med students

[Samoa]

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True scut, in my opinion, is:

1. making copies of things
2. getting coffee when you weren't already getting some for yourself
3. running personal errands for your resident (that you didn't offer, but were asked to do)


That's it. Everything else is has some educational value, even if only in the sense that you will be doing lots more of it as an intern, so it serves you well to get efficient about it now.

 

[Dr JPH]

Perhaps you should not pass judgment on people you know nothing of And I am not demonstrating poor attitude - I am just speaking from what I see and from experiences of my friends and I (granted not a lot!).

Ever take the time to consider that your limited experiences have given you a limited ability to speak on the subject?

Why make such bold statements and remarks if your experience is a mere few weeks in the hospital.

I wasn't talking about you persay but rather an intern telling that to a student. I have no clue what PGY you are. Regardless, being condescending is not taking the high road. True character can be easily seen by how one treats their inferiors.

I couldnt agree more.

Showing my students the confidence I have in them to perform duties that, though not directly related to patient care, will greatly help the overall performance of the Service and therefore translate to a better outcome is, in my mind, a way of helping them develop their own confidence and a better understanding of how the process works.

Having my students prepare small presentations and then pimping them on questions doesnt equate to being mean or ruthless, but it prepares them for when they need to really be on top of things.

Having my students call attendings and track down information isnt using them as a secretarial service, but it gives them a chance to learn how the different specialties co-exist and work together to formulate a care plan...from a perspective other than the team they round with on a daily basis.

So despite your thoughts towards me, I do indeed care about my students. So much so that I spent a 5th year of medical school in a teaching role at my school.

Just because you have your own idea of what should and should not be done doesnt make you right.

Sometimes listening to people who have come before you, even if they are only a few years ahead, can be a valuable learning experience.

Everything else is has some educational value, even if only in the sense that you will be doing lots more of it as an intern, so it serves you well to get efficient about it now.

Well said.

 

[Samoa]

How about you get off my nutz and worry about other things than my spelling? O ya I am so emmmbbbarrassed pllease comme help me.

Apparently you like looking ignorant. Don't let me stop you.

 

[GuP]

Ever take the time to consider that your limited experiences have given you a limited ability to speak on the subject?

Why make such bold statements and remarks if your experience is a mere few weeks in the hospital.

So having limited experience means having no opinion and say on the subject? Bold statements and remarks? Someone is a little sensitive.

And again you make statements w/o knowing the full story. Few Weeks? Right.

So despite your thoughts towards me, I do indeed care about my students. So much so that I spent a 5th year of medical school in a teaching role at my school.

Just because you have your own idea of what should and should not be done doesnt make you right.

Sometimes listening to people who have come before you, even if they are only a few years ahead, can be a valuable learning experience.

I have no thoughts about you - I am just going by what you post here and that last line was condescending but more power to you if you like teaching.

I agree experience can be a good thing but having your one's own opinion isn't wrong.

 

[Dr JPH]

Few Weeks? Right.

So then you're a 4th year med student?

 

[snoopy brown]

You know what this thread mostly illustrates? That about 99% of the problems of the medical field are due to differences in work ethic between people. That's whether it's between people who are on the same service or between different specialties. Some people and some specialities will always have a tendency to push work off onto others and that causes friction. The people like GuP will always view people who have a more robust work ethic as being jerks if they expect the same of her. Likewise, people with a stronger work ethic will always see these slackers and hate them. I wish there was a solution, some way to make the slackers do their own work, but there isn't.

 

[Dr JPH]

You know what this thread mostly illustrates? That about 99% of the problems of the medical field are due to differences in work ethic between people. That's whether it's between people who are on the same service or between different specialties. Some people and some specialities will always have a tendency to push work off onto others and that causes friction. The people like GuP will always view people who have a more robust work ethic as being jerks if they expect the same of her. Likewise, people with a stronger work ethic will always see these slackers and hate them. I wish there was a solution, some way to make the slackers do their own work, but there isn't.

👍

Its a nice feeling knowing that the people who are slackers in med school and residency have a reputation as such that doesnt leave them once they complete their training.

 

[GuP]

So then you're a 4th year med student?

Yes indeed.

You guys can think what you want - it's all good. I guess if you voice something different than the herd you are labeled a slacker and the minions are quick to attack and put you down. Whatever.

 

[8744]

Don't worry, soon, he too will be soon sold into slavery. The match is coming.

He has no idea what he is getting into.

 

[Dr JPH]

Yes indeed.

You guys can think what you want - it's all good. I guess if you voice something different than the herd you are labeled a slacker and the minions are quick to attack and put you down. Whatever.

Seems your voicing an opinion different from everyone who has come before you.

I wonder what your classmates think about your "dont make me do work, its not nice" attitude.

I bet they will love being in internship with you...when you complain about having to stay an extra hour to give sign out because someone else is too busy to drop everything for you.

Youre in for a rude awakening my friend. I wish you the best of luck.

 

[GuP]

Seems your voicing an opinion different from everyone who has come before you.

I wonder what your classmates think about your "dont make me do work, its not nice" attitude.

I bet they will love being in internship with you...when you complain about having to stay an extra hour to give sign out because someone else is too busy to drop everything for you.

Youre in for a rude awakening my friend. I wish you the best of luck.

You know nothing of my work ethic yet you continue to make these claims that I am this and that and slacker and what not.

My classmates are perfectly groovy - it's two different things to voice an opinion and then actually acting on it.

Just b/c I don't agree with you or the herd about SCUT, you now imply that now I will be a crappy resident. Thanks for the words of wisdom.

 

[Dr JPH]

You know nothing of my work ethic yet you continue to make these claims that I am this and that and slacker and what not.

My classmates are perfectly groovy - it's two different things to voice an opinion and then actually acting on it.

Just b/c I don't agree with you or the herd about SCUT, you now imply that now I will be a crappy resident. Thanks for the words of wisdom.

I think the problem is that we dont agree on what scutwork IS and what it ISNT.

Your definition of scutwork is fairly broad...seemingly encompassing any activity that doesnt directly correlate with patient care. Most people will disagree with this.

I think a more appropriate definition is similar to what Samoa said above...tasks that are not AT ALL related to patient care.

Just because something doesnt involve examining, talking with or touching a patient doesnt mean its not an important step in the overall care of that patient. Gathering data for presentations is just one step in increasing the functionality of the entire team.

So next time youre asked to do something by your intern...you should think "is this going to help the patient, my service or increase the quality of the care the patient is getting?"

I think you will find that most things fit into that category.

If you can find a better way for a service to function then share your ideas. Having each member of the team perform certain duties so that no one person is overwhelmed and therefore unable to function efficiently is what we have now. And that includes having students perform "menial" tasks like gathering labs and doing chart-checks.

 

[DebDynamite]

You know what this thread mostly illustrates? That about 99% of the problems of the medical field are due to differences in work ethic between people. That's whether it's between people who are on the same service or between different specialties. Some people and some specialities will always have a tendency to push work off onto others and that causes friction. The people like GuP will always view people who have a more robust work ethic as being jerks if they expect the same of her. Likewise, people with a stronger work ethic will always see these slackers and hate them. I wish there was a solution, some way to make the slackers do their own work, but there isn't.

Not only is this the truth, but also teams are "thrown together" for weeks at a time and have to instantly get along. Which isn't always easy. The two extremes of med student that Fang & Tired both wrote of are really, really irritating to the "moderate" med student stuck on their team.They are why I marvel that anyone bothers teaching at all anymore- I'm a med student and these folks drove me bonkers all last year.

As for scut, I once had a PGY-2 resident say to me,"I need you to go round on these eleven patients before Attending X gets here (I had 1.5 hours)." I had been a third year about 4-5 months. Although it's flattering scut, that's still what it is. Looking up labs isn't scut, it keeps a med student awake.

 

[colbgw02]

As for scut, I once had a PGY-2 resident say to me,"I need you to go round on these eleven patients before Attending X gets here (I had 1.5 hours)." I had been a third year about 4-5 months. Although it's flattering scut, that's still what it is. Looking up labs isn't scut, it keeps a med student awake.

See, I don't see this as scut. I see it as the resident being a lazy jerk. Unless you're on surgery - only there could rounding be considering scut.

Residents can overwork their students, but that's not the same as scutting them out.

 

[Hard24Get]

Here's the bottom line. In medicine there are all types of people, which is why there are all types of residents and attendings. GuP, you have the attitude that it's not your job (yet) to do certain things and that will show. If the people around you don't care that's fine. However we've all worked with interns and residents who clearly had that same mentality as medical students and carried it into residency. If you go into a field where that is acceptable like ER then fine.

What the @*%# is that supposed to mean? That is a pretty strong insult you have generated without much to back it up. Residents who act like medical students (esp medical students like GuP) are not appropriate for ANY specialty, particularly one which focuses on initial diagnosis and stabilization. I hate it when people act like their specialty is the only one that matters 👎

 

[Dr JPH]

What the @*%# is that supposed to mean? That is a pretty strong insult you have generated without much to back it up. Residents who act like medical students (esp medical students like GuP) are not appropriate for ANY specialty, particularly one which focuses on initial diagnosis and stabilization. I hate it when people act like their specialty is the only one that matters 👎

ER docs dont focus on diagnosis. They focus on "going to live and go home" or "going to die and needs to be admitted". Nothing against them, thats just their method of focusing on the patients that need them. Afterall, if ER docs were concerned with a diagnosis they would begin treatment in the ER rather than just stabilize and ship.

 

[swpm]

I've heard this before and disagree. I always feel that the students are there to demonstrate whether they are good or not which is the point of grading after all.

And this is where you're wrong: students are there to learn medicine. Grading is necessary, but certainly not the point of them coming to the hospital each day.

Equally obvious should be the fact that part of the intern's job is to teach the students. It's not as important as #1) do no harm or #2) heal the sick, but I'd slide it in right there at #3. And what is teaching if not talking to your students and reviewing key concepts relevant to their patients?

Passively watching your students sink or swim, and then filling out their report cards after 4-6 weeks is easy and objective ... even fair ... but it's not teaching. It is, unfortunately, what a lot of lazy interns and residents do.

If you hold their hand on the patients, feed them the answers for all pimp questions, and do everything for them so they look stellar, why are they there?

To learn medicine, first and foremost.

I think you're reading too much into what I wrote. I have no psychic powers; I didn't know what the chief or attending would pimp the students on. But I did know (moreso than the students, anyway) where the fertile pimping ground lay, and I made a daily effort with all of my students to ensure they were well prepared for rounds.

We had students who did practically nothing. For example, they'd sometimes do an exam and sometimes not (no joke)

That's inexcusable.

and when they didn't some intern would always key them in on the right thing to say.

And so is that. There's a world of difference between actively concealing a student's laziness, and spending time teaching them things that are so relevant, so pertinent, so immediate to their patients' treatment that the pimp questions are easily predictable.

 

[GuP]

What the @*%# is that supposed to mean? That is a pretty strong insult you have generated without much to back it up. Residents who act like medical students (esp medical students like GuP) are not appropriate for ANY specialty, particularly one which focuses on initial diagnosis and stabilization. I hate it when people act like their specialty is the only one that matters 👎

Got your panties in a bunch? How am I acting like? Voicing my opinion on what I think? Do you know me?

BTW, EM sux!! (j/k - seriously, don't cry)

 

[Dr. Will]

ER docs dont focus on diagnosis. They focus on "going to live and go home" or "going to die and needs to be admitted". Nothing against them, thats just their method of focusing on the patients that need them. Afterall, if ER docs were concerned with a diagnosis they would begin treatment in the ER rather than just stabilize and ship.

Seriously? Lets get back to the topic at hand instead of putting your foot in your mouth. We prefer to use a magic 8 ball when it comes to patients on deciding whether they are sick or not. There is never any treatment in the ED, or actual diagnosing occuring, either.

Personally, all my consults/admissions begin with "Hi, we've got a 47 year old man down here who the magic 8 ball says is sick and needs to be admitted. We haven't treated him with anything yet since that's your job...No you have to come down now and not in a couple hours because we can't and never treat down here."

 

[Hard24Get]

ER docs dont focus on diagnosis. They focus on "going to live and go home" or "going to die and needs to be admitted". Nothing against them, thats just their method of focusing on the patients that need them. Afterall, if ER docs were concerned with a diagnosis they would begin treatment in the ER rather than just stabilize and ship.

Really - so I guess surgeons just decide between "going to need surgery" and "don't need surgery, punt to IM?".

I'm just going to assume you are in an institution with a sub-par ED (like, in the 1900s) since you are usually better informed. I have yet to work a shift where a diagnosis and initial treatment wasn't generated for the majority of the patients. Maybe ER docs only do dispo, but when EM docs or EPs staff the ED, there is actually medicine going on. Let's test snoopy brown's theory by putting a bunch of medical students staff the ED for a week so you surgeons can get paged for everybody with a tummy ache.

Oh, and to GuP: 🙄

 

[Dr JPH]

Really - so I guess surgeons just decide between "going to need surgery" and "don't need surgery, punt to IM?".

Actually, yes.

And when they need surgery we take them to the OR and fix them.

We dont call an intern to come write Admit orders and ship them out.

🙂

 

[Dr JPH]

Let's test snoopy brown's theory by putting a bunch of medical students staff the ED for a week so you surgeons can get paged for everybody with a tummy ache.

In the sue happy society we live in today, you give me an ER doc that will take a patient with abdominal pain and NOT consult surgery and I will eat my scrub hat.

 

[Tired]

In the sue happy society we live in today, you give me an ER doc that will take a patient with abdominal pain and NOT consult surgery and I will eat my scrub hat.

You're exagerating.

Sometimes the Ob/Gyn's catch those consults if it's a woman.

 

[Dr. Will]

In the sue happy society we live in today, you give me an ER doc that will take a patient with abdominal pain and NOT consult surgery and I will eat my scrub hat.

Wow...you are narrow minded. Even as an intern now, I don't consult surgery, or any other service, unless there is a need to. Not everyone that comes in with tummy pain needs a call to surgery, not everyone with chest pain means a call to IM, and not everyone with vaginal bleeding needs a call to ob. Spend a day in the ED I work in (the first program in the country) and I'll bring you a choice of bbq, ketchup, mustard or ranch to throw on your scrub hat. Peace out...get back on topic. You need to pull the scalpel out of your arse and stop thinking your god's gift to surgery.

 

[lucky_deadman]

In the sue happy society we live in today, you give me an ER doc that will take a patient with abdominal pain and NOT consult surgery and I will eat my scrub hat.

So do you like your scrub hat with a side of crow? Cause I'm more than happy to show you as many as you can count.

The problem is that I'm sure you get "soft" consults. But how about the hundreds and even thousands of patients we see, treat, and disposition home without ever even thinking of pulling your chain?

Let's attempt at least an effort at civility here. Don't insult my chosen profession, my work habit, or my intelligence and I won't return the favor.

 

[MirrorTodd]

He has no idea what he is getting into.

LOL how long did it take you to write all that?

 

[snoopy brown]

What the @*%# is that supposed to mean? That is a pretty strong insult you have generated without much to back it up. Residents who act like medical students (esp medical students like GuP) are not appropriate for ANY specialty, particularly one which focuses on initial diagnosis and stabilization. I hate it when people act like their specialty is the only one that matters 👎

Well I don't know how to put this except to make the same analogy. Everything is relative. GuP for example probably has the same viewpoint, where she views herself as a hard worker and a very good medical student. This is not to beat up on her more but just to make this point. In the same way you see your specialty. In my limited experience, when ER residents rotate on other services, they are generally analogous to GuP. They are there similar hours, yes, but don't do the same amount of work. You can see it in their attitude and affect. I guess you can take that as an insult, but I wonder why you would? I presume you picked your speciality for a certain reason and I presume lifestyle was one of those reasons. But at the same time then why do you get touchy when people say that you are a lifestyle person? Do you mean that you think you work as hard or as much as a surgery person? Or an OB?I don't think we have to insult each other, but I also don't think it gets us anywhere to pretend that everyone is perfectly equal and the same. That's like saying all medical students are exactly the same and how dare you imply otherwise because it's an insult.And I agree with JP. When we have ER residents rotate through, it's about a week before even they get irritated about how often the ER calls for consults and admissions. And they're just there for a month.

 

[smq123]

I don't think we have to insult each other, but I also don't think it gets us anywhere to pretend that everyone is perfectly equal and the same. That's like saying all medical students are exactly the same and how dare you imply otherwise because it's an insult

PEOPLE!! I think we can stop with the "ER vs. other specialties" arguments!

For the med students who are lurking on these boards (particularly for the MS3s who are here) - it would be beneficial if the residents and attendings could outline what they feel is scutwork and what is not. That could help me throughout this year because then I won't needlessly get my panties in a twist if the resident suggests that I go and hunt up a CXR or a pathology report or something.

So - your thoughts (especially if you're a resident) on...

• What is scutwork?
• What is scutwork vs. what is just clearly brown-nosing?
• Why do you ask your med students to run and get something (CXR, labs, etc) for you? Is it because you truly feel it will help them learn, because you don't feel like getting it yourself, or because you're so overwhelmed with your other patients that you just can't do it?
• How fast should a med student be able to pre-round by the middle of the year? How many patients/hour?
• If there is one thing that your "dream student" would do on a regular basis what would it be? (And please, no "Have the body of Heidi Klum and walk around in a Speedo" type of comments. I'm being serious.)
• What's the worst part of your day as an intern/resident, and is there anything that you wish the med student would do to help you?
• What's the biggest mistake that most junior med students make? What's the biggest mistake that you made?

Sorry that these are such dumb questions, but I'm trying really hard to get this thread back on track!

 

[me454555]

I'm an intern as well and dealing w/medical students too, mostly 3rd years. These people are fresh off the boards and don't know jack. I remember what it was like and breaking down a chart is a tough thing to do so I understand when they don't know what they're doing. It's 2 months into the year and a for most of them this may be their first real experience in note writing so I cut them some slack. If they're still like this in June, then we got problems but for right now, give em a break and advice.

For the people that don't know what they're doing yet - Wards is a new feeling and most don't know what's important and what's not. They don't know where to look or how to look for it. These are the students that you've gotta give strict orders to for each pt. Tell them, you need to do xyz, read abc, and look for ghi. If they tell you they don't know how to do it, you teach em and show em. After doing this for a day or 2, they will be fine and get it. I am always trying to make my med students look good on rounds and wards. If I think they'll get pimped on something, I'll go over it w/them before hand, if they have to present, I go over it w/them so they look good. By the end of the month, they don't need my help and they know exactly how I like things done.

For the slacker - same philosophy. I was def perceived as "that guy" early in 3rd year. It wasn't b/c I was trying to slack but just b/c I didn't know wtf to do. I knew kinda what to do but not always. Again, give him/her strict guidlines to follow. If they don't do what they're told, then you can go talk to them. Most medical students are just naive and not slackers

Overlyambitious - They get scutted like no tomorrow. Not cause I'm trying to be mean just b/c they annoy me. Eventually they figure it out and don't ask me all this crap.

Student: Dr. What are some of the treatments for xyz
Me: Why don't you go look it up and we'll discuss it later

After a few days of this operant conditioning they learn, and usually I just tell them flat out if you ask me an open ended Q like that I'm gonna make you read it first. They learn real quick.

Student: Here's your (insert random scut work)
Me: Thanx. I didn't really need it but just to let you know, the more you volunteer for stuff the more I'm gonna scut you out. The choice is yours

They learn real quick. Just remember, these are still students and they're not even close to being interns yet. Don't expect them to be mini interns and teach them. I know I appreciated a lot of it when I was an MS 3 so pass it on.

 

[snoopy brown]

I think what you aren't understanding is that there is no definition of scutwork; clearly, what someone like GuP views to be "scut" is not the same as what someone as JP Hazelton views as "scut." Everything is what you make of it and what your personal work ethic is. The only things that people would agree on are things that are on the extremes. Getting coffee or food for people is not even scut, it's lower. That's just people taking advantage of others.

 

[Dr. Will]

Well I don't know how to put this except to make the same analogy. Everything is relative. GuP for example probably has the same viewpoint, where she views herself as a hard worker and a very good medical student. This is not to beat up on her more but just to make this point. In the same way you see your specialty. In my limited experience, when ER residents rotate on other services, they are generally analogous to GuP. They are there similar hours, yes, but don't do the same amount of work. You can see it in their attitude and affect. I guess you can take that as an insult, but I wonder why you would? I presume you picked your speciality for a certain reason and I presume lifestyle was one of those reasons. But at the same time then why do you get touchy when people say that you are a lifestyle person? Do you mean that you think you work as hard or as much as a surgery person? Or an OB?I don't think we have to insult each other, but I also don't think it gets us anywhere to pretend that everyone is perfectly equal and the same. That's like saying all medical students are exactly the same and how dare you imply otherwise because it's an insult.And I agree with JP. When we have ER residents rotate through, it's about a week before even they get irritated about how often the ER calls for consults and admissions. And they're just there for a month.

This is the last time I'm going to respond to this wave of EM bashing that was completely uncalled for considering the original topic. I think you are completely off base when it comes to your last statement here. I'm sure most people, whether in EM or not, hate being off service for a variety of reasons. There were plenty of off service surgery, medicine, ob residents who started in the ED this month and hated it because of the schedule. Ask them how much they enjoyed a string of 6 12 hour overnights in a row, and how busy it got. For you to even say we don't work hard is an insult. Yes, we don't have the same hours as some of our other colleagues, but that doesn't mean you work harder than I. Step into many ED's across the country and you will see they have enough volume to keep you on your feet the entire shift. I've gone many a shift where I realize I haven't eaten, drank anything, or peed. You can say you work more hours...but you can't really comment on overall work ethic in the ED.

Also, I've seen many off service residents who sit around carrying one or two patients, cherry picking through charts. Yes some are lazy but some don't know how the system works well enough to become truly efficient. The same goes for anyone rotating on any off service. Are you comparing a resident doing their specialty for a few months vs. an EM resident just there for 4 weeks? I'm sure the resident in their specialty will get more work done b/c they are more efficient, etc, etc. Doesn't mean the off service person is truly lazy...and again you said the magic words yourself, "In my limited experience." Ask JP up there what he thinks of those words himself and it kinda takes that point out of the picture.

I agree that no one is equal...but only in terms of the number of hours you work. But it really annoys me when people make generalizations about that. Your statement implies, if you aren't a surgeon or working 80 hours a week...you aren't working hard at all. Something is wrong with that thought process and it's time to get off your high horse. I don't know what year of residency you are in, but if you are an intern, that's ballsy to say only 1 month in.

And one last thing, don't compare us to Gup up there. I personally am of the view point that any scutwork related to a patient you are taking care of is educational. Don't generalize that EM residents are all lazy. You assume too much and you know what that makes you.

 

[BADMD]

In the sue happy society we live in today, you give me an ER doc that will take a patient with abdominal pain and NOT consult surgery and I will eat my scrub hat.

You have a very narrow view of the hospital system that you are in. I think you'll be amazed when you hit the real world. Plenty of EPs only consult surgery when they think the patient needs an operation.

 

[Dr JPH]

• What is scutwork?

• 
  
  Any task that is assigned to someone that has absolutely no educational value or its only purpose is to demean another. Any task that is not, in some way, related to patient care.
  
  

  [*]What is scutwork vs. what is just clearly brown-nosing?

  
  Not sure what you mean by this.
  
  

  [*]Why do you ask your med students to run and get something (CXR, labs, etc) for you? Is it because you truly feel it will help them learn, because you don't feel like getting it yourself, or because you're so overwhelmed with your other patients that you just can't do it?

  
  I had a student ask me this past week "where is radiology" after she was on service for almost 3 weeks. 😡
  
  Lets say Im preparing a morning conference on a particular patient. I will often ask the student assigned to that patient to help me prepare the data and case presentation. Why? Well, not because Im too lazy to do it...Ive done this a hundred times and it would probably be FASTER if they DIDNT help. BUT, its their patient. I want them to be involved in everything that happens with that patient...this includes admission orders, gathering lab data, calling Nutrition and writing the discharge instructions.
  
  When they are interns these are all components of what needs to be done. Now, am I training them to be interns? I dont know...maybe a little.
  
  Im at least trying to give them an idea of all the little things that need to be done that arent always thought about until you need to do them. Every day I hear a student say "OH, I never thought of that". Well, there you go. Now you know what goes on.
  
  So am I lazy? Not at all. I can see a patient and write a consult in 20 minutes. I can see a patient in the ER and write up the admission, including calling the attending, in under 45mins...depending on how backed up things are with labs, imaging and if the attending gets back to me in time.
  
  When I have a student with me it takes considerably longer. I let them do the questioning, writing and let them make the phone call to present to the attending (depending on who the attending is). Why? Not because it makes it easier for me. It takes longer and to be honest my head hurts after going step by step through those things sometimes. But I dont really mind. I want them to learn how to do this. Im glad to take the time IF I feel they learned something from the experience.
  
  My last night on call I was literally walking about the hospital looking for a patient who needed a Foley because my third year student earlier in the day told me she wanted to put in a Foley. I even told the ER to page me in the middle of the night so that I could wake her up and get her that Foley.
  
  

  [*]How fast should a med student be able to pre-round by the middle of the year? How many patients/hour?

  
  I think with every inpatient rotation they should get considerably faster. After 3-4 inpatient rotations they should be able to see a patient and write a note in half an hour. 20 minutes if the patient isnt complicated OR if they have been following the patient for a few days.
  
  Morning conference is at 7:30 and rounds start right after. I tell my students to get there by 6:00 to start seeing patients. Early? Yes. But I dont make them do something that I wont. Im there by 5:30, often already seen their patients and Im walking the floors answering questions and offering advice.
  
  So I talk the talk, but I walk the walk.
  
  

  [*]If there is one thing that your "dream student" would do on a regular basis what would it be? (And please, no "Have the body of Heidi Klum and walk around in a Speedo" type of comments. I'm being serious.)

  
  Do things before they were asked. Keep me updated on things that are happening. Take initiative to know the next step.
  
  On rounds we need to know labs. Looking them up beforehand so that we arent fighting for a computer at the nurses station. Reading the notes from consultants so we arent digging through the chart on rounds.
  
  Now...this wont happen for most until 3-4 months into 3rd year and for some they take more time to adjust to a new hospital. I get that and I understand.
  
  But if you have been on service for 3 weeks, there should be a level of competency regarding these types of tasks.
  
  And the interesting thing is this: we expect these things to be done and we as interns and residents do them 50 times a day. YET if we ASK someone to do it, it turns into scut. I view it as being thorough with your patient care. The student who doesnt want to do it views it as SCUT. 🙄
  
  

  [*]What's the worst part of your day as an intern/resident, and is there anything that you wish the med student would do to help you?

  
  As I said above, many of the things that students do often slow me down. The exceptions are some 4th year students who know how it goes.
  
  But a student can help the service by being prepared, especially on rounds.
  Knowing your patient, the labs, the plan from consultants...that really helps. I have yet to work on a service, as student or resident, where the student is vital to the functioning of the service. They either help the service and make it easier for everyone OR they slow everyone down.
  
  

  [*]What's the biggest mistake that most junior med students make? What's the biggest mistake that you made?

Waiting for something to happen. Dont wait for me to ask "did you check the results of that ECHO?" or "did the Path report come back?"

Know what we are waiting for and keep an eye out for it.

There is nothing worse on rounds when someone asks a student "what was the potassium this morning" and the student saying "I dont know", "It isnt back yet", or giving a wrong answer.

ESPECIALLY because I already know and likely already told the Attending. The attending is often asking because he wants to see if YOU Know.

 

[sophiejane]

There is nothing worse on rounds when someone asks a student "what was the potassium this morning" and the student saying "I dont know", "It isnt back yet", or giving a wrong answer.

However, if it really isn't back yet, which is possible, given that report often start at 7:30, and if labs are drawn at 6 am and you see the patient at 5:30 am...

At my hospital, it is fairly common (though frustrating) for some labs not to be resulted before we start morning report.

A better answer in that case might be: "Potassium wasn't resulted before morning report, but I'll follow up on that as soon as we finish here."

On a side note, this thread is starting to go downhill. Let's try to keep it civil, or take it to the Lounge.

 

[plastikosmd]

regarding the ER, it is a tough job and i wouldn't want it. as a surgeon it is my job to decide if the patient needs surgery and not the ER, and i dont expect them to make the decision...so call me. I only ask..if i ask for a lab, a CT or whatever..that i get it...and not some quoted study....if i need to gather more info as the consultant..the let me. i dont mind being called about a patient and would rather be called and make a decision not to operate than not be called. Both the ER and surgery and others are all overworked, it sucks but the only way to get through it is to work together, we all have our stories of lazy MD's on all sides...it is not the norm.

regarding the OP and scut, i matched in a competitive field..where most students "go the extra mile" to impress on the service. I did when i rotated and im sure it was a reason for me matching. at least for surgery it is 2 things both a team and a hierarchy. this is for all levels right up to the attending. you as the student look up from the bottom and see a lot of scut...believe me the intern looks up and sees much of the same...so does the 3rd ....then the chief in deference to the attending, heck the attending sees it from the insurance company. every day there is a general amount of work that needs to get done. as a team this should be divided up. things like running charts, grabbing bandages, xrays etc is still a part of the teams work. some would consider this scut. if it needs to be done and if you as the lowest member of the team can contribute this, that is great. It is great if you are recognized and thanked..but dont be miffed if you are not....unless you are thanking the intern for running all the labs after rounds or getting vitals on afternoon rounds...or maybe thanking the 3rd for stayin late in clinic to finish up when the chief goes to operate...or thanking the chief everytime an off service case needs covering...or the attending for sigining on for one more call. the feelings of doing pointless things doesn't go away.

maybe i was a tool, but i was never "better" than that in doing the work that needed to be done. i realized i couldnt do much in the grand scheme of taking care of the patient..but what i could do..i would be good at. every chart was at the bedside, i carried a dressing box, nobody could find an xray faster (prior to PACS system..yuck). i realize not everyone functions this way, some are to proud, some have no real world work experience, some are not team players, some dont understand how to move as a group along in the right direction..and this is for all levels of training.

reading the chart..i have found things the resident missed (always expect sabotage) xrays....and grabbing them..that was always a great time to pop them up and run them with the radiologist to see the findings..so i could point them out...learning them for myself. bandages....looking at a wound as an intern..i could cover it the correct way, dry a macerated wound, keep a tendon from drying, or gauze from sticking to bowel. rotating through multiple hospitals..i could walk in and figure out how to get a pager, logon for computer, parking etc all in 2 hrs..instead of a day or more..be oriented in 1/2 a day instead of stumbling around for a week as you do in the beginning.

having said all that..there is "real" scut. those things center around personal needs, pay my bills, run to the post office, go buy me a cup of coffee just as you lay down to sleep....etc. just as there are lazy students...those students grow up and dont progress and become lazy interns, residents and attendings. try not to let them be your generalization for an entire field.

i did not want this to sound preachy...just my experience and what worked for me.

 

[Hard24Get]

In my limited experience, when ER residents rotate on other services, they are generally analogous to GuP. They are there similar hours, yes, but don't do the same amount of work. You can see it in their attitude and affect. I guess you can take that as an insult, but I wonder why you would? I presume you picked your speciality for a certain reason and I presume lifestyle was one of those reasons. But at the same time then why do you get touchy when people say that you are a lifestyle person? Do you mean that you think you work as hard or as much as a surgery person? Or an OB?I don't think we have to insult each other, but I also don't think it gets us anywhere to pretend that everyone is perfectly equal and the same. That's like saying all medical students are exactly the same and how dare you imply otherwise because it's an insult.And I agree with JP. When we have ER residents rotate through, it's about a week before even they get irritated about how often the ER calls for consults and admissions. And they're just there for a month.

Ok, I am done after this. Just wanted to say that your experience is indeed limited. I am still a medical student and my evals from multiple services (including Surgery) pointed out that I was one of the hardest working medical students they ever had, so I don't think I'm disillusioned as to my work ethic. I just get bored during long surgeries, so I chose EM because I like the pace, I like taking the first stab at <gasp> diagnosis and treatment, and I like providing care for people who are less fortunate, and even working at night. Lifestyle, other than research opportunities, was not a major factor in my choice and I have no intention of slacking off on my off-service rotations and I don't think anyone should. I do not get "touchy" if someone tells me my hours will be better than Surgery or Ob, but do take exception to being told a medical student could do my specialty. That is a crazy insult (do you really think morbidity and mortality would be the same), but I have never insulted yours or any other specialty because I think they all have an important role in the hospital. I also feel sorry for you if your ED is inappropriately calling consults - but you can send your med student to learn something (see how I tied it in to the thread?).

Anyway, the point of my showing up on this thread was to represent a med student who believes in working hard and taking on as much responsibility as I possibly can. I agree with everything JPHazelton and snoopy brown said that was relevant to this thread, and will leave them to it instead of

 

[elwademd]

Any task that is assigned to someone that has absolutely no educational value or its only purpose is to demean another. Any task that is not, in some way, related to patient care.



Not sure what you mean by this.



I had a student ask me this past week "where is radiology" after she was on service for almost 3 weeks. 😡

Lets say Im preparing a morning conference on a particular patient. I will often ask the student assigned to that patient to help me prepare the data and case presentation. Why? Well, not because Im too lazy to do it...Ive done this a hundred times and it would probably be FASTER if they DIDNT help. BUT, its their patient. I want them to be involved in everything that happens with that patient...this includes admission orders, gathering lab data, calling Nutrition and writing the discharge instructions.

When they are interns these are all components of what needs to be done. Now, am I training them to be interns? I dont know...maybe a little.

Im at least trying to give them an idea of all the little things that need to be done that arent always thought about until you need to do them. Every day I hear a student say "OH, I never thought of that". Well, there you go. Now you know what goes on.

So am I lazy? Not at all. I can see a patient and write a consult in 20 minutes. I can see a patient in the ER and write up the admission, including calling the attending, in under 45mins...depending on how backed up things are with labs, imaging and if the attending gets back to me in time.

When I have a student with me it takes considerably longer. I let them do the questioning, writing and let them make the phone call to present to the attending (depending on who the attending is). Why? Not because it makes it easier for me. It takes longer and to be honest my head hurts after going step by step through those things sometimes. But I dont really mind. I want them to learn how to do this. Im glad to take the time IF I feel they learned something from the experience.

My last night on call I was literally walking about the hospital looking for a patient who needed a Foley because my third year student earlier in the day told me she wanted to put in a Foley. I even told the ER to page me in the middle of the night so that I could wake her up and get her that Foley.



I think with every inpatient rotation they should get considerably faster. After 3-4 inpatient rotations they should be able to see a patient and write a note in half an hour. 20 minutes if the patient isnt complicated OR if they have been following the patient for a few days.

Morning conference is at 7:30 and rounds start right after. I tell my students to get there by 6:00 to start seeing patients. Early? Yes. But I dont make them do something that I wont. Im there by 5:30, often already seen their patients and Im walking the floors answering questions and offering advice.

So I talk the talk, but I walk the walk.



Do things before they were asked. Keep me updated on things that are happening. Take initiative to know the next step.

On rounds we need to know labs. Looking them up beforehand so that we arent fighting for a computer at the nurses station. Reading the notes from consultants so we arent digging through the chart on rounds.

Now...this wont happen for most until 3-4 months into 3rd year and for some they take more time to adjust to a new hospital. I get that and I understand.

But if you have been on service for 3 weeks, there should be a level of competency regarding these types of tasks.

And the interesting thing is this: we expect these things to be done and we as interns and residents do them 50 times a day. YET if we ASK someone to do it, it turns into scut. I view it as being thorough with your patient care. The student who doesnt want to do it views it as SCUT. 🙄



As I said above, many of the things that students do often slow me down. The exceptions are some 4th year students who know how it goes.

But a student can help the service by being prepared, especially on rounds.
Knowing your patient, the labs, the plan from consultants...that really helps. I have yet to work on a service, as student or resident, where the student is vital to the functioning of the service. They either help the service and make it easier for everyone OR they slow everyone down.



Waiting for something to happen. Dont wait for me to ask "did you check the results of that ECHO?" or "did the Path report come back?"

Know what we are waiting for and keep an eye out for it.

There is nothing worse on rounds when someone asks a student "what was the potassium this morning" and the student saying "I dont know", "It isnt back yet", or giving a wrong answer.

ESPECIALLY because I already know and likely already told the Attending. The attending is often asking because he wants to see if YOU Know.

well said.

the funny thing is, things that are considered "scut" in medical school become things you do daily when an intern/resident/attending- checking labs, x rays, talking with consultants, following up on studies... that's a part of patient care- and a vital part at that.

if a resident's asking a medical student to check up on a lab or an xray, that's completely different than asking a medical student to get a cup of coffee or grab a donut. sadly, some students see labs and donuts equally! lol.

 

[snoopy brown]

I just wanted to point out that I was being very fair in saying "in my limited experience" and all the ER people immediately jumped on that. In all likelihood their experience is equally limited (including one medical student who has less experience) and yet they acted like their opinions were infintely more valid. Like I say I am not here to change your opinion about your specialty, just as I am not here to change GuP's opinion about her approach to scut. That would be silly. I'm merely stating my observations and opinions. But I think it's being silly acting like people don't choose ER for lifestyle or that a certain personality doesn't go into ER.Re: scut, like I said if you read the thread you will find that most clashes in the medical field relate to differences in work ethic. What is scut for one person is just normal work for another. Clearly as a medical student you need to adapt to the rotation you are on, or you will always come away frustrated. It's as simple as that.

 

[Dr. Will]

I just wanted to point out that I was being very fair in saying "in my limited experience" and all the ER people immediately jumped on that. In all likelihood their experience is equally limited (including one medical student who has less experience) and yet they acted like their opinions were infintely more valid. Like I say I am not here to change your opinion about your specialty, just as I am not here to change GuP's opinion about her approach to scut. That would be silly. I'm merely stating my observations and opinions. But I think it's being silly acting like people don't choose ER for lifestyle or that a certain personality doesn't go into ER.Re: scut, like I said if you read the thread you will find that most clashes in the medical field relate to differences in work ethic. What is scut for one person is just normal work for another. Clearly as a medical student you need to adapt to the rotation you are on, or you will always come away frustrated. It's as simple as that.

The problem with your statements, whether limited in experience or not, is that you choose to generalize. Most people in EM don't consider it to be a lifestyle specialty. You work a very greuling schedule that has you switching between days and nights, and will have to work many weekends and holidays throughout your career. The trade off is that you are a shift worker. But 12 hour shifts that easily extend to 13 and 14 hours at times is difficult and draining when you have a string of 4 or 5 more nights coming up.

And yes, I agree, certain personalities tend to gravititate towards certain specialties. But I wouldn't again generalize by calling EM residents former lazy medical students/current lazy residents, as I wouldn't generalize most surgery residents as glory seeking a$$holes, or orthopods being muscle head jocks. The reality is that this does not hold true. So be careful with how you phrase things, regardless of limited experience or not.

The difference is that none of us attacking your statments put down whatever specialty you are a part of, nor attacked your work ethic. But you doing that when you do not work in the ED, and generalizing towards us, really shows a lack of respect. As someone said before, it's a team effort. I have nothing but respect for my surg colleagues and appreciate their help when it's needed...cuz it isn't always needed.

And with that, I'm truly done.

 

[boboli]

The definition of scut is always in debate. When we start as MS-3's there are very few things that don't have educational value. A lot of us learned normal lab values and what to be concerned about by copying a lot of labs into charts. Of course this gets old after awhile, but looking at lab values is something that physicians will do for the rest of their careers. The same thing holds for reading notes and looking at films. The students hope is that doing these rather mundane things will result in some teaching -- this patient is hypokalemic, now what should we do? Not, thank you for writing these down, now go sit in the corner and don't bother me while I write the orders. If residents can find pearls to share with students for this "scut" this engenders good will among all.
However, there are somethings that just unfair. I remember going to one specialty clinic where I was told stay around, but not see any patients, as with the attending and resident there would be too many people in the room. So I spent the day sitting in the corner, being used as a gopher to go find x-rays or charts in other parts of the hospital. That would be the accurate definition of scut, in my mind. Days like these made me really dislike a rotation and pretty resistant to being a good team member in the future.

 

[deleted109597]

I had a student ask me this past week "where is radiology" after she was on service for almost 3 weeks. 😡

Was she supposed to find it in her free time, for fun? If she hadn't ever been there, she can't very well find it. I still find new places in my hospital and I've been here almost a month. Mainly because our orientation consisted of "Don't **** the patients, don't **** the staff, don't take narcotics or give them to your family."

My last night on call I was literally walking about the hospital looking for a patient who needed a Foley because my third year student earlier in the day told me she wanted to put in a Foley. I even told the ER to page me in the middle of the night so that I could wake her up and get her that Foley.

Does your hospital's annual ED census hover in the single digits? I used to put in over 10 per shift working at a place with only 40K annual visits. If she wanted to put in a foley (god knows why anyone would want to outside of some dumb rotation requirement), she could have just made friends with an ED nurse and gotten it in less than 10 min.

I think with every inpatient rotation they should get considerably faster. After 3-4 inpatient rotations they should be able to see a patient and write a note in half an hour. 20 minutes if the patient isnt complicated OR if they have been following the patient for a few days.

Morning conference is at 7:30 and rounds start right after. I tell my students to get there by 6:00 to start seeing patients. Early? Yes. But I dont make them do something that I wont. Im there by 5:30, often already seen their patients and Im walking the floors answering questions and offering advice.

530 isn't early or walking the walk. When you have to preround with the first of two senior residents at 615 so you can make daily conference at 7, and you have 16 patients, you had better be there at 4 and be fast. Unfortunately, while I think that this is bad overall for patient care, as a new intern none of my suggestions are likely to be listened to.


However, scutwork will always be things that don't help you to learn. This means calling home health companies, because the residents know it takes forever. This means looking up labs for patients that aren't yours. If you are a resident that gives this job to a student, be prepared when they don't follow through, or worse, don't notify you of a aberrant lab value. It is like checking out a CXR for central line placement. You put it there, that dropped lung will be your fault, so don't leave it up to someone else.

 

[snoopy brown]

Most people in EM don't consider it to be a lifestyle specialty.

It's no dermatology I'll grant you, but I've heard too many EM applicants, residents, and attendings talking about their work schedules to buy that they consider it to be grueling.

I wouldn't generalize most surgery residents as glory seeking a$$holes, or orthopods being muscle head jocks.

That's pretty childish. All you did was call people names and add, "this is what I don't say" and act like you're not making the generalizations.To Dr. McNinja, why is asking a medical student to look up labs for patients that aren't theirs wrong? It's something that helps the team and something they can do. It's hardly abusive and it takes a few minutes to do and it affects patient care. If you consider that to be abusive scut, what do you consider acceptable tasks for medical students?

 

[Dr JPH]

Was she supposed to find it in her free time, for fun? If she hadn't ever been there, she can't very well find it. I still find new places in my hospital and I've been here almost a month. Mainly because our orientation consisted of "Don't **** the patients, don't **** the staff, don't take narcotics or give them to your family."

Hmmm. 3 weeks in a 100 bed hospital, not to mention those giant SIGNS all over the place. I bet 90 of 100 patient could find radiology if they wanted to.

Does your hospital's annual ED census hover in the single digits? I used to put in over 10 per shift working at a place with only 40K annual visits. If she wanted to put in a foley (god knows why anyone would want to outside of some dumb rotation requirement), she could have just made friends with an ED nurse and gotten it in less than 10 min.

??

I told that story as an example of how I was trying to help out a 3rd year student to learn something she wanted to learn. I dont know why you would turn that into an argument. Weird.

530 isn't early or walking the walk. When you have to preround with the first of two senior residents at 615 so you can make daily conference at 7, and you have 16 patients, you had better be there at 4 and be fast.

5:30am for a medicine service? Yeah, thats early.

Trust me, Ive done my share of 4am prerounds, 6am resident rounds and 8am chief rounds.

Unfortunately, while I think that this is bad overall for patient care, as a new intern none of my suggestions are likely to be listened to.

Perhaps its your attitude.

However, scutwork will always be things that don't help you to learn. This means calling home health companies, because the residents know it takes forever. This means looking up labs for patients that aren't yours. If you are a resident that gives this job to a student, be prepared when they don't follow through, or worse, don't notify you of a aberrant lab value. It is like checking out a CXR for central line placement. You put it there, that dropped lung will be your fault, so don't leave it up to someone else.

I dont know where youre getting some of these things from but I surely never said them.

 

[deleted109597]

Hmmm. 3 weeks in a 100 bed hospital, not to mention those giant SIGNS all over the place. I bet 90 of 100 patient could find radiology if they wanted to.

Then I stand corrected, maybe she's just an idiot.

??

I told that story as an example of how I was trying to help out a 3rd year student to learn something she wanted to learn. I dont know why you would turn that into an argument. Weird.

I wasn't arguing, I was saying that there were better ways.

5:30am for a medicine service? Yeah, thats early.

Trust me, Ive done my share of 4am prerounds, 6am resident rounds and 8am chief rounds.

Yeah, I'm getting sick of it.

Perhaps its your attitude.

In this case, hardly. When our daily conference has the words "Halstedian method" more than twice a week, the status quo is the way it is, regardless of how actually educational it is. Apparently the ACGME has gotten onto them at the last site visit for the amount of work they do without as much educational time.

I dont know where youre getting some of these things from but I surely never said them.

Yeah, I guess I should have had a page break in there or something. They were me trying to get back to the original topic of scutwork, and no connection was implied to you. Sorry if you took it personally though.

 

[Dr. Will]

That's pretty childish. All you did was call people names and add, "this is what I don't say" and act like you're not making the generalizations.

Wow...someone is trying to take what I said completely out of context and twist my words around because they really don't have much of an argument. Unfortunately, I've heard many people consider surgeons and orthopods to fit this stereotype. I've met a few that do fit that description, but the MAJORITY DO NOT! See...I'm not generalizing. In now way am I saying that they all are, nor the majority of them. There may be a few lazy EM residents out there. But...wait for it...the MAJORITY ARE NOT. See how that works? I'm not generalizing.

Again...let me spell it out for you...the generalizations made in your post are what some have taken issue with.

 

[8744]

I also want to point out re other specialties vs. Emergency Medicine that EM is more competitive than FM, IM, OB-Gyn, Pathology, General Surgery, Neurology, and a few other of the none "ROAD" specialties meaning that, on average, EM residents have better grades and higher board scores which would lead one to believe that they are not lazy, ex-medical students.

I think you people confuse a low tolerance for boredom and malignancy with being lazy. I am certainly not lazy but I also most certainly did not kill myself doing my resident's scut work when I was a medical student. **** 'em. They're getting paid, I was not, and true scut (fetching things for example, or copying lab values to a chart) has no educational value whatsoever. They call the ward group a "team" but it is usually a highly dysfunctional team to which loyalty is impossible.

My philosophy with my medical students? Zero scut and the interns shall do their own work. H&Ps, progress notes, following patients, procedures, and the like are not scut work, however. But as medical students will be abused plenty as residents, I try to give them a break if I can.

 

[THP]

I have a hard time believing any student would consider looking up labs or x-rays as scut. How are you supposed to know if the patient needs his K replace or a transfusion if he is anemic if you don't look up labs.

If you report an abnormal physical exam finding in the lungs, for example, the attending is going to ask you what the CXR showed. This is vital to learning, knowing how to correlate a presentation to a diagnosis. This is what we are supposed to be learning how to do!

You cannot formulate and assessment and plan without looking at all the information you have available. Are you ever going to start vancomycin without first looking at the patient's creatinine?

The other is that you generally can't (even as a student) leave until checkout to the night float which doesn't occur until all the work for the day is done. If I can get out of the hospital earlier by helping the interns set-up follow-up on the discharges or call to get records from outside hospitals (even if they are no my patients) I will definitely do it.

Scut is when you are asked to run to a residents car to get their I-pod so they can have music while operating.

 

[snoopy brown]

I also want to point out re other specialties vs. Emergency Medicine that EM is more competitive than FM, IM, OB-Gyn, Pathology, General Surgery, Neurology, and a few other of the none "ROAD" specialties meaning that, on average, EM residents have better grades and higher board scores which would lead one to believe that they are not lazy, ex-medical students.

That's not exactly an argument that makes sense. Whether someone has better board scores reflects not at all on their clinical work ethic, yes? I think it's also not relevant to talk about grades because usually people excel in the area they are interested in and their grades in other rotations are relatively ignored. Unless EM candidates are all AOA and everyone else isn't. Plus letters are very important. In other words, making such a simplistic assessment based on a single fact (which I don't know if it's true but I'll accept for sake of argument) shows poor analysis at best. Again, talk to people going into the field and usually lifestyle issues will come up fairly rapidly.

**** 'em. They're getting paid, I was not, and true scut (fetching things for example, or copying lab values to a chart) has no educational value whatsoever.

I too am not thrilled by many things about training. But you seem to be much more "loyal" if I can use that word to the medical students than the remainder of your colleagues. You protect the students and view it as everyone for themselves when it comes to the housestaff. I suppose that's fine because yes the housestaff are getting paid, but maybe you need to evaluate that attitude becuase it's a little odd. Were you shafted by a colleague or something?

I think if a medical student is going to be a doctor they should start thinking that they are the doctor as soon as possible. That means doing what they can for their patient. If they want to view it as not their job then nobody is going to shoot them but how can you expect people to respect them for that attitude?

 

[Faebinder]

I also want to point out re other specialties vs. Emergency Medicine that EM is more competitive than FM, IM, OB-Gyn, Pathology, General Surgery, Neurology, and a few other of the none "ROAD" specialties meaning that, on average, EM residents have better grades and higher board scores which would lead one to believe that they are not lazy, ex-medical students.

I think you people confuse a low tolerance for boredom and malignancy with being lazy. I am certainly not lazy but I also most certainly did not kill myself doing my resident's scut work when I was a medical student. **** 'em. They're getting paid, I was not, and true scut (fetching things for example, or copying lab values to a chart) has no educational value whatsoever. They call the ward group a "team" but it is usually a highly dysfunctional team to which loyalty is impossible.

My philosophy with my medical students? Zero scut and the interns shall do their own work. H&Ps, progress notes, following patients, procedures, and the like are not scut work, however. But as medical students will be abused plenty as residents, I try to give them a break if I can.

I share that philosophy.

 

[8744]

That's not exactly an argument that makes sense. Whether someone has better board scores reflects not at all on their clinical work ethic, yes? I think it's also not relevant to talk about grades because usually people excel in the area they are interested in and their grades in other rotations are relatively ignored. Unless EM candidates are all AOA and everyone else isn't. Plus letters are very important. In other words, making such a simplistic assessment based on a single fact (which I don't know if it's true but I'll accept for sake of argument) shows poor analysis at best. Again, talk to people going into the field and usually lifestyle issues will come up fairly rapidly.




I too am not thrilled by many things about training. But you seem to be much more "loyal" if I can use that word to the medical students than the remainder of your colleagues. You protect the students and view it as everyone for themselves when it comes to the housestaff. I suppose that's fine because yes the housestaff are getting paid, but maybe you need to evaluate that attitude becuase it's a little odd. Were you shafted by a colleague or something?

I think if a medical student is going to be a doctor they should start thinking that they are the doctor as soon as possible. That means doing what they can for their patient. If they want to view it as not their job then nobody is going to shoot them but how can you expect people to respect them for that attitude?

Residency programs look at grades, USMLE scores, and letters among other things. Non-clinical grades, as they effect both your GPA and your class rank are very important. You can have the best clinical work ethic but still not match because your non-clinical grades brought your class rank or GPA so low as to remove you from consideration. Many programs have automatic cut-offs for class rank, board scores, and GPA.

Additionally, your grades from every rotation, not just your specialty of interest, are important. They are most certainly not ignored. It would be natural for a surgery-bound medical student to "honor" his surgery rotations but if he fails his family practice rotation or OB-Gyn he will find it difficult to match, not only because his cumulative GPA will suffer but because he will look like an undisciplined guy. In other words, lazy medical students don't match, all other things being equal, into competitive specialties.

The people I knew who matched into the ROAD specalties did exceptionally well in all aspects of medical school and worked extremely hard, a lot harder than I did.

As for the housestaff, we have a job to do and real responsibility. It is not pretend or practice responsibility so more is expected. But it's not like I am a hard ass to anybody. Most residents know their responsibilities and are very conscientious without any direction in that regard. I have never heard of a resident, for example, leaving for the night without either resolving his patient's issues or appropriately signing it out to his relief. It just doesn't happen...or at least not in my experience.