What would you do when you see another student take advantage of others?

[Thewonderer]

What would you do when you seen others students who lie out of their a$$ to get out of clinical duties? Since residents are busy, it is real easy to do that.

Say, both scenarios happen on surgery rotation.....

Scenario #1) For required lectures on the rotation, everyone shows up, signs in and sits down to listen. However, one particular individual shows up, signs in and then leaves to go back to the floor and suck up to the residents and interns big time while other students are gone (in the lectures).

Scenario #2) One student lies about lectures so he can scrub out of OR cases to go take some naps. Then while on call, he lies to the residents on consecutive nights and tell them different stories about how he has already taken call the other night so he can get out of it. AND on another couple call nights, he goes home and did not rush in until he was paged about pending OR cases (in the mean time, other oncall students are being pulled on the floor to do blood draws on several patients since they could not find that individual anyway).

What would you do?

Self-police among yourselves and tell the course director or the resident about that individual's behavior? Or bitch about it to your mom, bf, gf, or whoever but let the incidents slide and hope that the individual's selfish, unprofessional behaviors will finally catch up to them when they become residents and attendings? Or join in and play the game well by copying their actions?

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[rirriri]

i say you should fight that person in the lobby of the hospital, "Fight Club"-like!!!!

hehe.

errrr, well, from my past experiences ive learned that there will ALWAYS be people like that around. the best thing to do (i think) is just to let things be. things like this catch up to people.

just concentrate on your own learning and you will live happily.

just an opinion.

cheers
rirriri

 

[DermRes]

things like that?

It happens everyday...

 

[Airborne]

Perhaps I've been isolated, but I have yet to see this type of behavior on the wards (although I am only ~60% through my MSIII year).

If I did encounter it, however, I'd probably be a jerk and would page the person back to lectures, the on-call room, etc. If the person got irrate about it, I'd appologize and indicate that perhaps it best to bring it up with the course director if such behavior was acceptable, as the rest of the students would all like to join in with the person in skipping lecture, going home on call, taking naps during OR cases (OK, I wouldn't like this as I am trying everything to get into the OR!).

I do agree, however, that this behavior catches up - residents know what's going on with their students - they saw it themselves only a few years ago.

Let us know what you decide to do.

Airborne

 

[ortho2003]

If I were you I would just blow it off. Bitching to your friends may seem like a nice way to vent, but all it does is make you more angry and make everyone around you think you are becoming more negative. I have seen this before. Trust me, this student isn't pulling anything over the resident's eyes. They aren't going to complain to him, but I am sure they will flame him in his clinical evals. He will get his eventually, you just keeping doing your part and you will get better evals, and more importantly, be a better physician and a better person.

 

[southerndoc]

I say if someone is doing that, then confront him/her. If it continues, then rat him/her out.

Residents notice these things though, trust me. Like one time a student was slacking off during rounds. I saw 6 patients one morning. He saw 2. When the resident noticed during rounds, he asked me why I was "hogging" the patients. I told him I offered 2 patients to the other student so we would both have 4, but he declined. Not good! (I'm not going to lie to protect the other student's lazy ass.)

During surgery, we had a student skip a lecture to scrub in on a really cool case -- one I would have loved to scrub in on, and so would the other students, but we couldn't because we were required to attend lecture. He was busted by an attending.

So don't think these things go unnoticed.

 

[Thewonderer]

These things happened before in the last couple years (and I am sure it is happening now somewhere around us). In both incidents, residents and interns have been oblivious. And it took some other med students to self-police and report the incidents. When residents are so busy that they don't care about what med students do, med students also adopt that attitude and screw each other over....unfortunately. In neither cases, students fail or kicked out. They simply pass (no high pass or honors designation of course), but they are allowed to move on.

 

[doepug]

I think Geek Medic is right.

I'd confront him/her, and would have no shame busting them if they didn't shape up.

Medicine is a team effort. If someone is not a team player, they need to start pulling their weight or get busted for it.

doepug

 

[southerndoc]

Originally posted by doepug
Medicine is a team effort. If someone is not a team player, they need to start pulling their weight or get busted for it.

Imagine how much of a risk this person would be if he/she was part of your practice.

 

[Thewonderer]

Originally posted by Geek Medic
Imagine how much of a risk this person would be if he/she was part of your practice.

I have asked an attending about that. He said that these people exist here and there in medicine, In general, people would tend to weed them out from their own private group practice. However, these individuals will become attendings and will be able to treat patients. And if they enter your group practice, it will take at least a couple years to wait until their contracts are up before you can kick them out.

Another attending also said that since residents get paid a set salary and students don't get paid at all, some of them do act somewhat unprofessional because there is no incentive for them to stay or go the extra mile for the sake of their fellow residents/medical students. They don't get paid more for working harder while students don't get paid at all. Of course, one can tell them that they gain clinical knowledge by working up more patients but most of them don't give a damn since they just want to go home and sleep. But once you join a group practice, you get paid by how much you work. So some of them will actually put in the hours necessary to get the jobs done. But of course, you always worry about the select few who will put in the "minimal" hours of work to get the job done "superficially" until the patients come back after developing some serious complications from their "minimal" workup.

 

[Samoa]

I'd like to add a slightly different perspective on this. I've been in a position to supervise people, and this kind of thing happens pretty much everywhere. It's a good bet that whoever is supervising you is aware of what's going on, and all you will do by "ratting out" your colleague is lower your supervisor's opinion of YOU. Yes, the other guy is not doing what he's supposed to, but unless it affects YOUR work, it's none of your business. And even if it does affect your work, you will still be labeled as a complainer and a poor team player.

You will be regarded much more highly, both by your peers and by your supervisors, if you behave as a team player regardless of the circumstances. And it's much better always to assume that you don't know the whole story. Because you probably don't. But your boss and your peers may, and you will only make yourself look bad.

Again, this may not be applicable to your particular situation, however I do believe that it's almost always better to suck it up and trust that other people have eyes too.

 

[Iron Horse]

Samoa, well said. Your plastic looks belie a thoughtful mind.

 

[Scanner]

Everywhere we go there will be individuals that think rules and requirements don't apply to them. Who gave them the power to veto what rules they think don't apply, we may never know. But when we entered this profession, we all became watchdogs, not for any other reason than to protect the patients.

In response to the last post:

Don't blame the original poster for doing the right thing. He/She is not the problem. The problem is the student who skips REQUIRED lectures. Just keep in mind the TRUE problem.

 

[Thewonderer]

As I mentioned in another thread, these stuff happened in previous years, not right now. I was not personally involved in either incidents, but my roomate was on the surgery rotation with one of the individuals above. So I got to hear it pretty much all the time for WEEKS (i.e. he chose option #2 in my original post)!

Originally posted by Samoa
I'd like to add a slightly different perspective on this. I've been in a position to supervise people, and this kind of thing happens pretty much everywhere. It's a good bet that whoever is supervising you is aware of what's going on, and all you will do by "ratting out" your colleague is lower your supervisor's opinion of YOU. Yes, the other guy is not doing what he's supposed to, but unless it affects YOUR work, it's none of your business. And even if it does affect your work, you will still be labeled as a complainer and a poor team player.

That's debatable. By lying and being poor team players themselves, they actually do affect the morale of not just the other students on the same team but also everyone else on that rotation! These things travel fast and in a blink of an eye, everyone becomes aware of those individuals' infamous reputation. And in both incidents, no supervisor stepped in because surgeons are, well, very very busy people. As I said before, when supervisors develop the "I don't care" attitude, med students also learn fast and pick up attitude toward each other as well.

Originally posted by Samoa

You will be regarded much more highly, both by your peers and by your supervisors, if you behave as a team player regardless of the circumstances. And it's much better always to assume that you don't know the whole story. Because you probably don't. But your boss and your peers may, and you will only make yourself look bad.

Again, this may not be applicable to your particular situation, however I do believe that it's almost always better to suck it up and trust that other people have eyes too.

That's why, in both incidents, I heard rumors that it took a couple people to get together and forward the complaint together.

It is a tough, tough situation. In agreement with your view, my roomate was afraid of being labeled a "whiner" once he would come forward. And the situation was allowed to go on UNTIL THE END of rotation when a couple students just could not stand it anymore and came forward. It must have been a tough decision for those people.

And even after those incidents, it took the clinical clerkship directors several months to bring everyone together and reiterate our "honor codes." But I still saw minor infarctions happening around me here and there.

Incidentally, later on, I was on internal medicine rotation with the individual in scenario #1. At our school, midway through your 6-week medicine rotation, you switch from your university teaching hospital to the VA (and the VA people switch to the university teaching hospital). During that last week before the swtich, the student grading conference among residents and attendings took place on a Thursday night. Well, on that Friday, after the grading conference had taken place, that individual told his team that during the switch over, the students get that weekend off. So he basically did not bother to come in that whole weekend and stayed only until 7pm on that Friday night call!!! All the rest of the students were not aware of that until the student on his sister team asked his residents why that person was gone the whole weekend. We had all assumed that he simply had nice residents who want to give him a nice break, while his residents assumed that there is an official med school policy to give students a break during the switch over. NO, we were all wrong!!! As you can see, it is not that hard to lie and get people confused and possibly get away with it. And since the grading conference had already taken place, his residents cannot do anything other than reporting it directly to the clerkship director. But if everyone has the attitude that "well, telling on somebody else is really not a 'nice' behavior," then basically that individual succeeded in fooling the system and made everyone else seem foolish.

In the end, I guess even after the surgery debacle, some individuals still don't learn and don't change. But I do have to admire their abilities to come up with these ingenious lies and to deliver those lies shamelessly out of their mouths.

 

[SomeFakeName]

Originally posted by Thewonderer
What would you do when you seen others students who lie out of their a$$ to get out of clinical duties? Since residents are busy, it is real easy to do that.

What would you do?

1. Turn your back

2. Walk the other way

3. Pretend it never happened

4. Finish 3rd year

5. Finish 4th year

6. Finish internship

7. Finish the rest of residency

8. Finally get a real job as an attending or go into private practice so you're
at least making more than peanuts

9. Buy a fancy car made in Europe

10. Buy a posh house in a gated community

11. Get divorced (this part is almost mandatory for a doctor)...wife gets house, car (also mandatory...despite what the prenup says)

12. Shack up with a nurse/PA/resident/secretary who is 15-20 years younger than you in an apartment by the beach. Drive a 89 Honda Civic.

13. Pay alimony and child support from your first marriage.

14. Have a mid-life crisis when you realize you're just another overweight, divorced middle-aged doctor who'se kids from your first marriage hate you and you're shacking up with a much younger woman who'll probably leave you any day now when she realizes that she's a much younger woman hanging out with an overweight, divorced middle-aged doctor who'se going through a mid-life crisis.

15. Girl you were shaking up with leaves for a younger doctor/lawyer/busboy at the Pigley Wigley

16. Become depressed, turn to alcoholic

17. Alcohol no longer working, start self-medicating

18. Medication no longer working, start drinking and medicating at the same time.

19. Enter rehab

20. Leave rehab and start piecing your life back together

21. Life slowly starting to come together again

22. Get sued for $5 million for token medical mistake

23. Go back to drinking, self-medicating

24. Settle case out of court

25. Insurance premiums skyrocket

26. You've had enough of medicine and want out

27. Retire

28. Play golf all day and hang out at the beach

29. Can't live off playing golf, plus you drinking problem and self-medication ain't getting any cheaper.

30. Get a job as one of a hundred "clinical instructors" at local med school

31. You realize that you're that old, cranky a-hole that none of the students like.

32. Be the biggest a-hole to get back at all you were put through during your years in med school and residency.

33. Students complain, falsely charged with sexual harrasment, your contract is not renewed for next year.

34. DEA takes away your drug license

34. You find yourself back in your little apartment as a 60-something year old has-been M.D. with a drinking problem and you can't even self-medicate anymore.

35. Point gun at head, pull trigger


Now I ask you does it really matter if some student gets out of 3rd year clinical duties??

 

[Thewonderer]

Originally posted by SomeFakeName
1. Turn your back

2. Walk the other way

3. Pretend it never happened

4. Finish 3rd year

5. Finish 4th year

6. Finish internship

7. Finish the rest of residency

8. Finally get a real job as an attending or go into private practice so you're
at least making more than peanuts

9. Buy a fancy car made in Europe

10. Buy a posh house in a gated community

11. Get divorced (this part is almost mandatory for a doctor)...wife gets house, car (also mandatory...despite what the prenup says)

12. Shack up with a nurse/PA/resident/secretary who is 15-20 years younger than you in an apartment by the beach. Drive a 89 Honda Civic.

13. Pay alimony and child support from your first marriage.

14. Have a mid-life crisis when you realize you're just another overweight, divorced middle-aged doctor who'se kids from your first marriage hate you and you're shacking up with a much younger woman who'll probably leave you any day now when she realizes that she's a much younger woman hanging out with an overweight, divorced middle-aged doctor who'se going through a mid-life crisis.

15. Girl you were shaking up with leaves for a younger doctor/lawyer/busboy at the Pigley Wigley

16. Become depressed, turn to alcoholic

17. Alcohol no longer working, start self-medicating

18. Medication no longer working, start drinking and medicating at the same time.

19. Enter rehab

20. Leave rehab and start piecing your life back together

21. Life slowly starting to come together again

22. Get sued for $5 million for token medical mistake

23. Go back to drinking, self-medicating

24. Settle case out of court

25. Insurance premiums skyrocket

26. You've had enough of medicine and want out

27. Retire

28. Play golf all day and hang out at the beach

29. Can't live off playing golf, plus you drinking problem and self-medication ain't getting any cheaper.

30. Get a job as one of a hundred "clinical instructors" at local med school

31. You realize that you're that old, cranky a-hole that none of the students like.

32. Be the biggest a-hole to get back at all you were put through during your years in med school and residency.

33. Students complain, falsely charged with sexual harrasment, your contract is not renewed for next year.

34. DEA takes away your drug license

34. You find yourself back in your little apartment as a 60-something year old has-been M.D. with a drinking problem and you can't even self-medicate anymore.

35. Point gun at head, pull trigger


Now I ask you does it really matter if some student gets out of 3rd year clinical duties??

DUH, yes, of course! because these individuals will become your colleagues in private practices, screw you over and speed up the onset of your mid-life crisis. You might even lose some money in the process and cannot pay your alimony on time and get jailed. What a sad existence with these people around....

 

[pimmar]

That is why you learn who is who before going into practice with them. As a med student I think I worked pretty hard during my 3rd year and at least for my sub-I's in the beginning of my 4th year (now I just skip out to go to interviews, and I am feeling a bit burnt out at times). And yes I know the individuals who disappeared, etc. I guess was usually pretty good and did what I was told because I usually like people to like me and would want my grades and letters to reflect positively. However, I think that often times as a student I only feel the need to put effort only if I am learning or gaining something out of a rotation. Once I feel that I am wasting my time and money (because not only are we not paid as students but we are actually paying to be there) then I feel that I can choose to utilize that time in a more productive fashion, whether its to go read on my own, do whatever write-ups or prepare for presentations, or even sleep. You also must think about students who have no interest in your field. Not every student wants to be a surgeon or an obstetrician, for the most part if it is not a field they are contemplating or a subject they are not really interested in, then they will do their best to get to know what they need for the boards but that is the extent of it. It is unfortunate but it is reality. I agree there are people who do need a lesson on responsibility, however, aggravating yourself trying to teach them to be responsible is the least of your worries. Ultimately a rotation will be what they make of it, it can be great if they participate or dull if they skip out, and I am sure that students who participate also encourage you as a resident to teach as well. Well just my two cents.

 

[fourthyear]

I have always been angered by cheating of any kind, ever since my kindergarten days of playing four-square in the schoolyard.

I, personally, go with confronting people on issues so blatent as signing in for lecture and leaving - i have done this once, walked right up to my classmate and said, " I hope you did not just sign in and plan to leave, because that's a violation of the honor code" (to a student who I observed do this several times before). She came to lecture every day after that, and probably hated me forever, but so what? I don't think it was the least bit fair for her to sign in and then sneak away to study so she could get a better grade than me with the extra 2 hours of study time every afternoon (by the way, I am not much of a lecture-learner, so I was admitadly a little bitter that we were required to go to clinical lectures anyway). You can say it does not affect the others, but it does.

It bothers me that people in a profession where so much is entrusted to us by our patients would be such fundamentally dishonest people. Most students I've worked with have been awesome and I have been very lucky that this type of bladently wrong behavior is pretty rare at my school.

 

[Thewonderer]

Originally posted by pimmar
Not every student wants to be a surgeon or an obstetrician, for the most part if it is not a field they are contemplating or a subject they are not really interested in, then they will do their best to get to know what they need for the boards but that is the extent of it. It is unfortunate but it is reality.

It is great that there is a variety of responses on this thread!

As for what pimmar said, that reminds me of the OB-GYN resident I knew who went on to infertility fellowship. Same as not everyone who enters medschool wants to be a surgeon, not everyone who enters ob-gyn wants to deliver babies and perform c-sections (if they plan to enter infertility fellowship which is HARD to get in). But the problem is that whoever signs up to be a med school knows AHEAD OF TIME that he or she will have to rotate through internal med, peds, pysch, surgery, etc. Same as whoever signs up to be an Ob-gyn resident knows that he/she has to rotate through labor-delivery, gyn-onc, clinics, etc. So if med students are allowed to pick and choose, "well, I really want to be a cardiologist, so why don't I just skip a few calls here and there on peds and surgery," then what is there, in principle, to stop ob-gyn resident from saying, "well, I want to go into infertility, so I don't really need to go to all three c-sections performed today and go see high-risk pregnancy cases where the moms are HIV positive. After all, my future clients are rich, highly paid professionals in their mid-30's who can afford my infertility expertise!"

The end result is that patient care suffers and the med students and residents alike act in an extremely unprofessional manner. I think it is a matter of principle and the contract you sign implicitly when you decide to enter the medical field.

 

[pimmar]

I agree with you wonderer, I am just pointing out what my experiences have been during clinical rotations.

 

[GO_MEDPEDS]

I have seen the same thing over and over again... The classmates who think they are exempt from lectures, who believe that they are entitlted to see fewer patients, who make a point at pointing out your shortcomings or lack of particular knowledge in front of others (especially attendings and residents) with hopes that it will boost their standing. I too agree that it is both frustrating, but I think the most important thing to do when these situations arise is to:

1. Without being confrontational, just talk to the individual about the situation... make it known that what they are doing is frustrating/upsetting you and others. The important thing NOT to do is to creat undue friction or problems by becoming accusatory or angry... these are people you need to work with on a regular basis. You are part of a team, and the only way that team will function properly is if all of its members understand they have both idividual and team responsibilities to fulfill.

2. If this fails, your next course of action should be passive resistance as devised with the other members of the team. Nobody covers for this individual... no one else signs off this person's attendance, no one gives this person notes from these lectures, etc. Importantly, do not allow patient care to suffer because of this... make sure the patients are still seen (if said individual is not pulling his fair share), just make it well known to both the individual and the residents (probably not attendings at this point) that certain members of the team are not pulling their own weight. You would be surprised how many times these individuals will get bitten on the ass when you stop covering for their mistakes...

Example:
One of my team members on OB/GYN decided that, as his surgeries had ended early this particular day, that he would leave campus early as well. The resident mentioned later in the day that she was changing the time of morning rounds the next AM. I, knowing this full well, made it a point to mention to the resident that said team member would be expecting to round at the normal time. When the resident had me page the student to let him know this, she was furious to find out that he was not answering his page.

It seems a little underhanded, but instead of directly ratting out your problematic team members and perhaps ruining your image as well, it sometimes goes much further to "set them up" per se.

3. If all else fails, the team may have to approach the residents/attending to rectify the situation.

Everything should be a concerted effort. Although the neglectful student may feel as though everyone is against him/her, it may be more likely to change his/her behavior if several individuals are confronting him or her rather than a single individual.

In any case, such infractions will continue to go on despite any interventions that we may take. Another important skill to develop is a coping/acceptance mechanism. Life is unfair, and being a 3rd year medical student is doubly unfair... you take part in lose/lose situations on almost a daily basis. Although it is difficult to hear "suck it up" again and again, there sometimes is no better alternative. We will have to deal with such people no matter what we do, and it will be a miserable existence if we allow them to get to us.

I hope this helps... trust me, I know the feeling!

 

[Dr. MAXY]

Originally posted by GO_MEDPEDS
I have seen the same thing over and over again... The classmates who think they are exempt from lectures, who believe that they are entitlted to see fewer patients, who make a point at pointing out your shortcomings or lack of particular knowledge in front of others (especially attendings and residents) with hopes that it will boost their standing. I too agree that it is both frustrating, but I think the most important thing to do when these situations arise is to:

Do Nothing just...... take that person out and beat the daylights out of him...oooops I guess that will be unprofessional...to bad.

 

[OwlMyste]

Originally posted by Geek Medic
Imagine how much of a risk this person would be if he/she was part of your practice.

note to self: dont ever let him/her ever be MY doctor if I'm the patient!

OY!

 

[ZfoUro]

As past/present medical students, we have all gone through this. I think, as the thread implies, it is most obvious in the surgery core who the really cutthroat ones lurking among us. All of us have stories about the person who skips out, studies on his own, and then pimps fellow students in front of the chiefs/attendings with the stuff he just read while you were in the mandatory lecture. Or the person who skips out on everything, fits his nasal sinus squarely on the anal verge of the closest chief/attending in smelling distance, and walks away with the same grade as everyone else, but with a face looking like the receiving end of a colostomy. Hell, some of us reading this might be those same bastards.

Once a premed, always a premed. More often than we would like to think.

Furthermore, I doubt we are the only profession that has to deal with this stuff. There are weasels and cutthroats in every job under the sun, just as there are altruistic and humane "good guys" everywhere as well. I doubt that a slap on the wrist or an occasional scolding from mommy will change the weasels in the world for long -- I'd guess that their behavior is somewhere near pathologic and hard to correct. I doubt they know any other way to behave, and behave the same way in rotation after rotation. I'm willing to bet that if every medical student in a given year writes down the top 5 annoying people in this regard, you are going to generate the same list from nearly every person (except, I guess, those 5 jackasses who top the lists). My point is that we all know who they are, they stick out within a few weeks of any given rotation, and they burn their bridges with their future peers. And though I don't claim to know a whole lot about the dynamics of peer comraderie in the physician population of the U.S., I do know that it is a small world when it comes to doctors. And word gets around.

A physician who I hold in the highest esteem once told me these deceptively simple words: "If you are good, you are good." The weasels in the world of medicine might get an ever-so-slight edge when it comes down to getting a residency, but once they are in there is so much responsibility as a resident (regardless of speciality or PGY status) and as a practicing physician that there is no way to escape from yourself. Your skills will be apparent, regardless of where you came from, and just as everyone knows who the slackers/weasels/cutthroats are in med school, everyone also knows who are the people that know their ****. This carries over to residency as well. And there is no escaping the fact that if you suck, if you used cheap tactics to get where you are, you will eventually be exposed. I believe the added responsibility of resident/physician independence does that.

If you are the one who makes life easier for the resident in terms of scutwork and patient management, if you are the one who gets there early and makes sure the work is done, then the resident will notice. Regardless of what some other guy does. And you will learn your core/elective, as only experience can teach you.

My personal belief. I'll step off my soap box now.

 

[OwlMyste]

Originally posted by ZfoUro
Or the person who skips out on everything, fits his nasal sinus squarely on the anal verge of the closest chief/attending in smelling distance, and walks away with the same grade as everyone else, but with a face looking like the receiving end of a colostomy.

when I get to Medical School in 4-5 years...I'll make a note to myself NEVER to be one of those who thinks they can skip out on everything...