Hey guys, currently I am an internal medicine intern at a fairly prestigious academic program. recently I received a sub-average score on my outpatient clinic evaluation and therefore made me develop some unwanted worries and thoughts about my future. I don't know about you guys, but we use a 5 point system, where 3 is average, 2 is below average, and 1 is requiring urgent intervention. I haven't received much feedback at all from any of my attending and/or my residents, but the few I have received have been pretty positive. The outpatient evaluation rated my performance as 2/5, commenting my presentation can be disorganized and my clinical decisions are still in development. This really messed with my self-esteem and confidence, only making me more paranoid and anxious during presentation. Any advise on how I should go about this? and how common is to receive such "bad" evaluation during residency? Thanks for the input.
sub-average scores on mid-term evaluation
- Thread starter Uhl88
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Are you not getting feedback at the end of each block? Why are you just hearing about this now?
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It's feedback. If you get *consistently* bad feedback, that may be cause for concern, but this? This is nothing. Hell, if your attendings are grading the way the scale was intended, half of your class is receiving "below average" feedback. Also, you're not a medical student anymore, and are not getting grades, so just take the feedback for what it is: advice on how you can improve.
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That said...while you're not necessarily being 'graded' as you were when you were a medical student, your performance still matters and will be closely followed by your program's leadership . When it comes time to write rec letters etc down the road (assuming you want a fellowship), evals will be scrutinized closely and a pattern of poor evals likely = a lukewarm letter. Furthermore, there seems to be substantial grade inflation out there and most attendings are not grading as they should be (i.e., early interns sometimes get '5s' which is supposed to correspond to 'ready for unlimited practice' etc).
If this is an isolated thing, it may not be a big deal (everyone gets a lousy/lukewarm/whatever eval every now and then, especially if personalities don't mesh or you run into an evaluator who is just a hardass), but a trend of subpar evals will raise eyebrows.
If this is an isolated thing, it may not be a big deal (everyone gets a lousy/lukewarm/whatever eval every now and then, especially if personalities don't mesh or you run into an evaluator who is just a hardass), but a trend of subpar evals will raise eyebrows.
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So the above posters are giving very reasonable advice. I'd add on to that advice with a suggestion that you work on improving the areas you were criticized about. In general, it's failing to do that which creates the downhill snowball that leads to termination. You'd be surprised how much impact the ability to take notes on your performance has on your career's success.
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Talk to the faculty and see how you can improve. Get recommendations.
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I'm usually the first to jump on with doom and gloom, so I hope the fact that even I, the most paranoid, am going to tell you to stay chill it'll be OK, that it can reassure you. I'm the first one to tell you call a lawyer, and your situation doesn't have me puckered yet in the slightest.
Truly, the most important thing you can do is try to keep a lid on your anxiety, cuz as you said that probably does the most to your performance.
Believe me, I know the vicious cycle that is criticism --> nervous --> worse performance round and round.
All of the above posters offered solid advice, from "don't worry too much" to "but don't blow it off."
Definitely ask what your attendings want from your presentation right off the bat. Also, clinical decision making in clinic is something a lot of IM interns struggle with (this according to my clinic preceptor). Med school is better at teaching you inpt management of hyponatremia than what to do for chronic low back pain (or the other musculoskeletal medicine that makes up like 50% of outpt medicine) IMHO. Start reading AAFP or pop into the FM forum for ideas on resources to help you in clinic.
Let us know how you do, will ya? Take care.
Truly, the most important thing you can do is try to keep a lid on your anxiety, cuz as you said that probably does the most to your performance.
Believe me, I know the vicious cycle that is criticism --> nervous --> worse performance round and round.
All of the above posters offered solid advice, from "don't worry too much" to "but don't blow it off."
Definitely ask what your attendings want from your presentation right off the bat. Also, clinical decision making in clinic is something a lot of IM interns struggle with (this according to my clinic preceptor). Med school is better at teaching you inpt management of hyponatremia than what to do for chronic low back pain (or the other musculoskeletal medicine that makes up like 50% of outpt medicine) IMHO. Start reading AAFP or pop into the FM forum for ideas on resources to help you in clinic.
Let us know how you do, will ya? Take care.
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One or two here and there are fine and expected.....we all are not perfect and can learn. Plus some like you and what you do and some don't.
But, a constant supply of negative evals would show a trend......and well we all know what that means.
So, take it, learn from it, and move on.
But, a constant supply of negative evals would show a trend......and well we all know what that means.
So, take it, learn from it, and move on.
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