Teaching as an MS4

[sloop]

So I'm a new 4th year med student and I've found myself actually doing a substantial amount of teaching 3rd years on my current SubI. I love to teach and have always been a tutor throughout med school and undergrad. The teaching appears well received by everyone, including the med students and residents, but I was wondering what people thought—is this appropriate or not?

I guess I'll start with what I absolutely do NOT do:
- I do not pimp the medical students. I do not ask them questions to try to "teach" them, especially not in front of any residents or attendings
-I do not give homework, obviously, and I do not expect people to listen to me

What I do:
-Make clear that I'm available to them for questions about logistical stuff, questions about what to ask when seeing psych patients, note writing, etc. with the obvious disclaimer that I don't know everything/am still learning too/am no substitute for a resident
-Ask if they would like something before doing any teaching
-Most of what I've done has been like "hey, if you'd like, I can quickly draft up an outline about the timelines for different psych disorders and antipsychotics and their side effects that I think you'll see on your shelf." Then I will distribute copies of that chart to the students in case they'd like them.

As I said, I'm clear that I have no expectation that they sit and be talked at by me or anything like that, and this all seems well-received. Most of it has actually been initiated by the third years coming up to me and asking me questions. They seem to be actually seeking me out for help with stuff.

I just don't want to come off as pretentious or a dick for taking up people's time. I don't think I am, but I wanted your input on now you would view a 4th year doing this sort of stuff.

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[ACSurgeon]

So I'm a new 4th year med student and I've found myself actually doing a substantial amount of teaching 3rd years on my current SubI. I love to teach and have always been a tutor throughout med school and undergrad. The teaching appears well received by everyone, including the med students and residents, but I was wondering what people thought—is this appropriate or not?

I guess I'll start with what I absolutely do NOT do:
- I do not pimp the medical students. I do not ask them questions to try to "teach" them, especially not in front of any residents or attendings
-I do not give homework, obviously, and I do not expect people to listen to me

What I do:
-Make clear that I'm available to them for questions about logistical stuff, questions about what to ask when seeing psych patients, note writing, etc. with the obvious disclaimer that I don't know everything/am still learning too/am no substitute for a resident
-Ask if they would like something before doing any teaching
-Most of what I've done has been like "hey, if you'd like, I can quickly draft up an outline about the timelines for different psych disorders and antipsychotics and their side effects that I think you'll see on your shelf." Then I will distribute copies of that chart to the students in case they'd like them.

As I said, I'm clear that I have no expectation that they sit and be talked at by me or anything like that, and this all seems well-received. Most of it has actually been initiated by the third years coming up to me and asking me questions. They seem to be actually seeking me out for help with stuff.

I just don't want to come off as pretentious or a dick for taking up people's time. I don't think I am, but I wanted your input on now you would view a 4th year doing this sort of stuff.

Answering questions and giving them tips on how to shine is great.

Sitting them down to lecture them is questionable at best and even potentially dangerous. You're hardly an expert on any of these things...

Giving them homework or anything else would be totally douche.

 

[Goro]

Forget about their precious little self-esteems and by all means, DO pimp them. It's more important to learn what you don't know than what you do know. I can still remember questions I got asked at my oral exams in grad school, some 30 years ago!

There's nothing wrong with asking "What deficit is seen with a lesion to ___ cranial nerve?"

I guess I'll start with what I absolutely do NOT do:
- I do not pimp the medical students. I do not ask them questions to try to "teach" them, especially not in front of any residents or attendings

 

[sloop]

To be clear, I do not sit them down and teach them. They come to me and talk to me about a patient and ask about the diagnosis and I'll just discuss depression with psychotic fx versus schizoaffective or whatever. One of the students expressed wanting to know about the timelines for different psych disorders so I put together a simple table with the timelines for the mood, psychotic and stress disorders (factually double-checked against my desk reference to the DSM V).

Mostly I've just been giving tips about what types of things are likely to show up on the shelf. I also tutor the psychiatry shelf for the school so I feel reasonably qualified to offer this type of advice.

 

[ACSurgeon]

To be clear, I do not sit them down and teach them. They come to me and talk to me about a patient and ask about the diagnosis and I'll just discuss depression with psychotic fx versus schizoaffective or whatever. One of the students expressed wanting to know about the timelines for different psych disorders so I put together a simple table with the timelines for the mood, psychotic and stress disorders (factually double-checked against my desk reference to the DSM V).

Mostly I've just been giving tips about what types of things are likely to show up on the shelf. I also tutor the psychiatry shelf for the school so I feel reasonably qualified to offer this type of advice.

Sounds like you're fine.

i would leave any complex discussions for the residents.

 

[Psai]

Forget about their precious little self-esteems and by all means, DO pimp them. It's more important to learn what you don't know than what you do know. I can still remember questions I got asked at my oral exams in grad school, some 30 years ago!

There's nothing wrong with asking "What deficit is seen with a lesion to ___ cranial nerve?"

Depends on the context. If you're explaining something and you want to illustrate a point then yeah. If you're in rounds and you do that I will find you.

 

[girlofgrace7]

I think teaching informally is fine, especially in July. When I was a 4th year, my upper level resident was out on sick leave for a while (so random upper levels who didn't know the team and who certainly didn't have time to teach when they were learning a whole new team) and most of the interns on were off-service and/or not from the med school and just trying to find the bathrooms and such. So, I did a fair amount of basic, informal teaching on my AI, especially on patients that I was the "intern" for. I think it helped to solidify my knowledge of why we were doing things as well as helping the brand new third years who mostly just need to learn how to present an H&P well at that stage. I'm a third year resident now, and I definitely wouldn't frown on a 4th year doing informal teaching with 3rd years, especially in July when we're all tied up trying to take care of the new interns and the 2nd years are freaking out about suddenly being upper levels. Definitely don't throw them under the bus or do formal teaching with them though.

 

[Donald Juan]

Agree with don't get into any formal teaching, and limit/be cautious how you do this type of thing in front of attendings. Also, always feel out if the students want your help.

I would also keep in mind that your biggest advantage as a M4 over a new M3 is that you know what a medical student is supposed to do. I've found most students need less help with the knowledge base (they know how to study) and more advice on writing notes, presenting, managing time, helping the team best, etc. Usually if you are going to go over study material I would frame it more as studying together. You definitely didn't learn everything or retain everything from M3, so no point in just regurgitating an uptodate article to them to make yourself look smart.

 

[Snoopy2006]

Sounds like you're doing a good deed to me. Drafting outlines/notes to help them with their studying, answering questions, helping them get a feel for the lay of the land and the logistics of a rotation - all good non-douchey stuff

 

[sloop]

Yeah, it's basically all informal and generally they initiate it by asking me stuff. When they asked more "overview"type questions, I have made a couple of UWorld-Esque charts on things I am very confident on, double checking against solid references (and all of which I am upfront about being mostly a simplified review version of what's in FA psych).

It has been well received, with one student telling me upfront that I'm an awesome fourth year.

Thanks for the feedback guys, it means a lot. I just wanted to make sure what I was doing was tactful and appropriate. As I said, I love to teach (almost as much as I love psychiatry) and it's one of the things I look forward to the most about residency and beyond. I just wanted to make sure I'm not getting ahead of myself.

 

[sliceofbread136]

Forget about their precious little self-esteems and by all means, DO pimp them. It's more important to learn what you don't know than what you do know. I can still remember questions I got asked at my oral exams in grad school, some 30 years ago!

There's nothing wrong with asking "What deficit is seen with a lesion to ___ cranial nerve?"

Do not listen to this...

Do NOT pimp
Do NOT "assign" work

Keep it as optional informal teaching, making cheat sheets is also great

 

[Crayola227]

giving out notes, papers, resources is fine

telling them they can ask you questions, fine

anything more, douchey

 

[Señor S]

Sitting them down to lecture them is questionable at best and even potentially dangerous. You're hardly an expert on any of these things...

I remember a 4th year who did this with us, it was annoying and not at all helpful. Like, you're still a med student boy, know your place.

What sloop is doing sounds fine though.

 

[sliceofbread136]

I remember a 4th year who did this with us, it was annoying and not at all helpful. Like, you're still a med student boy, know your place.

What sloop is doing sounds fine though.

I think it's fine if it's like "is there anything you guys wanna go over?", otherwise I agree

 

[lymphocyte]

So I'm a new 4th year med student and I've found myself actually doing a substantial amount of teaching 3rd years on my current SubI. I love to teach and have always been a tutor throughout med school and undergrad. The teaching appears well received by everyone, including the med students and residents, but I was wondering what people thought—is this appropriate or not?

I guess I'll start with what I absolutely do NOT do:
- I do not pimp the medical students. I do not ask them questions to try to "teach" them, especially not in front of any residents or attendings
-I do not give homework, obviously, and I do not expect people to listen to me

What I do:
-Make clear that I'm available to them for questions about logistical stuff, questions about what to ask when seeing psych patients, note writing, etc. with the obvious disclaimer that I don't know everything/am still learning too/am no substitute for a resident
-Ask if they would like something before doing any teaching
-Most of what I've done has been like "hey, if you'd like, I can quickly draft up an outline about the timelines for different psych disorders and antipsychotics and their side effects that I think you'll see on your shelf." Then I will distribute copies of that chart to the students in case they'd like them.

As I said, I'm clear that I have no expectation that they sit and be talked at by me or anything like that, and this all seems well-received. Most of it has actually been initiated by the third years coming up to me and asking me questions. They seem to be actually seeking me out for help with stuff.

I just don't want to come off as pretentious or a dick for taking up people's time. I don't think I am, but I wanted your input on now you would view a 4th year doing this sort of stuff.

@sloop, I was in a similar position. I was assigned MS3s as a Sub-I, and I love to teach to as well. I can't speak to what's appropriate or not, but I can provide my own experiences on things that got me good feedback:

1. I tried to help them where I could. Look at their notes before they had show it to the senior resident. Demonstrate physical exams manoeuvres they might be asked to perform during rounds. Provide as many resources or tips as they asked for, even when it came to things like studying for Step 2CK.

2. Yes, I would pimp them. Sorry guys, but I disagree here. Why? Because I'd try to anticipate the attending's pimp questions. It made some of the students look like prepared rockstars during rounds. I'd always be friendly about it, frame it as "you might get asked X," and I'd back-off if it seemed like I was making them nervous. I never pimped in public (even in front of other MS3s). It just seems rude. The goal was to empower, not to unintentionally humiliate.

3. I asked them what their career plans were. During a neuro Sub-I, I'd totally geek out with a future neurologist, but I might ask the ones interested in EM if they wanted to do a procedure, like a LP. Lots of medical students actually don't know why they'd like to see--or they make something up to be congenial. A waste of time for everybody. You can start with their interests in mind and go from there.

4. I'd listen to them vent. It sucks being a MS3. When we were getting coffee or something (never near a resident or attending), I'd just ask them how things were going, if they felt like they were learning, if they felt prepared for the shelf exam, etc. It sounds pat if you ask them in the first few days, but once you've spent some time with them, I think they appreciate that you care.

5. Formal teaching, never. I did, however, pass along a few notes and had informal tutorials for the shelf exam. If I out-and-out said, "It's at 5p and completely voluntary"--I'd worry that some might feel pressured to attend... and it frankly puts a lot of pressure on me to make it worthwhile. But if they told me that they were worried or didn't understand something, pull up a chair! I can help with this.

6. No extra work. Never. Ever. Even if they asked. I also owned my own scut. No way a MS3 is faxing or getting the team coffee or doing something ridiculous like that when they could be learning (or having some valuable free time). I'm only mentioning this, because, yes, there was another Sub-I who scutted out his MS3, and it made me want to stab him in the face with a spork.

 

[OnePunchBiopsy]

Just started 4th year and asked myself this same question.

The way I worked around it is I simply do not "teach" in front of interns, residents, or attendings. If a third year asks me for information, I say we can meet up later and study what they are unsure about. I like to think of myself as a "third year with 1 year of clinical experience," meaning we are still supposed to assume a "student" role.

 

[sliceofbread136]

@sloop, I was in a similar position. I was assigned MS3s as a Sub-I, and I love to teach to as well. I can't speak to what's appropriate or not, but I can provide my own experiences on things that got me good feedback (from students and attendings). As a caveat, there are lots of things I don't know. There are lots of things I don't know that I don't know. But there are some things I do know, like what a good note looks like, how to pass the Shelf, or how to perform certain physical exam manoeuvres. I think we should all try, within our expertise, to teach (hell it's even in the Hippocratic Oath somewhere).

1. I focused on making the students' lives better. I'd take a look at their notes before they had show it to the senior resident; I'd demonstrate physical exams manoeuvres they might be asked to perform during rounds; and I'd provide as many resources or practical tips as they asked for, even when it came to things like studying for Step 2CK.

2. Yes, I would pimp them. Sorry guys, but I disagree here. Why? Because I'd try to anticipate the attending's pimp questions. It made some of my students look like prepared rockstars during rounds. I'd always be friendly about it, frame it as "you might get asked X," and I'd back-off if it seemed like I was making them nervous. I never pimped in public (even in front of other MS3s). It just seems rude. The goal was to empower, not to unintentionally humiliate.

3. I asked them what their career plans were. During a neuro Sub-I, I'd totally geek out with a future neurologist, but I might ask the ones interested in EM if they wanted to do a procedure, like a LP. Lots of medical students actually don't know why they'd like to see--or they make something up to be congenial. A waste of time for everybody. I start with their interests in mind and go from there.

4. I'd listen to them vent. It sucks being a MS3. When we were getting coffee or something (never near a resident or attending), I'd just ask them how things were going, if they felt like they were learning, if they felt prepared for the shelf exam, etc. It sounds pat if you ask them in the first few days, but once you've spent some time with them, I think they appreciate that you care.

5. Formal teaching, never. I did, however, pass along a few notes and had informal, completely voluntary tutorials for the shelf exam. If I out-and-out said, "It's at 5p and completely voluntary"--I worried that some might feel pressured to attend. But if they told me that they were worried or don't understand something, pull up a chair! I can help with this.

6. No extra work. Never. Ever. Even if they asked. I also owned my own scut. No way a MS3 is faxing or getting the team coffee or doing something ridiculous like that when they could be learning (or having some valuable free time). I would actively stop them from doing so. I'm only mentioning this, because, yes, there was another Sub-I who scutted out his MS3, and it made me want to stab him in the face with a spork.

Hope this helps. Honestly you sound like a teacher that I would have been lucky to have as a MS3--one that's self-aware, actually cares, and wants to get better. Good luck.

All I know is if an ms4 tried to pimp me as an ms3 Id have a few choice words for them. Saying "oh you might get asked this question" is 100% different, wouldn't classify that as pimping

 

[sloop]

All I know is if an ms4 tried to pimp me as an ms3 Id have a few choice words for them. Saying "oh you might get asked this question" is 100% different, wouldn't classify that as pimping

Yeah, never ever would pimp the students. I never even ask them a question at all if residents or attendings are in earshot. The most I've done on a question front is like, for example, "X attending will always want you to mention MCV and TSH even if they're irrelevant, so just write it on every consult, but in general do you have any idea why they want to know MCV? [they gave some answer that is pretty close and I just clarified it]" or they would ask what medications are most important to mention in a presentation and I'd say like "so a good way to think of this is to think about drugs you know that can cause major psych symptoms. What drugs do you think are like this? [they'll list some like steroids and ergot alkaloids, l-dopa, etc. and I'll reinforce that those are important and just fill in beta blockers, etc.]

I will also back off on any question and just explain the concept if I get even the slightest feeling the student is uncomfortable (which honestly hasn't happened yet).

 

[hallowmann]

I think it's not a big deal to ask MS3s questions. It all hinges on how you do it. Obviously don't do it in front of the residents/attendings, don't do it in a condescending way, do it in the midst of teaching and motivating, not "quizzing". If you're in any way unsure of how you're doing it, maybe it's safer not to.

I had MS4s ask me questions, half came off as really helpful, but 1 or 2 tried to do like real hardcore resident and attending style pimping, and they just came off as tools that actually didn't really know their stuff.

As far as "homework", again it depends on how you do it. The only "homework" I was given by MS4s was them asking me what do I want to talk/learn about tomorrow given the patients I had to read up on. So basically it was stuff I was going to do anyway and would probably be asked by my seniors or attendings, it was informal, low pressure, and again not in front of residents or attendings. I was fine with that. Again, if you don't know how you would do that in a positive and low pressure way, maybe it is best not to do it.

Otherwise, I think teaching is great. I valued it done right by 4th years and I can think of multiple things I know now that I was taught by them.

 

[StrongIslandDoc]

Forget about their precious little self-esteems and by all means, DO pimp them. It's more important to learn what you don't know than what you do know. I can still remember questions I got asked at my oral exams in grad school, some 30 years ago!

There's nothing wrong with asking "What deficit is seen with a lesion to ___ cranial nerve?"

Pinealoma. Go!