Worried about assertiveness for 3rd year

[FulfilledDeer]

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I'm really worried about 3rd year. I'm an MS-1 but will be doing clinical rotations in less than a year. I'm worried because I'm not super assertive about doing things. Like, if I have a defined role, I'm fantastic, but I'm really uncomfortable when things are not defined.

Case in point: I shadowed the ED a couple Fridays ago. I was signed up to be with a certain doc, and when he showed up he basically told a resident "hey, if you're seeing someone, bring him (me) with you". Fine, totally good. But I just stood and said nothing during the interview. Afterwards we went back to the computer and I asked a couple of question while the resident (intern maybe) was doing something, and she said "okay, just wait here". Like she was coming back. 45 mins later, it turns out she literally just dumped me and I stood there like a....shy person. I probably would have stood around all night had it not been for an amazing 3rd year who saw what was happening with me (nothing) and literally grabbed me and took me around. He salvaged my experience. But if not for him, I would have gotten nothing out of it.

So I'm worried. I'm nervous to even shadow again because I'm usually really quiet and while I get a lot out of it, I think it isn't what is expected of me. Thoughts? Help? Advice?

 

[slickster032]

I wouldn't worry about it; it's called shadowing for a reason. No one expects you to know anything useful or to be of any utility as an MS-1. I'm about to finish my MS-IV year, and I am just beginning to feel confident in my clinical skills just in time for internship, and like I am more helpful than burdensome to the team. Even as a third year, I felt unsure most of the time. If you like shadowing and feel like you're getting a lot out of it, continue with it by all means. Nobody will care that you're quiet/don't ask questions during the H/P, in fact they'll probably appreciate it. Just try to stay interested and engaged and ask thoughtful questions when you have the opportunity; and if you have some down time, go on access medicine or uptodate and read about what you just saw. I always felt awkward shadowing too; it's really no big deal. It will get better as you gain more experience.

 

[JourneyAgent]

I'm really worried about 3rd year. I'm an MS-1 but will be doing clinical rotations in less than a year. I'm worried because I'm not super assertive about doing things. Like, if I have a defined role, I'm fantastic, but I'm really uncomfortable when things are not defined.

Case in point: I shadowed the ED a couple Fridays ago. I was signed up to be with a certain doc, and when he showed up he basically told a resident "hey, if you're seeing someone, bring him (me) with you". Fine, totally good. But I just stood and said nothing during the interview. Afterwards we went back to the computer and I asked a couple of question while the resident (intern maybe) was doing something, and she said "okay, just wait here". Like she was coming back. 45 mins later, it turns out she literally just dumped me and I stood there like a....shy person. I probably would have stood around all night had it not been for an amazing 3rd year who saw what was happening with me (nothing) and literally grabbed me and took me around. He salvaged my experience. But if not for him, I would have gotten nothing out of it.

So I'm worried. I'm nervous to even shadow again because I'm usually really quiet and while I get a lot out of it, I think it isn't what is expected of me. Thoughts? Help? Advice?

The only people who value pure uninformed assertiveness are surgeons.

You got your first dose of how useless clinical training can make you feel. I wouldn't ask questions of an overwhelmed intern. Not while their working. Just become less cognizant of yourself and just follow them and look around and try to imagine yourself as them. If your dialing yourself into their world you might notice they need a light. Boom, as they think it do it. I bring all sorts of gear in my pocket just for these rare opportunities to be as useful as a tool box. Which way more useful that my considerable taking up of space. Many times I've wished I was a smaller size person.

Pay attention the most during the patient interview. And remember an experienced resident can get more information out of several questions than you can get in hours with them. The interview is an art form that gets perfected slowly over thousands of repititions.

I was the other day, useless as you, but totally absorbed while this adolescent medicine doc interviewed a troubled teen and her mother. It was masterful. And I learned a lot. And did nothing except consume oxygen.

It's kind of like watching MMA. If you haven't wrestled or done jui jitsu it looks like 2 men involved in some rigorous dry humping foreplay. But there is nuance and things to learn once you know enough to do so.

Don't sweat it. You'll get used to being useless.

 

[futuredoctor10]

Yeah you will get more comfortable with everything in the clinical setting. Even as a third year, it takes some time to warm up to everything.

I would say try to be assertive, I know it can be hard. But just stick to whomever you are shadowing, they won't mind and know you are just there to listen/learn!

 

[FulfilledDeer]

Thanks everyone - I'm glad to know it's not just me. It always sounds like my classmates have these amazing clinical experiences where they get to do stuff and I'm just...plodding along.

Yeah you will get more comfortable with everything in the clinical setting. Even as a third year, it takes some time to warm up to everything.

I would say try to be assertive, I know it can be hard. But just stick to whomever you are shadowing, they won't mind and know you are just there to listen/learn!

The thing that threw me is this intern totally minded me being there. She like...intentionally left me hanging. I felt like she was my dad who said "I'm just going to the convenience store to get a pack of cigarettes" and then I never saw her again. Except I did and she always tried to avoid eye contact.

The worst part isn't feeling useless, but feeling like I have no role. Nothing defined. Except being awkward and silent and trying not to annoy the doctor yet somehow probably doing that with the silence....

...sometimes I wonder how I even made it to medical school.

 

[JourneyAgent]

Thanks everyone - I'm glad to know it's not just me. It always sounds like my classmates have these amazing clinical experiences where they get to do stuff and I'm just...plodding along.





The thing that threw me is this intern totally minded me being there. She like...intentionally left me hanging. I felt like she was my dad who said "I'm just going to the convenience store to get a pack of cigarettes" and then I never saw her again. Except I did and she always tried to avoid eye contact.

The worst part isn't feeling useless, but feeling like I have no role. Nothing defined. Except being awkward and silent and trying not to annoy the doctor yet somehow probably doing that with the silence....

...sometimes I wonder how I even made it to medical school.

That's because you're right. You have no role. When they start paying you is when the hurry-up offense gets run on your professional development. When you're paying them its lots of hit or miss. And it's so much luck that one person on a rotation makes a difference that comparisons are not useful.

I never no what getting to do stuff means by m1-m2's without health care experience, but if it's getting to retract or cut the string of a knot you're welcome to my turn at it. Doing stuff is what they have to sign off on you as a junior resident so that you can be competent and graduate your program. If you want a procedural field or one that requires them you might have to be assertive in gaining the experience. Or staying late to help the resident who is doing them. But those opportunities will come if you just show enthusiasm and asking to help do them in years 3 and 4. Don't worry about singular cperiences with interns or whatever. That intern may have just needed to concentrate to get their work done. Don't worry about it for a second if they didn't handle it well.

 

[Dmr6186]

Thanks everyone - I'm glad to know it's not just me. It always sounds like my classmates have these amazing clinical experiences where they get to do stuff and I'm just...plodding along.





The thing that threw me is this intern totally minded me being there. She like...intentionally left me hanging. I felt like she was my dad who said "I'm just going to the convenience store to get a pack of cigarettes" and then I never saw her again. Except I did and she always tried to avoid eye contact.

The worst part isn't feeling useless, but feeling like I have no role. Nothing defined. Except being awkward and silent and trying not to annoy the doctor yet somehow probably doing that with the silence....

...sometimes I wonder how I even made it to medical school.

While I'm not in rotations yet (and won't be for a while lol), I have shadowed doctors in the past, including the ED. If you were matched up with someone, just follow them. Don't wait for them to tell you what to do. You know what to do. Just follow, observe, and learn. I'd say most of the time they just want you to show most if not all the effort because they have enough stuff to worry about.

 

[JShephard]

I'm really worried about 3rd year. I'm an MS-1 but will be doing clinical rotations in less than a year. I'm worried because I'm not super assertive about doing things. Like, if I have a defined role, I'm fantastic, but I'm really uncomfortable when things are not defined.

Case in point: I shadowed the ED a couple Fridays ago. I was signed up to be with a certain doc, and when he showed up he basically told a resident "hey, if you're seeing someone, bring him (me) with you". Fine, totally good. But I just stood and said nothing during the interview. Afterwards we went back to the computer and I asked a couple of question while the resident (intern maybe) was doing something, and she said "okay, just wait here". Like she was coming back. 45 mins later, it turns out she literally just dumped me and I stood there like a....shy person. I probably would have stood around all night had it not been for an amazing 3rd year who saw what was happening with me (nothing) and literally grabbed me and took me around. He salvaged my experience. But if not for him, I would have gotten nothing out of it.

So I'm worried. I'm nervous to even shadow again because I'm usually really quiet and while I get a lot out of it, I think it isn't what is expected of me. Thoughts? Help? Advice?

Take it one day at a time. You are there to observe people who are busy doing their job. They are doing you a favor. Try to be useful or have something to do instead of waiting around. You should feel odd standing around.

 

[JShephard]

Thanks everyone - I'm glad to know it's not just me. It always sounds like my classmates have these amazing clinical experiences where they get to do stuff and I'm just...plodding along.





The thing that threw me is this intern totally minded me being there. She like...intentionally left me hanging. I felt like she was my dad who said "I'm just going to the convenience store to get a pack of cigarettes" and then I never saw her again. Except I did and she always tried to avoid eye contact.

The worst part isn't feeling useless, but feeling like I have no role. Nothing defined. Except being awkward and silent and trying not to annoy the doctor yet somehow probably doing that with the silence....

...sometimes I wonder how I even made it to medical school.

This is where real world experience helps. Find a role. Find a way to serve. Don't get in anyone's way. People can be annoyed by your presence of you are standing around doing nothing but feeling weird, that rubs off on others. Do something or have something to do. Learn a skill that's useful. Save someone time. Be interested. Be hungry. Be quiet.

 

[kwel]

Thanks everyone - I'm glad to know it's not just me. It always sounds like my classmates have these amazing clinical experiences where they get to do stuff and I'm just...plodding along.





The thing that threw me is this intern totally minded me being there. She like...intentionally left me hanging. I felt like she was my dad who said "I'm just going to the convenience store to get a pack of cigarettes" and then I never saw her again. Except I did and she always tried to avoid eye contact.

The worst part isn't feeling useless, but feeling like I have no role. Nothing defined. Except being awkward and silent and trying not to annoy the doctor yet somehow probably doing that with the silence....

...sometimes I wonder how I even made it to medical school.

I felt the EXACT same way coming into 3rd year. Unfortunately as a medical student they expect you to slow the pace down a bit for the team--but it's OK because you're at a teaching hospital. Everyone (residents, attendings, etc.) is supposed to take extra time to teach you, let you give somewhat lengthier presentations, and allow you to think a bit slower as you start getting the hang of things. Your job is to slow everything down as little as possible, which is easier said than done. The key is knowing your team's routine and trying to anticipate what's going to happen next so you don't have to play catch-up the whole time. Learning the routine doesn't happen on Day 1; you have to be on the team at least a couple days in order to figure out how you can be helpful. Your ED experience is common. You didn't know how things worked there, so you just stood there for 45 min, but if you go shadow next time you'll know to avoid that particular resident, you'll know something is amiss if you're standing around for long periods of time, and you'll probably have a better idea of how things run in the ED so you can get yourself back on track if you realize you're a lost lamb.

Note: surgeons don't adhere to the above. They all expect you to be functioning at the level of a PGY-2 on Day 1. can't do much about that.