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Discussion in 'Pre-Medical - MD' started by Pkboi24, Sep 8, 2006.
*in the voice of Dr. Cox: By god newbie, you are reHEHEAlly getting on my nerves with your complaints. Now go get me some coffee and then you can go play with your dollhouse for a few minutes.
Give me a break!
Somebody call the waaaahhhmbulance. Yeah, you're going to get insulted or belittled. It's bound to happen - someone will be condescending at some point. Everyone does it, it's a form of displacing stress. You can either cry about it, or you can suck it up and move on.
It's a great question for your interviews... how is your school responding to this recent study?
exactly who I was thinking of while reading the article only I was thinking of,
*voice of Dr. Cox* "Are you an actual doctor or a doctor like Dr. Pepper?"
Harassment is so subjective. The real question is if the rates of reported harassment are any higher than any other job with this level of social interaction.
medicine is a rough field in and of itself. if you can't handle a little "harassment" from your superior for not being the best you can be, how do you handle patients dying?
Very good point. The numbers in and of themselves don't mean a whole lot without some point of reference.
It's not harrassment as much as "hazing". You want into this "club" called the medical profession. They make you wear a short coat instead of a pledge pin, but the status is the same. At least they aren't making you swallow goldfish or go streaking in the hospital cafeteria. Chill.
I have been the "fng" in the military and the "probie" on a fire department so I am looking foward to nice, friendly interactions compared to those jobs.
Yea. I'm pretty sure everyone expects a little harassment...but with this article we really have no reference how extreme it is. The fact is..we could give it the "suck it up and take it" attitude or we could mellow it out a bit. Harassment just isn't good for learning...I'm not talking being a little critical every now and then when a mistake is made...that is fine but if it is just to be d!ck and because it is some part of an initiation process then..well it is just more counter-productive than anything. People bitch and moan about these people that essentially make their life hell and then they eventually become those people....I highly doubt it reaches true hazing levels or anything but would you rather have an attending that inspires you to learn more and model yourself after, or one that constantly belittles you? It is a fine balance between positive criticism and useless harassment sometimes. Yes a person has to be able to handle a death of patient...but a kick in the stomach after that isn't always necessary.
fyi..I am just kind of saying this as devil's advocate to maybe spark a convo. If anything little debates and thoughts help us prepare for interviews.lol
Very good point.
There's also the element that a disproportionately high number of medical students come from upper middle class suburban backgrounds. Threshholds for what constitutes harrassment and stress might be lower than folks from more challenging backgrounds.
Can we still do that if we want to?
seriously though... nothing worth doing is ever easy.
Who says we don't ?
None of this comes as a surprise after watching "Scrubs".
Others before us have endured all of this, so why can't we?
isn't training in the military just as or even more so severe? just wondering....
Soooo freakin true I've witnessed this during my military background, and I'm convinced its no different in the civillian world. It's a vicious cycle that could be stopped if people would just pull their heads out of their prideful @$$es and realize that putting people down is not the only way to make yourself feel like a badazz . I think it stems from the immaturity on behalf of those who are doing the harrasing. Most of the time, I can look at a person and say "you probably were the biggest nerd growing up and got bullied day after day." These same nerds become your attending physicians/residents/classmates with a chip on their shoulder since they are in a place of authority and would like to make up for all the lunch money they lost in grade school. Some people never learn to stop being bullies. That being said, there's two ways to deal with these bastards: 1. You can keep silent and continue to take it up the rear until you feel suicidal, or 2. You can buck back until they leave you alone because we all know bullies single out people who they think are weak. I personally choose the latter
From what I have heard, I bet the average PhD student takes more harrassment than the average medical student.
Ya, talking about cheap labor. PhD candidates tend to work longer hours than med students, but it's different kind of stress, and highly advisor-dependent.
Here's the thing.
I agree that others before us endured it, but others before us also endured much longer hours during residency before the 80-hour stipulation was enacted.
There is always a need to examine what the standard is versus what it could be in the interest of not only the med student but also all the people who interact with the med student.
You know how they say you're supposed to leave all your emotional baggage at the door before you come to work... but nobody ever does? If a med student is overly upset, that could translate over in dealing with a patient, which could affect not only the patient but also reflect poorly on the hospital.
Hospitals don't want this, obviously. Sure, some patients have little choice in where they recieve medical treatment because they have to be treated by certain specialists, but... the average patient may have a bad experience with a mean medical student and seek care elsewhere in the future. Don't pretend like this doesn't happen.
Everybody learned in general psychology class that people who are positively-reinforced operate at a much more efficient level than their negatively-reinforced counterparts. If it's your first time doing a minor procedure and you mess it up, your attending should not respond by calling you a "f*cking idiot that has absolutely no place in medicine". He should show you the right way to do it and say he believes you'll do it right the next time (whether that's true or not).
That sounds flowery, whatever, but it works. What's important is that the med student learned the procedure and maintained a positive outlook in the process.
So to write the complaints off as nothing and say "this is just how it's done" is really unacceptable.
It's so funny to hear a bunch of pre-meds talking about this when the third-year forums is full of people going through it now complaining about how awful it is. Really, unless you've been through it, I don't think you can just dismiss it as "something that happens." You won't know how it is until you get there and regardless of how you think you'll react to it, I would bet that most of the people who pretend it's no big deal will actually be pretty disturbed by the experience when it happens.
Exactly. There's probably a disproportionate number of people who have never had a job before too.
Now THAT is an excellent point. I think that med school could be a very different experience for someone that comes from a challenged working backround let alone someone who has played the part of FNG in highstress\no respect jobs like the millitary or construction work.
The people going through it now are not the first, nor will they be the last. That is why you can totally dismiss it as something that happens. Sure, it is disturbing but is nothing new -- no revelations here.
For one of the ambulance agencies I work with, my trainer for my first few shifts is the kind of person who questions "why" for everything. When you discuss the call afterwards, he'll ask "why" you did everything, will ask for more details, will ask for you to remember the physiological reasoning behind what's happening and why what you're doing works. When there was a question you should have known the answer to but didn't, it made you feel stupid and insignificant. To a lot of people, especially those who hadn't worked in high stress situations before, they couldn't stand training with him, because to them he came across as belittling, but those people who could deal with the constant questioning learned a lot and didn't forget the important details. All he was doing was making sure that you remembered everything from class- he wasn't asking you to know more than that but expected you to know what it was you were supposed to learn. I can imagine rotations being the same way- your resident, attending, whoever is asking you questions about a condition/procedure that you've been over in class and you don't remember, they have every reason to say "you don't know that? But you went over that in ____ class." Yeah, it may be belittling, but really, you should have known that.
Note- I have no idea what is constituted as "belittling" in medical school, but that's how I'd interpret it based on my experiences.
Dialogue from House of God:
"What's suicide about?" I asked Berry. "Here," she said, drawing me to her, "put your head here. Close your eyes. What are you feeling?"
Blank. Then fury: "I'm pissed. I'm so serious I could kill!"
"That's what sucide is all about. Under incredible pressure, alone with no support from your bosses, most of you have found bizarre ways - this role labeling of Hooper with death and the Runt with sex - to project your anger outside yourselves. Pott's didn't. He never acted strange, he never got mad. he took his rage and blasted himself. introjection. The opposite of what you do Roy."
"What do I do?"
"You rail at everything, you're sarcastic, and even though you're pretty obnoxious, it's the one way you've chosen to survive.
Good book, but not as good as I had hoped. I think I missed the climax of the book. Was it when Potts died? If so, it wasn't that climactic.
tuck it in, show up at 6am, go home at 8pm, study for your boards, repeat for 2 years.
There is no climax in internship, or residency for that matter. You get through it, you get a job and life begins.
If you don't figure out how to have a life before graduating from med school, your chances of having one after getting a job are pretty slim.
I had a great life before and through medschool, didn't have much of a life during internship, residency and fellowship. It's looking up since.
house of god is the worst book ever written.
Nice job of stereotyping there.
its the only way they'll learn
Welllllllllllllllllllllll there may be some truth to that!...but then again maybe not...b/c harrassment is harrassment...people just deal with it differently...hint hint
I am very surprised by some of the reactions here by many posters. A hostile and unsupportive working or training atmosphere is at best unhelpful and at worst very detrimental to the experience as a whole. It is true that to be a doctor one must learn to grow thick skin and deal with all sorts of people and situations; however, that does not justify the kind of ridicule and harrassment meant for pure degredation and abuse of those with lower stature in the medical heirarchy. I do not yet know the extent and frequency with which a typical medical student or intern/resident is subjected to such unfortunate experiences, but I do feel that a medical culture in which such behaviors are accepted and even encouraged does not serve the best interest of the students or the patients. Of course students need to be challenged, of course they need to be criticised for not meeting expectations or not living up to their potential, but this can be done constrictively for the benefit of all involved. The goal here is to give the patients the best care possible and the medical students the best training and guidance possible. Hazing or harrassment has no place in such a serious and important mission. It has no place in medicine. That being said, I suspect that perhaps at few bad apples are simply giving the whole process a bad name. For the sake of the patients and the quality of our medical education, I hope that this is the case.
Well, there is usually some degree of truth in most stereotypes
I read the article and here is the direct quote.
"Most medical students in the United States are graduating from medical school having had experiences that they report as being either belittling or harassing,"
I agree that you get belittled or criticized when you are a medical student or even as an resident, but alot of it is subjective. What is considered belittling to someone, might be considered constructive criticism to me. Some people are sensitive more so than others. Alot of medical students / residents go around with egos and when someone says to them that you are not doing a good job because so and so, or something like " how can you not know that as a 4th year medical student.... you should go home and spend more time reading!" The problem is that if the only thing you ever get from someone is "oh you are such a good student, there is nothing that you can improve, you are great, etc, etc." Then you will never improve and get better. Sometimes it takes a person higher up to knock you off from your ego trip to become a better physician. I was a medical student not too long ago, now I am a resident and have the responsibility of eval / working with medical students. At the same time, I get criticized by my attendings. I have been on both side of the fence, and I can say that it is important to tell a student if they are doing a good job or if they have areas that they need to improve upon.... If no one is willing to point out your weakness, then you will never improve, that is the bottomline. Some times, the method of pointing out these weakness can seem belittling or harassing.... but you know what, as a med student or resident, just suck it up.... because one day, you may look back and say hey, that was a great criticism. No matter what you end up doing in life, business / waiting tables / janitor / nurse / doctor, you will always be criticized by either your boss, colleague, or patient. How you perceive these criticisms can have great effects on your work and happiness.
On the other hand, some things are considered harassment, this is a true story, one of the Duke med students years ago, during her surgery rotation, was retracting in the OR, the attending was pissed off that the retracting was not good, and put a staple into this medical student's hand. This example is crossing the lines.
The article and your reaction to it demonstrate well that todays medstudents are probably different from medstudents past. It is an 'experience' and god forbid, it could be 'unsupportive'. This is not grammar school, where 'we all are unique and precious in our own way'. There are pretty clear standards, and keeping those standards up is important for our end-user, the patient.
If it is for the pure degradation and abuse, it is certainly wrong. If being asked a question which you don't know the answer to in front of your peers is 'harrassment', then you probably shouldn't be in medschool.
Sing with me: kumbayahh...
Hazing and harrassment: No.
Pimping in front of your peers: Yes.
Maybe I did not make myself clear. I am in no way comparing medical school to grammar school, and certainly never made any sort of comment about us being unique and precious in our own way. I also never said anything about not wanting to be asked questions that I don't know the answer to in front of my peers. I think you mare taking my comments and extending them to mean something that they were not intended for. Your "kumbayahh" comment is kind of funny, but my point still stands. Medical training should be done for the benefit of all involved. Good training means good doctors, which equates to better patient care.
I do not consider pimping in front of peers or legitimate criticism of performance to be harrassment. It is a given that we should be challenged and put on the spot, even chewed out for not living up to expectations. It is when things cross the line to being malicious and deliberately degrading that we are really talking about here. And I suspect that you would agree that this is not appropriate. I subscribe to the mentorship approach to learning and training in both academics and the professional world. High standards should be expected, those that live up to them should not be allowed to continue, but maintaining professional boundries and showing mutual respect goes a long way in facilitating the effective transfer of information. I do not belive one has to endure a trial by fire, be tough as nails, and eat babies for breakfast be be a good doctor. The profession is founded on compassion, service, and altruism (all those perhaps considered by some to be "kumbahya" ideals) and it may benefit from focusing on these in its training as well.
Great post. I agree. But "true harrassment" may also include harm that is more psychological. There are certainly many other malicious things that residents and attendings can do to medical students that would similarly cross the line, and yet not result in physical injury. But I do agree that criticism is essential.
There is definitely malignant attendings and residents. Especially in the culture of General Surgery..... it is this hazing that people talk about. I was an intern last yr in the Gen Surg department and I can tell you some stories that are on the line of harassing and physical / psychological harm. One med student on one of surgical services here was 3 months pregnant.... she was in the OR scrubed, but the case required use of Fluoro, which means that you have to wear lead. If you are pregnant, then you should not be around fluoro period. Well, she had to scrube out when the fluoro was in use, this happened several times and the attending was annoyed that she had to scrube in / out, told her "either you stay for the whole case, or scrube out and don't come back again!". Give that you are a med student, and you have the pressure of getting good grades, she actually stayed and did not scrube out again. I learned later that this person had a miscarriage.... it is probably not due to the fluoro, but probably due to the stress of the surgery rotation (80-90 hrs each week, getting pimped in rounds in front of many people, coming in at 4:30 am to get vitals and pre round each morning, leaving at 7-9pm each night, then be on call on the weekends, ect etc). Medicine can be a very stressful job.
Just wait. More ignorant pre-meds are on the way to tell you (and that poor med student) that if you can't handle a little miscarriage every now and then, you don't deserve to get through med school...
Oh good lord. I said:
"There's also the element that a disproportionately high number of medical students come from upper middle class suburban backgrounds."
This is different from "Medical students are rich". See the difference in phrasing? I went out of my way to not stereotype. Did everything short of a footnote with a legal disclaimer. Sorry it wasn't enough.
Go to a medical school and see how many folks grew up in comfortable upbringings. Then check out the last national census.
I guess we are talking about the same thing here.
It was just the 'newspeak' in your post that got me going. Through residencies and fellowship, I have been a teacher to medical students for a couple of years. The school I did my residency at was engrossed in the new-age sensitive 'we are all valuable' teaching concept (with only pass/fail determinations and no AOA chapter). After I dared to ask a medstudent to look up something and get back to the group the next day, I got a call from the assistant associate sub-dean for medical student education telling me that 'this is not how we do things here' (This was a stark contrast to the places I did my internship and fellowship. As a result, kids from those schools had their choice of specialties when match-time came around).