Preceptor leaving negative comments

[SkyHighMig25]

Hey all,

Third year here. I completed a whole rotation with an FM preceptor and regularly asked for feedback on my performance, etc. Only thing they said was that I should make my notes more detailed (and at the end of the rotation they said my notes have substantially improved). After the rotation ends they leave comments saying that I was not focused and did not see patients, which isn't true as I saw all of the patients I was asked to. These comments came completely out of nowhere for me.

I also completed 2 weeks with an OB and recently I made the honest mistake of asking a patient how much an IUD insertion hurt, (I was trying to gauge their pain as I saw them grimacing) which the OB took offense to.

Now the school has suspended my rotations while they contact the preceptor(s) for more information. I have a bad feeling that my school may want to dismiss me for what they are saying amounts to unprofessional behavior because they will (ofcourse) give more credibility to the preceptors.

What would you do in this situation? Is there something I can do or bring up to help my case?

Thanks!

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[jurassicpark]

Hey all,

Third year here. I completed a whole rotation with an FM preceptor and regularly asked for feedback on my performance, etc. Only thing they said was that I should make my notes more detailed (and at the end of the rotation they said my notes have substantially improved). After the rotation ends they leave comments saying that I was not focused and did not see patients, which isn't true as I saw all of the patients I was asked to. These comments came completely out of nowhere for me.

I also completed 2 weeks with an OB and recently I made the honest mistake of asking a patient how much an IUD insertion hurt, (I was trying to gauge their pain as I saw them grimacing) which the OB took offense to.

Now the school has suspended my rotations while they contact the preceptor(s) for more information. I have a bad feeling that my school may want to dismiss me for what they are saying amounts to unprofessional behavior because they will (ofcourse) give more credibility to the preceptors.

What would you do in this situation? Is there something I can do or bring up to help my case?

Thanks!

Question, did you get pulled off of the OB rotation because of that comment? Or was it because of FM and everything else? One misspoken comment doesn't get someone yanked off a rotation unless it was said in a really unprofessional and probably profane and vulgar manner.

Unfortunately, we are only getting this from your side so it's hard for us to help. But one isolated incident makes it an overkill, however from what you're describing that a previous preceptor is trashing your evaluation and now on a completely different rotation, OB preceptor is not happy with your performance makes it seem like a pattern. Could it be that you may have, possibly unintentionally been missing instructions, cues, or overstepping your bounds as a med student?

Did you keep logs of the patients you saw or anything that proves you were seeing patients? I would collect as much information, hand outs, etc that you may have received and compile it together to show you were working hard, and not skipping on patients. If you rotated with another student, get in contact with them to see if they noticed any irregular behavior or received similar treatment? You will have to get it from the school though exactly what they're accusing you of for unprofessional behavior.

Asking a patient how badly it hurts is not a comment a medical student should be dismissed of by itself.

 

[Noemata]

Your Student Affairs Deans will be your best ally in such a situation. I would recommend getting in touch with them and explaining your position clearly.

I would also recommend that you thoroughly review your Student Handbook and course syllabi and look at your school's policies on professionalism and advancement through the M3 year. Also, look at the process and algorithm for filing a complaint or an appeal against a decision that could potentially hurt you.

At my school, professionalism is taken seriously, but you have to know the policies and the system to maneuver through such a scenario.

Remember, you are paying to go there and ultimately are the customer in this case. Maintain your ethos, professionalism, and tact as you communicate with anyone about this case.

 

[Petrichor1]

Sorry to say this but no matter what the above person says, your school will take the preceptor's word. I think ob gyns are a special bunch in that even if you breath incorrectly they will have an issue with you. I would try seeing if the FM preceptor didnt just mistake you with another student since that is what it looks like.

 

[denalirun]

i've been on a committee that dealt with these issues and we very rarely saw any students dismissed based on relatively isolated incidents. Most people who have been through 3rd year realize that attending evaluations are difficult to standardize. If it's the OB comment, then you just need to be honest and explain what happened and how you understand maybe it could be perceived in a way you did not intend. The real problem, in my limited experience, was when students failed to see that they made a mistake, or they have a consistent trail of professionalism concerns. Good luck.

 

[WheezyBaby]

It is kind of an tactless thing to ask "how bad does that hurt" to a patient in the middle of an obviously uncomfortable procedure that you aren't performing and aren't going to adjust anything for based on their response. That said, I don't expect anything will come of this ultimately for you and I'm surprised they took you off rotation for this (assuming we have the full story)

 

[ciestar]

It is kind of an tactless thing to ask "how bad does that hurt" to a patient in the middle of an obviously uncomfortable procedure that you aren't performing and aren't going to adjust anything for based on their response. That said, I don't expect anything will come of this ultimately for you and I'm surprised they took you off rotation for this (assuming we have the full story)

Agreed.

spoiler: it frikkin hurts

 

[deleted645092]

Situation sucks I’m sorry. Med students are so awkward lmao.

for the future when a patient is in pain or uncomfortable they love it if you offer to hold their hand or have them squeeze you. Last month I let a guy squeeze my hand while the resident reduced some **** and they almost popped my bicep instead I swear.

 

[calivianya]

Situation sucks I’m sorry. Med students are so awkward lmao.

for the future when a patient is in pain or uncomfortable they love it if you offer to hold their hand or have them squeeze you. Last month I let a guy squeeze my hand while the resident reduced some **** and they almost popped my bicep instead I swear.

My favorite workaround for this is to only give them two fingers. Come around the backside of their hand and just put your pointer and middle fingers in their hand and drape the rest of your hand around their hand so it's not too weird. Almost impossible for someone to squeeze two fingers hard enough to really hurt you. I've had people do a number on my hand when they had my whole hand.

 

[CautiousLearner]

Hey all,

Third year here. I completed a whole rotation with an FM preceptor and regularly asked for feedback on my performance, etc. Only thing they said was that I should make my notes more detailed (and at the end of the rotation they said my notes have substantially improved). After the rotation ends they leave comments saying that I was not focused and did not see patients, which isn't true as I saw all of the patients I was asked to. These comments came completely out of nowhere for me.

I also completed 2 weeks with an OB and recently I made the honest mistake of asking a patient how much an IUD insertion hurt, (I was trying to gauge their pain as I saw them grimacing) which the OB took offense to.

Now the school has suspended my rotations while they contact the preceptor(s) for more information. I have a bad feeling that my school may want to dismiss me for what they are saying amounts to unprofessional behavior because they will (ofcourse) give more credibility to the preceptors.

What would you do in this situation? Is there something I can do or bring up to help my case?

Thanks!

They will make a big hoopla of it, but move on honestly. The school will eventually be more understanding of this, but remember eventually is the key. Institute the following two lessons for the future, working with attendings:
1. Ask only what helps you in your evaluation!
2. If not important smile politely thank them and move on.

 

[Redpancreas]

I'm sorry to hear this is happening to you. This escalation sounds like a bit much for what you describe which either means one or a combination of the following:

1) You're underplaying things
2) Your program is being unfair (not uncommon) and you have got the microscope on you due to your unconventional approaches to things.
3) There's a problem with your insight.

The reason I say this are that these two isolated examples are too little to take this kind of action on. The way you describe them are not egregious. A bit tactless with the "how much pain". My suspicion is the OB already disliked you for some reason which may be the underlying issue here. The other possibility is that your school has little experience with how to handle issues on rotations.

1.) Do not allow this to mess with your head. If you truly think that these were two isolated events, don't get nervous as it can make you appear less trust-worthy. Develop good relationships with your preceptors/colleagues, this is more important than you think.

2.) Ask loved ones/close friends if they can see how others can mistake your actions for being malignant when they're not. If that seems to be an issue, there are professionals who can help with this. Believe me when I say this lesson is much better learnt now than later.

3.) Be proactive in your communication. As mentioned above, contact the Dean of Student Affairs, give detailed accounts (proofread your drafts) and submit them.

I think things will be OK. Just be careful moving forward. Evaluations are a stupid hierarchy and too many in academic medicine use it as a way to pick on personalities they do not like. That said, if this is consistently happening maybe it's something you're doing. When getting feedback, never argue, always smile politely and accept criticism unless its blatantly incorrect criticism that you can clarify briefly. Learn to strike a balance between being politely vocal instead of keeping your mouth shut because sometimes because develop unfair impressions. At the same time, learn to not thread on toes.