Need advice on Specific Rotation Issue

[confusedpremed12345]

So on my rotation, at the end of my first day, my preceptor told me to meet her the next day at 7 AM, so I did, and then that day she said she was teaching a class and so I should go see my patients and then her meet her back at 8 for rounds, so I did that. Then the next day, Wednesday, the same thing happened, so at this point, I had established in my mind that I should be there at 7 AM and then start seeing my patients. Then on Thursday, I knew she had a surgery scheduled for 7:30 AM, and I didn’t ask her when I should meet her the next day as I thought that 7 was still the agreed-upon time for me to be there, having not been told otherwise. I showed up at 7 again, and then she asked if I had already seen my patients. I was a little confused by this as I didn’t know that I was expected to have already seen my patients, but I didn’t think much of it and I just honestly answered that no I had not, and she told me to go see them and meet her back before 7:30 AM, and so I did that and then we went to surgery, and we did not round until the late afternoon. In hindsight, at this point, I should have asked her if I was expected to have pre-rounded by 7 AM and if I should expect rounds to be at 7 AM, but it did not occur to me at that time. Anyway, on Friday, I showed up at 7 AM again and said hello to her. She did not respond, but I figured she was maybe busy concentrating on something, so I went about my work again and saw my patients and then went back to our regular meeting place. When she got there, she said “I really need you to work on being done with seeing your patients by 7 AM so that you are ready for rounds by 7 AM.” At this point, I just said “ok, sure, I’ll do that” and then we went about our day. Reflecting back, I am wondering if I should have let her know that I was confused and if I should bring it up if I see her again or if I should just let it be now that it has happened. She’s not the one writing my eval and I won't be working with her again for at least another week (though she is close to the person who is) but I don’t want her to think I was just showing up late or not caring. That being said, I also don’t know if it’s too late to say anything about it. In any case, I’ve learned that I should always double-check and ask when rounds are and what time I should be there and not assume they’ll be at the same time every day even if I’m not told otherwise.

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[Maximus2020]

Yeah this sucks and it's her fault. She sucks, sounds horrible. She, like many attendings, fail to explain the details to you early on and ends up blaming you.

Best thing to do is learn from it, smile, say thank you, just like a pledge in a fraternity. This is just people. If you let her know you were confused, she would make it seem like it was your fault so don't bring that up to her. From now on, get to the hospital to pre-round and try to be done 15 minutes before you are supposed to be done. It's always better to be early, not rush, and have time to sit around than to just make it.

Have faith in the few good attendings/surgeons out there. Be one of those good people. When you become an attending, as I am now, remember these horrible memories, as I do and smile at, and try to be the better/kinder person to students, other staff, etc. Stay strong and power through this.

 

[FutureInternist]

Paragraphs

 

[ortnakas]

“Dr X sorry about last week, I misunderstood and thought you meant come by 7 not round by 7” and leave it at that. Not a big deal.

 

[drcrispmd]

Advice from an attending. If it is not clear when to meet, rounds or expectations, ask on day 1 or email the attending before starting. It is ok to ask these questions.

 

[Redpancreas]

So on my rotation, at the end of my first day, my preceptor told me to meet her the next day at 7 AM, so I did, and then that day she said she was teaching a class and so I should go see my patients and then her meet her back at 8 for rounds, so I did that. Then the next day, Wednesday, the same thing happened, so at this point, I had established in my mind that I should be there at 7 AM and then start seeing my patients. Then on Thursday, I knew she had a surgery scheduled for 7:30 AM, and I didn’t ask her when I should meet her the next day as I thought that 7 was still the agreed-upon time for me to be there, having not been told otherwise. I showed up at 7 again, and then she asked if I had already seen my patients. I was a little confused by this as I didn’t know that I was expected to have already seen my patients, but I didn’t think much of it and I just honestly answered that no I had not, and she told me to go see them and meet her back before 7:30 AM, and so I did that and then we went to surgery, and we did not round until the late afternoon. In hindsight, at this point, I should have asked her if I was expected to have pre-rounded by 7 AM and if I should expect rounds to be at 7 AM, but it did not occur to me at that time. Anyway, on Friday, I showed up at 7 AM again and said hello to her. She did not respond, but I figured she was maybe busy concentrating on something, so I went about my work again and saw my patients and then went back to our regular meeting place. When she got there, she said “I really need you to work on being done with seeing your patients by 7 AM so that you are ready for rounds by 7 AM.” At this point, I just said “ok, sure, I’ll do that” and then we went about our day. Reflecting back, I am wondering if I should have let her know that I was confused and if I should bring it up if I see her again or if I should just let it be now that it has happened. She’s not the one writing my eval and I won't be working with her again for at least another week (though she is close to the person who is) but I don’t want her to think I was just showing up late or not caring. That being said, I also don’t know if it’s too late to say anything about it. In any case, I’ve learned that I should always double-check and ask when rounds are and what time I should be there and not assume they’ll be at the same time every day even if I’m not told otherwise.

Honestly, I hate to blame the attending, but this really seems like her issue like Maximus says. She seems like one of those attendings who has detached herself from any adversity students/residents face and makes it a point to do things based on her convenience. Her behavior Thursday is an example of this. She seems to not give a damn if that includes gas lighting students to maintain her fragile confidence or making students struggle for little reason without caring (maybe because she was treated this way and sees it as a right of passage).

The issue is how to address it. I agree with the one-liner Ortnakas gave. Don't call attention to it. Deep down she knows she f'ed up or at least was not clear. The more you apologize, the more you're indirectly trying to make her apologize (something she seems hellbent on not doing). Just state plainly that you thought rounds were at 8am, but you will now be ready by 7am. Expect the wrath and prepare for the worst. Do your best to redeem yourself, but don't expect her impression/treatment of you to change. Some attendings are like this. Just be prepared to be treated unfairly. Try to frame it as playing a video game on hard to try to get better and pity her. She's likely displacing anger from something else.

In the future, always ask even if you have even a little bit of doubt as there's little room for error in the culture of medical training. This is one lesson in medicine I learnt the hard way. In most cases, the question won't be necessary and will seem silly. I used to laugh (in my head) when others asked such obvious questions but one day that obvious question will save you a** from arriving to the hospital and your attending paging you asking to meet her to run through the patients.

One optional piece of advice is to write to your clerkship coordinator. Be apologetic and accept blame for not clarifying, but also assert that you did not intent to be late (be sure that 7 am rounding time was not an expectation discussed at orientation, d/w classmates). This way, if she complains, there's a clear explanation. You do, however, risk the consequence of drawing attention to the issue when attention was not on it. Weight the benefits/risks in your scenario. Give the dates, etc. like you did to further support your story. I'm willing to bet her reviews from medical students are not ideal.