Bastardly residents!!!

[Vince]

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[phoenixsupra]

phoenix- Interesting.. the same thing happened here with GS and IM. Now they are pretty tight about making sure people get the hell out.... Adn with good reason. I have pulled some nasty 36 hours on adn ones brain jsut doesn't function well after that. And its dangerous for those that are writing orders (aka not med students) to do this...

This is an interesting thread, because having been a teacher for 5+ yeasr, and ensuring I was at a residency where I would get to teach, I find that I can empathize with both sides of this arguement.

1-there are crappy residents.
2-there are crappy med students
3- med students shouldn't sit around and do nothing
4- residents shouldn't have to take time out to hunt down thier med students.
5- there is a degree of suck it up that is missing in many med students
6- sitting around waiting as a med student sucks.

and on and on.

As a second year, I heard a panel of third years. A woman with two kids was offering up advice which was fantastic...

She said that what she did was that when she was done with her work, she would find her resident and say, 'I'm done with my work, is there something I can do to help you?'. If given a task she would complete it, then repeat.

I adopted the same thing during clerkships and it works great. The first time I thought it was being pesky, but my eval came back: eager, alwasy willing to ihelp, a great team player, etc...

Another great way to deal with this is an ammended version: I'm done with my work, is there anything I can do to help out? no? okay, I am goign to go and read up on a case... here is my pager number, if you need help with anything feel free to page me. Then I would go off, read and check in every hour or so....

If it was an approriate time to leave, I would say, can I help you with anything before I head out?

Yeah, that is good advice roja. I generally do that and am not shy about it. Ocassionally though ..... well we all know the exceptions.

 

[phoenixsupra]

Congrats. Livewires, you have become what you despise.

I don't think he has become it. But, you're right, that is a real danger.

PS, phoenixsupra: everyone here (including you, including me) is more type A than B

I'd agree with that. That's what I thought when I entered medschool first. I mean if you took the most laid back med student (that's actually passing courses) and told, say an average cop or store clerk how much he studies to pass those courses. D'you think the cop would think he was type A? I'd bet any money he would.

But medschool is intense and sometimes insular. The differences across the spectrum of type A's become more important and we tend to forget that as a group we are all basically type a. That seems reasonable with me. But I think I'm close to the B end in med school. I have had issues with people at the other end. My goal is to defuse these situations before they happen. Take a look at my type a tread Citizen. I'd like to get your perspective.

 

[scootad.]

dont even try it. yer just a closet type A

 

[phoenixsupra]

dont even try it. yer just a closet type A

Ha ha. That's pretty funny. Maybe there should be A rights and an A pride parade. There's definately quite a few closet type A's in medschool.

 

[MustafaMond]

Congrats. Vince, you've added your name to te list of idiot residents that sparted me to start this thread. You're in the company of Boomer. Hope you feel good about yourself. Fool. You probably post like this because you have a little penis.

If I was your senior I would be dastardly bastardly to you. You seem really annoying....kind of like cbc.

Go ahead, add me to the idiot-residents/small-penis list.

 

[phoenixsupra]

If I was your senior I would be dastardly bastardly to you. You seem really annoying....kind of like cbc.

Go ahead, add me to the idiot-residents/small-penis list.

Ha ha. A bastard with a sense of humour. What sort of things do you residents do when you want to be a bastard? Seems at my school each specialty seem to have their own bag of tricks. Do these differ from hospital to hospital. Or are they pretty standard.

 

[Vince]

I'm a fourth year medical student by the way.

I have had some interns/residents that didn't really bother to teach me anything and that I wasn't too impressed with either, but I am in NO POSITION TO JUDGE THEM, especially as a fourth year medical student. And I'm pretty sure that a 3rd year isn't in any position either to judge. Who knows what's going on outside their job, i.e. at home, etc.

Bottom line is that when I am an intern/resident I plan on teaching whatever I possibly can to the students that are on my service. Its going to be one of MY responsibilities as an intern. If others don't want to do it, then that's their choice, but I hope and pray that I don't have a snotnosed punk of a student on my service that doesn't appreciate the things that he or she's learning, even if they don't realize it right now.

And if you are on my service, then so be it, but I bet other students will be appreciative of my efforts.

YOU DO YOUR JOB AND MOVE ON.

 

[phoenixsupra]

I'm a fourth year medical student by the way.

I have had some interns/residents that didn't really bother to teach me anything and that I wasn't too impressed with either, but I am in NO POSITION TO JUDGE THEM, especially as a fourth year medical student. And I'm pretty sure that a 3rd year isn't in any position either to judge. Who knows what's going on outside their job, i.e. at home, etc.

Bottom line is that when I am an intern/resident I plan on teaching whatever I possibly can to the students that are on my service. Its going to be one of MY responsibilities as an intern. If others don't want to do it, then that's their choice, but I hope and pray that I don't have a snotnosed punk of a student on my service that doesn't appreciate the things that he or she's learning, even if they don't realize it right now.

And if you are on my service, then so be it, but I bet other students will be appreciative of my efforts.

YOU DO YOUR JOB AND MOVE ON.

Sounds like you'll probably be an ok resident. This thread is only about the bastards. ie. the ones that are basterdly to you for no reason that you can understand. They probably aren't bastardly to everyone and might be well thought of by many. But when you clash with a senior it is easy to lose your perspective. Lets make this thread about constructive ways to solve interpersonal problems in the hospital. It's all much easier said than done.

Dead right, we can't judge residents outright. But we can and do judge them as they appear from our 3rd/4th year perspective. Yes, they may have other problems making them ornery. But so can we. That cuts both ways.
Sure they are all tired. But some use this as an excuse to be nasty while others control themselves. I've had lot's of residents who were great to work for no matter how tired they are. I bet the ones who use tiredness as an excuse in residency also gave the same excuse as medstudents and as pre-meds and all the way back problably. Even in specialties with long hours and highly malignant cultures you find exceptions who are calm, hardworking and pleasant at all times.

But it's easy for me to point my finger. The reality is that interpersonal problems take a fair bit of reflection and work to overcome. Usually they aren't solved in the heat of the moment. When you residents are swamped, and you have a student who for whatever reason is getting on your last nerve, what sort of things are you tempted to do? What sort of things do you do? What are some of the stories/legends in your program of what others have done. Is being bastardly sometimes a phase that residents go through after being burned by an incompatible student until they find a more efficient way of dealing? How rare is it for a student to actually be oppositional enough to be a bastard back? I know a few, though I definately don't recomend that.

 

[MustafaMond]

How rare is it for a student to actually be oppositional enough to be a bastard back?

It may seem pretty stupid to do that, considering the senior has some say over you evaluation. But it can be done, and I have witnessed it.

I have, seen it happen in two situations.

1) There are two seniors on a team- the other one sides with you and also thinks the guy is bastard-like. In this case, you guys can join forces, and the cool senior will back you up in any arguments/struggles.

2) There is no respect for the senior resident by the attending. Then it doesn't matter what the dastardly bastard thinks.

The above scenarios can and do happen. I have been involved in #1 and heard about #2.

Disclaimer- Don't try #1 if the bastard is the Chief Resident.

 

[roja]

You really shouldn't ever be bastardly, even if someone is bastardly first. Remember, this logic didn't work in the first grade and you really should work at dealing with it in an adult manner. Doesn't mean you shouldn't come to a forum like this and vent, but you really should learn how to cope with difficult people in an effective manner.

We recently had a discussion about this in our weekly confrence. People were justifying thier bad behavior to surgical residents because the surgical residents were difficult with them. In all honesty, you only make yourself look weak and immature. Realize that in medicine you will deal with difficult people: nurses, residents, patients, attendings, consults. You have to learn how to stand your ground without being a dick, when to stand your ground and how to let it wash over you.

This is NOT just letting someone get away with it but learning the finer points of managing people.

In the ED, I know my job is to deal with consultants and privates. I have to negotiate a lot of personalities. I ASSUME my surgeons will be difficult and try and cut them some slack... I don't go in looking for a fight. I won't let them walk all over me, and suprisingly, they dont. They know that I won't try and get in a pissing match with them and they know I have a reason when I stand my ground. I also try adn do small things that make them realize that I am working WITH them, not for them adn that tey are working WITH me, not for me.

Phoenix- I totally agree. I think it IS the place for third and fourth years to critically appraise thier residents. You are forming yourself as a physician. (and resident) as third years. You will pick and choose who to emulate based on your experience. You will pick attendings as residents to emulate. No, you don't know what its like, but they are showing you by example, and that's why sucky residents can still teach... they teach you how NOT to act.

 

[livewires]

Wouldn't it be nice to just once hear a resident say, "So how am I doing as your mentor and are you happy with what you are learning and comfortable with what you are being asked to do?" Is this so unheard of and taboo in medicine? Are some residents so arrogant that they just could give a damn less about how they are percieved as a mentor and as a fellow "advanced" student. Aren't we all students of medicine forever?

The relationship between resident and student is dynamic and one that needs to be treated with MUTUAL respect. Bad days will always happen, whether inside or outside of the hospital, but it is NEVER okay to be "bastardly" with students and patients for that matter.

By the way, yesterday, while rounding, I was last out of the room and heard a pt. mumble in disgust about what a prick my resident was because he kept interrupting this guy and wouldn't let him complete a sentence. What a shame.

 

[phoenixsupra]

Wouldn't it be nice to just once hear a resident say, "So how am I doing as your mentor and are you happy with what you are learning and comfortable with what you are being asked to do?" Is this so unheard of and taboo in medicine? Are some residents so arrogant that they just could give a damn less about how they are percieved as a mentor and as a fellow "advanced" student. Aren't we all students of medicine forever?

I had a chief once who did almost exactly that. He was very cool though, and I didn't really have any complaints. But I did talk with him a bit about my learning style and he made some adjustments to help. He was real grateful and all. I was very impressed and I think I'd like to do that myself when I'm a resident. Come to think of it I'm surprized more residents don't do this. As far as I can see much of the dissatisfaction with resident teaching comes from lack of communication about learning style (which is more than mere choice BTW).

 

[roja]

Wouldn't it be nice to just once hear a resident say, "So how am I doing as your mentor and are you happy with what you are learning and comfortable with what you are being asked to do?" Is this so unheard of and taboo in medicine? Are some residents so arrogant that they just could give a damn less about how they are percieved as a mentor and as a fellow "advanced" student. Aren't we all students of medicine forever?

The relationship between resident and student is dynamic and one that needs to be treated with MUTUAL respect. Bad days will always happen, whether inside or outside of the hospital, but it is NEVER okay to be "bastardly" with students and patients for that matter.

By the way, yesterday, while rounding, I was last out of the room and heard a pt. mumble in disgust about what a prick my resident was because he kept interrupting this guy and wouldn't let him complete a sentence. What a shame.

livewires that chip on your shoulder seems to be incredibly heavy. Why is it that you assume the worst of residents because you have ONE sucky resident? Wouldn't it be dreamy if every resident had the time to sit down with each medical student they have and ask them how things were going, how they were doing as a teacher etc? Yes, most definately. However, just because a resident DOESN"T do this, doesn't mean they are arrogant or uncaring.

There are a couple of reasons why this will always be an issue, and why they can't all sit down and mentor you.

1-the vast majority of residents DON"T go into academics. They have never taught, don't want to teach, and have no plans to teach. Thus, they don't know how and don't want to. Just like having to memorize the Krebs cycle is something we have to do in med school, dealing with med students is something that residents have to do. some enjoy it more than others.

2-Sit back and take a look at the residents around you. Even with 80 hour work weeks, residents are killed. They carry HUGE patient loads. They have to fight with off service consults, with radiology, with surgeons, with the ED. They are learning how to get crap done from nurses, etc. They are also trying to make sure that they not only DONT" kill someone but that they give them good care. They are trying to figure out if they need a fellowship. Research etc. They are trying to find some time to have a life outside of work and also figure out when they are going to take step 3, their boards, etc. And they have to deal with attendings as well. the list goes on and on.

There is a huge safety in being a medical student. You can't really harm anyone and you are really there to learn, either by direct teaching, observation or self learning.

If you get a resident that loves to teach, then let them know it. And cut those that don't some slack.

Now, having said that, there is absolutely NO reason, wether a resident teaches or not, a resident should NEVER treat a med student badly, even if the med students act poorly (not that you are.. just in general)