Our team's interns were given an assignment yesterday by the team's attending (I am a 3rd-year med student). They were told to present data and their own analysis of that data of huge drug trials like ALLHAT and ACCOMPLISH in front of the entire team. In the process, one of the interns mistakenly understood the implications of a trial and was subsequently torn apart by the attending. Evidently the entire purpose of the assignment was to give the interns the tools necessary to evaluate drug trials so that they could prescribe medication they felt was safe according their analysis of the trials. Have any of you guys have experienced something similar to this? Is this something that I should expect as an intern, not that it's a terribly bad/hard thing to keep up on? For the record, this is a community residency program.
Yes, you should definitely expect that. This is a huge part of residency education, designed to teach you how to critically read the medical literature when you are practicing independently. You'll need to be able to evaluate evidence to determine if it is valid, if it proves or disproves what the authors say it does, and if it applies to your patient population. You'll have many opportunities to work on this skill, including journal clubs, team assignments like the one you describe above, and independent reading and research. My medical school had a whole course on it (Evidence-Based Medicine in the 4th year) which has given me an edge during residency.
While all residency programs make an effort to critically read journal articles, not all attendings will tear apart residents when presenting. For example, I have seen journal article clubs that are pretty fun and everybody reads the article, i.e. students and residents and discusses the implications. Sure an attending will have more experience on which to judge the article. I have seen residents miss the point of the article, but they don't get creamed. In the end, either you are up to date in your field and read the articles on a weekly basis or you don't. It is easy to see who is up on their stuff and residents who can't interpret the meaning of a study stick out like a sore thumb and they basically only read what they have to.
Are you asking whether you'll have to learn to interpret the literature? I'd say yes. It's a good thing in general. Are you asking whether an attending will decide to rip you a new one when you are an intern? Answer is probably yes, almost certainly yes! I actually had this experience much more as a medical student, particularly in 3rd year, but that's because my med school was really hard core I think. Some attendings just like to be tough and a few are even sadistic. Pretty much anyone who has a higher rank can abuse you a bit if they want to. It's kind of like being in the military.
Happens all the time in Journal Club here, or when a resident is talking about a relevant paper during M&M.
