DAE think med students need to grow thicker skin?

[xALIAx]

I overhear people in the lounge talking about how "an attending chewed them out", or a "resident yelled at them". When I know for a fact that they simply received a stern comment, or were asked to explain their reasoning for a wrong pimp answer (since I was there). Also, med students pore over the subjective evals as if they are intelligence analysts inspecting satellite film of Soviet Union military bases and then will complain to the dean about any comment that is either neutral or (gasp!) negative.

Just makes me shake my head.

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[xALIAx]

I actually liked the hierarchy and culture of med students being perpetually wrong on surgery. Maybe that is why competitive surgical subspecialties like former athletes - these guys just "get it". Attendings aren't always being harsh because they have personality disorders... I still remember how much I learned in just 1 week with a harsh attending compared to 12 weeks with surfer bro dude weed types

 

[differentiating]

I actually liked the hierarchy and culture of med students being perpetually wrong on surgery. Maybe that is why competitive surgical subspecialties like former athletes - these guys just "get it". Attendings aren't always being harsh because they have personality disorders... I still remember how much I learned in just 1 week with a harsh attending compared to 12 weeks with surfer bro dude weed types

This is probably a difference in learning styles, honestly. Pimping may work for you, but I'm sure you have some classmates who felt the exact opposite and learned more from the attendings who taught students. I'm definitely of the latter opinion myself.

 

[ciestar]

Oh yes, nothing better than being embarrassed in front of your peers and other people.

 

[xALIAx]

Why do you feel embarassed when you get pimp questions wrong? A student is not supposed to be right all the time. When I get pimped I enjoy throwing out the dumbest possible answer out there and seeing the attending blink out of shock, and I have still honored rotations, all because I understand the role of a medical student.

 

[ciestar]

Why do you feel embarassed when you get pimp questions wrong? A student is not supposed to be right all the time. When I get pimped I enjoy throwing out the dumbest possible answer out there and seeing the attending blink out of shock, and I have still honored rotations, all because I understand the role of a medical student.

No, not when I get a question wrong, but condescending marks after asking they teach this in med school anymore or if they mock your intelligence. Getting it wrong and being told to look it up is fine, I don’t care about that, but some go way too far.

 

[xALIAx]

I hope this thread helps some lurker reading this understand that you do not have to identify your self worth on your pimping answers. As far as the majority of SDN users, they are without hope.

 

[puahate]

Probably depends on who you are and who you grew up with.

I know when I was young and learning stuff my parents would get mad at me for not knowing the right answer as if i was trying to look stupid. (I wasn't)

I was also bullied in middle school, rejected by multiple girls due to my height, sucked at wrestling ect.

I am used to criticism and people talking s*** to me. Right now when i get criticism I don't really care or flinch, i just incorporate the constructive info and anything negative is usually a repeat of what I have heard before throughout life. (Short, ugly, weirdo, ect)

There are only so many new insults you come across.

 

[LebronManning]

Lol I think this is why indians and other asians do so well in medicine. We've been getting pimped by our parents since 6 years old. Started with the times tables

 

[xALIAx]

Probably depends on who you are and who you grew up with.

I know when I was young and learning stuff my parents would get mad at me for not knowing the right answer as if i was trying to look stupid. (I wasn't)

I was also bullied in middle school, rejected by multiple girls due to my height, sucked at wrestling ect.

I am used to criticism and people talking s*** to me. Right now when i get criticism I don't really care or flinch, i just incorporate the constructive info and anything negative is usually a repeat of what I have heard before throughout life. (Short, ugly, weirdo, ect)

There's only so much new insults you come across.

Exactly.I think this is why people who are resilient, whether through emotional abuse (sorry you went through it) or greek life or athletics tend to do well on clerkships. Meanwhile I heard of a med student getting into an argument with a scrub tech about whether he had to wet scrub or not.. Like, dude... Just do it!!

 

[puahate]

Lol I think this is why indians and other asians do so well in medicine. We've been getting pimped by our parents since 6 years old. Started with the times tables

My parents would legit get mad if I could not get a question right in the times table. Lol it forced me to get it right.

 

[puahate]

Meanwhile I heard of a med student getting into an argument with a scrub tech about whether he had to wet scrub or not.. Like, dude... Just do it!!

Yeah man. I know people like that. At the end of the day, you need to look at the bigger picture. Who cares what the scrub tech or the nurse or anyone else thinks. Just smile, do your best and realize all of this is temporary.

 

[ciestar]

Lol I think this is why indians and other asians do so well in medicine. We've been getting pimped by our parents since 6 years old. Started with the times tables

Maybe I am just more sensitive. I just don’t appreciate being called out on something that could be said in private. My childhood plays a role in how i process emotion, though. Im not asian, but I still could never live up the standards of my father.

 

[enalli]

Exactly.I think this is why people who are resilient, whether through emotional abuse (sorry you went through it) or greek life or athletics tend to do well on clerkships.

Being able to deal with insulting attendings is certainly a helpful trait to have, but that doesn't excuse rude behavior.

 

[LebronManning]

Maybe I am just more sensitive. I just don’t appreciate being called out on something that could be said in private. My childhood plays a role in how i process emotion, though. Im not asian, but I still could never live up the standards of my father.

I think you just gotta understand it’s not personal at all even if the words sound like they might be. It’s a culture caused by the demand for excellence. And honestly it’s the only way to do it. When everyone’s nice and being wrong is ok, more people are wrong.

There’s more leeway in places like FM or Psych and so that’s why attendings are so much nicer and lack of pimping. But there’s no leeway in the MICU or OR or Cath lab and I think that’s why attendings there have to be harsh in your evaluation. You either cut it or you don’t.

 

[Nurse2MD2018]

It’s not always a matter of sensitivity. Standing on the other side as a nurse I witness some vile behavior from attendings, fellows, residents, hell even nurses towards each other and med students. No point in perpetuating behaviors that don’t really create a productive learning and work environment. The best teachers don’t need to rely on humiliation and verbal abuse to get their point across.

 

[ciestar]

I think you just gotta understand it’s not personal at all even if the words sound like they might be. It’s a culture caused by the demand for excellence. And honestly it’s the only way to do it. When everyone’s nice and being wrong is ok, more people are wrong.

There’s more leeway in places like FM or Psych and so that’s why attendings are so much nicer and lack of pimping. But there’s no leeway in the MICU or OR or Cath lab and I think that’s why attendings there have to be harsh in your evaluation. You either cut it or you don’t.

No calling a student stupid in front of other people certainly is personal and there is no excuse for it.

I wasn’t talking about pimping or any of the constructive stuff. We make mistakes and need to learn from them. I am not that sensitive.

 

[Newyawk]

I always enjoy getting pimped, as long as the attending/resident is doing it with the intent to teach me and not embarrass me. Pimping is a great way to show you know stuff and if you dont, youre willing to learn and ask good questions. I had one resident pimp me incessantly for weeks, most of which i knew, but he seemed disappointed when i got multiple questions right in a row. It was obvious his goal wasnt to teach me, but to flex his own knowledge. Not surprisingly, when giving me feedback he claimed my knowledge was subpar (who even says that?) despite the fact that i got almost all of his Qs right.

 

[Neopolymath]

Med students absolutely need to grow thicker skin but so do a lot of people. If you sit in a staff OR lounge for 15 minutes you will hear people talk about "Dr. So and So just roasted whoever" and go on and on. Rewind 20 minutes ago when you were in the OR and the doc just told someone not to do something a particular way using a tone that ensured that the message got across. This happens a lot in life. Often times a particularly demanding doc from preclinical would say any criticism or challenge a student and you would hear about it later like he was so harsh and mean. Pretty much every time the student said something ******ed. Some people, particularly surgeons, demand students strive for perfection and push them to the next level. Somehow this gets grouped with people doing truly egregious things like throwing ****.

It's definitely a personality thing though. I am in a sport/hobby that has a lot of yelling to convey urgency and safety/coordination so when someone speaks loudly and directly I don't assume they are a prick. I also enjoy the people who say they are disappointed or that I suck though too. It's a fun challenge to deal with tough people. Makes me smile which can be misinterpreted.

 

[Neopolymath]

I always enjoy getting pimped, as long as the attending/resident is doing it with the intent to teach me and not embarrass me. Pimping is a great way to show you know stuff and if you dont, youre willing to learn and ask good questions. I had one resident pimp me incessantly for weeks, most of which i knew, but he seemed disappointed when i got multiple questions right in a row. It was obvious his goal wasnt to teach me, but to flex his own knowledge. Not surprisingly, when giving me feedback he claimed my knowledge was subpar (who even says that?) despite the fact that i got almost all of his Qs right.

Right, the challenge is really enjoyable and if you win as a student you shouldn't get punished but that's how some losers are in life.

 

[Goro]

I overhear people in the lounge talking about how "an attending chewed them out", or a "resident yelled at them". When I know for a fact that they simply received a stern comment, or were asked to explain their reasoning for a wrong pimp answer (since I was there). Also, med students pore over the subjective evals as if they are intelligence analysts inspecting satellite film of Soviet Union military bases and then will complain to the dean about any comment that is either neutral or (gasp!) negative.

Just makes me shake my head.

Gawd, I have students who are so thin skinned that light passes right through them.

We do adult learners no favors by wrapping them in cocoons and prolonging their childhoods. Life is filled with unpleasantness, and getting offended doesn't help.

As exhibit A, look up the thread posted by someone complaining about how we SDNers use the term "Rosy Franklin" as shorthand for the Chicago Medical School.

 

[deleted480308]

DAE?

 

[Nurse2MD2018]

DAE?

“Does anyone else “ was my assumption.

 

[SurfingDoctor]

I don’t know what the right solution is but telling all the students they are just the greatest think sliced bread isn’t particularly useful. But people like being lied to instead of being told something constructive. It's human nature and not possible to rectify.

 

[Gilakend]

Wow, I never thought about how the competitive surgical specialties seem to like former athletes. Makes a lot of sense tbh.

 

[Mass Effect]

I don’t know what the right solution is but telling all the students they are just the greatest think sliced bread isn’t particularly useful.

It's called a happy medium. There is a huge difference between constructive criticism and bullying/cruelty/abuse, the latter of which is rampant in medicine. Most other industries have figured out how to train those in junior roles without resorting to such tactics. I suggest medicine give it a go too.

 

[SurfingDoctor]

It's called a happy medium. There is a huge difference between constructive criticism and bullying/cruelty/abuse, the latter of which is rampant in medicine. Most other industries have figured out how to train those in junior roles without resorting to such tactics. I suggest medicine give it a go too.

I’m not going to pretend that medicine is like other industries... mainly because students are paying to be there. They are customers and the customer is always right. That leaves no room for any type of constructive criticism.

Even residency and fellowship aren’t the same as the general business world of employment at will. Trainees also can receive constructive criticism and retaliate for things they don’t like. I’ve seen it happen a couple of times.

Dancing on eggshells is the only thing I’ve seen that is the least headache inducing for everyone...

 

[Mass Effect]

I’m not going to pretend that medicine is like other industries... mainly because students are paying to be there. They are customers and the customer is always right. That leaves no room for any type of constructive criticism

Then how is it that it leaves room for abuse?

Even residency and fellowship aren’t the same as the general business world of employment at will. Trainees also can receive constructive criticism and retaliate for things they don’t like. I’ve seen it happen a couple of times.

Dancing on eggshells is the only thing I’ve seen that is the least headache inducing for everyone...

People who teach need to feel comfortable giving constructive criticism, even when met with anger by those receiving it. As long as it's done in a professional way, I don't see how they can retaliate in any meaningful way.

 

[mistafab]

The thin skin is just a side effect of their upbringing. Pity the fools rather than loathe them.

 

[SurfingDoctor]

Then how is it that it leaves room for abuse?

People who teach need to feel comfortable giving constructive criticism, even when met with anger by those receiving it. As long as it's done in a professional way, I don't see how they can retaliate in any meaningful way.

Old people, tenure, some people are just d--ks, but it isn't the big problem that the internet will lead to believe. The reality is that some people are just mean and on the other hand, some trainees just aren't very good. The problem becomes that when I want to just do my job of taking care of patients and doing my research, but me offering constructive feedback is perceived is being mean... my solution is to... stop offering feedback. Problem solved for me. Kinda crappy for the other person, but if their peers leave a bad taste in the mouth so to speak, I'm not interested in engaging and making any trouble for myself. I wish people could delineate between the two of someone offering constructive feedback and someone intentionally being mean... but I haven't seen it.

As for your second comment, maybe, but not really. I've seen trainees report feedback as being attacked. They report it to the ACGME (which they have to do every year as part of program evaluations), the program gets reviewed via their anonymous report, everyone gets extra "sensitivity training" and the program has to demonstrate compliance and improvement. In return, everyone dances around eggshells, does everything and anything to get them to graduate the program and once they do... they never speak of them again. The fact that you haven't seen it just means you haven't been around long enough to experience it. In fact there's two whole ACGME mechanisms dedicated to it:
Office of the Ombudsperson and Office of Complaints
Of course, some of the reporting may be warranted, but I also guarantee you the mechanism can also be used for retaliation for whatever.

As I said before, I haven't seen a good solution to the basis human fact that most people (including people in medicine) want to be told that they are the greatest thing since sliced bread. So far, the best solution I've found is saying "sure, whatever". That being said, there are some people who actually want honest feedback and they usually seek it out and seek it out over time. Those numbers are few though.

 

[Goro]

The thin skin is just a side effect of their upbringing. Pity the fools rather than loathe them.

You haven't had to teach them.

 

[AsianPersuasion]

I have to say, the toughest attendings I've ever had were peds. Not sure if it's because it's kiddies and their family but they were the roughest on me. Second was IM, but the least was surprisingly surgery. Surgery just felt right and the attendings were all glad to teach.

 

[Newyawk]

I have to say, the toughest attendings I've ever had were peds. Not sure if it's because it's kiddies and their family but they were the roughest on me. Second was IM, but the least was surprisingly surgery. Surgery just felt right and the attendings were all glad to teach.

We get it, you love vascular.

 

[AsianPersuasion]

We get it, you love vascular.

Good. Cause it's a bombass field. And I'll continue to shove it down everyone's throat.

 

[puahate]

I have to say, the toughest attendings I've ever had were peds. Not sure if it's because it's kiddies and their family but they were the roughest on me. Second was IM, but the least was surprisingly surgery. Surgery just felt right and the attendings were all glad to teach.

The first two findings are not surprising.

 

[Nurse2MD2018]

I have to say, the toughest attendings I've ever had were peds. Not sure if it's because it's kiddies and their family but they were the roughest on me. Second was IM, but the least was surprisingly surgery. Surgery just felt right and the attendings were all glad to teach.

I’m still trying to figure out what is it about the Peds subspecalities that attracts all the crazies... Some of the personalities I’ve witnessed in Peds make surgeons look like saints.

 

[evilbooyaa]

People's definitions of pimping are different.

I propose two categories of pimping:
Benign pimping - Being asked progressively tougher questions (as long as you continue to get them right) in regards to a topic. When the pimpee gets a question incorrect, he/she is told to "look it up for next time" (or some other blunt variation, with any praise to the pimpee being optional) by the pimper, and the situation (surgery, rounds, clinic, whatever) moves forward. This, ideally, results in the pimpee feeling some sense of pride in being able to verbally fend off the pimper for a brief amount of time, and sparks an interest in reading further about the topic at hand, with the pimpee remembering the golden rule of pimping: "You are allowed to get a question wrong once, and only once, to be the best [member of pimpee group]". Pimpees that are sensitive can still consider this to be embarassing or shameful to them, resulting in clinical rotation, residency programs, and ACGME complaints, where benign pimping is occuring, but the pimpee feels that it is malignant (as defined below), hence referred to as "pseudomalignant pimping"

Malignant pimping - Being asked an esoteric or outrageously out of scope question for the level of training of the pimpee, then when that question is missed, respond with "gah [members of the pimpee group] don't learn anything nowadays" in public and (optionally) a personal insult to the pimpee by the pimper in regards to appearance, intelligence, or personality, resulting in shame and embarassment in the pimpee. Most will agree that this is not effective practice. Some who consider pimping in a negative light may have experienced true malignant pimping. However, many will only have experienced pseudomalignant pimping.

 

[afib123]

Teaching is 1000x better than pimping. Teaching once then pimping is what it should be. Of course, if you pimp and then if the student doesn't know it, you teach that's OK. But asking stupid pimp questions that the student will never care once they are out of the particular service is worthless.

When I am an attending and resident, my primarily goal will be teach students what they need to know about that field regardless of whatever field they go into as a good physician. It will be on overarching disease presentations, treatment, etc. Not on some random artery in the OR or other random stupid facts

 

[Goro]

People's definitions of pimping are different.

I propose two categories of pimping:
Benign pimping - Being asked progressively tougher questions (as long as you continue to get them right) in regards to a topic. When the pimpee gets a question incorrect, he/she is told to "look it up for next time" (or some other blunt variation, with any praise to the pimpee being optional) by the pimper, and the situation (surgery, rounds, clinic, whatever) moves forward. This, ideally, results in the pimpee feeling some sense of pride in being able to verbally fend off the pimper for a brief amount of time, and sparks an interest in reading further about the topic at hand, with the pimpee remembering the golden rule of pimping: "You are allowed to get a question wrong once, and only once, to be the best [member of pimpee group]". Pimpees that are sensitive can still consider this to be embarassing or shameful to them, resulting in clinical rotation, residency programs, and ACGME complaints, where benign pimping is occuring, but the pimpee feels that it is malignant (as defined below), hence referred to as "pseudomalignant pimping"

The problem is that too many of the current generation of medical students feel that any pimping is malignant.

 

[SurfingDoctor]

I’m still trying to figure out what is it about the Peds subspecalities that attracts all the crazies... Some of the personalities I’ve witnessed in Peds make surgeons look like saints.

Even my psychiatrist can’t figure it out...

 

[ndafife]

I’m still trying to figure out what is it about the Peds subspecalities that attracts all the crazies... Some of the personalities I’ve witnessed in Peds make surgeons look like saints.

I think its that they spend extra years in training to make less than they would as a General Pediatrician on average

 

[SurfingDoctor]

The problem is that too many of the current generation of medical students feel that any pimping is malignant.

It all depends on the reason for asking and the delivery.

Do you need to be tested for esoteric stuff just for the sake of it? No.
Do you need to at least show that you’ve put any resemblance of a reasonable thought into why you would consider treatment “X” or plan “Y”? Yes.

 

[Goro]

It all depends on the reason for asking and the delivery.

Do you need to be tested for esoteric stuff just for the sake of it? No.
Do you need to at least show that you’ve put any resemblance of a reasonable thought into why you would consider treatment “X” or plan “Y”? Yes.

Nothing wrong with asking something like "what are some of the causes of renal failure?"

 

[SurfingDoctor]

Nothing wrong with asking something like "what are some of the causes of renal failure?"

Or the indications for dialysis. I don’t need all of them, or the studies that go into the guidelines... just come up with answer that shows you know something about the disease.

 

[AsianPersuasion]

A peds attending ripped me a new one when asked about Hurler syndrome and I couldn't think of gargoylism so i said "troll-like" features and she took it as if I was insulting those with Hurler's...she went ape **** on me.

 

[xALIAx]

A peds attending ripped me a new one when asked about Hurler syndrome and I couldn't think of gargoylism so i said "troll-like" features and she took it as if I was insulting those with Hurler's...she went ape **** on me.

you really cant speak like that as a doctor.

 

[VA Hopeful Dr]

Teaching is 1000x better than pimping. Teaching once then pimping is what it should be. Of course, if you pimp and then if the student doesn't know it, you teach that's OK. But asking stupid pimp questions that the student will never care once they are out of the particular service is worthless.

When I am an attending and resident, my primarily goal will be teach students what they need to know about that field regardless of whatever field they go into as a good physician. It will be on overarching disease presentations, treatment, etc. Not on some random artery in the OR or other random stupid facts

That's a good thought, and I truly hope you do things that way.

But very few people think to themselves: "man, I can't wait to be a ****ty teaching attending and really make those medical students feel like idiots".

Teaching well actually is kinda tough, especially on top of an already fairly stressful job.

 

[SurfingDoctor]

A peds attending ripped me a new one when asked about Hurler syndrome and I couldn't think of gargoylism so i said "troll-like" features and she took it as if I was insulting those with Hurler's...she went ape **** on me.

I mean, it’s not really hard to remember “coarse facial features” instead of “troll-like” but if want to fall on your own sword... no one should stop you.

 

[Isoval]

I was chewed out the other day for something we've never been taught. Not that I'm upset about it, but I admit I was caught very off-guard.

He treated me like an idiot for about five minutes then walked off. I can assure you we only learned that x receptor exists and not its density distribution on the skin...

 

[SurfingDoctor]

I was chewed out the other day for something we've never been taught. Not that I'm upset about it, but I admit I was caught very off-guard.

He treated me like an idiot for about five minutes then walked off. I can assure you we only learned that x receptor exists and not its density distribution on the skin...

Next time say "CRISPR"