Intern is annoying as hell

[Sikrouf]

Hello
As an attending how do you handle such situations ?
Long story short he s sitting at the top of mount stupid in the dunning-kruger way of seeing knowledge
Just looking for peoples experience on this matter

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[littlefred]

Lead by example.

Looking back at my training, we take the good/bad from attendings we rotate with. So try to teach the intern how to interact with ancillary staff and how to interact with patients. If you supervise interactions with patients try to find points where their personality can be detrimental to the patient-doctor relationship and discuss with them afterwards.

 

[Sushirolls]

Pull them aside.
Let them know they will get a passing evaluation at the end. The formal written will be meh. Take that fear of being a trainee off the table.

But then let them know you are about to give them verbal harsh feedback that won't be filtered 'the real feedback.' Let them know that this is their warning shot across the bow. If you are seeing these things, other certainly will, and others will likely be harsher and put it in writing.

This is one idea. Others might disagree.

 

[comp1]

I like warning and confirming passing before giving anything resembling negative feedback to any trainee. You don't want to worsen this sort of behavior as a coping skill. That said...make sure you've processed this yourself as much as you can about how it relates to you personally. What (VERY specifically) annoys you about this intern? Why? Talk about them with other attendings, including possibly outside of your rotation. Make sure to clarify what is their issue and what is yours.

 

[Celexa]

Is he annoying or is he dangerous? Because there's a big difference. It's not your job to turn him unto a likable person if he's mainly massively annoying. If his ignorance and attitude put patient care in jeopardy its a whole separate discussion.

 

[Bartelby]

Is the intern basically arrogant? One option is to call out whenever he gets it wrong. I would also try to sort out whether there is some over-compensation for his feeling inadequate going on (basically is this him putting on a face of what he believes is competence for the rotation or is this just his personality?).

 

[splik]

I'm having a hard time grasping what the issue is. Some residents are just annoying and there isn't much that can be done about that. You aren't going to click with everyone. Some can be overconfident (which may either be arrogance or trying to overcompensate). Overconfidence is not necessarily a problem however sometimes it can bleed into residents not doing what we tell them to do and this can harm patient care. I am fine with residents having wrong opinions, but I am not okay with them marching to their own drumbeat and actively disobeying me. If there are other problematic aspects and they do not take on feedback from me then I ask the chief resident to discuss these issues with them, and if that isn't sufficient, then I would discuss concerns with the APD and PD. Often, if the resident has some sort of problem, you are not the first person to catch on to it. other attendings will have had similar concerns. As a last resort, I tell them they will have to remediate but I've only ever had to do that once and it was followed by a miraculous turnaround.

One thing to remember as well is that residents are still in the mind set from med school of feeling evaluated all the time and can be sensitive to any perceived criticism. Like anyone else, they do not respond to feedback if they don't think you care about them and have their best interests at heart. I think it is better to be direct about any feedback (the feedback sandwich doesn't work), but it needs to be in the context of a relationship where you are trying to encourage, validate and nurture them and they feel like you have their back. Otherwise they just won't take in the feedback.

 

[Sushirolls]

Annoying personalities should be conveyed - ideally oustide the formal paperwork - because those annoying personalities will be the context of running into conflict with hospital admin in the future or irritating colleagues in the future. They don't have to change, necessarily, but at least letting some one know its there to self reflect is still valuable.

I had possibly 2 nick names in residency. First glance are positive, and not demeaning, but still something to reflect on with how I interact with peers, hospital admin, and lesser so patients.

 

[PsyDr]

Behaviorally, whatever he's doing is being rewarded somehow. The motivation almost doesn't matter. Just punish the behavior. He says something stupid? Ask him to bring 10 references, with copies, so everyone can read this tomorrow. Ask him to write a paper that reconciles his stupid position with the thickest textbook you can find. You know that weird research professor that has a room in some weird annex, who publishes about some sub-unit receptors in the vas deferens? Ask that guy to give the student a lecture about how that applies to SSRI sexual dysfunction/

The student will either get the point, or you will feel better.

 

[deleted1100659]

I think having the context would be important to know what to do. I expect interns to not have a ton of knowledge, I don't mind people with a lot to learn if they work hard to learn it. Lazy though, I do not like that. Whats the main things going on?

 

[NickNaylor]

As others have mentioned, the course of action depends on what the actual problem is.

If someone is interpersonally difficult but performs well clinically, I would proceed cautiously. You can put yourself in a tough situation by commenting on or attempting to change someone's demeanor and personality. I find that it is rarely the case that someone who is interpersonally difficult to work with doesn't have some kind of negative impact on their clinical performance because of that. However, the feedback needs to be couched in clinical terms. For example, someone who is abrasive, defensive, demanding, unable to receive feedback, etc. often struggles to work effectively with other members with the clinical team. While this may not make the resident "dangerous," per se, it's certainly warranted to provide some degree of feedback about it so that they're aware. I agree with the suggestion of providing this feedback verbally rather than bombing them with a written evaluation. If you want to get something in writing, you could consider e-mailing the program director separately.

Working with annoying residents is part of the job of an academic doc. If someone is otherwise a good clinician but I just don't get along with them, I generally approach them the same way I do with other people I feel similarly about: limit my interaction to what is needed and nothing more while trying to be as cordial as possible. I generally don't provide "annoying" residents with feedback about this unless it is clearly impacting their ability to be a psychiatrist.

 

[whopper]

You didn't provide enough information.

I tell patients this when they don't give me information and this is based on a true story. I had a patient who drank 30 cups of coffee. This was real. Her problem? "Doc I don't sleep well and I'm very jittery." I asked how much coffee she drank and she told me "not that much." So I told her that doesn't tell me how much coffee she drank and told her to give me an objective amount like a cup a day, a cup every few days, etc. She replied, "well you know. It's not that much." I again told her she needed to give me an objective amount. After 3 more failures she responded, "I didn't know I was going to be interviewed by the coffee nazi!"
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6 months later with no progress she finally told me she drank about 30 cups of coffee a day. Seriously. I told her, "have you considered that this amount of coffee is why you can't sleep and you're jittery?" Reply-"how was I supposed to know that?"

Given that she was avoidant her first meeting, and I even wrote down in details she was hesitant to answer, I showed her my notes where I wrote she was avoidant, I asked her to be specific and she was unspecific with each reply and then in quotations wrote the "I didn't know I was going to be interviewed by the coffee nazi!"

The first post is the equivalent of above the line. We're given some notion without much else, and that notion of " he s sitting at the top of mount stupid in the dunning-kruger way of seeing knowledge" pretty much answers itself if that's all you're going to give.

My response? If you're a professor you should be prepped on how to deal with a Dunning-Kruger type of resident. That's all you gave us. That's your answer.

But if you care to give more details go ahead and we can give you a better answer.