Honoring rotations with toxic preceptors?

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PathNeuroIMorFM

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This is a two part question. I have my schedule for my next 3 rotations, all 3 of which have been classified as particularly toxic or malignant by other classmates and even my dean!

One rotation is OBGYN and is essentially glorified shadowing, another is gross/transplant surgery which has a lot of miserable residents. Both of which have very jaded residents and near-absent attendings with little interest in teaching. The third is addiction FM, which doesn't have the worst reputation, but I'm particularly interested in honoring. Ideally, I want to honor all three to help strengthen my residency application and get out of this awful city. Admins are aware of how bad it is, but nothing much has been done about it.

First question: Can I just straight up say to my residents/attendings near the start of my rotation, "I am interested this rotation, what can I do to make that happen"? Or will that sound pretentious and hurt me later?

Second, what is the best way to navigate mean residents/atttendings? I have a thick skin and I'm not afraid of them, but I am worried about my grades.

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Always always always be present. When they say " where is that med student?", you reply "I'm here." Make them chase you out of the hospital with a stick. Read ahead and know answers to obvious anatomy questions. Know as much as possible about each patient, their current condition and labs. These are super type A people, so to honor you will need to impress them. Secondly, if you can help with any scut work for the miserable residents and make their life easier, that will help. They very often take part in your evaluation. Ask politely if there is anything you can do to help. Even if you don't Honor, you will gain lots of experience.
 
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Take everything you hear with a grain of salt. I was told similar things about some of my rotations, even that one attending never gives honors. That attending even told me himself that he never gives honors early in the year because students aren’t advanced enough yet. I told him I was going to be the first. And I was.

I wouldn’t recommend that approach for everyone, but I’m a good read of people and it worked in that situation. I do think making it clear you want to earn honors and asking in feedback if your performance is worthy of that and where you can improve so it is. Asking what they personally look for in an honors student is a fair question early on.

Other rotations and preceptors that had bad reputations turned out to be pretty cool people when I got there. I often found that “toxic” translated into having high standards and expecting students to meet them. Even at post rotation feedback meetings, I watched other students talk about the same “toxic” preceptors and recall “toxic” interactions that I was present for and which didn’t even register with me as anything unusual.

Overall you just need to work so hard that people can’t help but say you earned an honors grade. Plenty of threads here that detail how to do that. In the end honors clinically tends to be how much people like you, so get to know those you work with. The residents - especially juniors - are only a couple years ahead of you.
 
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I think you're missing a few words but if you mean saying "how can I honor that rotation" that phrasing does rub me the wrong way as a preceptor. I might say something more like how can I be successful on this rotation? what would you recommend I do to get the most out of this rotation? what are some behaviors of students you've seen that have done well on this rotation?

Ask for feedback early and often, even (especially!) from folks that are difficult to work with, and actually take it into account.

For people that are just negative people...work hard and have everything they could possibly expect of you handled and ready to go, but do it quietly and don't act like a try-hard. If they're being abusive, read up on the grey rock method. If there are any tidbits of useful feedback they offer, try to take it seriously, but not personally, and recognize there may be some useful advice even if it's in an ugly package. Recognize that 99% of the time their abusive behavior is about THEM and not about you or anything you've done.

ETA: Also, if you don't honor...it's okay. It sounds like many people don't on these rotations, and residencies will see the distribution of grades on your MSPE and see that only X% of students who take this rotation get honors.
 
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