How often do you get pimped?

[GreenShirt]

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I'm the part of the first class of my school to start clinical rotations (new school). I always imagined that rotation would mostly involve me seeing the patient, presenting to the physician, then getting pimped. In reality, I never get pimped! I frequently do H&P's and presentations but usually don't get more then a nod of the head from the preceptor. How am I supposed to learn anything? We rotate through community hospitals and offices rather than teaching hospitals which most likely accounts for the difference. I hear people say it's better to be the only student with a physician preceptor because you'll learn more rather than one of a dozen students following a resident but I think residents probably know better what you're supposed to know than a clinician who's been out of school for years.

So to all you guys and gals getting pimped out there, appreciate it! You're lucky!

 

[JStub]

I like a mix of both and I learn better by reading up on patient conditions rather than getting pimped. I don't want to get into surgery so I don't care for the surgeon to pimp me on random stuff I don't care about or would affect my ability to practice medicine (ie those landmarks and triangles). I also tend to score higher on the evals when its a nonpimping environment since I don't look as dumb. So appreciate it! You're also lucky at times 🙂

 

[cpants]

I probably get pimped a few times a day. Usually it's like 10 questions in a row though. Like a question about patient's treatment, followed by a bunch of follow up questions. I actually kind of like it too. It's a big motivator to read up on stuff that the patients on your service have. No one really cares if you get them wrong either.

 

[GreenShirt]

I probably get pimped a few times a day. Usually it's like 10 questions in a row though. Like a question about patient's treatment, followed by a bunch of follow up questions. I actually kind of like it too. It's a big motivator to read up on stuff that the patients on your service have. No one really cares if you get them wrong either.

I agree. It tests you on what you really know and helps motivate you. I was just curious if I was missing out on certain teaching experiences or if the experience wouldn't be that different at a teaching hospital. Oh well, maybe I'll get a little bit of it in residency. Do you do a lot of your own H&Ps at teaching centers or mainly round and answer questions?

 

[45408]

I also don't like it when they never ask you anything, because then they if you did read all about the disease, you won't get any credit for it. I don't like pimping for the sake of making you look dumb, but I think if it's used properly, it should be used every day.

 

[The Angriest Bird]

"Pimping" is more like an attending-personality than a required part of your 3rd year medical education. Surgeons LOVE pimping, and they are very well known for pimping stuffs that you will never see on any exams. My 3rd year pimping experience goes from maybe 20 pimps per rounding to less than 10 pimps in a 2-month rotation.

Like everything in third year, who you are working with is the #1 determining factor for everything, by far (and this is why I hate 3rd year but that's a whole another topic)

And I agree, when you have already studied a lot and know a lot of stuffs, it gets very frustrating when they don't ask anything.

 

[Trismegistus4]

"Pimping" has got to be the stupidest practice in the entire medical world. Don't give me any of this crap about Socratic instruction. How is it instruction to be asked questions you're already supposed to know the answers to, and either answer them correctly, or be raked over the coals for not knowing the answer? What exactly does that teach you, other than that the attending is an *****hole? I've got news for you, birdbrains: teaching involves telling, not asking. Anyway, didn't I already pass tests on all this stuff during my first two years? So why are my 3rd year evals based on whether or not I can still answer questions about it?

Answer: because the entire structure of academic medicine is set up to feed the egos of the arrogant SOBs who go into it. May God strike me dead if I ever think of becoming an "attending."

 

[FractureFixer]

"Pimping" has got to be the stupidest practice in the entire medical world. Don't give me any of this crap about Socratic instruction. How is it instruction to be asked questions you're already supposed to know the answers to, and either answer them correctly, or be raked over the coals for not knowing the answer? What exactly does that teach you, other than that the attending is an *****hole? I've got news for you, birdbrains: teaching involves telling, not asking. Anyway, didn't I already pass tests on all this stuff during my first two years? So why are my 3rd year evals based on whether or not I can still answer questions about it?

Answer: because the entire structure of academic medicine is set up to feed the egos of the arrogant SOBs who go into it. May God strike me dead if I ever think of becoming an "attending."

Hmmn, Maybe because the stuff you learned in years 1-2 is medicine, and since you are probably (I use this loosely) going to be a doctor, I am guessing it would be good to know medicine?

 

[nope80]

I'm with you. Don't get pimped at all really - at least not yet!! Now watch just because I said that, tomorrow i'm going to get questioned like crazy. I definitely feel like it would be better to be asked certain fair questions or have a little eentsy bit of teaching (God forbid). I feel like everything I learn is through my own reading and not through anything that happens throughout the day! Maybe not all schools are like this...

 

[J1515]

"Pimping" has got to be the stupidest practice in the entire medical world. Don't give me any of this crap about Socratic instruction. How is it instruction to be asked questions you're already supposed to know the answers to, and either answer them correctly, or be raked over the coals for not knowing the answer? What exactly does that teach you, other than that the attending is an *****hole? I've got news for you, birdbrains: teaching involves telling, not asking. Anyway, didn't I already pass tests on all this stuff during my first two years? So why are my 3rd year evals based on whether or not I can still answer questions about it?

Answer: because the entire structure of academic medicine is set up to feed the egos of the arrogant SOBs who go into it. May God strike me dead if I ever think of becoming an "attending."

Wrong. I can't even begin to say how wrong you are. There's a reason why most of us "birdbrains" don't remember so much of the first two years. It's because we sit in lecture and lecturers just talk and we listen. There is no active participation. We regurgitate info for the test, and then it's gone. The reason why so much learning and remembering occurs in years 3 and 4 is because it's interactive learning. There is NOTHING wrong with 'pimping' when done properly. It is not supposed to make you look dumb, unless you truly are dumb and don't know the answers to any of the questions. Instead it's supposed to make you think and go home and read about it later that day. You aren't supposed to "already know the answers" to the questions as you put it. That's not the point. If you know the answer to one or two questions, the doctor/resident should follow it up with another question to make you think. It's usually the people with very fragile egos or limited knowledge base who whine and complain about pimping. People who truly want to learn actually don't mind it.

This is all assuming it's done properly. Yelling and making fun of a student for not knowing the answer is worthless and not educational. Telling the student to go home and read up on it is worthwhile.

 

[Doctor4Life1769]

I get intermittent pimping, but I don't allow him to pimp me as much, as I ask questions quite a bit (not excessively and not ridiculous Qs either). There's learning in all sorta of settings. If you don't ask Qs, then yea, the attending will pimp you.

 

[Deferoxamine]

Today was the ultimate pimping experience - I think I needed a helmet. Got asked nearly 25 questions right on the spot - almost all of them pharm-related. Got about 5 or 6 of them wrong and I still feel like a *******.

 

[Whats_up_doc]

Def, 20 out of 25 is not that bad. Come on...

🙄

Today I got "pimped" in all types of murmurs, sounds, tones and EKG's but I feel it was done properly. It was more like teaching and I had my colleague by my side so we did a good job as a team. I felt I was learning, not being ridiculed; the way "pimping" should be.

 

[SweetnessFollow]

We get pimped on a regular basis starting M1. From lectures, to small groups. I think the worst part of it is fellow classmates who think instead of working w e/o, they need to "shine." I am not looking forward to seeing how bad that gets 3rd year.

 

[spicedmanna]

For the most part, getting pimped doesn't bother me too much, as long it isn't done in a way that is ridiculously demeaning, which defeats the purpose of it, in my opinion. I was already somewhat exposed to it during the first two years of medical school. I find that I tend to remember what I was pimped on pretty well and it makes me want to investigate the topic further, when I can. Also, the questions asked tend to help me think about what kinds of questions I should be asking myself when seeing a patient presenting a certain way.

I just started my clinical rotations. So far there hasn't been a whole lot of pimping as such, although every once in a while, when I present a particularly interesting patient, my attending will throw in a question or two. About every one out of two times, I will get it wrong, or not know the answer at all, so the questioning stops pretty quick, sometimes to my embarrassment. My attending is pretty nice about it and is very encouraging, although, I sometimes imagine him thinking that I must not know very much (which is true). Sometimes, I will get the answer wrong, only to look it up and find out that I knew what it was all along, I just couldn't recall it in the moment with someone pressuring me on the spot. I really wish I could stuff more into my brain, but the days are full and at night I'm lucky if I can get an hour of reading in (very tired and just want to crash out).

There's so much to learn, so little time. I know I'm never going to learn it all, but I'll settle for the basics right now. I feel like the only thing I'm even remotely good at right now is talking to patients. I feel so distant sometimes from being able to competently come up with an assessment and plan. I often don't have a clue how to pin-point my questioning during my H&P. I'm all over the place until my attending comes in and asks two or three poignant questions to the patient and it's all over. Heck, I'd love to, for example, be able to examine a patient with pitting edema of the lower extremities and remember, in the moment, how to grade the severity of the edema and immediately know that I need to r/o DVT and possible PE, etc. I guess all that will come. In the meantime, pimping helps focus the learning.

 

[nlax30]

Yup, depends on the rotation and attending/residents. My first two IM rotations were at a communiy hospital that had an IM program so most of my time was spent with the interns/residents and they would pimp some but definitely in a good, playful way. During afternoon rounds with the teaching attending he would do more of the typical pimping but still in a good "I'm asking you these things because these are the basics you need to know" type of way.

Last month OB/GYN it was similar. Residents/interns were for the most part easy to get along with and did a mixture of straight up teaching and some pimping, less interaction with attendings.... just when presenting patients to them during clinic days.

So far my pimping experience has been good. I really don't have a problem saying I don't know so I tend not to get really flustered or nervous when an attending starts on me, which from what I've seen seems to be half the problem some people have. I remember on my second month of IM one afternoon I happened to be sitting right next to the teaching attending who was a little intimidating (mainly because he was just so stinkin smart) and of course I was first to present a patient and for the next 20-30min he grilled me about the patient, the disease, treatment, tests, etc... After rounds I think each intern thanked me for taking the brunt of that afternoon's grilling session.
Main thing I quickly realized is that you are not going to know everything and just stay calm and be honest if you don't know, no need to get all nervous or flustered.

I'm still trying to figure out how to really study while on rotations so I sympathize with you there spicedmanna.

 

[J ROD]

To me, there is a difference between "pimping" and being an *****hole.

I have experienced both and I like the teaching aspect of pimping but some pimps do not understand how to handle their "pimp power".

 

[USArmyDoc]

Getting pimped is effective. I enjoy it.

 

[Trismegistus4]

Hmmn, Maybe because the stuff you learned in years 1-2 is medicine, and since you are probably (I use this loosely) going to be a doctor, I am guessing it would be good to know medicine?

If they want to make sure we still know the basics of years 1-2, why not just give us another written test?

It is not supposed to make you look dumb, unless you truly are dumb and don't know the answers to any of the questions. Instead it's supposed to make you think and go home and read about it later that day. You aren't supposed to "already know the answers" to the questions as you put it.

My experience is limited, as I've only done 2 rotations so far, but from what I've seen, you are supposed to know the answers. You're given signs of approval if you know the answers, and signs of disapproval if you don't, and I received a negative evaluation that included the comment that I wasn't able to answer many questions.

Today I got "pimped" in all types of murmurs, sounds, tones and EKG's but I feel it was done properly. It was more like teaching and I had my colleague by my side so we did a good job as a team. I felt I was learning, not being ridiculed; the way "pimping" should be.

I have experienced both and I like the teaching aspect of pimping but some pimps do not understand how to handle their "pimp power".

Getting pimped is effective. I enjoy it.

Again, how is pimping effective? How can you learn from it? In what way does being asked questions you don't know the answers to, constitute teaching?

 

[QofQuimica]

Today was the ultimate pimping experience - I think I needed a helmet. Got asked nearly 25 questions right on the spot - almost all of them pharm-related. Got about 5 or 6 of them wrong and I still feel like a *******.

I love pharm-related pimping because it makes me look good. But hard core anatomy-related pimping usually makes me look not so good. 😳

Best pimp question I ever got asked was to name the structure of a drug using organic nomenclature. The attending, who was not aware of my background, was surprised when I did it, and said, "no one has ever gotten this question right!" It would have been even sweeter if my resident hadn't felt the need to blurt out, "She has a PhD in organic chemistry; that's why she knew. It's not fair!" But it still impressed the attending enough that he commented about it the following week. And there I was, foolishly thinking that organic chemistry would never be useful in med school. 😛

 

[MJB]

Some pimping is good...some pimping is ridiculous. I like the pimping that ends in teaching points.


My personal favorite was "Discuss pneumonias for me".

I love IM...I really, really do.🙄

 

[alphaholic06]

I love pharm-related pimping because it makes me look good. But hard core anatomy-related pimping usually makes me look not so good. 😳

Best pimp question I ever got asked was to name the structure of a drug using organic nomenclature. The attending, who was not aware of my background, was surprised when I did it, and said, "no one has ever gotten this question right!" It would have been even sweeter if my resident hadn't felt the need to blurt out, "She has a PhD in organic chemistry; that's why she knew. It's not fair!" But it still impressed the attending enough that he commented about it the following week. And there I was, foolishly thinking that organic chemistry would never be useful in med school. 😛

Your resident was lame!

 

[Instatewaiter]

I recently did my Sub-I and almost never got pimped. I really felt like I was missing out- believe it or not. Often times I have found that pimping really brings to light an important point that I overlooked. If it's done right you shouldnt feel like the attending is picking on you.

An easy way to grade edema, is the number of pennies that would fit in the hole left by your finger.

 

[MJB]

"What's Jumping Frenchmen of Maine Syndrome?"





one more week.

 

[Jwax]

My experience is limited, as I've only done 2 rotations so far, but from what I've seen, you are supposed to know the answers. You're given signs of approval if you know the answers, and signs of disapproval if you don't, and I received a negative evaluation that included the comment that I wasn't able to answer many questions.

Again, how is pimping effective? How can you learn from it? In what way does being asked questions you don't know the answers to, constitute teaching?

Sure, you're supposed to know some answers and you will get more approval when you know answers. Knowing nothing will of course look bad. I was advised early on that pimping will generally follow the format of easy --> hard questions and they tend to keep going until you get things wrong. Our level of knowledge is less than that of our upper levels so even if you're well read on a topic, there comes a point where there is some clinical tidbit that we won't know. If we're not well read, well then we'll just get the shallow questions until we work up to harder ones. I personally feel pimping is effective because of the anxiety stimuli associated with pimping. You want to look good, so you get anxious. Anxiety --> better retention. I forget how, but I remember reading studies on it that indicate this is a real phenomenon. Plus, being forced to work through answers instead of just guessing out of a list of choices involves more thought process vs simple regurgitation or word recognition.

 

[RisingSun]

The key to pimping success is to start strong. If you flounder with a softball question, and it is a surgeon throwing you the softball, then you better be prepared for either merciless pimping or to be totally ignored and disregarded for the duration of your relationship with that person.

I screwed up one of the classic intraop pimping questions two weeks ago and was then subjected to merciless, take-no-prisoners pimping for the next 5 hours of a liver case. I had the same surgeon a week later, was scared ****less and prepped like crazy, nailed the first series of questions, was congratulated on having an excellent understanding of the pt and her disease process, and then basically ignored for the rest of the case. What a relief.

Take home message: prep like your life (grade!) depends on it, start strong, and don't waffle - just give an answer with confidence and it is either right or wrong.

Take home message #2: never speak unless spoken to (unless you are with the rare attending who actually gives a crap about education). People will expose your lack of understanding of whatever it is you are asking a question about, and then make you look stupid for ever asking the question. Sometimes you might learn a thing or two along the way, though.