Social tips on the wards?

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MickyMyki

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Hi all. I am having trouble figuring out the extent to which I can be myself in the hospital setting. I have so many add-ons, jokes, and witty things to say in my head but I hold back for fear that, being at the bottom of the totem pole (med student), saying more than I should could have repercussions. Could you please answer the following questions:

1) To reiterate, to what extent can I be myself in terms of humor/comments with attendings/nurses? I am confused as to whether playing the submissive puppy is appreciated or if showing confidence by joking back gains other people's respect. On the other hand, I have heard that joking back can be considered talking back. here are some scenarios below: please let me know if which are acceptable (sorry if these sound petty; I seriously don't know):

i) Nurse throws her checkbook out at me. My reply, "I mean I know I could use the money, but keep it."

ii) Dr. tells me there better be pizza at an event he is going to or else I am going to be in trouble. My response: "well even if there isn't, at least you won't get diabetes"

iii). Dr. comments that the lesion was on this area of of the mouth, rather than the other part. My response: defensive- that's true, I had though it was in so and so location because that's what the referring doctor had written"- this is a big one: to what extent am I allowed to defend myself?

iv). After learning history of pt, Dr. comments - 'teenage girls and complicated problems- tell me something new." My response: well teenage boys do have their own issues too

2) Also, for the socially adept or the inept who became adept (especially the latter group), what are social tips and tricks that you use or have learned that help you become more liked in the wards setting? I am in the habit of asking others about themselves, their lives (i.e. good listener). So I think I'm considered nice, but I don't think my personality stands out as being charismatic. Any way I can bump it up a few notches?

Thanks for reading and thanks for your help!
 
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MickyMyki said:
i) Nurse throws her checkbook out at me. My reply, "I mean I know I could use the money, but keep it."
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Bad joke, don't.
MickyMyki said:
ii) Dr. tells me there better be pizza at an event he is going to or else I am going to be in trouble. My response: "well even if there isn't, at least you still be a step away from diabetes"
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Even worse joke, why is this your default response?
MickyMyki said:
iii). Dr. comments that the lesion was on this area of of the mouth, rather than the other part. My response: defensive- that's true, I had though it was in so and so location because that's what the referring doctor had written"- this is a big one: to what extent am I allowed to defend myself?
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NEVER get defensive - just apologize for making the mistake and thank your attending/resident for correcting you.
MickyMyki said:
iv). After learning history of pt, Dr. comments - 'teenage girls and complicated problems- tell me something new." My response: well teenage boys do have their own issues too
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You should just stop with all the bad jokes...seriously.

Just work hard, speak when you are supposed to, NEVER get defensive about anything, always help your team with whatever mundane task/scut that needs to be done, NEVER complain, and NEVER EVER talk back to the attending or anyone on your team who is your senior. Your default responses should be, "Yes, sir/ma'am," "No, sir/ma'am," "I'm sorry, sir/ma'am, it won't happen again," and "I don't know, but I will look it up." I've had great experiences so far during third year by accepting my role as the bottom of the totem pole - other classmates who are more abrasive/arrogant/proud/defensive not so much.
 
Ace Khalifa said:
Bad joke, don't.

Even worse joke, why is this your default response?

NEVER get defensive - just apologize for making the mistake and thank your attending/resident for correcting you.

You should just stop with all the bad jokes...seriously.

Just work hard, speak when you are supposed to, NEVER get defensive about anything, always help your team with whatever mundane task/scut that needs to be done, NEVER complain, and NEVER EVER talk back to the attending or anyone on your team who is your senior. Your default responses should be, "Yes, sir/ma'am," "No, sir/ma'am," "I'm sorry, sir/ma'am, it won't happen again," and "I don't know, but I will look it up." I've had great experiences so far during third year by accepting my role as the bottom of the totem pole - other classmates who are more abrasive/arrogant/proud/defensive not so much.
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Ace Khalifa said:
Bad joke, don't.

Even worse joke, why is this your default response?

NEVER get defensive - just apologize for making the mistake and thank your attending/resident for correcting you.

You should just stop with all the bad jokes...seriously.

Just work hard, speak when you are supposed to, NEVER get defensive about anything, always help your team with whatever mundane task/scut that needs to be done, NEVER complain, and NEVER EVER talk back to the attending or anyone on your team who is your senior. Your default responses should be, "Yes, sir/ma'am," "No, sir/ma'am," "I'm sorry, sir/ma'am, it won't happen again," and "I don't know, but I will look it up." I've had great experiences so far during third year by accepting my role as the bottom of the totem pole - other classmates who are more abrasive/arrogant/proud/defensive not so much.
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Haha I'm certainly not the comic I guess! I was mainly wondering how much lee way I having in talking back...I guess none! Good thing I never said anything.
 
MickyMyki said:
Haha I'm certainly not the comic I guess! I was mainly wondering how much lee way I having in talking back...I guess none! Good thing I never said anything.
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I'm sorry...what made you think it was ever a good idea to talk back to your attending? Or your senior resident? Or your junior resident? Or your intern? Or your 4th year sub-I? Medicine has a hierarchy - under NO circumstances do you ever talk back to your superiors, especially not with crap remarks that you think are funny but clearly aren't. The sooner you realize this, the better. I'm telling you this because I have seen and heard examples of med students getting reamed hard by their residents and attendings for talking back - you don't want to have that reputation.
 
Ace Khalifa said:
I'm sorry...what made you think it was ever a good idea to talk back to your attending? Or your senior resident? Or your junior resident? Or your intern? Or your 4th year sub-I? Medicine has a hierarchy - under NO circumstances do you ever talk back to your superiors, especially not with crap remarks that you think are funny but clearly aren't. The sooner you realize this, the better. I'm telling you this because I have seen and heard examples of med students getting reamed hard by their residents and attendings for talking back - you don't want to have that reputation.
Click to expand...
You're certainly right. I was just wondering if standing up for yourself might look good too. Guess not. I mean right now I have been doing the whole yes sir/maam thing. I am just worried that I might come across as too boring/nice because of it. Why do people say 3rd year is a personality contest then?
 
You need to feel it out. Every person is different. If it's an attending who wants some humor on the service every now and then, then respond accordingly. If it's a more serious by-the-book attending, then be as professional as possible and stick to the business. In the end, work hard, try not to piss people off, and your experience overall should be positive. You get some freedom to choose later what kinds of people you want to work with when you apply for residency, but for now you need the grades.
 
I joked around a lot with attendings and residents on many of my services. In the end those tended to be the rotations where I got the best evaluations and letters since we often built good personal relationships. However, there were certainly some attendings (e.g., many surgeons, older subspecialists) where I wouldn't dream of it and followed the "don't speak unless spoken to, address them formally, always present formally unless told otherwise, etc." guidelines.

Basically: you have to be good at feeling what is and is not appropriate to each attending in specific situations. If you're having trouble figuring out the extent to which you can 'be yourself' certainly err on the side of being conservative. Always start every rotation assuming your superiors expect 100% professionalism and deference all of the time.

It's better to be known as the 'super professional' student than the 'annoying jokes at inappropriate times' student.
 
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You should read Art of the Deal. Best book besides the Bible hands down. It will make you a master negotiator. So when you end up in the Dean's office, after you run your mouth, you have a .1% less chance of being reprimanded...
 
SpartanWolverine said:
I joked around a lot with attendings and residents on many of my services. In the end those tended to be the rotations where I got the best evaluations and letters since we often built good personal relationships. However, there were certainly some attendings (e.g., many surgeons, older subspecialists) where I wouldn't dream of it and followed the "don't speak unless spoken to, address them formally, always present formally unless told otherwise, etc." guidelines.

Basically: you have to be good at feeling what is and is not appropriate to each attending in specific situations. If you're having trouble figuring out the extent to which you can 'be yourself' certainly err on the side of being conservative. Always start every rotation assuming your superiors expect 100% professionalism and deference all of the time.

It's better to be known as the 'super professional' student than the 'annoying jokes at inappropriate times' student.
Click to expand...

Yes. Read the room!
 
If those are your idea of jokes, best to stay quiet.

My favorite medical students are normal hard working people who show a normal amount of interest and want to learn. It's not hard, but a lot of people in med school don't understand the hierarchy or have odd senses of humor. In that case it's best to just be the hardworking student who helps their residents and doesn't get in the way.

The worst qualities to avoid in a student: 1) arrogance 2) defensiveness and 3) laziness. Avoid those three and you should do OK.

When people say 3rd year is about a "personality contest," they're not telling you to make diabetes jokes to your attending. I had two medical students rotate with me recently. One asked questions every 20 seconds so by the end of clinic, I had gotten 0 notes done. The other was a quieter but normal dude who watched, asked questions at appropriate times, tried his best to anticipate what was going to happen next and help out, and in our down time we talked about music and recent concerts we've been to. In other words, one was a normal guy who tried his best to help out, and the other got in my way and slowed me down.

Clinical years aren't as hard as people make them out to be. If you're not sure if your sense of humor is appropriate for the wards, ask an honest friend who knows you well. Better to err on the side of being boring than to be remembered for being offensive or odd.
 
The best jokes would probably revolve around you admitting that you're a third year student who's ready to take it up the a$$.

So, for example, to the scenario in which the surgeon is threatening copious amount of pain to you if there's no pizza:

I would say: well, sir, let's hope there is insert surgeon type of pizza there. But, I shall have my sleeping bag packed and ready for a 24-48 hrs shift if things don't go your way.
 
Why would a nurse throw her checkbook at you, or an attending expect you to buy pizza for a meeting, or even say “teenage girls and their problems, tell me something else new”. I can’t imagine any such scenarios even happening. And if you can’t tell where a lesion is by looking at someone why would you even attempt to blame it on someone else.
 
Yeah agreeing with those above. For whatever reason, it appears you don’t have a great sense of humor or self awareness and as I play out your above scenarios in my mind, I cannot for the life of me concoct a situation or tone that would make any of them even approach the level of acceptable, much less humorous. You will convey a lack of professionalism and seriousness and your evaluations will reflect as much.

In some ways, you really can’t go wrong by taking your upper lip and pressig it firmly against your lower lip. Whenever you feel the urge to be funny, press harder. I use this trick whenever I’m in a situation where I can’t quite read the room. It’s also handy as a reply to inappropriate jokes or other comments. Pretty much can’t go wrong.
 
Now that I'm a resident, there's nothing more than I hate than when a med student starts acting really comfortable like he or she is hanging out with their buddies and tries to continuously joke around. Most of the time the jokes aren't even funny and it comes across as trying too hard. It's always better to err on the side of caution in regards to professionalism. You can be engaged and socially appropriate without one-liner jokes.
 
AMEHigh said:
Now that I'm a resident, there's nothing more than I hate than when a med student starts acting really comfortable like he or she is hanging out with their buddies and tries to continuously joke around. Most of the time the jokes aren't even funny and it comes across as trying too hard. It's always better to err on the side of caution in regards to professionalism. You can be engaged and socially appropriate without one-liner jokes.
Click to expand...
Can you list out some traits/characteristics please that you consider to be professional? Does this just mean that I should be hardworking, serious, attentive, helpful, and courteous? Anything I'm missing?
 
MickyMyki said:
Can you list out some traits/characteristics please that you consider to be professional? Does this just mean that I should be hardworking, serious, attentive, helpful, and courteous? Anything I'm missing?
Click to expand...

You don't have to be serious. I don't know, just be a normal human being. If the doctors or residents are talking about a tv show, sports game, etc, feel free to smile, join in or whatever. But "comebacks" with 1 liner jokes are usually obnoxious and not funny. I'm a pretty laid back and fun person, but I'm not at work to make friends with the med students, so just do what you're asked, act interested and you shouldn't have any problems.
 
MickyMyki said:
Can you list out some traits/characteristics please that you consider to be professional? Does this just mean that I should be hardworking, serious, attentive, helpful, and courteous? Anything I'm missing?
Click to expand...

Pretty much.

We also had a medical student that acted waaaay too familiar with us. It's not a good look at all.
 
Thanks all! I appreciate the help. Keep in mind that I never actually said the above scenarios. They were just examples for me to gauge where the line was. Turns out I have been basically acting according to how you have all suggested up to this point, so I guess that is good news.
 
MickyMyki said:
Thanks all! I appreciate the help. Keep in mind that I never actually said the above scenarios. They were just examples for me to gauge where the line was. Turns out I have been basically acting according to how you have all suggested up to this point, so I guess that is good news.
Click to expand...
n8umjWj_d.jpg
 
In general, I’ve found that students that are more genuine tend to be more interesting and enjoyable to work with. People that try and be “the perfect med student” tend to be uptight and boring.

This isn’t really relevant for the purposes of your performance as both types of students can do well. Be professional, but being a human being with your own personality is fine.
 
MickyMyki said:
Hi all. I am having trouble figuring out the extent to which I can be myself in the hospital setting. I have so many add-ons, jokes, and witty things to say in my head but I hold back for fear that, being at the bottom of the totem pole (med student), saying more than I should could have repercussions. Could you please answer the following questions:

1) To reiterate, to what extent can I be myself in terms of humor/comments with attendings/nurses? I am confused as to whether playing the submissive puppy is appreciated or if showing confidence by joking back gains other people's respect. On the other hand, I have heard that joking back can be considered talking back. here are some scenarios below: please let me know if which are acceptable (sorry if these sound petty; I seriously don't know):

i) Nurse throws her checkbook out at me. My reply, "I mean I know I could use the money, but keep it."

ii) Dr. tells me there better be pizza at an event he is going to or else I am going to be in trouble. My response: "well even if there isn't, at least you won't get diabetes"

iii). Dr. comments that the lesion was on this area of of the mouth, rather than the other part. My response: defensive- that's true, I had though it was in so and so location because that's what the referring doctor had written"- this is a big one: to what extent am I allowed to defend myself?

iv). After learning history of pt, Dr. comments - 'teenage girls and complicated problems- tell me something new." My response: well teenage boys do have their own issues too

2) Also, for the socially adept or the inept who became adept (especially the latter group), what are social tips and tricks that you use or have learned that help you become more liked in the wards setting? I am in the habit of asking others about themselves, their lives (i.e. good listener). So I think I'm considered nice, but I don't think my personality stands out as being charismatic. Any way I can bump it up a few notches?

Thanks for reading and thanks for your help!
Click to expand...

Not a general response, but it is pretty clear in your case you should not be using humor. Yikes.

Just do your job.

Also, don’t get defensive. Double check everything yourself, trust but verify the information you get from other people (and I’m not sure about the trust part).

“Someone else told me that” is never a valid excuse on the wards, although for some reason it works for the president.
 
No one's really answered the second part of your question which is how to develop charisma. I'm not sure there is a good answer. There's websites that claim to teach you social skills but in my opinion if you've made it to adulthood and lack charisma it's a hard trait to develop.

You at least have the insight to realize some of those things might not be OK and asked for advice, which I think is the best thing you can do - ask close friends (with good social skills) to be honest with you and use their perspectives as a gauge.
 
If people don’t like your jokes, either they’re bad jokes or you’re not good at delivering them. Now’s the time to stop trying to win people over with humor or charisma and just act like everyone else. It’s actually fairly easy to act properly on rotations. Always look interested, always stay alert, and never turn down an opportunity to help within reason. Remember that any extra personality on rotations is polarizing. Some people may love it, but others can be annoyed. Only one of those groups can hurt you badly and that’s the group that won’t even react to whatever you’re doing so you’ll never know.
 
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VincentAdultman said:
Pretty much.

We also had a medical student that acted waaaay too familiar with us. It's not a good look at all.
Click to expand...

Exactly. I feel like every resident ‘s pet peeves develop based on what annoyed them as an M3. As a future resident (hopefully) mine is any med student who tries to own the room with his or her “personality”. I’m pretty introverted myself and was all too used to seeing louder personalities take up all the attention and have tons to say to attendings. In the end, they’re all just trying to get better evals and I see them as even more fake than the “robot” M3s. You can have a personality, but try not to get carried away.
 
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Newyawk said:
Apparently dont ask for any honest advice from anyone who is even a year above you or youll get gifted a new orifice.
Click to expand...

As general surgeons, we are adept at both expanding and creating new orifices. It is a gift. Thank you for noticing.

And more importantly:
“Don’t believe everything you read on the internet.”
- Abraham Lincoln
 
It's not that hard. Read the room. So much of medicine is reading people. At least you asked, I'll give you that. There are people who are completely oblivious to their own ridiculousness. You need to develop a strong sense of self-awareness.

MS3 is 90% social intelligence, 51% shelf exams.
 
MickyMyki said:
You're certainly right. I was just wondering if standing up for yourself might look good too. Guess not. I mean right now I have been doing the whole yes sir/maam thing. I am just worried that I might come across as too boring/nice because of it. Why do people say 3rd year is a personality contest then?
Click to expand...

Generally speaking, it does not. Take the lick, learn from it, and move on. Now, it is possible to defend yourself/stand up for yourself and not have it come across that way or as being defensive. The key is to make it sound like you're genuinely asking them a question to learn and not as a defense of your action/statement. Given you're asking about the appropriateness of those jokes, I wouldn't recommend trying this on the wards.

In the example you gave I also don't think trying to turn the mistake into a learning moment would really work, I'd basically apologize for the mistake and move on. It's not an egregious error, so there's not really a need to get defensive about it in the first place.

AMEHigh said:
Now that I'm a resident, there's nothing more than I hate than when a med student starts acting really comfortable like he or she is hanging out with their buddies and tries to continuously joke around. Most of the time the jokes aren't even funny and it comes across as trying too hard. It's always better to err on the side of caution in regards to professionalism. You can be engaged and socially appropriate without one-liner jokes.
Click to expand...

VincentAdultman said:
Pretty much.

We also had a medical student that acted waaaay too familiar with us. It's not a good look at all.
Click to expand...

What would you consider to be "too familiar". I feel like I may have been that way on a rotation at one point, but thought it wasn't an issue as the residents seemed to initiate a lot of the non-medical conversations and gave me really positive feedback as a whole other than one person. Additionally, the one resident that I didn't really click with seemed to not really like interacting with any of the med students. Just curious as I feel like my interactions have all been socially appropriate and professional.
 
Stagg737 said:
What would you consider to be "too familiar". I feel like I may have been that way on a rotation at one point, but thought it wasn't an issue as the residents seemed to initiate a lot of the non-medical conversations and gave me really positive feedback as a whole other than one person. Additionally, the one resident that I didn't really click with seemed to not really like interacting with any of the med students. Just curious as I feel like my interactions have all been socially appropriate and professional.
Click to expand...

Wasn’t asked of me but I don’t think you understand what he meant and are worrying for no reason. It’s fine if the residents initiated it. The annoying people are the ones who try to dictate or take charge of the social situation and think their schmoozer skills (“who you know” mentality) is all they need in order to do well on rotations.
 
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Stagg737 said:
What would you consider to be "too familiar". I feel like I may have been that way on a rotation at one point, but thought it wasn't an issue as the residents seemed to initiate a lot of the non-medical conversations and gave me really positive feedback as a whole other than one person. Additionally, the one resident that I didn't really click with seemed to not really like interacting with any of the med students. Just curious as I feel like my interactions have all been socially appropriate and professional.
Click to expand...

That's not what I'm talking about. I mean the medical students that act like they've been bffs with the senior residents for years. They try to participate in inside jokes, or talk sht to them, or try to get really personal when it's really none of their damn business. There's a huuuuge difference between being friendly an sociable and just coming off as a douchy try-hard.
 
Anti-PD1 said:
It's not that hard. Read the room. So much of medicine is reading people. At least you asked, I'll give you that. There are people who are completely oblivious to their own ridiculousness. You need to develop a strong sense of self-awareness.

MS3 is 90% social intelligence, 51% shelf exams.
Click to expand...

Completely agree. Clinical intelligence is obviously helpful, but the students that tend do the best aren’t necessarily the brightest but those who 1) recognize their shortcomings, 2) actively try to correct those shortcomings, 3) are easy to work with, 4) try and be useful to the team and service, and 5) express some degree of interest in what’s going on. I’m in psychiatry, so I am fully aware that a good number of students don’t give a **** about psychiatric problems, aren’t interested in psychiatry, and would rather be doing just about anything else. Fair enough, but there is still important information that can be learned from the rotation which will be valuable for the rest of your clinical career irrespective of the field you end up going into.

Note that all of the things I mentioned above have zero to do with clinical intelligence; it’s all about attitude and how you interact with your patients, the staff, your residents, and your attendings.
 
Couple more cardinal rules:
-if someone looks busy leave them the frick alone. Leave it at “let me know if you need any help”
-don’t act like you are the best thing since sliced bread. Even if you think you are smart than intern/senior/other Med students keep it to yourself
 
In general, self deprecating humor works better as a medical student and early in your training years. You have more freedom to be a witty smartass after you develop some rapport. But that takes some time.
 
getdown said:
Man ... them jokes ... I would not be amused.
Click to expand...


Yes. They sound like someone who is trying too hard to leave an impression. OP needs to work on EQ and learn to calibrate to the situation. The fact that the thread was started is a hopeful sign that they have some awareness.
 
MickyMyki said:
Hi all. I am having trouble figuring out the extent to which I can be myself in the hospital setting. I have so many add-ons, jokes, and witty things to say in my head but I hold back for fear that, being at the bottom of the totem pole (med student), saying more than I should could have repercussions. Could you please answer the following questions:

1) To reiterate, to what extent can I be myself in terms of humor/comments with attendings/nurses? I am confused as to whether playing the submissive puppy is appreciated or if showing confidence by joking back gains other people's respect. On the other hand, I have heard that joking back can be considered talking back. here are some scenarios below: please let me know if which are acceptable (sorry if these sound petty; I seriously don't know):

i) Nurse throws her checkbook out at me. My reply, "I mean I know I could use the money, but keep it."

ii) Dr. tells me there better be pizza at an event he is going to or else I am going to be in trouble. My response: "well even if there isn't, at least you won't get diabetes"

iii). Dr. comments that the lesion was on this area of of the mouth, rather than the other part. My response: defensive- that's true, I had though it was in so and so location because that's what the referring doctor had written"- this is a big one: to what extent am I allowed to defend myself?

iv). After learning history of pt, Dr. comments - 'teenage girls and complicated problems- tell me something new." My response: well teenage boys do have their own issues too

2) Also, for the socially adept or the inept who became adept (especially the latter group), what are social tips and tricks that you use or have learned that help you become more liked in the wards setting? I am in the habit of asking others about themselves, their lives (i.e. good listener). So I think I'm considered nice, but I don't think my personality stands out as being charismatic. Any way I can bump it up a few notches?

Thanks for reading and thanks for your help!
Click to expand...


Don’t try so hard. Being nice and normal and not overbearing is way more important than being charismatic.

Focus on learning medicine and stop worrying so much about how people see you. Any effort to “show confidence” or “charisma” are likely to backfire. Confidence comes with experience. As a medical student, you are not expected to be confident. Just be willing to listen and learn and absorb the wisdom of those around you.
 
I just stumbled upon this file in the Clinical Rotations subsection. I thought it was amazing in terms of things to do and not to do during 3rd and 4th year
 

Attachments

It took me a while to realize. That not everyone does well socially..

And on rotations. I followed these words from an attending. "No comments from the peanut gallery"
 
EspressoDrip42 said:
I just stumbled upon this file in the Clinical Rotations subsection. I thought it was amazing in terms of things to do and not to do during 3rd and 4th year
Click to expand...
I remember reading this before my rotation and was little taken aback by how serious that whole document is highlighting the hierarchy of medicine on pretty much every page.
If someone is reading that document before 3rd year, just remember most people in medicine are not as described in that document (maybe in malignant surgery rotations, haven't had that yet). 60-70% attendings and residents are friendly, normal human beings that understand what being a medical student is like and want to teach. Be enthusiastic, prepared,polite and 3rd year should be fine (although evals might not always go your way). You don't need to buy anyone coffee like that person in the document says and very few people are that uptight like he describes.
 
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