Difficult Attending -- what to do?

[pagingstat11111]

Just came off of FM rotation and was actually excited about outpatient medicine heading into it. Attending never let me perform a physical exam independently (not once). I was only permitted to see patients on my own if it was 1. something acute and 2. the patient was on time/early. Attending was preoccupied with time to the point where if a patient was 5-10 minutes late he would become agitated and even sometimes lash out at staff or the patient. However, appointments were scheduled at 40 minute intervals so more often than not we were waiting around for the next patient. Otherwise he seemed pleasant enough as long as we were talking about a topic he wanted to discuss. I received no feedback whatsoever even when asking repeatedly. Attending seemed put off by my presence at times. I even offered to help with notes or to ask patients if they wanted flu shots and was turned down. He basically said he gives everyone similar grades. I reached out to the student who had him before me and student confirmed he had the same experience and received a poor evaluation. When my concerns were brought up to the clerkship director he said he had never heard anything like this about this particular attending.

The other issue was that he was very passive aggressive with staff and patients at times. Would be pleasant enough to their face but make snide comments in conversation or speak poorly of them to other providers (NPs or physicians). Found it to be very unprofessional and quite honestly juvenile. Mostly just concerned this was occurring with me and I may not have been aware of it.

Basically: I essentially shadowed for the entire month and was told I can expect a poor eval. Not sure what to do given there were no real opportunities to demonstrate my H&P skills nor my medical knowledge. What do I do?

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[thumbz]

Are you a DO? Sadly this is just luck of the draw with preceptor based rotations. My school had an eval system where students could fill out candid evals on preceptors that were kept in a database for other students to check out - we had to go to the rotations office on campus and use a computer to look at them but they were gold. There you could read a review that was exactly like what you just wrote, and then spend the next week trying every trick in the book to switch preceptors (at one point I signed up for an hour long commute to avoid a glorified shadowing gig).

Every preceptor takes students for different reasons. Some like to tell stories and have a captive audience. Some like the extra workforce (so they can see more patients, but these rotations tend to be awesome as you get treated like an intern). Some like the pittance the school pays them ($400-$1000/student/month) and tend to give a similar experience like you had above.

Your clerkship director may be legit, but more likely they're full of crap. My school always knew who the terrible preceptors were, but due to supply/demand they had to stay on staff. I sucked up to my rotation director and had a much better 3rd/4th year experience for it. You'll always hear the party line of "we had no idea" even when it's well documented.

Take comfort knowing 3rd year grades are worth about as much as a pile of cow dung. A stinging comment will hurt if it makes it into the Dean's letter, but your school will often remove these. Just move on an proactively (before the rotation) find other students who have had that preceptor and if you find another rotation like this try to transfer off of it.

 

[SpoiledMilk]

I feel ya OP. You're not alone.

Very similar situation with FM attending also. Gave me a poor evaluation and was badmouthing nurses and staff behind their backs to me. Totally unprofessional. Single person responsible for turning me off FM. Clerkship director was unimpressed, MIA, and useless when I protested.

Draft a stinging letter in your email, but don't ever send it. Go back from time to read what you wrote and motivate yourself to kick ass going forward...

 

[Fatalis]

Just move forward from it. Medicine has a ton of malignant personalities. Learn how NOT to be like that person.

 

[Bacchus]

You had a ****ty preceptor. Most are better than this. If you’re interested in FM I would do an early elective. COVID has put a damper on these so it may be more difficult.

 

[Dr. Brandon Green]

Don’t let one person or experience dictate your future. Seek out other experiences and don’t regret in future any decisions. Things happen for a reason, you’ve got this far so follow through on your plans/dreams.