Monthly Archives: January 2008

Slacker Stories and How You Can Get Away With More Than You Think

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Radiology rotations at my school were known for being extremely laid-back. With that in mind, most students at my school took a radiology elective at some point during their senior year.

Not to pass up on the good times (who really wants to be doing a SICU rotation instead of a radiology elective, anyway?), I promptly scheduled myself for a general radiology rotation about midway through my fourth year. Here was my schedule:

Day 1: Hung out with residents and got a read of just how much I could get away with.

Monday-Friday: Came into the hospital around 10:00 am, signed a paper to validate that I was present, left the hospital at 10:15 am and went back home.

Saturday-Sunday: Off.

Repeat for four weeks.

Seriously, that was my rotation.

Am I competent to read films? Nope.
Do I care? Not at all.

I had no plans to even practice medicine, much less read a damn radiology study. I thought “why not make the most of this rotation?” And that’s exactly what I did.

How You Can Get Away With More Than You Think

I was supposed to be hanging out with the radiology residents from around 8am-5pm Monday-Friday. That’s what the other students did, anyway. What most students don’t realize is that you can get away with far more than you think you can on rotations. Of course, it’s rotation-specific. For example, I couldn’t have done this on Surgery or IM. You have to just read the residents.

I saw on day one that there were quite a few students rotating with me and that the residents and attendings weren’t keeping detailed logs of attendance. The only attendance log was one that stayed up for the entire week that I signed myself. That’s an early Christmas present for you because it essentially means that nobody really knows who you are or where you’re supposed to be. This was all I really needed in order to pull the schedule out of my ass for the month.

For evaluations, I simply picked a few random residents that were on the service. They didn’t know who I was anyway, so they just filled out the evaluation and gave me pretty good comments.

My final grade on the rotation: A

The key is to simply keep your ear to the ground always looking for opportunities to exploit. Just like in business, you need to find market inefficiencies and then take advantage of those inefficiencies in order to create a profit.

Do You Have Any “Slacker” Stories?

It’d be cool to hear about any slacker stories that you guys may have while on rotations. Perhaps you “beat the system” and got a little payback for the long hours and abuse you had to put up with during your third year. If so, I’d love to hear about it.

Sexual Harassment In Medical School

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Sexual harassment on student rotations is probably something that happens more often than we think. I honestly believe it gets under-reported due to fears of a bad evaluation or getting kicked out of medical school altogether. Residents or attending physicians that make inappropriate advances or comments toward students are a vital part of a medical school’s academic program and seeing a big stink over a sexual harassment case is the last thing that the administration wants. That being said, programs and departments will go to great lengths to attempt and cover up or candy coat any sexual harassment complaints that a student may have.

As I was browsing SDN today, I came across a thread about sexual harassment during student rotations. Reading through the replies, you’ll see that feelings are mixed. Some students believe in reporting the offense immediately while others would decide to let the offense go in lieu of a poor evaluation.

Here are some examples from the thread:

The chief resident was staring at a medical students breasts, and made a ridiculous comment about them in front of the group.

A surgery attending asked if a student wanted to see his persian cucumber.

A resident created a nickname for a medical student, which happened to mean vagina in another language. He called her this in public.

An anesthesia attending touched a nurse inappropriately, but she just brushed it off.

A chief resident grabbed a medical students hands and would not let it go. He gave suggestions along the lines of she should come back with him.

See, here’s the problem. People are still scared to report inappropriate work environments, even when we’re dealing with something as serious as sexual harassment. Guys, we’re going to have to get rid of these ideas that your medical school has brainwashed you into believing if this kind of crap is ever going to stop.

I want to see sexual harassment offenders lose all practice priveleges, be terminated from the institution in which they practice, and have their medical license brought up for review by the licensing committee. If serious actions are taken, these assholes will quit thinking that they’re God and start playing nicely.

If you’re the victim of sexual harassment while on rotations as a student or resident, here’s what I think you should not do:

  • Don’t bring up any complaints to junior staff. They’ll most likely side with their superior and probably don’t want to get involved with it anyway.
  • Don’t mention the offense to the perpetrator. The offender knows that he or she is doing wrong and will blatantly deny that any offense ever took place.
  • Do not take your complaint to the Dean of Medicine, or anybody else in the administration that is linked to the practice of clinical medicine or rotations at your institution. As explained earlier, they’ll do all they can to protect the school and program. You are not in their best interest.
  • Do not wait until your grade is released to file a complaint. This could backfire on you.
  • Do not threaten the perpetrator that you will turn them in. Let them think that all is harmless.

OK, so what should you do if you’re a victim of sexual harassment on rotations?

  • Contact a lawyer for advice. Preferably get one that specializes in workplace sexual harassment abuse.
  • Contact your hospital’s legal department and risk management informing them that you have been a victim of sexual harassment. Let them know you have already talked to your lawyer, which should expedite getting your appointment scheduled.
  • Set up an appointment to talk to risk management about the incident and make sure that your lawyer accompanies you to the meeting.

In my opinion, you should bypass all clinical faculty completely. I know that administration tells you to let them know about problems such as these, but I honestly believe it’s because they want to intercept the problem before it reaches legal and/or risk management. Take it right to the source immediately.

What Are The Implications of Reporting?

Most of you might be worried about the implications of reporting an incident. I’m not going to lie and tell you that other attendings aren’t going to know that you were the one who squealed. I think you’ll find that the majority of attendings and staff are not going to show any ill-feelings towards you. You certainly will not be dismissed from school and your grades on other rotations shouldn’t suffer.

Take a lesson from the movie North Country and report the abuse. Only then will change take place.

The Falling-Down Professions – Medicine

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While once a top-of-the-top profession, medicine has been sliding down in-line with a regular old J.O.B. The mainstream media is beginning to see it, too. A recent article in the New York Times spells it out:

As of 2006, nearly 60 percent of doctors polled by the American College of Physician Executives said they had considered getting out of medicine because of low morale, and nearly 70 percent knew someone who already had.

This is hardly news for you guys that have been reading MSH for awhile. I do find it interesting that the mainsteam media — and the general public who consumes it — are now beginning to get the education that they deserve.

Physicians just don’t have what they used to have in terms of prestige. The money is still above-average, but the amount of social respect is dwindling.

In a culture that prizes risk and outsize reward — where professional heroes are college dropouts with billion-dollar Web sites — some doctors and lawyers feel they have slipped a notch in social status, drifting toward the safe-and-staid realm of dentists and accountants. It’s not just because the professions have changed, but also because the standards of what makes a prestigious career have changed.

This decline, Mr. Florida argued, is rooted in a broader shift in definitions of success, essentially, a realignment of the pillars. Especially among young people, professional status is now inextricably linked to ideas of flexibility and creativity, concepts alien to seemingly everyone but art students even a generation ago.

Patients are more savvy about their conditions, and news stories of physician FUBARs add fuel to the fire. The old-school, hardcore docs are finally retiring out of the profession and the younger kids that will be entering college and careers are reshaping the way society views the medical professional. I see a day in the near future where physicians will be reduced to technologists in the public eye, and that’s only the beginning.

Medicine just isn’t what it used to be. Will it ever recover to the olden days? I highly doubt it.

Check out the article, The Falling-Down Professions. Don’t say I didn’t tell ya so.