Dealing with bad ob resident

[azuka]

I came really close to telling my chief resident off today. This woman has been so mean to me before i even got on her team. She finds faults in everything I do. She even told me to reconsider my specialty in indirect terms today. I want to do ob/gyn. My other evals are great. How do I keep her from ruining my life. I have 3 more days with her. I am so close to losing it. It seems like she would do anything in her power to destroy me. She did that to another student but she is not planning on going into ob/gyn.

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[mimelim]

1) Stop having so many faults.
2) If you don't have any faults, then ignore her.
3) Move on with your life.

Not exactly rocket schience.




ps. if you think you don't have any faults, then you are delusional. There are terrible residents and attendings out there, but a lot of medical students can't imagine that they aren't perfect and certainly something to consider. Despite your "great evals".

 

[civic4982]

There's a line between "mean" and "abuse".

If it's the latter then discuss it with your faculty advisor or clerkship director.

If it's the first one then toughen up and find ways to bend their behaviour to what you are looking for. You will run into plenty of people in your life who want to make it difficult. Learning to deal with them is apart of your experience.

Good luck!

 

[azuka]

1) Stop having so many faults.
2) If you don't have any faults, then ignore her.
3) Move on with your life.

Not exactly rocket schience.




ps. if you think you don't have any faults, then you are delusional. There are terrible residents and attendings out there, but a lot of medical students can't imagine that they aren't perfect and certainly something to consider. Despite your "great evals".

i don't think I'm perfect. It is one thing to be perfect. It is another to be extremely mean to a medical student telling to find a different field and that they are extremely dumb when they are not. That being yet, i get your point. I am just venting.

 

[VenusinFurs]

OB GYN residents are often not happy campers because of their rough schedules, and they can be real tough on the students. That doesn't mean they're out to get you or anything. I ended up getting bad OB evals, but on reflection, I could have done a lot of things differently and the eval was basically just reflective of the fact that I obviously did not want to be there. A lot of the kids who got yelled at ended up getting good evals. If you're actually sincere and show you're willing to work hard, a few words of criticism isn't the end of the world. Just hang in there and don't let 'em see you sweat.

 

[jerseytrash]

1) Stop having so many faults.
2) If you don't have any faults, then ignore her.
3) Move on with your life.

Not exactly rocket schience.




ps. if you think you don't have any faults, then you are delusional. There are terrible residents and attendings out there, but a lot of medical students can't imagine that they aren't perfect and certainly something to consider. Despite your "great evals".

Or azuka could have vindictive, catty, and crappy residents, which is sometimes the case, and seems to be a big one in a "high-strung" residency like OB.

I have classmates who went into OB who absolutely hated our residents because they were like that. These sorts of vindictive nasty people do exist.

 

[jerseytrash]

OB GYN residents are often not happy campers because of their rough schedules, and they can be real tough on the students. That doesn't mean they're out to get you or anything. I ended up getting bad OB evals, but on reflection, I could have done a lot of things differently and the eval was basically just reflective of the fact that I obviously did not want to be there. A lot of the kids who got yelled at ended up getting good evals. If you're actually sincere and show you're willing to work hard, a few words of criticism isn't the end of the world. Just hang in there and don't let 'em see you sweat.

Psh whatever very few of my gen surg residents would flip out at students if they were tired and I can guarantee their schedules were just as bad if not worse than the OB residents. I've also seen equally bad schedules with the cardiology fellows I've worked with and they were amongst the nicest people.

 

[Eilat87]

Everyone I've come across, seems to have hated their OB rotation.

 

[VenusinFurs]

Psh whatever very few of my gen surg residents would flip out at students if they were tired and I can guarantee their schedules were just as bad if not worse than the OB residents. I've also seen equally bad schedules with the cardiology fellows I've worked with and they were amongst the nicest people.

Well good point.

 

[jerseytrash]

Everyone I've come across, seems to have hated their OB rotation.

I didn't hate the stuff I was doing on OB - I loved obstetrics. I thought delivering babies and MFM and REI was awesome - pregnancy does some crazy stuff to the physiology and I enjoyed the whole delivery process and how happy it was. But yes, I disliked the people.

 

[PTPoeny]

Everyone I've come across, seems to have hated their OB rotation.

I loved mine and so did the other 3 students that I rotated with and none of us went into OB. But I picked my location and time of year very specifically and location for OB was one of the things that I put down that I really cared about.

Also, I think the attendings and schedule do make a big difference in the residents. At my school we rotate at two different hospitals with the same group of residents and very consistently the residents are rated as better teachers and better leaders at one location versus the other. But some people are just mean-spirited nasty people no matter what. Nothing you can do about it but hope that your home PD is aware of this person's tendencies

Also, if this person is currently a chief resident, at least it means they won't be around for your sub-is or when you are interviewing which will be much more important than your third year grades.

 

[Top Gun]

1) Stop having so many faults.
2) If you don't have any faults, then ignore her.
3) Move on with your life.

Not exactly rocket schience.




ps. if you think you don't have any faults, then you are delusional. There are terrible residents and attendings out there, but a lot of medical students can't imagine that they aren't perfect and certainly something to consider. Despite your "great evals".

Not saying the student is perfect, but I suspect she is putting forth her best effort, and attempting to correct any deficiencies, considering she wants to do Ob/Gyn. It is possible she could just have a bitch resident who hates dealing with med students. I had plenty of them during my Ob/Gyn rotation as a med student. No need to be so tough on her.

 

[link2swim06]

I came really close to telling my chief resident off today. This woman has been so mean to me before i even got on her team. She finds faults in everything I do. She even told me to reconsider my specialty in indirect terms today. I want to do ob/gyn. My other evals are great. How do I keep her from ruining my life. I have 3 more days with her. I am so close to losing it. It seems like she would do anything in her power to destroy me. She did that to another student but she is not planning on going into ob/gyn.

1. OB blows
2. The resident SHOULD be telling you what you are doing wrong....we are only students, we gotta learn it someway. Them not telling you is more harmful imo.
3. Them being mean to you would be equal to going to a lecture where a professor screams at you for not knowing everything he is about to present. This is an obvious problem with him and not you.

I suspect her meanness is a projection of her ****ty life and nothing more.

 

[mimelim]

Not saying the student is perfect, but I suspect she is putting forth her best effort, and attempting to correct any deficiencies, considering she wants to do Ob/Gyn. It is possible she could just have a bitch resident who hates dealing with med students. I had plenty of them during my Ob/Gyn rotation as a med student. No need to be so tough on her.

In my limited experience, exposed to a couple dozen medical students on the wards, of all the people complaining about mean residents/attendings, I would say one had reason. Every single other case had something else going on that they either weren't aware of or in short the student was lazy. Given the prevailing sense of entitlement in most medical students and residents, statistically, I would strongly consider that the resident isn't "just being a big meany".

I know few students that actually put for their best effort, never mind that that simply may not be enough to cut it in certain areas of medicine. Once again, this is not to say that this resident is a great person or a good teacher. But, in short, there is nothing that you can do about it, even in the event that you are entirely in the clear. You can only modify your own behavior. OB is not going to be the last place that people are going to be critical of students. If you can't take criticism, right or wrong, then you are not going to make it in medical training.

 

[mercaptovizadeh]

I think Ob/Gyn is one of those rotations where if you don't already have a very good knowledge base and are very interested (asking good questions), they tend to dismiss you as uninterested. Sometimes people are just tetchy. You have to be very sensitive to that and try to avoid pissing them off/try to leave a somewhat good impression. I think it's harder to do that in L&D or surgery than in clinic, but you just have to do your best.

There were numerous times where I felt that the only reason the residents/attendings had some respect for me was because I actually knew the pelvic anatomy, knew about fibroids before watching fibroid resection, could answer their pimp questions on vaginitis, knew how to interpret fetal heart monitors, etc. And I felt this a lot more in ob/gyn than on pediatrics or internal medicine, where they seemed to be OK with "I don't know" and then they explained to you what was going on.

 

[smq123]

In my limited experience, exposed to a couple dozen medical students on the wards, of all the people complaining about mean residents/attendings, I would say one had reason. Every single other case had something else going on that they either weren't aware of or in short the student was lazy. Given the prevailing sense of entitlement in most medical students and residents, statistically, I would strongly consider that the resident isn't "just being a big meany".

I know few students that actually put for their best effort, never mind that that simply may not be enough to cut it in certain areas of medicine. Once again, this is not to say that this resident is a great person or a good teacher. But, in short, there is nothing that you can do about it, even in the event that you are entirely in the clear. You can only modify your own behavior. OB is not going to be the last place that people are going to be critical of students. If you can't take criticism, right or wrong, then you are not going to make it in medical training.

I see what you're saying, but OB DOES have a significant reputation for med student abuse. I think it has a worse reputation than any of the other surgical fields.

When I was an MS3, I got yelled at by the OB resident because I called in a consult. I misunderstood her instructions, and that's what I thought I was supposed to be doing. It was my 2nd rotation, so I didn't know any better.

She reamed me out in front of everyone. Said a lot of things that, in retrospect, were unnecessarily harsh. And yeah, it made me angry. I don't think that that meant I was entitled, but rather that she was a poor teacher who responded badly to a fairly simple situation.

 

[Top Gun]

In my limited experience, exposed to a couple dozen medical students on the wards, of all the people complaining about mean residents/attendings, I would say one had reason. Every single other case had something else going on that they either weren't aware of or in short the student was lazy. Given the prevailing sense of entitlement in most medical students and residents, statistically, I would strongly consider that the resident isn't "just being a big meany".

I know few students that actually put for their best effort, never mind that that simply may not be enough to cut it in certain areas of medicine. Once again, this is not to say that this resident is a great person or a good teacher. But, in short, there is nothing that you can do about it, even in the event that you are entirely in the clear. You can only modify your own behavior. OB is not going to be the last place that people are going to be critical of students. If you can't take criticism, right or wrong, then you are not going to make it in medical training.

I agree with you that there are quite a few med students with an entitlement mentality and very poor insight into their own deficiencies. However, Ob/Gyn is notorious for having miserable residents and attendings that seem to enjoy berating and abusing med students. We don't know the situation. It is possible the OP is not aware of what she is doing wrong, or she just rubbed the chief the wrong way. But if you're a med student doing a rotation in a field you want to specialize in, odds are you're going to do everything you can to impress your residents and attendings, and are going to try to go above and beyond what is expected of you. The chief could also be frequently criticizing the OP because she suspects she has the potential to become a good Ob/Gyn resident, and is trying to motivate her. Or she could just be a miserable bitch, who hates her life and crappy schedule, and is taking out her frustration on a med student. We'll never know. All I'm saying is that we shouldn't automatically assume the OP is entirely at fault when we don't know the whole story.

 

[VenusinFurs]

I think what mimelim's saying is essentially right. You need a tough skin to survive 3rd year and residency. Whether criticism is warranted and constructive or just someone being mean/ overly harsh, you gotta take it for what it is and try not to have an emotional reaction.

 

[survivordo]

No matter what you do you're going to run into miserable people. Use them as examples of who you do NOT want to be.

Survivor DO

 

[link2swim06]

In my limited experience, exposed to a couple dozen medical students on the wards, of all the people complaining about mean residents/attendings, I would say one had reason. Every single other case had something else going on that they either weren't aware of or in short the student was lazy. Given the prevailing sense of entitlement in most medical students and residents, statistically, I would strongly consider that the resident isn't "just being a big meany".

I know few students that actually put for their best effort, never mind that that simply may not be enough to cut it in certain areas of medicine. Once again, this is not to say that this resident is a great person or a good teacher. But, in short, there is nothing that you can do about it, even in the event that you are entirely in the clear. You can only modify your own behavior. OB is not going to be the last place that people are going to be critical of students. If you can't take criticism, right or wrong, then you are not going to make it in medical training.

Even in this case the resident should sit down the student and explain the expectations and how the student is falling short. It would LITERALLY take 2 minutes max.

Instead of just being an ******* to med student. That helps nobody.

 

[mimelim]

Even in this case the resident should sit down the student and explain the expectations and how the student is falling short. It would LITERALLY take 2 minutes max.

Instead of just being an ******* to med student. That helps nobody.

Personally? I would. Seems like the right thing to do for minimal effort, then again if it were me, this wouldn't happen.

On the other hand... You are asking someone who works minimum wage with no control over their lifestyle to do something above and beyond their job description. Residents don't have any duty to medical students or their education. Some people simply don't derive satisfaction from teaching or helping others. Given the lack of other incentives, I can hardly blame them.

 

[JourneyAgent]

Lack of insight is not just a medical student problem. Actually it probably gets worse the more you know clinically and mis-extrapolate that self-confidence to other areas of personnel management.

I was sitting in a grand rounds lecture from a visiting expert in medical curricula on how to evaluate residents and med students. She asked the question: "how many of you think that evaluations by attending's are subjective? (With a room full of attendings, in one of the most hierarchical and retributive training systems ever devised). Holy confirmation bias batman! She then took this show of support and explained it as such: "that's because we're masters of assessment". "We can asses more in a few minutes than most people do all day." Etc.

Insightopenia profundus.

With regards to the OP. Walk away. Try to get support from other people on the rotation. Giving the res ammunition to execute you with is damn foolish.

Yes I agree with the others saying we need thick skin. Mines getting thicker by the day. I'm almost completely free of worrying about evaluation and just concentrating on education. If there's something I can use with a criticism, I'll try to use it to my advantage. But I no longer believe the evaluation process means a damn thing except I showed up and didn't do anything really stupid.

 

[jerseytrash]

Personally? I would. Seems like the right thing to do for minimal effort, then again if it were me, this wouldn't happen.

On the other hand... You are asking someone who works minimum wage with no control over their lifestyle to do something above and beyond their job description. Residents don't have any duty to medical students or their education. Some people simply don't derive satisfaction from teaching or helping others. Given the lack of other incentives, I can hardly blame them.

Really? Teaching medical students is beyond the job description of a resident? I somehow doubt that. In my residency contract part of our job is teaching (granted, it's academic IM, but if this site has med students it seems more likely than not that it's part of their job).

And if being nice to somebody requires an incentive, then there's something wrong with that person.

 

[jerseytrash]

I think Ob/Gyn is one of those rotations where if you don't already have a very good knowledge base and are very interested (asking good questions), they tend to dismiss you as uninterested. Sometimes people are just tetchy. You have to be very sensitive to that and try to avoid pissing them off/try to leave a somewhat good impression. I think it's harder to do that in L&D or surgery than in clinic, but you just have to do your best.

There were numerous times where I felt that the only reason the residents/attendings had some respect for me was because I actually knew the pelvic anatomy, knew about fibroids before watching fibroid resection, could answer their pimp questions on vaginitis, knew how to interpret fetal heart monitors, etc. And I felt this a lot more in ob/gyn than on pediatrics or internal medicine, where they seemed to be OK with "I don't know" and then they explained to you what was going on.

I would agree that certainly having a knowledge of the basics is key. That helped me out a lot in OB and in surgery, but also in medicine and peds. I had a couple very nice OB residents and attendings who took the time while doing the operation to get me involved and explain stuff I didn't know.

Ultimately I think it's personality. Someone with a crappy personality, even in the lightest of specialties, will find a way to be a jerk to students. Someone with a good personality in the most hardcore of specialties, be it neurosurgery or interventional cards or EM, will find a way to be nice to people. I don't think people can write off "oh it's stressful" as an excuse.

And as always the only way to deal with it is having a thick skin.

 

[mimelim]

Really? Teaching medical students is beyond the job description of a resident? I somehow doubt that. In my residency contract part of our job is teaching (granted, it's academic IM, but if this site has med students it seems more likely than not that it's part of their job).

And if being nice to somebody requires an incentive, then there's something wrong with that person.

I'd like to see that contract and the wording. I just re-read mine. Certainly nothing in there that mentions working with students (academic surgery program). I also asked a resident at our neighboring program and they don't have anything in there about teaching. I am a little at a loss as to how you could get that into a contract, but now I'm curious, if you don't mind sharing.

It is not the responsibility of residents to teach. It is the responsibility of residents to meet the standards for learning and advancement, follow duty hours, provide patient care consistent with the values of the institution, comply with procedure and case log reporting requirements etc. You are an employee of a hospital. Certain contracts may have academic requirements, but that is certainly not the norm.

While it is a common belief among medical students that they "pay for school" and therefore are entitled to attendings, residents and other's time, that is simply not true and nor should it be. I am among the most helpful and education oriented residents. But I'm not going to waste my time and energy on people who are lazy or nonmotivated. I also certainly don't expect other residents to give two craps about medical students. Again, you have someone who is chronically overworked and underpaid, expecting them to go above/beyond their job is just asinine.

Also, your last statement... Sorry to break it to you, but the world isn't nice. People don't give away things for free. No population, students, residents, attendings, or the population at large is comprised of people that will on average help you just for the sake of helping you.

 

[KnuxNole]

To be honest, that's one part of residency I'm not looking forward to...teaching. I don't mind impromptu teaching, but I generally don't see myself as a good teacher at all.

Also, something that came to mind, if residents are not expected to teach, why do some residents get mad when a student doesn't want to learn from them and instead asks the attending or reads in the library?

 

[Democritus]

I'd like to see that contract and the wording. I just re-read mine. Certainly nothing in there that mentions working with students (academic surgery program). I also asked a resident at our neighboring program and they don't have anything in there about teaching. I am a little at a loss as to how you could get that into a contract, but now I'm curious, if you don't mind sharing.

It is not the responsibility of residents to teach. It is the responsibility of residents to meet the standards for learning and advancement, follow duty hours, provide patient care consistent with the values of the institution, comply with procedure and case log reporting requirements etc. You are an employee of a hospital. Certain contracts may have academic requirements, but that is certainly not the norm.

While it is a common belief among medical students that they "pay for school" and therefore are entitled to attendings, residents and other's time, that is simply not true and nor should it be. I am among the most helpful and education oriented residents. But I'm not going to waste my time and energy on people who are lazy or nonmotivated. I also certainly don't expect other residents to give two craps about medical students. Again, you have someone who is chronically overworked and underpaid, expecting them to go above/beyond their job is just asinine.

Also, your last statement... Sorry to break it to you, but the world isn't nice. People don't give away things for free. No population, students, residents, attendings, or the population at large is comprised of people that will on average help you just for the sake of helping you.

So you have no obligation to the education of medical students. Yet you think there's a context for interacting with them and insulting them about how they are so poorly educated?

Can you explain what you think the purpose of your interactions with medical students is, if not related to their education?

 

[JourneyAgent]

So you have no obligation to the education of medical students. Yet you think there's a context for interacting with them and insulting them about how they are so poorly educated?

Can you explain what you think the purpose of your interactions with medical students is, if not related to their education?

Great questions. They illustrate the incongruence between medical student and resident goals. Residents are the engine of the hospital. So no....they don't really have any obligation to teach. And I don't blame them either. It's just up to medical students to observe, think, read, present on their patients. And treat small interactions with attendings--usually the main source of evaluation--as auditions for your song and dance talents.

That's pretty much it. The faster your can write notes, call consults, keep your to do list for patients organized and up to date and ready for the discharge, the easier the transition to intern year will be.

But, nothing will make it easy. And there's a whole set of performance markers that a medical student must meet that have absolutely nothing to do with patient to do lists. And so you make the compromises of serving multiple master you need to. For some this showy game of slickness come easily. And if you can hit your TelePrompts crisply and on cue with the right polish and panache then you've mastered 3rd year game.

But I wouldn't worry about what that means for education and your career. Very little. And that's fine because it's good cause for cutting the residents a break. They don't owe us anything. We're just learning the elementary aspects of their language and then we go on and try to fill their shoes and so on as the years progress.

Education is largely irrelevant to the work of treating patients. It's one of the reasons it takes so long. It's on the senior residents to give the academic physicians enough cush to keep the whole circus moving on. Don't worry about what scooping elephant poop means in the grand scheme.

 

[mimelim]

So you have no obligation to the education of medical students. Yet you think there's a context for interacting with them and insulting them about how they are so poorly educated?

Can you explain what you think the purpose of your interactions with medical students is, if not related to their education?

I would suggest you matriculate medical school and spend some time on the wards prior to trying to argue something that you know nothing about.

Residents have zero duty or obligation to teach students. Yes, basic work place etiquette should be in play and being abusive should never be tolerated. But, if someone doesn't read appropriately, if someone doesn't practice basic skills prior to showing up, if someone gets in the way, then I absolutely think that residents have every right to tell the students to get out of the way and sit in the corner.

Would I personally? Absolutely not. I have made a career over medical student and resident education. I've won multiple teaching awards etc. But, even coming from that background, the sense of entitlement of medical students is absolutely astounding and I certainly do not fault my colleagues from not caring about medical student education at all.

 

[JourneyAgent]

I would suggest you matriculate medical school and spend some time on the wards prior to trying to argue something that you know nothing about.

Residents have zero duty or obligation to teach students. Yes, basic work place etiquette should be in play and being abusive should never be tolerated. But, if someone doesn't read appropriately, if someone doesn't practice basic skills prior to showing up, if someone gets in the way, then I absolutely think that residents have every right to tell the students to get out of the way and sit in the corner.

Would I personally? Absolutely not. I have made a career over medical student and resident education. I've won multiple teaching awards etc. But, even coming from that background, the sense of entitlement of medical students is absolutely astounding and I certainly do not fault my colleagues from not caring about medical student education at all.

You act like its a kids of today thing. Maybe. But the clerkship role has largely been rendered boar tits. Medical/legal from one end. The predomnance of standardized testing and shelf exams on the other. All the while tuition is skyrocketing. One could easily, if they weren't as wearily accepting of the uselessness of most of life, like me, or extremely over worked on the other side of it, be convinced its a raw deal.

Waiting for Dr. Godot is the clerk story. People just waiting. Not really sure on what. Activity that goes one way. Expectations that go another. All manner of institutional-scale pretense and artiface setting them up for it. Wtf are we paying for? Make me an intern's intern and let's get on with this b!tch. Being a clerk is f'n stupid.

You can't act like its the best educational model ever and then fault people for the lack of buy in. The only ones that stay late to kiss you're ass are the ones that don't have a choice and want your job at the midway point up mt. surgery. But that's not a normal human response to epic uselessness.

You can't have your dogma both ways. Well...you can...cause this isn't a democracy...but that doesn't mean we don't recognize the bull**** in your sermonizing.

 

[mimelim]

Nobody ever said that it was the best training model. I don't fault people for buying in either. I re-read my posts and find it very hard to believe that anyone would think that I said either of those two things. I would appreciate it if you didn't put words into my mouth and respond to things that nobody is arguing.

I agree that the largest problem right now are how clerkships are setup. Medical students are not responsible for anything unless they specifically ask for it, which makes it very difficult for them to learn.

 

[VisionaryTics]

I agree that the largest problem right now are how clerkships are setup. Medical students are not responsible for anything unless they specifically ask for it, which makes it very difficult for them to learn.

And even if we do ask, we aren't allowed any responsibility for legal reasons. We should have training wheels, but instead we pretend to have a bike.

 

[Siverhideo1985]

OB = princess central. Just smile and get through their tantrums...you'll be fine.

 

[mimelim]

And even if we do ask, we aren't allowed any responsibility for legal reasons. We should have training wheels, but instead we pretend to have a bike.

I never had that problem and neither do any of the stronger medical students that I have worked with in the past year. I have never heard of legal restrictions that actually affect what happens on the wards. It may not be the culture of an institution to allow students to do things, but there certainly are not blanket legal restrictions.

http://forums.studentdoctor.net/showpost.php?p=13752337&postcount=21

My students see patients, write notes, present to attendings with me piping in only if necessary. They put in central lines and chest tubes, close skin, place wound vacs, do dressing changes etc. The only thing a medical student can't do that I can is put in orders.

Unless, you are talking about something different...

 

[evilbooyaa]

As I've stated before mimelim, I like the cut of your jib in terms of giving students real responsibilities. I might be contacting you when I'm a 4th year for possibly doing an away rotation at your site. I'm not plannign to go into a surgical subspecialty, but I want to do some minor procedural stuff (like central lines, chest tubes) and enjoy basic suturing.

 

[JourneyAgent]

Nobody ever said that it was the best training model. I don't fault people for buying in either. I re-read my posts and find it very hard to believe that anyone would think that I said either of those two things. I would appreciate it if you didn't put words into my mouth and respond to things that nobody is arguing.

I agree that the largest problem right now are how clerkships are setup. Medical students are not responsible for anything unless they specifically ask for it, which makes it very difficult for them to learn.

You said we're entitled. And seemed to imply this was the reason why didn't learn or do well.

What I'm saying is that doing well and learning well are separate activities. I'm all for getting there early, getting all the things that happened to our patient together, and then trying to baby talk my way through a patients clinical situation to a more experienced clinician and then getting asked probing questions, that I can think about and read on.

That's good for some AM hours. And then some in the PM for the same. There's definitely something to be gained. But the guy who whimsically drops his/her opinion for my grade comes and goes for a tiny fraction of the day. If they're a surgeon I'm a mask holding a light. Useful as the butt of jokes and a relief to all small creatures of the realm that they, for the moment, are not the smallest. Our gift to them.

But for my money, I'd like at least like an old bottle of scotch or something. And some time to just leave me the hell alone so I can pass these big tests. I'm interested in a few basic procedures, but not that much. Only to get me through intern year.

And so what I can I do. A grown @ss man looking at another grown @ss man or lady. We both know wassup. I have no ability to fake a f'n thing. And I don't want to waste your time.

I'd be completely happy doing whatever clerical **** you want, or just take a walk to the cafeteria to get us both some coffee.

But it's your fiefdom and as much as have all boy kings past have done, you will dole out rewards and punishments for enthusiasm for games you make up the spontaneous rules for. And call it objective evaluation. Confident as Custer.

Such that all of us are entitled.

You got it chief. We are spoiled brats, who hate work, and are not cut out to be surgeons. Do you like balls lifted while I do my business or are you a if finger in the bum kind of guy.

How do you like it?

And it cost me thousands to turn these tricks.

 

[VisionaryTics]

I never had that problem and neither do any of the stronger medical students that I have worked with in the past year. I have never heard of legal restrictions that actually affect what happens on the wards. It may not be the culture of an institution to allow students to do things, but there certainly are not blanket legal restrictions.

http://forums.studentdoctor.net/showpost.php?p=13752337&postcount=21

My students see patients, write notes, present to attendings with me piping in only if necessary. They put in central lines and chest tubes, close skin, place wound vacs, do dressing changes etc. The only thing a medical student can't do that I can is put in orders.

Unless, you are talking about something different...

That was what my surgical rotation was like. Now, I'm on peds. I was laughed at by an attending (literally, laughed at) when I asked to suture a gash in some kid's leg. My resident co-signed one of my notes last week, and the residency director had a meeting with the entire damn program reminding them that students' notes are not to be considered part of the medical record since the hospital could get sued.

God, I miss surgery.

 

[evilbooyaa]

If I had an attending that laughed at me for asking to do work, I'd be kind of annoyed. Were you at the same hospital? I'd tell them that Dr. Big-shot-surgery-attending liked my skin suturing work a few weeks ago.

Actually, I wouldn't, cause this attending is probably evaluating you so you can't say that's actually on your mind. But I would in my head. I'd totally be a huge dick to him/her. Totally.

 

[ijn]

Most residents I've worked with don't let you do anything near that. You're lucky if you get to take an H&P and present to an attending or chief resident. On most days I just shadow. Yet still get honors...

 

[VisionaryTics]

If I had an attending that laughed at me for asking to do work, I'd be kind of annoyed. Were you at the same hospital? I'd tell them that Dr. Big-shot-surgery-attending liked my skin suturing work a few weeks ago.

Actually, I wouldn't, cause this attending is probably evaluating you so you can't say that's actually on your mind. But I would in my head. I'd totally be a huge dick to him/her. Totally.

Different hospital than my surgery rotation.

The worst part was watching the second year peds resident who hadn't sutured anything at all since medical school struggle through the repair.

Whatever, I get the rest of my life to operate.

 

[jerseytrash]

I'd like to see that contract and the wording. I just re-read mine. Certainly nothing in there that mentions working with students (academic surgery program). I also asked a resident at our neighboring program and they don't have anything in there about teaching. I am a little at a loss as to how you could get that into a contract, but now I'm curious, if you don't mind sharing.

It is not the responsibility of residents to teach. It is the responsibility of residents to meet the standards for learning and advancement, follow duty hours, provide patient care consistent with the values of the institution, comply with procedure and case log reporting requirements etc. You are an employee of a hospital. Certain contracts may have academic requirements, but that is certainly not the norm.

While it is a common belief among medical students that they "pay for school" and therefore are entitled to attendings, residents and other's time, that is simply not true and nor should it be. I am among the most helpful and education oriented residents. But I'm not going to waste my time and energy on people who are lazy or nonmotivated. I also certainly don't expect other residents to give two craps about medical students. Again, you have someone who is chronically overworked and underpaid, expecting them to go above/beyond their job is just asinine.

Also, your last statement... Sorry to break it to you, but the world isn't nice. People don't give away things for free. No population, students, residents, attendings, or the population at large is comprised of people that will on average help you just for the sake of helping you.

I didn't say that the world is nice. I said that living your life purely for quid pro quo is a terrible way to live your life.

I don't actually have a copy of my contract now but if not strictly stated (which it might be, as far as 'managing medical students on the team' goes which I partly interpret as teaching) then I think it's implied. You were a medical student not such a long time ago, I would hope that you remember how awkward and dull being a 3rd year clerk can be if you have no guidance or teaching. The fact that you teach more to students who want to work in whatever field you are in is great. That doesn't mean you should avoid teaching students who might want to go into IM or peds or whatever it is that isn't your field (vascular surgery?) just because it doesn't flatter you. If anything it will get them MORE interested in your field.

 

[IGotGas]

Medical student teaching/supervision is specifically mentioned in my contract.

 

[Bacchus]

Mine mentions it specifically too, FWIW:

Participate fully in the educational activities of the program, including responsibility for teaching and supervising of the residents and medical students as assigned...

 

[JourneyAgent]

I suppose whether contractual or not. It just isn't part of a gentleman's code to sit back and pile on one more responsibility onto the backs of the most overworked members of the team. How about that attending knocking off by 3 pm stop by and earn that Cush that they're riding all the way up into the damn stable. Or just none at all. I can read and observe and see patients and present. Anything else is gamble on wasting somebody's time. Mine, theirs.

I mean I love a good teaching session. But expecting it of residents is just not going about it with any cool.

 

[jerseytrash]

Medical student teaching/supervision is specifically mentioned in my contract.

Yup mine too, it's actually even more explicit than I expected:

"The Resident/Fellow will ... as authorized by the teaching staff ... assume responsibility for teaching and supervising other residents/fellows and students."

I'm fairly sure most academic residencies, whether IM or surgical or peds, do have something about teaching because they are either affiliated with or are part of a medical school.

 

[jerseytrash]

I suppose whether contractual or not. It just isn't part of a gentleman's code to sit back and pile on one more responsibility onto the backs of the most overworked members of the team. How about that attending knocking off by 3 pm stop by and earn that Cush that they're riding all the way up into the damn stable. Or just none at all. I can read and observe and see patients and present. Anything else is gamble on wasting somebody's time. Mine, theirs.

I mean I love a good teaching session. But expecting it of residents is just not going about it with any cool.

I highly, highly disagree. As a resident if you have chosen to go to an academic institution you have an obligation to teach other medical students, who will possibly in a few more years be your co-residents and work with you.

I don't know what sort of experience you have had but I always enjoyed my rotations more when my residents got me involved and taught me things, even if it was a field I absolutely hated.

 

[JourneyAgent]

I highly, highly disagree. As a resident if you have chosen to go to an academic institution you have an obligation to teach other medical students, who will possibly in a few more years be your co-residents and work with you.

I don't know what sort of experience you have had but I always enjoyed my rotations more when my residents got me involved and taught me things, even if it was a field I absolutely hated.

Yeah. I mean of course that's cool. I think it's just that we are most in contact with the people who are most overwhelmed by most of the details that have to be carried out on any patient load. Ideally the people higher up the chain--fellows, attendings, and senior residents should be tasked with doing the teaching. Cause their not bogged down with keeping all the patient care moving.

That happens sometimes. And it makes for a better experience. But when it doesn't. And when the team has too many chiefs and not enough indians. And even the teaching gets passed down hill. Then I think it's time for us to learn self-education skills. The things we'll need for the rest of our careers. Instead of leaning on the overwhelmed so that we can sit back and be taught clinical pearls so that they have to crap and eat less to do it for us.

I don't think we disagree really. It's just a question of style and semantics.

 

[Top Gun]

In my opinion, teaching does have a place, but its secondary to patient care. The resident's first priority is patient care, obviously. But if the resident has down time, then s/he ought to be making an effort to teach the med student, provided, of course, the med student is motivated, diligent, and eager to learn. Part of being a physician is being an educator, whether it involves educating patients with regard to diet and exercise, or teaching med students and residents.

 

[toftt]

Whether or not it mentions "teaching" in your contract, if you're going to take the time to yell at a student in front of a bunch of other people (which is pretty uncharismatic by the way.. there's a time and place for everything), you better make sure that the student at least walks away with a good idea of what he/she did wrong, why it was wrong, and what should be done in the future. Otherwise, yelling at the student is a complete waste of time--both for the resident and the student--because the student remains uneducated about the mistake and will likely make the same mistake again, which will waste even more of the resident's time (not to mention the impact on patient care, which is ultimately the most important thing at stake here).

If the student is lazy/unmotivated then I agree the student doesn't deserve the resident's time. If the student is genuinely trying hard, asking for feedback, and yet still can't figure out what he/she is doing wrong, then the resident probably isn't communicating properly. It really is a two-way street.

 

[jerseytrash]

Yeah. I mean of course that's cool. I think it's just that we are most in contact with the people who are most overwhelmed by most of the details that have to be carried out on any patient load. Ideally the people higher up the chain--fellows, attendings, and senior residents should be tasked with doing the teaching. Cause their not bogged down with keeping all the patient care moving.

That happens sometimes. And it makes for a better experience. But when it doesn't. And when the team has too many chiefs and not enough indians. And even the teaching gets passed down hill. Then I think it's time for us to learn self-education skills. The things we'll need for the rest of our careers. Instead of leaning on the overwhelmed so that we can sit back and be taught clinical pearls so that they have to crap and eat less to do it for us.

I don't think we disagree really. It's just a question of style and semantics.

I agree that attendings and senior residents should take the bulk of it since they're less bogged down with busy work but I think even interns have valuable things to teach as well - certainly some know more than your average 4th year medical student (though I imagine in July they may actually know less, lol).

Agreed for sure with Top Gun that patient care is the first priority for any healthcare professional and teaching comes second but at an academic institution I think a lot should be done to equalize the importance of the two.