I’ve decided that I’m being too nice to the medical students. I let them ask me really dumb questions (like what the patient’s ins and outs were, when they should look on the vitals sheet, or what exact surgery the patient had, when they should look on the op note, or what diet the patient is on, when they should look in the orders, and medical knowledge questions that I should be asking them, not vice versa). They like it, of course, but it’s not good for them. For one thing, it gives them a false impression of what surgery is like. No one else is going to be as soft as I am, either to students or to interns. For another, it makes them unprepared to meet real trouble. One of my students, for instance, is going to join a service where I know the chief literally tortures the medical students, psychologically. He does it to the interns too, so I know, but I’ve seen him go way overboard on the students. My student is going to get cut to pieces when she meets him, because I haven’t given her any practice at standing up to tough questions, and thinking under pressure.
So after these meditations, an unfortunate medical student on a specialty service whom we had consulted on one of our patients made the mistake of asking me what was going on with the patient, since he couldn’t read the handwriting in the chart. I’m afraid I astonished my junior resident (again, after my essay in bad jokes) by becoming quite stern, and asking him if he had access to the electronic medical records, and whether he had looked the patient up in there before asking me (of course he hadn’t). Then I regretted it, and gave him a nice summary of the situation, and warned him to go find the details in the computer before trying to present to his residents.
I need to find a happy medium: being demanding enough to teach them well, without going too far the other way and being unnecessarily strict.
It’s funny. At the beginning of the year, I felt no different than the medical students, and had the greatest difficulty telling them what to do. Now, I feel ten years older than the third year students, and was astonished to discover that my ”young” students are actually older than me.
January 19, 2008 at 1:48 pm
>>I need to find a happy medium: being demanding enough to teach them well, without going too far the other way and being unnecessarily strict.<<
Nice to know that even a doctor has this problem. Teaching in an inner city high school, no different.
January 20, 2008 at 4:27 am
You might try prefacing your expectations with a short explanation of why you are stern with them. Redirect them to where they should get that particular information.
If a student expresses great interest in surgery and is not meeting expectations, attempt to explain what expectations will be. If the student is not comprehending or does not believe you, increase expectations and push them. Some people quickly understand what you are getting at, others need to struggle and experience grief to understand.
I say, always give a student opportunities to receive direction and elucidation verbally before resorting to castigation. Some will drive themselves instead of needing you to whip them. A much less civil and potentially abusive method that becomes the culture.
January 20, 2008 at 5:54 am
i always found it good to state expectations and both ways on day one. but never forget how it was for you when you were in their shoes.
January 20, 2008 at 11:47 am
dkzody – Any tips? I’m guessing your students are often less motivated and more difficult to manage than mine.
Castillonis – The students I’ve had so far are pretty cooperative and willing to do whatever they’re told. It’s really my problem for not telling them how high our expectations are, rather than theirs for not meeting something they haven’t been informed of.
Bongi – Yeah, giving some ground rules at the beginning would be good. I won’t be there the first few days with this next group of students, but I bet my seniors will do a better job than I did with that. It’s because I remember too well how it was to be them that I have this problem; I remember more how much it hurt when people were harsh, and not enough how much I learned when they pushed me.
January 20, 2008 at 7:11 pm
Oh, boy, much less motivated. Funny thing, though, many of them tell me they want to be a doctor. They hate science and have failed math. Not one to squash another’s dreams, I just tell them they have to be interested in both or they will never get to med school, much less college. You’re dealing with life and death, I’m just dealing with graduation rates.
January 22, 2008 at 6:28 pm
lol, yes, I love that kind of student. Even in college in my premed classes I had to figure out what to say when friends I knew were at the bottom of the class said they wanted to go to medical school. I tried to help, but there has to be a certain drive, and I think a certain minimum aptitude for science to start with.