What makes a student/resident enjoyable to teach?

[epsilonprodigy]

We're all smart, and had workers for the most part, but beyond this, what's the makeup of those who are "a joy to teach?" How do these people deal with those awkward moments when the attending/chief/whatever is trying to explain how to do something, but it's just totally not making sense to the learner? (I'm mostly talking about surgery, but this applies to anything.)

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[22031 Alum]

While having an aptitude for the material always helps, the things I am teaching/explaining to students aren't exactly rocket surgery. If a verbal explanation doesn't seem to be cutting it, a demonstration usually works. Thinking back on those I've considered "a joy to teach," a good attitude is probably 99% of it.

 

[Winged Scapula]

It really is about the attitude.

Students who seem interested, engaged and know how to carry on a conversation are the most fun to have around.

 

[Bacchus]

It really is about the attitude.

Students who seem interested, engaged and know how to carry on a conversation are the most fun to have around.

Agreed. You can be dumb as a rock (ok, that's a bit over-the-top) but if you're a joy to be a round I 1) Like you and 2) Like teaching you.

I'm not in a sexy specialty and I hate the first day I meet our new students and there's already an air to them of disinterest. Being humble and eager go a very long way. If the student's going to be a PITA, it's very easy to send them into the room, record their information when they talk to you, and just keep the schedule moving. But, if the medical students are making a good faith effort and wanting to learn medicine I take my time with them.

I used to be annoyed that students weren't showing an interest. Now I just go about my day. It's not worth it. If they don't perk up or show some interest after a quick talking to I'm not wasting anymore time.

 

[Kaustikos]

I can't speak for residents/physicians but I see what they mean.
I've always had this weird mentality with fields I'm not interested in pursuing where I'm 100% in learning about it because I want to get an idea how things work there. Most residents/attendings were okay with me saying "yeah, I'm interested in surgery, but I want to learn about your specialty."
Then jokingly add "so I don't piss you off with consults "

 

[justin1390]

As a 3rd year, at my medical school we actually take on first year students during the end and beginning of the academic year. It actually gives us really valuable experience being responsible for the education of another. Having said that, it really opens your eyes to what makes you a truly good student.

I agree attitude is so much of it, and I think that spills into a lot of other areas to that are important. I hate it when the first years are late, or glued to their phones the entire time. I am on a service right now where we have no resident, so I am the acting intern. My first years have been great and really showed a lot of interest. Actually took the option to stay to do a MMSE, and offer to come in early if I need the extra help. That was super impressive to me vs surgery where my first years tried to leave as soon as possible. Showed up an hour late, and one disappeared randomly and I had no idea where they went. I tend to be the "easy going," "get people out as soon as I possibly can" type of guy. But a good attitude makes teaching way more fun.

 

[Bacchus]

As a 3rd year, at my medical school we actually take on first year students during the end and beginning of the academic year. It actually gives us really valuable experience being responsible for the education of another. Having said that, it really opens your eyes to what makes you a truly good student.

I agree attitude is so much of it, and I think that spills into a lot of other areas to that are important. I hate it when the first years are late, or glued to their phones the entire time. I am on a service right now where we have no resident, so I am the acting intern. My first years have been great and really showed a lot of interest. Actually took the option to stay to do a MMSE, and offer to come in early if I need the extra help. That was super impressive to me vs surgery where my first years tried to leave as soon as possible. Showed up an hour late, and one disappeared randomly and I had no idea where they went. I tend to be the "easy going," "get people out as soon as I possibly can" type of guy. But a good attitude makes teaching way more fun.

Meh, going into my PGY-3, I don't know if MS3s have the capacity to teach students under them any significant on the wards. You're just a baby, yourself, to be honest. Hopefully you're an MS3 going to MS4.

 

[JustPlainBill]

My god, so true.

You can walk into the room and just feel it sometimes.

We have all of our students rotate through and take a couple of shifts on trauma and emergency general surgery. The theory is to get them all an opportunity to see new cases of surgical emergencies. But it means they are only with us for a day or two at a time on those services.

The difference is mind-boggling. We will have some that I spend the whole day with, talking about diagnosis and management, taking them with me to the ED and the ICU.

Then we have others who ask if they can go get coffee at 8AM, then send me a page asking me to let them know if anything interesting comes in, and I don't see them the rest of the day.

And this is where I would consider sending their pager number to the school's clinical coordinator and the service attending to see if they could be paged to a conference room for an unforgettable chat that would forever embed in their memory that they have responsibilities as future physicians and skating isn't one of them. Pardon me, but this annoys me to no end -- I am a military brat and can do a fairly good imitation of a pissed off SNCO and use compound-complex profanity in various non-repeating sequences and I can tell you I would have a difficult time restraining myself in that situation.....

 

[Freddie Mercury]

Then we have others who ask if they can go get coffee at 8AM, then send me a page asking me to let them know if anything interesting comes in, and I don't see them the rest of the day.

Wow

 

[DOFOSHO]

.

 

[Psai]

Ok I thought this good attitude thing was bs before but now that I've spent some time with a few first years that have been shadowing, I totally get what you guys are talking about. I loved the guy who listened to what I was saying and did the stuff I showed him how to do. Hated the person who seemed disinterested when I was explaining things to them that took me forever to figure out and would look away as if they weren't listening. No response to carry the conversation even though I felt like they were pretty smart. I wish I could tell how I come off to others

 

[justin1390]

Meh, going into my PGY-3, I don't know if MS3s have the capacity to teach students under them any significant on the wards. You're just a baby, yourself, to be honest. Hopefully you're an MS3 going to MS4.

I think this depends primarily on where you go to school and what the atmosphere is like. I feel there is a sizable percentage of third years who are not proactive, not interested in clerkships, and frankly, just not good at leadership. On the other side of the same coin, you have to consider the difference in education level. True, my fund of knowledge is quite deficient compared to say, an endocrinologist fellow. But how much do you suspect a 1st year is going to gain listening to such a person spout off his fund of knowledge (if you've listened to a fluid mechanic, you get the picture)? A first year is a clean slate, and in that sense I think that good 3rd years offer perhaps more than a resident in the most important foundation to beginning a medical education: a lesson in strong work ethic, nuances of patient care (we have more time), and basic knowledge more relative to where they are in their education.

Then again, this is all so relative on the student. Not picking on fellow third years here, as I am far from a gunner student, but the attitude in medical school is not typically optimal for learning. It's optimal for getting home early. One rotation a while back, a resident got sick. I saw 9 patients and wrote all their notes for a week. That's being a part of, and not just "on" a team.

 

[Perrotfish]

We're all smart, and had workers for the most part, but beyond this, what's the makeup of those who are "a joy to teach?" How do these people deal with those awkward moments when the attending/chief/whatever is trying to explain how to do something, but it's just totally not making sense to the learner? (I'm mostly talking about surgery, but this applies to anything.)

There's no universal answer. You need to know your boss and adapt. Some want humor, some want a barrage of questions, and some want closed loop communications to show your interested and understand. Some just want silent nodding, some want you to stay out of the way, some grade you entirely on scut and bribes (food for the team). Some want you to act naturally, other want you to 'show an interest' like dog waiting for a treat. Some want to see good time management and independence, others think that you're not interested if you're not trailing them like a lap dog. Some want you to bring articles, others want to see you teach, others want you to suggest research and case reports, and still others think any of those three things is presumptuous and smacks of grade grubbing.

In residency, and then for the rest of your career, you will study your bosses the same way you will study your trade. Unfortunately in MS3 you rotate through too many bosses too fast and with too little feedback, and likely will figure out their preferences just in time to get a bad eval. Focus on the universal preferences (know/read on your patients, be on time, dress professionally with no nose rings or skimpy clothes, birddog your labs, and smile), and when you get a bad eval anyway try not to worry too much.

And this is where I would consider sending their pager number to the school's clinical coordinator and the service attending to see if they could be paged to a conference room for an unforgettable chat that would forever embed in their memory that they have responsibilities as future physicians and skating isn't one of them. I am a military brat and can do a fairly good imitation of a pissed off SNCO and use compound-complex profanity in various non-repeating sequences and I can tell you I would have a difficult time restraining myself in that situation.....

Or you could tell them where you want them to be and what you want them to do in a polite an professional way, and only involve there program if they are deliberately failing to follow your orders. Students are not mind readers, and if there is nothing to do 'call me when you need me' is not a bizarre thing to say, especially for someone who has a parallel responsibility to study for a shelf exam. Its not like they're not asking/available. What you're suggesting above combines almost every possible kind of bad leadership: unclear expectations, passive aggressive indirect response though an intermediary, and a sprinkling of grossly unprofessional profanity just to make it special (that part would get you justifiably counseled, BTW, with remediation/probation if it became a habit)

On an unrelated note, if you're going to behave badly, please do not credit the military with your performance. SNCOs are in general some of the most controlled, artificially polite people I have ever met (in most situations). Crazy outbursts after slight provocations are for movies and recruit training.

 

[Cytarabine]

Meh, going into my PGY-3, I don't know if MS3s have the capacity to teach students under them any significant on the wards. You're just a baby, yourself, to be honest. Hopefully you're an MS3 going to MS4.

I'm at the end of my 3rd year and just had a first year shadowing the attending I was with. There's a huge clinical knowledge gap between a 1st year and 3rd year that's been on rotations for a while. They potentially haven't even had any path, pharm, etc, much less any idea about how things work on a floor, writing notes, etc, and they don't have much H&P experience. So I'd disagree. I think there are plenty of things a 3rd year can teach a 1st year.

 

[Psai]

I'm at the end of my 3rd year and just had a first year shadowing the attending I was with. There's a huge clinical knowledge gap between a 1st year and 3rd year that's been on rotations for a while. They potentially haven't even had any path, pharm, etc, much less any idea about how things work on a floor, writing notes, etc, and they don't have much H&P experience. So I'd disagree. I think there are plenty of things a 3rd year can teach a 1st year.

He's saying that a fresh third year doesn't have much to offer which is pretty true. By the middle you have some and by the end you have a lot. I complain a lot about this year but I can see how far I've come when I see the other students

 

[Cytarabine]

He's saying that a fresh third year doesn't have much to offer which is pretty true. By the middle you have some and by the end you have a lot. I complain a lot about this year but I can see how far I've come when I see the other students

Ah ok, that'd be fair. If they're going to get preclinical students into the hospital on rounds and whatnot, it would prob be a good system to have them paired with 4th years, like 3rd years are paired with interns and 4th years are paired with upper levels

 

[JustPlainBill]

Or you could tell them where you want them to be and what you want them to do in a polite an professional way, and only involve there program if they are deliberately failing to follow your orders. Students are not mind readers, and if there is nothing to do 'call me when you need me' is not a bizarre thing to say, especially for someone who has a parallel responsibility to study for a shelf exam. Its not like they're not asking/available. What you're suggesting above combines almost every possible kind of bad leadership: unclear expectations, passive aggressive indirect response though an intermediary, and a sprinkling of grossly unprofessional profanity just to make it special (that part would get you justifiably counseled, BTW, with remediation/probation if it became a habit)

On an unrelated note, if you're going to behave badly, please do not credit the military with your performance. SNCOs are in general some of the most controlled, artificially polite people I have ever met (in most situations). Crazy outbursts after slight provocations are for movies and recruit training.

You are correct in certain ways --- however, the parallel responsibility of a shelf exam is nothing we all haven't done and to try to shirk responsibility and duck out with a "call me if you need me" comment is not the way to handle that -- there are a lot of study materials that you can carry in your white coat pockets and read while you're waiting -- been there, done that. As far as bad leadership -- I think most reasonable people know that they are expected to show up and stay for rotations until they're allowed to leave -- if that has to be communicated, there is an issue; passive aggressive? No, "try working through the appropriate "chain of command"";

And to your unrelated note -- there used to be this thing called "NCO justice" where a non-performer would be "counseled" (also known as "wall to wall" counseling") rather than have it appear on their record or have an Article 15 for it -- conversations with non-performers usually did a lot to improve unit discipline -- this went out in the 70s, which is right around the time I was coming of age as a brat -- I agree, most of the SNCOs I was around in the days of my youth were quite professional and restrained -- and would not hesitate to provide appropriate "counseling" -- but then again, times have changed and things have gotten kinder/gentler -- why, we even have sensitivity training now -- rather than the old adage of "you come to me as mama's little biscuit eater and I fix you" -- and yes, I've heard that numerous times outside of recruit training and movies -- by 2 war veterans -- so no, I don't credit the military with behaving badly -- just with having a low tolerance for BS and being rather direct in dealing with it.

Have a great day....

 

[Kaustikos]

Disappearing at 8 in the morning, on a day when your sole job is to hang around with the on call team and await new consults, is a pretty clear shirking of responsibilities.

Yeah,
That's just... you can honestly be failed for that immediately.

 

[Goro]

Interestingly, we some data that suggests that students this lazy fail Step II.

I hope that you smack 'em silly if they behave this way. Or fail them.

My god, so true.

You can walk into the room and just feel it sometimes.

We have all of our students rotate through and take a couple of shifts on trauma and emergency general surgery. The theory is to get them all an opportunity to see new cases of surgical emergencies. But it means they are only with us for a day or two at a time on those services.

The difference is mind-boggling. We will have some that I spend the whole day with, talking about diagnosis and management, taking them with me to the ED and the ICU.

Then we have others who ask if they can go get coffee at 8AM, then send me a page asking me to let them know if anything interesting comes in, and I don't see them the rest of the day.

 

[JustPlainBill]

My god, so true.

You can walk into the room and just feel it sometimes.

We have all of our students rotate through and take a couple of shifts on trauma and emergency general surgery. The theory is to get them all an opportunity to see new cases of surgical emergencies. But it means they are only with us for a day or two at a time on those services.

The difference is mind-boggling. We will have some that I spend the whole day with, talking about diagnosis and management, taking them with me to the ED and the ICU.

Then we have others who ask if they can go get coffee at 8AM, then send me a page asking me to let them know if anything interesting comes in, and I don't see them the rest of the day.

I hadn't thought of this one at the time -- here's another method that could be used -- and it would serve to get them used to the idea that responsibilities don't end at 5PM or suddently start at 8PM after your latte and banana bread from Hamsterbucks ---

Give their pager number to your night float -- have them wait until that 2AM admit that's going to be the case presentation at morning report -- by definition interesting (although you can make diabetic cellulitis interesting if you know how and can pimp deep enough) -- and then voila', an interesting case has come in -- page them and have them come in and do the H&P for presentation at morning rounds --- that should stop the BS quickly....

I know, it's fundamental harassment and yes, you're likely to get barked at but unless you've got a real pinhead for an attending, you'll likely get dressed down publicly, given some scut work for a while but silently cheered on for attempting to inculcate the obvious....

I know, I'm twisted -- flame on....

 

[VisionaryTics]

Disappearing at 8 in the morning, on a day when your sole job is to hang around with the on call team and await new consults, is a pretty clear shirking of responsibilities.

Really looking forward to being a full-time ENT resident in 10 days. Having students around who want to learn and work, rather than the dreck hiding in the lounge for 8 weeks on general "surgery". I put surgery in quotes because I'm not sure they learn anything surgical.

Then again, I'm an off-service intern on anesthesia right now and my laziness has reached critical mass. Still working on my airway skills, though.

 

[Kaustikos]

I hadn't thought of this one at the time -- here's another method that could be used -- and it would serve to get them used to the idea that responsibilities don't end at 5PM or suddently start at 8PM after your latte and banana bread from Hamsterbucks ---

Okay, I don't get this. Why are you waiting until 8 or when you get there to ****ing get coffee? Coffee places open way earlier and gas stations are always open.
If I can manage to get coffee at 4:30 before surgery rounds, there is absolutely no excuse for "I'm here, time for coffee"
Except for my radiology rotation.. Where morning rounds happened at the hospital Starbucks. lol

 

[Psai]

Really looking forward to being a full-time ENT resident in 10 days. Having students around who want to learn and work, rather than the dreck hiding in the lounge for 8 weeks on general "surgery". I put surgery in quotes because I'm not sure they learn anything surgical.

Then again, I'm an off-service intern on anesthesia right now and my laziness has reached critical mass. Still working on my airway skills, though.

man where are these medical students

 

[JustPlainBill]

Okay, I don't get this. Why are you waiting until 8 or when you get there to ****ing get coffee? Coffee places open way earlier and gas stations are always open.
If I can manage to get coffee at 4:30 before surgery rounds, there is absolutely no excuse for "I'm here, time for coffee"
Except for my radiology rotation.. Where morning rounds happened at the hospital Starbucks. lol

Sooo true -- the 7-11 gut bomb coffee was usually fresh at 0430 on the way to Chateau Parkland --- the Hamsterbucks didn't open until 0500 and the hospital Hamsterbucks didn't open until 0630 -- Always loved it when a student would hit the rounding room at 7:30 and think they were in early --- Heck, had one of my interns that didn't get the hint when they showed up at 06:30 and I had already had the first cup of coffee, remnants of breakfast, taken checkout and had vitals/labs looked over --- Even after specific written instructions on expectations 2 weeks before I took over as chief of service, they still couldn't get the notes done by attending rounds at 0900 --- we had a heart to heart after 3 days of coming in late and bucking to leave early --- Thankfully, the attendings backed me up ....

 

[charmiedermie]

Really looking forward to being a full-time ENT resident in 10 days. Having students around who want to learn and work, rather than the dreck hiding in the lounge for 8 weeks on general "surgery". I put surgery in quotes because I'm not sure they learn anything surgical.

Then again, I'm an off-service intern on anesthesia right now and my laziness has reached critical mass. Still working on my airway skills, though.

There is a little bit of difference between the third year who has no choice but to rotate in through your specialty, and the fourth year who actually wants to do your specialty and chooses it as an elective.

 

[Kaustikos]

There is a little bit of difference between the third year who has no choice but to rotate in through your specialty, and the fourth year who actually wants to do your specialty and chooses it as an elective.

True.
I always tried my best third year. But, a certain rotation - cough - OB - cough - dismissed me and treated me like **** that I just studied. But I never just left.

Also, on the coffee thing. The funniest moment I had was when we were switching attendings the next day and the residents say we weren't rounding until 7:30. I show up at 7 with a cup of coffee in the team room. The resident looks at me with the look of sadness and says "they're already rounding your patients... "
In my "zero ****s given" moment, I find the team and just show up with coffee in hand. The other students were having a stroke seeing me show up. The attending didn't really notice. We go back to the team room and the attending leaves. Other resident immediately is like "I have never seen a medical student show up late so calmly and act like nothing was up"
I didn't get in trouble, because thankfully the residents told the attending about what time they thought we were rounding. Attending found it humorous. But that was the only time (and last time).

 

[VisionaryTics]

There is a little bit of difference between the third year who has no choice but to rotate in through your specialty, and the fourth year who actually wants to do your specialty and chooses it as an elective.

I know. It's painful dealing with most M3s.

 

[charmiedermie]

True.
I always tried my best third year. But, a certain rotation - cough - OB - cough - dismissed me and treated me like **** that I just studied. But I never just left.

Also, on the coffee thing. The funniest moment I had was when we were switching attendings the next day and the residents say we weren't rounding until 7:30. I show up at 7 with a cup of coffee in the team room. The resident looks at me with the look of sadness and says "they're already rounding your patients... "
In my "zero ****s given" moment, I find the team and just show up with coffee in hand. The other students were having a stroke seeing me show up. The attending didn't really notice. We go back to the team room and the attending leaves. Other resident immediately is like "I have never seen a medical student show up late so calmly and act like nothing was up"
I didn't get in trouble, because thankfully the residents told the attending about what time they thought we were rounding. Attending found it humorous. But that was the only time (and last time).

I agree, just leaving never to be found is just asking for a Fail. And credit to you for not letting a resident's comment get under your skin - and they even told you that rounding is at 7:30! Did they want you to run like a chicken with its head cut off or feel guilty?

I know. It's painful dealing with most M3s.

And now you'll get the complete opposite with 4th years wanting to be you!

 

[Kaustikos]

I agree, just leaving never to be found is just asking for a Fail. And credit to you for not letting a resident's comment get under your skin - and they even told you that rounding is at 7:30! Did they want you to run like a chicken with its head cut off or feel guilty?

Nah,
It wasn't their fault. We had been rounding at that time every day. This attending, though, just preferred rounding at 7. They could have texted or paged me, but it wouldn't of made a difference.

Oh the stories I wish I could tell (they'd make the students immediately identifiable though...too unique)

Yeah,
I think it's that no medical student tells other people about this. And the residents I worked with only brought it up if we asked what the worst thing a medical student has done.