How to recover from petty criticisms on my Surgery Eval

[seelee]

Quick background: MS3 - completed my medicine and my surgery rotation (12 weeks each) and I am halfway through my 6-week Psych rotation. I got a B (High Pass) in both medicine and surgery. On medicine, I got an A on my clinical eval (objective grading) and a B on my shelf and OSCE. On surgery I got an A on my shelf, and A on my oral board, and a low B on my clinical eval.

Before I got my clinical grade, the clerkship director called me into his office to discuss some of the comments that had been made. I know the director personally from church and this was a courtesy because the comments were largely negative, and he hadn't drawn the same conclusions.

The comments given by various residents and attending were vague and non-constructive. Things like:
"tries to be funny all the time...inappropriate humor"
"Too casual with the attendings...doesn't respect the hierarchy"
"Lazy...not prepared for rounds...insufficient fund of knowledge"
Oh and last but not least
"His size (I am 6'4 and 250lbs) makes him intimidating"

Like I said, the clerkship director who I worked with a fair amount said that he didn't pick up on any of those things and thought that I had been hard working and attentive with natural leadership qualities.

Worse was the fact that there were no specific circumstances cited. I have no idea what lead them to believe that I was "lazy" or "inappropriate".

When I asked students in my group what they thought, they all agreed that the criticisms were way off base.

The blurb that will go into the deans letter has comments talking about how my shelf and oral scores were significantly above average for the class, and that I have natural leadership qualities but that I pay "insufficient attention to detail" (I have no idea what that was based on".

So my goal is anesthesiology. My question is how bad does this hurt me? I don't know what to fix, because I don't know what the problem is. I felt like I worked hard, payed close attention, behaved appropriately, etc. I just don't know what more I am supposed to do. I suspect that the criticism is based on guilt by association (there were a few students in my group who repeatedly dropped the ball and resulted in all of us getting chewed out), and by petty people determined to find something to complain about.

I am particularly concerned about the "insufficient attention to detail" since I want to go into a field that is very detail oriented. How much weight will be put on that comment?

I am also concerned about how a B in surgery and medicine looks to residency directors.

Two of the surgeons (including the program director) have agreed to write strong LORs for me. How much will that override the negatives in my eval?

Appreciate any advice.

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[Guillemot]

Hmm...so this doesnt really help, but yes I agree that evals are somewhat bull****.

Anesthesiology isnt that competitive though so you dont need to H everything.

 

[45408]

The comments given by various residents and attending were vague and non-constructive. Things like:
"tries to be funny all the time...inappropriate humor"
"Too casual with the attendings...doesn't respect the hierarchy"
"Lazy...not prepared for rounds...insufficient fund of knowledge"
Oh and last but not least
"His size (I am 6'4 and 250lbs) makes him intimidating"

Like I said, the clerkship director who I worked with a fair amount said that he didn't pick up on any of those things and thought that I had been hard working and attentive with natural leadership qualities.

Worse was the fact that there were no specific circumstances cited. I have no idea what lead them to believe that I was "lazy" or "inappropriate".

They said you were unprepared for rounds and had an insufficient fund of knowledge. That's why they thought you were lazy. They thought you were inappropriate because you were trying to be funny all the time. Those are actually reasonably specific critiques.

When I asked students in my group what they thought, they all agreed that the criticisms were way off base.

They may not be the best group to judge that or tell you that though...

I suspect that the criticism is based on guilt by association (there were a few students in my group who repeatedly dropped the ball and resulted in all of us getting chewed out), and by petty people determined to find something to complain about.

It's possible. People who evaluate you are human and take bias into account, whether they should or not.

Saying you're intimidating because you're big is an inappropriate criticism, but the other ones still sound legitimate. If they're the exception on your evaluations, I wouldn't worry about it too much, but keep it in mind for how you behave on your other rotations.

 

[myhandsarecold]

it probably annoyed the 5 ft tall resident that he/she had to use steps in order to accommodate the 6'4 ft tall med student

 

[turkeyjerky]

Consider yourself lucky that the course director is being far less critical in the dean's letter comments. Honestly, i wouldn't sweat this too much--that remark will probably just be glossed over and nobody'll even notice it when you're applying to residencies. I really don't believe people read those things too closely. (It could be an issue, however, if a pattern emerges in your clinical evals and this gets mentioned in the summary paragraph, however.)

On the off chance it does get mentioned during interviews, have a response hand; something like "I actually pride myself on being detail-oriented so that came as somewhat of a shock. In hindsight, there were a few instances early in third year when I could have been more prepared for rounds, however I've made an effort to improve and the rest of my evaluations bear that out."

As far as trying to be funny, I think it's probably best to avoid having much of a personality or trying to have fun at the hospital, at least until you get a good feel for the residents. Remember, even if almost everyone likes you and thinks you're a riot, it just takes one to completely sink your eval.

 

[seelee]

They said you were unprepared for rounds and had an insufficient fund of knowledge. That's why they thought you were lazy. They thought you were inappropriate because you were trying to be funny all the time. Those are actually reasonably specific critiques.


They may not be the best group to judge that or tell you that though...


It's possible. People who evaluate you are human and take bias into account, whether they should or not.

Saying you're intimidating because you're big is an inappropriate criticism, but the other ones still sound legitimate. If they're the exception on your evaluations, I wouldn't worry about it too much, but keep it in mind for how you behave on your other rotations.

I get what your saying. My confusion was that I don't understand why they thought I was unprepared for rounds when I did my best to go above and beyond what they asked for. I admit that I am one of those guys who tries to be funny, but in the OR and on rounds I feel like I kept a pretty tight lid on it.

My question is how am I supposed to avoid the comments in the future? If I already am doing everything to prepare for rounds, how to I get better unless I know exactly what I was deficient in? If I the few jokes I told were too many then should I tell absolutely no jokes?

I get that perception is reality. My biggest concern is how I can recover from this.

 

[45408]

I get what your saying. My confusion was that I don't understand why they thought I was unprepared for rounds when I did my best to go above and beyond what they asked for. I admit that I am one of those guys who tries to be funny, but in the OR and on rounds I feel like I kept a pretty tight lid on it.

Unfortunately, all it takes is for you not to know one significant fact at one time for someone to notice. You're only as good as your last big mistake sometimes, unfortunately. Maybe the student just before you was super awesome, and you just looked lackluster by comparison.

Telling jokes can be dicey, unless you have a pretty good feel for who's around. Maybe the staff and most of the residents thought you were hilarious, but that one didn't. I was making Dave Chappelle jokes on rounds on trauma surgery, but it's because the attending was too. He thought it was hilarious, but I'm sure some people were less amused.

Or you could be like the student who would be laughing and giggling at 6am when we're all tired and have flat affects, and we're walking in to wake up our patients. That behavior definitely led to a negative evaluation.

My question is how am I supposed to avoid the comments in the future? If I already am doing everything to prepare for rounds, how to I get better unless I know exactly what I was deficient in? If I the few jokes I told were too many then should I tell absolutely no jokes?

I get that perception is reality. My biggest concern is how I can recover from this.

Just do your best. You can't win them all. I'd probably skip the jokes.

Ask for pointed, mid-rotation feedback. A lot of residents/staff won't give it, and most won't give it unless you ask. I'm pretty forward about it, unless I don't think the student cares at all.

 

[Rollo]

Agree about skipping the stand up routine. I was with a kid on my surgery rotation who made...how do I put this...just plain weird jokes that would have been funny had we all known the kid. But we didn't. And the content of the jokes made us all wonder if he was serious or ???.

Lot of times this type of behavior can also be seen as "sucking up", a trait universally disliked. Like the time when a female student giggled and flirted with everyone...some of the residents dug it because she was mildly attractive, but others, especially female residents, definitely thought she was a big time w----.

 

[jdh71]

Eh. They're surgeons. No one except surgeons will take it that seriously. If anyone will appreciate the amount of douche-baggary that can come from a surgeon it would be the anesthesia people.