Fed up with 3rd year...

[CaptKirk]

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I hate it. Way too f-ing subjective. At least during years 1 and 2, and Step 1 to some extent, you can work hard and do moderately well. I work my butt off now but my evals are always "just average." The residents and attendings are always on different rotations schedules so the resident/attending that ends up doing my eval has only spent a week and a half with me, after I've gotten used to doing things the way the other residents/attending wanted them done. I try to have a good attitude, work hard, all that crap. I study for the shelves, try to read on patients (doesn't always happen) but point is I see others getting better evals for doing less. Not bc they're more likeable or whatever but just bc they have diff residents/attending at the time evals roll around. I've pretty much gotten screwed every rotation so far because of this. And I just read a post about how much it sucks to scramble... probably my fate at this rate.

 

[deleted109597]

I hear you. At my school, there are two psychiatrists at one site. One gives great grades just for breathing, and pretending to care. The other won't give you an A unless you see every patient on the floor and express an undying interest in psychiatry, even so far as asking for a letter of rec. It is ridiculous, because we can't choose who we get.

 

[abc56]

i need to VENT!!!!!!
i feel all consumed by this year. i used to feel so enthusiastic and happy all the time, but at this point, im on my 3rd rotation (pediatrics) and have no juice left. i am tired of constantly worrying about what the interns/residents/attendings think of me, its exhausting!!

i hate how its so subjective- one resident thinks your average and the other thinks your honors-worthy. it sucks!! especially when you work your butt off no matter what.

i recently missed a couple of days b/c i was really sick (fever, cough) and now i feel all this guilt and i feel like the residents and the course director think im a SLACKER!!

seriously, i know im paranoid. 3rd year is making me into a crazy lady.

anyone out there know how i feel?

any tips on how to relax and not freak out about grades so much? its not like i want to do derm or ortho or anything like that..... and i think no matter what i will get a high-pass at least (but i want honors obviously, who doesnt)

thanks a bunch
sincerely
the 3rd year thats losing her mind

 

[abc56]

looks like we posted almost the same thing, oopsies. i totally agree with you guys. read my post as well for more complaining

 

[Llenroc]

My father, whose a doctor, said of third year: "I would spend a few hours with the students in the mornings, showing them things. Then I would dismiss them for the day."

How unlike my experience that's been! On Surgery, I don't think I learned a god damn thing standing around on the wards holding retractors for 12-30 hours straight. Every question I got right on the exam was because I read it in a book. In Surgery, if you don't talk enough they say, "So, do you not want to be a surgeon? Why aren't you showing interest. Do you think your better than me?" But then when you do ask questions, they say, "Go read about it in a book." OB-GYN wasn't much better.

As a 4th year student told me, the 3rd year of medical school is basically a giant exercise in patience. You wait around all day to be dismissed, so that you can go home and do some reading to actually pass the exam.

 

[Arsenic]

My father, whose a doctor, said of third year: "I would spend a few hours with the students in the mornings, showing them things. Then I would dismiss them for the day."

How unlike my experience that's been! On Surgery, I don't think I learned a god damn thing standing around on the wards holding retractors for 12-30 hours straight. Every question I got right on the exam was because I read it in a book. In Surgery, if you don't talk enough they say, "So, do you not want to be a surgeon? Why aren't you showing interest. Do you think your better than me?" But then when you do ask questions, they say, "Go read about it in a book." OB-GYN wasn't much better.

As a 4th year student told me, the 3rd year of medical school is basically a giant exercise in patience. You wait around all day to be dismissed, so that you can go home and do some reading to actually pass the exam.

that description rocks

 

[closertofine]

Thank you all! Seriously, what part of being a quiet person = not being interested or = not honors?! Just because I prefer to speak only when I think I have something useful to say or a non-obvious question to ask, rather than just to hear myself talk or get brownie points, I get marked down...

Anybody else getting kind of depressed thinking about dealing with this kind of stuff for the rest of the year (at least)?

 

[efex101]

Focus on whatever patient care you *can* do and to the hell with everything else. Trying to satisfy/impress everyone is impossible...at my school half the time we do not even know who *really* is evaluating you...it varies from the intern to the senior etc/// so it's all a mystery to some extent. Some students can shine while doing nothing but looking pretty and flirting with the residents while others can work their tails off and not get noticed. Do not worry do your best and move on to the next rotation. Third year does go fast and it will be over before you know it. Good luck!

 

[DebDynamite]

I wish I could share with all of you what has happened to me, which is this: I truly don't care anymore. Somehow, consequently, my evals have gone up a tad. I think this is because I have started acting like the self respecting adult I was before medical school ever happened to me. I speak to the attendings that treat me well and say very little if anything to the others. If I'm pimped and I don't know, I just say I dunno. If I'm pimped and it seems interesting and I don't know, then maybe I go look it up, maybe not. If some resident who has nothing to do with my grade gives me a homework assignment I'm not interested, I don't do it. I actually called in sick yesterday (I really took my Mom to outpatient surgery, because in the long run my relationship with her is more important than a day on my psych rotation) without remorse or hesitation.

I guess I've sort of changed the way I think about 3rd year because now I simply see it as a process of elimination (I still think it is just about the most worthless year of medical education). I have to figure out which one of these fields would be lucky to have me, not the other way around, 'ya know. The same goes for everyone posting on this board. If they are lucky enough to get you, it's because of something you experienced/saw in med school, so they better treat your fine gluteals right. I mean, sheesh, I'm good enough, I'm smart enough, I'm hard working, attractive, a team playa and all that so seriously forget about it. I have no critical function whatsoever in third year except as an asset to myself; the team doesn't "need" me, so I guess I'll do something for myself and figure out which of these dreadful fields will warrant my committment. That's about all I care about these days.


The only disclaimer to the above proclomation is that I have already made it out of surgery and half of OBGYN.

 

[chintu]

I was so going to post a this thread. My first couple rotations were great mainly because I was the only student with the attending and not being constantly compared against others and I was learning a lot. Now I am on my peds rotation where we do 4 wks of outpatient at different clinic every day, and we get evaluated at each clinic based on our interactions with the attending on that day; its just so variable and subjective. Apparently one of the days we had a really mean attending and she wrote something really bad about me in the eval that I am now supposed to meet with the course director about it and discuss the issue; common give me a break it was one day with the attending that every other med student bitches about, i basically got shafted probably cuz I didn't do all the scut bull$$$$ she was asking me to do. I have gotten nothing short of exceptional evals so far by fair attendings. I can't wait for this crapshoot to be over and put this behind me.

 

[CaptKirk]

Yeah, I never bought into the whole "you are a vital member of the team" rhetoric. I started with Surgery... and maybe that was a good thing because it very clearly, and in no uncertain terms, established from the get-go how absolutely worthless my presence is on the wards. I'm not a vital member, I'm not even an accessory. Even so, I made the mistake of taking my "work" seriously. I'm thinking this is what has made 3rd year so absolutely miserable. I like the more centrist attitude and frankly, now that I think about it, the students who exhibit that demeanor seem to get better treatment all around. Yeah, the occasional attending or resident might be put off, but I'd rather have one or two less than stellar evals and a few really good ones rather than the WHOLE DAMN SLEW of average ones I'm currently pulling in.

 

[Caffeinated]

As much as we all complain about the grading system, the residents, and the attendings, most of us will end up becoming what we despise. At some point most of us will make that transformation. Some of 4th years may have already begun to see that tranformation happening in some of your classmates. But I think for most of us, it happens as you go from intern to resident. Most interns I met during 3rd year were really cool, and treated me like a regular person. As an MS-4, I have come across residents who were cool interns when I was an MS-3, who now will not lower themselves to acknowledge my existence.

 

[efex101]

During second year at my school we start rotations...I still remember this totally obnoxious peds consultant who thought she was the best thing since sliced bread....she is horrific and pretty much dedicates herself to tearing new anal sphincters to any medical student that graces her service. What a tool.

 

[chrisisinnocent]

You guys realize most of us are supposed to get average ratings. Not everyone gets to be "special" lol. Just because you think: "OMG I worked so HARD! GIMME HONORS." Doesn't mean you should.

 

[Dr. Will]

3rd year sucks, but we all gotta do it. I think there are two keys to succeeding, but again it's subjective so it's no guarantee. Number 1...stop caring so much about what everyone thinks about you and if you are impressing anyone. Just show up, do your job, and try to learn as much as you can. You have little control over your evals. My evals improved after I stopped caring (even in OB/GYN, where my attitude started to actually suck!). Number 2 (and very important)...study your asses off for the shelf exam because it is the only objective measure you have and the only thing you truly have control over! Trust me, it helps!

I know it's tough...but you'll survive. You all have much to look forward to in your 4th year. It does get better!

 

[signomi]

At my school, there are two psychiatrists at one site. One gives great grades just for breathing, and pretending to care. The other won't give you an A unless you see every patient on the floor and express an undying interest in psychiatry, even so far as asking for a letter of rec.

Heh. I read this and wondered if you are going to my alma mater. There was a crazy psych bitch there that I got stuck with because I was a transfer student and my schedule was made after everything/one good was taken.

 

[abc56]

well, i must say, it feels good to hear that so many others are feeling miserable at this point during 3rd year. i dont understand why during 2nd year everyone was like "oh my god it gets SO much better 3rd year". sometimes i wish i could sleep in, skip class, study for a few hours at starbucks and then call it a day.

siiigh. i do think that once we get a little more authority and stop feeling like insignifanct retractor holders that cant even suction correctly, well, maybe things will be better.


heres hoping,
d

 

[efex101]

To be honest I am loving third year much more than first and second. To me it is much better to be out there doing something than passively sitting and learning.
We all know that not everyone will get honors/high pass, but, it is pretty ridiculous when you see students majorly kissing arse and playing the part only when they are being watched....it is all about playing the game and that is what get infuriating after a while. =

 

[enanareina]

well, i must say, it feels good to hear that so many others are feeling miserable at this point during 3rd year. i dont understand why during 2nd year everyone was like "oh my god it gets SO much better 3rd year". sometimes i wish i could sleep in, skip class, study for a few hours at starbucks and then call it a day.

Amen.

I think my favorite part of third year is when I present a patient to an attending (I'm on internal) and I get yelled at for whatever lab tests/procedures were or weren't ordered on the patient. Because, you know, I ordered/didn't order them. I love it.

It's so good to hear other people express this frustration--the other night on call, I almost left I was so pissed off with medicine in general.

 

[enanareina]

Yeah, I never bought into the whole "you are a vital member of the team" rhetoric. I started with Surgery... and maybe that was a good thing because it very clearly, and in no uncertain terms, established from the get-go how absolutely worthless my presence is on the wards. I'm not a vital member, I'm not even an accessory.

I think it was made very clear to me on my surgery rotation that my job was to stay as far out of the way as possible, because every breath I took was adding to my intern's/resident's/attending's workload and bad mood.

 

[CaptKirk]

--the other night on call, I almost left I was so pissed off with medicine in general.

I did leave call the other night actually. I paged the resident on call when I got here (on call at one institution, actually rotating at another... yeah it's stupid but oh well). Resident tells me "we'll page you when there's an admission" (internal medicine). I called again at 9:30 just to check in... thinking, you know, maybe there some something interesting on the floors or something... again... "you have a pager right?... [me]'Yes' Well, we'll page you when there's an admission" *click* And uh yeah... midnight hits, no page. Then, I went to the call room... you see, like the idiotic medical student I am, I had been wandering the wards thinking I might get in on something by virtue of being there. Nope. Got the call rooms... I had a key... no one ever told me which room the key opened and the number engraved on the key did not correspond to a call room. So there I was... midnight, no pages, basically blown off, and a call room I can't get into (and yes I did try my key in all the doors but since it was midnight and I figured some residents were sleeping and might get angry at me vigorously trying to get into their room, I didn't force the key very hard). SO... I said hell with this and went home. Came back for morning report at 8am, no one knew I was gone. No pages, all night long... but there were two admissions actually.

And to whatever ***** said "most people will be average" third year... yeah I know that Captain Obvious. What I am talking about is being with one resident for two weeks who is cool, laid back, talks to me, likes me, and who basically says "I wish I was doing your eval because you've done a great job and you should get a little credit" and then getting another resident from India for the last two weeks who thinks anyone who hasn't memorized whatever textbook used in the UK for physical exam is a subpar medical student. VARIABLE. That is what bothers me you idiot, not the repeated "average" clerkship grades.

 

[CaptKirk]

And before some other jerk comes here to say that I should be more proactive about my education, like, instead of aimlessly wandering the wards I should have been down in the ER or something. You can take that line and shove it. I pay 39k a year for this pile of bull and I think that, at the very least, the f'ing residents can page me when something's going on.

 

[mdphd2b]

Heh. I read this and wondered if you are going to my alma mater. There was a crazy psych bitch there that I got stuck with because I was a transfer student and my schedule was made after everything/one good was taken.

Dude I hear ya! I never thought I'd be complaining about my Psych rotation!👎

Here Psych = 5wk Psych + 3wk Neuro. On my Psych rotation, I spent 4wk with a certain resident, who basically told me on my mid-course eval that my pt interviewing was "pretty bad" and I should be more like her. She said to forget the method of open-ended questions that we learned in pt interviewing and in psych orientation (where we were told to "just let the pt talk with few interruptions..."). Instead, she said to use only yes/no ques, then cut the pt off if they take too long b/c the "attendings get bored". During the 5th and last wk, we got a new resident, who told me to can the yes/no ques approach and do only open-ended Qs with all my pts. Otherwise, they will feel uncomfortable and "interrogated." Unfortunately, it's the 1st resident who will be doing my final eval, and I don't think I ever improved in her eyes 😕

 

[8744]

On a certain rotation I did as an intern at a certain medical center that we will call "Earl" to avoid affending anyone I had an upper level resident who spent fifteen minutes "counseling" me on what a poor job I had done and what I needed to do to improve. She (or he) then handed me evaluation in an envelope to take back to my program.

I just threw it in the trash on the way out.

 

[8744]

duplicate

 

[efex101]

He he he....

 

[Hard24Get]

i logged on tonight to start this thread it's not only the subjective gradig and wildy different preferences - i hate the rotations where you are a complete appendage. i feel completely unmotivated to present a pt to my resident after he/she has already seen them, put in orders, and presented them to the attending. and i hate when nurses/docs,etc treat med students like vermin. i feel we-everybody- deserves more respect than that. i exist, dammitt

 

[closertofine]

3rd year sucks, but we all gotta do it. I think there are two keys to succeeding, but again it's subjective so it's no guarantee. Number 1...stop caring so much about what everyone thinks about you and if you are impressing anyone. Just show up, do your job, and try to learn as much as you can.

That's honestly what I would really like to do. And on at least one rotation (that I really liked), I could actually do this. But on the clinical floors, it seems like there is no real "job" for me to do most of the time. I follow up on my patients, do what I am able to (which takes only a tiny bit of time since there isn't much!), but when I ask the intern what else I could help with, the answer is generally "nothing."

And then I hear things like I didn't seem very interested because I wasn't seeking out extra things. So my problem is that it does seem like some stupid game...to do well, it seems to me like you have to do more than just show up, do your job, and learn what you can. But it's never clear to me what that "more" is exactly.

 

[tr]

i hate the rotations where you are a complete appendage. i feel completely unmotivated to present a pt to my resident after he/she has already seen them, put in orders, and presented them to the attending.

Totally. I think the one thing that all the rotations I've enjoyed had in common was that I actually had responsibility for something. Sure, someone else was going to check my work; but I did have my jobs and I did them myself. The rotations I've hated were the ones where I had no responsibilities and was just supposed to trail the residents around all day. Lame.

Btw I have never been the type of person who gives a fig about whether I am being evaluated by someone else. I think this attitude has allowed me to enjoy third year a lot more than those who are forever concerned about their grades do. Perhaps this is easier said than done for many, but I really don't think it's particularly productive to waste your mental energy worrying about how to impress the residents. You'll be saner and learn more if you concentrate on getting what you need for yourself out of the rotation.

 

[ThisisReno]

Mid-way through her cardiac examination I had an attending pimp me in front of 2 interns and a Senior Resident. No big deal. I am not averse pimping. It is fun, kind of like a game show. However, I feel certain in saying that my 14 month old son could have managed to come out on top of this particular game show.

Anyways, the attending breaks her cardiac auscultation and suddenly points at the patient's stomach. She says to me, "What is that?" (Prepare to be amazed) The patient's stomach was YELLOW. I think to myself, am I being pimped on jaundice? Jaundice? Seriously? Something that, theoretically status post traumatic brain injury, I could pick out of a line up 100% of the time? Jaundice. This is where my tuition dollars are going? To the visual examination of JAUNDICE? I went ahead and afforded her the answer that was obvious, but thinking that this could not be what she is looking for. I silently prepared for a rebutal that would be followed with an elegant pathophysiological description that would flog any internist's pleasure spot.

This is not what happened at all. She smiled at me, gave me an approving nod, and went back to her cardiac exam. I was dumbfounded. The senior resident whispered in my ear that I was the greatest junior medical student she had ever seen. She also, of course, appreciated the utter idiocy intertwined in the pimping of a medical student on jaundice and we shared a quiet laughter.

So this is my advice to you people: Jaundice is a very elusive symptom that often goes unnoticed. I want you to think about it. See what NEJM has to say about it and then - and only then - will you understand the true genious of my perfect recognition of jaundice in this patient
.
I look forward to paying that answer of sometime 10 years from now. Thank you and enojy your 3rd year of medical school, one and all.

 

[ThisisReno]

Mid-way through her cardiac examination I had an attending pimp me in front of 2 interns and a Senior Resident. No big deal. I am not averse pimping. It is fun, kind of like a game show. However, I feel certain in saying that my 14 month old son could have managed to come out on top of this particular game show.

Anyways, the attending breaks her cardiac auscultation and suddenly points at the patient's stomach. She says to me, "What is that?" (Prepare to be amazed) The patient's stomach was YELLOW. I think to myself, am I being pimped on jaundice? Jaundice? Seriously? Something that, theoretically status post traumatic brain injury, I could pick out of a line up 100% of the time? Jaundice. This is where my tuition dollars are going? To the visual examination of JAUNDICE? I went ahead and afforded her the answer that was obvious, but thinking that this could not be what she is looking for. I silently prepared for a rebutal that would be followed with an elegant pathophysiological description that would flog any internist's pleasure spot.

This is not what happened at all. She smiled at me, gave me an approving nod, and went back to her cardiac exam. I was dumbfounded. The senior resident whispered in my ear that I was the greatest junior medical student she had ever seen. She also, of course, appreciated the utter idiocy intertwined in the pimping of a medical student on jaundice and we shared a quiet laughter.

So this is my advice to you people: Jaundice is a very elusive symptom that often goes unnoticed. I want you to think about it. See what NEJM has to say about it and then - and only then - will you understand the true genious of my perfect recognition of jaundice in this patient
.
I look forward to paying that answer of sometime 10 years from now. Thank you and enojy your 3rd year of medical school, one and all.

 

[nat17]

i have to say,

im SO glad i found this thread. i thought i was the only one feeling this way.

I kept telling myself thru the first two years that third year would be way better. thats also what everyone else was telling me and what ppl want u to believe. now i see what ive known all along...everyone LIES...they LIE i tell u~!!!!

everyday i go home and have this pit feeling in my stomach and a sense of dread about the upcoming day. im constantly anxious and often times depressed. i feel like third year is causing me to have psych disorders. jusst like u guys i stress about my performance, about how im perceived. im a naturally quiet person...so it sucks, i feel like i have to strain to be more talkative, that actually stresses me out a lot. plus ppl who are in medicine seem to have extremely short tempers. at least they do in ob gyn.

now im stressed out about the freakin shelf. i HATE ob gyn!!! long long hours, no time off, and im never sitting around, we are always moving and moving fast. ive not had time to study...i think it sucks. UGH.

 

[VALSALVA]

You guys realize most of us are supposed to get average ratings. Not everyone gets to be "special" lol. Just because you think: "OMG I worked so HARD! GIMME HONORS." Doesn't mean you should.

Agreed. Doing what you're supposed to do should (and usually will) get you an average grade. This isn't junior soccer anymore! Not everyone gets a trophy just for participating!!

 

[nat17]

im not expecting honors =( im not expecting anything at all. i would just like to maintain my sanity. that's not so easy when ur working with a bunch of ppl who stress u out everyday. i just want to survive dang it!

 

[OnMyWayThere]

I wish I could share with all of you what has happened to me, which is this: I truly don't care anymore. Somehow, consequently, my evals have gone up a tad. I think this is because I have started acting like the self respecting adult I was before medical school ever happened to me. I speak to the attendings that treat me well and say very little if anything to the others. If I'm pimped and I don't know, I just say I dunno. If I'm pimped and it seems interesting and I don't know, then maybe I go look it up, maybe not. If some resident who has nothing to do with my grade gives me a homework assignment I'm not interested, I don't do it. I actually called in sick yesterday (I really took my Mom to outpatient surgery, because in the long run my relationship with her is more important than a day on my psych rotation) without remorse or hesitation.

I guess I've sort of changed the way I think about 3rd year because now I simply see it as a process of elimination (I still think it is just about the most worthless year of medical education). I have to figure out which one of these fields would be lucky to have me, not the other way around, 'ya know. The same goes for everyone posting on this board. If they are lucky enough to get you, it's because of something you experienced/saw in med school, so they better treat your fine gluteals right. I mean, sheesh, I'm good enough, I'm smart enough, I'm hard working, attractive, a team playa and all that so seriously forget about it. I have no critical function whatsoever in third year except as an asset to myself; the team doesn't "need" me, so I guess I'll do something for myself and figure out which of these dreadful fields will warrant my committment. That's about all I care about these days.


The only disclaimer to the above proclomation is that I have already made it out of surgery and half of OBGYN.

Great post... 👍

 

[8744]

Thank you all! Seriously, what part of being a quiet person = not being interested or = not honors?! Just because I prefer to speak only when I think I have something useful to say or a non-obvious question to ask, rather than just to hear myself talk or get brownie points, I get marked down...

Anybody else getting kind of depressed thinking about dealing with this kind of stuff for the rest of the year (at least)?

You have hit the nail on the head. I'm a pretty aggressive guy when necessary but on rounds as a third and fourth year medical student I rarely had anything of value to add to the conversation so I kept my cake-hole shut.

Keeping one's cake-hole clamped is a skill that is unfortunately neither taught nor encouraged. I finally got to the point in medical school where I just looked amused if I was asked a question the answer to which I did not know. Maybe I gave a little shrug with a glance to the heavens implying that only the Saints would know the answer. It drives anal compulsive residents up the wall. I even did this when I knew the answer. I am just anti-pimping. I never pimp my medical students.

 

[Llenroc]

You have hit the nail on the head. I'm a pretty aggressive guy when necessary but on rounds as a third and fourth year medical student I rarely had anything of value to add to the conversation so I kept my cake-hole shut.

Keeping one's cake-hole clamped is a skill that is unfortunately neither taught nor encouraged. I finally got to the point in medical school where I just looked amused if I was asked a question the answer to which I did not know. Maybe I gave a little shrug with a glance to the heavens implying that only the Saints would know the answer. It drives anal compulsive residents up the wall. I even did this when I knew the answer. I am just anti-pimping. I never pimp my medical students.

I think that's a good policy. The best doctors are ones that make an educational point if they have to make it.

 

[Taciturngosamer]

I think that's a good policy. The best doctors are ones that make an educational point if they have to make it.

That may be what makes the best doctors but I think its a sure way of getting a 'needs to show more initiative' comment on your eval. Which isn't the end all and be all of the third year, but it is what residency directors see.

And I am anti pimping too, but I think 60% of third year is remembering that your job is to perform like a trained seal. No it doesn't make you a better person/ student/ doctor but it will help your evals. No I'm not talking about a$$ kissing, but attempting to answer the questions has got to look better than acting like they're beneath you or utterly impossible (which they very well may be).

I'm just looking forward to getting rid of my beach ball and flippers during fourth year.

 

[juddson]

So here's my question: do third year grades matter all that much? Of course, of course, if you are are going into derm, optho and plastics they matter a whole hell of a lot (plus you need good board scores), but what about the rest of the teaming masses destined for internal medicine (and it's multiple cousins), psychiatry and anesthesia? Don't most of us get mostly "pass"es, and don't almost all of us find good paying jobs after underpaid residencies anyway.

Make me feel better. I've resigned myself to the fact that I'm probably not going to "honor" in much of anything (important).

judd

 

[chintu]

You are right; for most of us it really doesn't matter whether we get passes or honors as far as our specialty choices go; it probably matters if you are shooting for a desirable place (such as a good academic program in cali) or something. And I think you are also right that most end up getting pretty much all passes; at least at our school they are only allowed to give at the most 40% Honors+NH total in 3rd year; Despite the subjectivity in grading I think for the most part shelf scores distinguish b/w students and pretty much decide who gets what and so I think a chunk of people in the class are going to honor a lot of the rotations while a good bunch will end up getting all passes. I do think that doing an away rotation at our top choice and getting honors and a good LOR is important in getting placed there.

 

[velo]

I am just anti-pimping. I never pimp my medical students.

As annoying as pimping can be, I found it even more frustrating to not get asked many questions during my recent surgery months. On other rotations I've done like medicine and neurology, one at least has ample oppertunity to display a fund of knowledge when presenting patients to the team-- you have the floor, people listen to you, you can show them whether or not you can speak intelligently about a patient.

On surgery the only time I presented patients was in clinic, and that was usually a 5 sec presentation as the attending literally gave you only the time it took him to walk down the hall and into the patients room. So I would have enjoyed more questions in the OR or on rounds. At least when they ask you a question it means they've noticed you're there. And when someone asks you some reasonable questions, it allows you to show them you actually know a thing or two (although some may argue that a "reasonable" question should not be considered a "pimp")

So far, my surgery evals have been honors, but I have no idea why. I feel as though my fund of knowledge was at honors level, but I couldn't tell you when I was ever able to display that. All I did was glorified shadowing-- follow people around, hold retractors, cut suture, close skin, put the notes in the charts, change dressings, blah blah blah. I guess the culture of education in surgery is so dysfunctional that doing honors level scut = honors on the rotation.

 

[ridirkulous]

As annoying as pimping can be, I found it even more frustrating to not get asked many questions during my recent surgery months. On other rotations I've done like medicine and neurology, one at least has ample oppertunity to display a fund of knowledge when presenting patients to the team-- you have the floor, people listen to you, you can show them whether or not you can speak intelligently about a patient.

On surgery the only time I presented patients was in clinic, and that was usually a 5 sec presentation as the attending literally gave you only the time it took him to walk down the hall and into the patients room. So I would have enjoyed more questions in the OR or on rounds. At least when they ask you a question it means they've noticed you're there. And when someone asks you some reasonable questions, it allows you to show them you actually know a thing or two (although some may argue that a "reasonable" question should not be considered a "pimp")

So far, my surgery evals have been honors, but I have no idea why. I feel as though my fund of knowledge was at honors level, but I couldn't tell you when I was ever able to display that. All I did was glorified shadowing-- follow people around, hold retractors, cut suture, close skin, put the notes in the charts, change dressings, blah blah blah. I guess the culture of education in surgery is so dysfunctional that doing honors level scut = honors on the rotation.

I'm telling dr winney you said that

 

[velo]

I'm telling dr winney you said that

haha, oh no!! I'll just tell him I'm sure my experience would have been 10x better if I had just gotten to do that trauma rotation...rats....

 

[TommyGunn04]

Agreed. Doing what you're supposed to do should (and usually will) get you an average grade. This isn't junior soccer anymore! Not everyone gets a trophy just for participating!!

I've only been an intern for about 6 months now, and being just barely out of medical school I can certainly remember what it was like waiting around for admissions, not feeling appreciated, of not being paid attention to. That said, in the past 6 months I've gained a different perspective, and have come to realize that there's a often a HUGE difference in the caliber of medical students on the medicine rotation (even at a top 10 school). It's interesting, because everyone seems to think they're doing a good job and doing what they're supposed to do, but some students are just much better than others and some are just plain slackerish, and this gets reflected in their evaluations. I used to think it was so arbitrary and subjective, but now I've come to think that it's actually much more merit-based than I thought it was when I was a student.

For example, the quality of daily notes that some of our students write is enormously variable. Interestingly, students themselves generally don't seem to realize whether they're writing good or bad notes. It's our job to teach them to improve, and I always try to do so, but there's often a clear difference that persists. For some students there's a clear difference in effort. Some spend lots of time reading, both at home and in the hospital, while others never seem to know anything about medical problems that their own patients have. I've had students who offer to help, who are enthusiastic and ask questions, and who want me to teach them how to draw blood, how to interpret labs, etc. I've also had students who constantly show up late, who don't know what's going on with their patients, who only want to take one patient on call, or who are so slow with note-writing and doing admissions that they're clearly behind many of their classmates in their knowledge and efficiency. Of course, part of my job is to help them with this, and I always try to do so, but my point here is that your performance on a rotation is often not nearly as subjective as it may seem to you! As I said, I used to think it was when I was a student, but I've come to realize that this often isn't the case.

I'm not trying to be critical of students. I really enjoy teaching, and love having students around. And I'm not very far removed from being one, so I remember vividly what it was like. I just thought you might appreciate hearing an opinion from someone who's now on the other side of the fence, who has gained a new perspective as a result. The evaluation process during the clinical year may not actually be as random as you think. So if you're getting lots of "average" or mediocre evaluations, make sure to take a good look at yourself before blaming the system. It very well may be much more than just a coincidence.

 

[efex101]

I have also recently noticed this difference. My class size is so small that we are never around other students *but* in some rotations there may be six of us together. I have seen that "some" students are like the above poster stated...late all the time, say they will do something and they do not do it and then leave everyone else to do it, and highly inefficient writing notes and getting work done. I have to say that this of course is my perspective from a very small sampling size. I have also heard some of the resident commenting about this.

 

[jdh71]

working hard and never noticed . . . that's life. you do not get any "cookies" for doing what you are supposed to be doing. its always funny that so many people want to be praised for doing what they are supposed to be doing. i think it was Chris Roc who did a bit about this, "I take care of my kids! Your supposed to take care of your kids!!". Average means you are doing what you are supposed ot be doing (basically not pissing anyone off). Getting great remarks is really a crap shoot because you have to be in the right place at the right time doing what you are supposed to be doing. For instance my last call on internal medicine at the VA had a new batch of residents one of whom was blind - and I do not mean figuritively, he had a dog - my senior was one of those middle-eastern FMG who was surgeon trained overseas, but was training in Interal here because that was all he could match (you can imagine how "pleasant" working with him was) - anyway he told me he was covering the floor because the blind intern was useless and the ED had my pager and he expected me to do all the addmitting (of course all this work would have his signature), which I did all night long. In the morning once the attending showed up he was singing my praises as if I was some sort of superstar. Did I do anything anyone else would not have? Nope. Right place, right time. That attending wrote me a letter this year that more than one residency iterviewer remarked on. Keep being solid because you never know when it will turn into your oppourtunity to shine.

 

[chintu]

From a resident's perspective I think its easy to tell who is working hard and are applying themselves and who is just plain slacking. However, in the rotations I've been on majority of grading and evals were based upon an attending's impression and very little did the resident's input count, especially an intern's. So as a student you might be busting your back trying to help an intern in writing notes, discharge summaries, and making phone calls to PCP but if you fluster a bit in your morning rounds or miss a key lab finding or something you get noticed as being careless. It also works the other way around, some students are sharp and know when its best to apply themselves and when to slack and end up getting great evals. So unless you can constantly keep up the diligent attitude, which is very difficult to do w/o stressing yourself all the time it pretty much turns out to be a bit of a crapshoot.

 

[jdh71]

it just takes time to figure out what is important, some figure it out sooner than others and for some this comes naturally and sometimes you'll run into an attending for whom you do nothing right no matter what. that's life. there is no magical recipee to follow. presenations get better with time. show up, do your work, and if you're stoked about a particular service let them know if you're not don't pretend - won't get you anywhere and everyone knows you're being phony. when I was on OB/GYN I hated delivery (I know, I know it's like saying you hate Perl Jam or Nirvana or whatever else is supposed to be cool - but why? - delivery sucks). I told them that once I had my catch I was not interested but they could count on my to scrub every c-section - everyone was cool with that including my lemming classmates who "loved" delivery. Be yourself. Quit worrying about BS you have no control over - to try and control things will only make you crazy and as I've said before the rod up your arse will find itself with its own rod up its arse. It's not worth it. Other's people opinion of me is none of my business - think about it - PM me if you dont get it.

 

[tr]

...in the past 6 months I've gained a different perspective, and have come to realize that there's a often a HUGE difference in the caliber of medical students on the medicine rotation (even at a top 10 school).... The evaluation process during the clinical year may not actually be as random as you think. So if you're getting lots of "average" or mediocre evaluations, make sure to take a good look at yourself before blaming the system.

Oh, definitely. I'm still a med student and I really haven't found my evals to be particularly subjective or inaccurate at all.

I pretty much knew whether I was going to pass or honor each rotation before I got my grade. I am a different med student for each rotation. For the ones I enjoyed, I was great: interested, professional, hardworking, with an excellent fund of knowledge. For the ones I didn't like, I was terrible: uninterested, did what I was supposed to but not a whit more, unimpressive fund of knowledge. I doubt my medicine residents would have recognized me had they run into me on ob-gyn, and vice versa.

But frankly I was never motivated enough by grades to try and improve them by faking interest in specialties I didn't enjoy. You should get honors in what you like; I don't see why I should fight for honors in ob-gyn when they ought to go to someone who is actually interested in that specialty.

 

[TIMMY]

You should get honors in what you like; I don't see why I should fight for honors in ob-gyn when they ought to go to someone who is actually interested in that specialty.

Good point.👍 Early on in the year I found myself focusing on trying to impress attendings with presentations........drained the crap outa me mentally and I lost track of the fact that soaking up knowledge was more important. Since then whenever I go on a rotation....I do the best I can to meet the expectations initially. If the rotation is fun, then I let my demeanor and attitude take my grades a step further(Gata kill the shelf too). It has worked at least once this year...and this is the specialty ive chosen to pursue.
Payce