pimping rules

[Thunder]

What's the rule for pimping?

Can anyone higher on the food chain than you ask you pimp questions? Or are pimping privileges reserved for attenings only?

Just wondering because I get pimped hard by a surgical intern (I'm an MS3 on surgery rotation), but only when the attending is around... almost like he does it because he needs to feel powerful, or show off in front of the attending. Is he abusing his power over me? He tends to ask questions that I believe are beyond MS3 level therefore I generally do quite poorly with his questions.

Either way, I'm not gonna do a thing about it as I'm almost done and just want to pass... no interest in pursuing surgery as a career.

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[doc05]

anyone higher on the food chain can pimp. That's the way it's done. I would ignore the intern because (1) most don't know anything and (2) they rarely have any input in your evaluation.

I would also venture to guess that if the intern knows the answer, you should too.

 

[njbmd]

Hi there,

Anyone can pimp you but listen to the nature of the intern's questions. They might be trying to direct your studying in a direction that will help you on shelf or in-house exam. Let the questions be a guide in your studying. If you don't know the answer to a question, say so and move on. At this point, you won't be penalized unless it is something basic like the types of hernias etc.


njbmd

 

[Samir Desai]

Any team member that is senior to the medical student may choose to "pimp" you. If done the right way, it can be an effective teaching technique. But too often, it is done in an inappropriate way that tries to make students feel inferior or stupid. I remember feeling that way many times as a student.

Now as an attending, at the beginning of every rotation, I tell my students that I am going to ask them a lot of questions. I also tell them that I don't expect them to have all the answers. One reason I ask them so many questions is so I can ascertain what they do know and what they don't. That way I can fill in the gaps and make sure they have a firm understanding of some important points. These are take-home points or points that may come up on the exam.

With regards to pimping, my advice is try your best. If you don't know the answer, just say so. It's okay. Shake it off because if you worry too much about it or get flustered, you will not be ready for the next question.

As for Thunder's situation, it's not clear to me why the surgery intern only asks him questions during attending rounds. It could be that things are so busy throughout the rest of the day, that there is no time. If that's the case, the surgery intern may be pimping to help educate the student. Sometimes, however, interns and residents pimp students in front of the attending in an effort to make themselves look good. By pimping students, they feel they are showing the attending their knowledge base or efforts to teach. Remember that interns and residents, just like students, are evaluated by attendings. When interns and residents are pimping for their own selfish reasons, many attendings (who have been around the block a time or two) can spot this.

In any case, don't worry too much about it, do your best to answer the questions, learn from the experience and discussion, and think about the right way to pimp a student when you become an intern, resident, or attending.

Samir Desai, MD
Assistant Professor of Medicine
Baylor College of Medicine

 

[rrreagan]

Professor Desai,

Are interns and residents formally evaluated by attendings in the same manner that students are?

 

[Samir Desai]

During internship and residency, you will continue to be evaluated, usually on a monthly basis. At the end of the month, team members who are senior to you evaluate your performance. If you are an intern, hopefully, your resident and attending will meet with you at the end of the month to give you feedback. Since this often does not happen, be sure to set up this meeting yourself. Otherwise, it's difficult to know what you are doing well and what you need to work on. If you are not able to meet with the attending or resident, you can read their evaluation of your performance. Evaluations are usually kept on file at the residency program and should be available to you. Ideally, you should strive to have this feedback meeting and read the evaluation. One should not take the place of the other.

At many institutions, there are meetings at the end of the month where attendings gather together with the residency program director, chief residents, and other involved faculty to talk about the performance of residents and interns. Everyone wants to make sure that residents and interns are progressing along and are where they need to be. If someone is doing a particularly stellar job, it is brought to the program director's attention. If someone is having difficulty, that too may be discussed.

It's not just senior members of the team that evaluate junior members but interns often have the chance to evaluate residents and attendings (and residents evaluate attendings). As an attending, it's useful for me to look at these evaluations because the comments can help me do a better job in the future.

Hope that answers your question,

Samir Desai, MD
Assistant Professor of Medicine
Baylor College of Medicine

 

[GO_MEDPEDS]

I think I found this on some other discussion on the SDN:

http://www.mcwmd.com/2004/other/artofpimiping.htm


I think pimping is great... if done correctly, that is. Thankfully, I have made it up to my 4th year now with only one incident of what I would call "malignant pimping": a 25-minute session of holy terror that ended with residents consoling me and offering to buy me ice cream (I was a little traumatized, but I think I'll be fine after some counseling and a whole lot of Zoloft). Honestly, it keeps everyone on their toes, spices up rounds and boring surgeries, and can be a great way to learn if it isn't malignant. (I define malignant pimping as being personally singled out for a series of questions, not being able to "pass" to the interns/residents but rather being forced to "reason through," and any time the pimping feels like it's "life or death"- namely your own)!

 

[Pilot]

Just one episode of malignant pimping??? I obviously went to the wrong school. I had more than that on surgery. One attending in particular would "choose" a student every day after rounds to give an impromptu lecture usually lasting 45 minutes to 1 hour.

"Tell me everything you know about gallbladder disease, in the same sequence you learned in school - Anatomy, then Histology, then Physiology, then Pathology. Lets also discuss imaging methods and surgical interventions.." When it happened to the intern on the first day, we thought "man, I'm glad I'm not an intern." Then we medical students got the same sessions... I laugh about it now, but it sure was nerve racking standing in front of students, interns, and residents with no answers coming to mind. Made me wish I had a pager so I could act like it was going off and leave like the residents would do after 10 minutes or so.

 

[Teufelhunden]

Originally posted by Pilot
"Tell me everything you know about gallbladder disease, in the same sequence you learned in school - Anatomy, then Histology, then Physiology, then Pathology. Lets also discuss imaging methods and surgical interventions.."

Wow! I that ever happens to me, I hope everyone is prepared for silence.

 

[rubyness]

Pimping is hard because it forces you to reveal what you don't know in public to your peers and superiors. As med students we are unbelievably uncomfortable with admitting that we don't know something, for a variety of reasons. Two main ones are that we think we will look stupid, and that we feel a professional responsibility to know everything because if we don't we could kill or injure people.

Actually I haven't been pimped that much as a 3rd year and I wish that I was more because as embarrassing as it can be, it really helps me remember and it also keeps me thinking while I'm on (boring) rounds.

2nd year we were pimped endlessly in pathology-- you were graded on your performance in that class and the questions were always of the "tell me everything you know about gallbladder disease" variety. People cried. I hated it then, but in retrospect I think it went a long way towards toughening me up for this year.

I think a good way to approach being pimped is to:
1. Know who you're dealing with. Get a sense of the person who is asking the questions and what kind of responses go over well and what ones bomb.

2. If the person is genuinely trying to teach, do your best to show that you're thinking through the problem and offer an answer. If you don't know, toss out your first guess in a confident voice. Often it's right. If not, at least you tried!

If the person is impatient with you, spend less time reasoning and more time guessing (if you have to) because hesitating to think a lot will probably irritate them and piss them off, thus making it worse for you.

3. I saved the absolute most important part for last.

NEVER EVER take ANYTHING PERSONALLY!!

It's not meant as an attack. Nobody is trying to make you feel bad or look stupid. It's ok to not know the answer and to say you don't know.

(even if the person is singling you out, it's still not about you-- it's about them and how miserable a person they are!)

 

[moops]

Hey Samir,

How long have you been a professor at baylor? were you there for med?

Originally posted by Samir Desai
Any team member that is senior to the medical student may choose to "pimp" you. If done the right way, it can be an effective teaching technique. But too often, it is done in an inappropriate way that tries to make students feel inferior or stupid. I remember feeling that way many times as a student.

Now as an attending, at the beginning of every rotation, I tell my students that I am going to ask them a lot of questions. I also tell them that I don't expect them to have all the answers. One reason I ask them so many questions is so I can ascertain what they do know and what they don't. That way I can fill in the gaps and make sure they have a firm understanding of some important points. These are take-home points or points that may come up on the exam.

With regards to pimping, my advice is try your best. If you don't know the answer, just say so. It's okay. Shake it off because if you worry too much about it or get flustered, you will not be ready for the next question.

As for Thunder's situation, it's not clear to me why the surgery intern only asks him questions during attending rounds. It could be that things are so busy throughout the rest of the day, that there is no time. If that's the case, the surgery intern may be pimping to help educate the student. Sometimes, however, interns and residents pimp students in front of the attending in an effort to make themselves look good. By pimping students, they feel they are showing the attending their knowledge base or efforts to teach. Remember that interns and residents, just like students, are evaluated by attendings. When interns and residents are pimping for their own selfish reasons, many attendings (who have been around the block a time or two) can spot this.

In any case, don't worry too much about it, do your best to answer the questions, learn from the experience and discussion, and think about the right way to pimp a student when you become an intern, resident, or attending.

Samir Desai, MD
Assistant Professor of Medicine
Baylor College of Medicine