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Peds experiences have been somewhat bad - what are others' experiences?

Discussion in 'Clinical Rotations' started by IonClaws, Dec 6, 2017 at 9:17 PM.

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  1. IonClaws

    IonClaws 5+ Year Member

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    May 3, 2011
    Florida
    Now, I'm not planning on becoming a pediatrician of any sort, so these questions aren't THAT important, but I need to hear what others have experienced. For most people, Pediatrics is a pretty happy go lucky rotation, and maybe the biggest problems come from the parents. Pediatricians have a reputation for being gentle...and yet, out of all my rotations in 3rd and 4th year, my worst evaluations have come from Pediatrics. Yes, worse than the so-called "difficult" rotations of Surgery and Ob/Gyn.

    I've had criticisms in other rotations before but not nearly as bad or critical as the evals in Peds. I was heavily criticized for not answering pimping questions correctly, for instance, in the core Peds clerkship. They also said my notes were poor (granted, they were, as I was not required to do any notes on most of my other rotations, probably to my detriment). Outside of Peds, I've never seen pimping questions used as an assessment tool, only as a teaching tool.

    And after a recent sub-I in a pediatric subspecialty related to my specialty of interest, I was described as unmotivated, requiring a significant amount of guidance, and lacking knowledge. I can understand requiring guidance as the sub-I was in a hospital where I've never worked and I didn't know how their lists worked and had to ask them a lot of questions about it...I figured it out, but I'm not sure what they expected...as for being unmotivated, I wasn't really sure what my role was in the clinic, or what I had to do to appear motivated. First couple of days were shadowing, and then I saw patients more on my own. Granted, my pediatrics interviewing wasn't great and I missed a lot of important points, which I eventually learned. One attending offered excellent guidance but was extremely picky with the histories presented and would not even discuss any management plan with me until I got the history just right. Ultimately I got a better grade out of this than the previous core Peds rotation but it was still somewhat shocking to me.

    I guess my overall point is, why does Pediatrics seem so harsh to me? I would describe myself as an introvert who is usually reserved. Could I be perceived as unkind, unfriendly or too "distant" by the pediatricians? Do pediatrician attendings just expect more out of students? Or am I just not good at taking care of children? Rant/questions/confusion over...
     
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  3. funtertaining15

    funtertaining15 Average Wizard 5+ Year Member

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    Aug 6, 2012
    Similar experience for me... Pretty introvert but I can be "extroverted-ish" when with patients, but more with kids. Peds is a very happy, more upbeat, which I realized is exhausting, at least for me in an outpatient field. I realized I was smiling all the time bc my natural expression is a RBF lol so I always felt like I had to put up a front bc my 2 doctors were either very happy but was kinda like me, more reserved but always laughing, or the other who liked to talk alot and pretty social. Not in inpatient it's a bit different atmosphere which I actually didn't mind. But peds was my first rotation and it wasn't the best in retrospect...one doc I had was fine but the other had a lot of things to critique...which I don't mind, but then if you're always gone, it's hard to judge for improvement lol. Anyways, I don't know if I'll go into peds now, not just because of that but I think I'd like to work with both kids and adults. But also have to figure out what works for my personality bc I'm pretty reserved and introverted too, but also I enjoy my free time...so idk anymore. But to your question...it depends how how your attendings are...if they're more social and upbeat, maybe view you as being that way, and you know it sucks, bc all of the evals and etc are subjective. So try as you may, but all you can do is what is comfortable and if all else fails, try asking questions more if you've talked about a patient or medication, etc....that's what I do bc otherwise I'm good seeing my patient, doing my note/w/e I need to so and bounce lol. Knowledge wise it can't be helped. It was hard for me too but just do your best. I've done all my required ones besides surgery and I can tell you that I still feel like I forget things I've learned...I barely remember much from peds to be honest. But good luck to you- don't let one bad apple ruin the bunch. Just try rotating elsewhere as an elective if you can. You got this!

    Sent from my Moto G (5) Plus using SDN mobile
     
  4. BigRedBeta

    BigRedBeta Why am I in a handbasket? Physician 10+ Year Member

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    Nov 1, 2007
    Clerkships are always going to be school specific.

    I can only speak for myself. When I was a resident and thus saw students on their clerkship, I pushed students on clinical skills for a number of reasons. I wouldn't be surprised if I was described as persnickety or worse by multiple students. But, my reasoning for this was as follows: I was extremely aware that most students weren't going to be pediatricians, and there is frequently a perception that Peds is worthless as a rotation if you're going to be a surgeon, a psychiatrist, a radiologist or a dermatologist, or essentially any field but pediatrics. The truth is, students are so inexperienced that there is no patient encounter that they can't use to get better. Whether it's improved efficiency at taking a history, learning to deal with difficult patients/parents, doing a physical exam with a less than cooperative patient, or writing a good note that is concise yet thorough, there is always a way to improve regardless of the field the student planned to enter. Along the way I could teach things unique to pediatrics, but after the 15th bronchiolitic of the week, what more was I going to do/say? Better to work on skills that would help everyone than dive deeper into pediatric nuance.
     
  5. 24blue8

    24blue8

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    Apr 20, 2016
    I agree that all of this could just be very specific to your rotations but-- you state that, though you improved, your knowledge initially was poor, your notes were bad and you did have a difficult time with presentations. It sounds like they evaluated you based on that? I don't see where your personality was evaluated? Or that you being an introvert or "perceived as unkind" had anything to do with it.

    Sometimes being the "fun" person can cover up deficiencies but that doesn't mean they aren't there. I'm not saying this to be harsh but to say it doesn't sound like you need to worry about how you come across-- just work on your knowledge base and your presentations. Which you did so it worked out in the long run!

    And I always thought pimp questions were ways to evaluate your knowledge. Not just fun random trivia they ask because they're bored.
     
  6. tick_tock400

    tick_tock400 2+ Year Member

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    Sep 19, 2014
    Look up the phenomenon "peds snob." What you're describing is an incredibly common experience that myself and a number of my peers have experienced both at my school and other schools. Nothing in my medical school experience has been nearly as malignant as my interactions with several pediatric residents and attendings; I've genuinely felt that some of the people I met in that department were unstable. On the flip side, I've also met many wonderful pediatricians. I'm sorry you're having a rough time; if you're really looking for constructive feedback, ask a mentor you know well or someone in the department you trust or look at your evals from other rotations.
     

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