Does anyone else have this issue with med students?

[Gem134]

Well, I can see both side of this story and I have to agree with the OP to some extent. I am on a rotation now where I see my classmates sucking up to the residents and attendings, schmoozing about their social/personal lives and then scooping up the "glory moments" and in general trying to shine on a short-term, time limited way. They make a big show when a resident/attending is around, but come in late and are generally rude and bossy to the nurses and staff.

They do not care an ounce for the patients, and make fun of them behind their backs. They also do not show up for required events if no resident or attending is there, and slip away as often as they can to read or whatever. I would agree that they are there soley for the good eval and brownie points, and from where I am standing it seems very insincere.

I think that the OP had an appropriate comment and some of the remarks are kind of harsh. As a fellow student I try and just ignore it and focus on my own work, but it is discomforting to see unprofessional behavior among your peers. I know that in residency these issues come to the forefront and people see over time who is hard working and who is a real slacker. I hope to be a good resident and be good to my students but I would be frustrated too, if they did not do their work and help with the team's work. This whole process can be very hard for both residents and students, it is an imperfect system.

---

Members don't see this ad.

 

[DarksideAllstar]

Still, I take a little offense to you assuming that residents are lazy or inept for asking you to do these things.

Either way, if you wear on your sleeve any of the sentiment that you're expressing on SDN when you're in a clinical environment, the team is going to pick up on it and label you as disrespectful and self-entitled.

Depending on the circumstances, I would argue that sometimes a resident is being lazy (asking me to do transfer orders on a patient not even on our service comes to mind). Don't get me wrong I had a pretty good experience as a med student. We only had a few bad apples in terms of residents really trying to take advantage of med students during my third year.

The sentiment that I am expressing on SDN is mainly derived from the OPs posts. It infuriates me that someone actually would say some of the things that she says (see my post where I highlighted some choice remarks). I still stand by the comments I made about my job as a med student whether or not you agree with them, and apparently my ideas didn't affect my ability to get along with anyone on any of the teams that I was part of (med, peds, surg, OB, etc).

 

[Hoo\/er]

This past year, our 3rd and 4th year classes have consisted of MANY MANY very LAZY students. I would have never dreamed of acting the way some of these people do. Not only are they lazy...but they don't really CARE that they are lazy. They don't seem to care that they are perceived as slackers - yet they are going after competative residencies, which always makes me laugh. The other day, I walked into the physician's lounge and found a 3rd year completely sprawled out SLEEPING on the couch! I've taken to documenting some of the behavior for when I have to make serious complaints to the DME. It just seems that pride is gone in these people. I don't mean a small percentage - I mean about 60% of our current students are like this. I can't imagine NOT caring that every attending/resident would potentially think I was worthless and this made me work even harder.

Any one else with this issue?

Yeah, I had an issue when I was found sleeping during third year and got that behavior documented.

 

[werewethere]

This past year, our 3rd and 4th year classes have consisted of MANY MANY very LAZY students. I would have never dreamed of acting the way some of these people do. Not only are they lazy...but they don't really CARE that they are lazy. They don't seem to care that they are perceived as slackers - yet they are going after competative residencies, which always makes me laugh. The other day, I walked into the physician's lounge and found a 3rd year completely sprawled out SLEEPING on the couch! I've taken to documenting some of the behavior for when I have to make serious complaints to the DME. It just seems that pride is gone in these people. I don't mean a small percentage - I mean about 60% of our current students are like this. I can't imagine NOT caring that every attending/resident would potentially think I was worthless and this made me work even harder.

Any one else with this issue?

Whatever happened to either a formal mid-clerkship evaluation and/or weekly informal individual meetings with the students to let know how they are performing and what it would mean if they continued acting this way? Some students may reform, others won't, but at least they won't be in the dark when they are average or below average in their overall grade. My best rotations were the ones that had such built in feedback mechanisms, so that I could figure out what needed to be worked on. As for M4s, I would cut them a little more slack given what they have gone through and what they will go through...

 

[deleted4401]

Hysterical!

Maybe people are right ... maybe there is a work ethic decline. But, maybe the 'new breed' are just more efficient, and lucky to have all these great handbooks and sources to learn from (standardized patients, those fancy robot simulators, case-based stuff, First Aid, Q-Bank).

I think that what happens is that since much of that can be done on one's own time without being on the floor, that when you're at the hospital with a resident that just makes you follow them around, you figure you're better off doing something else. I don't know ... I don't think the quality of the residents is a lot worse now, in terms of performance (maybe in attitude) compared to the old timers.

The only thing I do disagree with is that all third year rotations are necessary for all future physicians. OB was worthless for me. Seriously, as a rad-onc, I gained absolutely nothing. I'd like that 4 weeks back. Every other rotation helped a bit (psych, neuro, surgery, med, peds, family), but I don't think OB did.

-S

 

[thewebthsp]

GYN is useful for people in radonc-- they treat gynecological cancers...

 

[deleted4401]

I didn't say GYN. That was very important. Just OB.
-S

 

[Thrombus]

Medical school is a nightmare.

You pay them to get abused.

And our best and brightest do this.

Horrible experience all the way around.

 

[sophiejane]

Medical school is a nightmare.

You pay them to get abused.

And our best and brightest do this.

Horrible experience all the way around.

I was never abused as a medical student--I don't think it's fair to make huge generalizations like that.

I think part of the problem is that the super-specialization of medicine has trickled down to M3s and M4s. They get this idea that there are things they will never need to know, like OB. So they slack, have bad attitudes, etc. Instead of just becoming a PHYSICIAN and specializing later, we are creating this monster who thinks they only need to know their narrow scope, and blow off the rest.

I find that really disturbing, actually. Why not just create a Rad-onc (or ortho or ENT or whatever) track from the beginning of medical school, and only teach what is absolutely necessary to do those jobs. You will apply to that track, and it will all be based on the MCAT. >40 get to do rad-onc, >35 ortho, etc.

Obviously, I'm being sarcastic. Might as well sign up for trade school.

 

[Thrombus]

As a former medical student looking back, I shudder at what is going on in today's hospitals.

We expect our best and brightest to go into medicine yet treat them like absolute ****. Then allow the government, legal, and business people to turn them into indentured servants while these young people PAY to do this.

It is an OUTRAGE and medicine will continue to go into the toilet unless things are changed.

Look at the hospitals today, and pretty much the only ones you can see going into primary medicine are FOREIGN NATIONALS. This is only the beginning and eventually this trend will spread to all specialities once the gauntlet continues to drop. The American doctor is becoming a thing of the past thanks to academics who are completely out of touch with reality and narcissists.

Add to that, the American physician is bullied by outside forces and who would even want this job anymore?

Time for the physician to FIGHT BACK and not put up with this anymore before it is too late. (Which it is already most likely).

It is time for HARDBALL.

 

[Thrombus]

I was never abused as a medical student--I don't think it's fair to make huge generalizations like that.

I think part of the problem is that the super-specialization of medicine has trickled down to M3s and M4s. They get this idea that there are things they will never need to know, like OB. So they slack, have bad attitudes, etc. Instead of just becoming a PHYSICIAN and specializing later, we are creating this monster who thinks they only need to know their narrow scope, and blow off the rest.

I find that really disturbing, actually. Why not just create a Rad-onc (or ortho or ENT or whatever) track from the beginning of medical school, and only teach what is absolutely necessary to do those jobs. You will apply to that track, and it will all be based on the MCAT. >40 get to do rad-onc, >35 ortho, etc.

Obviously, I'm being sarcastic. Might as well sign up for trade school.

Yes, being forced to stay up all night working and PAYING TO DO SO OR ELSE constitutes ABUSE.

Indentured servants never had it so bad.

 

[deleted4401]

I don't claim to know what other specialists need to know or don't need to know. I don't think it's about slacking - I really think dealing with pregant patients is as important to my job as dealing with patients' with Gaucher's disease (It's nice to have read about it, but spending a month on it was overkill). 9 months in, haven't seen one pregnant lady yet.

And of course you have to be a physician first, but what's wrong with 'tracks' as long as you have the basics covered? And what does it mean to have the basics covered and how do you know who has become a 'physician'. Does it mean just going through all the rotations and passing? Does it mean breezing by, but killing the shelf exam and getting a good grade? Does it mean staying 30 hours and being a resident's conversation buddy/coffee fetcher or does it mean spending 10 hours actually doing and learning? Does it mean killing your boards? Does it mean brown-nosing your way to a good letter?

If you're a student or even a resident, it's hard to say what each one of us 'needs' to be a good doc. I know there are great older docs and great new generation docs. Again, their attitude behind closed doors may be entitled and narrow in scope, but what of it? As long as they know their field and the literature, have good beside manner, and communicate well with other physicians, the job will get done.

And I think the track idea might actually be a good substitute for the vacuum that is fourth year. I think what's most disturbing is when people assume they know what is right for everybody else. I know slacker med students who are amazing interns (b/c they finally are doing something real, not pointless meandering and 'Wondering if there I was anything I could do to help?'), and I know many folks that were the resident's pal for 30 hour shifts who still cannot distinguish their anus from their elbow and struggle with residency.

It's not blowing off things or acting like it's trade school. That four years was my opportunity to learn medicine and I paid a lot of money for it. A lot of it was useless. I'm not going to pretend that just "being at the hospital" was a learning experience. That's a silly attitude and revisionist history.

-S

 

[Samoa]

I don't claim to know what other specialists need to know or don't need to know. I don't think it's about slacking - I really think dealing with pregant patients is as important to my job as dealing with patients' with Gaucher's disease (It's nice to have read about it, but spending a month on it was overkill). 9 months in, haven't seen one pregnant lady yet.

And of course you have to be a physician first, but what's wrong with 'tracks' as long as you have the basics covered? And what does it mean to have the basics covered and how do you know who has become a 'physician'. Does it mean just going through all the rotations and passing? Does it mean breezing by, but killing the shelf exam and getting a good grade? Does it mean staying 30 hours and being a resident's conversation buddy/coffee fetcher or does it mean spending 10 hours actually doing and learning? Does it mean killing your boards? Does it mean brown-nosing your way to a good letter?

If you're a student or even a resident, it's hard to say what each one of us 'needs' to be a good doc. I know there are great older docs and great new generation docs. Again, their attitude behind closed doors may be entitled and narrow in scope, but what of it? As long as they know their field and the literature, have good beside manner, and communicate well with other physicians, the job will get done.

And I think the track idea might actually be a good substitute for the vacuum that is fourth year. I think what's most disturbing is when people assume they know what is right for everybody else. I know slacker med students who are amazing interns (b/c they finally are doing something real, not pointless meandering and 'Wondering if there I was anything I could do to help?'), and I know many folks that were the resident's pal for 30 hour shifts who still cannot distinguish their anus from their elbow and struggle with residency.

It's not blowing off things or acting like it's trade school. That four years was my opportunity to learn medicine and I paid a lot of money for it. A lot of it was useless. I'm not going to pretend that just "being at the hospital" was a learning experience. That's a silly attitude and revisionist history.

-S

Excellent post.

 

[BeatrixKiddo]

Things lucrative subspec like derm, rads, ortho, plastics etc to be financially solvent in 10 years. When the future looks grim it is very easy to become despondent or angry.
3.) This isnt the Marine Corps. Doctors dont have that old school reputation of being Iron Men anymore. The "Carrots" that made people care of income and societal status are decaying and dying.
Be lucky Im not a med student again.
Med students are CUSTOMERS, not recruits for the Navy SEALs, and in our increasing "Me" focused society, the customer is always right.

What's a Carrot.

 

[BeatrixKiddo]

Yes, being forced to stay up all night working and PAYING TO DO SO OR ELSE constitutes ABUSE.

Indentured servants never had it so bad.

Well technically it would be masochism not abuse, since it's an elective school, I mean if you wanted you could have dropped out of school at age 16 I'm pretty sure, maybe it depends on your state.

 

[Long Dong]

I don't claim to know what other specialists need to know or don't need to know. I don't think it's about slacking - I really think dealing with pregant patients is as important to my job as dealing with patients' with Gaucher's disease (It's nice to have read about it, but spending a month on it was overkill). 9 months in, haven't seen one pregnant lady yet.

And of course you have to be a physician first, but what's wrong with 'tracks' as long as you have the basics covered? And what does it mean to have the basics covered and how do you know who has become a 'physician'. Does it mean just going through all the rotations and passing? Does it mean breezing by, but killing the shelf exam and getting a good grade? Does it mean staying 30 hours and being a resident's conversation buddy/coffee fetcher or does it mean spending 10 hours actually doing and learning? Does it mean killing your boards? Does it mean brown-nosing your way to a good letter?

If you're a student or even a resident, it's hard to say what each one of us 'needs' to be a good doc. I know there are great older docs and great new generation docs. Again, their attitude behind closed doors may be entitled and narrow in scope, but what of it? As long as they know their field and the literature, have good beside manner, and communicate well with other physicians, the job will get done.

And I think the track idea might actually be a good substitute for the vacuum that is fourth year. I think what's most disturbing is when people assume they know what is right for everybody else. I know slacker med students who are amazing interns (b/c they finally are doing something real, not pointless meandering and 'Wondering if there I was anything I could do to help?'), and I know many folks that were the resident's pal for 30 hour shifts who still cannot distinguish their anus from their elbow and struggle with residency.

It's not blowing off things or acting like it's trade school. That four years was my opportunity to learn medicine and I paid a lot of money for it. A lot of it was useless. I'm not going to pretend that just "being at the hospital" was a learning experience. That's a silly attitude and revisionist history.

-S

Excellent post.

I second that.

 

[sophiejane]

And I think the track idea might actually be a good substitute for the vacuum that is fourth year. I think what's most disturbing is when people assume they know what is right for everybody else.

And yet...you are apparently assuming that the track idea for fourth year would be a good idea for "everyone else"?

There are a lot of problems in medical education, but somehow we keep turning out doctors...not always good ones, and I agree with you 100% there communication and bedside manner cannot be taught, and this is what separates the girls from the women, as it were.

However, what disturbs me is that some physicians are so narrow in their scope and knowledge that they have lost the ability to see the patient as an interconnected network of medical (and social and emotional and financial etc etc) issues and considerations, and not their one problem to be solved and shuffled off to the next specialist. I believe if more physicians thought globally and acted locally, rather than having only the narrow blinders of their specialty and to hell with everything else, we might catch things for each other, and help patients more.

I'm not saying we don't need experts---of course we do. God knows I'd be thankful for someone like you if I got cancer. I'm just saying that I think a broad foundation in not just basic science but in clinical medicine in the "core" fields is absolutely essential to creating physicians who are thinkers and not technicians.

 

[Winged Scapula]

Heck, IMHO, instead of tracking people earlier we should be following the British model which has everyone do some general medicine years after medical school.

It'll never happen in our instant gratification society of course, but I can help but see that those guys tend to be better all-around physicians because of the experience.

 

[Long Dong]

Heck, IMHO, instead of tracking people earlier we should be following the British model which has everyone do some general medicine years after medical school.

It'll never happen in our instant gratification society of course, but I can help but see that those guys tend to be better all-around physicians because of the experience.

It is my understanding that they also don't have an undergraduate requirement. So if you'd cut out undergrad (for me it was 5 years) I'd be all for spending more time in general medicine before specializing. Hell I'd be willing to do a whole FP residency before specializing.

 

[colbgw02]

It'll never happen in our instant gratification society of course

Ummm...did you really just intimate/imply/insinuate that our current medical education system provides instant gratification?

 

[werewethere]

Ummm...did you really just intimate/imply/insinuate that our current medical education system provides instant gratification?

Instant gratification is a relative term, I guess. The hierarchy in some places in Europe is so thick that you can be over halfway done with your career before you get to do some of the stuff that you might get to do as a resident in the States. Makes for better all around doctors who are frustrated as H***.

 

[Thrombus]

Well technically it would be masochism not abuse, since it's an elective school, I mean if you wanted you could have dropped out of school at age 16 I'm pretty sure, maybe it depends on your state.

Consider for a moment the following:

You are a bright young high school grad just entering college. You work hard, excel, and achieve. You get results for your work with scholarships etc. You see doctors in your community doing important work requiring intelligence and skill, caring for people while living the "good life" on a comfortable income. You see that these doctors are smart and can readily identify with them. So you decide AT THAT MOMENT you will become one of them.

You go through 4 years of college and perform at a high level -- racking up loans -- but oh well you will make lots of money at being a doctor right?

You then enter medical school, pay exhuberant tuition in order to become a doctor.

BOOM!

Third year of medical school comes. You are all of a sudden.....****. You are surrounded by a$$-ki$$ers and other people ready to stomp on you to achieve what they want you to do. You must follow around foreigners who are completely out of touch with America (outside of the hospital) and obey everything they say sometimes 30+ hours at a time. You are away from your family and attempts to contact them can draw the ire of these same narcissistic residents and attendings who only know 1 way of life -- the academic hospital.

You are STUCK with no way out. You have a huge debt and loads of residency in front of you. You see outside forces at work harming your future autonomy and income potential. Hillary Clinton is at work getting the government to take over your career and turn you into a "VA employee". I could go on for days but I will spare you.

THAT is what life looks as a medical student.

Show them sympathy please.

 

[sirus_virus]

Consider for a moment the following:

You are a bright young high school grad just entering college. You work hard, excel, and achieve. You get results for your work with scholarships etc. You see doctors in your community doing important work requiring intelligence and skill, caring for people while living the "good life" on a comfortable income. You see that these doctors are smart and can readily identify with them. So you decide AT THAT MOMENT you will become one of them.

You go through 4 years of college and perform at a high level -- racking up loans -- but oh well you will make lots of money at being a doctor right?

You then enter medical school, pay exhuberant tuition in order to become a doctor.

BOOM!

Third year of medical school comes. You are all of a sudden.....****. You are surrounded by a$$-ki$$ers and other people ready to stomp on you to achieve what they want you to do. You must follow around foreigners who are completely out of touch with America (outside of the hospital) and obey everything they say sometimes 30+ hours at a time. You are away from your family and attempts to contact them can draw the ire of these same narcissistic residents and attendings who only know 1 way of life -- the academic hospital.

You are STUCK with no way out. You have a huge debt and loads of residency in front of you. You see outside forces at work harming your future autonomy and income potential. Hillary Clinton is at work getting the government to take over your career and turn you into a "VA employee". I could go on for days but I will spare you.

THAT is what life looks as a medical student.

Show them sympathy please.

This is some hell of a picture you just painted.

 

[plastikosmd]

well in reading this thread i have learned that i was a "gunner." funny i never ran across that term years ago. learn somethin new every day.

 

[Winged Scapula]

Ummm...did you really just intimate/imply/insinuate that our current medical education system provides instant gratification?

Nope. Implied that our society demands instant gratification and that perhaps, intimated because of that, no one would see fit to change our current medical education system because they couldn't stand to work a minute longer toward their goals or to be a better physician.

As noted above, "instant gratification" is relative (ie, I know that compared to our friends who got good paying jobs right out of college, we know the meaning of delayed gratification) but no one seems to want to work any longer even if it means for a possibly better outcome. Anyone for longer residencies since the 80 hr work week? I didn't think so.

 

[Winged Scapula]

Instant gratification is a relative term, I guess. The hierarchy in some places in Europe is so thick that you can be over halfway done with your career before you get to do some of the stuff that you might get to do as a resident in the States. Makes for better all around doctors who are frustrated as H***.

Agreed. Specialty training is really where the British system falls apart. Too much "good old boy", too much "where you went to school", too much hierarchy making for people staying in training schemes years beyond when they should be a consultant. But I still like the idea of a couple years of House Officer work before applying for specialty training.

 

[Winged Scapula]

It is my understanding that they also don't have an undergraduate requirement. So if you'd cut out undergrad (for me it was 5 years) I'd be all for spending more time in general medicine before specializing. Hell I'd be willing to do a whole FP residency before specializing.

Most don't (ie, require an undergraduate degree) but rather take high school "leavers" (ie, seniors). But med school for a high school leaver is a 6 year program so you aren't saving much time over doing a degree first.

I like the American system of having a college degree first, the British system of two house officer years, then the American system of residency training for the best amalgamation of both. But it would never fly here...

 

[PediBoneDoc]

a wonderful group of posts. the back and forth about medical education and how inefficient it is, everyone knows how to do it better. my time is better spent reading about taking care of patients than actually taking care of patients.

truth be told, no system is perfect. many smart people have come up with a system that has worked and many people have have come from far away to be trained by many of the best an brightest in the world. can things be better? yes. is there waisted time? yes. but for know, it has worked.

let me give you a little perspective.

we will have a shortage physicians in the comming years. there have been efforts to increase the number of medical students and even opening new medical schools to meet this demand. the residency CAP (number of residents CMS will fund) has not been increased. therefore the number of funded resident spots will not change. (more physicians but no increase in residencies) and resident funding (IME) will be decreased in this comming year decreasing by about $10,000 or more per resident. Many hospitals are funding their own residency slots.

the insurance reimbursements are going down, research grants are harder to come by, so many academic institutions are pushing increase in clinical income to make ends meet. salaries are being tied to production not teaching. i personally see no income from the medical school (it is all clinical production based), if i teach or not, my income does not change.

the new generation of physician wants to work less hours. requires both more physicians to cover the time and incomes for physicians will decrease.

physician extenders will be more comon place in the future (more so than they are now) therefore the volume that a medical student or resident will see will decrease causing their learning curve to be leangthened.

if you all actually look at the system as a whole, there are some significant changes coming down the pipeline. you havereally only seen the begining of some major changes. one that may be coming is a decrease in residency slots if they pull the medicaid funding as put out in a recent bill in congress. i have a feeling things are going to get worse before they get better.

i'm juss sayin'

 

[Long Dong]

well in reading this thread i have learned that i was a "gunner." funny i never ran across that term years ago. learn somethin new every day.

By looking at your screen name I'm assuming you didn't match into your field by being a slacker.

 

[deleted4401]

A few certainties about medical education:

1) People will always say the 'way it was' was better

2) The sky will always be falling

3) Anything new will be maligned, even though the sky is falling.

4) Rinse

5) Repeat

We continue to train the best doctors in the world - home grown and foreign born. We provide amazing medical care (to those who can afford it). People are dying to be trained and treated here. There is always room for improvement in education and treatment. Those senior will continue to dog those junior, and say they are lazier/stupider/less passionate/more concerned about money than they ever were. Changes will be made and criticized, before becoming 'conventional'. The Cubs will continue to rejuvenate and then disappoint.

That is the way of life.

-S

 

[werewethere]

A few certainties about medical education:

1) People will always say the 'way it was' was better

2) The sky will always be falling

3) Anything new will be maligned, even though the sky is falling.

4) Rinse

5) Repeat

We continue to train the best doctors in the world - home grown and foreign born. We provide amazing medical care (to those who can afford it). People are dying to be trained and treated here. There is always room for improvement in education and treatment. Those senior will continue to dog those junior, and say they are lazier/stupider/less passionate/more concerned about money than they ever were. Changes will be made and criticized, before becoming 'conventional'. The Cubs will continue to rejuvenate and then disappoint.

That is the way of life.

-S

This is the general attitude of most people in most fields in which there is a substantial upfront investment of time and money. Many people join a profession at such a high cost because they want security. Anything that keeps the status quo adds to security, anything that changes the field, either for better or worse, changes the status quo and reduces security. You won't change this attitude, since it was probably present prior to training and strengthened by it, since do no harm applies to yourself as well as to the patient. All this squaking about the ever collapsing medical world is an ineffective way people deal with their insecurity. It may be a hard time to be a doctor, but being a doctor still means something, something good. Medicine may change, but the need for healers, cures, and treatments will never fade.

 

[TheRoach]

No, I'm really not complaining that they don't do 'enough' work...ANYthing is very appreciated. I'm complaining about the ones who don't do 'any' work. There is a difference. And yes, the work does get done - I make sure it get's done. That is my job, I 100% agree. I don't expect anything out of my student that I wouldn't do myself. I would never send a med student off to scut while I eat bonbons in the lounge...I'm working hard too. And the reason that it matters that I am a senior resident is because there are OTHER responsibilites...lectures, OTHER students to interact with, ER patients to go see (no, I don't send the student to see these patients), consults -because students can't do those at all. Our program is small and EVERYONE is extremely busy.

When I was a 4th year student, I ended up being on call with the same intern 3-4 times in a row. I would be doing an admit and I'd look up and see the intern standing in the doorway just watching me do the admit. He'd stand there, silent - not doing anything. Finally, I told him if he had enough time to stand around and watch me - he could do the admits himself. (mostly because it creeped me out) But, if I need some help getting things done - notes written, H&Ps, whatever...it's because I'm slammed, not because I want to watch Oprah.

Part of what I value (and enjoy) with my education of students is giving them the 'freedom' (not sure if that's the right word) of trying to go see a patient and simply coming back to tell me if the patient is 'sick'. Sounds stupid, but not everyone can simply look at a patient and think - wow - this isn't good. I've seen many students really progress with simple things like this (no matter how book-smart they are) and it's nice to see someone begin to think like a clinician. When a student is simply NOT around...there is NO opportunity for education. There are 2 sides to this...yeah, sometimes and extra pair of hands would be nice...but they also miss out on the cool stuff that goes on. (and then it really steams me when they expect to participate in procedures when they've been MIA the entire day). I just get the picture that alot of our students we have really don't want anything to do with patient care at all. They would be perfectly happy getting thru the entire month not even auscultating a set of lungs. (just my opinion...I guess this has all been my opinion, hasn't it? )

I really don't think I expect too much, well - being someone going into critical care - I know I'm a little more intense about stuff, however I greatly appreciate ANY paperwork that a student gets done..and admits (especially those, because I hate to dictate!). I've bought thank you cards, given gift cards..I do try to let people know when they've been a big help (med student, nurse, intern, whomever).

SLUuser11 - I completely agree with you.

I'm not sure if my b*tching is about not having help...or simply that I am in disbelief of the behavior people think they is acceptable.

And for DarksideAllStar - I'm going to try using your logic the next time my attending asks me to go see a patient..."Don't YOU get paid to do that? Last time I checked, it is really YOUR responsibility to make sure these patients are taken care of and I'm simply here to be taught." You can try that next year and fill us in oh how it goes.

It is the students job to learn not do your scut. They not only are writing notes but hopefully trying to learn alot in a short period of time. If they are sleeping on the couch it probably means they have been up all night studying. That is why they are called students. If you start feeling Nazi like urges just because you have a long coat then maybe you should get some professional help. Just my opinion.

 

[PainDr]

It is the students job to learn not do your scut. They not only are writing notes but hopefully trying to learn alot in a short period of time. If they are sleeping on the couch it probably means they have been up all night studying. That is why they are called students. If you start feeling Nazi like urges just because you have a long coat then maybe you should get some professional help. Just my opinion.

Trying to reason with posters like this is futile. Some of them just won't "get it" until they're residents themselves, so stop banging your heads against the wall.

 

[drtx]

There is some learning value in scut ( biased future surgeon speaking) - When I was a 4th year med student I was given the task of removing a chest tube. I pulled the tube and was so obsessed (and scared %^&tless) with the occlusive dressing that I freakin' left the whole system laying on the FLOOR!!! Left the hospital later all proud of myself....

The next day the resident paged me as was like "You can't leave that nasty crap on the floor, the nurses called me later all hysterical thinking it had fallen out..."

Point: There is always little things to learn and no one is above it!

 

[deleted113029]

It is my understanding that they also don't have an undergraduate requirement. So if you'd cut out undergrad (for me it was 5 years) I'd be all for spending more time in general medicine before specializing. Hell I'd be willing to do a whole FP residency before specializing.

surely you jest! (i've never met a derm person who said that kind of rubbish.)

 

[LADoc00]

This is a pretty hilarious thread I must admit. To be frank and well...honest, the overall tone of medicine has changed DRAMATICALLY over the last decades with the decreasing job satisfaction people have in medicine. I wouldnt be suprised if in 10-20 years you see docs not even bothering to step away from internet porn and choking the one-eyed snake to rush to a code, let alone admitting patients after hours. Yes, there will always be that self flagellating 1% that loves to serve society so much they will leap onto hand grenades, but most will see the writing on the wall: the masses want health care for free, and lots of it! They will have their free health care one day and I assure you we will look back on today's sleeping MS3-4s and be baffled why the hell they worked so hard!!!!

HASTA.

 

[sequela]

oh my, ladoc00. you're on fire today.

 

[turkleton]

There seems to be some sort of disconnect at the OP's school. If the students are as "lazy" (I use this loosely) as you claim, then I'd think attendings- or at least other residents- would recognize it and evaluate the students appropriately. Med students aren't that dumb- they know the importance of 3rd year grades to get the residency they want, and 'lazy schmuck" just doesn't look good on the ol deans letter. A string of bad evals or passes and you can kiss that plastics/derm/optho residency goodbye. And if the students from your school are getting into competitive residencies like you say then either the collective faculty of that school just doesn't give two **its about grading and hands out Honors like candy -- or you might be being a little too critical of students just trying to catch their breath in what I thought was the worst year of med school. If my school is any indication, most students are in the middle- do the work thats asked of them and try to squeeze any learning in when they can. Then you have the annoying gunners who stay till midnight and the ones who call it a day at noon- but those are the extremes.

 

[dutchman]

This is a pretty hilarious thread I must admit. To be frank and well...honest, the overall tone of medicine has changed DRAMATICALLY over the last decades with the decreasing job satisfaction people have in medicine. I wouldnt be suprised if in 10-20 years you see docs not even bothering to step away from internet porn and choking the one-eyed snake to rush to a code, let alone admitting patients after hours. Yes, there will always be that self flagellating 1% that loves to serve society so much they will leap onto hand grenades, but most will see the writing on the wall: the masses want health care for free, and lots of it! They will have their free health care one day and I assure you we will look back on today's sleeping MS3-4s and be baffled why the hell they worked so hard!!!!

HASTA.

LMAO

 

[abefromann]

The author of the original post must be kidding, right? 60% slackers? Doubtful. Sleeping? It's not like they were doing lines and getting a lap dance.

 

[tum]

this is the most spectacular hijacking of all time

 

[mdphd2b]

In my situation I could care less what the residents thought of my work during the surgery rotation since it was the attending filling out the evaluation!! LOL.

LOL...Third year is all a game and how you play it!

Case in point: My two most MISERABLE third year rotations were Psych and OB/GYN. I utilized whatever excuse was necessary to limit my time on the floors. I'd disappear for hours from the evil residents, pretending to look busy, check in every few hours, then do what I pleased. And the beauty of it is, I HONORED both these rotations

Why should I work hard on the specialties I'm least interested in? There will be plenty of hard work as a Peds intern as it is!

 

[2121115]

Well, since everyone has thrown in their 2 cents, here's mine...

1. It is the resident's job to get the work done and its the student's job to learn how to get the work done. The student is under no obligation to work hard or do scut or whatever you want to call it. The resident, however, is under no obligation to write a good evaluation. It always surprises me that residents forget this fact - that they have the last laugh. Don't think a student is taking the rotation seriously? No reason to get upset, after all you have the power to fail/low pass him.

2. Unfortunately, the way you get good (i.e. competitive) residency spots is to a) score high on the boards/shelf's/other tests, b) get good letter's during a 4th year specialty-specific rotation, and c) don't screw up your class rank too badly during third year. That is the game. On some level, you can't blame a student for playing the game. After all, they didn't make the rules. "Don't hate the playa... etc"

3. It is only human nature that when there is a smaller "carrot" at the end of the tunnel, people will not work as hard to get there.

4. There is absolutely learning value in much of what is called "scut".

 

[Faebinder]

You are the resident. You are getting paid. You have a job.

They are the students. They are paying to be there. It's up to them how much to be involved and frankly, there are MANY MANY MANY more important things for them to do than to follow the intern around and kiss ass. Including as others stated:

1) Getting high board scores, (Are you going to garauntee him/her going into residency if they get crappy scores?)
2) Getting letters of recommendation,
3) Passing some shelf exam,
4) Catching up with reading the things that residents dont teach you,
5) Making sure their loans are approved (can you imagine focusing on an H&P when your third year loan is denied due to credit and you need to register for step 2 soon?)
6) Kissing some relative's ass so that they can pay the bill for a test/interview/rent/insurance etc etc when they are not getting paid (yes that counts to me as more important than making sure an intern is happy, every student likes his/her rent/water/electricity bill paid)...

The list is endless and I can make up a long list. Don't let the bitterness of having so much work get to you and make you think its okay to criticize others who are not yet in residency. They will get their chance to pay their dues and suffer the same issues as you.

(As for the older older doc generation trained in the 80s and complain about this generation not wanting to do as much... I could say a lot of mean things but I will just say "Health care is the mess it is cause of your generation, thank you." I wont go into the debate of which is harder, establishing a medical career now or in the 80s.)

 

[AmoryBlaine]

Well, since everyone has thrown in their 2 cents, here's mine...

1. It is the resident's job to get the work done and its the student's job to learn how to get the work done. The student is under no obligation to work hard or do scut or whatever you want to call it. The resident, however, is under no obligation to write a good evaluation. It always surprises me that residents forget this fact - that they have the last laugh. Don't think a student is taking the rotation seriously? No reason to get upset, after all you have the power to fail/low pass him.

2. Unfortunately, the way you get good (i.e. competitive) residency spots is to a) score high on the boards/shelf's/other tests, b) get good letter's during a 4th year specialty-specific rotation, and c) don't screw up your class rank too badly during third year. That is the game. On some level, you can't blame a student for playing the game. After all, they didn't make the rules. "Don't hate the playa... etc"

3. It is only human nature that when there is a smaller "carrot" at the end of the tunnel, people will not work as hard to get there.

4. There is absolutely learning value in much of what is called "scut".

Totally agree, and some of this learning value is learning to put the team and patient care before your own fatigue/fun/laziness etc. I mean, wheeling beds in and out of the OR, putting in Foleys, schlepping the compression stockings are not exactly red-letter educational experiences but you'd better believe that the RNs and residents will notice.

Some med students (i.e. this one) don't mind being "scutted" to a reasonable degree. I've had the opposite problem where residents are so terrified of "scutting" that they end up not asking the med students to do anything at all. I can only read CNN.com so many times in a day...

 

[sophiejane]

I've had the opposite problem where residents are so terrified of "scutting" that they end up not asking the med students to do anything at all. I can only read CNN.com so many times in a day...

This is absolutely true, and was my experience in a couple of cases. My so-called "sub-I" in medicine was a joke. Either they didn't trust me to do the work or thought it was easier to do it themselves, or they just didn't understand my role on the team...whatever. The only valuable part of my day was rounds, and they usually let me go after that. Great. I would have happily stayed and done work, just like another poster said, to learn how to do the work.

 

[oldbearprofessor]

(As for the older older doc generation trained in the 80s ......... I could say a lot of mean things but I will just say "Health care is the mess it is cause of your generation, thank you."

Come on now, I can take it. They say an unexamined life isn't worth living and I'm so old, I better start that examining soon. Just don't violate the TOS so the thread gets closed. Explain to me, how I personally helped create the mess. It would be more useful if you made your comments specific to an academic research faculty member whose primary source of funding has been federal grants throughout my entire career. What should I have done differently?

Go for it! Really, I won't get mad. I don't promise to defend myself, but I'd like to know what I did to cause the mess you see?

 

[DeLaughterDO]

This is absolutely true, and was my experience in a couple of cases. My so-called "sub-I" in medicine was a joke. Either they didn't trust me to do the work or thought it was easier to do it themselves, or they just didn't understand my role on the team...whatever. The only valuable part of my day was rounds, and they usually let me go after that. Great. I would have happily stayed and done work, just like another poster said, to learn how to do the work.

Completely off topic, but when I read this I couldn't resist:

One of the best EVER descriptions of how work should be divided between intern/resident and medical student, from, where else? The venerable, timeless HOUSE OF GOD:

Dr. Roy G. Basch was sleeping in the call room (yeah, who gets to do this anymore?) and his medical student came in and remarked how Dr. Basch is always sleeping and he (the med stud) is always up all night working. Dr. Basch explained it this way -

I (the intern/resident) am on a fixed salary, therefore the more I work, the less I get paid (relatively). The converse is also true.

You (the medical student) are paying to be working in the hospital. The more hours you put in and work, the less you are paying.

Brilliant!! I always get a huge laugh when I think about it - especially when I'm on a light rotation where I get to work only about 40 hours a week.

jd

 

[DeLaughterDO]

Ok, I just re-read that.

How disgusting is it that I said only about 40 hours a week?

What a screwed up profession!

 

[Winged Scapula]

Medical students do have better things to do than just following some intern around and kissing their arse. If the resident isn't involved in teaching, and there is no educational value in the student being around (ie, doing some scut or other work), then I see little reason for the student to be there...just to be there.

However, I do take exception to the idea that students should be allowed out of work and/or what we consider educational experience because they need to study for USMLEs, shelf exams, etc. These (studying) are things that are done after the work is done. If that means your social life suffers or that you are tired, so be it.

I am reminded of being a research assistant and being asked to help author a paper. When I inquired as to when I would get it done, given my 40+ hr per week schedule, the physicians replied, "after hours and on weekends, like we do." Of course I thought they were full of it since I was paid minimum wage but have since come to realize that that's how life works. The residents also have exams to study for, but this is done when they go home, on weekends off, on post-call days. Clinical rotations are for not only learning about the particular specialty but about medicine in general. It is unfair to allow students to think that their lives won't change because of their chosen career - it will.

I don't advocate keeping students around when there isn't really anything for them to learn from the experience or when they have something to do which must be done during the day (ie, talking to their bank or taking care of an ill family member, etc.). But I do object to being asked to relieve them of important clinical learning experiences so they can study for their exams. Studying is a personal choice - you do more or less depending on your needs. It is not my job to see that you have more time to do it in. Lest I be seen as mean and nasty, let it be known that I do encourage students to use any downtime to study because I realize that they too have lives and other things they want to do on the weekends and after hours. I do the same (ie, try and study at the hospital).

But to imply that they should be relieved from their rotation to study seems to be shortsighted (heck, why do rotations at all...why not just stay home and read about medicine and surgery?) as well as poor preparation for a career in which you do have work outside of normal hours, keeping up with current literature, doing CMEs, and just the daily workload.