•••quote:•••Originally posted by mrp:
•I have steam literally shooting from my ears right now, so I thought I'd vent on this board.
Got my pediatrics eval today. It turns out that the attending who seemed so friendly while I was on the ward ACTUALLY thought I was doing a bad job. She wrote in my eval that I showed limited interest and effort in learning pediatrics. Additionally, she wrote that I didn't make an extra effort to learn about other patients on the ward.
I sure wish she could have mentioned her thoughts to my face BEFORE the rotation ended. This totally came out of left field--I previously had thought I was doing great, and that I had a shot at honoring the course.
Anyone else have similar stories?
<img border="0" alt="[Pity]" title="" src="graemlins/pity.gif" />
-mrp•••••Hi there,
Attendings get much of their evaluation material from residents so make sure you are communicating well with your residents and interns. Sometimes not asking questions is interpreted as not being interested in the patients or the rotation. I really tried to benefit from my attendings' and chief resident's experiences in patient care. I always read about every patient on the service especially those that I was not taking care of. I also made it a point to ask for good references for conditions that were not commonly seen in my rotation location such as pediatric oncology.
Some attendings are touchy about you asking about grades and focusing on your grade too soon. Instead, focus on making sure that you have covered the major pathology of a particular rotation. Great questions would be: Why did you handle this problem at this point in this manner? How much of so and so are you seeing? What do you find most interesting about peds etc? Would treatment X be a better alternative than treatment Y if the patient had presented with ...? Make your attending give you the benefit of his or her experiences in patient care. Try to discuss some cases that are confusing to you.Pull some out of a review book i you have to. Try to tie each rotation into broadening your clinical knowledge base as a physician.
Take care of any personal disagreements on the spot. While your grade is your business, it can quickly become a personal item for a resident or attending that you have a personality conflict with. I can't tell you how many little cynical comments by a medical student translated into poor evaluations by residents/attendings. You may not have made the comment but the attending might have heard it from your direction. This is a lousy system but it is a hoop that you have to jump through. Needless to say, do very well on the shelf exam even if your clinical evaluation is not stellar. This can be a good leverage point if you have to appeal your grade. If you really feel like you deserved a better evaluation, discuss this with the resident first, then the attending and then the department chair. Do this from the standpoint that you want learn from your mistakes and not repeat them in the future. Ask that attending to elaborate on what you could have done to show more interest.
If all else fails and you are interested in said specialty, do a couple of early outside electives during fourth year and have a good relationship with the department chairman. You can always explain a poor third-year grade to learning the ropes after shining in fourth year.
I learned that there was a certain amount of "kissing up" on some rotations. Find out what you have to do early (from students who just left the rotation) and make sure you touch all bases. Our class was very good about getting the word out about poor residents and poor teaching. Always talk with your classmates to find out the scoop on their rotation experiences. Talk to folks who did well and talk to folks who had difficulty. You can learn from both.
Finally, if you are having a bad time on a rotation, try to find some good and hang on.If you are very determined to get the best out of a bad situation, you will. Most interns and residents don't have the energy to keep hammering you if you don't yield early. They can abuse you but they can't stop the clock. Eventually, the rotation will end and you will cut your losses and move on. Just document every poor situation and have this documentation ready for the appeal.
Your comments really hit home. My inpatient peds experience was, hands down, the worst 4 weeks of medical school. The residents were, without question, the biggest collection of judgemental, passive-aggressive, back-stabbing whiners I have ever been around. To add to the fun, my intern hated me-- so basically anything I did was wrong. She told me within a four day period that 1)I needed to show more interest in peds, and 2)I was asking too many questions (...that she didn't know the answer to). So, which is it? Am I not interested, or am I too interested? 
