staying on top of things- need some insight

[abc56]

is it just me, or does it seem hard to stay on top of the latest events, the latest info, the latest critical labs, the latest consults, when it comes to the patients that you're following as a 3rd year medical student? i am finding this particularly hard in my surgery rotation, where i feel like i spend most of my time in the OR, conference, or in clinic (which is located outside the hospital)

is it easier as an intern/sub-i? do people actually inform you when things happen? or is it better to make it a habit to constantly make rounds, read charts, etc, by yourself? theres got to be more time for regular floor work and stuff like that later on, right?

i just dont know how i can keep on top of things when im in clinic all day off site and then have to come back and round with the team, for example.

the reason i ask is....

i had an "incident" today with an intern. she basically belittled me and tried to "teach me a lesson" because i didnt know what a consult had said about my patient that day. im sorry but i was gone all day and then admitting a patient in the er. she asked me if i knew what the consult said and i was like "no im sorry, i havent had a chance to go catch up upstairs" and shes like "well i know what the consult said. its too bad you dont. shes actually getting a procedure done right now, and you should know that too- but you dont" or something like that. SOOO inappropriate. im so annoyed. only 4 more days with her. i was warned that she was a miserable human being....

 

[SLUser11]

is it just me, or does it seem hard to stay on top of the latest events, the latest info, the latest critical labs, the latest consults, when it comes to the patients that you're following as a 3rd year medical student? i am finding this particularly hard in my surgery rotation, where i feel like i spend most of my time in the OR, conference, or in clinic (which is located outside the hospital)

is it easier as an intern/sub-i? do people actually inform you when things happen? or is it better to make it a habit to constantly make rounds, read charts, etc, by yourself? theres got to be more time for regular floor work and stuff like that later on, right?

i just dont know how i can keep on top of things when im in clinic all day off site and then have to come back and round with the team, for example.

the reason i ask is....

i had an "incident" today with an intern. she basically belittled me and tried to "teach me a lesson" because i didnt know what a consult had said about my patient that day. im sorry but i was gone all day and then admitting a patient in the er. she asked me if i knew what the consult said and i was like "no im sorry, i havent had a chance to go catch up upstairs" and shes like "well i know what the consult said. its too bad you dont. shes actually getting a procedure done right now, and you should know that too- but you dont" or something like that. SOOO inappropriate. im so annoyed. only 4 more days with her. i was warned that she was a miserable human being....

Obviously, the farther up you go, the more of an effort people will make to inform you about your patients. That being said, as an intern, I'd still be pretty much out of the loop on some things if I didn't keep close tabs.

For me, the biggest frustration is finding out when certain cases are going to start without calling the OR desk a million times or wasting my time by sitting down there waiting for the case to happen.

Anyway, I feel that being a med student is a lot like waiting tables, and you'll slowly learn how to multitask, etc (and some people are just naturally better at it, and can do it without getting flustered, while others freak out when they're "In the weeds.").....in the meantime, every time you get a free minute, collect your thoughts and systematically evaluate what needs to be done or be found out about your patients.

Also, while it is quite possible that your intern is a jerk, I have a hard time sympathizing with a student who "doesn't have time" to check a lab, or read a consult from the chart, because it only takes a minute, and I doubt you're really that busy. Often it's just about time management and priorities.

 

[abc56]

i think you are misunderstanding me. i realize it only takes a second. i didnt refuse to do something because i didnt have time. i just didnt have a chance to do something yet because i was doing other medical student related things....

i just think my intern was inappropriate. being more than 1/2 way done with third year, i think i have an idea of whats an appropriate way to treat a medical student and whats not. i dont think belittling someone, or trying to teach them a lesson in front of their peers is at all appropriate.

 

[Bertelman]

Whether you believe this behavior is acceptable or appropriate is not at all part of the argument here. It is a fact that this "dressing down" happens everywhere, particularly among surgeons. Don't sweat it, but do all you can to prevent it from happening. And don't believe your life will magically improve when she goes off rotation. Interns talk. Be aware that the next group may expect more from you to prove you aren't really who she says you are.

As for your problem, I can understand the concern, and yes, you will be in the information pipeline as an intern, etc., something you currently are not. One way to prevent future events such as this is to routinely check in with your team members. Interns in general will realize that you aren't receiving pages with critical lab values. That's why you need to make time to check in with them throughout the day, particularly immediately before rounds. But don't EVER make excuses that "I was in the clinic all day". The intern wasn't exactly sitting on their butt, waiting for that consult to happen. The intern was likely busier than you.

I'm not sure what your facilities are like, but the computers in my rotation made all that stuff very easy. I could check on a consult in the ER just as easily as in the computer next to the patient's bed. Same with offsite clinics. Just a thought, but it sounds like you are wading in tons 'o paper.

Final thought: if you truly treat your intern well, and they believe you are busting your a$$ to stay on top of things, they tend to keep you in the loop more often than not. It behooves every member of the team when the med students perform well. If the med student starts the presentation off right, everybody is happy, from the attending down. You may have lost your shot, if you ever had one, with this intern. Just keep it in mind down the line. If you act interested in every step of the way, and do everything you can to stay on top of it, you will be treated like a member of the team. Don't ever make an excuse for yourself.

 

[Tired]

is it easier as an intern/sub-i? do people actually inform you when things happen? or is it better to make it a habit to constantly make rounds, read charts, etc, by yourself? theres got to be more time for regular floor work and stuff like that later on, right?

To answer your question (and get away from the "appropriate behavior" topic), I found that, as a sub-i, it was a little easier. This is simply because you aren't scheduled for all the med student lectures, and can follow the intern/resident schedule instead. What probably happened in your case was that you had to go to an MS3 lecture, while your intern was still on the wards. As a sub-i, you can spend more time on the floors following your patients.

Tracking consults can be hard, because at least in my hospitals, consults are often dictated or hand written, making it harder for a student to access if they aren't physically on the wards. On the other hand, in an era when most lab values are on the computer, there is really no good excuse for not knowing those. You just have to get used to remembering which values are pending, and making a point to check them regularly.

 

[abc56]

my point is, i DID check in with the intern, and she refused to give me any new information, to teach me a lesson. im sorry but i think thats really stupid and doesnt benefit anybody

i think i do a pretty good job of keeping up with labs, studies, consults, etc. but every now and then, i dont think its unreasonable to check in with your intern when they are sitting right there. this is the first time in over 7 months that checking in with the intern worked against me

thanks for the advice, everyone. its nice to know that once im higher up on the totem pole, it will be easier to stay on top of patients (less time doing med student type things, and people actually paging me with info)

thanks again
abc

 

[Gem134]

Don't ever make an excuse for yourself.

On my second day of third year I was chewed out for not knowing/doing something, I can't remember what. I said: this is my second day of being on the wards and I was told by the intern that that was not a worthwhile excuse. ?????

I think what I don't get about third year is how sometimes you are golden no matter what you do, and other times - like in surgery - you are not.

I think you are allowed to have the excuse of it being your second day and you'd never done a procedure or whatever. Didn't get the lab info. As a student, the interns do things on "your" patients all the time and I have spent half my energy trailing behind them to figure out what they had done and why. I say, four more days of phony smiling and then let it go.

 

[abc56]

haha, yeah gem134, seriously!! i feel like im constantly trailing the interns to see what they did for the patients. then you get chewed out for not knowing AND chewed out if you ask!!

maybe its just surgery, but sometimes i feel like you cant win. i did NOT have this problem in medicine. maybe its because i wasnt in the OR 75% of the time, or maybe its because the people i was dealing with were nicer and werent on power trips.

ive gotten pretty good at the fake smile, in fact my cheeks hurt from all the fakeness!!

 

[pillowhead]

is it just me, or does it seem hard to stay on top of the latest events, the latest info, the latest critical labs, the latest consults, when it comes to the patients that you're following as a 3rd year medical student? i am finding this particularly hard in my surgery rotation, where i feel like i spend most of my time in the OR, conference, or in clinic (which is located outside the hospital)

is it easier as an intern/sub-i? do people actually inform you when things happen? or is it better to make it a habit to constantly make rounds, read charts, etc, by yourself? theres got to be more time for regular floor work and stuff like that later on, right?

i just dont know how i can keep on top of things when im in clinic all day off site and then have to come back and round with the team, for example.

the reason i ask is....

i had an "incident" today with an intern. she basically belittled me and tried to "teach me a lesson" because i didnt know what a consult had said about my patient that day. im sorry but i was gone all day and then admitting a patient in the er. she asked me if i knew what the consult said and i was like "no im sorry, i havent had a chance to go catch up upstairs" and shes like "well i know what the consult said. its too bad you dont. shes actually getting a procedure done right now, and you should know that too- but you dont" or something like that. SOOO inappropriate. im so annoyed. only 4 more days with her. i was warned that she was a miserable human being....

Ah, don't sweat it. 3rd year sucks for stuff like that. The whole "know your patient better than anyone else" is a nice though but basically impossible, especially if you are in a large, dysfunctional, county hosptial where you're not even given log-ins for some of the computer systems and basically everything is still done on paper. And with lectures and school breaks not matching up with the residents, it basically becomes impossible. as long as ALL your interns aren't telling you off (then i would think something is wrong with you), don't lose too much sleep about it.

4th year is very different, at least for the rotations that matter. for my current emergency medicine rotation, if i don't do it or know it, no one does it or knows it and my patients would sit in the ED until my next shift! frequently, i have the resident sign off on blank order forms and prescriptions, give a one minute overview of the important stuff, and then just do it myself. Of course, you do have to earn that level of independence to some degree by proving your competence.

 

[efex101]

No matter what rotation you are in and no matter how hard you work, there are just ass people everywhere. I am in ob-gyn right now and by FAR these are the most malignant people I have to meet yet. I am almost done with third year with only IM to go and by far the most unprofessional, back biting, rude, and malignant personalities are in ob-gyn at my place. They completely ignore the medical students yet EXPECT us to know how to fill out every form known to mankind but yet nobody wants to actually take the TIME to explain things to you. The men are by FAR much worse than the women I have met and they have some semi God complex and think they can treat students like ****. This rotation cannot be over soon enough. Good riddance.

 

[Bertelman]

On my second day of third year I was chewed out for not knowing/doing something, I can't remember what. I said: this is my second day of being on the wards and I was told by the intern that that was not a worthwhile excuse. ?????

I get where you're coming from. But, as someone who worked at a few jobs for a few years before med school, my point is that you don't have to make an excuse for yourself. I didn't say there's not ever a good excuse, just that you should not use one in response to your superior.

I think you have to be able to read the person you are dealing with to act appropriately. I'm sure you've noticed by now, but surgery isn't the rotation that's going to nurture your soul. If the intern jumps on you for not doing X, don't tell them why you didn't do it (unless they ask). Tell them you'll do it the right way next time. Or right now.

Every med student has a similar story with surgery interns. I know I do. This often happens through no fault of you, and in that situation you just brush it off, and put a smile on the next day. But I believe there is a skill in reading a person's personality and attitude, and I can sniff the kind of person who appreciates hearing why I don't know that patient's latest Echo report v. the intern who would rather see me burn in front of the attending.

 

[Hard24Get]

Also, while it is quite possible that your intern is a jerk, I have a hard time sympathizing with a student who "doesn't have time" to check a lab, or read a consult from the chart, because it only takes a minute, and I doubt you're really that busy. Often it's just about time management and priorities.

Part of the problem for med students starting out, too, is the thought that you can't get away. It is true that there are chief resident, etc, who take the students with them whereever they go, and are reluctant to let us leave. For the most part, though, you can say, "I'm just going to do a chart check real quick since I'm between pts" (or even just go), and no one will mind. Many med students starting off in the clinics, rather than thinking they're too busy, don't realize this type of initiative is ok.

I kind of disagree about checking in with the intern to stay on top, as the vast majority will become annoyed with this unless they are already volunteering the info. It's better to check out the orders placed, and ask questions if you can't figure out why.

Sounds like this intern is a jerk, but try to rise to the occasion.

 

[Tired]

I kind of disagree about checking in with the intern to stay on top, as the vast majority will become annoyed with this unless they are already volunteering the info. It's better to check out the orders placed, and ask questions if you can't figure out why.

This is a great point. Remember that the hierarchy is constructed such that information is supposed to flow up the chain. When the med student checks with the intern on what's happened with the patient, it is equivalent to the resident calling the chief. Personally I never did this, and I'm a little suprised to learn that it is commonplace at other schools.

 

[QuinnB]

at my school, no matter what you do, the intern always gets paged about stuff. You really have to check with the intern (unless you are a subI) to figure out what is going on AS IT IS happening so that you can be involved in the medical decision making process (even as a bystander). It is totally different if it was a consult placed the day before or a daily lab value. I think the med student should just know that. Come in a half hour earlier. What I did, and I absolutely DO NOT recommend doing this, was that I would page the consult team or go meet up with them in the conference room and talk about the patient - the fellows were usually really stoked to talk shop, as long as you have some idea about what you are talking about. I ended up getting a lot of "great professional demeanor" comments on my evals.

By the by, most of the interns where I'm at don't really care if you ask them...by this I mean that they don't get upset and usually take the time to catch you up, but that doesn't mean that they aren't storing it in the back of their minds, even subconciously, to bring it up when the senior/attending asks about your performance (this happens ALL THE TIME at my school).

 

[Tired]

By the by, most of the interns where I'm at don't really care if you ask them...by this I mean that they don't get upset and usually take the time to catch you up, but that doesn't mean that they aren't storing it in the back of their minds, even subconciously, to bring it up when the senior/attending asks about your performance (this happens ALL THE TIME at my school).

Mine did care, on every rotation. And their rationale was simple, "Why are you asking me something that you can look up in the chart?" Did the patient get a consult? Look in the chart. Did you order more lab tests? Look in the chart. Is the patient going to the OR today? Look in the chart. I mean, it's really not all that hard, and if you have a computerized medical record, it's easy as pie. I think most of us learned early not to ask questions if we can look up the answers our selves. You must have had some really cool interns.

The OP's problem seems to be that he/she got ripped on for not knowing something. This really isn't that big of a deal, most likely will have no bearing on his/her grade, and we all dealt with it at various points during the third year. If it were a recurring thing, then the OP would have some problems. But for a one-time thing . . . well, just be grateful you got this far through the first year before it happened. Me, I got it on my very first week. Now that sucks.

 

[Bertelman]

Mine did care, on every rotation. And their rationale was simple, "Why are you asking me something that you can look up in the chart?" Did the patient get a consult? Look in the chart. Did you order more lab tests? Look in the chart. Is the patient going to the OR today? Look in the chart. I mean, it's really not all that hard, and if you have a computerized medical record, it's easy as pie. I think most of us learned early not to ask questions if we can look up the answers our selves. You must have had some really cool interns.

Certainly you should be looking up stuff in charts, computers, etc. Where I trained, though, if we did afternoon rounds, consults were rarely available. Let's say consult team does their thing at 11:00. Intern is paged, patient discussed. Consult team gets around to writing note by 5:00 p.m. Or maybe intern pages Rads to get a quick read on the Abd CT. They don't do the official report until it's staffed. If you don't act as though you care by asking your intern what has happened in these cases, they can leave you out to dry.

 

[abc56]

while i totally agree that there is a hierarchy in medicine (especially surgery) and that those at the highest levels are the ones who get the info "fed" to them, i think its unreasonable to always take this concept so seriously. do you really think that the medical student can be more "in the know" than the intern? the intern is the one who is writing all the orders, getting paged with all of the issues, etc, so obviously they are going to know certain things before the student. certain attendings dont even want to speak to students, so when it comes to consults, all we're left with is reading chicken scratch in the patients chart. obviously, it doesnt take much for the student to look things up on the computer/in the chart at the same time, but there is always going to be a delay in terms of when the student finds things out. therefore, how can info always be passed upwards from the medstudent-->intern-->resident-->attending when the student is not the one writing orders/getting paged, etc.

all im saying is, what ever happened to the concept of working as a team? why all of these stupid rules about what you can/cant say to an intern? who cares? i think from time to time, me discussing a plan with the intern standing right there (who is not busy) makes more sense than ALWAYS running to look in a chart to find the answer just to avoid asking the intern a question.

do i have a point here? im not trying to make excuses for myself, i just get frustrated in situations like these where stupid rules override common sense.

 

[Hard24Get]

while i totally agree that there is a hierarchy in medicine (especially surgery) and that those at the highest levels are the ones who get the info "fed" to them, i think its unreasonable to always take this concept so seriously. do you really think that the medical student can be more "in the know" than the intern? the intern is the one who is writing all the orders, getting paged with all of the issues, etc, so obviously they are going to know certain things before the student. certain attendings dont even want to speak to students, so when it comes to consults, all we're left with is reading chicken scratch in the patients chart. obviously, it doesnt take much for the student to look things up on the computer/in the chart at the same time, but there is always going to be a delay in terms of when the student finds things out. therefore, how can info always be passed upwards from the medstudent-->intern-->resident-->attending when the student is not the one writing orders/getting paged, etc.

all im saying is, what ever happened to the concept of working as a team? why all of these stupid rules about what you can/cant say to an intern? who cares? i think from time to time, me discussing a plan with the intern standing right there (who is not busy) makes more sense than ALWAYS running to look in a chart to find the answer just to avoid asking the intern a question.

do i have a point here? im not trying to make excuses for myself, i just get frustrated in situations like these where stupid rules override common sense.

No, no - you're right. The intern will always know the most up to date info, we are only expected to be the masters of relatively static stuff like pending studies, problem lists, family members - details others have no time for.

What we are trying to say is that a balance must be struck. You shouldn't be doing nothing at all, then asking the intern to feed you all the info, in that case you are just a parasite and a burden.

you should do chart checks (b/c the intern does not get paged by all consults all the time and you may actually help), and see what orders they have already executed (did you order that beta-blocker sounds like checking up on them, for instance). Then, it is reasonable to say, "did you see that note from Surgery?, or "did you ever hear back from so and so?". That is part of being a team. If you are both working to gather info you are less likely to miss things. Working this way, I usually end up being trusted to call consults and give them MY pager number, etc....

Besides, the intern is usually busy (or at least enjoying a well-deserved break).

 

[Tired]

all im saying is, what ever happened to the concept of working as a team? why all of these stupid rules about what you can/cant say to an intern? who cares? i think from time to time, me discussing a plan with the intern standing right there (who is not busy) makes more sense than ALWAYS running to look in a chart to find the answer just to avoid asking the intern a question.

Of course it's a crappy system, and I'm not trying to defend it so much as at least explain it (more for the benefit of any soon-to-be MS3s, obviously not to you who already lives it). When you really think about it, the dump that the intern took on you was probably more the result of having lazy MS3s before you who made him bitter, and you are just taking the brunt of his/her frustration.

Again, I would maintain that if you got this far before this happened to you, you must be doing pretty well. I honored most of my rotations 3rd year, and was getting shots like this from pretty much from day one.

 

[abc56]

thanks for the vote of confidence, tired


im over it. im not going to let one bitter intern make me feel like i am lazy/doing a bad job. after all this is the first time it happened so i shouldnt be so hard on myself.

 

[AmoryBlaine]

I think interns who yell at medical students should be shot.* An upper level resident has alot more perspective on things and could maybe get away with it. An intern is not even a year out of med school. The best ones just do their sh!t and don't harrass the med students.



Punishment should increase for yelling/pimping/abusing medical students as the yeller/pimper/abuser gets lower in their medical education. If an intern should be shot for abusing M3s, an M4 should be tortured and left exposed on the hillside. An M3 who pimps M1s, well, I can't even describe the appropriate punishment here...

 

[Anka]

I agree with those who say it's not possible for the medical student to be aware of everything going on with the patient. That ethos (at least as far as I can tell) came from an era where things moved a lot more slowly, where the intern wasn't getting paged that test A came back with results X and making a decision to order test B which came back with results Y and so did S, Q and R, then got a repeat A, and so on. It used to be decisions were made slowly over the course of the day, it took a while to get the results back, and so by the time anyone was making a decision the student probably really could have looked it up in the chart.

As far as interns pimping medical students, etc. I often find that my classmates feel really put down by what was a genuinly benign question on the part of the intern, mainly intended to make sure he/she wasn't about to explain something the person already knew. No one, not even an attending, should ask pimp questions for the purpose of abusing/putting in place a student... but for some reason you take someone three years into medical school and ask them a question they get all freaked out.

Best,
Anka

Best,
Anka

 

[Samir Desai]

As a student, you will often find yourself out of the loop. Important patient information may bypass you. You may be off the floor when there is a change in your patient's hospital course. Your intern, being busy with work, may forget to inform you of what has happened. Every day, situations of this sort leave students frustrated.

As frustrating as it may be, do your best to stay current. To stay current, you must be proactive. I recommend:

*Reading the chart frequently for new progress notes, consultants' notes, and new orders. This is especially important if you have been away at a one-hour conference. As you know, things can change quickly.

*Be aware of changes in vital signs, lab test results, and so on.

*Visit the patient multiple times throughout the day. Before checking in with your intern or resident, start by saying, "I just saw Mrs. Smith and she is breathing better ..." Then ask your intern if there is anything new on his end. This is a better approach than just approaching your intern with "Anything new with Mrs. Smith?"

If you use this approach, it won't take long for a resident or intern to see that you are dedicated to patient care. Then when something happens and you are out of the information loop, it's less likely that the intern or resident will think poorly of you.

As people become interns, residents, and attendings, many tend to lose sight of what life was like as a student. For those of us who are past med school, it's important that we remember the challenges of being a student.

 

[jdh71]

First off, don't sweat the surgery intern, everyone knows the amazing ability of surgeons and those going into surgery to show aptitude for emotional grabage, perfectionism, and elitism - truth is: they are still mad at daddy, but since they are surgeons and you cannot tell them **** are all in denial making them "wonderful" people to be around. You are not important if you cannot do anything for them. People like that are not worth the space you rent them in yoru brain. Be a duck . . . let it run off your back.

Second, being on top of things reqires you to be ORGANIZED, ORGANIZED, ORGANIZED . . . did I mention the organization. Buy a binder. Create a patient template - your own personal "list" where you keep up with everything for the day for your patients. On rounds AM, pay attention to the plan - write down everything! - volunteer to make any and all phone calls - run to micro and get results before they show up in the computer - in other words, for your patients, do all your own floor work. Multitask - while writing discharge summaries, page your consults for instance - one thing at a time will be you behind the 8-ball (did someone say 8-ball?!) If that means staying late . . . stay. You wanted to be on top of things right? After evening rounds look at all the orders and make sure you know what to look for in the AM. At the end of the day look for all consults. There is virtually no way you'll be completely out of the loop this way. Finally, don't leave until the intern does, check out one last time. The intern might also be nicer if they see you hutsling like this. (After finishing my sub-i, I now see which 3rd year students are "appropriate for level of training" and which students stand-out - I'm giving you the picture of the "stand-outs")

 

[Samir Desai]

Excellent points by jdh71. Organization is key. jdh71 also writes about the importance of initiative. Finally, take ownership of your patients and strive to function at an intern level.

 

[thewebthsp]

Multitask - while writing discharge summaries, page your consults for instance - one thing at a time will be you behind the 8-ball (did someone say 8-ball?!)

Agree with everything but this -- studies show that people do things faster one task at a time. Multitasking results in lower efficiency -- something like 1 1/2 times as much. FOCUS on one thing at a time, do not get distracted!

 

[Hard24Get]

Agree with everything but this -- studies show that people do things faster one task at a time. Multitasking results in lower efficiency -- something like 1 1/2 times as much. FOCUS on one thing at a time, do not get distracted!

Good point, but I don't recommend FOCUSing on waiting for a consult to call back. Writing while waiting is reasonable...

Agree with jdh71 ('cept I use a clipboard) but the way he/she describes it all sounds exhausting! It's actuallly second nature once you start taking "ownership" of the pt.

 

[tupac_don]

while i totally agree that there is a hierarchy in medicine (especially surgery) and that those at the highest levels are the ones who get the info "fed" to them, i think its unreasonable to always take this concept so seriously. do you really think that the medical student can be more "in the know" than the intern? the intern is the one who is writing all the orders, getting paged with all of the issues, etc, so obviously they are going to know certain things before the student. certain attendings dont even want to speak to students, so when it comes to consults, all we're left with is reading chicken scratch in the patients chart. obviously, it doesnt take much for the student to look things up on the computer/in the chart at the same time, but there is always going to be a delay in terms of when the student finds things out. therefore, how can info always be passed upwards from the medstudent-->intern-->resident-->attending when the student is not the one writing orders/getting paged, etc.

all im saying is, what ever happened to the concept of working as a team? why all of these stupid rules about what you can/cant say to an intern? who cares? i think from time to time, me discussing a plan with the intern standing right there (who is not busy) makes more sense than ALWAYS running to look in a chart to find the answer just to avoid asking the intern a question.

do i have a point here? im not trying to make excuses for myself, i just get frustrated in situations like these where stupid rules override common sense.

The problem is that interns don't wanna be bothered, especially if they are tired and don't wanna deal with a med student. I found that if a student asks lots of questions, often words like "look it up and tell me" would pop up.

Bottom line its human nature, some interns will like talking shop and won't mind cluing you in. Others just want their day to run as smooth as possible and since med student is at the bottom of the totem pole, they don't wanna deal with you.

Best way to get someone not to bother is to tell them to look something up. Some use it as a strategy so you don't ask em questions.