How often can I ask attending questions as a resident?

[hopefulscribe2]

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Hello there,

I was wondering how many questions we can ask our attendings regarding pathophysiology, pharmacology, or their thinking, I know we have a schedule to adhere to but let's say that there is enough time. can I ask a few questions a day or is this entirely attending dependent?

 

[GoSpursGo]

You *can* ask questions at any time, especially when it impacts patient care or if you're trying to ask something that is truly their opinion. But in general, if it's something that can be looked up like pathophysiology it probably helps the whole day run more smoothly if you look those things up on your own.

 

[shaggybill]

You're supposed to ask questions. But not too many questions. Some attendings will want you to ask questions or they will think you are uninterested. Some attendings will think you are incompetent if you ask questions. Some will want you to look up everything before you ask. Others get offended if you don't come to them first, because that's what they are there for. One attending will tell you how to do something a certain way, but the next attending will give you a bad eval when they see you do it that way.

It's a great system with lots of guessing. Have fun.

 

[Angler]

When I teach residents, I like being asked questions. It shows that you want to learn. I especially like open ended questions that may have more than one correct answer. Or questions that have no absolutely correct answer.

 

[PTPoeny]

The timing of questions is much more important than the number. Do not ask pathophysiology questions during a code. Do not interrupt your co-residents to ask questions. Do ask questions to clarify any orders before you put them in.

 

[LucidSplash]

I like being asked questions most of the time.

Every once in awhile there’s a resident that asks questions in a way that it is clear they are: testing to see what I know, asking questions to try to impress others with their questions, doesn’t bother to do any self-directed learning and wants to be spoon-fed everything, asking a super complex question with many parts when there is only a 2-minute gap of time available to answer the question, asking a question in response instead of answering a question they were asked when they do not know the answer.

I do not like those questions.

 

[dozitgetchahi]

You're supposed to ask questions. But not too many questions. Some attendings will want you to ask questions or they will think you are uninterested. Some attendings will think you are incompetent if you ask questions. Some will want you to look up everything before you ask. Others get offended if you don't come to them first, because that's what they are there for. One attending will tell you how to do something a certain way, but the next attending will give you a bad eval when they see you do it that way.

It's a great system with lots of guessing. Have fun.

That’s a good way of putting it. The worst part are the attendings who insist there’s only one correct way to do something, and then the attendings who get pissed when you do something that same “only correct way” you were previously taught.

 

[HemeOncHopeful19]

I’ve usually asked questions once I’ve looked something up and it still doesn’t make sense.

For example if my attending wants to do something a certain way X in clinic but I’ve looked up the guidelines and it seems to me that way Y would actually be recommended then I might ask (WORD THIS CAREFULLY, DON’T BE A *******) the rationale for X over Y.

The key to asking questions of your attending IMO is it needs to be a genuine question for your educational purposes and not some ulterior motive like showing off that you read or know some other answer. If you’ve given it a shot at looking something up and you still need clarification but they are giving you crap for asking then that’s on them not you, that’s part of their job and what they’re paid for.

 

[Saddleshoes]

As an attending, I have yet to have a resident that asked too many questions.
I have had them ask questions at the wrong time and place however. Remember your question is secondary to the care of the patient.

 

[mvenus929]

As an attending, I'm fine answering any questions that are asked, unless the questions intentionally seem to be trying to trap me into something or trying to make the question asker look good. I've yet to run into anyone asking those questions as an attending, but definitely had some as a resident.

But, you know, time and place. Asking questions in clinic during downtime=fine. Asking (non-clarifying) questions in the middle of a code=not so fine.

 

[Tangerine123]

If it's something short, pertinent and concise ask away. Setting is important, as a few mentioned above.

If it's something more complex, write them a more detailed email formulating the question. I've had good results with this. The attending took his time to explain the details and even sent me some PDF with guidelines and a lecture he gave on the subject. I've also emailed attendings from other wards that I previously rotated in.

 

[theacks1]

When I teach residents, I like being asked questions. It shows that you want to learn. I especially like open ended questions that may have more than one correct answer. Or questions that have no absolutely correct answer.

Go not to the Attendings for counsel, for they will say both no and yes.

I did have one bit of resident feedback saying they wish I would just give a straight answer sometimes, so I will try to be more explicit if I have personal opinions but I always try to give multiple perspectives. I also try to bring up relevant literature or consensus statements to show where I am getting my information in hopes that they will know where to look in the future. I would always try to look things up first as a resident so I try not to discount anyone from not asking questions as long as their work demonstrates that they are staying on top of things.

Otherwise, agree with everyone else. Asking questions is good, but keep in mind the situation, both clinically as well as what time it is. 11:55 may not be the best time to ask a complex question.

 

[dgdg]

As mentioned above, there are going to be complex situations where you can't just 'look it up' on your own self study. You have the basic facts (because you already knew the basics or just read about it), but applying it to a complex specific patient situation is where the attending can help you.
It's a teaching hospital - they teach, you learn. Appropriate questions are essential and should be received eagerly by your mentors.

 

[FutureInternist]

Some attendings may be so far out that they don’t even remember the pathophys etc.

Just be careful not to make them look bad by asking ones that they don’t have answers to…..the good ones will admit they don’t know, say “Why don’t both of us look it up and we can discuss in AM”.. but some may not like it

 

[kidthor]

I’ve never had a resisent ask too many questions… and the purpose of residency is to learn. So in my view you should ask away!

 

[Neuronix]

The more intelligent questions I'm asked, the more I engage the resident.

I love to be challenged. If someone finds a brand new paper or some existing paper that disagrees with our approach. Excellent! Maybe there's something I can learn too!

I will go on and on and on teaching for someone who seems to be interested.

I like to assign reading, have them go out and read it, and come back to me for intelligent discussion.

Conversely, too basic for level or repeated questions that shows someone is not learning is more concerning. Also, I don't want to "spoon feed". I'm not a textbook. This is a give and take operation. An hour a day of independent reading is very reasonable in my specialty.

 

[SurfingDoctor]

Ask questions. A lot of thoughtful questions. Then read to confirm.

Nothing is worse than regurgitating something and saying “well, ‘so and so’ told me X” when “so and so” is FOS. That’s not just residents or fellows, but attendings can be FOS too. That’s how bad ideas become gospel.

 

[NontradICUdoc]

I enjoy answering questions because it shows me that the resident or student is interested and wants to learn. In addition, it opens the door for me to show them how to use medical literature to look at the data and answer the question for themselves, and also forces me to stay up to date.

 

[Redpancreas]

On weekends at noon when you have given crisp, perfect presentations so rounds have ended early and the attending is in a good mood you are permitted to ask the attending a single question. Just be aware if it is a bad question, all your hard work for the week will be called into question.

Seriously, try to limit them to 2-3 per day. Timing is important. It needs to flow with the momentum of rounds. And don't be the guy that asks questions you already know the answer to. Don’t try to get super academic about the rationale for everything like hyponatremia, etc.

A lot of these lab values we see in IM like abnormal bicarbs, Hb fluctuations are insignificant. (Sometimes they’re not so be careful) but hyper focusing on these details and generating questions is where I see most annoying questions generated from.

Also avoid questions you can find in a textbook like what the cutoff is for doing XYZ, etc. unless you’ve actually looked and it’s not there. Typically the best questions are ones you run into commonly as an IM resident in gray zones.

Ex.) What do you do if the effusion is transudative but you’re suspecting cancer without any alternative diagnoses?

Ex.) In patients with recent PEs should be generally how long should we anticoagulation for major bleeding?