In my initial post about pimping I discussed it in a general sense. But, you see, there are many, many types to be encountered during medical school. Some are bad, and on the other hand, some are really bad. This list is by no means exhaustive, but kind of a “pimping sampler” of some of the varieties you can expect while in Hell.

1. Open group question: Not a type of pimping, but here for comparison. An attending/professor asks a group a question like, “Where do you find stratified squamous epithelium in the urethra?” He then opens it up to the entire group. This is fair because you’re not put on the spot, and the gunners who study 12 hours a day and read Harrison’s for pleasure will immediately jump in with the answer so they can “shine.”

2. Rhetorical pimping: Pimpus interruptus. You’re asked a pimp question, and immediately you start to sweat about the answer. A pause…then…voila! The attending answers it. Hopefully if the subject matter REALLY blows then the attending will ask a line of rhetorical questions and then answer them all himself. This is the lightest type of pimping and barely qualifies as such. Consider yourself damn lucky.

3. One-on-one pimping: A fair type of pimping if there is one because you’re in medical school to ostensibly learn something, and the only embarrassment you risk is between you and the question asker. “Which type of hemorrhoids hurt, and why?” If you don’t remember, you risk looking like a dolt (if you actually care) but not in front of a large group of people. If he poses more questions and you get them wrong, the attending may take mercy on you and transition into rhetorical pimping. Then you can surreptitiously wipe your brow and breathe a sigh of relief. Although, you might have blown your evaluation and grade (again, if you actually care).

4. OR pimping: This can be the most brutal because there’s really no escape possible. This type of pimping can be rapid fire and malignant. So you’re scrubbed up for a case and in the OR. The patient is most likely opened up and the surgeon is digging around, relishing in his God-like abilities to cut through flesh with a knife, push a small camera through holes, and sew simple patterns repetitively. It’s you, the surgeon, the resident, and the scrub tech. The surgeon feels obligated to pimp you, possibly for a few reasons: 1) he’s a bastard and enjoys making students sweat while inflating his ego, 2) he feels that his job requires him to, or 3) he genuinely wants you to learn. The last one can be a rarity. Non-stop questions concerning esoteric surgical anatomy (and surgical history) can often be the scenario. All this while your hands are numb due to clutching the bastard’s damn retractors for too long. Plus, you’re doing him a favor by laughing at his stupid ass non-funny jokes. Once in a while you’ll come upon a rare surgeon who will teach you and not expect you to know everything about surgery in a few f’ing weeks. (Of course, it helps if you give a rat’s ass about surgery.)

5. Around-the-table pimping: Uh oh, you’re in close quarters with a group of fellow students and usually one attending. The attending decides to be a damn game show host: “Let’s go around the table and each of you tell a cause of pancreatitis.” In a perfect world, you’d like to say, “Screw off, I’m here for a lecture. Lecture me.” But you don’t want to be kicked out. Anyway, this may allow you to feel stupid to the greatest degree, especially because your fellow students are there to snicker and giggle because you’re at the end of the line and forgot “spider bite” as a cause of pancreatitis (actually, no one forgets that cause).

6. Rounds pimping: Perhaps the most prevalent type of pimping. This goes on when you make rounds in the hospital every day. Both “sit down rounds” (patients discussed in a meeting room) and “stand up rounds” (patients discussed in/outside of patients’ rooms) can encompass lots of pimping. Your only hope is that there are lots of patients to be seen so there’s no time for the team to have some laughs at the expense of the poor medical student. Of course, that also means you might have to pick up more nasty, smelly patients. Hmm…quite a quandary.

7. Classroom random pimping: I envision law school having lots of this going on. The professor/attending randomly calls students out to answer questions. Especially if you have a big med school class, the odds are in your favor, so you may get out of it. If the odds fail you, and you’re not paying attention to the lecturer, prepare to look stupid because you don’t know the detailed pathogenesis of Idiopathic Thrombocytopenic Purpura!

8. Fellow student pimping: Sometimes your fellow med students will pimp you. These dickwads have no real seniority over you, even if you’re a 3rd year and they’re a 4th. Interns barely know more than you, much less 4th years. But 3rd year to 3rd year pimping is the lowest of the low. Feel free to smack them, drop-kick them, or use the sharp end of your reflex hammer (or some metal point used for neurological testing) to show them how offended you are. Many medical students, in fact, feel that pimping by interns is completely out of bounds as well. Senior/chief residents and attendings only. Only people with an actual knowledge base get to push up their egos by pushing down yours.

9. Nurse pimping: Nothing against nurses. I usually like them better than many or all of the residents and attendings. But they shouldn’t be pimping medical students. Nurses must see attendings do it and figure they will help contribute to the “learning process.” Or maybe they’re sad they didn’t go to medical school (although they don’t know the Hell they’d be experiencing). Good grief.

10. Resident pimping: I’m your “friend”, but I will nevertheless exercise my supposed authority over you. Don’t forget my burgeoning God complex! Depending on who grades you, you might be able to laugh at him and say that you have no idea. However, you risk bad comments getting back to the attending, especially if the pimper is the chief resident. To be fair, I have noticed that residents will often pimp in a more palatable fashion, so it’s not as bad as when an attending with 50 years of experience thinks you should know the detailed treatment methodologies for some esoteric disease buried in Harrison’s.

To all attendings: you were peon medical students once too. If you’ve seen My Name Is Earl, you know that karma is real. Don’t be jerks just because you can.