How to bring in an article to rounds without looking like a douche

[LadyJubilee8_18]

Everyone always says bringing an article about your patient to rounds is a great way to stand out. While I'm sure this is true, it seems to me that bringing in an article and suddenly presenting it to the attending during rounds could make one look as though he or she wanted to out-shine fellow students. However, I have a patient with a crazy calcified frontal lobe lipoma and dysgenesis of the corpus callosum, and I'd like to provide some research on the subject since it's so rare and interesting. So how do you bring in an article without looking like you're not a team player? Should I tell the other students on my team first? Bringing enough articles for everyone is a given. Anyone have experience with this?

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[The Buff]

I totally agree with you that it can be hard not to look like a douche while doing this, but I think in your case it is pretty easy. Just "I was doing some reading on this crazy rare thing and I found this one article about it." The attending probably doesnt even know that much aboutit and the other students will expect its the only place you could read about your pt anyway. The time when you look like a douche is when you bring in a paper about the management of dyslipidemia or something else really simple that doesn't really require literature support. (Not like that keeps the douches in my class from doing it though. "Afib requires rate control not rhythm control.." kill me).

 

[Tired]

Everyone always says bringing an article about your patient to rounds is a great way to stand out. While I'm sure this is true, it seems to me that bringing in an article and suddenly presenting it to the attending during rounds could make one look as though he or she wanted to out-shine fellow students. However, I have a patient with a crazy calcified frontal lobe lipoma and dysgenesis of the corpus callosum, and I'd like to provide some research on the subject since it's so rare and interesting. So how do you bring in an article without looking like you're not a team player? Should I tell the other students on my team first? Bringing enough articles for everyone is a given. Anyone have experience with this?

If you're on Medicine, I subscribe to the "tell 'em what they already know" school. Meaning, bring up a classic paper they're already familiar with, briefly summarize it, then let them feel important by pointing out its limitations. That way they get to feel smart, you appear well-read and studious, and everyone wins.

The problem with bringing up research in something like what you mention above is this: (1) They don't know anything about it, so may feel stupid; (2) All you're going to find is descriptive papers and case reports, which while intellectually interesting, doesn't really help anyone on rounds; and (3) it doesn't demonstrate any real learning on your part, just trivia.

 

[LadyJubilee8_18]

If you're on Medicine, I subscribe to the "tell 'em what they already know" school. Meaning, bring up a classic paper they're already familiar with, briefly summarize it, then let them feel important by pointing out its limitations. That way they get to feel smart, you appear well-read and studious, and everyone wins.

The problem with bringing up research in something like what you mention above is this: (1) They don't know anything about it, so may feel stupid; (2) All you're going to find is descriptive papers and case reports, which while intellectually interesting, doesn't really help anyone on rounds; and (3) it doesn't demonstrate any real learning on your part, just trivia.

Awww, but pedi neuro is all about mental masturbation. All the articles I've found feature seven patients...that they had to wait ten years to find...and presented in a number of different countries. The finding is really cool, but totally inconsequential. Before prenatal ultrasounds most people with CNS lipomas were just found incidentally. Since it causes dysgenesis of the corpus callosum, it could cause seizures later on, but besides that people just sort of hang out with fat in their brains. This kid is being followed by pedi surg, and the articles I've found say that the lipoma doesn't require surgery and in fact surgery can be injurious because all the nerves and vessels grow through the lipoma. I feel like this could be relevant to the plan of care considering pedi surg may be looking to operate.

 

[Ypo.]

Another way (besides Tired's-which I don't know how you could be assured they had read any research if it's an obscure disease) is to say "I was reading up on this last night in this article published in BMJ and apparently blah blah blah"-just one or two short sentences. If they are interested you can go on, and if not, hey you only took 2 seconds of their time.

I think they expect medical students to read up on that stuff (because we have more free time). Most teams appreciate a succint presentation on something they don't have time to read themselves. Try and think how you'll summarize it beforehand. Most important is to read and summarize something useful to patient care as opposed to just "showing off" that you've read or something. Most likely no one on the team really knows how to treat said obscure disease, so if you can teach them a thing or two it will be good for everyone. Good luck.

 

[Ypo.]

Since it causes dysgenesis of the corpus callosum, it could cause seizures later on, but besides that people just sort of hang out with fat in their brains. This kid is being followed by pedi surg, and the articles I've found say that the lipoma doesn't require surgery and in fact surgery can be injurious because all the nerves and vessels grow through the lipoma. I feel like this could be relevant to the plan of care considering pedi surg may be looking to operate.

This is perfect, and it's all you need to say. You can elaborate more if they show interest. Let us know how it goes.

 

[LadyJubilee8_18]

This is perfect, and it's all you need to say. You can elaborate more if they show interest. Let us know how it goes.

So, I ended up bringing both an article AND my fellow medical student's favorite girl scout cookies (thin mints), so everyone was happy. When I summarized it, both my attending and resident were very interested, so I handed the thing out. It ended up affecting how we're going to manage the patient. From what I can gather, the secret is to 1. Bring in an article that actually matters for the patient and 2. Bring food for those who could care less.

 

[MirkoCrocop]

dude. dont bring an article to rounds. thats so gay. if i was a fellow student and you flipped out an article during rounds, not only would i want to vomit a little, i would be pissed about the extra time this was taking. also, that sets a precedent for the rest of the rotation, a precedent that will annoy the heck outta everyone.

keep your extra reading to yourself
if you really, really are genuinely interested in the topic, go find the attending later and bring up the article. my 2 cents, but ive never liked medicine, so maybe my opinion sucks.

 

[Tired]

dude. dont bring an article to rounds. thats so gay. if i was a fellow student and you flipped out an article during rounds, not only would i want to vomit a little, i would be pissed about the extra time this was taking. also, that sets a precedent for the rest of the rotation, a precedent that will annoy the heck outta everyone.

keep your extra reading to yourself
if you really, really are genuinely interested in the topic, go find the attending later and bring up the article. my 2 cents, but ive never liked medicine, so maybe my opinion sucks.

Have fun in the scramble.

 

[pseudoknot]

my 2 cents, but ive never liked medicine, so maybe my opinion sucks.

Quoted for emphasis.

To the OP, it sounds like you found a great solution, and I learned something helpful by reading your thread. Thanks!

 

[Anka]

I'd usually just warn the other medical student on service that I was bringing a paper in, and give them a copy ahead of time so they could read the paper and/or read up on the subject. One of the attending moves when a paper is brought in is to say, "Can you summarize it for us?" And then pimp you and your collegues about the general topic. If you give the other med student a copy of the paper and fair warning, they can come out looking like a star (along with you).

Anka

 

[LadyJubilee8_18]

I'd usually just warn the other medical student on service that I was bringing a paper in, and give them a copy ahead of time so they could read the paper and/or read up on the subject. One of the attending moves when a paper is brought in is to say, "Can you summarize it for us?" And then pimp you and your collegues about the general topic. If you give the other med student a copy of the paper and fair warning, they can come out looking like a star (along with you).

Anka

Thats a really good idea. With this situation the disorder was so rare not even the attending knew about it, but when I'm on surgery or medicine and I have a semi-normal disorder to research, I'll totally keep this in mind

 

[MadameLULU]

dude. dont bring an article to rounds. thats so gay. if i was a fellow student and you flipped out an article during rounds, not only would i want to vomit a little, i would be pissed about the extra time this was taking. also, that sets a precedent for the rest of the rotation, a precedent that will annoy the heck outta everyone.

keep your extra reading to yourself
if you really, really are genuinely interested in the topic, go find the attending later and bring up the article. my 2 cents, but ive never liked medicine, so maybe my opinion sucks.

ridiculous

 

[blz]

I actually kind of agree with Mirkocrocop. Cookies too? oh man thats too much.

 

[Ypo.]

So, I ended up bringing both an article AND my fellow medical student's favorite girl scout cookies (thin mints), so everyone was happy. When I summarized it, both my attending and resident were very interested, so I handed the thing out. It ended up affecting how we're going to manage the patient. From what I can gather, the secret is to 1. Bring in an article that actually matters for the patient and 2. Bring food for those who could care less.

You've got it. I've always thought as long as this (patient care) is your goal, who cares what other people think (ie-neurotic med students who think everyone is out to make them look bad). People (attendings/residents) can sense genuineness and patient dedication.

And the cookies are a plus, too. I'd have been stoked.

 

[Ypo.]

dude. dont bring an article to rounds. thats so gay. if i was a fellow student and you flipped out an article during rounds, not only would i want to vomit a little, i would be pissed about the extra time this was taking. also, that sets a precedent for the rest of the rotation, a precedent that will annoy the heck outta everyone.

keep your extra reading to yourself
if you really, really are genuinely interested in the topic, go find the attending later and bring up the article. my 2 cents, but ive never liked medicine, so maybe my opinion sucks.

Huh? Man, if someone actually wants to teach me something that is CITED by an article, I'm more than stoked. As long as they don't ramble on and on of course.

 

[LadyJubilee8_18]

I actually kind of agree with Mirkocrocop. Cookies too? oh man thats too much.

You're just jealous because you didn't get any thin mints

the cookies were sort of for selfish reasons also. Thin mints+me needing study snacks= one big fat AS$

 

[velo]

So, I ended up bringing both an article AND my fellow medical student's favorite girl scout cookies (thin mints), so everyone was happy. When I summarized it, both my attending and resident were very interested, so I handed the thing out. It ended up affecting how we're going to manage the patient. From what I can gather, the secret is to 1. Bring in an article that actually matters for the patient and 2. Bring food for those who could care less.

Glad you decided to bring the article in. In my opinion you should never feel shy about doing this (on an IM rotation)--especially if it's an opportunity to teach your team something they didn't know. Everyone on your team wishes they had more time to do reading but are also super busy. If you can read about something interesting, summarize it in a useful way, and then efficiently teach the team about it you are doing everyone a favor.

Yes, etiquette does dictate that you inform the other students on the rotation that you're planning on trying to present something (just so you don't blindside them), but etiquette does NOT dictate you purposefully slack off to keep their lazy *** from looking bad if they don't want to do any outside reading of their own. For anyone to suggest you should feel guilty for reading about your patients just reeks of a juvenile, back-of-the-classroom mentality that you need to rise above.

 

[velo]

You've got it. I've always thought as long as this (patient care) is your goal, who cares what other people think (ie-neurotic med students who think everyone is out to make them look bad). People (attendings/residents) can sense genuineness and patient dedication.

And the cookies are a plus, too. I'd have been stoked.

Yeah, totally agree. To add to what I said above, looking up good quality EBM stuff is the most meaningful ways you can affect patient care as a medical student. When something you looked up changes management suddenly you're not just a passenger on the rotation anymore!

 

[velo]

Thats a really good idea. With this situation the disorder was so rare not even the attending knew about it, but when I'm on surgery or medicine and I have a semi-normal disorder to research, I'll totally keep this in mind

This post prompted the tangent below which is to be taken with the following GIANT grain of salt-- "velo didn't care for surgery" ...to put it lightly...

I'd be careful about doing this kind of stuff too much on surgery. Those goddamn scalpel-monkeys don't give two ****s what you have to say about anything, regardless of how knowledgeable you may be. I learned this the hard way when I rotated from a cardiology floor to orthopedics. On call one night we had a patient who was having a NSTEMI, the resident didn't know what to do really, I started describing the initial management, and the response was, "I hear what you're saying, but I'm just going to call a cards consult so why are you even talking?" Direct quote. Not the most intellectually curious bunch.

Doing well on surgery is easy. Keep your head down, work hard, have (on the surface) a great attitude, and most importantly NEVER COMPLAIN ABOUT ANYTHING! That's all you have to do on surgery to do well. Learning anything is totally optional. And they don't want anything to do with any article you bring in.

 

[alphaholic06]

So when you bring an article, is it from a specialty specific journal or can you bring an article from an Emergency Medicine journal for a Cardiology team?

 

[AmoryBlaine]

Isn't it odd that we are in medical school trying to learn how to dx/tx diseases that can kill and maim and we are afraid to bring in supplementary educational material because we are worried that other students won't like it?

I agree with what others have said, warn your fellows and then drop a few sentences on rounds like the OP did. Sounds like a great strategy. If you have a super-rare case on your service and the other students are completely uninterested in learning anything about it you should bring some brochures for dental school to pass out.

We are physicians for crying out loud.

 

[docjagermeister]

I agree with the minority opinion on this one: bringing in unsolicited articles as a med student is way beyond your pay-grade. Others may argue that this is 'what medicine is about' or 'it's for the sake of learning', but in the end you are cramming your lust for knowledge down the throats of uninterested others. The attending either knows of it or will never see another case of it, the residents are far too busy to care, and fellow students feel at best that they have to work a hell of alot harder to meet your standards or at worst betrayed (especially if they are not pursuing medicine residencies).
I read a half hour to hour a day about either cases I encountered that I had questions about, or tore into Blueprints or similar review books for the speciality.
And btw, I had exceptional clinical grades and glowing letters of rec, and ended up pre-matching to my #1 choice in internal medicine. All with this 'slacker' attitude apparently....
Wake up people-being a medical student (esp. fourth year) is a great experience...Enjoy it and prepare for the next level where some of the advice mentioned in this thread may be more applicable.

 

[DOanesthesia]

I'm also with the minority here. There is no way to bring in an article without looking like a douche. Any way you frame it, there is going to be that element of douche baggery. When I come across good articles, I make a mental note. If I have the opportunity, I mention that I was reading about ABC in the journal of XYZ and that has been good enough.

 

[blz]

I have to mention this again: YOU BROUGHT IN COOKIES TOO!??

lol...i'm not gonna play that high and mighty we are physcians game. dont dick over the other students like that.

 

[AmoryBlaine]

I have to mention this again: YOU BROUGHT IN COOKIES TOO!??

lol...i'm not gonna play that high and mighty we are physcians game. dont dick over the other students like that.

Hold on.

Say that a student is carrying a particularly interesting patient and reads a particularly interesting article about that patient. Say furthermore that the student has a genuine interest in the topic at hand and has a good-faith desire to share their new-found knowledge with their team. You are saying that action constitutions the "dicking over" of the other students on the team?

If so, that's a completely ridiculous thing to say.

 

[ranmyaku]

I'd agree that bringing in cookies is completely ridiculous

 

[velo]

but in the end you are cramming your lust for knowledge down the throats of uninterested others. The attending either knows of it or will never see another case of it, the residents are far too busy to care, and fellow students feel at best that they have to work a hell of alot harder to meet your standards or at worst betrayed (especially if they are not pursuing medicine residencies)

If that's the way things really are at your school then that's just sad. I hope that at an academic medical center people don't feel like they're having another person's "lust for knowledge crammed down their uninterested throats" when someone on their team looks something up for them

With regards to the other comments, every time someone from my team has brought in baked goods I have had one, pure, uncomplicated opinion of it: "ooo cookies!!!"

Seriously, who doesn't like cookies? fascists...

 

[Southpaw]

The only articles I've brought in and discussed were ones requested by my attending/residents. When I've been in your situation, I've done some reading of case reports, etc., and while presenting my patient I might add to the A/P part of my presentation "I read that management includes A, B, and C based on this case report I found". If they want more, they'll ask you to bring in the article.

And I agree, if you've got a fellow student on your team, you need to forewarn them that you're about to break into gunner mode and they need to put on the full body armor.

Cookies? Really? That's just really, really lame.

 

[diosa428]

I have to mention this again: YOU BROUGHT IN COOKIES TOO!??

lol...i'm not gonna play that high and mighty we are physcians game. dont dick over the other students like that.

You know what I love to do? Offer to get my residents coffee. Then they're always like, here's my card, get yourself something too. MMMMM

 

[LadyJubilee8_18]

I'd agree that bringing in cookies is completely ridiculous

Is it really that ridiculous? As far as I can tell, pediatrics is all about cookies, candy, and sweets! People are always bringing bronies or cookies for their teams. We even have "candy rounds" where the cheif resident goes to every floor passing out candy on friday afternoons. Maybe on medicine or some "serious" adult rotation bringing sweets is a bad idea, but for pediatrics, the more the better. This is reason #346 to go into pedi

 

[Ypo.]

"How dare you read an article and try and teach the team? ARE YOU TRYING TO THREATEN MY CHANCES OF HONORING? There is an unspoken moral code among medical students that we should all look equally dumb. If you don't agree you must be a gunner! And, no I don't like cookies because I'm a mean grumpy medical student and believe that no one is capable of a spontaneous act of kindness. On the contrary, everyone must be like me; calculating every move with the ultimate goal of matching into _______________ (insert ultra-competitive residency of choice)."

If anyone acted like this in my class most of my classmates would tell them to stuff it. Talk about neurotic.

Ayyy!!! When will it end?

 

[velo]

Is it really that ridiculous? As far as I can tell, pediatrics is all about cookies, candy, and sweets! People are always bringing bronies or cookies for their teams. We even have "candy rounds" where the cheif resident goes to every floor passing out candy on friday afternoons. Maybe on medicine or some "serious" adult rotation bringing sweets is a bad idea, but for pediatrics, the more the better. This is reason #346 to go into pedi

It's not ridiculous, don't listen to them. You can bring me cookies anytime

 

[blz]

Hold on.

Say that a student is carrying a particularly interesting patient and reads a particularly interesting article about that patient. Say furthermore that the student has a genuine interest in the topic at hand and has a good-faith desire to share their new-found knowledge with their team. You are saying that action constitutions the "dicking over" of the other students on the team?

If so, that's a completely ridiculous thing to say.

She didn't let the other students know she was doing this AND she brought in cookies!?? who the hell does that, lol. respect the code.

 

[Ypo.]

respect the code.

They're more guidelines, really.

 

[Southpaw]

This thread is hilarious....just look at the thread title. Lady Jubs had an idea that what she was doing was crossing the line, she just crossed it anyway. I love how midway into this whole thing she neatly slides in the "oh, and by the way, I BROUGHT COOKIES!!!! YAY!!!". Hilarious.

 

[MirkoCrocop]

LOL

that pretty much sums it up. you gotta respect the code.

and to the chap that told me to have fun in the scramble, i juts want to say too late, cuz i already matched

 

[AmoryBlaine]

She didn't let the other students know she was doing this AND she brought in cookies!?? who the hell does that, lol. respect the code.

It sounds like she genuinely didnt think she was doing anything wrong. I am still giving the OP absolution for a very venial sin and praising her for intellectual curiosity.


I love the way that almost every such discussion on SDN assumes that a "team" is made up thusly:
*an arogant, distant, cantankerous attending
*a senior resident who delights in pimping
*an intern who is so overworked that they cannot even brush their teeth
*a group of medical students who are so checked out they can't even remember what rotation they are on
* +/- an appalling guner who everyone hates

On SDN, all of these people hate each other and try to bring each other down. Give me a break, most of my teams ranged between tolerable and genuinely fun. If a student had done something that was questionable one-upsmanship usually we would all good enough friends to just give each other crap about it for the day (often with the attending/residents joining in) and then move on with our lives.



Oh, and if someone wants to bring in cookies, I usually just eat them instead of looking for a sinister purpose. Unless they are sugar cookies, I hate sugar cookies.

 

[LadyJubilee8_18]

She didn't let the other students know she was doing this AND she brought in cookies!?? who the hell does that, lol. respect the code.

I did let the other students know, and I brought in cookies for them.

 

[docjagermeister]

Yeah, this thread has become quite hilarious! Suffice it to say, every institution has gunners, and if you give them enough rope they will hang themselves.... Case in point:
I was on peds with another student who brought in candy the first day. Harmless enough, as I have as much of a sweet tooth as the next guy. Then the next day he followed up by bringing in a 5-lb bag of dum-dums! He wanted to restock the office's supply for the kids apparently. I let this slide then, as if he wanted to go into peds and score that honors eval more power to him. What really got on everyone's nerves is when one of the peds docs ruptured his achilles and had to use one of those rolling carts to get around the office. This guy used his own hard cash to deck out the doc's push cart with a horn and spinner! Needless to say, it was just plain awkward and he was the laughingstock of the office. The second to last day of the rotation the docs told me they were sending me home early and gving me the next day off, just so this douche would take a hike also. Turns out he had to remediate the rotation.
Alright, back on track: I personally would be very interested in the OP's topic they had to present. But I am equally confident that there would be someone else on the team that could care less. Just remember the skew in numbers of gunners vs. non-gunners on this forum.
And shame on you velo for attacking my institution. Our school has a disgusting amount of gunners as well... I think they're out bleaching their white coats for July now!

 

[blz]

Obv this chick had good intentions (although who can really read your mind to know this in the real world) and it seems like food was the norm on that rotation. that's fine. My point is that when you do something out of the norm, you will come off as a douche.

 

[velo]

Obv this chick had good intentions (although who can really read your mind to know this in the real world) and it seems like food was the norm on that rotation. that's fine. My point is that when you do something out of the norm, you will come off as a douche.

That's a good point, most of our disagreements may stem from the differing norms at our respective schools. For example, every time I bring up the idea of med students bringing in articles and doing little presentations for their team on this board people look at me like I've grown a 2nd head (and that that head is a giant gunner!). But I think that's pretty much par for the course here--while it's not stated explicitly by the clerkship director that you have to do it, it is "strongly encouraged" and I think falls well within the bounds of something "you're expected to do" as a med student on an IM rotation here.

If this is not the norm at other schools then I can understand how people would find the suggestion 'gunnerish.' But I also think that's a shame, doing the EBM stuff was one of the more rewarding parts of my medicine clerkship. It was certainly the only time I could say something in rounds that would significantly affect the team's management. And the interns seemed to genuinely appreciate having a bunch of literature, relevant to their patient, distilled onto a little one page handout.

And I'll say again, the war against baked goods people are starting here is un-american and I won't stand for it! I LOVES ME SOME COOKIES!!!