Disillusioned w/ 3rd Year

[waitlist22]

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Two months in and I am already sick of playing the BS games and the subjective crap. Look I am not naïve and realize this is the way it goes, but just needed a place to vent and see how other people are dealing with it and getting over it. By no means do I think I am the best student on rotations but I ask questions, give pretty thorough patient presentations and notes and have ask for verbal feedback every week. I always get verbal comments that I am doing great and my notes are good and on one rotation was told that myself and the other medical student were performing at an intern level and carrying an intern patient load. Then the evaluation comes back as a 79 👎. Not once did I get any negative feedback or things to improve upon despite repeatedly asking for them. Any strategies on how to just let it go and move on or how do you all just get over it and forget about it?

Its even worse because I scored pretty high on the shelf (highest in my rotation group) but it won't be enough to offset this evaluation in order to honor the rotation. Really just looking to see if anyone is feeling the same way. Not trying to prove I am the best student ever and should honor every rotation with 100%s.

 

[Kahreek]

I dont really know how to answer this, some people might try to rationalize it.

In my opinion, there is always some rotation where you are given unfair evaluation. And sometimes when you try to compare to other classmates it can only make it worse.
Sometimes people judge charisma more than skills and if you are not charismatic you might end with the short stick.
Just don't get down because of it, and continue to do your best in the future.

 

[JP2740]

agreed. it's not objective at all.

it's bull****.

life is unfair.

spend more time with women and profit

 

[Kal EI]

agreed. it's not objective at all.

it's bull****.

life is unfair.

spend more time with women and profit

👍. Don't stress.

 

[J ROD]

I have been there exactly in pharm school.

Best thing you can do is just do your best and learn so you can be a good MD later on. I just did my thing and tried to play their game to some point. Just get through it. I dont get all worked up and learned the deal.

It sucks and it is not fair but that is the subjective nature of it.

Just do what you have to and move on. In the end, it doesnt really matter.

usually.......I guess it could if that is what you plan to go into. But, even then a strong app will cover you.

 

[Ilovewater]

It happens. I recently had a meeting with the writer for my dean's letter for residency application. She read the comments on my evaluations and asked me how I didn't honor the rotation with such "amazing" comments. The student who was on the same team I was for that rotation would purposely skip out on some call days with random excuses, and he got honors. It's not fair, but it is what it is.... All you can do is work hard and hope that the attendings/residents evaluating you are fair.

 

[Nasrudin]

I agree with my colleagues. And it's understandable to get frustrated. You're particularly unfortunate if going for a very competitive specialty. If so, you'll have to study the art of war. Which, in this case, despite what your superiors will imagine it means, amounts to knowing at all times who to impress and laser focusing your schmooze in that direction. It might mean acting as if all that comes out if their mouth is prophecy and to scribbled down and cherished as such for the future of mankind. Ego massage is an art. And academic attendings are particularly fond of themselves. It's part of their compensation package.

Otherwise. Just be a good team member and learn as much as you can. Sometimes you'll get accolades other times mediocre evals from people you've barely met. That's how it goes playin in a band.

 

[Smurfette]

Clinical grades in 3rd year are highly subjective.
Some people will NEVER give honors, or don't like to select the "extremes" on evals that result in the higher grade depending how it is calculated. I've seen it worded on evals that the top grade is "best 1% of all students you've ever worked with". Every school, and sometimes every clerkship has a different grading system.
Some people will give everyone honors.
Some people will confuse which student is which, or not fill it out until weeks after a student has rotated off-service.
It's not always fair, but most of your classmates will encounter similar issues in their rotations as well.

 

[Stellar Clouds]

Clinical grades in 3rd year are highly subjective.
Some people will NEVER give honors, or don't like to select the "extremes" on evals that result in the higher grade depending how it is calculated. I've seen it worded on evals that the top grade is "best 1% of all students you've ever worked with". Every school, and sometimes every clerkship has a different grading system.
Some people will give everyone honors.
Some people will confuse which student is which, or not fill it out until weeks after a student has rotated off-service.
It's not always fair, but most of your classmates will encounter similar issues in their rotations as well.

+1

Translation: equally less than ideal for all.

Keep your chin up, show interest, work hard, know your patients like the back of your hand, take initiative. At least then you won't say to yourself, "well if I had just done this..."

Or take the equally opposite tract...don't care, don't learn, get probably the same or a similar grade, but be clueless come July 1st (the real one).

 

[mdeast]

Very few people get honors on their first rotation (I assume this is your first?). In fact, I get the sense that during the first MS3 summer, schools almost intentionally give you a pass grade to make sure you work harder on subsequent rotations.

I think the best advice for third year is to try and ignore as much off the bs as possible, and just make sure you're actually learning something on a rotation. The worst case scenario is you getting to residency, being given a lot of responsibility over people's live, and not knowing how to handle it. I'm much more afraid of that than not getting honors in a class.

 

[link2swim06]

The goal of 3rd year is to find what you like and don't like.

Learn as much as you can...it goes by fast.

 

[Trastuz]

Two months in and I am already sick of playing the BS games and the subjective crap. Look I am not naïve and realize this is the way it goes, but just needed a place to vent and see how other people are dealing with it and getting over it. By no means do I think I am the best student on rotations but I ask questions, give pretty thorough patient presentations and notes and have ask for verbal feedback every week. I always get verbal comments that I am doing great and my notes are good and on one rotation was told that myself and the other medical student were performing at an intern level and carrying an intern patient load. Then the evaluation comes back as a 79 👎. Not once did I get any negative feedback or things to improve upon despite repeatedly asking for them. Any strategies on how to just let it go and move on or how do you all just get over it and forget about it?

Its even worse because I scored pretty high on the shelf (highest in my rotation group) but it won't be enough to offset this evaluation in order to honor the rotation. Really just looking to see if anyone is feeling the same way. Not trying to prove I am the best student ever and should honor every rotation with 100%s.

You should check out the "things I hate about 3rd year" thread. It might make you feel better.

 

[DoctorDermis]

Two months in and I am already sick of playing the BS games and the subjective crap. Look I am not naïve and realize this is the way it goes, but just needed a place to vent and see how other people are dealing with it and getting over it. By no means do I think I am the best student on rotations but I ask questions, give pretty thorough patient presentations and notes and have ask for verbal feedback every week. I always get verbal comments that I am doing great and my notes are good and on one rotation was told that myself and the other medical student were performing at an intern level and carrying an intern patient load. Then the evaluation comes back as a 79 👎. Not once did I get any negative feedback or things to improve upon despite repeatedly asking for them. Any strategies on how to just let it go and move on or how do you all just get over it and forget about it?

Its even worse because I scored pretty high on the shelf (highest in my rotation group) but it won't be enough to offset this evaluation in order to honor the rotation. Really just looking to see if anyone is feeling the same way. Not trying to prove I am the best student ever and should honor every rotation with 100%s.

I totally sympathize with you on this - it is obvious that you have done your homework on "how to do well during clinical rotations", and have been trying to implement various strategies to do well. I struggled in 3rd year in terms of trying to meet all those areas on the evaluation for my attending to justify giving me a favorable grade - sometimes it just didn't work out.

However - just wanted to get some more detail from you. You mentioned that you seeked verbal feedback and were very proactive.
1) was this with the attending who was responsible for your evaluation, and did you schedule a meeting for a mid-rotation evaluation? Or, was the feedback sessions you elicited more of a end-of-clinic / post-rounds curbside chat?
2) is it possible that in some ways, you may have come off as over-eager or potentially rubbed some people the wrong way? (this is one area I personally got burned on, and learned the hard way that there is a fine line between helpful / interested, and irritating / gunner).

Be aware that some people will tell you that you are doing fine and will not take the effort or time to provide honest feedback to actually help you improve - Instead, they will rather simply wait until your name pops up on evals and let their true feelings known.

 

[gators21]

Ok I'm gonna play the bad guy.
People always tend to point out things that they think they are doing well, but completely neglect the annoying/irresponsible/gunner/whatever things. Just from your post alone it sounds a little "I did this, this, and this I deserve an A."
1) Were you ever late?
2) Are you someone who no matter what was happening on the floor, went and took an hour lunch?
3) Did you always sit at a computer screen, taking up one of the very few accessible comps/phones/chairs on the unit?
4) Refused to do something if you thought it was beneath you (move a patient, help the nurse clean a pt, run to the lab)?
5) Steal procedures from another student?
6) Ask questions that take 2 seconds of effort to look up?
7) Not follow up on things that you were told to read up on?
8) Act like you were an intern. (remember you are a med student on the bottom of a massive crap pile. Medicine is very old school and hierarchical, don't overstep you boundaries)
9) Talk back/demand something from a nurse?
See where I'm going with this. Just because you perceive yourself as an awesome student, doesn't mean that you come off that way to other people.

But then again some people are just a-holes that wanna see the world burn

 

[thedoctor8706]

I hear you OP, I'm just finishing up my medicine rotation, and I feel my last evaluation was less than fair. My attending even apologized that she didn't try to teach me more, and it was because she was way too busy trying to get brand new interns up to speed. So even though I busted my tail, she didn't take notice and my evaluation was less than stellar. Oh well, we all make it through, I'm just learning quickly to take things in stride...

 

[waitlist22]

Thanks for all the replies all, just one of those frustrating times and had to vent. I also appreciate the devil's advocate position as well. I certainly think I could come off as over-eager but and that is definitely a possibility but to me seems like it should only account for a 4-5 point drop on an evaluation. I don't feel that it is in a gunner fashion but really just a desire to learn from those that have more clinical experience. I can learn from reading but it isn't the same when you are in clinic and asking questions that you can associate answers with a specific patient or situation. I certainly think personality could account for a lower than expected evaluation but not this much lower in my opinion. It is just really fishy because every single one of my other evaluations from like 8-9 other faculty are in the 89-100 range so something just isn't adding up with this one evaluation. And unfortunately this 79 evaluation accounts for 30% of my grade, practically impossible to make up even with a great shelf score and my other evaluations.

As far as the multiple questions from the poster playing devil's advocate, the only thing I may have done from that list is ask questions I could have easily looked up and that is certainly true. I frequently did scut work for the residents and they even pointed it out and we only took lunch when the residents took lunch. I obviously think everyone thinks they are superior students but I consider myself pretty good at self reflecting and knowing my short-comings and when I am not rubbing people quite the right way. Anyway thanks everyone for the responses and a little bit of commiserating.

 

[Evil_Abed]

Thanks for all the replies all, just one of those frustrating times and had to vent. I also appreciate the devil's advocate position as well. I certainly think I could come off as over-eager but and that is definitely a possibility but to me seems like it should only account for a 4-5 point drop on an evaluation. I don't feel that it is in a gunner fashion but really just a desire to learn from those that have more clinical experience. I can learn from reading but it isn't the same when you are in clinic and asking questions that you can associate answers with a specific patient or situation. I certainly think personality could account for a lower than expected evaluation but not this much lower in my opinion. It is just really fishy because every single one of my other evaluations from like 8-9 other faculty are in the 89-100 range so something just isn't adding up with this one evaluation. And unfortunately this 79 evaluation accounts for 30% of my grade, practically impossible to make up even with a great shelf score and my other evaluations.

As far as the multiple questions from the poster playing devil's advocate, the only thing I may have done from that list is ask questions I could have easily looked up and that is certainly true. I frequently did scut work for the residents and they even pointed it out and we only took lunch when the residents took lunch. I obviously think everyone thinks they are superior students but I consider myself pretty good at self reflecting and knowing my short-comings and when I am not rubbing people quite the right way. Anyway thanks everyone for the responses and a little bit of commiserating.

That could actually be kind of a big deal. Why do you deserve honors if you were incapable of looking up basic things? I can definitely see an attending dinging you for "competency" issues -- if you're being lazy or genuinely having trouble looking things up (not saying you were, OP), I can see it coming off as concerning. Just playing more Devil's advocate.

 

[Nasrudin]

I think all these advocates for satan are over analyzing the randomness of third year. You either become a cock seeking suck missile to maintain your candidacy for derm and the like or you act like a normal human being and take it for what it is. Or somewhere in between. Like most of us perhaps.

But all these rational analyses of pedagogy in this system are laughable. And a thousand Johnnie Cochrans couldn't make it otherwise.

We are essentially a nuisance in the business of healthcare. Our tuition doesn't cover the cost of crackers. We're nonfactor's nonfactor. Learn what you can and keep it movin. The best part of third year is that it stays movin. You're never in one place for that long. The consummate social skill is rolling with punches.

 

[D elegans]

That could actually be kind of a big deal. Why do you deserve honors if you were incapable of looking up basic things? I can definitely see an attending dinging you for "competency" issues -- if you're being lazy or genuinely having trouble looking things up (not saying you were, OP), I can see it coming off as concerning. Just playing more Devil's advocate.

I think this is highly rotation dependent. Many of the attendings I had on my surgery rotation made me develop an attitude of never asking questions because of course I can look up anything myself and they didn't like being bothered. However, my current attending on IM expects us to ask questions. I'd say just figure out your comfort zone with the attending. I mean, they ARE supposed to be teachers. Anyone can respond, "Why don't you go look that up?" And of course you should look up things, but they are paid to be clinical INSTRUCTORS for a reason

 

[IJL]

We're nonfactor's nonfactor.

wtf does that even mean??

The consummate social skill is rolling with punches.

👍

 

[evilbooyaa]

I think this is highly rotation dependent. Many of the attendings I had on my surgery rotation made me develop an attitude of never asking questions because of course I can look up anything myself and they didn't like being bothered. However, my current attending on IM expects us to ask questions. I'd say just figure out your comfort zone with the attending. I mean, they ARE supposed to be teachers. Anyone can respond, "Why don't you go look that up?" And of course you should look up things, but they are paid to be clinical INSTRUCTORS for a reason

Clinical instructors shouldn't mean spoon feeding you answers. If you look something up and still don't understand the reason, then asking your attending is appropriate. If an attending truly wanted to teach, he'd tell you to stop asking stupid questions and go look up everything that you asked and have a presentation ready for tomorrow.

 

[Kahreek]

Clinical instructors shouldn't mean spoon feeding you answers. If you look something up and still don't understand the reason, then asking your attending is appropriate. If an attending truly wanted to teach, he'd tell you to stop asking stupid questions and go look up everything that you asked and have a presentation ready for tomorrow.

i cant agree, if it is a hands on learning, and it is related, I see no reason not to answer. All the best teachers i had answered whatever was the question, even if after they said something like, hey you should check that topic later.

 

[newdoc2013]

Two months in and I am already sick of playing the BS games and the subjective crap. Look I am not naïve and realize this is the way it goes, but just needed a place to vent and see how other people are dealing with it and getting over it. By no means do I think I am the best student on rotations but I ask questions, give pretty thorough patient presentations and notes and have ask for verbal feedback every week. I always get verbal comments that I am doing great and my notes are good and on one rotation was told that myself and the other medical student were performing at an intern level and carrying an intern patient load. Then the evaluation comes back as a 79 👎. Not once did I get any negative feedback or things to improve upon despite repeatedly asking for them. Any strategies on how to just let it go and move on or how do you all just get over it and forget about it?

Its even worse because I scored pretty high on the shelf (highest in my rotation group) but it won't be enough to offset this evaluation in order to honor the rotation. Really just looking to see if anyone is feeling the same way. Not trying to prove I am the best student ever and should honor every rotation with 100%s.

third year is THE WORST. everyone knows its subjective including future program directors who are evaluating you for a residency slot. just work as hard as you can and some honors will come! btw, im a tern now... and its WAY better. like 100x better. I HATED THIRD YEAR.