malignant attending

This is one time when it is appropriate to quote House of God. "They can always hurt you more." This is particularly true if he's the surgical attending evaluating you and you're a lowly med student. Keep your head down, answer questions posed, decide if you like surgery and get on with your life.

 

I continue to maintain that the field of medicine has more malignant, personality disordered (i.e. narcissistic, histrionic), and plain-old 'grown up spoiled brat' people and any other profession by far. I, too, have been in situations like you describe. My advice is to just steer clear...keep a low profile and GET THROUGH.

Truth be told...if any of these people had to work in the private sector in a business atmosphere, their social idiocy would not be tolerated for one day. Where else can a person get away with calling their co-workers disparaging names and even throw objects at them or around the room (surgical supplies)?
The more reaction (good or bad) that you give him, the more he feeds off of it like a parasitic lamprey, which simply fuels his perverted desire to continue his inappropriate behavior.


Even if you do like surgery, this one person will not affect your career in an everlasting manner if you don't want it to.

As an aside, I still feel that most physicians that behave this way come from sheltered backgrounds in which they did not have to do any beneath-them "blue collar work," and/or are still attempting to atone for thier miserable highschool lives in which they were made fun of in gym for getting their asses kicked in dodge ball or any other sporting event.

Just my .02

Good luck to you. You will be fine.
(Remember....low profile)

 

If I were you I would drop the whole confrontational thing and don't be obnoxious. I wouldn't be spineless or kiss his ass either. I would be confident, quiet and keep a low profile. Don't worry about the eval, let the cards fall where they will.
Your surgical eval doesn't really matter a whole lot unless you want to do surgery or a surgical subspecialty. Everyone has had to deal with people like this. The funny thing is he may not dislike you as much as you think he does. I ended up getting a great letter from someone like this, and he would chew me out on a daily basis.

 

I feel and understand your frustration, but the playing field is so far from being level, that you are going to get yourself blow out of the water. I had a similar experience with my Psych attending this past summer. He was(still is) bi-polar and completely nuts. He is on meds..and would tweak...so instead of getting mad at him..I would tweak him further...which made me feel better, and got him wound up....in the end...I ended up getting a "B" in a simple rotation, instead of an "A".
Surgery is a pretty solid rotation, and always looks good to get a high grade in it, as well as your IM's. My advice to you is just suck it up, be pleasant, not necessarly spineless, but acknowledge his authority...its not worth the risk of being crushed in the end...which there is a strong likeliness of this happening....

You can play...but know YOU WILL LOSE....and you will hurt in the end...not them.

 

Some real good advice has been already been offered by Yosh and Masonator. I'd like to echo their comments and offer a few of my own. It's unfortunate that you find yourself in the position of working with this type of attending. While the attending is certainly making this an unpleasant experience for you, to say the least, it's important not to fuel the fire. No matter how tempted you are to be confrontational, doing so is not likely to benefit you in any way.

As a student, it's best to remain professional when you encounter difficult personalities (attendings, residents, interns, or patients). In these difficult situations, you may want to explode and lash out at the individual. It's better, however, to keep these emotions inside and maintain a calm demeanor externally. A confrontational approach will often just fan the flames of their anger/agitation.

I am not suggesting that you be spineless nor do I recommend kissing a.... I do recommend that you work hard, take good care of your patients, learn a lot, and be the best team player that you can. Conduct yourself with the highest degree of professionalism. The others on your surgery team will take notice of that. Also remember that in surgery, the hierarchy means a lot. That is, the junior members of the team are supposed to show the senior members of the team respect. Although it can be difficult to respect the attending you have described given his behavior, we can be fairly confident that this attending is not used to having junior members of the team be confrontational with him (remember everybody else you're working with is kissing ...). In the end, a confrontational attitude may hurt you on the evaluation.

Best of luck,

Samir Desai

 

I agree with the last three responses. One more perspective - it's important for your personal emotional equilibrium to deal with this situation with dignity and grace. It is important to establish good emotional responses early in your career to difficult personalities and situations. There is a tendency to repeat emotional responses to similar situations. The first time I dealt with a DKA patient, I freaked out a bit, and even now after a year of seeing multiple diabetic pts, I still flinch a bit remembering my initial emotional uncertainty.

If you are concerned about your evaluation, keep in mind you will have a chance to explain this in a Dean's letter. Your Dean will probably have dealt with student evaluations from this particular professor in the past. Most likely, if his evaluation is the only negative critique you receive all year, then you will not have a problem with your application.

 

"Last 3 responses?" This implies that my response was unacceptable. My inherent advice was essentially no different from the others', only with added commentary about the personality disorders that people of this unprofessional caliber tend to have in the world of medicine.

Making excuses for these peoples' unprofessional behavior is wrong and only serves to demonstrate your own cowardice to those who had the great privilage to be born a few years before you. This does not imply disrespect toward those in these settings. In fact, you should ever show them respect, AS THEY SHOULD TO YOU. Simply being an attending or "being used to receiving respect" is neither logical nor self-fulfilling...for you or them.

Unprofessionalism is never wanted, excused, or acceptable regardless of the circumstances. These malignancies to the profession have done nothing but serve hostility and discontent wherever they walk, and frankly should be punished for doing so. In this bizarro world of medicine, personality disorders abound. Simply keep this in mind and get through. Remember their unprofessionalism when you are in their position, so that you never repeat it.

One evaluation does not a resident candidate make.....remember this.