What am I doing wrong?

[bluebirdie]

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So I'm about halfway into my second year of pediatrics. I work very hard, read regularly, enjoy my job, and feel like I do a good job. I just recently got my inservice scores back and scored well into the 400's. One thing that seems to really bother me is that no matter what I do, I only seem to get very generic, blah evaluations that say things like "good job, works hard, read more". I know evaluations don't mean much, but I just feel like I pour a lot into my work and don't feel like I get much back. I've gotten a lot of positive feedback from the medical students about my teaching abilities, but I have never had one mentioning on an evaluation that this is something positive that I do. There are some people in my program that no matter what they do, they are turning water into wine and raising the dead. The major difference I can see is that I am a little quieter and bs a lot less than my peers. What am I doing wrong?

 

[DarthNeurology]

So I'm about halfway into my second year of pediatrics. I work very hard, read regularly, enjoy my job, and feel like I do a good job. I just recently got my inservice scores back and scored well into the 400's. One thing that seems to really bother me is that no matter what I do, I only seem to get very generic, blah evaluations that say things like "good job, works hard, read more". I know evaluations don't mean much, but I just feel like I pour a lot into my work and don't feel like I get much back. I've gotten a lot of positive feedback from the medical students about my teaching abilities, but I have never had one mentioning on an evaluation that this is something positive that I do. There are some people in my program that no matter what they do, they are turning water into wine and raising the dead. The major difference I can see is that I am a little quieter and bs a lot less than my peers. What am I doing wrong?

My impressions of academic pediatricians:

1. Some peds attendings can be very much less impressed by a good fund of knowledge, often because they didn't have great scores themselves in medical school and sort of gave up studying or were never that interested in it themselves. Of course there are exceptions, but if you have good/great board scores, i.e. above 80th percentile, and if you like kids then you go into a surgical specialty or a peds specialty or something besides general peds, at least this is somewhat common in some places. Your attendings are probably general pediatricians who didn't do as well as you on inservice exams.

2. If you are a shining star, i.e. teach med students well (god bless you for this) then people notice, but often times they don't reward this as it is more personal interaction with the attendings than how well you are doing teaching others.

3. You say you don't "bs" as much as the other residents. It is important to have a good team attitude and not think that the other residents are "bs"ing the attendings, although this may indeed happen. Basically I think that attending evaluations *are* popularity contests to a great degree, so if you don't go around being super friendly with the attendings then you won't get a great eval.

4. At this point focus on your future career and doing what you are doing as it seems more than ok. I would go for a specialty as general pediatricians are a surly group of doctors and in a specialty your brains will be more respected. Attendings can for some reason or another not like a residnet/student based on minor diferences in personality. If a resident also likes cooking fancy italian meals like an attending, and if they talk about that or another common interest then the attending won't give them a bad eval. It is much more of a game than you realize.

 

[TexasRose]

My impressions of academic pediatricians:

1. Some peds attendings can be very much less impressed by a good fund of knowledge, often because they didn't have great scores themselves in medical school and sort of gave up studying or were never that interested in it themselves. Your attendings are probably general pediatricians who didn't do as well as you on inservice exams.



4. .. as general pediatricians are a surly group of doctors and in a specialty your brains will be more respected.

Your generalizations in this forum are offensive. For those of us who have had the opportunity to read your posts over the years, it is clear you had a bad experience on your Peds rotation and hold a major grudge about it. At the very least, if you are going to post this kind of rubbish here you could preface it by saying something like "I hate general pediatricians, so take this opinion with a grain of salt."

 

[TexasRose]

So I'm about halfway into my second year of pediatrics. I work very hard, read regularly, enjoy my job, and feel like I do a good job. I just recently got my inservice scores back and scored well into the 400's. One thing that seems to really bother me is that no matter what I do, I only seem to get very generic, blah evaluations that say things like "good job, works hard, read more". I know evaluations don't mean much, but I just feel like I pour a lot into my work and don't feel like I get much back. I've gotten a lot of positive feedback from the medical students about my teaching abilities, but I have never had one mentioning on an evaluation that this is something positive that I do. There are some people in my program that no matter what they do, they are turning water into wine and raising the dead. The major difference I can see is that I am a little quieter and bs a lot less than my peers. What am I doing wrong?

I'm truly sorry you're having this experience. If you were at my program, I'm sure you would be praised for your teaching and your fund of knowledge.

Is there an attending you have connected well with who could give you some feedback on this? I remember once I got a lukewarm eval on a rotation where I had worked my butt off and it really bothered me. A week or so later a very kind attending I work with pointed out that when I am thinking hard or feeling stressed, I frown a lot. To other people, I may look angry or upset. I didn't realize that was happening and it allowed me to at least say when I'm stressed that I'm frowning because I'm thinking hard.

I also just take attending's evals with a grain of salt. Some people you connect with and others you don't. Every attending puts "read more" because it's the no-thought reply.

 

[twilightdoc]

Evaluations and feedback (both formative and summative) are important components of residency training. You might want to share your concerns with your residency program director, who would know if there is a problem with the "local culture" regarding the lack of constructive content in the evaluations. If there is, he/she needs to work on faculty development to improve the evaluations and to make them more useful to the residents (and to the program director). And as others have said, take outliers with a grain of salt. Some faculty routinely praise everyone to the heavens, while others provide lukewarm assessments with little content or substance.

 

[bks524]

So, this is much more common than you may think. It is easy to just give the gentle pat on the back and say you're doing ok and move along. I think it is important to seek out face-to-face feedback. You can do this in a non-confrontational way and I also feel like this is usually more thorough if you give them advance notice

"Do you think we could get a few minutes on Friday to talk about my performance on this rotation?"

Give a specific day so it doesn't get ignored.

By the way, you sound a bit like someone I know and she always felt like she was not getting any at-a-boys. Reality was, she was ignored because attendings didn't feel like they had anything to add. They thought she was doing a great job.

 

[Stitch]

"Do you think we could get a few minutes on Friday to talk about my performance on this rotation?"

Give a specific day so it doesn't get ignored.

By the way, you sound a bit like someone I know and she always felt like she was not getting any at-a-boys. Reality was, she was ignored because attendings didn't feel like they had anything to add. They thought she was doing a great job.

I agree. And unfortunately lack of 'good job' type feedback is common in medicine. It seems most people (and this goes for any specialty) feel that only negative feedback is needed. But if the worst you hear is 'needs to keep reading' or 'read more,' then I'm guessing you're doing just fine.