Why is being "quiet" a bad thing on rotations?

You should watch this then:

http://www.ted.com/talks/susan_cain_the_power_of_introverts.html

 

Fact: I'm quieter when I'm not happy/ not feeling sure of myself.

 

Depending on who does your evals, quiet could mean several things. Quite often you only interact with an attending for 1-2 hours during rounds not giving much time to socialize or schmooze. Perhaps to them being quiet is a way of saying you're not taking ownership of your patients? It's hard to do as a med student with limited responsibilites but what I think they're after is just knowing the patients well (ie lab/imaging results, meds, the plan, etc). When the attending throws questions out to the group don't be afraid to jump in and answer them if you can. You don't have to be rude or cut anyone off but don't be afraid to put yourself out there to offer insight (maybe the patient said something to you so you think it's X syndrome and not Y syndrome). As long as you're polite it helps you seem interested and stand out.

If it's the residents that do the evals than being quiet is likely just not putting yourself out there. There's nothing wrong with being quiet but it helps the busy residents remember who you are if they actually get to know you a bit (and as long as you did a good job, that means a good eval). Of course, many attendings ask the residents who worked with you their opinions of you so it never hurts to socialize a little with them.

 

Introverts fail in medicine. It's not because they don't schmooze. It's not because they can't connect with their residents or attendings. It's not because extroverts are more likeable... that is a small fraction of it.

Medicine, as a field, has become team-centered, with the physicians at the helm. If you are introverted, you might know the medicine cold. You might know it better than everyone else. But if you cant communicate, if you can't connect with people, if you rub people the wrong way, you won't be able to implement your plans. You have to talk with consultants; get them to do procedures or help manage your patients. You have to talk to nursing staff, to get your orders done correctly. You have to talk to patients, families, social workers, etc.

Of course this is not an introvert vs extrovert thing. Extroverts can screw this up to. But people who rub people the wrong way, people who don't get along, or people who don't know how to communicate are going to fail in these regards. Life will be harder. Work will be less fulfilling.

Is Introversion a weakness in LIFE? No.
Is Introversion a weakness in MEDICINE? Yes.

Now, you can say, "I dont care, I am who I am." Fine. People think Im an arrogant *******. I accept that. Hell, maybe I am. I am not willing to change. Because, in order to change that perception, I have to behave differently. When stressed, I would revert to me, and then people would see me as duplicitous, which is worse than arrogant *******. Also, I have reconciled that the qualities of my personality have outshined the problems it creates. Ive tweaked it enough so that if you get short interactions at the wrong time, you get arrogant *******... but work with me long enough and the better qualities come out.

You can say the same thing. Either accept that introversion does poorly on a team of doctors or change. Accept the weaker evals, accept the failures in communication, accept that people will look down on you, or change. The bottom line is that you control one thing: you. Trying to alter perceptions of other people isn't going to work. Especially when those perceptions fall in balance with the qualities that make a better physician.

Remember this: people don't get sued because of medical mismanagement, but because patients don't like them. People don't get positions because they are more qualified, but because they fit in better. That's life. God's rules (or whatever cosmic powerhouse you choose to beleive or not believe in). You can't change them, but you sure as hell can play by them, and get ahead.

 

P.S. Great leaders (the better residents) will identify the introvert and intentionally get them involved. Those who don't are probably insecure themselves and are even more likely to give you poor evals. Its a way you can reconcile your evaluations, if poor. BUT, its better to manipulate the crap out of THEM before your grade suffers.

 

Good leaders do that. Great leaders get them involved in a way that caters to their strengths. Not that I disagree or anything. Just really common for people to thinking "involving" them is putting that person on the spot and forcing them to talk and answer more.

 

Yep, often times the extroverts do screw this up worse and more often than introverts because they have strong personality conflicts. See it all the time, especially when they say things off the cuff and don't pay attention to the words that come out of their mouth. I get along much better with consultants/colleagues than many of my extroverted friends.

I wholeheartedly disagree.

Why does an introvert function poorly on a team? Because they don't communicate well? That's not the mainstay of introverts. It's more frequent that they don't speak up unless they feel like they are adding something meaningful to the conversation. When I ran ACLS cases for our sim lab, I was told I was the best at directing people out of all the groups. It was a situation where I needed to speak up and my actions were impactful.

I'm an introvert at heart (had to work on being an extrovert for situations like residency interviews), but if you start talking about something I am really involved in or are a long-time friend, I'll talk your ear off...but I don't just offer my opinion when it a) doesnt matter b)won't change anyone's opinion, c) I just don't care what your talking about. I'm not the guy your going to get talking about politics because I just don't care, don't care about other peoples opinions on the topic and lastly don't know enough to offer a well developed thought that will significantly impact a conversation.

This did negatively impact my clinical grades (had a conversation with an attending that I ended up working with again and he stated it had) as I just didn't get to know my attendings well enough to just chat about crap I don't care about or kiss ***. I won't change because it won't make me a better physician.

The biggest thing that I find funny is that most people say introverts make bad leaders. That's ridiculous. Some of the best leaders are introverted...they sit back and watch people, make well formed decisions on how they would suggest/change whatever and they sit down with that person instead of on-the-fly minor non-impactful suggestions. You don't have to be a "guns a-blazing" person to be a great leader.

 

As an introvert myself, here's some advice for all the introverts on this thread getting defensive:

1) RELAX.

2) Learn to shoot the breeze with other medical students/residents/interns (when appropriate, of course). You'll all be happier throughout the day.

 

Thanks for the link, I quite enjoyed that Gonna have to check out her book

 

1. It makes you seem disinterested
2. It puts your knowledge into question (people don't know what you know unless you share it)
3. It puts you at risk for being professionally bullied

Don't worry. Try to be more extroverted because in medicine that is key, but don't lose signt of the fact that being quiet (i.e. being introverted) has its virtues too.

 

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her hands, feels bad man

 

You forgot bored and tired of dealing with morons whose pronouncements vis-a-vis everything show an appalling lack of life experience.

 

Best post so far.

 

Introverts make great leaders when surrounded by creative and driven people. If it is the type of leadership that necessitates yelling and micromanagement, then not so much.

 

The powerful introvert who manipulates the **** out of people isnt who we're talking about. Your description of yourself is similar to my description of me. I have deep introspection, I prefer to be alone, and have trouble making meaningful connections with other human beings. Yet, when I choose to, I am (and have been told this) speak incredibly well, demonstrate extreme empathy, and am generally well like. I can - win friends and influence people- but practice - the 7 habits of highly effective people. -

I dare say that schmoozing and kissing ass DOES make you a better physician in that you do the pieces of the job that AREN'T medicine. If you can fake it for an attending, you sure will be able to fake it for a nurse, a clerk, a patient. When they are talking about something you DONT CARE ABOUT, if you act like that, they aren't going to care about you either. If you really wont talk unless it interests you, you need to find the skill to fake it to make it. To say -im an introvert, I don't care- is to suffer defeat before you even get started.
If you use the TedTalk's definition of introvert (incredibly brilliant person who, whenever they want, can get up in front of 10,000 people on stage and give a talk about how she's an introvert) well DUH its better to be introverted.

If instead you use the layman's term of introvert: shy, quiet, reclusive, scared to contribute, then, illustrating the weaknesses in the definition, my points hold true.

If you use the definition of extrovert as loud mouth, off the cuff, demands constant attention from the crowd at all times, then, illustrating the weakness in the definition, who would want to be an extrovert?

Instead, if you use the layman's term of extrovert (engaging, empathic, motivating, well-spoken, likable), then my points hold true.

Of course you are supposed to be in the middle. Of course its shades of grey. Of course extremes don't work, and you have to be able to move between them. But if you show up as a proclaimed introvert, and you feed into the definition of the layman, its not going to work out. It isn't that one is better than another, its that extremes fail and everyone needs to know when to play the part of the extrovert and when to play the part of the introvert

 

It's difficult to be all work all the time. I find that some people are trying to be too proper/professional at times. Being professional is one of the most important things in medicine, never lie, treat others with respect, show up on time, etc. With that said you should bring some of yourself and your life to your job. It shouldn't be all about the patient or work. You should be able to talk about your upcoming marriage, or the superbowl, or that vacation you just went on. You should be able to laugh at others' jokes even if they are slightly inappropriate at times.

In general, it will help you more through residency and as an attending to be somewhat soical. Contrary to what someone said before the most competent doctors don't always get the patients. There are a lot of bad doctors out there that survive on personality and connections alone, which is really unfortunate. If you come across as more social, more friendly and competent you will gain more trust from your staff and colleagues and be a better leader. You'll also learn quickly that if nurses don't like your going to get twice as many pages all night long, consultants aren't going to rush to help you out as quickly, and you're not going to get their real oral impressions of whats going on just some barely readible note that says nothing of use.

 

Hi han14tra,

How you feel is absolutely valid. Culture of this country (and the Western world) values extroverts rather than introverts; in my culture there is a saying "An empty can sounds the loudest". Since you are living in this country in order to succeed it is easier if you are perceived positively from the majority of this country. What I've been saying sounds racist and are generalizations. But, these generalizations are more true than if you were talking about an introvert. Of course there are hugely successful introverts (Bill Gates etc....) in this country. But, for the most part people of this country looks more favorably on someone who speaks with more authority and speaks more frequently. For an example NY Giants' QB Eli Manning has a very laid back and soft spoken style. Many people in the media thought that he was soft, not a leader, didn't have passion for winning etc......even after his first Super Bowl win. It took Eli Manning's second Super Bowl win to shut them up.

When rounding there's got to be stuff you are curious about. I know I have to hold my tongue and not ask too many questions since there still are so much I don't know in medicine. So, why not just ask relevant/smart questions? Although you may not feel like doing this, view it as a way to learn something rather than attempting to appear more outgoing than you really are. Don't view it as "changing myself". Just view it as a way to learn and in the process getting a better grade. You do want better grades, right? There are so many unfair things in this world. But, that's how this world is. By speaking out more isn't like "compromising one's integrity" or anything of that significance. It's just a way to behave so that you improve the likelihood of getting what you want. View it that way. I hope this helps.

 

That's not at all what "being quiet" means. I can think of plenty of socially awkward types who aren't quiet when it comes to discussing patient care. I would never mark down a student for being socially quiet, but it's a very different thing than being quiet on rounds, being quiet during a consult, being quiet in the OR, being quiet about offering to write orders or do a post-op check, being quiet during an interactive conference....

 

I feel like being talkative in the OR made the surgeons pissed, but maybe the ones I worked with didn't like students talking

And I agree with what you are saying. I do feel like there are people in general who think both are the same thing. That if they are socially quiet, they are also quiet in work, which is not the case. Personally, I'm more of a socially quiet side(who is branching out more and more too!), but I try to get involved as far as rounds and work is concerned.

 

This becomes much less of an issue once you're a resident. I often get the "quiet student" feedback which is funny becomes I'm not quiet at all, I just don't like to interrupt people when they're busy, or ask questions that can be looked up to make myself seem interested. I agree it makes you a "bad" student but definitely not a bad doctor. It also depends who is grading you..I find the super talkative students extremely annoying when I'm either trying to get work done or finish rounds and they asking inane questions, seem to have no insight that we exist to take care of patients. There is a good and bad timing.

 

After one week on my first 3rd year rotation (IM), my reserved nature has labeled me as incompetent, uninterested, and quite frankly marginalized by the team. I've always had problems interrupting and being forceful when necessary with people in positions of power over me (residents and interns in this case). They sense this and begin treating me poorly, which only had made the problem worse. They present patients I'm supposed to present, and even hijack presentations while I'm in the middle of them. I just hope I pass this rotation so I don't have to relive what has been a week of exhaustion, frustration, and despair.

 

These posts are solid. Lots of wisdom in here.