Teams pull together. They’ve got your back. They work together towards a common goal. The term “team” is used very loosely in the medical world. The fact is there is no team in medicine — it’s just a term used to foster some semblance of cohesiveness within dysfunctional rotations. Don’t let them try and tell you otherwise.
Medical school rotations are typically made up of an attending, one or more residents, and one or more medical students. This is what is collectively called the “team” on ward medicine. If you look deeper you’ll soon realize that an accumulation of more than one body isn’t adequate to truly define a team.
The common goal on ward medicine is typically to care for patients. This is really where the teamwork both begins and ends. Unlike a football or basketball team, there is a lot going on behind the scenes in medicine to ensure that teamwork does not truly exist.
- Other students will go behind your back and attempt to show you up. This can include answering questions about your patients or bringing in journal articles when other students aren’t prepared.
- Some residents will not tell you where you need to be and then fault you for not being wherever it is that they (supposedly) wanted you to be.
- Attendings are malignant about “pimping” and some verbally abuse students and/or residents for not knowing the answers.
- You are overworked and very rarely will another person put in some extra effort to make sure you’re out on time.
- Attendings waste tremendous amounts of time. They’ll tell you that they want to round at 5 PM and then not show up until 6:30 PM. No phone calls are made to let the residents know that he is going to be late. You sit around for an hour and a half with your thumb up your ass.
- Nurses, who are sometimes considered part of the “team,” are incredibly slow about getting things done.
- As a student, you are made to complete meaningless extraneous tasks such as coming up with a presentation about some topic you’ll never use ever again. This time could be spent studying for your shelf exam.
- Most residents and attendings don’t care that you have an exam at the end of the rotation to study for. Instead, they’d rather you follow them around and waste 4 hours every day.
With just a few examples, you can see that there really is no teamwork in academic ward medicine. Here is what you actually have:
- The attending is getting paid a monthly bonus on top of his regular clinical (or academic) duties and salary to participate on the wards. Thus by nature of the situation his ward duties come second.
- The residents are there to please the attending and to do the daily “scut” work. They just want to make sure that everything is in order before rounds.
- The students are there because they were told to do so. At best they want to learn something useful to apply to their career. At worst they just want to pass the rotation and could care less if they remember anything 1 day after the shelf exam.
- In order to impress the attending, cut-throat measures on the part of students and residents will sometimes be employed. After all, they want good letters for that competitive fellowship or residency.
So in reality, you have three different individuals: Attending, resident, and student. Each wants something different. This in itself defeats the “team” in medicine.
Contrast this with a football or basketball team. The coach wants to win. The players want to win. They pull together to make it happen.
There is no team in medicine. What once might have been a team has transformed into a cut-throat competitive atmosphere where each participant has their own individual goals. Without well-defined universal objectives that apply to each participant as a whole, teamwork cannot and will not exist.