Med school self-reflections - Pearls of wisdom for clinical rotations, by Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
After finishing med school I randomly started writing about my experiences. I was doing it at first as just a self-reflective/-therapy exercise, and then found myself writing for many days at a time. In the end, I developed this document.

Colloquially, you could think of this as a version of a 'Dos and Don'ts of clinical rotations" PDF. But I haven't formally organized it that way.

I hope you find this even minimally helpful,

~Phloston
 

Attachments

TorsoLigament

2+ Year Member
Jun 23, 2014
36
15
New York
Status
Medical Student
Appreciate this post. Very well written.

Kudos & Congrats.
 
  • Like
Reactions: Vulfman

Labrat07

5+ Year Member
May 20, 2013
300
249
Status
Medical Student (Accepted)
Thank you for posting this. I just read part of it but I really enjoyed it. There are many valuable lessons being taught here outside of academic. They are gems. Thank you so much!!
 
About the Ads
Mar 8, 2015
972
1,308
Status
Medical Student
This is pretty awesome, and thank you so much for sharing. I hope I don't offend you with my inquires, but I do wonder about how generalizable some of this information is? I am not even a med student yet, but I do a decent job of interacting with people. I am wondering if some of your techniques, specifically like those in which you are describing down to the details of voice tone and where your eyes should be pointing and for how long, are applicable to others? It seems like you realized how you were unaware of social graces and then resorted to "hardcoding" these interactions into your life (to great benefit for you) in order to fill in for what you were not naturally able to do. Others may have different, more dynamic abilities to intuit social cues and these hardcoded interactions may actually come across as more forced or unnatural from them. Again, I have no experience on the wards or even in medical school, maybe it really does take this level of metacognitive control to thrive, but that sounds a bit depressing to me. Any thoughts on this?

Anyways, a great read!
 
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
This is pretty awesome, and thank you so much for sharing. I hope I don't offend you with my inquires, but I do wonder about how generalizable some of this information is? I am not even a med student yet, but I do a decent job of interacting with people. I am wondering if some of your techniques, specifically like those in which you are describing down to the details of voice tone and where your eyes should be pointing and for how long, are applicable to others? It seems like you realized how you were unaware of social graces and then resorted to "hardcoding" these interactions into your life (to great benefit for you) in order to fill in for what you were not naturally able to do. Others may have different, more dynamic abilities to intuit social cues and these hardcoded interactions may actually come across as more forced or unnatural from them. Again, I have no experience on the wards or even in medical school, maybe it really does take this level of metacognitive control to thrive, but that sounds a bit depressing to me. Any thoughts on this?

Anyways, a great read!
Think of clinical propriety like every day propriety on overdrive. Things you do on the street that are normal can be considered rude in the hospital. If you're asking someone for directions and wave him or her down and say, "Excuse me, do you know where x is?" There's no issue. But the baseline is a lot higher in a healthcare setting, and saying sorry before and after shows you're unquestionably putting the person in front of you first.

If you do end up attending a medical school, you'll interact with a lot of staff just fine and won't ever know something comes off rude until you look back and see your own behavior changing. And if you asked me before I started med school I certainly would have said I got on well with people. The character you expect out of your doctor though doesn't have wiggle room to be borderline, which is why a lot of these interactive mechanisms can seem excessive.

Hope that helps,
 

mimelim

Vascular Surgery
7+ Year Member
Sep 19, 2011
4,878
14,359
Status
Attending Physician
Strong write-up. Only real disagreement...

I strongly disagree with your coffee thoughts. You should not be buying coffee (or anything for that matter) for residents/others. That is inappropriate on several levels. It is one thing to integrate into a team and intermittently buy coffee for one another when you can't all go to starbucks. But, to stand in line together (like your example) and then pay for coffee is pretty poor form on the part of the physician and can lead to awkward/bad team dynamics. Further, some of us do not drink coffee. I can comfortably say that I work longer hours than anyone you rotated with through medical school and I do not drink coffee at all and I am certainly not the only one.
 
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
Strong write-up. Only real disagreement...

I strongly disagree with your coffee thoughts. You should not be buying coffee (or anything for that matter) for residents/others. That is inappropriate on several levels. It is one thing to integrate into a team and intermittently buy coffee for one another when you can't all go to starbucks. But, to stand in line together (like your example) and then pay for coffee is pretty poor form on the part of the physician and can lead to awkward/bad team dynamics. Further, some of us do not drink coffee. I can comfortably say that I work longer hours than anyone you rotated with through medical school and I do not drink coffee at all and I am certainly not the only one.
I don't think our perspectives are in discord here. The example you're referring to is when I was buying another student a coffee on my tab, not the whole team. But either way, having one ready for the intern for pre-rounds is fine as long as it falls in line with good character.
 

AzizImSorry

2+ Year Member
Jun 9, 2015
215
204
Status
Medical Student (Accepted)
I don't think our perspectives are in discord here. The example you're referring to is when I was buying another student a coffee on my tab, not the whole team. But either way, having one ready for the intern for pre-rounds is fine as long as it falls in line with good character.
This post was enlightening, so I hope you don't get the wrong impression, but I think the coffee thing was a bit weird too....

"Don’t buy the intern coffee every day. One or two days per week is good." p. 15

" I would arrive to hospital around 6:08 and get them venti coffees from our hospital Starbucks and label the caps with “The Intern” and “JHO”. I did this maybe twice/week despite them protesting..." p. 16

"On this term I bought the intern and other med student coffee twice/week" p. 17

"Buy large coffees once or twice a week for others" p. 17

How much do you estimate you spent on coffee for other people on rotations? I'm sure your intentions were genuine and thoughtful, but I'm not sure I would do the same. Maybe you think I would be a bad student.

Also, the whole "If you’re not drinking large coffees, you’re not working hard enough" sentiment is a little dramatic. That's like saying if you don't sweat at least 3 buckets-worth during a workout, you aren't working out hard enough. Because the first two buckets don't count for anything...

I don't drink coffee myself, but I'm just wondering how this mentality comes about. I mean... "if they only drink small/medium, they’ll toughen up." Literally changing someone's order - "On my tab he once ordered: 'I’ll have a small, skinny cappuccino please.' I inserted myself and said, 'He’ll have a large, heavy cappuccino please.'" is something you see on TV
 
Mar 8, 2015
972
1,308
Status
Medical Student
Literally changing someone's order - "On my tab he once ordered: 'I’ll have a small, skinny cappuccino please.' I inserted myself and said, 'He’ll have a large, heavy cappuccino please.'" is something you see on TV
If that happened to me I would've been forced to find a way to secretly toss the coffee. Drinking that would have given me the SS (the sh*ts and the shakes).
 

Psai

This space for lease
Removed
5+ Year Member
Jan 2, 2014
11,514
23,532
ヽ(´ー`)ノ
Status
Resident [Any Field]
This post was enlightening, so I hope you don't get the wrong impression, but I think the coffee thing was a bit weird too....

"Don’t buy the intern coffee every day. One or two days per week is good." p. 15

" I would arrive to hospital around 6:08 and get them venti coffees from our hospital Starbucks and label the caps with “The Intern” and “JHO”. I did this maybe twice/week despite them protesting..." p. 16

"On this term I bought the intern and other med student coffee twice/week" p. 17

"Buy large coffees once or twice a week for others" p. 17

How much do you estimate you spent on coffee for other people on rotations? I'm sure your intentions were genuine and thoughtful, but I'm not sure I would do the same. Maybe you think I would be a bad student.

Also, the whole "If you’re not drinking large coffees, you’re not working hard enough" sentiment is a little dramatic. That's like saying if you don't sweat at least 3 buckets-worth during a workout, you aren't working out hard enough. Because the first two buckets don't count for anything...

I don't drink coffee myself, but I'm just wondering how this mentality comes about. I mean... "if they only drink small/medium, they’ll toughen up." Literally changing someone's order - "On my tab he once ordered: 'I’ll have a small, skinny cappuccino please.' I inserted myself and said, 'He’ll have a large, heavy cappuccino please.'" is something you see on TV
I bought a resident coffee once in all of med school and that's cause we were super chill and I knew he had a terrible day the day before. Usually they bought stuff for me. But twice a week? For real?
 

AzizImSorry

2+ Year Member
Jun 9, 2015
215
204
Status
Medical Student (Accepted)
I bought a resident coffee once in all of med school and that's cause we were super chill and I knew he had a terrible day the day before. Usually they bought stuff for me. But twice a week? For real?
Twice a week for 2 people at 3$ a cup for two years.... that **** adds up! Next time just buy each intern a coffee maker. Teach a man to fish, ya know?
 
About the Ads

Psai

This space for lease
Removed
5+ Year Member
Jan 2, 2014
11,514
23,532
ヽ(´ー`)ノ
Status
Resident [Any Field]
Twice a week for 2 people at 3$ a cup for two years.... that **** adds up! Next time just buy each intern a coffee maker. Teach a man to fish, ya know?
Start with a hot water boiler and some mugs. The avantco stainless steel coffee urn is a great value buy and you can get it for under 50 dollars. The mugs should be nondescript but memorable enough so that each resident can stake a claim to one and form a bond with it. White or any other light color is good so that they can see the coffee in them and associate the right feelings with the lovely mahogany hues. Visual cues are an important factor in what we're trying to do. But make sure they have different phrases like #1 doctor, #1 dad, #1 wonderwoman, #1 dog owner, whatever fits your residents' personalities best. Buy some instant coffee at any supermarket; I'm partial to tasters' choice. When you only drink instant coffee, you start to develop a taste for it, even start to crave it. You begin by giving out the coffee for free, even have some ready for them when they come in or after grand rounds. When you can tell that they have a visceral need for your coffee, that's when you start charging them. Small amounts at first, maybe 5 cents per packet but once you know they're addicted, you start jacking up the price. IOUs are okay as long as they know that you are keeping meticulous records and that collections come due regularly. Make a clear example out of the ones that don't pay to keep the others in line. Once you have them up to 10 cups a day, you'll be charging 50 cents per pack. That's barely the cost of a cup of coffee at starbucks! They're practically saving money!
 

AzizImSorry

2+ Year Member
Jun 9, 2015
215
204
Status
Medical Student (Accepted)
I don't think you've offended anyone... not me anyway.
Start with a hot water boiler and some mugs. The avantco stainless steel coffee urn is a great value buy and you can get it for under 50 dollars. The mugs should be nondescript but memorable enough so that each resident can stake a claim to one and form a bond with it. White or any other light color is good so that they can see the coffee in them and associate the right feelings with the lovely mahogany hues. Visual cues are an important factor in what we're trying to do. But make sure they have different phrases like #1 doctor, #1 dad, #1 wonderwoman, #1 dog owner, whatever fits your residents' personalities best. Buy some instant coffee at any supermarket; I'm partial to tasters' choice. When you only drink instant coffee, you start to develop a taste for it, even start to crave it. You begin by giving out the coffee for free, even have some ready for them when they come in or after grand rounds. When you can tell that they have a visceral need for your coffee, that's when you start charging them. Small amounts at first, maybe 5 cents per packet but once you know they're addicted, you start jacking up the price. IOUs are okay as long as they know that you are keeping meticulous records and that collections come due regularly. Make a clear example out of the ones that don't pay to keep the others in line. Once you have them up to 10 cups a day, you'll be charging 50 cents per pack. That's barely the cost of a cup of coffee at starbucks! They're practically saving money!
Hahahaha so unnecessary
 

sb247

Doer of things
7+ Year Member
Jul 5, 2012
21,789
34,605
Galt's Gulch
forums.studentdoctor.net
Start with a hot water boiler and some mugs. The avantco stainless steel coffee urn is a great value buy and you can get it for under 50 dollars. The mugs should be nondescript but memorable enough so that each resident can stake a claim to one and form a bond with it. White or any other light color is good so that they can see the coffee in them and associate the right feelings with the lovely mahogany hues. Visual cues are an important factor in what we're trying to do. But make sure they have different phrases like #1 doctor, #1 dad, #1 wonderwoman, #1 dog owner, whatever fits your residents' personalities best. Buy some instant coffee at any supermarket; I'm partial to tasters' choice. When you only drink instant coffee, you start to develop a taste for it, even start to crave it. You begin by giving out the coffee for free, even have some ready for them when they come in or after grand rounds. When you can tell that they have a visceral need for your coffee, that's when you start charging them. Small amounts at first, maybe 5 cents per packet but once you know they're addicted, you start jacking up the price. IOUs are okay as long as they know that you are keeping meticulous records and that collections come due regularly. Make a clear example out of the ones that don't pay to keep the others in line. Once you have them up to 10 cups a day, you'll be charging 50 cents per pack. That's barely the cost of a cup of coffee at starbucks! They're practically saving money!
 
Aug 2, 2013
44
7
Status
Medical Student
Start with a hot water boiler and some mugs. The avantco stainless steel coffee urn is a great value buy and you can get it for under 50 dollars. The mugs should be nondescript but memorable enough so that each resident can stake a claim to one and form a bond with it. White or any other light color is good so that they can see the coffee in them and associate the right feelings with the lovely mahogany hues. Visual cues are an important factor in what we're trying to do. But make sure they have different phrases like #1 doctor, #1 dad, #1 wonderwoman, #1 dog owner, whatever fits your residents' personalities best. Buy some instant coffee at any supermarket; I'm partial to tasters' choice. When you only drink instant coffee, you start to develop a taste for it, even start to crave it. You begin by giving out the coffee for free, even have some ready for them when they come in or after grand rounds. When you can tell that they have a visceral need for your coffee, that's when you start charging them. Small amounts at first, maybe 5 cents per packet but once you know they're addicted, you start jacking up the price. IOUs are okay as long as they know that you are keeping meticulous records and that collections come due regularly. Make a clear example out of the ones that don't pay to keep the others in line. Once you have them up to 10 cups a day, you'll be charging 50 cents per pack. That's barely the cost of a cup of coffee at starbucks! They're practically saving money!
Reps for life
 

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
Thank you for putting this together--lots of obvious though sometimes forgotten advice--but it has a lot of odd advice too. I've trained in Australia just like you, so it seems even odder in that context (where student evaluations mean so little, individual relationships matter much more, etc.).

A 15-second template on asking somebody for an obs chart? With multiple examples including various tones of voice? With explanations for eye contact? Why not, "Pardon, where's X? Got it. Thank you"! You may be trying very hard to convey an impression, but people are busy trying to get things done. At some point, you gotta stop calling attention to yourself. Be kind, be polite, but be efficient.

Buying coffee twice a week for your intern? You're an international student attending medical school on high-interest loans with no guarantee of a job when you graduate. It's not even close to fair. Everyone knows this, and it probably makes them feel incredibly uncomfortable. I bought a very good registrar an ice cream cone. Once. And I've received outstanding evaluations on all my rotations both in Australia and the US. (I do send thank you emails though--when genuinely deserved.)

"The answer is always: why of course you do." Really? I'm at the point where I'll kindly refuse scut work from an intern that's puts zero effort in teaching. They're getting paid to do it (including overtime in Australia). You're paying for the privilege. I'll do anything and everything for my team (even happily transporting patients or changing sheets when we were short on staff), but if some random intern asks for bloods on patient X, I'll very politely say "Sorry, I'm already doing A, B, and C" (unless they look well and truly desperate). Part of being a doctor is learning how to develop healthy boundaries. Otherwise, you're setting yourself up for misery down the road.

"Do not ever, by the pain of death, no matter how subtly, answer up the hierarchy or one-up anyone." Completely agree. But the corollary is this: "Always blame your success on your seniors." This gesture accomplishes three things: 1) it's humble and collegial and gets noticed as being such (it's also probably true), 2) it makes your senior look good, and 3) it makes your seniors more willing to teach you. I'll never forget a US Sub-I where I was assigned a 3rd year to teach. I 8/8 guessed what the attending's pimp questions were going to be and prepped the student accordingly. The attending was thoroughly impressed with the student, but the student said, "Thank you, but it's lymphocyte's fault. He/she taught me all about it." My jaw dropped. It was an incredibly kind thing to say; it resulted in very positive comments on both of our evaluations; and I would do anything for him after that.

I took this lesson to heart when I returned to Australia, and I made a habit of CC'ing the consultants all my thank you emails to my JMO's (for whom evaluations matter a lot more). I now have a strong network of grateful contacts. Make your colleagues look good. Not to convey an impression, not to appear that you're X, Y, and Z, but because it's a genuinely kind thing to do. Hell, it's even mentioned in the Hippocratic Oath. (Somewhere in the back.)

And then there's this:

"The reg then asked me. My answer was, “Well you know I’m not allowed to answer up the hierarchy.” And they both were like, “Hah, what do you mean?” And I said, “You know, I’m not supposed to do that.” And this was done in such a way where it came off as conscientious, rather than supercilious, because it was in concord with the rest of my behavior. I know that both the reg and JHO saw it as a good move."
This actually sounds like a very bizarre move. Again, you're trying very hard to convey an impression, but people are busy trying to get things done. Why not say, "I think Dr JHO said before that it was X. Isn't that right"? Done. Face-saving for all involved.

Don't take this the wrong way, but I know you're taking time off after medical school, and I feel like you'll end up like Michael J. Burry or someone similar. That's meant as a massive compliment and also as an intimation for psychological evaluation. I wish you the best of luck.
 
Last edited:
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
A 15-second template on asking somebody for an obs chart? With multiple examples including various tones of voice? With explanations for eye contact? Why not, "Pardon, where's X? Got it. Thank you"! You may be trying very hard to convey an impression, but people are busy trying to get things done. At some point, you gotta stop calling attention to yourself. Be kind, be polite, but be efficient.
Interesting you frame your statement as if one would intentionally make asking for a chart a 15-second encounter. Reminds me of when a reporter accused Obama of being "content" about not tying release of American hostages to the Iran deal.

If you say, "I'm sorry to bother you. I know you're busy. Do you have any idea where the bed chart is for bed 21?" And the nurse knows where it is, the interaction takes 3 seconds. If you said, "Pardon, where's X?" And the nurse doesn't know where it is, your interaction will still take longer. So I'm not quite following your logic here about efficiency.

I personally would view, "Pardon, where's X?" as quite abrupt and rude. This isn't about giving circumlocutory and long-winded intros that consume others' time; it's about quick interactions that convey conscientiousness.

"Buying coffee twice a week for your intern? You're an international student attending medical school on high-interest loans with no guarantee of a job when you graduate. It's not even close to fair. Everyone knows this, and it probably makes them feel incredibly uncomfortable.
Your second and third sentences communicate entitlement. Paying for med school is real life. Life isn't fair. If you feel resentment for your circumstances and somehow that means one shouldn't consider doing things for others, you'll find yourself in a very insular world. I knew a guy who was dirt poor who would buy food every session for his PBL/CBL group; people told him to stop, and it probably made them uncomfortable because they themselves couldn't conceive of spending that much on others, but he was just a legend of a guy.

"I bought a very good registrar an ice cream cone. Once.
This I find very bizarre. And really, was the registrar very good? In your expert opinion, how do you know he or she wasn't just slightly above average. However it's awesome to see the very good registrar won an ice cream cone from you. Maybe if I'm fortunate enough to get the same very good evaluation from you, I'd get a sorbet or something.

"And I've received outstanding evaluations on all my rotations both in Australia and the US. (I do send thank you emails though--when genuinely deserved.)
You must be an outstanding guy to work with. It's good to see you're elite enough to make the assessment as to when a thank-you email is well-deserved.

"The answer is always: why of course you do." Really? I'm at the point where I'll kindly refuse scut work from an intern that's puts zero effort in teaching. They're getting paid to do it (including overtime in Australia). You're paying for the privilege.
Red flag. I find this to be a very disturbing statement. You're at the point? You're at the point of what? Of being overworked and realizing medicine is a busy career? At the point of causing harm to yourself or others?

Refusing to do jobs because an intern isn't catering to you is rock-bottom self-focused and entitled.

People are busy. The intern works long hours and is managing patients. He or she isn't required to enthusiastically cater to you.

And if you feel in any way the intern isn't busy, either you have no idea what an intern actually does or he or she senses your entitlement and doesn't want to work with you. If I had a med student working under me who refused to do jobs, I'd have a sit-down with him or her. And that whole process would consume even more of everyone's time.

I'll doanything and everything for my team (even happily transporting patients or changing sheets when we were short on staff), but if some random intern asks for bloods on patient X, I'll very politely say "Sorry, I'm already doing A, B, and C" (unless they look well and truly desperate). Part of being a doctor is learning how to develop healthy boundaries. Otherwise, you're setting yourself up for misery down the road.
Once again, red flag. Also very self-focused and entitled. It's good to see that you are choosing which jobs you want to do. This conduct wouldn't make anyone like you, nor is it professional, I can guarantee you that. Any healthy boundaries you develop need to take others into account. A self-entitled approach will actually make you miserable. It's not about what jobs you want to do; it's about getting things done to help the patients and intern.

"Do not ever, by the pain of death, no matter how subtly, answer up the hierarchy or one-up anyone." Completely agree. But the corollary is this: "Always blame your success on your seniors." This gesture accomplishes three things: 1) it's humble and collegial and gets noticed as being such (it's also probably true), 2) it makes your senior look good, and 3) it makes your seniors more willing to teach you. I'll never forget a US Sub-I where I was assigned a 3rd year to teach. I 8/8 guessed what the attending's pimp questions were going to be and prepped the student accordingly. The attending was thoroughly impressed with the student, but the student said, "Thank you, but it's lymphocyte's fault. He/she taught me all about it." My jaw dropped. It was an incredibly kind thing to say; it resulted in very positive comments on both of our evaluations; and I would do anything for him after that.
You must feel real proud that you guessed 8/8 on the attending's pimp questions. Are you sure it wasn't 9/9, or 10/10? It's amazing that the attending was thoroughly impressed by you. You must be a really smart guy.

Point #5 in the PDF might apply strongly to you here.

I took this lesson to heart when I returned to Australia, and I made a habit of CC'ing the consultants all my thank you emails to my JMO's (for whom evaluations matter a lot more). I now have a strong network of grateful contacts. Make your colleagues look good. Not to convey an impression, not to appear that you're X, Y, and Z, but because it's a genuinely kind thing to do. Hell, it's even mentioned in the Hippocratic Oath. (Somewhere in the back.)
I sense narcissism. To be completely honest, I find it very unusual that you'd CC all consultants in thank-you emails to others. Once again, self-entitlement. Do they need to spend their limited time seeing the emails you write to someone else? Why do you think your evaluation and thoughts of a superior are so important?

The consultant can acknowledge you were fond of your superior, but whether he or she writes a good evaluation for his or her reg or resident is based almost entirely on the work that person does and his or her character, not an email you write. If you did this as a one-off thing, that's fine. But the fact that you say it's a routine of yours shows you think your evaluations are somehow so important.

And then there's this:

"The reg then asked me. My answer was, “Well you know I’m not allowed to answer up the hierarchy.” And they both were like, “Hah, what do you mean?” And I said, “You know, I’m not supposed to do that.” And this was done in such a way where it came off as conscientious, rather than supercilious, because it was in concord with the rest of my behavior. I know that both the reg and JHO saw it as a good move."
This actually sounds like a very bizarre move. Again, you're trying very hard to convey an impression, but people are busy trying to get things done. Why not say, "I think Dr JHO said before that it was X. Isn't that right"? Done. Face-saving for all involved.
- When you put others first, it's not about trying to convey any type of impression. Yes, people are working to get things done. Which is why moving on is sometimes the best solution.

Don't take this the wrong way, but I know you're taking time off after medical school, and I feel like you'll end up like Michael J. Burry or someone similar. That's meant as a massive compliment and also as an intimation for psychological evaluation. I wish you the best of luck.
I can't quite share the sentiment that forgoing residency, giving away all of my possessions, and moving to Japan after med school are in line with a pecuniary trajectory. If you mean to say you're aware not everyone makes his or her life solely about medicine, that's reasonable.
 

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
Interesting you frame your statement as if one would intentionally make asking for a chart a 15-second encounter. Reminds me of when a reporter accused Obama of being "content" about not tying release of American hostages to the Iran deal.

If you say, "I'm sorry to bother you. I know you're busy. Do you have any idea where the bed chart is for bed 21?" And the nurse knows where it is, the interaction takes 3 seconds. If you said, "Pardon, where's X?" And the nurse doesn't know where it is, your interaction will still take longer. So I'm not quite following your logic here about efficiency.

I personally would view, "Pardon, where's X?" as quite abrupt and rude. This isn't about giving circumlocutory and long-winded intros that consume others' time; it's about quick interactions that convey conscientiousness.



Your second and third sentences communicate entitlement. Paying for med school is real life. Life isn't fair. If you feel resentment for your circumstances and somehow that means one shouldn't consider doing things for others, you'll find yourself in a very insular world. I knew a guy who was dirt poor who would buy food every session for his PBL/CBL group; people told him to stop, and it probably made them uncomfortable because they themselves couldn't conceive of spending that much on others, but he was just a legend of a guy.



This I find very bizarre. And really, was the registrar very good? In your expert opinion, how do you know he or she wasn't just slightly above average. However it's awesome to see the very good registrar won an ice cream cone from you. Maybe if I'm fortunate enough to get the same very good evaluation from you, I'd get a sorbet or something.



You must be an outstanding guy to work with. It's good to see you're elite enough to make the assessment as to when a thank-you email is well-deserved.



Red flag. I find this to be a very disturbing statement. You're at the point? You're at the point of what? Of being overworked and realizing medicine is a busy career? At the point of causing harm to yourself or others?

Refusing to do jobs because an intern isn't catering to you is rock-bottom self-focused and entitled.

People are busy. The intern works long hours and is managing patients. He or she isn't required to enthusiastically cater to you.

And if you feel in any way the intern isn't busy, either you have no idea what an intern actually does or he or she senses your entitlement and doesn't want to work with you. If I had a med student working under me who refused to do jobs, I'd have a sit-down with him or her. And that whole process would consume even more of everyone's time.



Once again, red flag. Also very self-focused and entitled. It's good to see that you are choosing which jobs you want to do. This conduct wouldn't make anyone like you, nor is it professional, I can guarantee you that. Any healthy boundaries you develop need to take others into account. A self-entitled approach will actually make you miserable. It's not about what jobs you want to do; it's about getting things done to help the patients and intern.



You must feel real proud that you guessed 8/8 on the attending's pimp questions. Are you sure it wasn't 9/9, or 10/10? It's amazing that the attending was thoroughly impressed by you. You must be a really smart guy.

Point #5 in the PDF might apply strongly to you here.



I sense narcissism. To be completely honest, I find it very unusual that you'd CC all consultants in thank-you emails to others. Once again, self-entitlement. Do they need to spend their limited time seeing the emails you write to someone else? Why do you think your evaluation and thoughts of a superior are so important?

The consultant can acknowledge you were fond of your superior, but whether he or she writes a good evaluation for his or her reg or resident is based almost entirely on the work that person does and his or her character, not an email you write. If you did this as a one-off thing, that's fine. But the fact that you say it's a routine of yours shows you think your evaluations are somehow so important.



- When you put others first, it's not about trying to convey any type of impression. Yes, people are working to get things done. Which is why moving on is sometimes the best solution.



I can't quite share the sentiment that forgoing residency, giving away all of my possessions, and moving to Japan after med school are in line with a pecuniary trajectory. If you mean to say you're aware not everyone makes his or her life solely about medicine, that's reasonable.
I've clearly struck a chord, to the point where you've very much misconstrued my points (e.g. very good registrar from a teaching point of view, spur of the moment, and I can't afford to spend borrowed money on others; you keep writing about how buying food makes others feel uncomfortable and yet still somehow reflects well; random intern vs. the team I'll do anything for--with the random intern potentially calling me away from helping my primary team (and I wrote that I would still help if they really seemed to need it vs merely pawning off scut work); the attending was thoroughly impressed by the student, and from that experience, I learned how kind it can be to make others look good; JMOs get evaluated for, in part, teaching so I'm trying to provide quotes--in the sense of a 360 review, which is important in an Australian context; by CCing the consultant, it also becomes a thank you note, effectively, to the team, etc.).

I don't want to argue with you. I really do wish you all the best in your future plans. And the Burry reference was not at all with regard to his financial savvy.
 
Last edited:
About the Ads
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
I've clearly struck a chord, to the point where you've very much misconstrued my points (e.g. very good registrar from a teaching point of view, you keep writing about how buying food makes others feel uncomfortable and yet still somehow reflects well, random intern vs. the team I'll do anything for, the attending was thoroughly impressed by the student, JMOs get evaluated for, in part, teaching so I'm trying to provide quotes--in the sense of a 360 review, which is important in an Australian context, etc.).

I don't want to argue with you. I really do wish you all the best in your future plans. And the Burry reference was not at all just with regard to his financial savvy.
You've still missed the point.

Doesn't matter in which way you thought the registrar was very good. It's your mere evaluation of him or her that's concerning.

Random intern vs intern on your team - who cares. So helping out someone not on your team is less important? The implication is that the need or request of the "random intern" is somehow trivial, or that the intern is bugging you because what you're doing is much more important.

The attending was thoroughly impressed by the student because of you, we know.

No arguments. I just think your critical analysis was a good showcase of red flags and self-focus.
 

Henry101

2+ Year Member
Jul 15, 2014
519
354
Status
Medical Student
Mr. Dr. @Phloston, do you have the preclinical version of this? I'm starting med school in the fall and I feel really lost. I was the kind of person to cram 1 day before a test and score above average and I don't know how to transition into medical school.
 

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
I just think your critical analysis was a good showcase of red flags and self-focus.
Might I just point out that you entitled your personal experiences as a 3.5 year medical student as Pearls of Wisdom?

Again, I appreciate your Joel Osteen-like aphorisms, but some of them really do come across as quite odd, as your other colleagues have mentioned above. I'm only highlighting this because any medical student who followed all of this advice would probably appear odd as well.
 
Last edited:
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
Might I just point out that you entitled your personal experiences as a 3.5 year medical student as Pearls of Wisdom?

Again, I appreciate your Joel Osteen-like aphorisms, but some of them really do come across as quite odd, as some of your other colleagues have mentioned above. I'm only highlighting this because any medical student who followed all of this advice would probably appear odd as well.
Truthfully, I don't want you to take our above discourse (i.e., post exchanges) the wrong way. This place really is a SDN and it doesn't hurt to get some constructive feedback here and there.
 
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com

Psai

This space for lease
Removed
5+ Year Member
Jan 2, 2014
11,514
23,532
ヽ(´ー`)ノ
Status
Resident [Any Field]
You've still missed the point.

Doesn't matter in which way you thought the registrar was very good. It's your mere evaluation of him or her that's concerning.

Random intern vs intern on your team - who cares. So helping out someone not on your team is less important? The implication is that the need or request of the "random intern" is somehow trivial, or that the intern is bugging you because what you're doing is much more important.

The attending was thoroughly impressed by the student because of you, we know.

No arguments. I just think your critical analysis was a good showcase of red flags and self-focus.
You don't need to help someone that's not on your team. The random intern should do their own work, not poach a medical student from another service
 
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
You don't need to help someone that's not on your team. The random intern should do their own work, not poach a medical student from another service
If an intern asks a medical student for assistance with something, then he or she should acquiesce. Not doing so is a red flag.
 
  • Like
Reactions: Crayola227

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
If an intern asks a medical student for assistance with something, then he or she should acquiesce. Not doing so is a red flag.
But @Phloston, by what authority are you making this declaration? You're not a doctor. You haven't finished 4th year. And correct me if I'm wrong, but you haven't been asked to evaluate junior medical students. Surely some of these declarations (or "Pearls of Wisdom") are up for discussion (and that's all anybody's offering at this point, for the benefit of preclinicals--to which you've admirably contributed)?

Obliging a random intern potentially distracts you from working with your primary team. In Australia, this could literally mean losing track of where your team physically is (I've seen it happen to 3rd years). In the US (at least for a Sub-I), this could mean not evaluating your patients, not having your notes done, not teaching your medical students, not responding to your consults, or even missing your attending's rounds. You got your own patients to worry about...

Interns are people. People sometimes make selfish requests. If any intern is desperate, I will always help them. But if it seems like their pawning off scut work, and they aren't on my team, then I'll politely decline. Again, I've happily transported patients and changed bed sheets when our team was short staffed, but no way I'm taking a routine FBC for a patient on the Endocrine ward if I'm meaningfully involved with my Neuro team... (yes, this has happened and the senior registrar caught wind--through the resident, not me--and had a sit-down with the intern). Is that really a red flag?
 
Last edited:
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
But @Phloston, by what authority are you making this self-confident proclamation? You're not a doctor. You haven't finished 4th year.
I finished med school. Yes I'm a doctor.

And correct me if I'm wrong, but you haven't even been asked to evaluate junior medical students. Surely some of these proclamations are up for discussion (and that's all anybody's offering at this point, for the benefit of preclinical students)? How are you calling your N=1 personal experiences "Pearls of Wisdom" and then taking others to task for being self-focused?
I wouldn't post here on SDN if I didn't think this stuff is up for discussion. The point on coffee is my personal touch and by all means people will feel 50/50 on that. However my reflections on unequivocally putting others first, apologizing, and general conduct I'm quite firm on.

Obliging a random intern potentially distracts you from working with your primary team. In Australia, this could literally mean losing track of where your team physically is (I've seen it happen to 3rd years). In the US (at least for a Sub-I), this could mean not evaluating your patients, not having your notes done, not teaching your medical students, not responding to your consults, or even missing your attending's rounds. You got your own patients to worry about...

Interns are people. People sometimes make selfish requests. If any intern is desperate, I will always help them. But if it seems like their pawning off scut work, and they aren't on my team, then I'll politely decline.
If an intern asks something of a medical student, it's outright expected the student acquiesces. Doesn't matter who's on team A vs B. It's part of the learning process for med students to take on the jobs of an intern. If anything, a medical student should be privileged to be running a job. I wouldn't suggest taking on the perspective that a "random intern" is indolent and attempting to circumvent his or her responsibilities by chucking jobs at a med student.

I am very firm here that if a med student declines a request from an intern it's a tremendous red flag.

If you're literally in the process of inserting a cannula, then, OK, a request can wait 30 seconds. But you can't reject the request, even if "politely." No matter what you're doing as a med student, if a doctor asks for your help with something, you drop what you're doing and attend to that.

Remember, it's a privilege to run a job for an intern. Not a chore. What will make you a good doctor is learning the job of the intern. Try to see the positive here.

Again, I've transported patients and changed bed sheets when our team was short staffed, but no way I'm taking a routine FBC for a patient on the Endocrine ward if I'm meaningfully involved with my Neuro team... (yes, this has happened and the senior registrar caught wind--through the resident, not me--and had a sit-down with the intern). Is that really a red flag?
There's no reason to speculate about the specifics of any given scenario you may have been involved in. I speak as a generality that unless you have an exceptionally good reason, never demur an intern's request for anything. And yes it's a massive red flag. Even if you're having "meaningful time" with your team and feel you're learning a lot, it's not about you and it's something you have to suck up.
 
  • Like
Reactions: Crayola227
About the Ads

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
I finished med school. Yes I'm a doctor.



I wouldn't post here on SDN if I didn't think this stuff is up for discussion. The point on coffee is my personal touch and by all means people will feel 50/50 on that. However my reflections on unequivocally putting others first, apologizing, and general conduct I'm quite firm on.



If an intern asks something of a medical student, it's outright expected the student acquiesces. Doesn't matter who's on team A vs B. It's part of the learning process for med students to take on the jobs of an intern. If anything, a medical student should be privileged to be running a job. I wouldn't suggest taking on the perspective that a "random intern" is indolent and attempting to circumvent his or her responsibilities by chucking jobs at a med student.

I am very firm here that if a med student declines a request from an intern it's a tremendous red flag.

If you're literally in the process of inserting a cannula, then, OK, a request can wait 30 seconds. But you can't reject the request, even if "politely." No matter what you're doing as a med student, if a doctor asks for your help with something, you drop what you're doing and attend to that.

Remember, it's a privilege to run a job for an intern. Not a chore. What will make you a good doctor is learning the job of the intern. Try to see the positive here.



There's no reason to speculate about the specifics of any given scenario you may have been involved in. I speak as a generality that unless you have an exceptionally good reason, never demur an intern's request for anything. And yes it's a massive red flag. Even if you're having "meaningful time" with your team and feel you're learning a lot, it's not about you and it's something you have to suck up.
My apologies. I thought you took the year off for Step 1. In that case, Pearl of Wisdom away.

My point is only this: Your primary devotion should always be to 1) your patients and 2) your team, not to any and all interns (a distant third). Doing scut for other teams risks detracting from 1) and 2). If that risk is worth it to you, then that's your prerogative.
 
Last edited:

Psai

This space for lease
Removed
5+ Year Member
Jan 2, 2014
11,514
23,532
ヽ(´ー`)ノ
Status
Resident [Any Field]
Maybe it's different where you're from but as a medical student you're a part of your team and no other. Would a neurology intern be at the beck and call of a surgical resident? No, it's absurd. Students do not have to do the work of other services and the intern asking for a favor from a student from another team is wrong. If they want to teach you something like a line, okay sure go ahead. If they want you to get some records for them and fax some papers to somewhere else, nope not gonna happen.

It's not the student's job to say no to the other guy but their intern or resident should have a word with that intern to set them straight. Not gonna let my med students get scutted out.
 
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
"Hi I'm John, one of the doctors on gastro." [hand shake]

"How are ya. I'm Psai, one of the med students on ortho." [standing idle on ward, not on ward round]

"I'm sorry to bother you, I know you're busy. Would you like to do a cannula on the patient in bed 21."

"Yeah no worries."

"Thanks a lot. The trolley is over here. If you have any issues just let one of the ward nurses know. I'll be across in 7B for the next ten minutes if you need me."

"K cool"

"Once again sorry to bother you."

[Smile] "No no it's all good."

-------

This helps the intern, the intern's team, and most importantly, the patient. The intern would observe as to whether a med student is busy on a ward round and wouldn't approach one in that scenario. But if it appears a student is idle, this is a professional exchange. And gives the med student the privilege of doing intern work, no matter how 'boring' a cannula might seem.
 

Amygdarya

10+ Year Member
Feb 14, 2009
2,135
1,685
Status
Resident [Any Field]
While I enthusiastically agree with Phloston's general point about practicing humility and putting your patients and your* team above your own interests - something many students, sadly, lack and should make an effort to learn - I find some of his specific advice excessive and, well, odd. Take the coffee thing, for example: I don't know what the medical culture is like in other countries, but in the US repeatedly buying coffee for your superiors will be seen as sucking up to them, plain and simple, which will make the said superiors uncomfortable and will sure as h*ll not help you make friends with other students on the team (and other students are something you need to consider as well, since students who get along make their team run smoother - and vice versa; after all, it's ultimately all for the sake of the team, right?).

(I also find the combination of exaggerated self-effacing humility and publishing a 30+ page document titled "Pearls of Wisdom by Phloston" quite curious. (stroking my imaginary beard**) NPD?)

* - I agree with @lymphocyte here that your duty is to *your* team, not any random person with an MD after their name. While in theory it's perfectly wonderful to help everyone on the wards, in reality it can turn into quite a mess as it can distract you from your duties. There is a reason students are assigned to a *team*, not to a floor
** - I'm actually a female, so alas no beard
 

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
While I enthusiastically agree with Phloston's general point about practicing humility and putting your patients and your* team above your own interests - something many students, sadly, lack and should make an effort to learn - I find some of his specific advice excessive and, well, odd. Take the coffee thing, for example: I don't know what the medical culture is like in other countries, but in the US repeatedly buying coffee for your superiors will be seen as sucking up to them, plain and simple, which will make the said superiors uncomfortable and will sure as h*ll not help you make friends with other students on the team (and other students are something you need to consider as well, since students who get along make their team run smoother - and vice versa; after all, it's ultimately all for the sake of the team, right?).

(I also find the combination of exaggerated self-effacing humility and publishing a 30+ page document titled "Pearls of Wisdom by Phloston" quite curious. (stroking my imaginary beard**) NPD?)

* - I agree with @lymphocyte here that your duty is to *your* team, not any random person with an MD after their name. While in theory it's perfectly wonderful to help everyone on the wards, in reality it can turn into quite a mess as it can distract you from your duties. There is a reason students are assigned to a *team*, not to a floor
** - I'm actually a female, so alas no beard
This behaviour would probably be viewed just as, if not more, suspiciously in Australia, which tends be less formal and takes a dim view on "tall poppies" (at least compared to New England, where I did my Sub-Is).

Also, you raise another great point for 2nd and 3rd years to reflect on: @Phloston, did you ever at all consider what impact your behaviours were having on your fellow medical students? You never mention other students in your "Pearls of Wisdom." Trying to make others look good is a huge green flag. Why? Because it betters your team and smoothens the dynamics. They're also your biggest support and future colleagues. Frankly, I would be loathe to work with someone who acted in such an obsequious way. Anecdotally, PDs tend to look for people that'd like to work with as junior colleagues, not coffee fetchers.

You're trying so hard to convey an impression, to project an image, I get it, but collegiality and being (or acting like) a normal, kind, and hardworking person seems to take people much further in life. In Australia, where there aren't Step exams or grades (not really, at least), developing a good reputation really matters, and it takes you that much further indeed.
 
Last edited:
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
While I enthusiastically agree with Phloston's general point about practicing humility and putting your patients and your* team above your own interests - something many students, sadly, lack and should make an effort to learn - I find some of his specific advice excessive and, well, odd. Take the coffee thing, for example: I don't know what the medical culture is like in other countries, but in the US repeatedly buying coffee for your superiors will be seen as sucking up to them, plain and simple, which will make the said superiors uncomfortable and will sure as h*ll not help you make friends with other students on the team (and other students are something you need to consider as well, since students who get along make their team run smoother - and vice versa; after all, it's ultimately all for the sake of the team, right?).
As I said above (and as it exhaustingly appears on this thread), I think people will generally feel 50/50 on the coffee concept. I imagine some naysayers are envisioning a scenario where you have an otherwise unhelpful student buying coffee to be a toady/sycophant. I raise the point that working well with the team, establishing professional rapport with the intern, and buying him or her coffee is acceptable, and should most certainly fall in concord with helpful behaviour.

In other words, if you check the coffee box, the other boxes have to be checked.

(I also find the combination of exaggerated self-effacing humility and publishing a 30+ page document titled "Pearls of Wisdom by Phloston" quite curious. (stroking my imaginary beard**) NPD?)
Hmm, you might be getting at something. Perhaps I'm an egotistical, inward-facing charlatan who wrote this document for attention and fame. I mean this PDF must be an overcompensation and not actually an attempt to help out others. Perhaps giving it a title/alias was a bad idea. Maybe we could get a petition going to rename it "Nonspecific Thoughts on Clinical Rotations - Unauthored".

* - I agree with @lymphocyte here that your duty is to *your* team, not any random person with an MD after their name. While in theory it's perfectly wonderful to help everyone on the wards, in reality it can turn into quite a mess as it can distract you from your duties. There is a reason students are assigned to a *team*, not to a floor
** - I'm actually a female, so alas no beard
Sure. There's order/organization in any healthcare setting. It doesn't remove the consideration that med students neglecting requests by interns is unacceptable. This presents the implication that somehow the intern is irresponsible and misguided for offering a job to a med student not on his or her team.
 
  • Like
Reactions: Crayola227
OP
Phloston

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,709
1,478
Osaka, Japan
mehlmanmedical.com
@Amygdarya, I can assure you that this behaviour would be viewed just as or if not more suspiciously in Australia, which tends be less formal and takes a dim view on "tall poppies" (at least compared to New England, where I did my Sub-Is).
This professional conduct, if anything, applies more to Australia, for the very reason you've stated. If one puts him or herself first (i.e., stands out in a negative way), the threshold is even lower for being red flagged. So yes, in a culture where the idea of the "tall poppy" is pervasive, one has to be preter-conscientious.

Also, you raise another great point for 2nd and 3rd years to reflect on: @Pholoston, did you ever at all consider what impact your behaviours were having on your fellow medical students? You never mention other students in your "Pearls of Wisdom." Trying to make others look good is a huge green flag. Why? Because it betters your team and smoothens the dynamics. They're also your biggest support and future colleagues.
Yes. Regarding the sections in the PDF on not one-upping anyone and internal/external validation (sections 4 + 5), I'd say these are the facets that relate most to working with other students. Especially in section 4, the example I gave about springboarding from John-the-intern's answer, the same is true with students.

I'm not so sure what you mean by "trying to make others look good." What do you mean by that? Do you mean relaying to my superiors how amazing another student is? Because with the email CCing example you gave in your above post, we've already addressed I don't see that as a good move.

To keep this positive (genuinely), I'd say before I finished medical school, the most salient way I consistently "made others look good" (not intentionally) was to communicate their willingness to get involved. I was once with another student (John) and I said to the reg something along the lines of, "John and I are pretty keen to do any jobs if you guys have."

So in other words, this isn't a compliment toward or about any one student per se, but I'd more just work to show other students were keen also, even if they were indifferent.

Frankly, I would be loathe to work with someone who acted in such an obsequious fashion. Anecdotally, PDs tend to look for people that'd like to work with as junior colleagues, not coffee fetchers.
I'd suggest it might be beneficial to imagine someone who is working to truly benefit the team, not a toady who is trying to work the system.

And really, do "PDs" matter here? I'm not talking about trying to impress an intern so that word of how amazing you are makes it's way to some magical PD. We're just talking about being helpful, humble, always available, and occasionally showing you're appreciative of the intern.

You're trying so hard to convey an impression, to project an image, but collegiality and being (or acting like) a normal, kind, hardworking, and emotionally sensitive person seems to take people much further in life.
Here you are again with "trying so hard to convey an impression." No one's trying hard to do anything. Maybe if one hasn't restructured to genuinely put others first, then he or she might feel inclined to project a facade. If you just simply put others first, then there's nothing to think about. There's nothing to try to do. Seriously. I'm trying to stay positive here.

In Australia, where there no Step exams or grades, and developing a great reputation really matters, it takes you that much further indeed.
Indeed. So professional conduct is of the utmost importance. Full agreement.
 

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
Hmm, you might be getting at something. Perhaps I'm an egotistical, inward-facing charlatan who wrote this document for attention and fame. I mean this PDF must be an overcompensation and not actually an attempt to help out others. Perhaps giving it a title/alias was a bad idea. Maybe we could get a petition going to rename it "Nonspecific Thoughts on Clinical Rotations - Unauthored".

Sure. There's order/organization in any healthcare setting. It doesn't remove the consideration that med students neglecting requests by interns is unacceptable. This presents the implication that somehow the intern is irresponsible and misguided for offering a job to a med student not on his or her team.
That's very black and white thinking. I hope you can see middle ground where your advice is both good and awful, and your PDF is both helpful and narcissistic (not in a negative or pathological way, but in the more benign and normal sense of providing narcissistic supply).

And, actually, it is irresponsible to poach medical students from another team.

I've seen two interns (one in the US and one in Australia) being dressed down for treating medical students as fungible commodities.

If you're just floating around, you're fair game... but leaving your team to help a random intern reflects very poor judgement on your part--unless there's actual desperation and you've let your senior resident know.
 
Last edited:

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
I was once with another student (John) and I said to the reg something along the lines of, "John and I are pretty keen to do any jobs if you guys have."

So in other words, this isn't a compliment toward or about any one student per se, but I'd more just work to show other students were keen also, even if they were indifferent.
If you hadn't checked with John before volunteering John, then John would have had every right to bludgeon you with all the coffee mugs in the world.

Does this type of post help you? Do you feel better? I mean should I continually reference post #23 above to point out concerns I have about you. But we can avoid the ad hominems here if at all possible.
Hokay dude. Great Manifesto. Lots for preclinicals to think about.
 
Last edited:
  • Like
Reactions: HungryHydrogen

Athina

5+ Year Member
Jun 30, 2011
40
7
Status
Resident [Any Field]
What's with the "I'm sorry"'s? I find it quite weird to begin every exchange with someone with an I'm sorry and end with one too. It makes you look weak and unsure of yourself. If you have a question, ask it nicely. I hardly expect the nurses who ask me questions or page me to start with an apology. I would begin to question their confidence...
 

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
"Hi I'm John, one of the doctors on gastro." [hand shake]

"How are ya. I'm Psai, one of the med students on ortho." [standing idle on ward, not on ward round]

"I'm sorry to bother you, I know you're busy. Would you like to do a cannula on the patient in bed 21."

"Yeah no worries."

"Thanks a lot. The trolley is over here. If you have any issues just let one of the ward nurses know. I'll be across in 7B for the next ten minutes if you need me."

"K cool"

"Once again sorry to bother you."

[Smile] "No no it's all good."

-------

This helps the intern, the intern's team, and most importantly, the patient. The intern would observe as to whether a med student is busy on a ward round and wouldn't approach one in that scenario. But if it appears a student is idle, this is a professional exchange. And gives the med student the privilege of doing intern work, no matter how 'boring' a cannula might seem.
Where in the US does this scenario happen routinely? Why is the medical student idle after rounds? Aren't there notes to write? Patients to admit (or at least H&P)? Investigations to chase? Consults to see? Didactics to attend? Team-scut to help with? Seeing a medical student stand idle is probably more concerning, if only because they didn't at least have the decency or common sense to help or learn from their assigned team.

Maybe you've only worked in an Australian context, where medical students "float" a bit more? (And nurses don't do cannulas.) Or maybe my only experience in America is from Sub-I's where everybody was really freakin' busy (me and the 3rd years under me included)?

But fair enough, I generally believe that you should do whatever it takes for your team. So if my team needed bloods, cannulas, IDCs, patients transported, whatever; hell yeah. Let's do it. That's what it means to work in a team. But leaving my team? Unthinkable. (Unless the random intern were desperate, and I let my senior resident know.)

Buying my intern coffee twice a week? Very odd. (And no @Phloston, the consensus above is that it's not even close to 50/50.) Volunteering my colleagues for extra work as a sign of collegiality? That merits a 12-gauge cannula shanking. Answering a patient-related question with "Well you know I’m not allowed to answer up the hierarchy." Really bizarre.

None of this is meant personally. No ad hominems. It's only directed at your self-proclaimed "Pearls of Wisdom." You're the one offering advice. And a few of your colleagues (and seniors) are pushing back, because some of it is really bad advice. Preclinicals should know what constitutes inappropriate behaviour, and some of the behaviour you're endorsing is inappropriate.

I agree with some of what you wrote. Never answer somebody else's pimp question. Keep your cool. Be helpful. Don't rely on others for validation. This advice is so general and amiable that it would be hard for anybody to disagree with it, though I suppose some forget the obvious.
 
Last edited:
  • Like
Reactions: FindersFee5

Amygdarya

10+ Year Member
Feb 14, 2009
2,135
1,685
Status
Resident [Any Field]
Frankly, I would be loathe to work with someone who acted in such an obsequious way. Anecdotally, PDs tend to look for people that'd like to work with as junior colleagues, not coffee fetchers.

You're trying so hard to convey an impression, to project an image, I get it, but collegiality and being (or acting like) a normal, kind, and hardworking person seems to take people much further in life.
Obsequious. This exact word was listed as one of interviwee's characteristics seen as very negative by psychiatry residency programs, according my school's book of residency application advice. (Along with arrogance, being disinterested and having nothing to say.) This is very true: while students should know their place, they are also junior and potential future colleagues, so surely they should behave in a respectful but self-assured way?

Just as @Athina says, following some of Phloston's advice may make one appear nonconfident - and lack of confidence is a huge turnoff in any setting, be that professional or personal. I'm a naturally shy and reserved person, and guess what - most of my "negative" feedback so far has been concerned with me being quiet and shy (even though I'm assertive in performing tasks). Again, I don't know what it's like n other countries, but in the US you're expected to actively participate in discussions, answer questions related to your patients on rounds etc. - otherwise you look weak and, even worse, incompetent.

So again, I agree with the spirit of Phloston's advice but not with the letter, so to speak.
 
Dec 5, 2012
865
700
Status
Medical Student
I don't understand the negativity towards the points about casually apologizing before and as you interrupt someone at work to ask him/her a question. If done in a polite, genuine & tactful manner, I'm not sure how this could be viewed as negative.

"Hi, sorry to bother you, but do you know where...?"
"Oh okay, thanks, sorry to bother you."

This isn't weak, incompetent, quiet, shy, etc. It's called respect.
 
Last edited:
  • Like
Reactions: Phloston

lymphocyte

5+ Year Member
Feb 27, 2015
2,087
3,442
COPD 50/50 Club
Status
Resident [Any Field]
I don't understand the negativity towards the points about casually apologizing before and as you interrupt someone at work to ask him/her a question. If done in a polite, genuine & tactful manner, I'm not sure how this could be viewed as negative.

"Hi, sorry to bother you, but do you where...?"
"Oh okay, thanks, sorry to bother you."

This isn't weak, incompetent, quiet, shy, etc. It's called respect.
Nobody disagrees with the obvious and commonsensical points... and it's always worth affirming what should be obvious and commonsensical... but some of it is excessively self-effacing.

Did you read the document? There are 5+ graded examples for introductory, mid-point, and concluding statements (that's 5+ for each) with timing and tone of voice to ask for an observation chart. Here's the suggested template:

Opening: “I’m sorry to bother you, I know you’re busy. Do you know where the chart is for bed 21?”
Midpoint: "Yeah, I really appreciate it."
Closing: “You’re a champion. Thanks. I really appreciate your time. Sorry to bother you.”

Have you ever been busy on the wards (as lots of nurses are)? Could you imagine if a medical student went through this rigamarole to ask for an obs chart? And "You're a champion"? For getting an obs chart? How condescending does that sound? Especially from a medical student.

A pleasant 5 minute coffee break does 1000x more for you in terms of building good-will and conveying kindness.

Seriously, if you and a nurse are both doing scut work, just ask them if they did anything fun last weekend. Shoot the **** for a few minutes. It's fun; it's light; it's other-centered; and it's being a normal human being. That's true respect. Then ask away for whatever whenever: "Sorry, do you know where X is? Got it. Thank you." Get on with it.
 
Last edited:
About the Ads