WTF...PA students = Medical students?!?!

[Back34]

I wanted to scrub in on a C-section today and was snubbed by the OB resident in favor of a PA student (I almost hit her with "I didn't realize PA's were doing C-sections now," but thought better). A few days ago, I was reamed out for having the audacity of trying to observe a birth without introducing myself to the patient first. No problem, my bad -- I wasn't aware of L&D etiquette and now make it a point to establish some kind of relationship with everybody on the floor first thing in the morning. Anyways, one of the patients went into labor yesterday and I go in, ready to help push and hopefully catch, only to find the PA student and a throng of nursing students crowding the joint. Not to sound elitist, but does anybody else do their 3rd year rotations with PA students? Things like this don't usually bother me, but as of late I'm the one to take the back seat, unless there's scut to be done. I figured my "Y" chromosome had something to do with it until one of the other female med students echoed my sentiment.

Please tell me if I'm in the wrong, but wouldn't it make more sense for the PA students to keep to their own kind and let me get my $33,000 worth of education. The residents know I'm pissed and know that if the program director comes down on them, I was the one who complained; thus, making life 10x worse for the remainder of the rotation and risking an unfavorable eval. Any suggestions or like experiences?

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[Buck Strong]

nope, I've never had anything like that when I've rotated with PA students. I actually don't mind them, since it's a bit of "eye candy", and I get less boring scut than I would if it were just me. Plus, pimping starts with them and moves up to me and then the residents, so I look good If i start getting questions right...as opposed to when I'm on with a gunner med student. That being said, I haven't had OB yet, where I've heard preference is sometimes given to girls, and guys who want to go into OB-gyn

 

[doc05]

1. don't worry about the PA students. 2. you're not a physician yet, so get off your high horse. 3. male med students are as a rule treated like crap during OB, so don't worry about it.

 

[AF_PedsBoy]

A) Sadly male medical students being treated like crap during OB is sadly right. Not only do the doctors bitch at you, the patients will kick you out of the room 80% of the time. I did ten times more pelvic exams during my ER rotation during 4th year than I did during Ob third year, and I didn't deliver a single baby - although I was a placenta delivering machine

B) I've had PA students on before, but only during my Child/Adolecent psych rotation, and since there are no procedures it was never a problem. And for some reason PA students ARE all uniformly hot - it's the wierdest thing. Do they actively select for this? However, while they never got in the way, they never took the heat either since pimping passed over them and came directly to me - they would pass over the third year in favor of me expecting me to know it, and sparing the third year because she was just starting the rotation and thus was expected to know nothing...

C) And get used to absorbing the abuse, especially as a third year. And remember - rather than a long coat being a source of pride, the short code is the equivalent of a "kick me" sign. Everyone - social workers, nursing students, PA's, cafeteria workers - has long coats, so no one instinctively perks up with respect when they see one; however only WE have short coats, and everyone will HAPPILY unload their bad day on you if you give them even the smallest chance. So be polite, be respectful, and if you have to, make sure no one sees it when you add some of your special sauce to their coffee.

 

[Back34]

1. don't worry about the PA students. 2. you're not a physician yet, so get off your high horse. 3. male med students are as a rule treated like crap during OB, so don't worry about it.

If assertiveness regarding my education is being on a "high horse," then somebody better get me a 50 foot ladder. I don't know about you, but I'll be about a quarter million in the black when all is said and done and I'll be darned if somebody cheats me out of what's rightly mine, not to mention hands on experience, for the benefit of my future patients should I choose to go the OB route.

And that little blurb I put in there about a female colleague going through the same thing should address your 3rd point.

 

[Vince]

I'll add my $0.02, but it doesn't completely relate to just PA students.

Often you'll be on rotations with people who jump the gun on you and take away procedures/opportunities.

Be assertive. If it is becoming a problem, you need to approach them. I had another medical student on a rotation who kept answering pimping questions obviously directed to me...and I had observed them doing the same to other students and even interns...

So after this incident I talked to them in private and told them how much it was annoying me and to knock it off. It helped and they didn't butt in anymore...

It would probably help if you could predefine your role with certain patients to that the PA's on your rotation know what you are expecting....but this might not be possible if the residents aren't working on your side...so if that's the case....I'll quote a very successful classmate of mine...

"Put up and shut up."

The rotation will be over soon.

 

[Back34]

I'll add my $0.02, but it doesn't completely relate to just PA students.

Often you'll be on rotations with people who jump the gun on you and take away procedures/opportunities.

Be assertive. If it is becoming a problem, you need to approach them. I had another medical student on a rotation who kept answering pimping questions obviously directed to me...and I had observed them doing the same to other students and even interns...

So after this incident I talked to them in private and told them how much it was annoying me and to knock it off. It helped and they didn't butt in anymore...

It would probably help if you could predefine your role with certain patients to that the PA's on your rotation know what you are expecting....but this might not be possible if the residents aren't working on your side...so if that's the case....I'll quote a very successful classmate of mine...

"Put up and shut up."

The rotation will be over soon.

I see your point, but the PA is actually a decent person. It's the residents who are passing me over, even when I question them directly, i.e., ME: "Would you mind if I scrubbed in on the C-section?" RESIDENT: "Well, the PA student is going to take this one, but you can have the next one (said about 45 minutes before it's time to go home)."

 

[Coach]

to set up an audition rotation for 4th year, they said they had to offer slots to PA students first and I could contact them in May and see if their were any remaining slots. Do they think the PA students are going to be filling their residency? I don't get it

 

[AF_PedsBoy]

to set up an audition rotation for 4th year, they said they had to offer slots to PA students first and I could contact them in May and see if their were any remaining slots. Do they think the PA students are going to be filling their residency? I don't get it

There are only so many slots on a team and perhaps they have a prior agreement with the PA program to train so many spots. If that were the case, it would be hard to justify not fulfilling their obligation and give the slot to an outside student, even if they WERE auditioning for residency.

 

[Back34]

I'll quote a very successful classmate of mine...

"Put up and shut up."

The rotation will be over soon.

Alas, your friend is correct. In a perfect world I'd confront the program director about the situation and all would be taken care of. In reality, I'm probably not going to say squat, hopefully get an "honors," and forget the miserable rotation ever existed. To quote a variation on your friend's theme: "I'll take it until I make it..." 'nuff said.

 

[punjabiMD]

(said about 45 minutes before it's time to go home)."

there's the problem. I've never heard the phrase "it's time to go home" during 3rd year.

experience (x) = opportunities that you seek out + opportunities that are handed to you (z)

during med school, y >> z, therefore you take advantage of any opporunities that are handed to you (z). Even if you have to stay after it's "time to go home."

 

[irlandesa]

We had the pleasure of being told on the first day of my OB/Gyn rotation that "PA students tend to do better on this rotation than MD students, I don't know why that is." Apparently it never occurred to the course director that allowing the residents to treat us like **** doesn't foster a high level of performance.. I also had to put up with this course director making asinine remarks about my religion; even though I'm not religious that didn't fly with me.. Well, he can attach his lips firmly to my gluteus maximass, b/c I've got a decent chance at matching at the very hospital where he did his residency.. Not matching in OB though, you couldn't pay me enough to do that..

 

[Back34]

there's the problem. I've never heard the phrase "it's time to go home" during 3rd year.

experience (x) = opportunities that you seek out + opportunities that are handed to you (z)

during med school, y >> z, therefore you take advantage of any opporunities that are handed to you (z). Even if you have to stay after it's "time to go home."

True true...but, it wasn't that the lack of opportunity had me up in arms (well, maybe a little), but that the resident was ignoring me in favor of the PA student. No way in H-E-doublehockeysticks would I ever spend one minute more in that hellhole than absolutely necessary.

On the lighter side, I used to think childbirth was a thing to be held in awe until I saw a woman with diarrhea give birth

Tubgirl ain't got nothin' on that little miss.

 

[AF_PedsBoy]

there's the problem. I've never heard the phrase "it's time to go home" during 3rd year.

experience (x) = opportunities that you seek out + opportunities that are handed to you (z)

during med school, y >> z, therefore you take advantage of any opporunities that are handed to you (z). Even if you have to stay after it's "time to go home."

I can imagine staying on a rotation because there was an interesting learning opportunity, but it's a little different if they've been abusing the crap out of you all day and giving those learning opportunities to the PA's all day. When they turn to you at 4:50 PM and say, "All the PA students have gone home and we have this case to do. You have to stay late but that's what you're paying $30K for, right? To learn?" My attitude is, "That's right, I'm here to LEARN, not take crap all day." That doesn't mean I don't take the crap - you gotta pay your dues, but don't expect that "Thank you sir, may I have another," attitude from me and actually have me mean it. But seriously, that attitude has only manifested during Ob/Gyn - even in surgery, they're yelling at you, but they do it because that's how they are; they're not actually trying to actively grind you into the dust, and they let you do all sorts of procedures in the OR and make some sort of effort to teach you. I'm still in awe of how some of my friends and some very nice med students are going into ob/gyn - maybe there's some sort of mandatory indoctrination phase during orientation when they become b!tches... Has ANYONE (not going into Ob/Gyn) actually had an enjoyable Ob/Gyn rotation???

 

[Ergo]

nope, I've never had anything like that when I've rotated with PA students. I actually don't mind them, since it's a bit of "eye candy", and I get less boring scut than I would if it were just me. Plus, pimping starts with them and moves up to me and then the residents, so I look good If i start getting questions right...as opposed to when I'm on with a gunner med student. That being said, I haven't had OB yet, where I've heard preference is sometimes given to girls, and guys who want to go into OB-gyn

At my program, guys are treated with respect and girls treated like they are second rate sluts rushing tri-delt. But then, this program hasn't matched a student from here in YEARS. They just dont foster the interest of their own med students in OBGyn.

 

[Powder]

I hated my OB/GYN experiance. First the residents all seemed to be hating their life more than any other residents in the hospital. During clinic I spent hours sitting and waiting for someone to say yes to the question "We have a male med student today, would it be OK for him to talk with you and examine you today?" I saw 1 out of 20 patients, and of those I was kicked out for the pelvic exam on over 50%. During OB I did not get to catch a baby, eventhough I had delivered 3 premature babies by myself before med school as a paramedic. I requested multiple times to do stuff and even stayed late without success. Many of my classmates had simmular experiances. It's only 8 weeks of hell. (No PA students here)

 

[tega]

ob/gyn is the worse rotation in med school. i have attempted suicide 4 times during my rotation so far.....i offered to quit school..my dean would not let me.

i dont even know why this crap is a core clerkship... .....this is the first rotation where even the nurses scut u.....and the residents encourage this....this is the only rotation where u admit the pateint..take the history, complete all those forms...start the IVS...get the bloods...take it down to the lab,....and come delivery time...a nurse kicks you out of the room.

 

[tega]

and then there are the Attending Midwives....lool...these clowns attribute too much importance to themselves...even with the service midwives...if u come within 10 miles of their pts...they'll probably call the cops on you....of course..unless u just want to start the IVs.

what keeps me sane is that i only have a couple more weeks...my last week, i am only there for half a day. And after this, ill never have to do this again ever.

 

[supercut]

I did an elective as a 4th year student in surgery at an institution where PA students were seen as equal to 3rd year med students. We would simply divide the cases up in advance. Everybody got the same (I could pull rank, but usually didn't)

HOwever at my current residency we have an ongoing problem on one service with the midlevel providers going to the OR in leiu of interns, and sometimes in leiu of med students. (in fact it was NP student who bumped him out of the case) I thought one student handled it well. He went to the DEAN of the MED SCHOOL with his complaint. In this instance, its rare to have NP student and residents have complained to our PD many times about the NPs in the OR. Nothing ever changes. But as you point out, complaining to the course director might earn you the reputation as a whiner.

You could also talk to the PA students and say "You have scrubbed X c sections and I've only done Y, I will do then next Z that come up and then we can alternate". IF they are reasonable people, they will agree. Then you can also say you attempted to work it out via every avenue when you complain to the dean of the med school.

And I agree, guys do get treated like crap in OB. I felt terrible for my male counterparts when doing OB.

 

[punjabiMD]

Has ANYONE (not going into Ob/Gyn) actually had an enjoyable Ob/Gyn rotation???

I had an excellent experience. did my rotation in Hamilton, NY (Colgate U.). Tiny community hospital. I was very, very busy (I was pretty much on call 24/7, and the nurses were good about calling me at the place I was staying for cases), but I also was able to do most stuff. I did a few NSVDs almost entirely on my own, and even first assisted on a few CSs and gyn surg. cases.

I could see my self enjoying ob/gyn as a career, although residency would suck. The thing is that as a male ob/gyn I wouldn't be able to compete w/ all the practicing females (I heard 80% of program spots currently are filled w/ females); also there are other things that I am more interested in doing (i.e. cardiology).

 

[scootad.]

This thread is cute. OP get over yerself. If you havent noticed yet, allopaths no longer dominate the medical field. Besides, when yer an attending, you'll have the PAs do all your work for you anyway, so they have to learn somewhere.

 

[Back34]

ob/gyn is the worse rotation in med school. i have attempted suicide 4 times during my rotation so far.....i offered to quit school..my dean would not let me.

I apologize in advance if you weren't kidding about this, but this is the funniest thing I've seen in a while.

 

[b&ierstiefel]

Back34, I assume you're doing the OB/GYN rotation at the U. In which case, all I can say is, "I'm sorry."

 

[toughlife]

This thread is cute. OP get over yerself. If you havent noticed yet, allopaths no longer dominate the medical field. Besides, when yer an attending, you'll have the PAs do all your work for you anyway, so they have to learn somewhere.

Not at the expense of someone who will be making the decisions (i.e., the med student). The MS needs to learn even more so he can tell the PAs what to do or how to proceed when they work for him. I,for one, will always give preference to the med student above all other midlevel students. If there are no med students rotating then the midlevel students get priority.

 

[MD'05]

I had the same experience with a PA student on OB/GYN. Be assertive and tell the PA student that you are doing X. No argument. He or she will get the hint and back off.

 

[Pili]

If assertiveness regarding my education is being on a "high horse," then somebody better get me a 50 foot ladder. I don't know about you, but I'll be about a quarter million in the black when all is said and done and I'll be darned if somebody cheats me out of what's rightly mine, not to mention hands on experience, for the benefit of my future patients should I choose to go the OB route.

And that little blurb I put in there about a female colleague going through the same thing should address your 3rd point.

I for one empathize with you...Medical Schools should make sure students get their education. Sadly, few do.

 

[14022]

I don't know about you, but I'll be about a quarter million in the black when all is said and done and I'll be darned if somebody cheats me out of what's rightly mine, not to mention hands on experience, for the benefit of my future patients should I choose to go the OB route. QUOTE]


You'll be $250,000 in the black when it is all said and done. I want to go where you go where they pay their students rather than charging tuition. I will be $250,000 in the red but that is neither here nor there.

PA students pay for tuition too man. And they need experience too if they go the OB route. Would you be mad if another medical student was doing this to you? Just because they are PA's doesn't make you any more important. I had a similar experience with a PA student on psych where she was just ridiculously more assertive than I desired to be. It sucked because I thought I looked bad compared to her, but I didn't care because I could care less about psych and had no desire to get there 2 hours before rounds just because she did. But I didn't fault her for being an overacheiver. You are going to be dealing with overassertiveness (is that a word?) for the rest of your life so either man up and try to outdo them or quit whining about it. If you honestly feel these PA's or residents are hindering your education then discuss (discuss, not complain) your concerns with the residents. If they are not of any help, talk to the course director. If you are honestly concerned with the quality of educational experience you are getting in terms of exposure to OB/GYN then you shouldn't worry about pissing the residents off if they are acting inappropriately.

 

[MD'05]

PAs don't pay the tuition that MDs pay. Please. It's a ripoff when you waste half of your time during a rotation fighting with these people. They should be assigned to residents that don't have MD students assigned and be assigned to hospitals where there are no MD students being trained.

 

[Back34]

I don't know about you, but I'll be about a quarter million in the black when all is said and done and I'll be darned if somebody cheats me out of what's rightly mine, not to mention hands on experience, for the benefit of my future patients should I choose to go the OB route. QUOTE]


You'll be $250,000 in the black when it is all said and done. I want to go where you go where they pay their students rather than charging tuition. I will be $250,000 in the red but that is neither here nor there.

PA students pay for tuition too man. And they need experience too if they go the OB route. Would you be mad if another medical student was doing this to you? Just because they are PA's doesn't make you any more important. I had a similar experience with a PA student on psych where she was just ridiculously more assertive than I desired to be. It sucked because I thought I looked bad compared to her, but I didn't care because I could care less about psych and had no desire to get there 2 hours before rounds just because she did. But I didn't fault her for being an overacheiver. You are going to be dealing with overassertiveness (is that a word?) for the rest of your life so either man up and try to outdo them or quit whining about it. If you honestly feel these PA's or residents are hindering your education then discuss (discuss, not complain) your concerns with the residents. If they are not of any help, talk to the course director. If you are honestly concerned with the quality of educational experience you are getting in terms of exposure to OB/GYN then you shouldn't worry about pissing the residents off if they are acting inappropriately.

Easy there tiger, maybe you should get the story straight before challenging me to "man up," i.e., read my posts again...carefully this time. The problem isn't the PA, it's the chief resident and her minions making life miserable. Trust me, if it was an overzealous med student or PA or whatever, they'd have heard from me by now.

 

[Freeeedom!]

When i was a med student, the situation was very similar...I didn't care a bit primarily because when it was all said and done...I was going to be aphysician and the PA student was going to ultimately be an Assistant. As a medical student on OB your role is minor and your life sucks. Who cares, just do it and in the blink of an eye it will be over.
OB residents are bitter...their life is horrible in residency.

 

[Cristagali]

I'm shooting from the hip here....Most PA's could be docs..but first there's not enough med schools in the US, so good candidates get put aside. The trusted old white guys who have been running allopathic med (AMA, AAMC, LCME, etc..) circled the wagons on doc salaries, but gave in to one trojan hourse after another,( CRNA, PA, NP's )who consistently take a larger and larger piece of the patient care pie. Maybe a 100 years from now, there'll be no docs left!! I'm a US citizen IMG in Europe. Thankfully our country deliberately graduates only 60-70% of the docs we need so people like me can come back and STILL get multiple job offers. Life is sweet. Guess who RUNS the hospitals folks..nurses! They saturate the administration. One hospital I rotated in last year..all staff had their "job title" (RN, RT, etc...except the docs..they wanted no sign of a MD anywhere in that hospital. As I hear, nurse as taught to be the patient advocate, to protect the patient from....guess?? ..the MD's!!! Anyway, at least in Europe the MD's run the show..nurses are..nurses, NO PA's, NO NP, NO DO's but even here..there are organizations probing for a weakness to get in the door. Sorry for the rant, DO's and PA's should be MD's. We put them on that pathway...We in allopathic medicine have watered down our own constituency and voting power, by allowing patient care to be taken by others. And these others make a bigger constituency than MD's..so guess who gets listened to more on Capitol Hill?? We lost this battle long ago...what hold in the future is anyones guess. I must end that I do support the nurses and PA's and DO's. I just don't embrace that patient care should be that fragmented with different professionals and had the AMA, AAMC etc done their job 20 years ago, most PA's and every DO would be an MD. (Hence, no PA students to take your procedure away )

 

[stomper627]

Who cares unless your going into OB/GYN. For me, hell, I was glad to give all my crap to the PA who wanted to do OB....good for her, take my workload, let me focus on something I like....

 

[drdrtoledo]

Sorry for the rant, DO's and PA's should be MD's. We put them on that pathway... I just don't embrace that patient care should be that fragmented with different professionals and had the AMA, AAMC etc done their job 20 years ago, most PA's and every DO would be an MD.

Biting my tongue... Definitely ignorant, but alas, this is not the time nor the place

Anyway, I agree that if an institution cannot provide enough experience for it's students (physician or non-physician) then it should not accept as many of one or the other. If the volume doesn't allow for everyone to get experience don't have 2 PA's, 2 MSIII's, 1 MS IV, and two interns on your service. To the OP, do you feel like the volume doesn't accommodate the amount of students? That may be a good thing to bring up to the dean/director.

On another note, I was actually considering OB/GYN until I saw that no matter how hard I busted my butt it still wasn't enough for the attending and residents (all female). I stayed late, did well on the pimping, and always volunteered for scut but they still found a way to give me a mediocre review. BS

 

[MD'05]

Nurses want to boss everyone around, but when it comes to decision making, they want no part of it. Therefore if they have something valuable to contribute, I listen; if not, I just ignore them. Same with the rest of the ancillary help.

 

[Cristagali]

To the DO's, my post is not a slight. DO and allopathic MD schools should have merged years ago. This = protecting OUR role in patient care. Instead, (as I heard nicely on another post) lower level encroachment (PA, NP, homeopathic, etc. will continue. Do you know that NJ almost gave full medical school status to an acupuncturist school!!!, but the gov. got in trouble on an unrelated matter and the issue died.) It's not ignorance..laws come from Capitol Hill... and the one with the most votes win...it's that simple. Long story short..MD/DO students SHOULD be at the top of the list for educational training, but due to the fragmented nature of patient care, we're out-numbered 10:1..thats why we are treated like sh%$!

 

[Back34]

On another note, I was actually considering OB/GYN until I saw that no matter how hard I busted my butt it still wasn't enough for the attending and residents (all female). I stayed late, did well on the pimping, and always volunteered for scut but they still found a way to give me a mediocre review. BS

Yeah, this definitely got my dander up, i.e., the only rotation that actually discourages enthusiasm (especially for those of us of the XY persuasion).

 

[stomper627]

Personally I think its *****ic as a male to go into OB/GYN. Think about it....already youve cut your patient population in half, now factor in the fact that 50% of incoming medical students are female, with the majority going into FP, OB/GYN, and Peds. With this number of future OB/Gyns being female, and most women want a female gyn, youve now put your future patient load at <15% of total population. Factor in the salary vs. malpractice insurance....youre left with one hell of a business model.
stomper

 

[artie-lange]

I see your point, but the PA is actually a decent person. It's the residents who are passing me over, even when I question them directly, i.e., ME: "Would you mind if I scrubbed in on the C-section?" RESIDENT: "Well, the PA student is going to take this one, but you can have the next one (said about 45 minutes before it's time to go home)."

next time stay late (as long as you're not stepping on another med student's toes) and hang out until you get the next one. you'll demonstrate that you really wanted to see that c-section. back when i did ob, if you followed the chick throuh labor and she needed a c-section you got to scrub on it. i think the trick to ob-gyn is
a) to accept the fact that if you're not going into it, they'll treat you like crap. if anyone asks you what you want to go into, just say you're not sure but you like procedures so you've been looking forward to this rotation (if you really like procedures, there is no lying there so it's an ethical answer. besides they can't pinn you down, stereotype you and punish you based on what you want to do with that answer).
b) pick up patients when they come in, not when they're on the last push.
c) to do well with c, hang around labor and delivery and make nice with the nurses. ob nurses are very territorial and if they like you, they'll let you in. sometimes that means you have to be their bitch, but f it...you'll be the one catching the baby with the resident/attending and in the end it pays off.
d) try to find those rare ob/gyn residents who are actually somewhat normal and cool to hang around. then, never leave their side! you'll be much happier!

 

[Goose...Fraba]

Man, I tell you what....speaking of PA's
I just started another surgical rotation, and there is this PA that freakin drives me cookoo...
At first things were good, then she starts asking me these freakin stupid a$$ questions... for example:
Oh, do you know what a suture is? WTF!! are you freakin kidding me, what the F do you think Ive been doing the last 3 yrs.. give me a freakin break, even a idoit off the street knows what a Freakin suture is.

Then she says, do you know what a SOAP note is, do you know how to write one?.......... STFU!...you crazy @#$%!

This goes on and on... and Im trying to be polite....

Then she freakin starts pimping me about the most basic crap.... WTF...now Im starting to get pissed...dont freakin pimp me you crazy @#$*%&!

Later on that day......

We were rounding on patients, and she looks at this guys labs, BUN 23 Creatinine 1.7 (slightly elevated) but putting out good urine, then she looks over her shoulder to me and says, yep acute renal insufficiency, may need to go to dialysis! Im just thinking to myself STFU, are you kidding me, I just finished a freakin nephrology rotation, WTF, your getting all excited about a creatinine of 1.7, give me a break do you even know what creatinine is?

Anyways to top it all off, then she starts lecturing to me about how competitive it is to get into PA school, and how PA's go thru the "med school route" unlike nurses, what ever the @*$^ that means. and how they were in all the same exact classes all the med students were in. Now I was a freakin Anatomy TA my 2nd year at my med school, and part of my responsibility was to TA the first year med students, as well as the PA's and PT's. And I can tell you for a freakin fact that they do not go into near the depth that med students did. for them it was like...what is that green thing over there? oh, that would be the gallbladder...

Again, I have never had a problem with nurses for the most part, and all the PA's at my school were cool, but this one is something else....

Now, I avoid her like the plague....sorry rant over...Goose..Fraba.... ahh much better....

 

[Teufelhunden]

and then there are the Attending Midwives....lool...these clowns attribute too much importance to themselves...even with the service midwives...if u come within 10 miles of their pts...they'll probably call the cops on you....

OMG! That is funny! (Because it's 100% true). LOL

 

[AF_PedsBoy]

OMG! That is funny! (Because it's 100% true). LOL

Whoo man, I totally forgot about it - you know how bad it is being a male medical student on Ob/Gyn? Well that's NOTHING compared to being a male medical student rotating through a midwife clinic - thankfully only one day. There's only so long you can force a smile while the midwifes and their patients explain in painstaking detail why all doctors are crap and why they would never go to one...

 

[Museless]

A few days ago, I was reamed out for having the audacity of trying to observe a birth without introducing myself to the patient first. No problem, my bad -- I wasn't aware of L&D etiquette and now make it a point to establish some kind of relationship with everybody on the floor first thing in the morning.

Seriously, that IS some audacity. Picture yourself squeezing out a watermelon, and someone unnamed walks into your hospital room, grabs a chair (or stands in the corner) and just watches.... without shaking your hand or telling you their name? This isn't L+D etiquette, this is everywhere etiquette - always start by introducing yourself to the patient. That goes for female med students too, so don't feel slighted.

That said, I won't ream you out about anything else. And hey, we all made the mistake of slinking into the room to watch in the beginning. It's cool in surgery, but when the patient's conscious, they want to know who's standing there looking at them.

I'd take the direct route if I were you - but also humble, because that's the MSIII's job. Approach the person(s) who kicked you out of the hospital room/OR/wherever it was, express your interest in doing/seeing more x or y, and ask what you could do to increase your exposure to that procedure. Going through school channels often takes too long, by the time they change anything - if they change anything - you'll probably have graduated.

 

[Trisomy13]

Not at the expense of someone who will be making the decisions (i.e., the med student). The MS needs to learn even more so he can tell the PAs what to do or how to proceed when they work for him. I,for one, will always give preference to the med student above all other midlevel students. If there are no med students rotating then the midlevel students get priority.

I have only seen OB-Gyn at one hospital, but at least here the PA's (not the PA students but the fully trained OB-Gyn PA's) practically run the floor when the attendings are off at their clinics or running formal ultrasounds, or taking a mango bath in their cush call room. The residents are too busy and are often unsure about what to do (the interns are always asking the PA's for help). In short, the 3 PAs here are the glue that hold the service together some days, and therefore absolutely need to have sufficient training. If you feel like you are being shorted you need to speak up and assert yourself. Talk to the PA student directly and say that you need to get some experience too.

The more diplomatic you are, and less "I'm a med student, i deserve such and such treatment because i pay a lot of money" attitude you have, the better off you will be, on any rotation.

 

[Monika]

Thank you Trisomy13 for offering a balanced, practical, & fair suggestion. As a PA student, I can say personally that it is never my intention to go into a rotation to compete with anyone. That would be a waste of my precious time, energy, & mental stability.

Many times, PA students are very eager to learn as much as possible due to the nature of our curriculum. We spend the first year of our master's program in didactics + limited patient contact, then we are in clinical rotations for the second year. If successful, we then graduate & must pass our board exam in order to practice under the supervision of a licensed physician(s).

We realize we are NOT medical students & we are not going to become doctors. We do want to do well though, since we have to learn rather quickly & our program directors expect us to perform at the level that our preceptors expect.

So far (after having completed 10 months of rotations) I have yet to see a preceptor who has made a distinction between PA students & medical students in regards to what is expected from our clinical performance. If anything, they sometimes make a point to say that they expect the same level of performance from us as the medical students. This is obviously very challenging to us, to say the least, since our program does not go into the same depth as yours. And with good reason, you will all be the physicians one day & our role is to complement both your training & expertise.

Personally, I have really grown to respect the sacrifice & motivation I have seen on the floors from many of the medical students. Most have been very helpful & have worked well with everyone on the team. I have learned many excellent clinical pearls fom medical students, too many to recall. Just like in life though, there will be people that just don't 'get it' & those folks tend to create unecessary misery for everyone around them. I am referring to both PA students, medical students, etc., in my last statement.

Respectfully yours,
Monica

 

[Goose...Fraba]

dang, after reading monikas post I feel guilty for blasting that PA (I couldnt help it she was just starting to get to me). I guess when she started pimping me, I bout lost it, and i vented on sdn. i feel dirty.


thanks monika for your kind and respectful post, your alright in my book
goose

 

[uxbridge]

I've worked with NP students during my clerkship. I'm proactive and often state to the NP students I have a certain quota of cases I need to handle within the short period of time I'm there. Often, they let me handle the case. Inform the other nurses as friendly and politely as you can about your quota and time limitations - they tend to be very cooperative Explanations for actions assist in obtaining goals.

With regards to residents shunning you for PAs, state politely that as you have not done any or only have done such and such, you'd really like to take on patient A. Letting people know what your expectations are and goals certainly aid in your learning experience. Residents do realize part of their responsibilities is to teach the clerk.

As for O&G attendings noticing PA students do better than clerks, feedback should be given to the rotation director regarding deficiencies/obstacles noticed - this can be done anonymously and the issue will be brought up with the attendings and residents.

 

[xxyyzz]

"Easy there tiger, maybe you should get the story straight before challenging me to "man up," i.e., read my posts again...carefully this time. The problem isn't the PA, it's the chief resident and her minions making life miserable. Trust me, if it was an overzealous med student or PA or whatever, they'd have heard from me by now." -Back34

Has anyone ever considered why the residents are treating the OP differently?

As a resident myself, I have worked with medical students and PA students. I treat them the same because they are there to learn and I am always willing to teach and give them every opportunity..equally regardless if they are MD/DO or PA. However, if that student has a questionable work ethic, attitude, or motivation then I will teach less and give them less opportunity. And this was how it was for all the residents in my program. It didn't matter how smart you were or if you memorized your books. If you sucked in work ethic and attitude, you were given bottom of the barrel duties.

I don't know you OP, and I may be dead wrong. But you have to consider...what do you think you may have done for the residents in general to treat you like crap? If it was just one of the residents treating you like crap then it's probably a personality clash. But it sounds like according to your posts it's not an isolated problem....

 

[DireWolf]

Man, I tell you what....speaking of PA's
I just started another surgical rotation, and there is this PA that freakin drives me cookoo...
At first things were good, then she starts asking me these freakin stupid a$$ questions... for example:
Oh, do you know what a suture is? WTF!! are you freakin kidding me, what the F do you think Ive been doing the last 3 yrs.. give me a freakin break, even a idoit off the street knows what a Freakin suture is.

Then she says, do you know what a SOAP note is, do you know how to write one?.......... STFU!...you crazy @#$%!

This goes on and on... and Im trying to be polite....

Then she freakin starts pimping me about the most basic crap.... WTF...now Im starting to get pissed...dont freakin pimp me you crazy @#$*%&!

Later on that day......

We were rounding on patients, and she looks at this guys labs, BUN 23 Creatinine 1.7 (slightly elevated) but putting out good urine, then she looks over her shoulder to me and says, yep acute renal insufficiency, may need to go to dialysis! Im just thinking to myself STFU, are you kidding me, I just finished a freakin nephrology rotation, WTF, your getting all excited about a creatinine of 1.7, give me a break do you even know what creatinine is?

Anyways to top it all off, then she starts lecturing to me about how competitive it is to get into PA school, and how PA's go thru the "med school route" unlike nurses, what ever the @*$^ that means. and how they were in all the same exact classes all the med students were in. Now I was a freakin Anatomy TA my 2nd year at my med school, and part of my responsibility was to TA the first year med students, as well as the PA's and PT's. And I can tell you for a freakin fact that they do not go into near the depth that med students did. for them it was like...what is that green thing over there? oh, that would be the gallbladder...

Again, I have never had a problem with nurses for the most part, and all the PA's at my school were cool, but this one is something else....

Now, I avoid her like the plague....sorry rant over...Goose..Fraba.... ahh much better....

 

[DOtobe]

Goose..fraba -
Just gotta say I love your avatar.

"I've got a fever - and the only cure is MORE COWBELL!"

 

[Espion]

The only time I ever worked with a PA student was on my OB-GYN rotation. He was a highly motivated and smart son-of-a-gun. It was hard keeping up with him considering how much I despised OB-GYN (looks like a sadly common theme).

George, to ya!