RxBoy

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Just wondering how other residency programs fair with the on site teaching? I feel many of my CA-1 cases (GYN, laproscopic, gastric banding, urology, minor abdominal surgeries), the attendings are there for induction and then that's it. I know they have a certain level of trust with me seeing as I am usually on top of things. Attendings check on some of the other residents a lot more often. Of course if anything went wrong and I called overhead they would be there in seconds.

But I feel they never come in and actually do any hands on teaching after induction. Like it would be nice to have an attending come in and start pimping me how to react in different scenarios. Sure you can read about it over and over, but it sinks in more when I get pimped, and even more when the scenario actually happens. A couple of attendings are good, but it seems like I learn the most from my seniors. Didactics are on par, but thats a totally different kind of teaching.

How do some of you other CA1's feel about your on site teaching?
 

psychbender

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At my hospitals, it is very similar. Attendings are there at the beginning and end, but if it is a simple procedure, most tend to be elsewhere during the majority of the case, and don't do a lot of pimping. There are a few, however, that will keep you busy with questions throughout the entire procedure, and I really enjoy working with those guys. One staff just got back from an operational tour with a bunch of SF guys (we're a military program), and tries to incorporate medicine in an operational or resource limited setting when cases are too simple/calm. He does a lot of "cockpit drills" (aka, here is some horrible catastrophe, what is going on, and what are you going to do about it?), or plays the "you don't get to use any of X drugs today" game.
 

Mman

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As a resident (particularly a first year), the majority of my attendings would have a teaching point for the day that we would go over. We'd talk about it a little when I called them the night before to discuss the cases and then we'd go over it in detail at some boring part of the middle of the case when they had 15-20 minutes to teach.

Some would print out some journal articles for me to read.

Others would give me a clinical situation to think about and then come back 30-60 minutes later to discuss.

But they would all teach. If you aren't getting teaching in the OR, you should voice some concerns to chief residents and/or program director.
 

cchoukal

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I'm on faculty at a large academic program and have a handful of advisees. I routinely ask them to carry the list of keywords from their ITE or AKT (a list of topics related to questions they got wrong) so that they always have something they can ask attendings about. It works even better if you mention a couple of keywords the night before so the attending can be ready to give you the best discussion possible. Teaching is great when it's a 2-way street; if you show up with a specific question about something, you'll not only look more interested and engaged, you'll also get more out of your time with your attending each day.
 
Jan 24, 2003
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An issue at most academic centers. You have a few attendings who are outstanding examples of clinical teaching faculty, use every situation as a teaching point, a bunch who are in between and make an effort to teach during an 8 hour ex-lap when you KNOW that they don't have much going on in their other room (s), and then a few who just induce and sit in their office until you call them. If I was with the first kind, I took full advantage. With the last kind, I didn't even bother asking them questions because I never found their answers useful because they didn't care about teaching anyway and just used that opportunity to read and learn on my own about the case we were doing (these are the attendings who preop with you in under 30 seconds when you're a CA-1). The middle group is the most flexible-- they just need a little knudge. As OPs have said, coming in with specific questions often helps-- or just ask them to give you an oral board type scenario-- not so much to practice how to do oral boards, but just to fine tune how you think about problems. One of the big advantages of preparing for orals is that it simply makes you a better thinker in the OR. Now, whenever I have a catastrophe in the OR, I have a voice in the back of my head that is explaining what I would do to an oral board examiner-- which means I don't miss anything. simple stuff like post-op laryngospasm, intraop hypoxia are great scenarios to run through.