"Doesn't seem interested"

[velouria]

---

Members don't see this ad.

I have heard on two evaluations from two different rotations that I don't seem very interested. Personally, I don't think I was crazy interested in either specialty, but I didn't think I was uninterested...and I certainly didn't mean to appear that way.
I tend to be a pretty quiet person and maybe fade into the background a bit. I don't want to spend the rest of third year getting so-so evaluations. Somebody give me some advice on how to improve! I feel silly asking questions just to be talking or getting noticed. Advice?
Thanks!

 

[(nicedream)]

I feel silly asking questions just to be talking or getting noticed.

You just have to suck it up and feel silly then. The same way shy/quiet people have to overcome that in order to interact socially, you have to overcome it to succeed in rotations - and it will feel uncomfortable, but you will get over it.

 

[chintu]

I know its hard to appear interested when you really are not sometimes. I just finished surgery and I was personally told by one of my chief that he knows that he figured I wasn't interested in surgery and needed to demonstrate more enthusiasm. There are some obvious ways I fixed it and he was fine at the end. Make sure you show up early and have enough time for prerounds w/ your patients. You don't necessarily have to take more patients but whoever you see make sure you know that pt inside out, especially labs and vitals and I/O. Even if you are not interested in the subject as a medical student if you can take good H&P and elicit a good presentation they will be impressed. I also learned that asking lots of questions is a very easy way to appear interested. In my various surgery services I would asked various questions whenever the residents had some free time or weren't doing much during cases. If you are curious about anything just ask, as a med student you are not expected to know all that much and there's no "stupid" question per say. If you do just this I am sure your residents/attendings will be fine and you will also feel like you learned something at the end of the day.

 

[Mayhem]

You don't have to (and never should) ask questions just to get attention, that's sad and pathetic, but at the same time don't blend into the background. These things are a game and you just have to learn the rules. I'm pretty quiet myself so here's a couple things I did on my surgery rotation:

1. Most important and simplest of all. Look interested. You'd be surprised at how many med students are staring out the window or at the floor or at their clipboard when somebody is talking. Don't do that. Look at the person who is talking, nod where apporpriate, if they say something good then write it down.

2. Stand in front (especially in a group of med students). I'm not saying anything and I'm not doing anything either but when I'm in front they see my face. Just like that you've won half the battle.

3. Be early. If the ward round starts at 7:30 be there at 7:15. It can be as little as 5 minutes early just as long as you get them to walk onto the ward and see you there preferably with a docket in your hand.

4. Fill your pockets with hospital stuff. Everybody needs gloves or tape or gauze but few Doctors normally walk with it. Just get some and wait, they'll ask.

5. Get to know the patients. There's nothing like walking up to a patient's bedside on a round, saying hello and getting a warm smile in response.

6. If they pull out a CT or X-ray just move close by and give the illusion that you're looking at it too. This is usually enough to get them to start telling you what's on it, but if they don't, it doesn't matter. It just has to look like you cared.

7. This one will require you to actually speak but it's only needed if situations are really dire. Ask to do a procedure (or watch one ). Doesn't matter what it is as long as you seemed interested to do it.

These things saved me during surgery. I was the only one that didn't get a lecture about being uninterested (well apart from the obligatory butt-kisser who asked every question that popped into his mind and stayed till midnight every night...he got a different lecture). Now, I was just as uninterested as the other 4 people in my group, probably more, because I really hated my attending and couldn't stand half of his residents. But I just didn't show it.

 

[emtji]

this might sound a little silly, but the things that i found that helped were

1. getting enough sleep so you can be wide eyed and bushy tailed.

2. leaning forward. never let your back touch the back of the chair when you're sitting. always sit forward.

 

[Caffeinated]

I also got a few of the "not interested" evals. I found that on surgery my evaluators' perception of my interest was based upon my answer to the question "what do you want to go into?" If there was any hint that I was interested in their specialty, then I got superstar evals. If I didn't say that I wanted to do their specialty as a career, then my quiet nature quickly became interpreted as "uninterested." It didn't matter that I showed up early, I knew about my patients, I was reading on conditions and procedures, and I asked occasional questions. Because I was honest about my career interests, I was penalized. But I passed the rotation, I never tried to be someone I was not, and I never sold out.

 

[Zuwie]

Study for the shelf, because this is the only aspect of your grade that you can really control. This especially applies to surgery, where grades are often given not based on your performance, but your appearance, demeanor, getting off on the right foot or simply the evaluator's personality.

 

[fang]

You don't have to be social or loud to look interested-- these are two separate skills. Mayhem had some great comments, but here is some more advice:

1. Be an active listener. As mayhem said, look at the person who is talking, and try not to look bored or confused. Look around at some of your other classmates, who might be staring at thr ground, leaning on the wall, or looking things up on palm-pilots. Imagine if you were talking to a bunch of students like that-- if you just look like you're absorbing the information and appreciate that the resident/attending is sharing it with you, that's automatic brownie points.

2. Be on the lookout for more work. Another patient, a short presentation on a pertinent topic, bringing in an article to share, etc.

3. Show up 15 minutes before your residents and leave when they do.

Good luck!!!

 

[MeowMix]

In the exciting world of medicine, the rules can change at any minute...

here I am on psych rotation, being a keen student, being sure to spend a full work day at the inpt and outpt facilities where I am assigned rather than slacking off and leaving early, not sucking up but just trying to learn more. Yesterday I got an absolute blast from one of the staff for spending too much time at work, because it was "disruptive" to them to have me there.😕

 

[Samoa]

Yeah, psych people are a different breed entirely. By and large, they're introverts, so you gotta let them have their space. Also, they deal with a lot of sensitive issues, where your presence can interfere with their rapport with a patient. So you have to know when to make yourself scarce, or at least how to appear so interested in your study material that you don't even notice that you're being excluded from whatever's going on. The bonus of this last tactic is that you still look interested, even though you're not participating.

The studying during downtime tactic works on every rotation. But it has to be an actual book, and not a book you've downloaded onto your PDA. The residents aren't dumb; they know that if you're staring intently at your PDA and tapping away at the screen, you're probably just playing games on it.

I'm a 4th year now, and I have yet to get an evaluation saying I appeared uninterested. And I was very clear the whole year about my career path, although I always kept an open mind about the possibility of going into whatever field I was in at the time. Also, I think it helped me keep a positive attitude.

But I pretty consistently did most of the things that Mayhem listed, and they really do work. It was never actually pretense on my part, but I'll confess I did have to remind myself that either it was something I would see again, and thus it would be better to learn about it now, or else I would never see it again, and this would be my last opportunity to become less ignorant about it. I never really went out of my way to ask for more work--generally, doing well at the work you're assigned, looking interested and getting along with people are sufficient.

 

[ivan lewis]

7. This one will require you to actually speak but it's only needed if situations are really dire. Ask to do a procedure (or watch one ). Doesn't matter what it is as long as you seemed interested to do it.

DING DING DING. We have a winner.

I can't stand it when I'm doing a procedure (in the OR or wherever) and the med student chooses to stand outside and shoot the $hit with his buddy. Jesus Christ, ask to watch, help out, or better yet, do the procedure!

I can't think of a better way to show interest. When I was a med student, I'd always ask the resident/attending if I could help open, close, put in peripheral iv's, central lines, foleys, whatever. I did that b/c I was really interested in learning how to do these things (well, not the foley part) and will assume that you're interested too if you show the same type of enthusiasm.

 

[chocomorsel]

Well, I got a ****ty IM clerkship eval and the newly minted attending thinks that I would gain some valuable knowledge if I repeated the course. Three months and he wants me to do it again. Never mind the fact that I was on time and seemed interested, worked well with the residents/interns and asked questions. Yes there were times I was clueless, and times I didn't know EVERYTHING about my patients, such as why they were getting a certain procedure, not answering some of questions to his daily oral quizzes because I didn't know the answers, then made a mistake once of forgetting to put the V/S on my presentation because at the time an intern was looking at the chart and I forgot to go back afterward to check the VS and didn't realize this till presentation time. I mean I went on to see another patient in the mean while.
As a med student, aren't we allowed to make mistakes? And they don't expect us to know the answer to every question they throw at us do they? I'm an average student, so of course there is plenty that I don't know. Don't I get a learning curve? Anyway, the eval sucked alot and now my grade is on the fence because some of the other faculty didn't eval me. One moved and needs to be tracked down, and the other worked with me for 2 weeks, didn't eval me. So I guess we'll see. I sure hope and pray that I don't have to repeat because I did pass the shelf which was tough. Three months is a long time.
Clerkship sucks sometimes.

 

[Paws]

Well, I got a ****ty IM clerkship eval and the newly minted attending thinks that I would gain some valuable knowledge if I repeated the course. Three months and he wants me to do it again.

As a med student, aren't we allowed to make mistakes? And they don't expect us to know the answer to every question they throw at us do they? I'm an average student, so of course there is plenty that I don't know. Don't I get a learning curve?

Clerkship sucks sometimes.

👍 👍 👍

This is Paw's three thumbs up. With a snap and a twirl.

I keep wondering this myself, aren't we allowed some sort of learning curve? Some people are really awesome and will say things like: you aren't really expected to know this at the begining of third year, or cut yourself some slack, this is your learning time. Those are great, comforting comments! But plenty of people - in IM, too I am sorry to say - seem to get all pissed off because I should "already know that." ???? I thought the purpose of third year was to LEARN this stuff, and not to be here because we already know it. I mean, is it my job to entertain the attendings? On some of my rotations I have felt that some attendings seem to want to be entertained by me, like I am supposed to be this jumping puppy who knows everything and can do and say everything perfectly. They get sort of irritated when on my first day I don't know how to do things. But I don't know things because I am here to learn. It takes time to learn things.

Like I said, most residents/interns etc are awesome, and pretty normal. But some attendings - well, maybe they're bored with students year after year and don't want to be teaching. That's not my problem, altho in the end it sure can be. Third year is really hard, on so many levels.

 

[shane_doc]

I can relate to the OP. I heard this a lot during MSIII year and it took me awhile to get what they were saying. I was always prompt, had notes written before residents, read up on my patients, etc. But I was too quiet and it seems as though you are uninterested. I agree 100% with mayhem's post. That is a good start. Try to ask some questions. This may result in more pimping but it shows that you are listening and awake.

On the flip side, as a resident I notice that some students are downright lazy dinguses. I have had students go home to shower the morning after call and be unprepared to present patients. I have been lied to by students about going to a conference when they really went home. I also had a stellar group of students that basically carried a clueless intern. I try to cut my students slack because I have been in their shoes. It may not seem like it sometimes but I'm sure most residents are doing the same.

 

[Hard24Get]

I love doing procedures, including mediocre things like putting in foleys, doing injections, or removing sutures, though I hesitate to ASK to close b/c I am obviously not as fast at it as the resident, I love when they let me. I have an effusive personality, so I usually get told that I am excitable and optimistic and will eventually be broken. 😕
Just can't win, I guess. 🙁

DING DING DING. We have a winner.

I can't stand it when I'm doing a procedure (in the OR or wherever) and the med student chooses to stand outside and shoot the $hit with his buddy. Jesus Christ, ask to watch, help out, or better yet, do the procedure!

I can't think of a better way to show interest. When I was a med student, I'd always ask the resident/attending if I could help open, close, put in peripheral iv's, central lines, foleys, whatever. I did that b/c I was really interested in learning how to do these things (well, not the foley part) and will assume that you're interested too if you show the same type of enthusiasm.

 

[raidermedic]

Sucks to be the quiet type during 3rd year. In fact it can go a long way towards ruining your transcript. It's a big change from classroom years where it didn't matter if you were the class clown or the quiet guy in the back of the room. It was mostly how well you did on the exam. On rotations it's almost the opposite. Objective criteria go out the window in favor of what the attending basically thinks of you as a person. A lot of the newer attendings tend to understand that people of all different types of personalities can contribute to medicine. But the old school attendings, they are all about being the vocal in your face type A personality. If you don't play along then you're pretty much screwed.

 

[Oceanview]

I have heard on two evaluations from two different rotations that I don't seem very interested. Personally, I don't think I was crazy interested in either specialty, but I didn't think I was uninterested...and I certainly didn't mean to appear that way.
I tend to be a pretty quiet person and maybe fade into the background a bit. I don't want to spend the rest of third year getting so-so evaluations. Somebody give me some advice on how to improve! I feel silly asking questions just to be talking or getting noticed. Advice?
Thanks!

It's pretty clear that the OP is not alone here.

I also am dealing with being congenitally shy, resulting in evaluations being peppered with statements like: "appeared uninterested" or "passive" or "quiet."

As you have seen there are various ways of compensating for verbalizing less and even many techniques that people use to overcome their tendency not to talk.

Fortunately, you were able to get this feedback early on. I hope you're able to learn from this and get more glowing evaluations in the future. Remember that your Dean will likely transcribe these comments word for word in your MSPE. And the last thing you want is all of your clerkship directors making similar comments indicating a trend.

I would reccomend making sure to talk to the Dean (or Dean's reprasentative) about this before she/he drafts your letter. If your latter clerkships show improvment in this area, an argument can be made for leaving out the initial comments.

My opinion is that these subjective comments such as "appearing disinterested" have no place being passed on to future potential employers. But such is the way our profession has chosen to operate.

One last thing, when 4th year rolls around, you'll have the opportunity to shine. Although you may be quiet, it's hard not to show enthusiasm for the subjects and rotations you've chosen to take.

 

[emily69]

Wallpapers don't do too well during the clinical years. Make an attempt at answering pimping questions. The attempt matters, equally or more than the correct answer. Quietude will be interpreted as apathy and an apathetic doctor is basically one who doesn't care. Ask questions, when residents and attendings aren't looking too busy. Ask questions that demonstrate that you ahve some knowledge - not blind questions which you can look up on your PDA. Know as much as you can about your assigned patient as if he/she were your own family member being hospitalized. This shows care, concern, and the ability to collect accurate information. The latter is particularly important. We may not be expected to make an assessment and plan, per se, but we are expected to collect all the relevant information and make an attempt at making a plan. I doubt you will be called "uninterested" after doing all of that.

 

[carrigallen]

It is totally a two-way street. Can you imagine being around a student who just hovers around you like a ghost or chained to you like a prisoner? Part of being on a team is being a good companion, telling stories, cheering people up.

 

[Ramoray]

If I got a nickel for everyone that told me on an eval I did not seem interested-I would be doin gwell-theoretically if you found something you liked than every subsequent thing that you quickly realize you dont like-then it makes sense you wont be interested. I hate 9/10s of medicine and specialities. there is maybe 2 that I find interesting and one of them I am going into. NEedless to say I was miserable and was not at all interested in the other rotations and it probably showed. The thing people say is it is important to learn all fields-well I argue that is simply untrue. Second most of the crap you do on the wards is all busy work, b.s etc. What you need to know is learned by reading for the shelf-that is the stuff that is important enough to carry with you to other fields-and that is the stuffy i did not mind learning. Anyway complete b.s-be proud you are not the type to like everything-that just means you found one thing you really like-or that you just do not like medicine-which I thought for a logn while until I found something I did like!

 

[Oceanview]

Taken from the "what do attendings and residents think of gunners" thread:

I'm a pretty good student, Ive never gotten below the 95th percentile on a shelf..regardless of the subject. And yet, when I did the same work/reading/answering of pimp questions with a bored look on my face in pediatrics...I get a fat PASS and...wait for it..."Needs to read more" on my eval.
Same effort, surgery rotation, I cut people off, ask questions I already know the answer too, GOD HELP ME I BROUGHT IN A JOURNAL ARTICLE! All fake, damn near made myself sick...everyone loved me => Honors.
Just as I suspected, just as I planned. I could barely live withmyself for being such a tool for that two months but hey, thats what it takes.

Thought it was relevant to the discussion going on here.

 

[closertofine]

How are you supposed to become "more aggressive"? I'm naturally quiet, but I always ask to help...and attendings like my presentations usually...but I just can't come up with that much to say in the floor setting...and knowing that people think I'm quiet and that they're evaluating me just creates a vicious cycle (I try not to think about it, but it seems unavoidable, especially with all the other med students and the weird social hierachy and atmosphere in the hospital). It all just makes me nervous, and it shows.

 

[Caffeinated]

How are you supposed to become "more aggressive"? I'm naturally quiet, but I always ask to help...and attendings like my presentations usually...but I just can't come up with that much to say in the floor setting...and knowing that people think I'm quiet and that they're evaluating me just creates a vicious cycle (I try not to think about it, but it seems unavoidable, especially with all the other med students and the weird social hierachy and atmosphere in the hospital). It all just makes me nervous, and it shows.

I'm with you. If I don't have anything to share, then I keep my mouth shut and my ears open so that I can actually learn something. If I have something to add, then I speak up. People like us seem to gravitate toward specialties where being quiet, contemplative, and deliberate serves us well (e.g., medicine, peds, radiology, pathology). On the other end of the spectrum, the outspoken aggressive types seem to lean towards EM and surgery.

The clinical years highlight one of the fundamentals of human relationships--it's impossible to get everyone to like you. All you can do is try to be part of the team, do well on the shelf exams, and come to terms with the fact that subjective grading and interpersonal conflicts are unavoidable.

 

[closertofine]

I'm with you. If I don't have anything to share, then I keep my mouth shut and my ears open so that I can actually learn something. If I have something to add, then I speak up. People like us seem to gravitate toward specialties where being quiet, contemplative, and deliberate serves us well (e.g., medicine, peds, radiology, pathology). On the other end of the spectrum, the outspoken aggressive types seem to lean towards EM and surgery.

The clinical years highlight one of the fundamentals of human relationships--it's impossible to get everyone to like you. All you can do is try to be part of the team, do well on the shelf exams, and come to terms with the fact that subjective grading and interpersonal conflicts are unavoidable.

Yeah...but more than one eval has mentioned it...so I guess I need to figure something out...but it doesn't seem like there's an easy way to become "more confident"...though I've done everything to try to seem like it!

 

[LukeWhite]

3rd year evaluations: the Passive Aggressive Approach

1. Answering Questions: One method of aggressively answering pimp questions without sounding obnoxious:

Attending: [question]
Student: "It's not...[answer], is it?" [puzzled furrow of eyebrows]

I call this the Columbo Method.

Additional bonus: if you're wrong, the attending can easily take you up on your invitation to be told you're wrong, and everyone's happy. Can also be used, carefully, to interject opinions in otherwise uninterjectable situations.

2. Surgery Clerkship: Learn how to tie knots one-handed. Never use this skill in the OR but carry a piece of string around and absentmindedly tie knots while talking to people. Look at the people, not what you're doing with the string.

3. Supplies: Accumulate supplies for common bedside procedures and walk around with them in your white coat. Carry a bright pocket flashlight. When attending/resident sends you fetch Tube/Wire/Gauze/Tape pull it out of your coat. Do not carry easily accessible/supercommon supplies as this will weight you down without making you look Prescient, which is your aim.

4. The Golden Notebook: Buy black Moleskine pocket Cahiers at B&N/Borders. They fit nicely in white coats and are cheap. Whenever your attending makes an interesting point (or a point they clearly consider interesting) pull out your book and write it down quickly (as with knots: look at the person, not the page). Toss book back into white coat, continue listening. This is particularly good for the introverts and the bored, as it allows you to participate without thinking too much. It will also spare you many pimp questions as pimp questions are a common way of telling whether you're paying attention. Preempt!

 

[deleted109597]

It could be worse, you could be labeled as "too aggressive."

Then you're screwed.

 

[Samoa]

I second the Moleskine notebooks. Not only does jotting stuff down make whoever's talking feel important, but it's much more impressive to pull out your own notes regarding things like how to calculate a free water deficit, or evaluate an ABG, when you're asked to do so.

 

[watermen]

3rd year evaluations: the Passive Aggressive Approach

1. Answering Questions: One method of aggressively answering pimp questions without sounding obnoxious:

Attending: [question]
Student: "It's not...[answer], is it?" [puzzled furrow of eyebrows]

Wouldn't that make your attending feel that you are doubting him/her?

 

[fang]

3rd year evaluations: the Passive Aggressive Approach

1. Answering Questions: One method of aggressively answering pimp questions without sounding obnoxious:

Attending: [question]
Student: "It's not...[answer], is it?" [puzzled furrow of eyebrows]

I call this the Columbo Method.

Additional bonus: if you're wrong, the attending can easily take you up on your invitation to be told you're wrong, and everyone's happy. Can also be used, carefully, to interject opinions in otherwise uninterjectable situations.

2. Surgery Clerkship: Learn how to tie knots one-handed. Never use this skill in the OR but carry a piece of string around and absentmindedly tie knots while talking to people. Look at the people, not what you're doing with the string.

3. Supplies: Accumulate supplies for common bedside procedures and walk around with them in your white coat. Carry a bright pocket flashlight. When attending/resident sends you fetch Tube/Wire/Gauze/Tape pull it out of your coat. Do not carry easily accessible/supercommon supplies as this will weight you down without making you look Prescient, which is your aim.

4. The Golden Notebook: Buy black Moleskine pocket Cahiers at B&N/Borders. They fit nicely in white coats and are cheap. Whenever your attending makes an interesting point (or a point they clearly consider interesting) pull out your book and write it down quickly (as with knots: look at the person, not the page). Toss book back into white coat, continue listening. This is particularly good for the introverts and the bored, as it allows you to participate without thinking too much. It will also spare you many pimp questions as pimp questions are a common way of telling whether you're paying attention. Preempt!

excellent-- I've definitely used some of these!! (especially the whipping supplies out of your pocket trick!)

I just want to reiterate that being an extrovert does NOT translate into clinical honors. I'm an introvert at heart... not excessively shy, but I don't know anything about sports and I don't usually joke around with people I just met. I was worried about that going into 3rd year, and it was unjustified-- I did great without having one conversation about football. I'm genuinely optimistic and enthusiastic overall, and maybe that can brighten the team's mood without a bubbly personality to go with it, I don't know.

Don't try to force your personality to be something it isn't; use some of the tricks above to show your intent instead.

 

[Entei]

3rd year evaluations: the Passive Aggressive Approach

1. Answering Questions: One method of aggressively answering pimp questions without sounding obnoxious:

Attending: [question]
Student: "It's not...[answer], is it?" [puzzled furrow of eyebrows]

I call this the Columbo Method.

Additional bonus: if you're wrong, the attending can easily take you up on your invitation to be told you're wrong, and everyone's happy. Can also be used, carefully, to interject opinions in otherwise uninterjectable situations.

Hahaha! Oh wow.

This is the way I answer questions sometimes, not because I'm trying to be like Columbo, but because I'm usually thinking through the answer while I talk. BE WARNED that this can backfire on you bigtime. For example, I've had exchanges like this:

Attn: What is this stuff? *points to some weird crusty stuff on the inside of a vein*
Stud: Oh... are those plaques?
Attn: I'm the one asking the questions here. What is it?
Stud: *peers in for a closer look, since the object in question is this big: .*
Attn: The answer's not going to change no matter how hard you look at it.

Good times.

Anyway, the point is that some people don't mind the thoughtful approach to answering questions, and some people just want you to answer assertively, even if you're wrong. The rest of your advice is solid, though, especially about carrying around supplies: scissors, bandages, tape, penlight, steth, extra pens, etc.