Note to two-faced residents:

[deleted128562]

---

Members don't see this ad.

Please do me and your other med students a favor - if I (or they) ask you for feedback nearly every ******* day of the rotation, and you have any sort of concern or complaint.... ummmm.... hows about you mention it rather than telling me repeatedly that I'm doing great and then knocking me on my eval???

Just sayin'.

 

[mmmcdowe]

Being a resident doesn't mean you are suddenly a master of confrontation. They may have thought you sucked the entire rotation, but couldn't admit it to your face. Alternatively, they may have been overwhelmed and you asking for feedback, though the world to you, is a minor thing on their docket.

There is also, unfortunately, the human tendency to report negatives more than remember positives.

 

[SLUser11]

Please do me and your other med students a favor - if I (or they) ask you for feedback nearly every ******* day of the rotation, and you have any sort of concern or complaint.... ummmm.... hows about you mention it rather than telling me repeatedly that I'm doing great and then knocking me on my eval???

Just sayin'.

Agreed. If you asked for frequent feedback, and they declined to share the negative stuff, they are preventing you from learning and improving.

As the second poster mentioned, residents are not masters of confrontation, and unfortunately they receive no formal training on how to teach and evaluate people. Some of us that are heavily involved in education are trying to change that, first on a local level then hopefully on a larger scale.

 

[deleted128562]

Them lacking a spine and being afraid of confrontation should not be my problem. And teaching is a major part of residency, if you don't have 2 minutes to provide feedback so someone can work to improve, you are either just a jerk or you suck at being a resident since plenty of your peers don't seem to have a problem making the time.

Would you stand up and justify the resident's behavior if they lied to a family about a prognosis or a poor outcome because they were afraid of a poor reaction or a confrontation?

Being a resident doesn't mean you are suddenly a master of confrontation. They may have thought you sucked the entire rotation, but couldn't admit it to your face. Alternatively, they may have been overwhelmed and you asking for feedback, though the world to you, is a minor thing on their docket.

There is also, unfortunately, the human tendency to report negatives more than remember positives.

 

[Law2Doc]

Them lacking a spine and being afraid of confrontation should not be my problem. And teaching is a major part of residency, if you don't have 2 minutes to provide feedback so someone can work to improve, you are either just a jerk or you suck at being a resident since plenty of your peers don't seem to have a problem making the time.

Would you stand up and justify the resident's behavior if they lied to a family about a prognosis or a poor outcome because they were afraid of a poor reaction or a confrontation?

I agree with you that feedback should be honest. If you needed to improve, I'd certainly have let you know and your resident should have. At the end of the day though, attendings are going to want candid feedback from residents, and specifically focus in on things you didn't do as well as your peers, versus things you excelled at. In my experience, the attendings to a very large extent evaluate you, and while input from residents is helpful, most attendings already have a good sense of what they want your evaluation to look like and use the residents comments just to tweak things. That being said, The guy who was told he needed to improve on X, Y and Z, and did improve, is still going to come up short as compared to the guy who didn't need any improvement. I do have to say that you probably overstate things when you say that "teaching is a major part of residency". It should be, but in fact at most places it really isn't. Most attendings only care about the residents taking care of their patients and putting out the various fires throughout the day. Residents are technically asked to teach, but not really held to any expectations at all in terms of quantity or quality. To a large extent it's an afterthought, some thing residents do if they have time throughout the day. there's often an inverse correlation between the residents who do a lot of teaching and the ones held in high regard by the attendings because there's only so many hours in the day (within duty hours), and patient care can easily duck up most of that time. So basically I'm saying that your example in terms of talking to a patients family is different because the attending would actually care about that -- giving feedback to med students he wouldn't put high on his daily priority list. That's the bleak reality.

 

[Top Gun]

I agree with you that feedback should be honest. If you needed to improve, I'd certainly have let you know and your resident should have. At the end of the day though, attendings are going to want candid feedback from residents, and specifically focus in on things you didn't do as well as your peers, versus things you excelled at.

I agree with you that teaching and evaluation are a secondary consideration for residents. However, I disagree that feedback should only focus on things the med student needs to improve on. If I was going to evaluate a med student, I would try to discuss with them both their specific strengths and weaknesses. I might say, for instance, "I like the way you did this and this and this. I think, however, you might need to work more on soandso. I think that if you can improve soandso, you will do better." This way, I'm letting the med student know that there is need for improvement but, at the same time, I'm not discouraging him/her. And I would try to do this throughout the whole rotation as well as on the final eval.

 

[KnuxNole]

So basically, 3rd and 4th years is viewed as useless by attendings/residents in terms of if they actually learn anything in these places where they hate teaching completely...?

 

[Top Gun]

So basically, 3rd and 4th years is viewed as useless by attendings/residents in terms of if they actually learn anything in these places where they hate teaching completely...?

No one said residents/attendings hate teaching completely. The majority of us would love to teach if we had the time. But we don't always have time. We have large patient loads, and many patients have complex issues. If we can find time to teach, we will do it, but obviously finding time is not always possible.

 

[KnuxNole]

That is understandable. I wonder if there is ideally an alternative to using busy residents as teachers for 3rd year rotations. Of course, residents should still play a role and keep the love of teaching for residents to remain, but maybe for the med student side, something else can be added for the teaching perspective.

And if teaching takes up so many resources and money, I wonder if there is a more efficient way to spend 3rd-4th year :/

 

[hrandani]

My hometown paper had an article in it yesterday talking about the prospects for a new medical school in the area.

It quoted the director of the residency program as saying that "teaching" the current medical students and residents who were rotating in his hospital cost them 45 million a year.

I laughed until I cried.

 

[SLUser11]

My hometown paper had an article in it yesterday talking about the prospects for a new medical school in the area.

It quoted the director of the residency program as saying that "teaching" the current medical students and residents who were rotating in his hospital cost them 45 million a year.

I laughed until I cried.

Teaching can be quite expensive. It takes time and resources, reduces efficiency, etc.

 

[mmmcdowe]

Them lacking a spine and being afraid of confrontation should not be my problem. And teaching is a major part of residency, if you don't have 2 minutes to provide feedback so someone can work to improve, you are either just a jerk or you suck at being a resident since plenty of your peers don't seem to have a problem making the time.

Would you stand up and justify the resident's behavior if they lied to a family about a prognosis or a poor outcome because they were afraid of a poor reaction or a confrontation?

I am not in any way supporting them or standing up for them, simply giving possible explanations as to why.

 

[Law2Doc]

That is understandable. I wonder if there is ideally an alternative to using busy residents as teachers for 3rd year rotations. Of course, residents should still play a role and keep the love of teaching for residents to remain, but maybe for the med student side, something else can be added for the teaching perspective.

And if teaching takes up so many resources and money, I wonder if there is a more efficient way to spend 3rd-4th year :/

I think most residents like teaching. But it's not a metric by which you are evaluated, so it becomes secondary in terms of your time allocation. The attending won't care if you spent a few minutes teaching or not, but he will care if you didn't spend that time checking labs or pre rounding.

 

[KnuxNole]

Then I'm assuming attendings are the real culprits who don't care that med students are taught!!!

Of course they have patient care duties first...but maybe retired attendings should do the teaching? Random longshot, but curious...

Then again, I'm sure the 3rd years might say "Screw that, I'll teach myself by reading a book!"...which is what happens anyway now.

 

[VenusinFurs]

Then I'm assuming attendings are the real culprits who don't care that med students are taught!!!

Of course they have patient care duties first...but maybe retired attendings should do the teaching? Random longshot, but curious...

Then again, I'm sure the 3rd years might say "Screw that, I'll teach myself by reading a book!"...which is what happens anyway now.

3rd year isn't useless. You pick up a lot of tidbits on management here and there if you are observant. You also kind of get an idea how to manage your time, how to present, the kinds of things you need to be vigilant about, etc from observing the residents.

 

[duckie99]

Please do me and your other med students a favor - if I (or they) ask you for feedback nearly every ******* day of the rotation, and you have any sort of concern or complaint.... ummmm.... hows about you mention it rather than telling me repeatedly that I'm doing great and then knocking me on my eval???

Just sayin'.

often times it's just easiest to say good things and avoid any sort of argument and making the student pissed off at you the rest of the month. Also perhaps in their mind you were doing fine, nothing bad but nothing super great, and then got the appropriate eval from their point of view.

And get off your high horse. Every 3rd yr med student thinks they are the hardest working, smartest student ever to grace a resident's presence. In all likely hood you are just average.

 

[deleted128562]

often times it's just easiest to say good things and avoid any sort of argument and making the student pissed off at you the rest of the month. Also perhaps in their mind you were doing fine, nothing bad but nothing super great, and then got the appropriate eval from their point of view.

And get off your high horse. Every 3rd yr med student thinks they are the hardest working, smartest student ever to grace a resident's presence. In all likely hood you are just average.

Please feel free to show me where I ever said I was the smartest, greatest student ever. All I'm asking for is honest feedback whether I am great, crappy, or average. Don't see how that is being on a high horse?? But thanks for your excellent** contribution to the conversation.




** Actually it was pretty average. And you might do well in life to lose the air of moral superiority.

 

[duckie99]

Please feel free to show me where I ever said I was the smartest, greatest student ever. All I'm asking for is honest feedback whether I am great, crappy, or average. Don't see how that is being on a high horse?? But thanks for your excellent** contribution to the conversation.

** Actually it was pretty average. And you might do well in life to lose the air of moral superiority.

Your original post suggested you thought you did great because no one told you anything you did that they felt was not great. And then when you get your average eval back you get pissed. Thus my reasoning for saying you likely thought you were awesome but in fact are not that awesome.

It's just the way it is. New 3rd years are being compared to previous experienced 3rd years and potentially 4th years as well. No way a new one can be as good. And not all students can be awesome. Most are average. Some are good. Few are great.

And my point that you got pissed about was not necessarily directed at you but at all 3rd years who complain (myself included when I was 3rd year). But I think your response even to that statement on this forum perhaps illustrates the very attitude you say you don't have. Those who evaluate you can see this. My 2 cents... stop begging for feedback and just do your best. You cannot control your evals.

 

[sylvanthus]

Your original post suggested you thought you did great because no one told you anything you did that they felt was not great. And then when you get your average eval back you get pissed. Thus my reasoning for saying you likely thought you were awesome but in fact are not that awesome.

It's just the way it is. New 3rd years are being compared to previous experienced 3rd years and potentially 4th years as well. No way a new one can be as good. And not all students can be awesome. Most are average. Some are good. Few are great.

And my point that you got pissed about was not necessarily directed at you but at all 3rd years who complain (myself included when I was 3rd year). But I think your response even to that statement on this forum perhaps illustrates the very attitude you say you don't have. Those who evaluate you can see this. My 2 cents... stop begging for feedback and just do your best. You cannot control your evals.

Ehh I think you are missing the point the OP is trying to make. I would also think that if I asked for feedback and was not told anything I needed to work on, that I was doing a good job and to basically to keep up the good work. If I were in a similiar situation, thought I was doing a good job, and then got a lukewarm feedback, I would be pretty pissed off also.

So, no I dont think it is because every 3rd year thinks they are the bomb like your previous post. That was quite a leap of logic there and quite frankly a ridiculous snotty comment.

 

[duckie99]

Ehh I think you are missing the point the OP is trying to make. I would also think that if I asked for feedback and was not told anything I needed to work on, that I was doing a good job and to basically to keep up the good work. If I were in a similiar situation, thought I was doing a good job, and then got a lukewarm feedback, I would be pretty pissed off also.

So, no I dont think it is because every 3rd year thinks they are the bomb like your previous post. That was quite a leap of logic there and quite frankly a ridiculous snotty comment.

if you guys really think that is snotty you have got to get over yourselves. I was a third year. I know how it goes. I and all of my classmates complained about our evals. People come here and complain about their evals. Point is no one is happy. Point is also that all of us think we are doing awesome, and especially when told we are "doing fine". Then when we get the "average" eval everyone gets pissed. "Doing fine" only means you are aren't a ***** and they don't hate you.

Average is not bad. It's just, well, average. As I said only few are great students and deserve that great eval. I simply have never heard a resident give a student poor feedback face-to-face. I had one attending who did give direct feedback (usually came off as negative) and guess what... everyone absolutely hated that guy. But you may be surprised to hear that when I went back and read again what he said about a year later, he was pretty accurate. The guy who gives negative direct feedback just makes everyone mad and the rotation sucks because you are then on your toes.

So stop asking for feedback unless you are required to. Just do your work, try hard, ask for more patients, don't be annoying, and don't complain. In all likelihood you are "doing fine". Some will give a good eval for that effort and others will give an average eval even though both tell you that "you are doing fine, no worries". It's just the way it is. Your goal is not to get a good eval. An average eval does not mean there are a bunch of things you did wrong. It likely only means you did average compared to other med students. That's not bad.

 

[sylvanthus]

if you guys really think that is snotty you have got to get over yourselves. I was a third year. I know how it goes. I and all of my classmates complained about our evals. People come here and complain about their evals. Point is no one is happy. Point is also that all of us think we are doing awesome, and especially when told we are "doing fine". Then when we get the "average" eval everyone gets pissed. "Doing fine" only means you are aren't a ***** and they don't hate you.

Average is not bad. It's just, well, average. As I said only few are great students and deserve that great eval. I simply have never heard a resident give a student poor feedback face-to-face. I had one attending who did give direct feedback (usually came off as negative) and guess what... everyone absolutely hated that guy. But you may be surprised to hear that when I went back and read again what he said about a year later, he was pretty accurate. The guy who gives negative direct feedback just makes everyone mad and the rotation sucks because you are then on your toes.

So stop asking for feedback unless you are required to. Just do your work, try hard, ask for more patients, don't be annoying, and don't complain. In all likelihood you are "doing fine". Some will give a good eval for that effort and others will give an average eval even though both tell you that "you are doing fine, no worries". It's just the way it is. Your goal is not to get a good eval. An average eval does not mean there are a bunch of things you did wrong. It likely only means you did average compared to other med students. That's not bad.

Sigh, really no point in arguing with a person who throws out such ridiculous, broad statements such as the above. Feel free to keep talking like you know every medical student in the country and what they are thinking.

 

[deleted128562]

Duckie, I think there is some misunderstanding because I wasn't specific enough from the beginning and was just cranky when I replied last night.

I am not mad about an average eval. That would have been fine. I am talking about an eval where over 1/2 of it was spent pointing out a very specific deficiency that they "had real concerns about, and is something Mr. Hat really needs to address." It had to do with my notes/ paperwork and in retrospect was probably a legitimate point. It was also something easily fixable which I think I have already improved 1000% on.

The point is: 1) The resident outright lied when they told me repeatedly I was doing great and had nothing to work on. 2) Had they told me their concern I could have EASILY fixed it over the course of the rotation. So basically they set me up for failure and then went on and on about it in the eval. I hope you don't see this as OK.

Incidentally the attending gave me a very nice eval and my grade was fine. So everything will likely be alright. But that still doesn't justify the resident's behavior.

 

[duckie99]

Duckie, I think there is some misunderstanding because I wasn't specific enough from the beginning and was just cranky when I replied last night.

I am not mad about an average eval. That would have been fine. I am talking about an eval where over 1/2 of it was spent pointing out a very specific deficiency that they "had real concerns about, and is something Mr. Hat really needs to address." It had to do with my notes/ paperwork and in retrospect was probably a legitimate point. It was also something easily fixable which I think I have already improved 1000% on.

The point is: 1) The resident outright lied when they told me repeatedly I was doing great and had nothing to work on. 2) Had they told me their concern I could have EASILY fixed it over the course of the rotation. So basically they set me up for failure and then went on and on about it in the eval. I hope you don't see this as OK.

Incidentally the attending gave me a very nice eval and my grade was fine. So everything will likely be alright. But that still doesn't justify the resident's behavior.

gotcha. Just to play devil's advocate it is possible when you asked for feedback you weren't very specific. Maybe if you had asked how the resident thought your notes were or how to improve them it would have been better. And in that case if the resident says they were "great" and then bashes you for bad notes on the eval then that's pretty low (though again perhaps the resident got you confused with someone else).

In any case, stuff like that happens all the time unfortunately. Just look to the final grade and that's all that matters.

 

[OveractiveBrain]

That is understandable. I wonder if there is ideally an alternative to using busy residents as teachers for 3rd year rotations. Of course, residents should still play a role and keep the love of teaching for residents to remain, but maybe for the med student side, something else can be added for the teaching perspective.

And if teaching takes up so many resources and money, I wonder if there is a more efficient way to spend 3rd-4th year :/

There is.

www.onlinemeded.org

But nothing can replace experiential training. Listening on rounds, hearing explanations, watching what orders get placed (and hopefully a little of the why) is a large part of training. Standing around looking at the wall expecting chalk-boar or powerpoint presentations means you are missing out. Teaching opportunities happen all the time, they just aren't the rhetoric you are used to in the classroom.