Tips/advice for managing/dealing with a moody med student?

[KnuxNole]

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I'm working on a service with a medical student this month, and this girl brings out a really nasty attitude and a snarl on her face. Like...I don't know if this girl even knows how to smile. I usually like to be friendly with everyone around me(nurses, co-residents, attendings, students) and saying hi resulted in a really nasty/moody response followed by an eyeroll. This kinda behavior usually throws me a curveball because everyone I've met so far in residency has been nice or at the very least friendly. When I tried to give advice and orient her, all I got back was back-talk and questioning every single thing. Heck, she was irritating and asked why I informed her to come pre-round on patients. I just have a bad feeling this won't be an easy month with me being stuck with her, and wondering what to do about this situation. I'm usually horrible with unfriendly people :/

 

[rokshana]

you're the resident...she is the med student...sit her down (as well as your other students so it doesn't look like you are singling her out) and tell them what the expectations are of med students on this rotation...esp if this is a core rotation. Discuss the core competencies and that poor behavior during the rotation can result in failure of the rotation.

there IS a hierarchy and she needs to realize it...and that she is as near to the bottom as it gets.

doesn't matter if she doesn't look happy or never smiles...thats her problem...bur when she back talks a residents and doesn't want to do the things required of med students (like pre rounding)...then it becomes your problem...emphasize to her that when it becomes your problem...she is not going to like it.

 

[SouthernSurgeon]

you're the resident...she is the med student...sit her down (as well as your other students so it doesn't look like you are singling her out) and tell them what the expectations are of med students on this rotation...esp if this is a core rotation. Discuss the core competencies and that poor behavior during the rotation can result in failure of the rotation.

there IS a hierarchy and she needs to realize it...and that she is as near to the bottom as it gets.

doesn't matter if she doesn't look happy or never smiles...thats her problem...bur when she back talks a residents and doesn't want to do the things required of med students (like pre rounding)...then it becomes your problem...emphasize to her that when it becomes your problem...she is not going to like it.

So I agree with sitting her down and discussing expectations.

But I would also be VERY wary of any "establishing the hierarchy" kind of talk. That's the sort of thing that tends to lead students (particularly those seemingly predisposed to it) to filing a formal complaint.

I would talk to her about your expectations for the rotation, and also ask what is going on and if there is something wrong that can be addressed.

Separately from all of this, I would talk to the clerkship director directly to let them know your concerns. They have much more carrot/stick to wield than you do as a resident, and can help establish a paper trail if by any chance the student were to in turn complain about you.

 

[NotAProgDirector]

If you have a faculty member rounding with you, give them a head's up. When I'm on service and there's a student whose performance is unsatisfactory, it needs to be addressed right up front. I've only found one method that seems to work. In private, I first ask how the student thinks their performance is going. Usually, they tell me that they think they are doing well. Then I tell them that their current performance is failing, and that I'm happy to help them fix that if they'd like. I'm specific about what issues are failing. In this case, the student's medical knowledge may not be the issue, and I stress that knowledge does not trump behavior. All that said, this should come from faculty if possible. If there isn't faculty and your evaluation is what will be used to grade the student, then the same advice holds but now you're stuck with it. You should consider having someone else in the room with you -- could be the clerkship director, or a nursing supervisor, or the intern. This protects you against any "unsavory" complaints.

 

[ruralsurg4now]

everyone I've met so far in residency has been nice or at the very least friendly

Let's see, it's November ...so you must have been drunk for four months straight so far by my count.

 

[Top Gun]

I'm working on a service with a medical student this month, and this girl brings out a really nasty attitude and a snarl on her face. Like...I don't know if this girl even knows how to smile. I usually like to be friendly with everyone around me(nurses, co-residents, attendings, students) and saying hi resulted in a really nasty/moody response followed by an eyeroll. This kinda behavior usually throws me a curveball because everyone I've met so far in residency has been nice or at the very least friendly. When I tried to give advice and orient her, all I got back was back-talk and questioning every single thing. Heck, she was irritating and asked why I informed her to come pre-round on patients. I just have a bad feeling this won't be an easy month with me being stuck with her, and wondering what to do about this situation. I'm usually horrible with unfriendly people :/

Just curious, is she like this only with you, or is she like this with other people in the hospital too (nurses, other residents, other med students, etc...)?

 

[ruralsurg4now]

The other thing is that the girls in my med school would actively flirt with residents in order to get higher grades. Is that really any better than this? I don't know.

 

[Shikima]

Wow, not a single mention of the white elephant in the room.

Have you asked her why she's "moody" and "irritable"? Family problems? Poorly sleeping? Underlying depression/anxiety? I bet you can develop a good relationship and help her through the rotation through good leadership in identifying this behavior trait which you find unsettling. And if you find something of concern, do bring it up with your supervisor but also assist her in getting the help she needs.

Colleagues, a good leader is one who leads from the front but also knows the tone of subordinates - if you don't want to take the time to figure it out, then you need not lead and step back.

 

[betamale]

tell her the truth. be upfront and say that you don't time for her at this time and if she wishes to go home early, she may do so. also, tell her it is okay not to pre-round and that you dont need help. dont give her your number or pager.

problem solved.

 

[Trastuz]

There are some awesome responses in this thread. It's a great snapshot of our medical education system: pragmatic and professional.

 

[e30ftw]

I give these students gentle tips to try to help them out, but if they still act a fool I just ignore them as much as possible.

There are some seriously socially maladjusted med students (although most are great) and honestly during a busy ED shift if I've given you fair warning and you still act entitled/argumentative/rude ain't nobody got time fo that.

KnoxNole I don't know this particular student but from your post it sounds like she's just generally rude and unable to maintain a professional demeanor. you can try to change it but that's extremely unlikely to do anything andcould also backfire (by the ? borderline personality d/o student flipping out and complaining about you to her school). You should probably just save your own energy by giving her the least amount of responsibility possible and ignoring her for the rest of the rotation.

 

[Top Gun]

Agree. I might try nicely to help the student at first, including talking with her about any potential issues and trying to work with her on her attitude. But, if there is no change, then I have no time for that. I will not call her for any H&P's or any cool procedures. I will not give her any patients to follow. As far as I'm concerned, she can just go sit in the library all day. And I'll be sure to trash her on her eval for lack of professionalism

 

[shan564]

When I'm trying to tell students to do something differently, I like to frame it as "here's an insider tip on how to get a better grade." Like, instead of saying "you should come in to pre-round," I might say something like "here's what you should do on pre-rounds to look good when you're presenting to the attending."

 

[Bacchus]

It'd be interesting to see what fields some of these comments are coming from, haha.