I'm highly sensitive and take humiliation very poorly. How do I survive?

[WanderingDave]

I'm a 30-something nontraditional student who's currently a MSIII. In many ways, third year has been great for me. I'm highly spontaneous and uninhibited, and can readily talk to people. I have a natural zest for learning and love to ask people questions, which is how I've gotten this far. I have no problem with working hard and working long hours, with much enthusiasm.

There's just one major problem I've run into: I absolutely do not take abusive or humiliating treatment from superiors. The avoidance of reprimand is a major motivating factor for me in all I do, and when it occurs, it leaves me stinging for hours, if not days. When it comes to "pimping", I tolerate it if it's done in a group setting, and I'm clearly not being singled out. But when I'm singled out for it because the pimper feels I've broken rank or don't "know my place", I'm so enraged that I can barely function.

Although I push myself very hard, I'm by nature, and on principle, not competitive with other people at all. I'm also fiercely anti-hierarchical; I handle authority well by earning the goodwill of people above me, because I don't handle authorities reminding me saliently that they are in power over me.

I'm intellectually aware that I should not take such treatment personally -- I don't need a lecture on that, and thinking about this doesn't soften the blow any. I'm highly opposed on principle to the whole macho "take abuse to earn your dues" mentality, because I don't think it builds better clinicians or better human beings in any way.

How does a person like me, who is convinced he can make it through and make a good doctor, strike a balance between impressing those above me and keeping sane?

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[danli77]

Hey,

I understand that you are frustrated and upset. But if that makes you feel better we are all the in same boat (med students).

First of all, you have to realize that you can't change people around you, but you can change the way to see things.

Even though it is unpleasant, there is a definite hierarchy in the field of medicine, and I think it goes something like this:

1. attending
2.fellow
3.resident
4.intern
5.nurse
6. ganetor
7. medical student

It is just how it is. Sometimes we get lucky and have attending who are personable, approachable and "real". They see you as a human being-simple.

Others (many of them) see you are "zero","waste of space".

We have all been pimped and singled out while being pimped and forced to feel like a piece of poop sometimes. Yes, its undeserved, but you cant do anything about it, thats how they are and you can't change them.
They are the boss, so you do not correct them or cross them if you want a good grade

Also, these rotations have an end, its not like you are stuck there FOREVER!
In 4-12 weeks you are out and living a happy life.

So, just try to look at the situation as temporary, learn your lessons from people and how NOT to be when you are the attending - it comes down to simple respect for EVERYONE. Not just people of the same status as you, some people dont live by that rule.

And the fact that you are hard working - good for you!

goodluck

I'm a 30-something nontraditional student who's currently a MSIII. In many ways, third year has been great for me. I'm highly spontaneous and uninhibited, and can readily talk to people. I have a natural zest for learning and love to ask people questions, which is how I've gotten this far. I have no problem with working hard and working long hours, with much enthusiasm.

There's just one major problem I've run into: I absolutely do not take abusive or humiliating treatment from superiors. The avoidance of reprimand is a major motivating factor for me in all I do, and when it occurs, it leaves me stinging for hours, if not days. When it comes to "pimping", I tolerate it if it's done in a group setting, and I'm clearly not being singled out. But when I'm singled out for it because the pimper feels I've broken rank or don't "know my place", I'm so enraged that I can barely function.

Although I push myself very hard, I'm by nature, and on principle, not competitive with other people at all. I'm also fiercely anti-hierarchical; I handle authority well by earning the goodwill of people above me, because I don't handle authorities reminding me saliently that they are in power over me.

I'm intellectually aware that I should not take such treatment personally -- I don't need a lecture on that, and thinking about this doesn't soften the blow any. I'm highly opposed on principle to the whole macho "take abuse to earn your dues" mentality, because I don't think it builds better clinicians or better human beings in any way.

How does a person like me, who is convinced he can make it through and make a good doctor, strike a balance between impressing those above me and keeping sane?

 

[WanderingDave]

^ So basically, I have no choice but to bow my head and take a beating from someone until I've risen to the top of your hierarchy and become an attending? Not going to happen. I can possibly find a way to cope with abrasive people for some brief 4~6 week periods until I'm no longer a student. But years and years of rigid and oppressive hierarchy even after that? I'd be one embittered attending by that point.

Is there a way I can pick and choose my rotations, and my residency, in such a way as to minimize the chances of having to put up with someone who insists on treating me abusively? What kind of questions might I ask a potential attending (or other supervisor), which would give a good indication of how much they enjoy making those under them squirm? Is there a certain type of clinical or geographic setting for residency that's likely to be more egalitarian, provided that I show early on that I'm conscientious?

My strongest interest is in geriatrics. I know that to do this specialty, I need to do an internal med residency. As of now, I have no desire to do one at a highly traditional university affiliated teaching hospital, which is where I did my IM rotation. Do I really have any other option, though? Even though it's a lot less favorable (but doable), I'm considering instead doing a family practice residency, then a geri fellowship, if this kind of setting is likely to be more chill and egalitarian.

 

[VA Hopeful Dr]

Is there a way I can pick and choose my rotations, and my residency, in such a way as to minimize the chances of having to put up with someone who insists on treating me abusively? What kind of questions might I ask a potential attending (or other supervisor), which would give a good indication of how much they enjoy making those under them squirm? Is there a certain type of clinical or geographic setting for residency that's likely to be more egalitarian, provided that I show early on that I'm conscientious?

OK, I'm going to say it since no one else has: Man up. Yes, it sucks getting yelled at, but grow a pair and endure it like everyone else.

With that out of my system, I'll address some points you made. Generally speaking, you have limited choice in med school rotations. What choices you do have can be worked to your advantage. Find out from fellow students which rotations have the nicest attendings and try and get those.

Residency is a different story. Ask the residents at that program how they're treated, though not in so direct a wording. If it is affiliated with a med school, as the students there what they think of the attendings in that program. They'll be brutally honest whereas the residents might not. If you go FM, most of us here know of places where you'll be treated OK.

My strongest interest is in geriatrics. I know that to do this specialty, I need to do an internal med residency. As of now, I have no desire to do one at a highly traditional university affiliated teaching hospital, which is where I did my IM rotation. Do I really have any other option, though? Even though it's a lot less favorable (but doable), I'm considering instead doing a family practice residency, then a geri fellowship, if this kind of setting is likely to be more chill and egalitarian.

Granted I'm biased, but I think that on the whole, family programs are more laid back.

 

[Knicks]

OK, I'm going to say it since no one else has: Man up. Yes, it sucks getting yelled at, but grow a pair and endure it like everyone else.

 

[WanderingDave]

OK, I'm going to say it since no one else has: Man up. Yes, it sucks getting yelled at, but grow a pair and endure it like everyone else.

Grow a pair? I'll not bore you with my life story, but I've accomplished some very difficult things and never been shy about leaving my comfort zone. Every day since I started working in healthcare, I've handled tricky interpersonal situations with aplomb on an almost daily basis. I have nothing to prove to you or anyone else.

If I am lazy, negligent, or improper, and I get yelled at, I have no problem sucking it up, because I deserved it. But I do not abide people breaking my chops unprovoked, in the name of building character or showing who's boss. I work too hard and care too much to tolerate that.

Being a real man means not giving up easily and standing on principle even when it's not pleasant. It has nothing to do with tolerating wanton humiliation. I'm here with this question because I know my limits and my weaknesses, and I wanted to be proactive about finding a solution, a.k.a not giving up easily. I didn't come here to whine, so I'll beg you not to talk to me like I'm a crybaby.

Trust me, I have enough restraint and street smarts to not retaliate or break down when a superior humiliates me needlessly. But I know myself enough to know that if I go on taking it for long periods of time, it will take its toll on me, and I'll lose most of the positive things I bring to the medical profession.

With that out of my system, I'll address some points you made. Generally speaking, you have limited choice in med school rotations. What choices you do have can be worked to your advantage. Find out from fellow students which rotations have the nicest attendings and try and get those.

Residency is a different story. Ask the residents at that program how they're treated, though not in so direct a wording. If it is affiliated with a med school, as the students there what they think of the attendings in that program. They'll be brutally honest whereas the residents might not. If you go FM, most of us here know of places where you'll be treated OK.

Granted I'm biased, but I think that on the whole, family programs are more laid back.

Thanks. That was very helpful.

 

[bonsaipalmtree]

Ask your fellow MS3s which attendings are nicest and try to schedule your rotations with them, or at least in their department (usually that's as much choice as your get). The MS3s here are always doing that, from what I've seen.

Also, I think there's something to be said for empathy (for the attendings) here.... in my experience, attendings often only act like jerks because they are under incredible amounts of pressure. It's hard to be the bigger person, but perhaps try to recognize when someone is under a ton of pressure and stress, respect it, and cut them a little slack. For the ones who are mean because they can be... think of it as an exercise in patience.

 

[peppy]

Pimping, yelling, and mockery are unavoidable in medical training. It's just how the culture is. I am in a very benign and friendly residency program, so none of the attendings in my specialty have been remotely malignant (Psych in general is just not like that), but even here I have run into a few attendings who like to pimp and shame people while on off-service rotations.
I think it helps to try to develop a sense of humor about it. The things we go through in medical training are so goofy and absurd, when you really think about it.
I also think that it helps a lot if you can just smile and nod. Don't get defensive. Don't try to retaliate in any way. Just take whatever kernel of education you can get from it and move on.
Also remember that many people in normal society have to put up with really obnoxious or demeaning bosses for years. At least our dealings with malignant attending are time-limited.

 

[Dr Bartlet]

Also, I think there's something to be said for empathy (for the attendings) here.... in my experience, attendings often only act like jerks because they are under incredible amounts of pressure. It's hard to be the bigger person, but perhaps try to recognize when someone is under a ton of pressure and stress, respect it, and cut them a little slack. For the ones who are mean because they can be... think of it as an exercise in patience.

Bull****. Being under stress or pressure gives no one the right to bully someone else, I don't care if you're a doctor or the president of the United States. All the BS med students spew is just that -- BS. The truth is, attendings and residents treat third years like this for one simple -- because they can. They get away with it for no earthly reason. In any other field, any "boss" who treated an employee the way some of these people treat med students would be on the losing end of a harassment suit and I say that as someone who used to work in HR for 10 years prior to med school.

You guys put up with it, they do it. Simple as that. Until med students "grow a pair" and stand up for themselves, the system won't change. When I was a third year, I didn't take crap. I lucked out and ended up with some good attendings/residents for the most part, but I was on two rotations where I was working for scum. I stood up for myself in a respectful manner and the only thing that happened is I didn't honor them. Boo freaking hoo. My self-respect is worth more than an H on my transcript.

 

[cpants]

Tough pimping and a certain amount of putting you in your place do serve an important role in medicine. Humility and knowing how little you actually know are vital attributes for a physician to have. Frankly, your posts have a certain sense of arrogance. At this point you are useless to the team. You are there to learn, and it comes at the expense of the team's efficiency and the patients' care. Recognize these things. Read as much as you can, and work your ass off. You will find that with increasing competence and knowledge, you will get increasing respect.

 

[Dr Bartlet]

Hate to break it to you, but it's usually not the students who need to be put in their place. They know they're the low man on the totem pole. They're clueless and most of them are scared to death when they're on a new rotation. If anyone needs a dose of humility thanks to an over-inflated ego, it's usually the resident and/or attending.

But hey, as long as they've got students defending their bullying, they're good as gold.

 

[robosurgeon]

hi,
i'm an ms III also and sympathize with you but I do feel there is a reason for the hierarchy and pimping -

Its great that you are enthusiastic and talk to people and have a natural zest about you. All great attributes to have. I feel like you as well and learn better when people encourage me rather than reprimand me. However, I spoke with a few old wise docs and it kind of opened up my eyes as to what goes on in their mind.

Right now, in our very young impressionable minds is when we start developing our own work ethics, style, and overall attitude towards medicine. Medicine is a profession where when a patient walks in the door, they expect you to be the best, know it all, and perform under pressure with no BS. It is a very tough job, and it is EXPECTED of you. In the real world, when we will be attendings, etc, no one will be holding our hand, no one will be telling us good job, not even our patients. If you want satisfaction from it, you need to turn inward. Otherwise, perfection is the minimum. And when we do mess up, its important to bounce back strong, stay level headed, and remember that performing your best for the patients is the most important thing.

Attendings pimping us and humiliating us are the smallest hurdles in life we will have to overcome when practicing medicine. There will come a day when I hope to practice surgery but will be battling many of life's other curve balls on the side (death, relationships, etc...) but in that moment, to clear your head, learn from a mistake, and execute flawlessly is expected.

When **** is hitting the fan around you, poise under pressure is a necessity.

Just my 2 cents. Who knows if what I said has any truth but at least when I view it this way, I have a positive attitude towards it.

 

[BigRedBeta]

There's just one major problem I've run into: I absolutely do not take abusive or humiliating treatment from superiors. The avoidance of reprimand is a major motivating factor for me in all I do, and when it occurs, it leaves me stinging for hours, if not days. When it comes to "pimping", I tolerate it if it's done in a group setting, and I'm clearly not being singled out. But when I'm singled out for it because the pimper feels I've broken rank or don't "know my place", I'm so enraged that I can barely function.

Although I push myself very hard, I'm by nature, and on principle, not competitive with other people at all. I'm also fiercely anti-hierarchical; I handle authority well by earning the goodwill of people above me, because I don't handle authorities reminding me saliently that they are in power over me.

I'm intellectually aware that I should not take such treatment personally -- I don't need a lecture on that, and thinking about this doesn't soften the blow any. I'm highly opposed on principle to the whole macho "take abuse to earn your dues" mentality, because I don't think it builds better clinicians or better human beings in any way.

How does a person like me, who is convinced he can make it through and make a good doctor, strike a balance between impressing those above me and keeping sane?

Abuse is one thing, and truly malignant behavior (with or without cause) is certainly something that needs to be reported to your clerkship directors or your Dean of Students. However, the challenge for you will be to separate out abusive behavior for the sake of being abusive or belittling and behavior by residents and attendings that is meant to challenge, stretch and educate.

I say this as a resident who loves to teach but who admittedly challenges students. I have had other residents tell me I can be intimidating. I do a lot of open ended cases, and if you get off track or start throwing out terms I'll make you explain your thought process. I know this can be nervewracking and can make some uncomfortable. But I promise, promise, promise that this is because I want my students to learn, to hopefully remember and be able to apply the knowledge later on. In my experience, on both sides of the coin, having high standards leads to greater motivation and knowledge attainment. If you were one of my students and this sort of set up bothered you (which depending on my mood one day or exactly how sensitive you are might result in you being steamed), it would leave me rather aghast that my intentions had been so misinterpreted. It's absolutely not about putting students in their place or trying to show that I know more...because I know I know more than they do, that's why I'm the one doing the teaching.

I do think that to a certain extent your anti-hierarchy "principles" are misguided at least to the point that by definition, medicine is hierarchal. I don't think I need to point out that you have a little "M3" next to your name while your interns, residents, fellows and attendings have something a bit different. And with that comes a very different load of responsibilities. An intern asking you to do something is not about making you know they have power over you, it's that they know more about what's going on and what needs to be done. Likewise, a resident going over your note and giving you criticism on what you can do better, or watching you perform a physical exam and correcting your deficiencies should not be viewed as a reprimand but as another opportunity to get better (or perhaps you could give other examples of the treatments that have bothered you on this rotation as these seem like really benign things I've come up with). And if you've really made a large mistake, overstepped your bounds, or are just so completely off base in your application of medical knowledge, then it really is something that needs to be addressed.

Again, my challenge to you is to consider intent.

As for residency, there definitely is a wide spectrum of behavior in regards to hierarchy. I'm a peds resident and I know of University based peds programs in which residents (and even students) are on a first name basis with attendings. I think, in general terms, the farther west you go, the more collegial programs tend to be, though by no means is this universal. It's absolutely something you can ask about on the interview trail.

 

[Perrotfish]

Abuse is one thing, and truly malignant behavior (with or without cause) is certainly something that needs to be reported to your clerkship directors or your Dean of Students. However, the challenge for you will be to separate out abusive behavior for the sake of being abusive or belittling and behavior by residents and attendings that is meant to challenge, stretch and educate.

1) I've generally found the worst behavior that I've seen is justified by someone telling me 'it's for your education' even though it usually plainly obvious that my education is really being sacrificed because the resident enjoys being rude. Not saying you're doing this, but if you were you wouldn't be the first person. The only reason this is tolerated in medicine is because medicine, alone out of all licensed professions, has given the private, profit driven institions that educate us the right to deny us a license. That's why they can charge more than anyone else for an education while still treating us like particularly worthless employees. If you could take a medical licensing exam without necessarily attending a medical school I promise you the abusive behavior at med schools would evaporate overnight as schools bent over backwards to attract now scarce customers.

2) I will admit, though, the problem is that malignant behavior is rarely 'abuse' or 'harassment' in the sense that you could make a case to a dean/lawyer. I've never had someone insult me, talk **** about my family, or shout expletives at me. Actually other than once or twice when I got near a sterile field in surgery I've never had anyone raise their voice to me at all. What I have had is passive agressive comments about my professionalism, pimping that leads nowhere on inane trivia, orders to fetch things (especially charts), and most of all I have been ignored for hours at a time as I trailed behind a resident/attending like a f-ing baby duck with nothing in particular to do. My personaly favorite is the selectively deaf resident, who won't respond to comments/questions asked by anyone who isn't a nurse or MD, not even to simple plesantries like 'good morning' or 'how was your weekend'. It's rude and pointless, but what exactly can you tell a dean about that?

 

[KnuxNole]

When I become a resident, I'm gonna make sure to never yell or harass the med students

 

[naus]

hi,
i'm an ms III also and sympathize with you but I do feel there is a reason for the hierarchy and pimping -

Its great that you are enthusiastic and talk to people and have a natural zest about you. All great attributes to have. I feel like you as well and learn better when people encourage me rather than reprimand me. However, I spoke with a few old wise docs and it kind of opened up my eyes as to what goes on in their mind.

Right now, in our very young impressionable minds is when we start developing our own work ethics, style, and overall attitude towards medicine. Medicine is a profession where when a patient walks in the door, they expect you to be the best, know it all, and perform under pressure with no BS. It is a very tough job, and it is EXPECTED of you. In the real world, when we will be attendings, etc, no one will be holding our hand, no one will be telling us good job, not even our patients. If you want satisfaction from it, you need to turn inward. Otherwise, perfection is the minimum. And when we do mess up, its important to bounce back strong, stay level headed, and remember that performing your best for the patients is the most important thing.

Attendings pimping us and humiliating us are the smallest hurdles in life we will have to overcome when practicing medicine. There will come a day when I hope to practice surgery but will be battling many of life's other curve balls on the side (death, relationships, etc...) but in that moment, to clear your head, learn from a mistake, and execute flawlessly is expected.

When **** is hitting the fan around you, poise under pressure is a necessity.

Just my 2 cents. Who knows if what I said has any truth but at least when I view it this way, I have a positive attitude towards it.

Good post. The OP has the wrong attitude to succeed in medicine (dwelling and bitter for days over criticism).

 

[BigRedBeta]

Abuse is one thing, and truly malignant behavior (with or without cause) is certainly something that needs to be reported to your clerkship directors or your Dean of Students. However, the challenge for you will be to separate out abusive behavior for the sake of being abusive or belittling and behavior by residents and attendings that is meant to challenge, stretch and educate.

Just to clarify this.

I'm not saying abuse that's "for education" is acceptable. Certainly, the attending at my medical school who handed out job applications to McDonald's to the third year medical students while on rounds crosses a fairly bright line.

What I am saying is that actions to which you or another student may feel uncomfortable with can have definite purpose. Situations in which you're put on the spot, feel intimidated or inadequate, or which draw an attending's or resident's frustration may be done on purpose. The resident or attending's desire to teach and improve your education may lead to you being uncomfortable.

For example, as a peds resident, one of the general peds topics I discuss frequently is asthma. I will generally start talking about respiratory distress in general and go through the process of what are all the possible causes of respiratory distress. If a student throws out croup as a possible cause, this may lead me down a path of talking about the difference between wheezing and stridor, at which point I may ask, what causes stridor. If a student (and this has happened) then says something about "thumb sign" or "steeple sign" which are vague answers that don't really answer my question, I'm going to make them tell me what those things are. My point is to make sure they know what the terms and signs actually are and to get to a deeper level of understanding than just a buzz word to remember on the shelf exam. I think this set up is far more effective than me talking for an hour. However the whole process can be uncomfortable, I'm fully aware of that, and it might be a situation that the OP might consider "humiliating" if he felt singled out. But that would have been the last thing on my mind at any time. And that's why it's important to for the OP to act on that intellectual knowledge he has of the situation, realize that in some (many) cases it's really about not about power plays, and move beyond it as best he can.


And perrotfish - if you think that medicine is the only place where students suffer maltreatment, you should try talking to some law students and see how they like the socratic method with their really tough professors. I assure you that there are plenty of law students who undergo extremely similar treatment as medical students do.

 

[HealingDoc]

I have dealt with nasty attendings, nurses and staff by calling it tough love. In most cases, I can see a teaching point behind the insult. I always leave the interaction by shaking it off and picking out what I was supposed to learn from the interaction or message. I try to put forth a kind, compassionate, and thoughtful persona in even these interactions. Usually by the end of the day, the people I didn't know before are calling me by my name instead of "STUDENT!" and having real conversations with me. Some even say "hi" to me in the hallway.

There is only one person so far who insulted me for no reason at all, and that man is the head of the department I am rotating at right now. After interacting with him a few times and watching him with others, I know not to take what he says personally. He has lots of pressure on him as the head of a very over-impacted department that spans 3 county hospitals, and he is not happy with his home life. If you feel like people are insulting you for no reason, take a moment to assume a birds eye view and realize that its really a cry for help in most cases. You can only wish the best for them and hope that they find happiness in the journey at one point or another.

 

[McGillGrad]

It is often helpful to remember that other people cannot 'make' you feel anything. You allow people to make you upset or embarrassed or small.

If people are REALLY yelling at you, then you probably deserve it.

 

[MilkmanAl]

It is often helpful to remember that other people cannot 'make' you feel anything. You allow people to make you upset or embarrassed or small.

If people are REALLY yelling at you, then you probably deserve it.

That's a pretty poor way of looking at it. You shouldn't have to kill yourself inside to survive a rotation. There's no reason for people to **** on you just because they can, whether you feel terrible afterward or not.

 

[Knicks]

It is often helpful to remember that other people cannot 'make' you feel anything. You allow people to make you upset or embarrassed or small.

If people are REALLY yelling at you, then you probably deserve it.

Is this a serious post?

 

[McGillGrad]

That's a pretty poor way of looking at it. You shouldn't have to kill yourself inside to survive a rotation. There's no reason for people to **** on you just because they can, whether you feel terrible afterward or not.

I am almost finished with rotations and I have yet to be yelled at by anyone. I have been pimped and grilled. I have had a few people be a little rude to me, but I just smile at them and imagine that they're having a crappy day.

The only time I have seen students get yelled at is when they do something wrong, or are too ignorant/immature to know they are being inappropriate.

 

[Gastrapathy]

You need to distinguish between pimping and abuse. Pimping, done correctly, can be a very effective educational tool. You rapidly determine the level of the individual trainee and can push from there. An effective pimper asks questions right on the border of that level, some that they can answer and some that they need to look up.

If I just lecture on the same topic, when I come back and ask the next day, students/residents often don't recall. But, a little pimping to get them engaged, works wonders.

If you are getting angry when asked a question just because you didn't know the answer and somehow find having that revealed to be embarrassing, then thats something you need to work on. Your comment that pimping is ok when done in a group totally misses the point that its being done for your benefit, not mine. I don't need to ask medical students questions to make myself feel smart.

Now, if they are abusive, thats different. I can't advise how to proceed because, even though its unfair, in our system, its the students and residents who face all the jeopardy for complaining. Much of the horrendous conduct you see in teaching hospitals disappears outside the academic environment. You probably shouldn't be a surgeon.

 

[Knicks]

You need to distinguish between pimping and abuse. Pimping, done correctly, can be a very effective educational tool. You rapidly determine the level of the individual trainee and can push from there. An effective pimper asks questions right on the border of that level, some that they can answer and some that they need to look up.

If I just lecture on the same topic, when I come back and ask the next day, students/residents often don't recall. But, a little pimping to get them engaged, works wonders.

If you are getting angry when asked a question just because you didn't know the answer and somehow find having that revealed to be embarrassing, then thats something you need to work on. Your comment that pimping is ok when done in a group totally misses the point that its being done for your benefit, not mine. I don't need to ask medical students questions to make myself feel smart.

Now, if they are abusive, thats different. I can't advise how to proceed because, even though its unfair, in our system, its the students and residents who face all the jeopardy for complaining. Much of the horrendous conduct you see in teaching hospitals disappears outside the academic environment. You probably shouldn't be a surgeon.

Welp! There's nothing more to see here, folks. Move along now. (The Mods can probably lock this thread at this point).


Good overall post.

 

[DaveinDallas]

Just to clarify this.

I'm not saying abuse that's "for education" is acceptable. Certainly, the attending at my medical school who handed out job applications to McDonald's to the third year medical students while on rounds crosses a fairly bright line.

What I am saying is that actions to which you or another student may feel uncomfortable with can have definite purpose. Situations in which you're put on the spot, feel intimidated or inadequate, or which draw an attending's or resident's frustration may be done on purpose. The resident or attending's desire to teach and improve your education may lead to you being uncomfortable.

For example, as a peds resident, one of the general peds topics I discuss frequently is asthma. I will generally start talking about respiratory distress in general and go through the process of what are all the possible causes of respiratory distress. If a student throws out croup as a possible cause, this may lead me down a path of talking about the difference between wheezing and stridor, at which point I may ask, what causes stridor. If a student (and this has happened) then says something about "thumb sign" or "steeple sign" which are vague answers that don't really answer my question, I'm going to make them tell me what those things are. My point is to make sure they know what the terms and signs actually are and to get to a deeper level of understanding than just a buzz word to remember on the shelf exam. I think this set up is far more effective than me talking for an hour. However the whole process can be uncomfortable, I'm fully aware of that, and it might be a situation that the OP might consider "humiliating" if he felt singled out. But that would have been the last thing on my mind at any time. And that's why it's important to for the OP to act on that intellectual knowledge he has of the situation, realize that in some (many) cases it's really about not about power plays, and move beyond it as best he can.


And perrotfish - if you think that medicine is the only place where students suffer maltreatment, you should try talking to some law students and see how they like the socratic method with their really tough professors. I assure you that there are plenty of law students who undergo extremely similar treatment as medical students do.

Or try having one of your attendings, who's also the Associate Dean of Medical Education at your school, giving lectures and going over cases in your 2nd year didactics who's also a lawyer and uses the socratic method in discussing clinical cases/teaching didactics.....he would always lead you up to the edge of your knowledge and then take you further.....
This, coupled with a pathology prof who had been SF in the Army, who would have you stand up to respond and use the same socratic method...you definitely learned your topics.....and while it wasn't necessarily pleasant, you wind up remembering what you need to know.....

 

[WanderingDave]

I appreciate everyone's responses. I'm overseas right now and haven't had much time, but I would like to respond to some key points.

Ask your fellow MS3s which attendings are nicest and try to schedule your rotations with them, or at least in their department (usually that's as much choice as your get). The MS3s here are always doing that, from what I've seen.

Cool. I'll do that. But what about fourth year rotations, which at my school, I'm on my own to schedule? I'll be looking for ones far and wide, including in many places where I won't know anyone connected with the place. Any suggestions for good 'indicators', for lack of a better word, when I go to visit or interview?

Bull****. Being under stress or pressure gives no one the right to bully someone else, I don't care if you're a doctor or the president of the United States. All the BS med students spew is just that -- BS. The truth is, attendings and residents treat third years like this for one simple -- because they can. They get away with it for no earthly reason. In any other field, any "boss" who treated an employee the way some of these people treat med students would be on the losing end of a harassment suit and I say that as someone who used to work in HR for 10 years prior to med school.

You guys put up with it, they do it. Simple as that. Until med students "grow a pair" and stand up for themselves, the system won't change. When I was a third year, I didn't take crap. I lucked out and ended up with some good attendings/residents for the most part, but I was on two rotations where I was working for scum. I stood up for myself in a respectful manner and the only thing that happened is I didn't honor them. Boo freaking hoo. My self-respect is worth more than an H on my transcript.

I like the cut of your jib. I really don't think I'd have a problem approaching an attending in private, after I've cooled off and he or she isn't under pressure, and letting them know respectfully that I'd like a little more respect. Just eing given the chance to speak my mind does wonders for feeling vindicated.

Tough pimping and a certain amount of putting you in your place do serve an important role in medicine. Humility and knowing how little you actually know are vital attributes for a physician to have. Frankly, your posts have a certain sense of arrogance.

You read me wrong. I don't think I'm better than anyone, and have great respect for those who know much more than I do. But I have a healthy sense of self-respect, and know when I've done quality work.

At this point you are useless to the team. You are there to learn, and it comes at the expense of the team's efficiency and the patients' care. Recognize these things.

Pish-posh. I've worked in healthcare for years. I have plenty to contribute, and take a lot of pride in my work. Just this last rotation, I came up with a plan of action for a rather difficult case that my attendings hadn't thought of. They put my idea to use and a good time was had by all. I think about the patients I'm given very seriously, and really try to come up with practical ways to improve their care. I'm a team player, and would like to be recognized as one, rather than as a parasite.

Read as much as you can, and work your ass off. You will find that with increasing competence and knowledge, you will get increasing respect.

Good advice. I agree with you on this -- the more I read and the better I know my basics, the more I'll get treated like someone with something to contribute.

I do think that to a certain extent your anti-hierarchy "principles" are misguided at least to the point that by definition, medicine is hierarchal. I don't think I need to point out that you have a little "M3" next to your name while your interns, residents, fellows and attendings have something a bit different. And with that comes a very different load of responsibilities. An intern asking you to do something is not about making you know they have power over you, it's that they know more about what's going on and what needs to be done. Likewise, a resident going over your note and giving you criticism on what you can do better, or watching you perform a physical exam and correcting your deficiencies should not be viewed as a reprimand but as another opportunity to get better (or perhaps you could give other examples of the treatments that have bothered you on this rotation as these seem like really benign things I've come up with). And if you've really made a large mistake, overstepped your bounds, or are just so completely off base in your application of medical knowledge, then it really is something that needs to be addressed.

Again, my challenge to you is to consider intent.

As for residency, there definitely is a wide spectrum of behavior in regards to hierarchy. I'm a peds resident and I know of University based peds programs in which residents (and even students) are on a first name basis with attendings. I think, in general terms, the farther west you go, the more collegial programs tend to be, though by no means is this universal. It's absolutely something you can ask about on the interview trail.

Thank you, BigRedBeta. Your posts have been probably the most helpful in this thread, in terms of putting things in perspective. Unfortunately, I've settled on the east coast, and as I'm married to someone without a mobile job, the greater NYC area is where I'm staying.

All I ask is that I be given a chance. I have absolutely no problem stating, "I don't know, Doctor, but I'll look that up and get back to you." And if I say that, you bet your butt I will look it up and know it cold the next day. But please, wait until I've dropped the ball that next day to let me know how useless I am. I don't perform well in situations where disrespect can, and will, come at me randomly at any time, without warning.

The OP has the wrong attitude to succeed in medicine (dwelling and bitter for days over criticism).

My attitude is one of conscientiousness, compassion, and openness to learning. What's amiss about that? Feeling upset is not a choice I make. I'm naturally just very sensitive (and fairly serious) and I've already stated that. I'm not going to apologize for this or admit it's "something I need to work on". At this age, I've had enough life experience to know that my skin isn't getting any thicker to being demeaned by people I've invested a lot of time and effort in.

Welp! There's nothing more to see here, folks. Move along now. (The Mods can probably lock this thread at this point).

Says the guy who's contributed nothing of value to this thread. See, I have no problem just concluding this poster is a jerk and paying him no mind, because I don't have a working relationship with him, and haven't invested any time, effort, or emotional energy in any collaborative team projects with him. That's the difference.

Right now, in our very young impressionable minds is when we start developing our own work ethics, style, and overall attitude towards medicine. Medicine is a profession where when a patient walks in the door, they expect you to be the best, know it all, and perform under pressure with no BS. It is a very tough job, and it is EXPECTED of you. In the real world, when we will be attendings, etc, no one will be holding our hand, no one will be telling us good job, not even our patients. If you want satisfaction from it, you need to turn inward. Otherwise, perfection is the minimum.

Perfection is the minimum? I think that's a little pie in the sky. The attendings I've most respected have been ones who've told me stories readily of times they've messed up.

I also disagree with you that no one will tell us 'good job'. I've already been told that by other staff and patients, when I was not fishing for it. I want to be a geriatrician, and a big motivating factor for me is how grateful my patients and their families often are, for the attention and concern I bring. I realize you probably have a different perspective going into surgery; please recognize that there are many medical jobs that fit many personality styles.

 

[Bike on a Trek]

I'm a 30-something nontraditional student who's currently a MSIII. In many ways, third year has been great for me. I'm highly spontaneous and uninhibited, and can readily talk to people. I have a natural zest for learning and love to ask people questions, which is how I've gotten this far. I have no problem with working hard and working long hours, with much enthusiasm.

How does a person like me, who is convinced he can make it through and make a good doctor, strike a balance between impressing those above me and keeping sane?

Since you describe yourself as "highly sensitive", I infer that you perceive humiliation that others don't. If you feel your responses are not a problem and not different than anyone elses, then no need to worry. If you feel you have a problem that is resulting in excessive responses that are counterproductive, then I would see if you could go to about 3-4 sessions with a psychiatrist or psychologist on your hospital's staff to a) figure out why you have these responses, and b) figure out some strategies to make it easier to deal with the perceived slight. I am NOT suggesting you have any mental health illness, and I DO believe you are entirely normal. But, your self-description implies a behavior that I think you can adapt to with less stress once you get some objective input.

 

[Knicks]

Says the guy who's contributed nothing of value to this thread. See, I have no problem just concluding this poster is a jerk and paying him no mind, because I don't have a working relationship with him, and haven't invested any time, effort, or emotional energy in any collaborative team projects with him. That's the difference.

 

[WanderingDave]

I need to revive this thread to give you all a salient example that really has me bothered. I'm on Family Medicine now, and am seriously considering this specialty, as I really enjoy the patient interaction and the general way the job works.

Yesterday, I diagnosed and prescribed a treatment for a case of pneumonia. I justified the diagnosis because the patient had a temp of 101.5, tachycardia, pleurisy, a feeling of something stuck in his lung, pulmonary dullness, and mentioned having spent the holidays with a family member recently diagnosed with pneumonia.

My attending thought the diagnosis was preposterous, simply because the patient didn't look sick (he was young and in good shape). He never gave me a chance to explain my rationale. "Stand against the door and answer yes or no, and don't say another f*&^%ing word -- does this man look SICK??!! Do people with pneumonia USUALLY look sick??!!"

Here's the kicker. After looking over the patient, the attending signed my SOAP note with no changes, and even scripted the drug I'd chosen at the dose I'd chosen, indicating to me that he agreed with my assessment and plan! But even then, he continued to berate me (both in front of the patient and then after), for having the audacity to suggest that a non septic looking patient could have pneumonia. He still had some kind of issue with how I went about it, even though I arrived at the right answer. He gave me not even the slightest acknowledgement that I'd done the right thing.

This man will be giving me my grade for family medicine. He is very much a jerk in general, and especially to medical students. I really feel like I can do no right by him. I have read diligently. I have taken his humiliating lessons to heart, without flinching, and he's never had to repeat anything to me. I've been positive and conscientious to a fault. But he seems determined to break me, even when I do the right thing and put a lot of thought into what I do. He's truly impossible to impress.

How, pray tell, is this supposed to motivate me or get me excited about family medicine? What exactly am I supposed to learn from such treatment? All I've really learned is to have minimal interactions with him, and that I want a job that maximizes time spent with patients and minimizes time spent with colleagues.

 

[footcloud]

I think that's just a ****ty experience and not representative of all attendings obviously. It doesn't mean you have to take anything away from it besides that you just try your best and as long as it doesn't cross serious lines where you need to school admin involved, just suck it up and you won't have to deal with it when you're a licensed doctor. Everyone's had crappy attendings/residents and we all deal in one way or another.

 

[MSmentor018]

I need to revive this thread to give you all a salient example that really has me bothered. I'm on Family Medicine now, and am seriously considering this specialty, as I really enjoy the patient interaction and the general way the job works.

Yesterday, I diagnosed and prescribed a treatment for a case of pneumonia. I justified the diagnosis because the patient had a temp of 101.5, tachycardia, pleurisy, a feeling of something stuck in his lung, pulmonary dullness, and mentioned having spent the holidays with a family member recently diagnosed with pneumonia.

My attending thought the diagnosis was preposterous, simply because the patient didn't look sick (he was young and in good shape). He never gave me a chance to explain my rationale. "Stand against the door and answer yes or no, and don't say another f*&^%ing word -- does this man look SICK??!! Do people with pneumonia USUALLY look sick??!!"

Here's the kicker. After looking over the patient, the attending signed my SOAP note with no changes, and even scripted the drug I'd chosen at the dose I'd chosen, indicating to me that he agreed with my assessment and plan! But even then, he continued to berate me (both in front of the patient and then after), for having the audacity to suggest that a non septic looking patient could have pneumonia. He still had some kind of issue with how I went about it, even though I arrived at the right answer. He gave me not even the slightest acknowledgement that I'd done the right thing.

This man will be giving me my grade for family medicine. He is very much a jerk in general, and especially to medical students. I really feel like I can do no right by him. I have read diligently. I have taken his humiliating lessons to heart, without flinching, and he's never had to repeat anything to me. I've been positive and conscientious to a fault. But he seems determined to break me, even when I do the right thing and put a lot of thought into what I do. He's truly impossible to impress.

How, pray tell, is this supposed to motivate me or get me excited about family medicine? What exactly am I supposed to learn from such treatment? All I've really learned is to have minimal interactions with him, and that I want a job that maximizes time spent with patients and minimizes time spent with colleagues.

yep....so what's new? all docs are diff and you'll learn something from all of them. emulate the ones you like and learn how not to act like from the bad ones. if FM is your interest then go rotate at academic programs, talk to the residents, spend time with them, ask around but definitely don't let 1 interaction in medicine change your perspective too much......because it's going to happen a lot! enjoy rotations, good luck

 

[WanderingDave]

yep....so what's new? all docs are diff and you'll learn something from all of them. emulate the ones you like and learn how not to act like from the bad ones. if FM is your interest then go rotate at academic programs, talk to the residents, spend time with them, ask around but definitely don't let 1 interaction in medicine change your perspective too much......because it's going to happen a lot! enjoy rotations, good luck

The problem is, this guy is grading and evaluating me, and I really don't need a lackluster evaluation in a specialty I'm interested in.

Trust me, I can't wait to rotate at a few more family practice programs -- the more exposure the better. But will a couple of good evals from elective rotations outweigh a poor one for my core family rotation?

There's a big difference between being pimped, versus doing the right thing and getting punished for it. And since this guy has literally ordered me not to speak in his presence unless asked a direct question by him, I really have no chance to turn this around.

 

[shopsteward]

The problem is, this guy is grading and evaluating me, and I really don't need a lackluster evaluation in a specialty I'm interested in.

And since this guy has literally ordered me not to speak in his presence unless asked a direct question by him, I really have no chance to turn this around.

Difficult but not necessarily impossible. Keep a good record of what you've done (eg the pneumonia patient you've just talked about). Keep up your attendance and involvement with patients to your current levels. Keep a good relationship with the residents, as they could provide input which will be valuable to you. And near the end of the rotation, before the evaluation, try to have a word with the attending (catch him in a good mood/unstressed situation, if you can), tell him (briefly) that the evaluation he will give you is important to you because this is the speciality you are hoping to go into, and hand him the record you've kept of what you've done, so he has written evidence in front of him on which to base his assessment.

In other words, no need to give up just yet. Good luck.

 

[BigRedBeta]

Wow...that's a pretty awful situation. Do you have any one else who witnessed this? I think you need to consider reporting this to your Dean's office, particularly if this was a physician who is a community/adjunct faculty and not an actual clinical professor at your medical school.

I would try as soon as possible (when this guy is in a good mood is a good idea), or at least at the next natural opportunity to elicit some feedback from this guy. If you're halfway through with the rotation, that's a perfect opportunity. Then, at least you know what he's looking for, and when it does come time for him to write an eval, you'll have spent the recent past doing what he wants. I'd paint it more as "I'm just trying to get better" rather than trying to say that the evaluation is what you're after.

I can understand your frustration in this case, and I'm sorry this ******* is affecting your educational experience.

 

[Birdstrike]

Wandering Dave:

I just happened to come across your post while scrolling down the main forum page. As an attending who's been through all of this an then some, here's my 2 cents: this guy's obviously a jerk. His behavior is more typical of what you'd see on a malignant surgical rotation. Its VERY outside the norm for a Family Practice attending. The guy probably has a miserable personal life. He may be doing this because he doesn't like you, or because he DOES like you and is hazing you. That being said, you need to survive the rotation. I'd document every inappropriate thing he's said, when, where, times, dates and who else witnessed it. Do this privately and don't tell anyone, yet. Continue to soldier on and do your best and don't say anything inappropriate. Talk to him in private and ask him what you can do to improve. You may be surprise what he says. He may not like how smart you are. He may want you to shut up so you don't make him look dumb. You may be surprised and get a great evaluation IF you play the game correctly. If not, you can present all the documentation to your Dean of Student affairs and appeal the grade. If you've had all good evaluations in everything else, you'll win. Also, make sure you ace the end of the rotation test. Just remember, you picked a career that has lots of people with severe ego issues. I once had an attending shred me on letter of recommendation without me knowing, then when I went to apply to his residency, he ranked me FIRST! Yeah, I know, psycho. You gotta play the game. Just my 2 cents.

 

[Dirt]

What exactly am I supposed to learn from such treatment?

That some people are @ssholes?

 

[VA Hopeful Dr]

The problem is, this guy is grading and evaluating me, and I really don't need a lackluster evaluation in a specialty I'm interested in.

Trust me, I can't wait to rotate at a few more family practice programs -- the more exposure the better. But will a couple of good evals from elective rotations outweigh a poor one for my core family rotation?

There's a big difference between being pimped, versus doing the right thing and getting punished for it. And since this guy has literally ordered me not to speak in his presence unless asked a direct question by him, I really have no chance to turn this around.

As an FM resident, allow me to throw in some advice.

Yes, do more rotations. That said, try to do at least 1 private practice rotation if you can. The real world is very very different from academia, especially for FM.

Rotate at programs where you might want to attend, if they really like you then you have a better chance at getting ranked despite what your clerkship grades may have been.

Sadly, FM is not exactly a super competitive specialty. My FM 3rd year grade was my worst one, I just worked harder on the others, did pretty well, and matched top choice. I'll tack on that I wasn't exactly a model student, so I think you'll be OK and this one ****ty attending won't sink your dreams.

 

[WanderingDave]

Thanks for all the helpful advice on my most recent situation, guys.

My rotation is entirely at my attending's "Dr. A's" outpatient practice, and there are no residents. He is widely known for being abrasive, and he was just elected to a very high position in the Osteopathic world. This guy draws a lot of water. But even Dr. A's cousin, who's part of the practice and mentors me a couple days a week, remarked (completely unsolicited) that Dr. A is a jackass.

I cannot figure out whether Dr. A truly doesn't like me, or whether he's just trying to stretch me (while saving face for himself). He clearly does not like the way I answer questions. I have a way with words, and can have an unorthodox way of verbally and logically attacking medical problems. My rationales are well thought out, but they're rarely the shortest distance between two buzzwords, if you get me. Dr. A wants brief, pat answers to his questions, like a drill sergeant.

I should also add that the whole 'way of the gentle warrior' thing I've got going on p Yeah cheesy, I know -- trust me, I don't take myself THAT seriously, but it gets the point across), tends make bully types want to pull out all the stops with me.

I left out one part of the story. Dr. A decided to give the pneumonia patient I described an IM Rocephin shot. He'd shown me the proper way to do an IM shot before, but I was so stunned and on edge by his unexpected reaction to my diagnosis, that I blanked and did it wrong. A large amount of his berating me had to do with me doing the shot wrong. Fair enough -- I deserved that, and should have been more on point. But this doesn't change the fact that I chose the correct diagnosis and treatment, and was treated as if I hadn't. The man is all stick and no carrot.

I've never dealt well with an abrasive person for long periods of time. My approach is either to disarm the person with conscientiousness and chillness, showing them that I'm no threat and don't need to be handled roughly. If that fails, I tend to have as little to do with them as possible, and am 'strictly business' with them.

Unfortunately no one else witnessed this incident, and getting the patient (who liked my consultation and handling of his case very much, might I add), involved to testify, would entail HIPAA violations. I think I'll write down as much as I remember from the incident, and only take action if I get panned on the evaluation.

 

[Danlee07]

You have to find your own way of handling things, but this is pretty complicated. I've met and actually gotten to know a wide variety of people from moving so many times.

Respect and honor is a lost manner in present times, especially in America. Individualizing yourself seems to be the key emphasis instead of a group mentality. I feel that if there were respect and honor, first, the attending wouldn't be berating your in front of a patient -- it'd be in a different location afterwards to explain the situation. However, people are very different. Most people who act big on the outside are very small on the inside. Also, you have to realize that some people just are not that good at expressing emotions in words. After all, emotion is really inside you and to effectively communicate is a whole different subject. From my experience, those who try to berate you only want to cause a stir from you. If you don't show you are affected, then it slowly dies down. Try to at least realize the exact emotion and when you feel it so you can learn to at least subdue it; it's going to show on your face, and you have to recognize it. After all, the person's expressions may be horrible, but his intentions may be great.

Knowing when and where to handle a situation is key and is what can make you individualistic and will help you out on the long run. Perhaps you could've talked to the attending about the situation later. If it doesn't go well, then you're out of luck but in the end, it doesn't do you any good for getting mad/angry/sad out of every single situation that occurs to you.

 

[cushie]

.

 

[zoirusha]

You need to toughen up. Don't take anything that is done to you personally - some people are just @sssssholes and mistreat everyone, not just you.
Right now you are assuming a role of a poor mistreated victim, and it is not going to win you any points. You must learn to be tough.

 

[ohboy]

What I did to deal with it was to start a blog. Posting stories from your ridiculous day and then having like minded people comment on them is very therapeutic.

 

[wannabeOBGYN]

I'm a 30-something nontraditional student who's currently a MSIII. In many ways, third year has been great for me. I'm highly spontaneous and uninhibited, and can readily talk to people. I have a natural zest for learning and love to ask people questions, which is how I've gotten this far. I have no problem with working hard and working long hours, with much enthusiasm.

There's just one major problem I've run into: I absolutely do not take abusive or humiliating treatment from superiors. The avoidance of reprimand is a major motivating factor for me in all I do, and when it occurs, it leaves me stinging for hours, if not days. When it comes to "pimping", I tolerate it if it's done in a group setting, and I'm clearly not being singled out. But when I'm singled out for it because the pimper feels I've broken rank or don't "know my place", I'm so enraged that I can barely function.

Although I push myself very hard, I'm by nature, and on principle, not competitive with other people at all. I'm also fiercely anti-hierarchical; I handle authority well by earning the goodwill of people above me, because I don't handle authorities reminding me saliently that they are in power over me.

I'm intellectually aware that I should not take such treatment personally -- I don't need a lecture on that, and thinking about this doesn't soften the blow any. I'm highly opposed on principle to the whole macho "take abuse to earn your dues" mentality, because I don't think it builds better clinicians or better human beings in any way.

How does a person like me, who is convinced he can make it through and make a good doctor, strike a balance between impressing those above me and keeping sane?

I don't do well in this kind of situation either. Luckily, I am in a smaller community for rotations and most of my time is spent one-on-one with physicians, with the exception of signing off between shifts. I am still asked questions like everyone else is, but the doctors here are very laid back and always clear that they're not trying to pimp me, they just want to see what I know, etc. When they feel I should have known something they suggest I go home and look it up, but I have yet to be really yelled at. So my suggestion would be to find smaller community based programs away from big universities.

I know a lot of people here just say to suck it up because everyone deals with it, but clearly, everyone does not. My friends who stayed at big county hospitals are constantly pimped, have terrible call schedules, and several have been brought to tears by embarrassment from pimping. I cannot tell you how happy I am to have gotten away from that kind of atmosphere. I only hope I can find something similar to my current rotations when I'm applying for residency. Good luck!

 

[AgentRaiden]

My friends who stayed in south Florida at big county hospitals are constantly pimped, have terrible call schedules, and several have been brought to tears by embarrassment from pimping. I cannot tell you how happy I am to have gotten away from that kind of atmosphere.

Aw,that's a bummer,I was hoping to schedule some of my rotations at south Florida.I am curious to hear where you currently rotate at,and the notorious Florida hospitals you speak of.

 

[wannabeOBGYN]

Aw,that's a bummer,I was hoping to schedule some of my rotations at south Florida.I am curious to hear where you currently rotate at,and the notorious Florida hospitals you speak of.

.

 

[jl lin]

Ok here is the truth OP...None of healthcare is for thin-skinned people, PERIOD. I don't care if its nursing, RT, the various lab technologies, pharmacy, or medicine. It is the nature of the beast. Can and should some of it be limited? Yep. But it will never, ever be chill or some utopia. It is what it is...but business can be a mean SOB too. And in fact, like it or not, healthcare is as much a business as anything else. It's reality. In this area,it is so much about picking your battles. I can guarantee you that there will be days when for one reason or another, whether it be from docs, students, nurses, admin, housekeeping, families, or patients, you WILL go home feeling hurt, kicked down, or totally disrespected and unappreciated. It's not a matter of if, it's a matter of when. Dealing with people that are having trouble w good interactions and communication skills, particularly while under stress is a HUGE part of the whole arena. So learning how to deal w your own feelings and responses is essential, since you really can't control anyone else's.

Also, some people are just plain unfair. Truth is, life is unfair at times, and you will have to find a productive, non-resentful way of dealing with it if you plan on being happy in your work.

Look at the situation w the FM person. Ask yourself if it is worth the battle. I mean, it totally may be...depending. OTOH, you may need to make the best of things so that you can move on. Don't get caught in a quagmire if you can learn what you can, respect the person for what he does and knows, and roll positive in spite of things. You will run out of steam so fast, if you make an issue of everything said or done to you. The key IMHO is understanding that you have power to control you, not anyone else. So you can choose to let it roll off of you if
possible, or you can let it control you in a negative way; thus giving other people a ton of power over you.

Please take this in the cordial but honest manner that it is intended.

 

[hikikomori]

To the OP:
It's just the way it is. Like other posters said, just try to find good attendings from your classmates' experience. I worked it out that way when I could, and it made 3rd yr more bearable.

You can't really change people. But once you become an attending, you can change the way medical education works. Or as alternative, you can always retaliate to those people. Send an anonymous tip to the INS, if they're a foreign attending, for example. If you have friends at the IRS, that's even better. Nothing is more devastating that a financial ruin (other than death itself, of course). Revenge is better served cold.

 

[WanderingDave]

Ok here is the truth OP...None of healthcare is for thin-skinned people, PERIOD. I don't care if its nursing, RT, the various lab technologies, pharmacy, or medicine. It is the nature of the beast. Can and should some of it be limited? Yep. But it will never, ever be chill or some utopia. It is what it is...but business can be a mean SOB too. And in fact, like it or not, healthcare is as much a business as anything else. It's reality.

Actually, I've worked in healthcare for several years before medical school. I was a CNA at 2 nursing homes and a hospital, and worked extensively with the nursing team and rehab at all 3 places. It was not easy, but I did just fine. I never complained or gave anyone attitude, unlike some of my coworkers. I was the hardest working CNA on the floor, and by the end of each job, had earned the respect of all the nurses and PTs, even the ones who were difficult. All I had to do was work very hard, always do my job, seldom call out, and never complain. My impression of nurses and PTs is almost wholly positive -- rough at times, but the salt of the earth.

I thought this method of would work in medical school too, for cultivating good working relationships with doctors. But my success with it has been very hit or miss. At small, out of the way departments and/or places, yes. Anywhere where I'm "just another medical student", no.

I got into medicine because I wanted a respectable, stable job that used my brain, but was dedicated toward helping people, and wasn't dog-eat-dog like the business world. Disrespect me all you want, but I have no desire for any postgrad program -- or future practice -- that requires a killer instinct to make it into or make it through.

I'm all done with the family program, and got a fair to middling evaluation. I deal with the doc in my mind by just trying not to look back and think about him at all. I'll definitely not be eager to help him with anything in the future, if we run in the same circles.

Being sensitive is a strength, as a primary care doctor. I've been told this by a number of people, and I've made up my mind I'm not going to let anyone, here or anywhere else, tell me otherwise. I've already seen this in action, when I've picked up on subtle cues in patient interactions that have led me to a more fitting diagnosis or treatment. Because in the end isn't patients getting better -- and liking and trusting their doc -- what it's all about?

 

[Noeljan]

Actually, I've worked in healthcare for several years before medical school. I was a CNA at 2 nursing homes and a hospital, and worked extensively with the nursing team and rehab at all 3 places. It was not easy, but I did just fine. I never complained or gave anyone attitude, unlike some of my coworkers. I was the hardest working CNA on the floor, and by the end of each job, had earned the respect of all the nurses and PTs, even the ones who were difficult. All I had to do was work very hard, always do my job, seldom call out, and never complain. My impression of nurses and PTs is almost wholly positive -- rough at times, but the salt of the earth.

I thought this method of would work in medical school too, for cultivating good working relationships with doctors. But my success with it has been very hit or miss. At small, out of the way departments and/or places, yes. Anywhere where I'm "just another medical student", no.

I got into medicine because I wanted a respectable, stable job that used my brain, but was dedicated toward helping people, and wasn't dog-eat-dog like the business world. Disrespect me all you want, but I have no desire for any postgrad program -- or future practice -- that requires a killer instinct to make it into or make it through.

I'm all done with the family program, and got a fair to middling evaluation. I deal with the doc in my mind by just trying not to look back and think about him at all. I'll definitely not be eager to help him with anything in the future, if we run in the same circles.

Being sensitive is a strength, as a primary care doctor. I've been told this by a number of people, and I've made up my mind I'm not going to let anyone, here or anywhere else, tell me otherwise. I've already seen this in action, when I've picked up on subtle cues in patient interactions that have led me to a more fitting diagnosis or treatment. Because in the end isn't patients getting better -- and liking and trusting their doc -- what it's all about?

ok so here is the thing...I do think your sensitivity is a strength in helping you feel for people. I too am sensitive, and it was difficult for me as well to have people be straight out nasty, act unprofessional (like making jabs about patients, students, etc) or rude...however you need to realize it doesn't matter what you think about this. You have to just deal with it if you are to succeed (at least until you have more control over your own fate). You can sit around and get huffy and analyze this attending or that resident, but why? It is what it is. You are going to have to deal with sooo many personalities in medicine. Many wont conform to what you deem appropriate. Unless someone is actively putting someone's life in danger, just get over it. Just do your work and smile.

 

[WanderingDave]

You have to just deal with it if you are to succeed (at least until you have more control over your own fate).

You know, that gives me an idea: I feel so strongly about this, that all this business might just make me an activist for reform of medical education, once I'm licensed and practicing. There must be some way to impart the necessary voluminous amount of knowledge -- and awareness of the narrow margin for error in this profession -- without a teacher-student power differential that naturally leads to abuse.

It is what it is. You are going to have to deal with sooo many personalities in medicine. Many wont conform to what you deem appropriate. Unless someone is actively putting someone's life in danger, just get over it. Just do your work and smile.

That's exactly what I do, at least on the outside.

I aim this comment at no one in particular: Maybe I'm perceiving this all wrong, but coming back and reading this thread sometimes gives me the feeling like I've done something shameful or broken some kind of unwritten code, as if anybody who's going to be a doctor shouldn't even THINK, much less express, the ideas I have. I think it's very sad that people can get away with being unkind and even giving out misinformation, both of which I've seen a good bit of in these forums, but that openly admitting a weakness in mentally (not outwardly, mind you!) dealing with jerks is major skin off my nose.