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How to deal with a bad senior

quickfeet

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Dec 2, 2010
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    On medicine wards, if your senior is both incredibly rude and incredibly incompetent, how do you deal with this? e.g. they try to micromanage your patients and constantly change your plans, and when the attending gets pissed about something in your management, senior attributes said mistake to you. They take any and all credit for the good work you do, and blame their bad decision-making on you.

    Not asking for myself, but for a former med school classmate in another program.
     

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      Suck it up and keep your thoughts to yourself if you have nothing nice to say about your senior.

      Pretty much anything you do (or say to a superior) has the potential to backfire, especially if it's perceived by others as an attempt to usurp the usual hierarchy or chain of command of things.
       
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      surgonc2017

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        Suck it up and don't say anything. Ultimately your senior is responsible for all good and bad things that happen on "your" patient to the attending whether you/him or anyone else does it. The senior knows that and the attendings know that.


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        12glaucoma34

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          On medicine wards, if your senior is both incredibly rude and incredibly incompetent, how do you deal with this? e.g. they try to micromanage your patients and constantly change your plans, and when the attending gets pissed about something in your management, senior attributes said mistake to you. They take any and all credit for the good work you do, and blame their bad decision-making on you.

          Not asking for myself, but for a former med school classmate in another program.

          Bite your tongue and be polite.
           
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          alternatecharacter

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          Jun 25, 2017
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            The worst part of intern year is when you have a weak senior. Strong seniors become some of the people you look up to the most. I have the hugest amount of respect and appreciation for the seniors who were awesome. And life was hell when I had to put up with the village idiots. Thankfully intern year will be over sooner than you expect!
             
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            akwho

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              The best way to deal with a bad senior is to take excellent care of the patients. If nothing bad happens to your patients while you're on service they will have less chances to throw you under the bus. At the end of the day the bad seniors are really just afraid of getting their own weaknesses exposed. If you help them run a tight service while you are on they will get your back.
              1. For small dumb things they do or say let it slide like water off your back.
              2. Medium size dumb stuff they want you to do, question why (maybe they have a good reason) or come up with alternative plan and present it to them via text or in front of other people so there is documentation.
              3. Big dumb stuff that would definitely harm the patient run it by an attending. If it's a weak senior the attending will know why you are running it by them.
               
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              cbrons

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                The best way to deal with a bad senior is to take excellent care of the patients. If nothing bad happens to your patients while you're on service they will have less chances to throw you under the bus. At the end of the day the bad seniors are really just afraid of getting their own weaknesses exposed. If you help them run a tight service while you are on they will get your back.
                1. For small dumb things they do or say let it slide like water off your back.
                2. Medium size dumb stuff they want you to do, question why (maybe they have a good reason) or come up with alternative plan and present it to them via text or in front of other people so there is documentation.
                3. Big dumb stuff that would definitely harm the patient run it by an attending. If it's a weak senior the attending will know why you are running it by them.
                I think this is good advice. One thing I've been told is to feel your senior out the first few hours and act accordingly. If theyre really incompetent then just try to leave as much of your assessment/plan for rounds with the attending. If they tell you to do things that are clearly unsafe, then try to get them to order it, cause a lot of the truly incompetent seniors will throw the intern under the bus when things go south.
                 
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