Stop using students for free labor

[deleted1119158]

On my extrenships I’ve learned so much. I’m thankful, one of the most important things I’ve learned is how to treat fellow student when I have the privilege of teaching.

Rules to live by:
1) don’t use us as scribes to chart all day everyday
2) don’t pimp us for your amusement
3) don’t use us as retraction monkeys
4) don’t use us to room patient
5) don’t use us to remove dressings
6) don’t use us as free nail nippers

After 2 weeks of all of the above; attending need to have confidence that we get it. At some point it becomes free labor/abuse instead of learning.

We are students, we are not payed employees. We are here to learn, not work as medical assistance, scribes or nursing staff.


Maybe I’m being stuck up, but this is how I feel and how I will navigate students in the future.

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[deleted1138023]

oh wait until you're a resident sweetie....

 

[PTPuser]

If not doing all those things, what exactly do you suggest?

I mean it the nicest way cause I feel exactly as you do at time but truthfully, what are we as 3rd and 4th year should do other than lend a helping hand and make the team's life a little "better".

I'm on rotations now and at times I feel the same way as you do and with some attending I get a little more freedom to "have a say" when they ask me what I think or what I should be looking for / soft pimping you might call it.

Unless you out right call me a dumb C U next Tuesday type of thing I don't see why doing some of those things above is so terrible.

*Edit* We don't add true value to the team. I don't mind rooming patients, get consents for surgery ready, making sure everything is cleaned up and done in a timely manner cause when they get to sit down and there's some down time, a lot of doc would actually go over things with me and teach me x-rays and other studies etc.

 

[wakaflocka88]

On my extrenships I’ve learned so much. I’m thankful, one of the most important things I’ve learned is how to treat fellow student when I have the privilege of teaching.

Rules to live by:
1) don’t use us as scribes to chart all day everyday
2) don’t pimp us for your amusement
3) don’t use us as retraction monkeys
4) don’t use us to room patient
5) don’t use us to remove dressings
6) don’t use us as free nail nippers

After 2 weeks of all of the above; attending need to have confidence that we get it. At some point it becomes free labor/abuse instead of learning.

We are students, we are not payed employees. We are here to learn, not work as medical assistance, scribes or nursing staff.


Maybe I’m being stuck up, but this is how I feel and how I will navigate students in the future.

Just wait till it comes time to look for jobs.

 

[deleted1138023]

OP do you expect them to let you, a student, do a whole surgery or something? why are you complaining retracting?

scrubbing in you're already doing more than half the externs out there likely

 

[deleted1119158]

OP do you expect them to let you, a student, do a whole surgery or something? why are you complaining retracting?

scrubbing in you're already doing more than half the externs out there likely

Totally, I take that back. I’ve learned a huge amount by being able to watch surgery. It’s a privilege and I’m happy to retract/help in the OR. It’s the least I can do because I always walk away feeling like I learned a tone of information, especially if I prep for the case. You have a good point. I was just typing in the heat of the moment.

 

[Feli]

It's a tough spot to be in. It'll be over before you know it.
Try to discern between actual productive work (gathering labs or bandage supplies to speed up morning rounds, retracting, holding leg for cast at surgery end, making a PPT for the group, asking questions to help you learn applicable stuff, etc) versus total stupidness (sending you to cafe for snacks or drinks run, having you see nothing but RFC consults, asking dumb pimp questions just for the sake of it, forcing you to stay in resident room until 4 or 5pm even when day's work is clearly done, etc).

At most places you want to go, there is plenty of real work. Not all of the work is fun, but you have to start somewhere.
I sure can't do a surgery as quickly or as well without retraction, and the retract-o-bots aren't around quite yet at any of my hospitals.
Try to change your mentality in that you view rooming a pt and removing a bandage as your way to say thanks for seeing a ORIF later... instead of thinking of it as being dumped on.

It is actually a double-edge sword, though. Smart residents will realize that a strong and well-read student can plant them on their face just as fast as they can dish out scut work to the student. If you read a lot and prepped, you should be smarter than at least half the residents in most places you go, at least in certain subject areas. You have to really pick your spots and use proper voice tonality (decisive answer versus soft and pretending to guess), but it's fine to answer an attending's question if the resident(s) he/she asked have a few seconds to answer and can't answer it and the attending clearly looks around the group and opens up for answers... you are the student and should have the most time to sit and read and be most ready for boards etc (caution flag here if you like the residents/program... tread carefully). One way to answer is, "oh, that's ABC... I read that a couple days ago in the library when [resident who couldn't answer] told me about X textbook; thanks man, I just learned it." Try to create win/win.

You can obviously display your preparation on questions fielded to all students or the whole group in academics or on rounds. Do that fairly often, but be careful guessing or be ready to answer follow-up. Some students eager to show off are easily put in their place. Be careful with pimping residents in front of attendings or their seniors (under guise of trying to learn, of course) unless they've been treating you terrible. It's usually better to pitch them softballs they can smack out of the park when the chief or attendings are around, have their supplies ready, never outshine the master, etc. Keep it conversational, minimal ego, in 1-to-1 or small group learning setups. It's a team game, even if some teammates aren't ideal or very prepared. Everyone has stressed/exhausted days. You'll figure it out.

 

[heybrother]

All activities serve a purpose, for awhile, within reason, and when well intentioned.. until they don't. Fourth year was cooler than third year but I was still ready for it to be over after a about July. 😉

 

[DexterMorganSK]

On my extrenships I’ve learned so much. I’m thankful, one of the most important things I’ve learned is how to treat fellow student when I have the privilege of teaching.

Rules to live by:
1) don’t use us as scribes to chart all day everyday
2) don’t pimp us for your amusement
3) don’t use us as retraction monkeys
4) don’t use us to room patient
5) don’t use us to remove dressings
6) don’t use us as free nail nippers

After 2 weeks of all of the above; attending need to have confidence that we get it. At some point it becomes free labor/abuse instead of learning.

We are students, we are not payed employees. We are here to learn, not work as medical assistance, scribes or nursing staff.


Maybe I’m being stuck up, but this is how I feel and how I will navigate students in the future.

I know what you are going through and felt the same way on those long-clinic days when a student job was just finishing the notes. But for now, show up on time, do what you are told, if asked a question and you do not know the answer..you better read up and find it that same day, and so on. But like everyone said here, it's part of the journey, and we all go through it.

And a little reminder to you students and where you all stand in the hierarchy:

 

[AttackNME]

Ever watched karate kid?

 

[emergentmd]

This thread is enlightening. Tomorrow, I think I will do pre rounds and do all the charting/orders. This way, they can do all the real "medical stuff" and learn what is imp.

Rules to live by:
1) don’t use us as scribes to chart all day everyday - This is 50% as your day as an attending
2) don’t pimp us for your amusement - How are they going to grade you if they can't evaluate your knowledge
3) don’t use us as retraction monkeys - You get to see surgery. Do you really expect to be slicing and dicing already
4) don’t use us to room patient - Would it be better if you waited an hr for the lowly PCT to room the pt, making everyone's day longer
5) don’t use us to remove dressings - Either you or wait an hr for the PCT. Lets all stay back an extra hr.
6) don’t use us as free nail nippers - Your a podiatrist, Nails are on the feet right?

Sorry, but sometimes you need to crawl before you walk. Know your place and leave your arrogance at the door.

 

[NatCh]

We are students, we are not payed employees. We are here to learn, not work as medical assistance, scribes or nursing staff.


Maybe I’m being stuck up, but this is how I feel and how I will navigate students in the future.

Hypothetically, let's say you're already an Attending. How would you teach your students? What would you have them do?

 

[iridocyclitiss]

Keep working hard! Good attendings and good residents notice when you are making their lives easier and from my experience they have gone out of their way to teach me/review cases with me/etc, and let me do more in the OR.

If they don't go out of their way to teach you or take your work for granted, the worst thing that happens is they remember you as a hard worker/ Just don't rank them or interview there.

Absolutely have been in your shoes and felt taken advantage of at a rotation, and the unfortunate part is the residents were in the exact same boat as me. Seeing all the wounds, ulcers, and basically observing surgeries as an R2. Keep on keeping on!

 

[Sweatshirt]

If it helps, you aren't actually free labor. You are going into the negative. You are actually PAYING your school to allow you to go work for someone for a month. You are also probably also paying for your own travel and room/board while on externships. Even better right?!

 

[NatCh]

If it helps, you aren't actually free labor. You are going into the negative. You are actually PAYING your school to allow you to go work for someone for a month. You are also probably also paying for your own travel and room/board while on externships. Even better right?!

Ouch!

 

[de Ribas]

If it helps, you aren't actually free labor. You are going into the negative. You are actually PAYING your school to allow you to go work for someone for a month. You are also probably also paying for your own travel and room/board while on externships. Even better right?!

Plus all of that is accruing interest.

 

[NatCh]

Plus all of that is accruing interest.

Salt, meet wound. Wound, this is salt.

 

[heybrother]

Salt, meet wound. Wound, this is salt.

That's my preferred wound care treatment. My NaCl rep is always dropping off lunch.

 

[PMG03470]

On my extrenships I’ve learned so much. I’m thankful, one of the most important things I’ve learned is how to treat fellow student when I have the privilege of teaching.

Rules to live by:
1) don’t use us as scribes to chart all day everyday
2) don’t pimp us for your amusement
3) don’t use us as retraction monkeys
4) don’t use us to room patient
5) don’t use us to remove dressings
6) don’t use us as free nail nippers

After 2 weeks of all of the above; attending need to have confidence that we get it. At some point it becomes free labor/abuse instead of learning.

We are students, we are not payed employees. We are here to learn, not work as medical assistance, scribes or nursing staff.


Maybe I’m being stuck up, but this is how I feel and how I will navigate students in the future.

Coming from someone who is only 1 year out of residency. We had many externs over the years. For me, a student who did these things without questions asked was someone who would be a willing and hard working intern. Those with your attitude that came in and didn’t want to help with the small stuff were very quickly crossed off our possible rank list. We didn’t necessarily have students do grunt work. But they would do things like bring a patient in the room, take dressing off etc. so when the resident came in they would start teaching and discussing the case. And pimping to a degree must be done, because guess what… even when you are a resident you get pimped by your attendings in the OR and you need to be able to handle it

It’s all a hierarchy, I HATED externing… but you suck it up for the few months you are doing it. If you are willing to help out with the little stuff and show programs your willingness you will be wanted everywhere…

 

[newfeet]

If it helps, you aren't actually free labor. You are going into the negative. You are actually PAYING your school to allow you to go work for someone for a month. You are also probably also paying for your own travel and room/board while on externships. Even better right?!

And I said thank you for the opportunity to go into negatives. 😞

 

[NatCh]

It’s all a hierarchy, I HATED externing… but you suck it up for the few months you are doing it. If you are willing to help out with the little stuff and show programs your willingness you will be wanted everywhere…

I hated a lot of it too, mostly because some of the people above me in the hierarchy were super-cocky, acting as if they were saving the planet or something. As a student, I recall one Resident proudly telling me, "This is where the rubber meets the road." In hindsight, all he was doing was debriding some fungal toenails. Jesus Hannukah Christ.

 

[OblivionDPM]

Agree with above posters. I hated this a lot too. It's something that should be a fine line. As a resident now dealing with students, I do try to ensure it's not "evil" or "without purpose".

Nothing pissed me off more than being asked really dumb pimp questions with no real context, purpose, or engagement; only meant to demoralize you and make you feel like you're stupid because you don't know the answer, like "How much fluid can a bulb syringe hold total including the bulb?".

Correct answer is not enough!!!!!!!!! Copious is COPIOUS BRO!

 

[wakaflocka88]

Agree with above posters. I hated this a lot too. It's something that should be a fine line. As a resident now dealing with students, I do try to ensure it's not "evil" or "without purpose".

Nothing pissed me off more than being asked really dumb pimp questions with no real context, purpose, or engagement; only meant to demoralize you and make you feel like you're stupid because you don't know the answer, like "How much fluid can a bulb syringe hold total including the bulb?".

Correct answer is not enough!!!!!!!!! Copious is COPIOUS BRO!

Or how about….student, what does ACE wrap stand for?

what does CAM boot stand for?

What structure did I just cut, even though you’re on the other side of the room?

What instrument should I use next out of these 10 trays?

My favorite was when senior residents whom are retracting the whole case pimping students/externs. Ya right bro. Focus on them retractors.

 

[emergentmd]

There sure are alot of students here who thinks wayyyyy to highly of themselves. Too many who think they should run before they know what crawling is.

 

[AttackNME]

There sure are alot of students here who thinks wayyyyy to highly of themselves. Too many who think they should run before they know what crawling is.

agree. Attendings have a thankless job and we don’t get paid to be slowed down in order to teach students and residents. Keep that in mind because sometimes an ounce of attitude is all it takes for an attending to not bother teaching you anything because we don’t owe it to anybody. Harsh reality of medical education

 

[Dr. Little Foot]

agree. Attendings have a thankless job and we don’t get paid to be slowed down in order to teach students and residents. Keep that in mind because sometimes an ounce of attitude is all it takes for an attending to not bother teaching you anything because we don’t owe it to anybody. Harsh reality of medical education

While I agree with everyone telling OP to humble himself and be grateful for the educational opportunities he's receiving...isn't that exactly what you get paid for? Or does all that government money go to program director/hospital admin for taking residents?

 

[AttackNME]

While I agree with everyone telling OP to humble himself and be grateful for the educational opportunities he's receiving...isn't that exactly what you get paid for? Or does all that government money go to program director/hospital admin for taking residents?

Probably only the director and admin gets a fee but I don't know if thats true, who else gets paid, or how much. The majority of hands-on training residents get are from attendings who get no payment from the residency program/funds

 

[NatCh]

While I agree with everyone telling OP to humble himself and be grateful for the educational opportunities he's receiving...isn't that exactly what you get paid for? Or does all that government money go to program director/hospital admin for taking residents?

When I had students and residents shadow me I blew all of my government money on lavish vacations, sports cars, jewelry, and cocaine. What did you guys do with yours?

 

[GreenHousePub]

Probably only the director and admin gets a fee but I don't know if thats true, who else gets paid, or how much. The majority of hands-on training residents get are from attendings who get no payment from the residency program/funds

I get a 20 dollar starbucks giftcard every year from the residency program I'm affiliated with.

 

[burritodoc]

sounds like a VA hospital?

I heard VA Tucson, VA Pheonix, Chino Valley is like that.

Hey, not sure where that rumor came from but I externed and did my residency at Chino Valley.

I wanted to provide some insight on this rotation. This is not a rotation where students are would be standing around or shadowing. The clinic is all hands on deck. 3rd and 4th year students see patients, present to a resident/attending, and do the note. It would then be edited by a resident if needed and feedback was provided to help improve the trainee. Externing students scrub in to the OR and are expected to prepare for the case, and help set up the OR. When a hard working student was put in the above scenario, it really helped the team function better and helped the residents. I saw a lot of growth from students from week 1 of their externship to week 4/5. I felt that I improved the most on this externship, and it clearly was a good fit, as I ranked it 1 and matched there. From personal experience, I hated the student rotations where I couldn't scrub in and couldn't see patients in clinic. I was so bored.

I do remember the days that it seemed like I did a lot of thankless work as a student and resident. It was so easy to get burnt out and feel frustrated. I'm sorry to those who are going through this now.

For what it's worth, I had an overall very positive experience as a resident at CVMC and ended up getting a great job after graduating. Hang in there.