Hey all,
I was one of you guys once. Now I'm head and shoulders above as I grab my long coat and get to toy with you as would a cat to a ball of yarn...
Seriously, though, I want your input into things I can do to be a good intern to you. It's too much work for everybody to be really generic here, so I'm going to present you a case and you tell me what I should do.
Patient in for, say, pneumonia, has a drop in HCT. No visible source of bleeding, not hemodilutional. Has history of OA and has been taking lots of ibuprofen for a number of months. Nurse thinks stools may have been dark and tarry but wasn't already ordered to sample for blood so didn't. We want to make sure it's not an upper GI bleed so we want do a rectal and guaiac the stool. (Actually if you're worried about a true bleed you won't bother guaiacing because you don't care about occult blood but that's neither here nor there for now.) At this point I can:
a) Do the rectal myself. You, however, as an eager student want to be involved and are more than willing to do it. I would be more than happy to let you do it because I don't enjoy doing them anyway but don't ask you because I'm afraid you'll feel pressured to say yes so I won't ding you on the eval, even though you really want to say no and I'm so busy with other things that I'll never remember that time you refused to do a rectal anyway.
b) Ask you if you want to do it. This time you are someone who is revolted by the idea of rectal exams and feel I am using my power and implied threat of a bad eval to get you to do my most unpleasant work for me. But you say yes so it won't affect your grade. In truth I am sincerely trying to get you involved and will never use it as some kind of way of judging your performance.
c) Ask if you want to do it but emphasize that it won't affect you negatively if you decline. However I was once a student too and would NEVER fall for that line, so effectively this is like option "(b*)" for lack of a better term.
So...what should I do? Or better put, what would you as an M3 prefer I do in a situation like this?
Aight, some general suggestions for residents/attendings, etc. or anyone else who has a hand at teaching, grading, and evaluating medical students:
1.)
Make the student a part of the team. As said before in this thread, outright assigning things for the student to do during the day is the best bet here. Particularly when working with multiple students, delegating tasks keeps everyone in line... if someone can't deliver with ALL this in place, THEN ding them.
2.)
Do not compare the student to previous students you've worked with. This is just terrible form, all around. Recently, a chief resident filled out my evaluation (gave me Honors), but gave me a few suggestions on how to work more "effectively". (S)he did this by pointing out another student in my class, and just how much "better" that student did things than me. What the chief resident did not realize was that the particular student (s)he was describing as the
paragon of clinical excellence 🙄 actually got a "Pass" on the rotation (straight from the student's mouth) - clearly lacking in other areas, and no this was not one of their first rotations. Just because a student is "fun" to work with and gives you a warm fuzzy feeling doesn't mean they are "better" than another student. Comparing me to someone else who didn't work under my circumstances is irrelevant to me, doesn't help me, and only makes you look like a douche in the end.
3.)
Do not praise the student who knows the answer to something only because they pulled out their iPhone or Pocket Encyclopedia or read it off an article printout or whatever else. They aren't proving anything except that they can use a search engine or index. But you can praise them for showing initiative to look things up, etc. Some of us go raw without this iPhone crap and can try to critically think through something based on what we've learned / read... please understand this.
4.)
Reprimand a student who interrupts the other student answering a question, or a student who answers the question that wasn't asked to them. I think this one is crucial, and I certainly plan on doing it when I become a resident. Please put these jerks in their place. I have had the
privilege of working with 2-3 students like this, it is downright awful and makes us all look
really bad.
5.)
Do not patronize me, the medical student. "OMG you made the photocopy for me? Excellent job! Best ever!"... "Excellent job listening to that patient's abdomen!!"... "Amazing job on clicking SEND on the orders on the computer chart system!" ... "Great job putting that gauze on the wound!"
😱 God I need a barfbag. Save the praise for when I really do something good, like showing up early, staying late, making a good finding on my patient, or taking care of business... I'm not 5 and this isn't Feel Good Happy Hills Summer Camp. Thx.
6.) All in all, joke with me, laugh with me, get to know me. Understand my situation. I want to do well... so don't take my willingness to work hard the wrong way... I'm just here to do my best, and you should be too. Don't punish me for working hard and doing the right thing. Smile. Pull me aside if I'm doing some minor thing wrong, don't embarrass me in front of the entire team. Be nice to patients and set a good example for me. Teach me. Ask me questions. Learn my name (first AND last). Show me something cool. Act your age... I am not impressed by your lax attitude, crass jokes, or use of 4-letter words. You're a doctor, act the part.
