And, no offense, but I have yet to meet a med student who could tell me succinctly why a patient required a surgical consult.
No offense taken. I felt so sorry for the GI fellow that I had to call on my first day of the rotation. I'd never called in a consult before (we weren't allowed to on other rotations), so I had no idea what to expect. I thought that I was just supposed to give her the patient's name, room, chief complaint, and MR number, and she'd take it from there!
We had a
two day long orientation before third year - in which they spent
half a frickin' day explaining to us how to use our PDAs.
But they "ran out of time" and neglected to explain useful things to us - such as how to correctly call in consults.
After some questioning the med students usually end with, "Sigh... OK, look... The resident asked me to call you. I really don't know why General Surgery needed to be called."
Actually, in this case, the frustration lies in the fact that I just finished my surgery rotation, and am now doing my internal med rotation at the same hospital. So I'm familiar with the surgery services, and how each one works. Which is why it's so frustrating that I'm a) being told to call in consults to the wrong service, and b) being told to call in consults that I
KNOW will not be seen by the surgeons.
1) For example, we had a patient who needed a g-tube changed. The fellow insisted that I call it in to general surgery - despite the fact that such consults ALWAYS go to trauma. When I (timidly) suggested that trauma would take care of the problem faster, I was told to just call general surgery anyway. The general surgery intern told me to (guess what?)
call trauma.
Trauma agreed to take her (since this is the type of stuff that they generally do, at least here), but the fellow refused to let them operate. The fellow insisted that general surgery take the patient.
After much cajoling, begging, and pleading from me, the general surgery team (grudgingly) agreed to take the patient on their service. I was told that Dr. A was going to operate on the patient.
Then, when I told the fellow that the patient was going to the OR, the fellow asked "Is Dr. W going to operate? It HAS to be Dr. W. Nobody else." (He didn't have a good reason for why Dr. W needed to change the g-tube - he just told me to call the gen surg team again.)
**slam head**
I think that the general surgery intern wanted to reach through the phone and throttle me. Not that I would have blamed him....
b) It really annoys me when medicine fellows/residents ask me to call surgical oncology for an "in-house evaluation." Surgical oncology NEVER evaluates patients in house. These patients rarely need to be rushed to the OR, and surg onc always insists that these patients follow up in the outpatient clinic 1 week after d/c. (I heard the intern say this over and over again when I was on surg onc.) But the fellow never seems to understand that, no matter how many times I tell him.
I can't believe I actually wanted to do internal med at one point.
