Before starting medical school, I worked many jobs. If something wasn’t going right on the job, not one time did I ever fake that everything was OK. Once I got to medical school, I started to pick up on many students coming to me in private expressing distaste in something that was going on in class or on rotations. These were the same people who I thought were loving every last minute of their medical school days! I admit, I was guilty of faking dissatisfaction with medical school also, especially early on.
What’s different about medical school? Why do people treat it differently than a job? In my opinion, it boils down to this:
Your teachers or attendings are directly evaluating you. While you are a paid employee on a regular job, you’re paying for school. Therefore the dynamics are much different. There is the feeling to “impress” or to otherwise “not piss off” those that are essentially behind the rest of your future. As a result, you “grin and bear” much more than you would in an ideal situation. On a regular job, it is the employers responsibility to assure that the employees are happy. The dynamic shift results in employees that demand a certain standard of treatment. If that treatment falls below a standard cut-off, employees are more vocal about the situation.
You Are Building Your Inner Workplace Dynamics
The problem with “faking it to get by” is that you are actively creating the attitudes and actions that you will use in the workplace from this day forward. The chances that you will magically change once you finish residency and get into practice are slim.
If you are a practice owner, you’re expectations for employee complaints might be much higher — something along the lines of what you’re used to now on the wards.
If you’re a member of a larger practice group, you might be less open about voicing dissatisfactions in the workplace.
Be Careful. It Might Continue Into Residency
Residency might be the first “real job” that many medical students have ever experienced. Taking the attitude to accept whatever is thrown your way — no matter how unfair it might be — with you almost guarantees that you will negatively impact your workplace dynamics for life. Being afraid to voice dissatisfaction with your employer increases your chances to become a disgruntled employee, and you’ll have to vent at some point.
Polite, But Stern
Don’t be afraid to complain when things aren’t right. You do not deserve to be whored out into Scutville on a daily basis. Your primary responsibility is to learn.
If a resident or attending asks you to complete a trivial, menial task such as getting their food or running a personal errand — outright refuse to do it and then offer an explanation as to why you won’t oblige them.
Next, have them explain their reasoning for expecting you to complete such tasks. You just might be surprised at how low you sit on the totem pole.
Hoover–
As much as I agree with you that interns and residents need to buck the system because it isn’t right, I have to tell you that it is an idea that just won’t go over well. Anyone who has made it into med school would be stupid to go against the grain. . . while they are in. That would be like telling an abused child to tell an abusive parent to fuck off. How do you deal with an abused child who can’t get out of an abusive situation? You tell them that they may get worse but to know that they can be different when they are (to interns) residents and get their own damned laundry or food, or as doctors. Get a plan of action to change it. It will happen slowly because you are changing a mindset of often long-ago-good-people who get into it and once on the other side laugh it off, “I had to pay my dues and they must pay theirs now.”
Know that one day you will be in a position to change this and react differently. There is already an asshole on the body of being a doctor. . . Dearest Interns and Residents, choose to be a brain cell or a heart valve. Do whatever you need to do to get through medical school and then when you mentor and teach, pull your moves to improve everything that you are able to.
Many doctors assume that everyone (interns, residents and patients) are stupid but themselves.
My experience both as an OB patient and a bystander to sick family members is that the shit that often doctors do to interns and residents they do to patients in other ways.
When a patient walks into a doctor’s office, their IQ drops. It starts with the nurses making friendly conversation. “I see you have– no way! Nine kids? Are you Mormon or Catholic? All from you? No step kids that you are claiming? haha” What they ask me, I would never dream of asking them. I do not owe them explanations for where my children are or what faith I practice or– this makes me mad, what I do with my kids when I am at school– they cannot fathom how my husband would watch them. Way to personal and I get asked that all the time– even when I have seen OBs who I know have delivered children for much larger families. Somehow while my large family is acknowledged, the nurses stand eighteen inches from my face and hand me the gown, shaking their heads at me when they say everything, “Take everything off. Your bra, your panties, everything.” If I look away they lean in and usually smile which does not endear me to them. No– I have these damned things and don’t know what to remove for an annual? I get that almost all the time and I feel insulted and violated. I speak clear, concise English. How can they think that I need to be told this? Bonus: delivery room nurses do the same thing AND call the patients Honey as in, “Honey, you don’t know what pain is! It’s just gonna get worse.” I had my baby very shortly after one nurse told me that and divorced my first husband a year later, partly because he sided with the nurses and I knew very well what was happening even though it was my first labor.
I had a nurse pat my bulge and tell me that I was “getting a cute little tummy.” Where the hell did she get the notion that she was allowed to do that? I have had doctors give me “lists of no-no’s.” I have been asked how I was poopin’ and peeing’– I go to the bathroom, people– ask if I am urinating and having decent dowel movements! I was raised to know that poopin’ and peein’ are curse words. Can’t they speak to patients like they are smart people? Don’t say, “Well most people are not that bright.” So be it– assume we are all smart and explain along the way.
I do yoga and help teach it at a shelter. Before I touch a client, I ask if it’s OK. If I am working on them I keep a monologue going, “OK, now I am helping you go into Triangle. Step back and face your feet toward the flag wall and hang forward as far as you can and let your arms hang as the do in Rag Doll. I’m right behind you and I am going to step [step] around to the front and put my hand on your waist and then. . .” Somehow my profession gets a new agey flaky reputation, but I am a professional. My clients know exactly what I am doing. I encourage them as I work with them, “You are doing great! Now this leg doesn’t seem like it can come up as high. Listen to your body. It’s giving you a boundary which you can honor and it will reward you by letting you go deeper into the pose. . .” Do you know how nice it would be to get feedback like this in an exam? Instead I find myself thinking of the shopping trip I promised myself for getting through another one of these, I look up and see nurses standing at bored attention like prison guards on tranquilizers and then wonder if I touched them if they’d fall over. Why do those dumb (dumb as in non speaking) hand maidens and the doctors themselves assume that I have to be told what articles of clothing to remove for my 20th annual, but don’t want to educate me and their sacred knowledge? Do I have to pay extra for that? “Now I need to examine your breasts. Exhale and relax because tense muscles can hide things. You are doing great. When I go in a circular motion, I feel more variations. When you do this at home, this is what you need to be aware of and looking for. If you find a lump or hardening mass, it probably won’t be very big– it may be as small as a grain of sand. YOUR breasts are/are not fiberous. Now on to your left breast. . .” Why isn’t the doctor or his nurse educating their patients during the exam and maybe if they are young or have never done it before, in their office afterward when the patient is clothed and showing them a fake breast with a lump so they can feel this? If a woman is too dense to figure out what articles of clothing to remove, donchy’all think she might benefit from some education about like umm, what she’s there for?
I am trying to get doctors to ask patients more and so far I have succeeded only in making them look at me like I’m a freak. Why do OB/GYNs ask if we smoke or drink, but not if our partners or we are engaged in extra-relationship affairs and that as OB/GYN’s, they should care about this and keep an eye out for creepy crawlies and whatever is going around if a woman is possibly high risk? I know someone who is involved with a man who has a great deal of power over her and she can’t get out of what he wants her to give him. She told her nice little Christian OB/GYN about this and he would find a very lame excuse to drop her, citing values differences and boundaries because she was flipping out and trying to make light of her situation when she told him and his nurse. She now entertains her new GYN any time she has abnormal discharge asking if she could have caught an STD from a toilet seat. (A pimple on her thigh sent her into orbit and she feared herpes or something that the guy could have caught from his hunting trips in Africa.) She’s a highly intelligent lady, but vulnerable and she can’t tell the person who is taking care of her what he needs to know to take the best possible care of her! It took her a very long time to tell the other doctor what was going on. I went to see the same guy because I needed a doctor closer to where I live– he’s a sweetheart but I told him that my husband was fooling around to test the waters and he handed me a copy of Dr. Laura’s Feeding and Proper Care of Husbands– he has several that he gives to women whose marriages are in crises. He asked me about the women I thought he was with and determined that my risk was low and affered to hold my hand and pray with me! Sheesh! (My husband is not fooling around on me. If he was, well, his little dumplin’ could have him and we could trade custody of our nine children every other week! I’d get a break!) The dear GYN gave me chocolate as I left his office so I know that he has a great understanding of women, but I’m glad that my girlfriend didn’t tell him what she has been subjected to in the past few years because he probably wouldn’t understand, even though he truly has great intentions. (He’s really religious but I do adore him.) Worse for her, nurses in many offices (screw HPPA) gossip worse than housewives . I know several wives of politicians up here who see GYNs in Another City for routine care because of what their husbands are up to and divorce isn’t an option or convenient. (Where I live, it’s like living in a terrarium.) It is painful knowing what this lady is going through, but how many others can’t admit things of this nature, Hoover? She really has no protection, she is not safe, and until something passes in her life, she has to deal with him. Do you think that OB/GYNs should be asking after high risk behaviors on the parts of the patient and her partner-s? Before I work with any of my clients anywhere, I ask about abuse issues or how I can avoid touching them in ways that make them feel creepy. Some people hate my constant complimenting and I back off. I have NEVER had a doctor or midwife ask this.
If doctors have issues with patients being stupid and not taking care of themselves, maybe the patients aren’t listening to the doctors. Has anyone reading this ever had a teacher who commanded respect? I’ve had several. They addressed us all and Miss or Mister and enjoyed the English language and transfixed even the stoners. Silence fell when they walked into school auditoriums. You would sit up straight and you liked to turn in good work. They wore invisible diadems and everyone respected them. I know a shop owner who is like this as well and trashy kids walk in to her boutique and respectable people walk out. She has The Presence. If a doctor had this presence he would have patients quiting smoking, loosing weight, no problem because a smile or a nod from them would mean they had pleased their mentor even from afar without him or her knowing it.
I asked tranquilized prison guard I mean nurse once why she go into nursing, expecting something sweet to allow me to like her. She said she got into it because she wanted to have a job where she got paid well for working just a few days a week. I did have a very great doctor who participated in working with interns. One of the times I went into labor with him as my OB, I arrived not knowing if I was in labor. (I am a ballet dancer. We perform on broken toes if we must. Pain is irrelevant.) I told the doctor to let the intern check me out and almost had my baby in his office. His nurse said that she became a nurse because she wanted to help provide the best possible care to people while working under the best doctors in the state. The intern wanted to work for that doctor when he graduated. That doctor would tell me lots of things about what was going on with the pregnancies and why I was making more (sorry) discharge or feeling upset or why I needed to cry and what was in my tears– those tears were ridding my body of bad toxins.
The cornerstone to medicine is treatment, not prevention or education and I don’t know how feasible it is to change this. “They” say a lot about how many Americans lack decent insurance but never say how many Americans with insurance avoid the doctor because they don’t want to deal with the hassles and insulting manner that many treat the patients with.
Patients have to fake that they are happy with doctors as well as interns and residents faking happiness with the medical education system. There are more patients who need help than doctors willing to treat back talking patients and only so much insurance money.
I’m sad that you aren’t practicing, Hoover. I think that I recall you saying that part of why you wanted to go to med school was for the money. Forget the Christian ethics– you are there to do a job and earn your $400,000+. Wouldn’t this mean that you’d do your job and EARN your salary and not aspire to sainthood and therefor the fallen world that we live in wouldn’t affect you as badly? A man who doesn’t wear rose tinted glasses can see the way more clearly and guide his patients. I have learned form your blog that we expect doctors to be as powerful as God with the disposition of saints, and that isn’t how it is– they go home to normal lives like anyone else, have the lawnmower die, fight with their mother in law, whatever. I hope others will be open to your vision when you write your book.
I think you owe him 130 for a therapy session.
shut the fuck up verbose bitch
ArghhH! It made sense in the beginning but then it seems like whatever drug you are on started to take effect and you became less and less comprehensible.
Thanks for giving me a headache.
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I like how a touching and intelligent response is posted here by K, and all the medschoolhell readers can conjure up are wimpy, pathetic responses. This page says a lot about the intelligence of the typical medschoolhell proponent.
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