and to treat them humanely, when in reality this should become a basic right as a medical student. Alot is being said about humanism, and bed-side manner in today's medicine, but I think without addressing the systematic abuse of medical students this is nothing more than lip service. Honestly, I think that medical students filing more lawsuits for abuse on the wards is one real world consequence that attendings should face if they are serial abusers.
While I may have been abused as a third year, I am not alone, a *majority* of medical students have been abused as medical students in medical school, and a lesser, although significant, amount report the abuse as being significant. Abused medical students are more likely to be unsatisfied with their career as a physician, and I would suspect this may negatively affect the care they give, there is a study in BMJ I believe that attests to this (i.e. abuse=unhappy doc), as does common sense.
Most attendings are not abusive, I did not say anywhere in this post that most attendings are abusive at all if you had carefully read my post, but abusive attendings and residents with whom I have worked have delivered sub-standard care, which I believe was influenced by the amount of time they spent harassing students and less time teaching and taking care of the patient, which resulted in three negative outcomes. While a minority of attendings are abusive, they are the ones that cause serious distress for students, and make an unsafe hospital environment for the patients, and are discussed by troubled students on the wards and on this discusson board. I have not been abused by attending for, well, a long time, for some reason my luck has placed me at excellent institutions, but when I hear about students who are obviously distressed, and possibly have legitimate concerns about an abusive attending I think we can all identify with that.
ChildNeuro