How to deal with sabotage on clerkships?

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PremedSurvivor

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Why do cleekships turn some people into soulless, cutthroat-competitive beasts?

I'm on a clerkship for a field I want to go into with a friend of mine who wants to go in an unrelated field. Because I want to go into this field, I'm going out of my way to prep and have gotten very positive feedback so far. The thing is, it feels like my friend will undercut me at every turn. If the attending pimps me on a question I get wrong, he'll say the answer a second after the attending does to make it look like he knew. He's offered the resident to look thing up for my patients (which is a line I NEVER cross with another student). He tries to take all the new patients without trying to negotiate. If we're both with the resident, he'll ask 4839595 questions so I can't get a word in edgewise. Like WTF? How do I deal with this without becoming a competitive jerk?

It just pisses me off all the more because A) this field actually matter for me, whereas it doesn't for him and B) I've answered his ?s and tried to be as collegial as possible

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Why do cleekships turn some people into soulless, cutthroat-competitive beasts?

I'm on a clerkship for a field I want to go into with a friend of mine who wants to go in an unrelated field. Because I want to go into this field, I'm going out of my way to prep and have gotten very positive feedback so far. The thing is, it feels like my friend will undercut me at every turn. If the attending pimps me on a question I get wrong, he'll say the answer a second after the attending does to make it look like he knew. He's offered the resident to look thing up for my patients (which is a line I NEVER cross with another student). He tries to take all the new patients without trying to negotiate. If we're both with the resident, he'll ask 4839595 questions so I can't get a word in edgewise. Like WTF? How do I deal with this without becoming a competitive jerk?

It just pisses me off all the more because A) this field actually matter for me, whereas it doesn't for him and B) I've answered his ?s and tried to be as collegial as possible
This is probably transparent to the attendings and residents. Don't let it bother you. Just work hard, demonstrate your interest, and be a pleasant human being. You'll do fine.
 
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As a resident, this person sounds annoying.
 
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How the hell are you referring to this person as a friend
 
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This sounds like overtly-obvious behavior that your seniors will see through. Don't "stoop to someone's level" because you think you need to.

when it comes to new patients, they should always be split 50-50. That's unacceptable and you should confront them.
 
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Agree with others who have said this is either not your friend, or you should have already taken him aside and gone "dude wtf stop ****ing with me on the field I wanna actually go into"
 
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Why do cleekships turn some people into soulless, cutthroat-competitive beasts?

Because they were soulless, cutthroat beasts prior to starting school. Better to learn now than when you really needed that “friend”

Treat them at arm’s length, dont show your cards and focus on you. No doubt your “friend” thinks likewise
 
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Residents and attendings were in your shoes at one point. They specialize in smelling BS. Most of these types of students end up getting in their own way. Yes, it's even possible to smile too much.
 
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And yes we notice and grade accordingly. Also, I like to find good "scut" work for that person to do.

Real talk here. But how does the OP actually make sure that he gets his fair share of pts and quests? Do the residents and attendings do anything about this or should OP just beat the crap out of his friend behind closed doors?

Would it appear bad if OP just go away and do something productive like checking on his pts or reading up on topics concerning his pts instead of pretending to look interested while his buddy is bouncing off a bunch of ******ed quests off the resident/attending? This kind of occurrence happens often even during my preclinical years and that has been my approach. I'm wondering if I need to change my demeanor.
 
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Real talk here. But how does the OP actually make sure that he gets his fair share of pts and quests? Do the residents and attendings do anything about this or should OP just beat the crap out of his friend behind closed doors?

Would it appear bad if OP just go away and do something productive like checking on his pts or reading up on topics concerning his pts instead of pretending to look interested while his buddy is bouncing off a bunch of ******ed quests off the resident/attending? This kind of occurrence happens often even during my preclinical years and that has been my approach. I'm wondering if I need to change my demeanor.
Basically be friendly, normal, and have a sense of humor. Don't be a douche. I really don't care how much you know if you annoy the hell out of me. In most cases, you are already slowing me down so don't make me dislike you as well. Help out, be cool, and not a fool!
 
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Echoing what everyone other resident/fellow/attending said here, unless our heads are in the clouds, we notice this kind of stuff.

That person is a douche, not your friend.
 
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Echoing what everyone other resident/fellow/attending said here, unless our heads are in the clouds, we notice this kind of stuff.

That person is a douche, not your friend.

You guys say that, but a lot of the times residents and attendings are so oblivious. Same crap happened to me with another student who did far worse and it got to a point where an attending chewed me out for something I was absolutely not responsible for that I had to talk to the chief resident to make him aware of the situation. He was super surprised and I'm like are you serious can you not tell that literally every med student hates this kid for being an dingus.
 
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Nah you shouldn't have to take your friend aside and say that. Not a friend.

In general I agree but the number of people I've met in medical school who seem to have a strong lacking in social awareness makes me think that inadvertently being obnoxious is high on the differential of this situation.
 
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Why do cleekships turn some people into soulless, cutthroat-competitive beasts?

I'm on a clerkship for a field I want to go into with a friend of mine who wants to go in an unrelated field. Because I want to go into this field, I'm going out of my way to prep and have gotten very positive feedback so far. The thing is, it feels like my friend will undercut me at every turn. If the attending pimps me on a question I get wrong, he'll say the answer a second after the attending does to make it look like he knew. He's offered the resident to look thing up for my patients (which is a line I NEVER cross with another student). He tries to take all the new patients without trying to negotiate. If we're both with the resident, he'll ask 4839595 questions so I can't get a word in edgewise. Like WTF? How do I deal with this without becoming a competitive jerk?

It just pisses me off all the more because A) this field actually matter for me, whereas it doesn't for him and B) I've answered his ?s and tried to be as collegial as possible

I'll be the dissenting voice here. This doesn't particularly sound like sabotage to me. You have described what sounds like a motivated, anxious medical student with no more than one clearly annoying habit (repeating the attendings answer right after he says it). It sounds like you're anxious because you feel his work is being perceived as better than yours.

1) There is no 'line' that you cannot learn about, or even present about, your teammates patients. You get your chance to shine on rounds when you present, otherwise you both should be learning about the entire service.
2). There is no maximum number of questions that get to ask. If you feel that you aren't being heard enough, speak more.
3) If your residents are not doing the job of distributing admissions, it's not your friends fault for taking patients. If you want them too, speak up. Have you asked him to create a system to distribute the patients?
4) Most importantly, there is no rotation don't 'doesn't matter' to a medical student. It might matter more to you than him, because this is your goal specialty, but he in no way obligated to take a knee and get a pass so that you can look better

Sabotage, to me, is when a student deliberately makes you appear worse than you are. If he is lying to the attending on rounds about your work, or feeding you wrong times/locations for meetings, or filing complaints about you with the administration then that is sabotage. On the other hand if he is making you look bad by doing well (answering more.questions correctly, knowing more about the service, etc) then that's not a problem that he needs to fix.
 
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I'll be the dissenting voice here. This doesn't particularly sound like sabotage to me. You have described what sounds like a motivated, anxious medical student with no more than one clearly annoying habit (repeating the attendings answer right after he says it). It sounds like you're anxious because you feel his work is being perceived as better than yours.

1) There is no 'line' that you cannot learn about, or even present about, your teammates patients. You get your chance to shine on rounds when you present, otherwise you both should be learning about the entire service.
2). There is no maximum number of questions that get to ask. If you feel that you aren't being heard enough, speak more.
3) If your residents are not doing the job of distributing admissions, it's not your friends fault for taking patients. If you want them too, speak up. Have you asked him to create a system to distribute the patients?
4) Most importantly, there is no rotation don't 'doesn't matter' to a medical student. It might matter more to you than him, because this is your goal specialty, but he in no way obligated to take a knee and get a pass so that you can look better

Sabotage, to me, is when a student deliberately makes you appear worse than you are. If he is lying to the attending on rounds about your work, or feeding you wrong times/locations for meetings, or filing complaints about you with the administration then that is sabotage. On the other hand if he is making you look bad by doing well (answering more.questions correctly, knowing more about the service, etc) then that's not a problem that he needs to fix.

I agree with your bottom statement, but I disagree with your first one. It is absolutely wrong to present a patient that is clearly assigned to another student that the other student has worked up and studied for. We can all shine and show that we are working hard/studying without throwing each other under the bus. I also do, however, agree that we should look up ALL the patients on the service and know everything about them. On one of my services, my colleague's patient was peritonitic and he had no idea because he ran out of time while prerounding and I whispered it to him as my team starting rounding. It allowed him to alert the team, present the patient, tell them that he did not get a chance to see the patient but I had (I got there early and was checking up on all the patients in an effort to learn how to manage the whole list). I gave the physical exam and the team ran to the patients room and wheeled the patient down to the OR in less than half an hour. Patient safety always comes first, but there is still an opportunity to be respectful of each other and do a good job. In this case, he didn't look bad for not having seen the patient, neither of us felt like I was overstepping, and we both actually became really good friends over the rotation because we always had each other's backs.
 
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First, this person is NOT your friend. They are an dingus.

hahaha I love this. Dingus.

It'd be nice if we could control other people's bad behavior, but we can't. If your goals are to feel less anxious or to do a good job on your rotation, you can still do both regardless of whatever your dingus-friend is doing in the other corner by himself.

That being said, it sounds like no fun being on the rotation with this person. There will be people like him in the future at any stage you find yourself in, and you will have had the practice for dealing with them. Kudos to you for persisting and learning from other's bad behavior to inform how you wish to work with your future colleagues.

dingus dingus dingus :whistle:
 
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And yes we notice and grade accordingly. Also, I like to find good "scut" work for that person to do.

ive seen this, IRL. i had a co-student who appeared to thumb his nose at unwritten ward rules ie not showing up for sign out, wearing way way way way too much PPE at the most inappropriate times, leaving the floor for way too long, asking to leave early, taking mad sick days, etc. my *attending* (read: everybody saw the game) had him not only retrieve outside paper records from another hospital, but go through them page by page and summarize them as part of his presentation for the next day....

seems like small potatoes, sure, as outside recs are important to integrate...but this student had also been copying resident notes and presenting them verbatim, as his own, during rounds.

they always KNOW.
 
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ive seen this, IRL. i had a co-student who appeared to thumb his nose at unwritten ward rules ie not showing up for sign out, wearing way way way way too much PPE at the most inappropriate times, leaving the floor for way too long, asking to leave early, taking mad sick days, etc. my *attending* (read: everybody saw the game) had him not only retrieve outside paper records from another hospital, but go through them page by page and summarize them as part of his presentation for the next day....

seems like small potatoes, sure, as outside recs are important to integrate...but this student had also been copying resident notes and presenting them verbatim, as his own, during rounds.

they always KNOW.

That is egregious. Goodness gracious. Where is the self-awareness??
 
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That is egregious. Goodness gracious. Where is the self-awareness??

my thoughts exactly. no details were modified in the making of that post!

different situation from the OP, but somewhat similarly difficult nonetheless, cause i didnt even get any satisfaction out of being the "better" student by default. i tried respectfully initiating a come to jesus moment, even at the request of the residents on the team, but no luck. it was super disturbing to see someone make it so far into the field and be so much of whatever you call that...
 
my thoughts exactly. no details were modified in the making of that post!

different situation from the OP, but somewhat similarly difficult nonetheless, cause i didnt even get any satisfaction out of being the "better" student by default. i tried respectfully initiating a come to jesus moment, even at the request of the residents on the team, but no luck. it was super disturbing to see someone make it so far into the field and be so much of whatever you call that...

In my class, the highest scoring people on step 1 aka the "best" students because in the medicine world apparently step 1 is the only way to decide people's careers (eyeroll bec i'm applying now and annoyed with the process, let me be bitter) are some of the most awkward and worst human beings I have ever met. So incredibly rude to other med students and patients, full of crap, and sometimes I'm just like the system is just messed up if these are the people that it's promoting.

THERE ARE PEOPLE AT MY SCHOOL THAT HIT ON GIRLS BY TELLING THEM WHAT THEIR STEP 1 SCORE IS. I'm looking at you, 273 that won't stop texting me.
 
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In my class, the highest scoring people on step 1 aka the "best" students because in the medicine world apparently step 1 is the only way to decide people's careers (eyeroll bec i'm applying now and annoyed with the process, let me be bitter) are some of the most awkward and worst human beings I have ever met. So incredibly rude to other med students and patients, full of crap, and sometimes I'm just like the system is just messed up if these are the people that it's promoting.

THERE ARE PEOPLE AT MY SCHOOL THAT HIT ON GIRLS BY TELLING THEM WHAT THEIR STEP 1 SCORE IS. I'm looking at you, 273 that won't stop texting me.

That's unfortunate. At my school, the highest Step I scorers were almost universally the nicest, most helpful and sociable people in the class.
 
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That's unfortunate. At my school, the highest Step I scorers were almost universally the nicest, most helpful and sociable people in the class.

I think any kind of generalizing by Step score usually is based on the handful of people you know who scored in 99th percentile range. All of the ones I personally know are among the friendliest in our class as well.
 
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I'll be the dissenting voice here. This doesn't particularly sound like sabotage to me. You have described what sounds like a motivated, anxious medical student with no more than one clearly annoying habit (repeating the attendings answer right after he says it). It sounds like you're anxious because you feel his work is being perceived as better than yours.

1) There is no 'line' that you cannot learn about, or even present about, your teammates patients. You get your chance to shine on rounds when you present, otherwise you both should be learning about the entire service.
2). There is no maximum number of questions that get to ask. If you feel that you aren't being heard enough, speak more.
3) If your residents are not doing the job of distributing admissions, it's not your friends fault for taking patients. If you want them too, speak up. Have you asked him to create a system to distribute the patients?
4) Most importantly, there is no rotation don't 'doesn't matter' to a medical student. It might matter more to you than him, because this is your goal specialty, but he in no way obligated to take a knee and get a pass so that you can look better

Sabotage, to me, is when a student deliberately makes you appear worse than you are. If he is lying to the attending on rounds about your work, or feeding you wrong times/locations for meetings, or filing complaints about you with the administration then that is sabotage. On the other hand if he is making you look bad by doing well (answering more.questions correctly, knowing more about the service, etc) then that's not a problem that he needs to fix.

1) Maybe there are no hard rules, but there's a difference between adding info that the student assigned to the patient may have missed/helping them out and going behind another students back to work things up on their patient without talking to them or just acting like they're your patient. At a minimum, the other student should be asking if the OP if he/she needs help with a patient or if they mind if they get involved with more than just looking stuff up in the charts. Communication matters in medicine, and it sounds like the other student is just trying to cut OP out, which is BS.
2) Agree, so long as the other student isn't trying to completely monopolize the attending's and residents' time intentionally or interrupting when OP is trying to ask questions, both of which I've seen.
3) Even if the residents aren't distributing the patients, it's very self-centered and frankly crap to take every single one and lazy to not take any at all. Again, working in a team and communicating is an important skill in medicine which some people really don't get.
4) Agree again. Even if the field seemingly has nothing to do with the field you hope to enter, there's always something you can get out of it.

That's unfortunate. At my school, the highest Step I scorers were almost universally the nicest, most helpful and sociable people in the class.
I think any kind of generalizing by Step score usually is based on the handful of people you know who scored in 99th percentile range. All of the ones I personally know are among the friendliest in our class as well.

There's a mix at my school. I know a couple people who dominated boards and felt almost embarrassed to tell me how well they did. Then we've got those people that walk around like they're suddenly god's gift to medicine after getting above the 90th percentile on boards. We had one guy whose wife posted on FB that she was so proud that her husband had the highest scores in our class and proceeded to list his actual scores and talk about how he was basically the best student at our school. Turns out he wasn't the highest score in our class, and probably wasn't even top 5. Also turns out that several attendings apparently found him almost unbearable to work with. I think most people would get a little bit of cockiness or pride if they found out they scored in the 99th percentile, but some are just better at keeping that in check than others.
 
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In my class, the highest scoring people on step 1 aka the "best" students because in the medicine world apparently step 1 is the only way to decide people's careers (eyeroll bec i'm applying now and annoyed with the process, let me be bitter) are some of the most awkward and worst human beings I have ever met. So incredibly rude to other med students and patients, full of crap, and sometimes I'm just like the system is just messed up if these are the people that it's promoting.

THERE ARE PEOPLE AT MY SCHOOL THAT HIT ON GIRLS BY TELLING THEM WHAT THEIR STEP 1 SCORE IS. I'm looking at you, 273 that won't stop texting me.
If I score 274, will I have a chance then?
 
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In my class, the highest scoring people on step 1 aka the "best" students because in the medicine world apparently step 1 is the only way to decide people's careers (eyeroll bec i'm applying now and annoyed with the process, let me be bitter) are some of the most awkward and worst human beings I have ever met. So incredibly rude to other med students and patients, full of crap, and sometimes I'm just like the system is just messed up if these are the people that it's promoting.

THERE ARE PEOPLE AT MY SCHOOL THAT HIT ON GIRLS BY TELLING THEM WHAT THEIR STEP 1 SCORE IS. I'm looking at you, 273 that won't stop texting me.

Lol, stop being so bitter. I don't know about you, but if I was seriously ill and needed the attention of a highly specialized physician, I would want the guy who scored a 273 on his Step 1. I could not care less if he was "awkward." I would even tolerate a rude physician if it meant a cure. Most patients aren't looking for someone to hold their hand and sing kumbaya - they're looking for answers.

I will even go a step further and say that this "holistic" approach to medicine that emphasizes interpersonal skills has gone too far in modern medical education...I swear, I often find myself sitting in small group discussions wondering if I attend a medical school or a social worker school. People will go on and on about the patient's feelings and social justice issues... Meanwhile they have only a tenuous grasp of the actual pathophysiology that lies at the heart of the matter. I'm not saying we should go back to the paternalistic ways of the past, but geeze, is it too much to ask to focus on actual medicine without being labeled "awkward" ?
 
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1) Maybe there are no hard rules, but there's a difference between adding info that the student assigned to the patient may have missed/helping them out and going behind another students back to work things up on their patient without talking to them or just acting like they're your patient. At a minimum, the other student should be asking if the OP if he/she needs help with a patient or if they mind if they get involved with more than just looking stuff up in the charts. Communication matters in medicine, and it sounds like the other student is just trying to cut OP out, which is BS.
2) Agree, so long as the other student isn't trying to completely monopolize the attending's and residents' time intentionally or interrupting when OP is trying to ask questions, both of which I've seen.
3) Even if the residents aren't distributing the patients, it's very self-centered and frankly crap to take every single one and lazy to not take any at all. Again, working in a team and communicating is an important skill in medicine which some people really don't get.
4) Agree again. Even if the field seemingly has nothing to do with the field you hope to enter, there's always something you can get out of it.




There's a mix at my school. I know a couple people who dominated boards and felt almost embarrassed to tell me how well they did. Then we've got those people that walk around like they're suddenly god's gift to medicine after getting above the 90th percentile on boards. We had one guy whose wife posted on FB that she was so proud that her husband had the highest scores in our class and proceeded to list his actual scores and talk about how he was basically the best student at our school. Turns out he wasn't the highest score in our class, and probably wasn't even top 5. Also turns out that several attendings apparently found him almost unbearable to work with. I think most people would get a little bit of cockiness or pride if they found out they scored in the 99th percentile, but some are just better at keeping that in check than others.

Note to self: supercharge that superego to keep that ego in check after crushing boards in 8 months.
 
Lol, stop being so bitter. I don't know about you, but if I was seriously ill and needed the attention of a highly specialized physician, I would want the guy who scored a 273 on his Step 1. I could not care less if he was "awkward." I would even tolerate a rude physician if it meant a cure. Most patients aren't looking for someone to hold their hand and sing kumbaya - they're looking for answers.

I will even go a step further and say that this "holistic" approach to medicine that emphasizes interpersonal skills has gone too far in modern medical education...I swear, I often find myself sitting in small group discussions wondering if I attend a medical school or a social worker school. People will go on and on about the patient's feelings and social justice issues... Meanwhile they have only a tenuous grasp of the actual pathophysiology that lies at the heart of the matter. I'm not saying we should go back to the paternalistic ways of the past, but geeze, is it too much to ask to focus on actual medicine without being labeled "awkward" ?

lol but none of that stuff matters if you don't have the therapeutic alliance

you need to be people smart

yes, you are a professional advice giver, no, most people aren't in a position to judge the quality of that advice, so they have to use other measures to judge you, hence why if you don't have enough people skills it won't matter how clever your treatment plan
 
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lol but none of that stuff matters if you don't have the therapeutic alliance

you need to be people smart

yes, you are a professional advice giver, no, most people aren't in a position to judge the quality of that advice, so they have to use other measures to judge you, hence why if you don't have enough people skills it won't matter how clever your treatment plan

I completely agree. I've heard patients say that they went to a different doctor only because they felt like the first one "didn't care" about them. They did this even in spite of the fact that the first doctor came from a more prestigious institution. I swear, in surgery, sometimes it doesn't even matter if you're clinically "good." Patients, for the most part, have no idea. But they will notice if you're not nice.


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lol but none of that stuff matters if you don't have the therapeutic alliance

you need to be people smart

yes, you are a professional advice giver, no, most people aren't in a position to judge the quality of that advice, so they have to use other measures to judge you, hence why if you don't have enough people skills it won't matter how clever your treatment plan

It's also relevant in terms of getting an accurate picture of what's happening. In real medicine there is no question stem provided to you and being able to elicit information from a patient through the H&P matters. If the person with a 273 is too awkward/arrogant/whatever to gain an accurate history or their physical exam skills are crap, that massive foundation of knowledge is completely useless.
 
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Just wanted to update everyone on the situation:

1) The student WAS attempting to work up my patients behind my back.

2) I called said student out privately and informed them that it was absolutely unacceptable to try and work up my patients, although they were welcome to read about them.

3) Out of 3 residents and 2 different attendings, only 1 noticed this behavior and spoke to the student. Even then, their major point was that the student would talk nonstop on rounds in an attempt to monopolize the conversation and this was slowing everyone down. Not one word about attempting to work up my patient.

So at the end of the day, if you see something, SAY SOMETHING. The residents and attendings are incredibly overworked; even those with the best of intentions might not have the time to address things like this.
 
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Lol, stop being so bitter. I don't know about you, but if I was seriously ill and needed the attention of a highly specialized physician, I would want the guy who scored a 273 on his Step 1. I could not care less if he was "awkward." I would even tolerate a rude physician if it meant a cure. Most patients aren't looking for someone to hold their hand and sing kumbaya - they're looking for answers.

I will even go a step further and say that this "holistic" approach to medicine that emphasizes interpersonal skills has gone too far in modern medical education...I swear, I often find myself sitting in small group discussions wondering if I attend a medical school or a social worker school. People will go on and on about the patient's feelings and social justice issues... Meanwhile they have only a tenuous grasp of the actual pathophysiology that lies at the heart of the matter. I'm not saying we should go back to the paternalistic ways of the past, but geeze, is it too much to ask to focus on actual medicine without being labeled "awkward" ?

Available, affable, and able. Importance given in that order.

Mantra of private practice, but applicable to all of medicine.
 
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