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.