Is this considered a malignant attending?

[circulus vitios]

Ladies and gentlemen, I think we have found the Law2Doc of surgery.

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[rocketbooster]

What can I do about this attending? I no longer have him now but I still want to at least evaluate him poorly. We usually have to send in our evaluations right after the rotation while the attendings+residents get 1 month to fill them out. I don't want my negative evaluation on him to further influence him to rate me even poorer than I'm sure he's already going to rate me, ha. Even though the evals are anonymous, I'm sure it'd be pretty easy for him to figure out which one is mine.

I could report him to the PD, but I honestly don't think being an ******* warrants action by the PD. I think that'd be blowing this out of proportion.

 

[sector9]

haha, nicely done, sir.

Definitely has changed. Although I'm still glad to be in 3rd year now rather than 2nd since that means I'm closer to finishing med school. Rdy to be done with this. I'm pretty confident on what field I want to do now. I wish I could apply to residency now and be done with it lol

I guess it's true when they say "Med school sucks"

 

[Raryn]

What can I do about this attending? I no longer have him now but I still want to at least evaluate him poorly. We usually have to send in our evaluations right after the rotation while the attendings+residents get 1 month to fill them out. I don't want my negative evaluation on him to further influence him to rate me even poorer than I'm sure he's already going to rate me, ha. Even though the evals are anonymous, I'm sure it'd be pretty easy for him to figure out which one is mine.

I could report him to the PD, but I honestly don't think being an ******* warrants action by the PD. I think that'd be blowing this out of proportion.

Your attendings get their evals back right after you do them? Ours get pooled evals back from all of their students every 6 months...

 

[45408]

What can I do about this attending? I no longer have him now but I still want to at least evaluate him poorly. We usually have to send in our evaluations right after the rotation while the attendings+residents get 1 month to fill them out. I don't want my negative evaluation on him to further influence him to rate me even poorer than I'm sure he's already going to rate me, ha. Even though the evals are anonymous, I'm sure it'd be pretty easy for him to figure out which one is mine.

I doubt he'll see it before he has to submit his. If you're in doubt, ask the secretary/clerkship coordinator.

Be honest but constructive. If you sound like you have an axe to grind, they'll probably just throw your evaluation out.

 

[Stacker]

Is he as bad as this guy?

[YOUTUBE]http://www.youtube.com/watch?v=VkJEt1UsUcs&feature=plcp[/YOUTUBE]

 

[Asp]

Nobody is going to hand hold you in the real world and nobody can really teach you "how to suction". General pointers, yes, how to do it well is about #1 watching others who are good at it and #2 practice. If someone is batting you out of their field, you are doing something wrong. If this is a difficult task for you, I'd recommend watching a resident with the suction or the attending when they are using the suction themselves. This has nothing to do with being malignant or not. This is standard for surgery. Nobody is going to hand hold you through the basics (like using a suction or scissors) and nobody likes people who get in their way when they are focused. This isn't a teachable moment that is being missed. This is a medical student trying to do something they aren't comfortable with.



You are going to have to clarify what you mean by "verbally abuses". Nobody should be telling a medical student that they are worthless. Does he actually use those words? Verbal abuse should never be tolerated.

What you are describing is more that he thinks you are useless, not worthless, which is a subtle, but distinct difference. Are you on his rotation? If yes, why are you ever in a position where the attending has something for you to do and you aren't either 1) already doing it or 2) ready to do it. Do NOT get me wrong. Being nice to nurses and anesthesia is important. I would never tell someone not to be helpful to other services or ancillary staff. But you are not their student or their underling. I can understand this happening once a rotation, but if it is something that you are repeatedly told, there is probably an issue. Others might not be bothered as much by it, but I'd be pretty pissed, even as a resident, if there was something relatively small to be done on the surgical team side that you weren't on top of because you were helping out another team. I can understand in emergencies or when patient care will be adversely affected, but those instances are very far and few in between.



Yelling is counterproductive. At the same time, my sympathies for nursing staff, other residents and students is limited, depending on what exactly happened. I would never call yelling "justified", but I would consider it "normal" and "understandable" in many instances. Nurses gabbing about the weekend instead of getting something needed on the field. Resident not reading for the case and understanding the prerequisite anatomy to assist in the case. Medical student cutting too close to knots, adjusting lights, retracting poorly, suctioning poorly. That will make an operator's blood start to boil. Surgery is at it's core a high risk endeavor and is stressful. Practiced hands help to limit this significantly, but when you start getting in the way, things will get ugly fast. Remember, every attending in the academic center you are at can operate 50-100% faster without residents or medical students around. Academic surgeons, even the nastiest budget time because residents and medical students need to learn. But also remember, that budget is not unlimited.

I have been put in a position where I have had to take assignments away from medical students, even while I was a medical student, because things just had to be done faster or better than they were being done. It sucks and you feel bad, but you simply can't keep the patient under or hold up rounds forever. You noted that the residents get less crap thrown at them because they are "competent", you are implying yourself that the rest, nurses and medical students, are not competent. Nobody is expecting you to function like a resident. But, if you are getting yelled at for things that you should be able to master or things that you shouldn't be doing, there is more than a malignant personality at play here.


All of that having been said, the attending is 99% likely a sub-optimal or poor teacher. At the same time, nothing you have described is truly terrible. Could be actually malignant, sure, but not based on what you have said. And, he may actually be Satan incarnate. But, I can tell you that from my experience, when medical students complain about OR things or attending personalities, there is an underlying problem with the medical student at least 50%+ of the time. It is rarely the only issue, but it is usually a contributing factor. It drives me absolutely bananas when people blame others and don't look introspectively, regardless of the circumstances.

At the end of the day, there is nothing you can do about this attending, even if he is really a bad guy. All you can do is focus on improving yourself and your competency. If you are doing things perfect and they still complain, then just move on and don't sweat it. You can't make everyone happy and there are always cynical, angry people out there. But, realize that just because other people have had issues with an attending, doesn't make them malignant. If you are sucking at suctioning, fix it. Watch residents, ask residents, think through why your hand got hit back or why the suction was ripped away. Are you not anticipating what is about to happen? Are you not visualizing where the surgeon is trying to go and are blocking his eyesight? etc etc.

You sound malignant.

 

[dr zaius]

I think everyone is forgetting this is a gyn-onc "surgeon"...enough said

What am I missing here? What are you getting at?

 

[username456789]

What am I missing here? What are you getting at?

Probably just pointing out that, although they like to think of themselves as such, OB/Gyn docs are not actually "surgeons" and it is not a surgical specialty (although if anyone would make an argument in the affirmative, a Gyn Onc would be the example to use, as they're probably the closest thing in the field to true surgeons.

Or maybe I'm reading too much into it and he's just suggesting that OB/Gyn is filled with an inordinate number of *******s.

 

[cincincyreds]

First week for me ever in the OR and on gyn onc, this attending always has med students retract and suction...which is pretty standard I'm sure. No one has explained to me how to "suction correctly." When I see blood, I try to suction. Half of the time I do, he hits my hand away. So then when I'm more cautious not to get in his field, he yells at me for not suctioning. Then he starts telling the resident how it's hard for him to operate when he has to suction for himself. I very nicely tell him I can do it for him, he gives it back but then takes it from me everytime I'm about to suction.

Then all day inside and outside the OR he verbally abuses me as much as possible. Yells at me, basically tells me how worthless I am, etc. There's been a number of times when the anesthesiologist or nurse asks for my help, then while I'm helping them he yells at me and tells me "how about you help with this instead of standing around." The anesthesiologist actually spoke up for me and said I was helping him. Of course, my attending didn't apologize to me or anything. Instead he loves making comments like "I've been working for 25 years, I shouldn't feel stressed in the OR so don't stress me out on this next case" implying how worthless I am.

He also yells at the nursing staff constantly. The residents get their fair share too but he isn't as bad toward them since they have some competencies at least. All the nurses and residents tell me how he has no patience and yells all the time so don't take it personally. Why is he accepting med students to work with him at a teaching hospital then? Isn't patience the #1 thing teachers should have?

Is this pretty standard behavior for surgery attendings? Is he considered a "malignant attending" or am I seriously just a failure? haha

First off, don't take anything personally from that guy. There is an old school behavior of malignant behavior eminating from certain physicians. All you need to do is ignore him and appear interested. The goal is to get through the rotation. Don't complain about the attending cause you won't win. I met many of these personalities when I was in medical school and I would just do what I am told. I did fine and now I make much more money than any of them.

 

[45408]

Probably just pointing out that, although they like to think of themselves as such, OB/Gyn docs are not actually "surgeons" and it is not a surgical specialty (although if anyone would make an argument in the affirmative, a Gyn Onc would be the example to use, as they're probably the closest thing in the field to true surgeons.

Or maybe I'm reading too much into it and he's just suggesting that OB/Gyn is filled with an inordinate number of *******s.

I'm in general surgery, and while we might crack jokes about OB/gyns, the gyn-oncs are completely different. They are definitely "real" surgeons.

 

[dr zaius]

I'm in general surgery, and while we might crack jokes about OB/gyns, the gyn-oncs are completely different. They are definitely "real" surgeons.

What would you consider the older attendings that primarily do gyn? I was in the OR quite a bit on my gyn rotation. There's a clinical aspect to it, too, but I'm not really sure why they wouldn't be considered a type of surgical subspecialty unless laparoscopy and transvaginal procedures are considered non-surgical. OB I can see, but gyn muddies the water for me a bit.

 

[rocketbooster]

What would you consider the older attendings that primarily do gyn? I was in the OR quite a bit on my gyn rotation. There's a clinical aspect to it, too, but I'm not really sure why they wouldn't be considered a type of surgical subspecialty unless laparoscopy and transvaginal procedures are considered non-surgical. OB I can see, but gyn muddies the water for me a bit.

Gyn oncs are without question "real" surgeons. On top of laparoscopy and trasvaginal procedures, they also do laparotomies all the time. Got a huge ovarian malignancy that metastasized to the entire abdomen, covering the omentum, intestine, liver, spleen, diaphragm, and abdominal wall? A gyn onc is removing all that for you by making a nice, long incision down your abdomen and opening you up. That's definitely "real" surgery.

 

[twistedjengki]

That's part of working in the hospital setting - dealing with all kinds of personalities.