It's not burnout; It's abuse!

[Dr. Harambe]

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who agrees? http://www.kevinmd.com/blog/2016/09/video-makes-case-must-stand-doctors.html

While there are certainly factors that you can determine yourself for your personal well-being, I grow frustrated by institutions' attempts to fix systemic problems with finger pointing at individual medical students and MDs.

 

[rederza]

This is never gonna happen because med students feel like the 'abuse' is a right of passage and too many older doctors justify it by saying "If I went through it you should too". Most wouldn't have the backbone to speak out against anything wrong because unfortunately the hospital admin/school admin have far too much power and ability to **** you over. Med schools have this theme of it's gonna get worse so it should be awful now which makes no sense in reality but hey, are you gonna throw away that 3.9 gpa, 34 mcat, and 100o hour of volunteer work when so many others are dying for your spot?

 

[Dr. Harambe]

I've been thinking about all the times questionable things happened to or in front of me as a 3rd year medical student and I said or did nothing, probably out of fear and intimidation tactics. Particularly one instance when a resident during rounds openly mocked and called another medical student "stupid" while laughing to her colleagues in front of all of us.

No such problems as an M4 and in my chosen field thankfully.

Here's another article: http://www.idealmedicalcare.org/blog/how-the-word-burnout-perpetuates-medicines-cycle-of-abuse/

 

[rederza]

I've been thinking about all the times questionable things happened to or in front of me as a 3rd year medical student and I said or did nothing, probably out of fear and intimidation tactics. Particularly one instance when a resident during rounds openly mocked and called another medical student "stupid" while laughing to her colleagues in front of all of us.

No such problems as an M4 and in my chosen field thankfully.

Here's another article: http://www.idealmedicalcare.org/blog/how-the-word-burnout-perpetuates-medicines-cycle-of-abuse/

Which is pathetic honestly. She wouldn't dare make a peep when some drug seeking psycho (or literally, any patient) comes swinging at her with insults or demands, any trailer trash can come up to you and call you every name under the book, but all she can do is bow her head and appease them because patient first right? The only power they have is over other medical students/ younger classmen because you can't bully literally ANYONE ELSE LOL. So unbelievably sad that your esteem is so shot, yet you somehow think you're at the top of your totem pole. Read: Delusional. I mean obviously she's capitalizing on the fact that the med student is just inferior (younger) than her, or she might think she's the ****. But jokes on her cause at the end of the day you're just another miserable unneeded pawn in the game of insurance companies vs hospital politics

Edit: But that "At least it's not happening to me" logic is why we're here in the first place. It shouldn't happen at all.

 

[futuremdforme]

I hadn't thought of it as abuse, but I have been thinking a lot lately about how it's counterproductive to shift the focus to burnout (individual) instead of recognizing the system that makes people so miserable! The irony is that a lot of attendings complain about the demands they face, but then shift to this "in my day..." mode when a learner tries to take a lunch break.

 

[Azete]

One thing I've noticed is that our schedule always intentionally places exams at the most inopportune times so we don't have as much time to study. Like the Monday after Thanksgiving, or bunching 3 exams together when they could easily have spaced them out, or keeping us in "mandatory" activities from 8am-7pm the day before an anatomy practical.

This is the kind of stuff that leads to burnout because the options are sacrifice sleep, food, exercise, and family, or remediate. It feels like med schools forgot a while ago that their job is to teach medical science to future physicians, and only seem to care about doing everything necessary to create a good distribution curve. God forbid they present the material in a way that everybody performs well, that would be way too irrational.

 

[easy peasy]

This is one of the reasons that some people choose not to go into medical. Many of the medical students and residents could easily become a psych patient from all of the stress that they internalize.

 

[JustPlainBill]

As recently as 2010 during residency --

1) I was slapped in the head on an OB rotation for forgetting to put the FHT reading into my progress note.
2) Told I was too stupid to read the English language by a specialty service during one of my inpatient months.
3) Sent to go fetch lunch while the M3 was allowed to stay in clinic and participate in procedural learning.
4) Mocked for not knowing the patient's sodium deficit on my first hyponatremia case on my first hospital month.
5) Chastised for "not knowing how to treat a fever" in a patient that was septic, becoming non-responsive while on broad spectrum antibiotics for a worsening cellulitis and going into septic shock. I had called the attending on nightfloat to inform them I was transferring a patient to ICU and thought they would like to know.
6) Written up for not knowing where the tele room was in a certain hospital.
7) Written up for casually using the phrase "train wreck" when presenting in the rounding room -- only to have the same attending who wrote me up use the phrase to describe a patient one month later while I'm standing there.
8) Chastised for not being able to see 12-15 patients per half day in clinic when the attendings were regularly scheduled for a "busy day" with 7.

 

[Psai]

As recently as 2010 during residency --

1) I was slapped in the head on an OB rotation for forgetting to put the FHT reading into my progress note.
2) Told I was too stupid to read the English language by a specialty service during one of my inpatient months.
3) Sent to go fetch lunch while the M3 was allowed to stay in clinic and participate in procedural learning.
4) Mocked for not knowing the patient's sodium deficit on my first hyponatremia case on my first hospital month.
5) Chastised for "not knowing how to treat a fever" in a patient that was septic, becoming non-responsive while on broad spectrum antibiotics for a worsening cellulitis and going into septic shock. I had called the attending on nightfloat to inform them I was transferring a patient to ICU and thought they would like to know.
6) Written up for not knowing where the tele room was in a certain hospital.
7) Written up for casually using the phrase "train wreck" when presenting in the rounding room -- only to have the same attending who wrote me up use the phrase to describe a patient one month later while I'm standing there.
8) Chastised for not being able to see 12-15 patients per half day in clinic when the attendings were regularly scheduled for a "busy day" with 7.

lol at 7. I won't ever forget when a psych attending made a huge deal about me calling a patient crazy during rounds. "We don't ever call our patients that word". Then 2 days later they used it 3 times (I counted) to describe a patient during rounds. I was like wtf...

 

[futuremdforme]

As recently as 2010 during residency --

1) I was slapped in the head on an OB rotation for forgetting to put the FHT reading into my progress note.
2) Told I was too stupid to read the English language by a specialty service during one of my inpatient months.
3) Sent to go fetch lunch while the M3 was allowed to stay in clinic and participate in procedural learning.
4) Mocked for not knowing the patient's sodium deficit on my first hyponatremia case on my first hospital month.
5) Chastised for "not knowing how to treat a fever" in a patient that was septic, becoming non-responsive while on broad spectrum antibiotics for a worsening cellulitis and going into septic shock. I had called the attending on nightfloat to inform them I was transferring a patient to ICU and thought they would like to know.
6) Written up for not knowing where the tele room was in a certain hospital.
7) Written up for casually using the phrase "train wreck" when presenting in the rounding room -- only to have the same attending who wrote me up use the phrase to describe a patient one month later while I'm standing there.
8) Chastised for not being able to see 12-15 patients per half day in clinic when the attendings were regularly scheduled for a "busy day" with 7.

That's really horrible. Wow.

Were there any red flags on interviewing? Would you have done residency elsewhere if you had known what the culture would be like?

 

[JustPlainBill]

That's really horrible. Wow.

Were there any red flags on interviewing? Would you have done residency elsewhere if you had known what the culture would be like?

Red flags? Sorta kinda....they had just hired in a former professor of FM from my school and told them they wanted them to producd better FM docs and then 6 months later yanked the rug out from under them. The people I'm really having trouble even being in the same room with today are those trolls from the TCOM class of 2008 who told me,"We've got your back." and then threw me to the wolves and joined the pack while it waseating my ass alive. I will never again in this lifetime trust another D.O. from TCOM either personally or professionally, period.

No, I would have gone to UT Tyler and moved my family for 3 years.

 

[rederza]

Red flags? Sorta kinda....they had just hired in a former professor of FM from my school and told them they wanted them to producd better FM docs and then 6 months later yanked the rug out from under them. The people I'm really having trouble even being in the same room with today are those trolls from the TCOM class of 2008 who told me,"We've got your back." and then threw me to the wolves and joined the pack while it waseating my ass alive. I will never again in this lifetime trust another D.O. from TCOM either personally or professionally, period.

No, I would have gone to UT Tyler and moved my family for 3 years.

UT Tyler has a med school? Are you a grad from TCOM? I'm having trouble following your post. TCOM from what I remember, is known for producing lots of good FM docs? Edit oh I think you mean you worked with TCOM residents...

 

[SurfingDoctor]

who agrees? http://www.kevinmd.com/blog/2016/09/video-makes-case-must-stand-doctors.html

While there are certainly factors that you can determine yourself for your personal well-being, I grow frustrated by institutions' attempts to fix systemic problems with finger pointing at individual medical students and MDs.

Burnout is a state of mind, essentially depression, in regards to one own field. Abuse is an act. Are they trying to say abuse leads to burnout? I would say that is probably true. Or are they saying burnout is abuse, which doesn't make sense because one is a action and one is a result.

Anyway, if its abuse that is the problem, is it in a specific area? Or is a specific area more problematic that another? I would say that in order to fix something systemic, you need to identify to initial actions or series of action that lead to the outcome. That's called a root cause analysis.

I'm not trying to suggest they are wrong in claiming there is abuse (I personally have not seen medical student abuse and personally wouldn't tolerate it), but in order to fix a problem, you have to identify it's source. Saying that everything in system is the problem (which is what I gathered from that video, unless I missed that this person was focusing on a specific problem) does nothing to alleviate the issue. To use an analogy, if someone has sepsis and the source is a septic joint, one does just keep giving fluids and antibiotics in the hopes that it goes away, you treat the septic hip, then the systemic issues resolve after source control.

 

[JustPlainBill]

UT Tyler has a med school? Are you a grad from TCOM? I'm habututing trouble following your post. TCOM from what I remember, is known for producing lots of good FM docs? Edit oh I think you mean you worked with TCOM residents...

The initial list of sins was during residency. I had some dorks from TCOM 2008 as upper levels when I was an intern. Yes, I graduated from TCOM also. I mistakenly believed in a sense of honor amongst D.O.s in that upperclassmen from your school would help you out if you wound up in the same residency. After all, they had verbalized it to me. Yeah, no such luck...but the whole help-the-guys-below-you probably comes from the fact that I'm a military brat and that's how I was raised....

If I had it to do again, I'd go to UT Tyler FM residency.....