How to own 3rd year and get awesome recommendations for the match

[lukemd]

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Hey guys, I’m proposing a talk for a medical student conference. If you were at a conference and saw the below description & summary, would you attend that session? Why or why not? Any feedback on how to make it more relevant, appealing, helpful? I’ll post the actual talk (and the outline of the content) on this thread when it’s finished (whether I get accepted to present at the conference or not). Thanks!

Session title *

What Is A “Good” Third Year Medical Student & How To Be One

Session description

Objective:

- Help upcoming 3rd year students understand that what separates ‘good’ 3rd years from ‘not good’ 3rd years is ‘engagement’ - not the “tips & tricks” (i.e. be on time, use a folding clipboard, etc.).

- Discuss three categories of things that will keep them from being engaged (attitude & expectations, distractions, physical comfort) and how they can counteract them.

Description:

There are plenty of blog posts & even books written about “how to be a good 3rd year medical student”. They are filled with great advice like “ask questions” and “read these two high-yield books”, but what they don’t address is what defines a “good” 3rd year student, beyond following the rules they just outlined. Students often get caught up trying to discover and implement as many of these ‘tips’ as possible, but as a resident now working with students, it has become clear that “good” students do not all behave identically. What they do all have in common is that they are getting better each day and have good attitudes. In a word, they are: engaged. But, since “be engaged” isn’t very actionable advice, and I spent plenty of time being disengaged as a student, I’ll share stories of mine & fellow classmates causes of disengagement and how they were, or could have been fixed. Students will walk away with a clear sense of what they are shooting for in third year, regardless of their rotation, and a newfound confidence that they’ll be a ‘good’ third year, no matter how they performed in their first two years of medical school.

Why this speaker:

Luke Murray was first diagnosed with ADHD during his first year of medical school. Though offered medication, he decided against it and code to implement whatever lifestyle changes he could think of. His low threshold for distraction was frequently exceeded in more ways than most medical students experience. As a result of these circumstances, through personal trial and error as well as interviews of some of his top-performing classmates, he developed exceptionally robust strategies to stay engaged while on the wards.

 

[WhippleWhileWeWork]

His low threshold for distraction was frequently exceeded in more ways than most medical students experience.

Personally, I'd like to hear more about this.

 

[Kahreek]

besides studying there is something intrinsic called charisma and great interpersonal skills. Those will boost your grades by large margin, but are a hard skill to learn.

 

[Kahreek]

staying engaged in the wards

staying engaged is a piece of pie, compared to the amount of bull****ting you'll have to endure for the littlest things.

 

[DermViser]

Hey guys, I’m proposing a talk for a medical student conference. If you were at a conference and saw the below description & summary, would you attend that session? Why or why not? Any feedback on how to make it more relevant, appealing, helpful? I’ll post the actual talk (and the outline of the content) on this thread when it’s finished (whether I get accepted to present at the conference or not). Thanks!

Session title *

What Is A “Good” Third Year Medical Student & How To Be One

Session description

Objective:
- Help upcoming 3rd year students understand that what separates ‘good’ 3rd years from ‘not good’ 3rd years is ‘engagement’ - not the “tips & tricks” (i.e. be on time, use a folding clipboard, etc.).

- Discuss three categories of things that will keep them from being engaged (attitude & expectations, distractions, physical comfort) and how they can counteract them.

Description:
There are plenty of blog posts & even books written about “how to be a good 3rd year medical student”. They are filled with great advice like “ask questions” and “read these two high-yield books”, but what they don’t address is what defines a “good” 3rd year student, beyond following the rules they just outlined. Students often get caught up trying to discover and implement as many of these ‘tips’ as possible, but as a resident now working with students, it has become clear that “good” students do not all behave identically. What they do all have in common is that they are getting better each day and have good attitudes. In a word, they are: engaged. But, since “be engaged” isn’t very actionable advice, and I spent plenty of time being disengaged as a student, I’ll share stories of mine & fellow classmates causes of disengagement and how they were, or could have been fixed. Students will walk away with a clear sense of what they are shooting for in third year, regardless of their rotation, and a newfound confidence that they’ll be a ‘good’ third year, no matter how they performed in their first two years of medical school.

Why this speaker:
Luke Murray was first diagnosed with ADHD during his first year of medical school. Though offered medication, he decided against it and code to implement whatever lifestyle changes he could think of. His low threshold for distraction was frequently exceeded in more ways than most medical students experience. As a result of these circumstances, through personal trial and error as well as interviews of some of his top-performing classmates, he developed exceptionally robust strategies to stay engaged while on the wards.

No, I wouldn't attend, esp by someone who was given medical advice to treat his medical problem and chose not to follow it.

 

[NontradCA]

No, I wouldn't, esp by someone who was given medical advice to treat his problem and chose not to follow it.

 

[DermViser]

Truth hurts. Hard to feel sorry about being "disengaged" when you have untreated ADHD.

 

[starstarie]

No, I wouldn't attend, esp by someone who was given medical advice to treat his medical problem and chose not to follow it.

ouch

 

[SouthernSurgeon]

To be honest, while the overall topic is obviously an interesting one for a medical student conference, the way you're approaching it almost sounds like some charismatic self-help guru. So I'm not sure I'd be interested if I were the one organizing the conference.

 

[lukemd]

Wow, thanks so much for the feedback, guys:

@Kahreek - Yes, I should totally address the degree of bull****ting that goes on. I'll add (a slightly more politically correct version of the concept) it to the description.

@DermViser - Geeze, I totally didn't see that angle. Thank you. The truth is a bit more complicated. ADHD is a multivariate test that has a "line in the sand" (as is the case with most DSM diagnoses) for each regarding what officially constitutes "ADHD" and what does not. According to the psychologist, I was over said line on some tests, and not on others. He did not say I needed medication, or that it was definitely indicated but said if I wanted to try he would allow it (read: recommend it and then have the psychiatrist actually write the script). The point in brining it up was that it's harder for me to pay attention than most people, so I can empathize with someone that thinks it is 'too hard' for them to be engaged. You seem to feel the exact opposite maybe? "Hard to talk about being "disengaged" when you have untreated ADHD". It's actually super easy for me because unless I'm running a super-tight ship, that's exactly what I am all the time...but maybe I misunderstood your point? Any advice on how I can make that same point without coming off as simply medically non-compliant?

@NontradCA - that gif is freaking perfect

@starstarie - I was thinking more like "hilarious"

@southernIM - Thanks for the feedback. What in the description makes it sound that way? Any advice on how to get across the same message about the topic without giving off a tony robbins, cheesy effect? I also don't want to make it sound as dry as regular med school lecture.

Thanks again everyone!

 

[DermViser]

Wow, thanks so much for the feedback, guys:

@Kahreek - Yes, I should totally address the degree of bull****ting that goes on. I'll add (a slightly more politically correct version of the concept) it to the description.

@DermViser - Geeze, I totally didn't see that angle. Thank you. The truth is a bit more complicated. ADHD is a multivariate test that has a "line in the sand" (as is the case with most DSM diagnoses) for each regarding what officially constitutes "ADHD" and what does not. According to the psychologist, I was over said line on some tests, and not on others. He did not say I needed medication, or that it was definitely indicated but said if I wanted to try he would allow it (read: recommend it and then have the psychiatrist actually write the script). The point in brining it up was that it's harder for me to pay attention than most people, so I can empathize with someone that thinks it is 'too hard' for them to be engaged. You seem to feel the exact opposite maybe? "Hard to talk about being "disengaged" when you have untreated ADHD". It's actually super easy for me because unless I'm running a super-tight ship, that's exactly what I am all the time...but maybe I misunderstood your point? Any advice on how I can make that same point without coming off as simply medically non-compliant?

@NontradCA - that gif is freaking perfect

@starstarie - I was thinking more like "hilarious"

@southernIM - Thanks for the feedback. What in the description makes it sound that way? Any advice on how to get across the same message about the topic without giving off a tony robbins, cheesy effect? I also don't want to make it sound as dry as regular med school lecture.

Thanks again everyone!

I would look at some of the clerkship books - i.e. 250 Mistakes by Samir Desai, First Aid for the Wards, and tie them into your experiences. I think MS-3 students have a hard time navigating the Hidden Curriculum in their quest to achieve Honors. That's what makes MS-3 year so difficult. Your mentioning your ADHD diagnosis with lack of pharm treatment may lead some med students to ask why they should take advice from you on how to be engaged when you would theoretically have difficulty engaging -- hence leave this part of your bio out. You also have to realize that different clerkships have different expectations with respect to student behavior (i.e. Family Medicine vs. Surgery). Might help to have different people from different MS-3 specialties talk about what they want from a good MS-3 student.

 

[lukemd]

@DermViser - cool! thanks. I'll take out the ADHD reference. I'll also check out those books. I was hoping to give advice that would be universally applicable regardless of rotation (hence the reference to the talk not just being "tips and tricks") but you're right. It's probably naive of me to think I can get away with that completely, since some rotations are so different from each other. I wouldn't be able to actually do a panel about different expectations (though that would be sweet), but I think it'd be a great idea to interview a few of them & include their responses in the talk. Again, I really appreciate you taking the time. cheers!

 

[DermViser]

@DermViser - cool! thanks. I'll take out the ADHD reference. I'll also check out those books. I was hoping to give advice that would be universally applicable regardless of rotation (hence the reference to the talk not just being "tips and tricks") but you're right. It's probably naive of me to think I can get away with that completely, since some rotations are so different from each other. I wouldn't be able to actually do a panel about different expectations (though that would be sweet), but I think it'd be a great idea to interview a few of them & include their responses in the talk. Again, I really appreciate you taking the time. cheers!

No problem! I mention the different clerkships as each one has such a different ambience so to speak. What what one clerkship would deem a "good" student would be deemed a "bad" student in a completely different clerkship. Good luck to you. Glad you're giving back to med students in your community. I always thought the people in Family Medicine were some of the nicest residents so I shouldn't be surprised that you're nice enough to do this.

 

[optopia]

Hey Luke - I found this thread from your Twitter/FB post 😉

I think it's a great topic and definitely one I'm interested in, as a newly incoming med student myself. But the key is how you sell it.

You're telling people how to be a "good student" but I'm not sure that pulls at the hearts of med students. Most med students are worried about matching for a competitive residency (whether a competitive specialty or location or both).

So, you might title it something like "How to own 3rd year and get awesome recommendations for the Match." Something that gets directly to their deepest concerns.

And the description might be something with more pull, like "87% [I'm just making this up] of med students say they weren't prepared for 3rd year. Don't be one of them. Learn the secrets of the best students who killed 3rd year and matched to the residency of their dreams."

OK, you don't want to oversell it too much. But IMHO, you should aim for a bit more emotional of a sales job.

 

[lukemd]

@DermViser agreed & thanks!

@optopia Great feedback & totally makes sense. Though I think I need to cover the concept of what a 'good' medical student is (defining a topic is usually how you start a paper, a presentation, anyway, etc.), making it the title's not really going to turn heads and get people excited. You have to talk in terms of other people's interest (credit: dale carnegie) and I was not connecting with the deeper concerns. Thank you. Also, glad to know how people are finding this (bitly's not that specific 😉

This talk grew out of a series of blog posts I was writing (that have yet to be published) for First Aid's blog. Here are the first drafts of the first 2 of 4 planned blog posts, which I'm thinking will be about half of the content, topics-wise (will probably need to add examples).


FIRST HALF OF FIRST DRAFT

At this point in my training, I’ve spent almost a year working with third year medical students as a physician, someone responsible for “evaluating their performance” on that specific rotation. Actually, I’ve made it a point to spend more time with the students than any other person on the team. I want to make sure they’re getting something out of their educational experience, because I hated being ignored as a third year. Also, now that I’m asked to determine how “good” third year medical students are in order to give them a grade, I became deeply interested in how to articulate what a “good” third year medical student is.


After nine or ten months of thinking about it, I had an answer somewhere along the lines of “a student that’s getting better each day and that has a good attitude”.


What do you have to do to get better every day? Pay attention, know what’s going on with your patients, read a lot, give presentations backwards when appropriate...basically everything we’ve already written about in our Wards Survival Series (here for example) as well as First Aid For The Wards and other resources. But this answer seemed a bit superficial and sounds close enough to circular reasoning to be pretty impotent (i.e. “A good medical student does all the things it says to do in the ‘How to be a good medical student’ books”).

And the “good attitude” thing was just a vague definition within my vague definition. Students that were “good” didn’t all have attitudes that were particularly positive, or optimistic or any other defining trait. They were universally not-negative, but “don’t be negative” seemed to leave enough room in a not-exactly-the-definition-of-good direction that I knew I wasn’t done.


Then I got it down to a word.


A good third year medical student is: Engaged.


So, yes, an “engaged” medical student is probably doing many of the “tips and tricks”. Perhaps it’s because they discovered them out of necessity. Maybe they bought the First Aid for the Wards and then read & applied its contents. But that’s the type of thing that medical students that are engaged naturally do – along with countless other things that no number of books could prepare you for.


And when you’re engaged, you’re not necessarily being super happy, especially if that’s not your personality. But you also aren’t whining, because that means you’re thinking about something other than what you are doing. In this case, if it’s unpleasant, you’re focusing on how you feel about chasing down outside medical records, instead of actually making the necessary phone calls, for example.


But as actionable advice goes, I still feel like “Be engaged” isn’t tangible enough. So, I’m going look at how to apply the advice in double-negative form:


Do not be disengaged.


As I’ve thought about my third year of medical school and all the reasons I would end up unplugging from the experience, three categories of causes began to emerge. I talk about the first (and most important) one below, along with the strategies I used (or wish I’d used) to avoid them.


Accept Circumstances & Calibrate Expectations



When I started third year I expected to be exposed to learning opportunities at a slightly slower pace than my first and second years. I understood we would be doing shadowing, paperwork, etc, so it made sense that you wouldn’t be spending 100% of your day cramming knowledge into your brain. I expected a drop of 10%...maybe 20%. I quickly discovered that the drop was well over 50% and the majority of the days it felt like 90%+.* This was unbelievably frustrating to me. I would be standing in the hallway, furious that we weren’t doing anything, begging in my mind to go to the library and sit down with a book or a qbank so I could at least walk out of the hospital with a little more knowledge about medicine than when I arrived that morning. I tried to get around it by looking at notes in my pocket, but I didn’t learn much and it pulled me even farther away from what the team was doing. And even though what they were doing didn’t involve me or teach me in any way, trying to learn instead of keep up on the details of who was doing what for which patient occasionally made me look (read: proved) that I wasn’t paying attention - which is, of course, frowned upon.


Unfortunately, what I did not do successfully, over the course of the entire school year, was accept that I was not in control of the amount, timing, quality, or the content of learning I got to do each day. And even though it was true that I could learn more faster by being given the freedom to study this stuff on my own, focusing on this fact only highlighted the gap between that possibility and the reality that I hadn’t done anything but stand in the hallway staring into space for the last 30 minutes while the attending & residents talked over, past, or through me. Needless to say, this mindset was extremely counterproductive, and the single biggest cause of my tendency to disengage as a student.


Once I recognized the degree to which I would be able to get involved (or not) I wish I would have accepted those circumstances and then calibrated my expectations appropriately. Teddy Roosevelt said, “Do the best you can, with what you have, where you are.” Instead, I focused on what I could have had somewhere else, and I paid the price with in both the quality of my experience and the quality of my evaluations. Neither of which were often “good”.


....


I’ll post the next 2 categories of reasons later. For now, thoughts on the above would be appreciated.

 

[bluefalcon32]

Thank you for the post @lukemd. Please keep them coming.

 

[DrSRJ]

I think this is a great start to your talk, and I think the idea of the talk in general (at least the way you're doing it) is very interesting. The latest product does a good job of not coming off as a (as one commenter put it) "charismatic self-help guru." Although the subject matter necessitates an inherent self-help perspective, I think your approach flows very well. The goal isn't to present some groundbreaking discovery of perfection, but illustrate how achievable the known ideal is. Your stream-of-conscious is a great presentation form in my opinion, because it's exactly how the thought process goes until you reach a nebulous definition that is either too vague to be helpful or too external to seem achievable. As you mention, "being engaged" is something that comes to great students naturally, an idea that can be disheartening and defeating to those who naturally lack it. It also lends to a learned helplessness that can easily progress to "Well that's just not how I am and there's nothing I can do about it." But I like how you lay it out: if you define it in the negative it becomes a workable problem with an attainable solution. The example of why whining is being disengaged is perfect, and it illustrates your point well. It's a novel way of looking at it that hadn't occurred to me, and it hits the nail squarely on the head.

Furthermore, I agree wholeheartedly with the idea of accepting your role on the team as the first step. Each service will be different, but for me it was helpful to think of my potential roles on a spectrum with a minimum desired input (collect vitals, do scut work, stave off boredom) and maximum (see patients independently, formulate and present plans/opinions as part of the team). No matter what I'm there for a reason and my role serves a distinct purpose, whether it is just to relieve the residents of busy-work and then sit quietly or help my resident make a plan, pick up things he might have missed, and voice my medical opinion along with his. Either way in my eyes I'm making the patient's care better by giving the resident less to do and less to think about. At the maximum, even if my opinions don't eventually matter at least they are heard. And as tough as it is sometimes to feel like I'm not being taught enough or talked to enough, I have to remember that the people above me have a responsibility to patient care first, my learning second. My residents have their own evaluations to worry about, their own learning, and they also have to go home with the patient's ultimate fate more or less still in their hands and on their minds.

Which honestly brings up my last thought on the matter. Sometimes students get caught up with what they THINK will give them a good evaluation (looking smart, knowing the patient best, etc) that they purposefully or inadvertently make their resident look bad. This may tie back in to the disengagement. If you are actively thinking about how to make yourself look good on a rotation, you've already lost sight of the team focus (the patient). If you have a thought on a diagnosis, or notice a missed medication or a physical exam finding, don't wait until rounds to bring it up just so you look like the doctor who saved the day. Don't hoard knowledge or opinion. It may be extremely important to the person entering orders and making decisions for the day.

 

[starstarie]

I like it. I just finished my first year and I think at least the first idea you brought up is something that I may not have even considered. In MS1-2 we are taught to want to be extremely efficient in studying, so I wouldn't have expected 3rd year to be the opposite. I took a lot of time between undergrad and med school and in those years I have learned over and over again that what actually occurs isn't as much of a problem as a situation not meeting one's expectations. And often, I wouldn't even consciously know I was making those expectations.

 

[atomi]

I don't know what medical school you went to, but at the one I went to, you owned third year by owning the shelf exams. In order to get honors you had to be in the top 20% or so on the shelf. It didn't matter how much butt you kissed or how engaged you were. As long as you were pleasant and put forth a minimal amount of effort on rotations, your evaluations weren't the limiting factor. MS3, like everything else in med school, stratifies students based on their ability to take timed written exams.

 

[NickNaylor]

I don't know what medical school you went to, but at the one I went to, you owned third year by owning the shelf exams. In order to get honors you had to be in the top 20% or so on the shelf. It didn't matter how much butt you kissed or how engaged you were. As long as you were pleasant and put forth a minimal amount of effort on rotations, your evaluations weren't the limiting factor. MS3, like everything else in med school, stratifies students based on their ability to take timed written exams.

This has been my experience as well. Unless you're socially inept or completely unprepared everyday, your clinical evals will likely not be the limiting factor in you getting honors. This is why some schools include "clinical" and "overall" designators in their MSPEs, as many students do very well on the wards and might otherwise receive an honors save for their shelf performance.

 

[Kaustikos]

I don't know what medical school you went to, but at the one I went to, you owned third year by owning the shelf exams. In order to get honors you had to be in the top 20% or so on the shelf. It didn't matter how much butt you kissed or how engaged you were. As long as you were pleasant and put forth a minimal amount of effort on rotations, your evaluations weren't the limiting factor. MS3, like everything else in med school, stratifies students based on their ability to take timed written exams.

Uh... it happens. I've had several classmates getting 95%th on exams and not getting honors. There are also people who've failed finals/shelf exams, repeatedly failed shelf exam and are still in school. There's bull**** in this.

 

[boogaloo]

I don't know what medical school you went to, but at the one I went to, you owned third year by owning the shelf exams. In order to get honors you had to be in the top 20% or so on the shelf. It didn't matter how much butt you kissed or how engaged you were. As long as you were pleasant and put forth a minimal amount of effort on rotations, your evaluations weren't the limiting factor. MS3, like everything else in med school, stratifies students based on their ability to take timed written exams.

This has been my experience as well. Unless you're socially inept or completely unprepared everyday, your clinical evals will likely not be the limiting factor in you getting honors. This is why some schools include "clinical" and "overall" designators in their MSPEs, as many students do very well on the wards and might otherwise receive an honors save for their shelf performance.

I kept hearing this on SDN before going into third year, but it has not been true for my school. Our clinical evals are the limiting factor for honors. Plenty of us have had to argue for our grades because we would honor the shelf exam, get great comments on our rotation evals (e.g., "hardworking, always prepared, good clinical knowledge"), but receive average numbers because most of the attendings don't know that giving us 3's is actually a bad thing. A lot of my friends have successfully argued for their grades, but a few weren't able to because of unreasonable clerkship directors. Basically, whether or not you honored clinical evals (and ultimately the rotation) came down to if you were lucky enough to get the attending who gives everyone honors or unlucky enough to get the attending who gives everyone 3's.

 

[DermViser]

I don't know what medical school you went to, but at the one I went to, you owned third year by owning the shelf exams. In order to get honors you had to be in the top 20% or so on the shelf. It didn't matter how much butt you kissed or how engaged you were. As long as you were pleasant and put forth a minimal amount of effort on rotations, your evaluations weren't the limiting factor. MS3, like everything else in med school, stratifies students based on their ability to take timed written exams.

Correct, same at our school. Even with the best clinical evaluations, the highest you could get was a "High Pass" if your shelf score wasn't above a certain cutoff. That being said, getting good clinical evaluations wasn't easy - it sometimes depended on the attending you had and the residents you had to work with.

Getting a certain score on the shelf still kept you in the running for Honors, but it wasn't a lock on getting Honors.

 

[DermViser]

I kept hearing this on SDN before going into third year, but it has not been true for my school. Our clinical evals are the limiting factor for honors. Plenty of us have had to argue for our grades because we would honor the shelf exam, get great comments on our rotation evals (e.g., "hardworking, always prepared, good clinical knowledge"), but receive average numbers because most of the attendings don't know that giving us 3's is actually a bad thing. A lot of my friends have successfully argued for their grades, but a few weren't able to because of unreasonable clerkship directors. Basically, whether or not you honored clinical evals (and ultimately the rotation) came down to if you were lucky enough to get the attending who gives everyone honors or unlucky enough to get the attending who gives everyone 3's.

Always amazed me how much attendings didn't know the grading system. Of course, my guess is med schools change the format of it so often, the attendings eventually just give up.

 

[DermViser]

Uh... it happens. I've had several classmates getting 95%th on exams and not getting honors. There are also people who've failed finals/shelf exams, repeatedly failed shelf exam and are still in school. There's bullcrap in this.

Yes, but failure of clerkships is noted in dean's letters. I think also you're put on probation until you redo the clerkship.

 

[boogaloo]

Always amazed me how much attendings didn't know the grading system. Of course, my guess is med schools change the format of it so often, the attendings eventually just give up.

This is exactly what happened. We are the guinea pigs to the new grading policy, thanks to a few of the current MS4's who complained about not being able to honor rotations because they couldn't make the grade on the shelf exams. The school made it so that people who didn't do so well on the shelf exams could honor, but now clinical evals play a bigger role in getting honors, unbeknownst to our attendings. It got so bad that the administration had to step in to adjust some of our grades.

 

[DermViser]

This is exactly what happened. We are the guinea pigs to the new grading policy, thanks to a few of the current MS4's who complained about not being able to honor rotations because they couldn't make the grade on the shelf exams. The school made it so that people who didn't do so well on the shelf exams could honor, but now clinical evals play a bigger role in getting honors, unbeknownst to our attendings. It got so bad that the administration had to step in to adjust some of our grades.

And now you know why PDs consider MS-3 rotation grades to be BS. It's always prone to being tweaked by med school administration to help their match. I'm surprised your school actually changed to make things easier for students with grading policy. 9 times out of 10 it's always to make things harder. The whole point of the shelf exam is to standardize across schools on medical knowledge.

 

[Kaustikos]

Yes, but failure of clerkships is noted in dean's letters. I think also you're put on probation until you redo the clerkship.

You're talking about what should be done and what actually happened. Technically; you fail to remediate an exam = you repeat the year. Technically is different than what happens.

This is exactly what happened. We are the guinea pigs to the new grading policy, thanks to a few of the current MS4's who complained about not being able to honor rotations because they couldn't make the grade on the shelf exams. The school made it so that people who didn't do so well on the shelf exams could honor, but now clinical evals play a bigger role in getting honors, unbeknownst to our attendings. It got so bad that the administration had to step in to adjust some of our grades.

We had an attending under professional scrutiny because he generally only gave 9 or 10/10 for evaluations. One of the students complained... I feel bad for residents/attendings sometimes. And embarrassed by how stupid we are.

 

[DermViser]

You're talking about what should be done and what actually happened. Technically; you fail to remediate an exam = you repeat the year. Technically is different than what happens.

What do you mean technically? If you fail a shelf exam, you fail the clerkship or maybe get a second chance to take the exam (if you passed on evals). If you fail the shelf exam again, then you fail the clerkship again. I don't know any medical school that fails to note that you failed a clerkship.

 

[Kaustikos]

What do you mean technically? If you fail a shelf exam, you fail the clerkship or maybe get a second chance to take the exam (if you passed on evals). If you fail the shelf exam again, then you fail the clerkship again. I don't know any medical school that fails to note that you failed a clerkship.

You fail a shelf exam that's conveniently on paper. You have to remediate by retaking the shelf and fail that, too. But conveniently are still not on academic probation nor repeating the year. I'm saying that someone didn't follow the rules and that not everything is by the books.

 

[DermViser]

You fail a shelf exam that's conveniently on paper. You have to remediate by retaking the shelf and fail that, too. But conveniently are still not on academic probation nor repeating the year. I'm saying that someone didn't follow the rules and that not everything is by the books.

Was the failure noted on his/her MSPE?

 

[Kaustikos]

Was the failure noted on his/her MSPE?

Of course not now. But he had the email that showed the score he got (failed). And how he miraculously didn't fail and still continued on and his transcript was clean.

 

[DermViser]

Of course not now. But he had the email that showed the score he got (failed). And how he miraculously didn't fail and still continued on and his transcript was clean.

Very unusual. Seems to be more due to a clerical error on the part of a clerkship coordinator who calculates and turns in grades.

 

[tco]

Uh... it happens. I've had several classmates getting 95%th on exams and not getting honors. There are also people who've failed finals/shelf exams, repeatedly failed shelf exam and are still in school. There's bullcrap in this.

That was me. I wouldn't play their games during rotations. I guess you can criticize me for that, but I have some dignity. No, I'm not going to say how much I love OB/GYN just because you're an OB/GYN. No, I'm not going to let you get away with making politically antagonistic comments that are directly opposed to my personal views (if we're just having a conversation) in the workroom because you're a resident and I'm a medical student. No, I'm not going to let you make snide comments about overweight patients because you're a surgery attending. No, I'm not going to let you insult students that you previously had on the rotation because you're...A surgery attending...I'll do what is necessary, learn what is necessary, and then I'll move on with my life.

Back on topic...It sounds like a fairly interesting subject. One that I would have likely attended, but "owning third year," varies so much between schools that I'm not sure the talk will be applicable to everyone. Sometimes it's kissing a**, sometimes it's owning the shelf, sometimes it's a combination of both.

 

[DermViser]

That was me. I wouldn't play their games during rotations. I guess you can criticize me for that, but I have some dignity. No, I'm not going to say how much I love OB/GYN just because you're an OB/GYN. No, I'm not going to let you get away with making politically antagonistic comments that are directly opposed to my personal views (if we're just having a conversation) in the workroom because you're a resident and I'm a medical student. No, I'm not going to let you make snide comments about overweight patients because you're a surgery attending. No, I'm not going to let you insult students that you previously had on the rotation because you're...A surgery attending...I'll do what is necessary, learn what is necessary, and then I'll move on with my life.

Back on topic...It sounds like a fairly interesting subject. One that I would have likely attended, but "owning third year," varies so much between schools that I'm not sure the talk will be applicable to everyone. Sometimes it's kissing a**, sometimes it's owning the shelf, sometimes it's a combination of both.

I don't think one needs to say that they "love" OB-Gyn. I think it's more important that you actually value what they do and show it. As far as the rest, regarding politics, etc. that's just you itching for a fight (definitely no surprise there).

As far as, "I'll do what is necessary, learn what is necessary" then it's not surprising that you wouldn't get Honors. Honors has to mean something and that usually means going beyond what is "necessary".

 

[pilotjoe]

I think I'm going to take the "Hear no evil, speak no evil, do no evil" approach to years three and four. I think there would be ways to go about getting good evals without "playing the game." Being engaged like the OP stated would be a good place to start. I'm going to be on the wards so I can increase my understanding of medicine and help decide what specialty I should go in, not debate the latest hot-button political issue or try to make my attending be a nicer person. Neither of the last two would be productive and as NDTyson said, "I don't have opinions that I require other people to have. So debates don't interest me for this reason."
But I'm just a lowly soon-to-be MS1, so what do I know? 😉

 

[Elixir6]

That was me. I wouldn't play their games during rotations. I guess you can criticize me for that, but I have some dignity. No, I'm not going to say how much I love OB/GYN just because you're an OB/GYN. No, I'm not going to let you get away with making politically antagonistic comments that are directly opposed to my personal views (if we're just having a conversation) in the workroom because you're a resident and I'm a medical student. No, I'm not going to let you make snide comments about overweight patients because you're a surgery attending. No, I'm not going to let you insult students that you previously had on the rotation because you're...A surgery attending...I'll do what is necessary, learn what is necessary, and then I'll move on with my life.

Back on topic...It sounds like a fairly interesting subject. One that I would have likely attended, but "owning third year," varies so much between schools that I'm not sure the talk will be applicable to everyone. Sometimes it's kissing a**, sometimes it's owning the shelf, sometimes it's a combination of both.

There is a fine line between being diplomatic and letting go of the improper things people who evaluate you are doing, vs being a pushover yes-b*tch. Actually its not a fine a line. If an attending made a fat joke about a patient, despite the fact that I agree its totally inappropriate, I would just make a neutral comment and let it go, "Oh yes, I see the patient is obese". You can tell them to shut it when you become an attending yourself.

 

[tco]

There is a fine line between being diplomatic and letting go of the improper things people who evaluate you are doing, vs being a pushover yes-b*tch. Actually its not a fine a line. If an attending made a fat joke about a patient, despite the fact that I agree its totally inappropriate, I would just make a neutral comment and let it go, "Oh yes, I see the patient is obese". You can tell them to shut it when you become an attending yourself.

Telling them to shut it and saying, "That's really not appropriate," are two separate approaches. Whether I hold my tongue or not is directly related to the level of inappropriateness of the comment.

 

[tco]

I don't think one needs to say that they "love" OB-Gyn. I think it's more important that you actually value what they do and show it. As far as the rest, regarding politics, etc. that's just you itching for a fight (definitely no surprise there).

As far as, "I'll do what is necessary, learn what is necessary" then it's not surprising that you wouldn't get Honors. Honors has to mean something and that usually means going beyond what is "necessary".

I'm over it. No regrets. Took the triage patients as they came in, did the appropriate exams, delivered babies, did what was expected of a third year, didn't get honors, and still will end up in my career of choice. Guess it worked out for me.

Then again, after I chemoembolize my future patient's HCC, they might ask me about my clerkship grades in OB/GYN...I never thought of that until now.

I'm done responding to this series of posts. I'm not going to contribute further to yet another thread (in a long line of EVERY thread) being derailed.