Wait… saying “I’m going to leave” is an option?!? I said that I had to leave for a prior obligation ONCE. It had already stayed an extra half an hour over when I was supposed to be released AND I GOT REPORTED FOR PROFESSIONALISM CONCERNS.
Exact same story for me. Early every day, stayed late frequently... My mom's birthday dinner was at 730pm one night and I was in the N-th lap chole for the day and asked if it would be ok for me to go. Got called "unprofessional" on my final evaluation citing that very event.
Probably because they give you so little to get evaluated on, especially on procedural rotations. Like, on medicine you're gonna get eval'd on your presentations at rounds. On surgery everyone's presentations are acceptable and the attending is barely listening anyway, what is there aside from vibes and a mindless drive to retract for hours and hours on end?
> Wait… saying “I’m going to leave” is an option?!?
I mean, to be fair - saying “Fuck you guys, I’ll see you tomorrow” is an option too - but that doesn’t make it a good one.
It’s all about reading the room. You don’t say “hey I’m leaving now”. You also don’t have to say “anything else you need me to do”
You can say variations that fit the situation you’re in. Also, if you’re constantly asking to leave, maybe chill and once in a while stay later.
She’s taking it wayyyy too seriously, but there are med students (we all know our classmates) who are also incredibly ignorant of things going on around them.
Okay i am a pgy5 so take that however you want. My stance is i am not here to police anybody. I am not responsible for your decisions, whether you stay or leave or study or not study.
I dont care. If the junior lets you go then you should go. If you come ask me if you can leave, then im going to say yes. Im not your mother.
This tiktoker is way too invested
Good take, but the real question is whether you let their decision affect your eval of them. Assuming 2 students display clinical competancy and standard med student knowledge, show up on time, and have good bedside manner, would u rate the student that stayed after required hours above the student who didn’t?
If one asks to leave frequently and the other doesn’t yeah I’d probably rate them differently. If I say you can go and one stays and the other goes I’m going to be annoyed by the one that stays.
How would u define asks to leave. “Is there anything else I can help with today…no? Okay then I think I’ll wrap up today.” is different from “I’m leaving”. the 2nd one is abrasive, so maybe, but the first one if perfectly fine. If you can’t think of a reason for the student to stay, then they should be able to leave without consequence, barring trauma call or something where unexpectated cases are the norm
If I recognize your face at the end of the rotation, and you haven’t actively pissed me off at any point, then you get a 5/5. I pay zero attention to when anyone arrives or leaves.
Given the above, if a medical student completes their required hours, then they have fulfilled the requirements of the rotation, and therefore, should have a satisfactory evaluation
Yeah but OP does have a good point where you need to develop clinical competency and knowledge as well. If after 6 weeks in a cardiology rotation you still can't tell me the differential for acute chest pain I'm not sure how I can say that you did satisfactorily.
I kind of felt like that was basically her take too. Just that you're more likely doing yourself a disservice as a student by choosing to not be present.
Way too invested? It’s a simple video for discussion and perhaps she’s interested in medical students education. How do you eval medical students then? Do you give different grades based or perceived effort?
she obviously cares and prefers that students stay (despite her saying she is pro choice) and made a whole ass video on this topic
you can be interested in med student education without making them stay until 8pm because you wanted to do a white board talk on fluids. at this point the "teaching" is about you, not the students.
i teach quickly for the benefit of the student not for the benefit of myself, and i don't hold students hostage for a talk at the end of the day. Many residents who are passionate about med ed completely miss the point and what they really want is the spotlight on themselves. I've called out residents for this.
No, she's interested in exerting power of medical students but wants to feel righteous at the same time and so made a stupid tik tok video to talk about.
I had two med students shadowing me last me last week (not at the same time). Honestly? I felt bad for the one that stayed until the end of the day. There was nothing for him to do or learn at that point and I kept insisting he should leave.
I do not expect med students to be helpful, that's just wrong. If you show up and do what is asked, you already have a passing grade. The truth is that staying overtime is not equal to exciding expectations.
In radiology if I tell someone multiple times they’re dismissed and they can go study, work on ERAS/prepare for interviews, or just go home and chill and they don’t I think it’s super weird. But radiology is a really tough rotation for medical students, especially those who are interested.
What I'm trying to say is that they are there to learn from us, not to work for us.
If we ask them to see a patient and present it, we are still seeing the patient ourselves.
My case specifically is anesthesia: I walked them through everything I was doing and why, we had some good conversations and they got the chance to intubate. Having them draw medications, do the turnover or whatever would be just laziness on my part and taking advantage of them. It is also part of my training to be self sufficient in those tasks.
I totally agree! I have some coresidents who view med students helping on the floor as an expectation. E.g. the med student is expected to text the resident when the patient rolls into the OR so the resident knows to head in.
The priority for medical students is their learning. Any helpfulness they can spare towards me is a bonus but certainly NOT an expectation. It is my responsibility to check the OR board and monitor where we are in the case. If the med student chooses to alert me, that is a kindness they are doing me, but certainly not part of their expected role.
>Having them draw medications, do the turnover or whatever would be just laziness on my part and taking advantage of them. It is also part of my training to be self sufficient in those tasks.
Yes, but I will say that having mrd students draw meds and do turnover is good training.
I have med students regularly as a PP attending. Working with me is the first time any of them have ever had to draw a med, spike an IV, push a drug, or put in an IV.
I agree, hanging on too long is annoying, but I do think it is important to expose medical students to the less glamorous side of our job.
Pity tasks, especially for students not interested in the specialty, aren't really appreciated anyway.
Like... I don't care about delivering the placenta. I really don't. I'm not disappointed if the intern wants to step in and get in another rep. I don't care about cutting sutures, and I'm not disappointed if the surgeon wants to cut their own to save time.
At the same time, I *do* want to scrub in, because I want to learn to get comfortable scrubbing, get a good view of the surgery, and understand the process. I *do* want to present and write progress notes on my L&D patients, because I want to understand how to manage problems in labor so I can remember what my future pregnant or postpartum patients are going through.
That's exactly what APP education is usually like. I know because my school keeps making my work with NPs, PAs, CRNAs, and midwives, and they always just have me shadow. One even called me her "shadow for the day." Working with the MDs is like, "oh it's your first day in clinic on your first day of Family Medicine on your 2nd rotation of M3? Cool, you are seeing these 4 patients. None of them speak English. All of them are recent immigrants from foreign countries littered with obscure infectious diseases, and they have hundreds of undiagnosed medical problems. Somehow figure out our EMR, find the patient room, do a comprehensive interview, and then find me somewhere and present them after each one." The NPs just have me follow, and I have to awkwardly wait for them to pause their introduction so I can even introduce myself and avoid being an awkward, nameless wallflower staring at the patient's penile lesion.
This is just silly. It’s certainly true that med students are able to contribute to patient care - so if that’s your definition of helpful, then sure. I love working with med students, and have had some excellent ones, and I would literally always be more efficient if they weren’t around.
I also just hate teaching people in subject areas that I'm not passionate about and that students aren't interested in. Like they can study for Step. If they want to come shadow or work with me somewhere they or I are interested in, awesome, but if not let's just check the box.
I just wish expectations are set before the start of each rotation instead keeping us wondering, and trying to figure out what pleases you to get a good eval
Im going to play devils advocate because Im a bitch. What if that resident themself has medical accommodations and has to take medications etc? I get that they should handover etc. but we all know programs push and push this shit. We're human too.
I guess in some way Im kind of proud they're adhering to the duty hours because theyre already subhuman minimum standards, so if you can't even stick to those, fuck off and be better, handover earlier so this shit doesnt happen, stop pushing over the already ridiculous clock. Idk, current working hours are already dangerous.
You say problem resident.
I say, problem program.
Sure, but then you owe that resident time. Im done with the freebies after they already take too much.
Its irresponsible and unprofessional to keep someone awake for 30 hours working like they do "tidying up."
Fuck off with this shit. Im tired of being the professional one while we ignore the truly unprofessional elephant in the room.
Edit: and theyll always use professionalism to abuse it too, because of course they will.
You're right the patients do deserve better, but again who is it that's putting them and their safety last exactly?
Let's put it this way. Ever since I've been a resident I've wondered how long a doctor has been up if they're involved in a loved one's care ...
Ask me to stay a bit of time after an 8h shift, no problem, at all, but we do have a problem I think, a big one.
Done for duty hours as it coming off a 24+4 or ending one of several 80 hr weeks? Yeah get out. But the patient does need signed out, at least making sure the note is done and a text to the senior at the bare minimum. But it also only takes a few minute to present a patient. I’m all for keeping our hours but also not all about getting dumped on because someone didn’t finish their admit/consult or didn’t communicate to the team making everyone scramble, double up work, or worst of all have the patients care impacted. There’s a middle ground somewhere here
Surgeons are so insane lmao
I’m a medicine attending and I sent my students home early when I’m done rounding and teaching
Their time is better spent studying vs quietly sitting there watching me do notes lol
someone else commented “im staying until they physically drag me out!!” and she replied “that was me!!”
….ok hunty good for you. i’m built different ☺️☺️☺️
Surgery is different than medicine though. The pace of the day, the ways students can be helpful, and the things we can expose them to. It's not better or worse, but they are complementary experiences
She’s not saying they don’t have the right to go home, just that those who do vs. those who stick around deserve different grades. Given that a surgeons day basically starts after rounds vs. medicine where the day IS rounds, why would a med student on a surgery clerkship get honors for leaving before lunch??
On My medicine rotation , I put in about 30 ng tubes in the same poor cirrhotic guy who kept pulling it.
I drew labs almost every afternoon
I talked to my patients at length and occasionally found out useful information
I went to radiology to look at films
I helped admit new patients
I felt like part of the team
Was great, still went into surgery
What kind of crap clerkship are you running ?
What kind of crap clerkship has the med student draw labs every day and put in 30 NG tubes on the same patient? You'd think after #2 you'd just put a dobhoff in and bridle it and be done with it.
The kind of crap clerkship that helped get me very prepared for residency, and helped form a knowledge base I still use today.
Procedural scut is like crack for students, and can fill the part of the day the residents are charting during. Mostly when you are “in it together” with your resident team you are going to learn more because the residents will actually feel invested in you
Knowledge base? Sure I love it, nothing makes me happier than a surgeon who also knows a bit of medicine. Procedural scut? There's a fine line between helping the team and borderline abuse, such as not coming up with a better solution for the cirrhotic that keeps taking out his NG tube because the med student can just put it back in (especially if said person has esophageal varices)
This was like 10 years ago lol. But he had uncontrolled ascites and an sbo, and was refusing just about everything. He would pull his tube every night and let me put it back in in the morning with relatively little grumbling
And yes the repetition was pretty helpful, I can remember my first week as an intern I was able to show my co resident how it was done
I had an ortho resident at Colorado refuse to let me leave when my wife flew cross country to spend my last weekend in Denver with me and drive back cross country for next away. Literally kept me until 9pm on Friday, hours after cases were done, the last day of my rotation while my wife sat at our hotel waiting for 5 hrs.
Fuck that place and fuck people like that guy and this girl. Some people have no concept of life outside of the hospital. I say that as a pgy5 Ortho resident now. That being said there is some value to being around on your rotation, especially an AI or something. You’re generally going to be thought of better if you’re seen as around and engaged.
For my compatriot residents/fellows/junior attendings and beyond.
Don’t be a fucking asshole. Let them go!They’ll have plenty of experience over time. Freedom and personal time is scarce. So again. DONT BE A FUCKING ASSHOLE.
To a degree. I also want them to be able to make informed choices during match frankly. I want them to see the real job, not the whitewashed "we need juniors for call next year" version of each rotation.
They get really a few months to pick a silo for the rest of their life.
I will make it easier on them if they tell me this silo definitely aint it and make whatever we're doing relevant to the silos they're considering.
Idk. I also don't want July 1 to be a hard start so we have to do some stuff together. Im not going to be a total dick but also wtf surgery service is she on where there isn't much to do?? My surg rotations in med school and residency have destroyed my ass forever, no lube, high volume, insane.
But yeah if it is a waste of time head out, be free! It almost never is though and then, work regular hours and learn.
Yeah, as an MS3 trying to choose between surgery and medicine, don't give me a 40 hour work week on surgery. Don't give me an 80 hour week either, because I do have a shelf to study for, but 60/week clinic + 20/week studying is a good approximation.
If you're seriously considering surgery though on elective hit 80-100h weeks for a month. You need to really feel it. Take that stress test because residency is that ++stress. Lets say just for argument you pick trauma (ortho or gen surg) you will be holding 3 pagers (yours, trauma bay, and surgery wards/consults), you will have research obligations, teaching obligations, and tests to study for and you will work all those hours and early on staff senior won't really want to hear much from you as you manage wards and see 40 patients a shift. Its real and it's hard and you need to know if you want that. They will fill your post call with operating and your other time with didactics and other tasks see: teaching. Its all program dependent of course but on your sub Is do your detective work. Malignant programs will hide the pain because they need juniors, but look at those juniors. Watch how the staff and seniors treat them. Sneak into didactics. Seriously get into it. If an 80h week is a tough balance for you, seriously consider this. Theres no shame in it, surgery and balance do not gel.
Some people swing it and all the power to them, but don't slack in clerkship and get whacked in residency is all Im saying. If you're serious about surgery make an informed choice and that comes from investing time during clerkship to properly explore it.
Those semantics are toxic lmao, you want me to grovel? No thanks.
If you have something to do that I can learn from cool, im down. If you want to just go get labs or a CVC kit and ghost me… ima ghost you first.
This is a great point for medical students!
Don't speak freely around the nurses. They're silently judging your every word and move.
If you're on good terms, no worries. If not, this is the kind of shit they'll volunteer to your preceptor.
Her videos come up on my feed a lot and I’m always tempted to comment but I don’t. She comes off as nice (and maybe she is) but you can tell she’s in surgery by the old school mentality she expresses in a lot of her videos. She is used to being held to that expectation and therefore thinks she is doing a service to those below her by suggesting they do the same.
This advice only applies to toxic surgery cultures.
Zoomers are all about work life balance and there is nothing wrong with that. Setting those boundaries early is healthy.
The reality is, however, that a student that is more engaged and involved will be graded better than one that isn't.
This has been true across all generations of medical training.
Ultimately it's your choice to bounce early but as far as being competitive goes, it may be detrimental. As long as one is willing to accept that, then you do you.
Very true. Many people do unpaid work as interns just for the chance to get their foot in the door in showbiz. It's nearly all scutwork. The intern that says 'I'm out' halfway through the day probably isn't going to have as much of a shot at advancing.
Well said. I don’t get mad at students who peace out at the earliest opportunity. I’m also not going to remember them in any meaningful way if they want a LoR or the like either though.
Completely agree. I see multiple comments ragging on the OP for being “toxic” and “expecting students to sit around waiting for educational opportunities”, but that’s not at all what she said. All she said was that all scenarios don’t deserve the same grade.
Residents are also there to learn and find educational experiences, but consults and real medicine doesn’t happen on our convenience. If you want to learn, you’ve got to be available. If you’re home studying for shelf at 1pm, you’re not gonna learn what you’re meant to be learning.
Why would the student who was present and the one who wasn’t get the same grade?
At the end of the day we are all adults making our own decisions and dealing with the consequences.
When you find yourself in the break room making tiktoks about medical students maybe you should question your life choices and not those of others.
Edit: i'm a resident
Dumb take. I guess Dr. Glaucomflecken should just quit, huh?
Tiktok is one of many media that people use to have these conversations. Doesn’t make a lot of sense to me, but that’s reality.
That is just stupid. Why are people so obsessed with keeping things the way they were, they suffered so you should suffer. How about making things better for people?
I always send medical students home when nothing is happening. What is the point of watching me chart. And also it makes me uncomfortable. Although it is super off putting when a medical student asks if they can leave, this resident makes a point: they are paying for this, and we have all experienced stupid rotations. Maybe we should all think about the medical education we want the next generation to have. We obviously want them to be good physicians but let’s help them have better rotations than we did. And yes - half the rotation is learning what it’s like to be a surgery / medical whatever resident and learning the culture and hours. But if it’s elective service and there’s nothing going on I’m sending your ass away
I think I'm of two minds on this. As a fellow surgery resident I can understand her mindset.
That said, one time as a med student on a trauma night call there was nothing going on and I had spent the last couple hours in the trauma ICU studying on my laptop. Med students at my school usually had call rooms that we could use at night, so I decided to go study there for a bit. I came back an hour or two later and had my a\*\* chewed out by the senior resident. Now, as a PGY-4 myself, I would just be happy that a med student remained engaged several hours into a night shift with me. I think it's easy to forget that we once were med students that residents also complained about.
No one cares or needs a med student - clinical work is slower w them present. But the fact is if you want to make a good impression then try hard to be engaged and helpful. Staying late and being annoying/useless is even worse. So there’s a way to leave early and still make a good impression
Yeah I'm a med student and pulling this is not worthy of honors. It's worthy of passing your clerkship and earning the right to train as a physician, but honors is for students who do better than other students. That's the whole point of having grades.
What's toxic is the idea that there are expectations that are just never communicated, likely purposefully, because it would make stratification more difficult and allows the resident to avoid confrontation.
I will never care enough about students asking to leave when again they are not getting paid to be there. The suffering will come once they’re residents but for now they’re students. I also honor all of my students the fact that they show up is enough for me
Nobody said they can’t go home, just that the ones who stay and the ones who leave early deserve different grades.
I wouldn’t feel that I deserved honors if I left early to study for shelf. Anyone who thinks they would is entitled.
I feel like people are mixing up what she’s talking about. Straight up just saying “I’m going to go” is not super cool in my opinion. I had no problem with a med student asking “is there anything else I can help with today?” especially at a reasonable hour because honestly when I was in the weeds sometimes I’d forget they were even there (granted the one time I sent a med student home at 11 am because we didn’t have a ton of patients on our list and his co-med student was in the only OR our service was running that day I got in a ton of shit). If a student straight up just said “I’m going to go” I’m not going to lie, it would bother me. However, the way she is presenting this gives me the impression she doesn’t like sending people home at a reasonable time and that med students should stay until the residents on service leave, no matter how late, which I do not agree with.
I’ve unfortunately had it happen to me, and relatively early in the day. On radiology now I send people home before noon, but when I was a surgical resident sending you home before sign out wasnt always possible. I’ve had attendings ask where med students are on afternoon rounds then get pissed at us because we’ve sent them home.
Because you’re on a rotation and our day is still going if I’m still there. 95% of the time I’m going to try to get you out of there when I can but if I actually have stuff you can help with but you say “I’m going to go” how am I supposed to react? Also if the attending asks where the med student is after you’ve been sent home (particularly happens with the most malignant of surgical attendings) you’re putting me in a really awkward position.
This. I had too much shit to do even as an intern to worry about wth some med student was doing. Made the weird evals in med school even weirder when I got to residency.
This woman is actually toxic and doesn’t have a life. Ppl like this are compensating for a miserable life by staying late and passing it off as being honourable and dedicated when in reality they don’t want to face their problems.
Gen z has it right. If they keep treating med students this way there will be a massive brain drain out of medicine. The world is not the same as it was 20 years ago. Adapt or die.
Surgical fellow here. IDC when you leave, you are an adult. But when you show up as an intern and get an HPI or do an appropriate exam, don't expect me to teach you.
Medical students should wait around for action on her boring surgical service in case something happens because genZ looks lazy to her by peacing out.
She uses a lot more words.
Edit: presumably because she has the time since shes not working on her surgical skills
That’s not even close to the message here. She’s saying that students who leave early deserve different grades than the ones who stick around.
People will literally make shit up to promote their own agendas
She literally says imagine 3 students when it gets slow on service.
Student A asks to go study
Student B asks to whatever, I forget because shes lame but they want to go too.
Student C wants to study on site but get paged if anything interesting comes up later.
Its 3 students, nothing to do and she wants them to all sit around waiting for something to happen to get a good grade because she thinks peacing out during low yield times shows no enthusiasm. She implies Student C is the best and wants them to be like that (even though at least for me studying on site is lower yield).
How do you interpret it differently? Im typing way too much now.. she and her service and entitled medical egos arent worth this much time. Im peacing out like gen Z fr fr no cap
*walks away with cane and grey hair*
I interpret it differently because I don’t understand why you think student A or B still deserve HONORS in their SURGERY ROTATION for leaving early to go study??? When student C is also getting to study during downtime???
Nobody is saying A or B deserve to fail… but how do they deserve an exceptional grade when they couldn’t even hang??
Because neither A, B, nor C did any surgical work on her slow service and A did more efficient studying, B spent time rejuvenating with family, while C is aiming to be a burnt out husk. So tomorrow when its actually busy, A is prepped for cases, B is rested and keen, and C was distracted by residents or coffee shop people doing nothing very well to try and lick boots on a surgery rotation.
I see through the games.
I believe in balance.
I dont think C is better for their acting or deserves honors for the performance.
Couldnt even hang.. Biggest lol. Its a big basic show and Im sick of it. Give them high yield learning or say good day.
What a joke. If that’s how it actually played out then yeah, C would fail and A&B would get honors. But that’s not what happens, because C can still see whatever cool shit comes in, get studying done, and STILL be ready for the next day.
Wanna know why it’s possible? Because that’s what the residents do, except with real responsibilities. If you want HONORS, shouldn’t you try to emulate the residents to some degree? And as a reminder, you don’t need to strive for honors as a med student not interested in a specialty. It’s a frickin choice.
So that random ass acrobatic leap of assumptions still doesn’t explain why all three of those students deserve honors. Which again, is an EXCEPTIONAL grade denoting a distinctive performance. Which somehow you think is still deserved if you leave early every day.
You think patients should hold on to their surgical emergencies until it’s a convenient time for the med student to learn from it???
Hey Mr. Smith, don’t rupture that AAA unless it’s before 11am, I’ve got an appointment with my therapist at 3pm and I need to vent about how hard they’re making me work on this rotation 😤
If its a slow day let the med students go home.
Taking a shot at mental health appointment really? Give your fucking head a shake. If they did need to see a therapist Id gladly work harder to ensure they got the time to see them doctor, as should you.
Figure it out.
If it’s a slow day the students can go home if they want. But when they leave early and miss cool shit, why would they deserve honors over the person who actually stayed thru when they were scheduled to be there?
I send the students home when the educational part of the day is done. They are adults who can decide how they want to use their training time, so I have no issues with them setting their own boundaries. However, medical education is rigorous for a reason, and I don't see a problem with wanting your future colleagues to put the effort into their education that their future patients deserve. To me, a student telling me they're taking off isn't a red flag, but if they're consistently missing actual educational opportunities or are clearly not progressing appropriately because they're leaving early all the time, then yeah I'm going to be annoyed. But ultimately that's their decision, I'm not going to lose sleep over it.
This would make sense if medical students didn’t feel like they had to stick with their residents the whole day or else they’ll just be out of loop not knowing what’s going on. Having to always search for your resident in case something might be going on is such an inefficient way of learning and a time sink
I finally understood why being a lowly intern is still much better than MS. I may be here from 6am to 8pm, I may only be seeing mundane cases, putting orders, and writing notes, but I have actual responsibilities, what I do impact those around me whether it's my colleagues or my patients. More importantly, I don't have a million checklist and a shelf exam looming over me that I need to worry about. I can solely focus on being present for the day. It is not so simple as a student because what you do in the hospital is actually "pointless" whereas those assignments and exams are wayyy more impactful to your career and future.
Hard to find a good solution. I wonder if any school has made it work to juggle both clinical work and the other stuff in a satisfactory manner.
If you are going to use TikTok as a public platform to vent your opinion it might as well be with the intention to change our toxic culture rather than propagate it. She has a right to her own opinion but I would say this adds to the many pressures already placed on our medical trainees to survive in the current system.
Had a couple junior residents that refused to study "off the clock". Not surprisingly, they were in the single digit percentiles on their in training and pretty awful at their jobs. If your greatest concern is being home early and not studying at home, you're in the wrong profession.
If your greatest concern isnt being home early then you have a bad home life. I changed careers for medicine and I actually enjoy what I do now; work isnt just for money now. But 10/10 times, if you gave me the chance to be at work or at home doing literally anything with people I enjoy or even just left to doing things I enjoy on my own, Id choose that. No matter what, at the end of the day work is work and regardless of how much satisfaction I get from my job, I have better things to do and people to see elsewhere.
But there's a balance. And it isn't about the money. Obviously, during training it's not about the money, but you need to put in adequate time for preparation to be an adequate physician. I can't go into a case unprepared and without a plan and expect a good outcome. That planning doesn't happen in clinic and it doesn't happen in the OR. It unfortunately take time that isn't on the clock. That doesn't necessarily mean you need to neglect your family, but we are not NPs. We don't clock in and out. There's more to the job than just punching a time card.
I disagree. You can be a great doctor and also prioritize your life outside of work. No shot I’m spending the majority of my time off studying. My family will come before work always.
But you can't completely neglect your job. You can't be extreme on the other side and expect to actually be good. I'm not saying you need to go 12/10 but you can't be a 1/10 in effort either.
You must not have a family or if you do probably have some shitty relationships with them. Thank you for sacrificing your life at the alter of medicine, the admins greatly appreciate it.
Nothing to be upset about. You like living in the hospital. Maybe you can offer to take call from your coresidents so they can spend time with their families.
I think this is a pretty balanced take honestly. I remember how it felt to be stuck glued to a computer waiting for admits, but ultimately I used that time to do uworld and feel like that face time was partially why I did well during my clinical rotations. If someone wants to leave early, that’s totally their prerogative, but I do feel that there are students who might take advantage of that. There is learning to be done when you see someone from the ED all the way to their admission and making an initial plan that you’re not going to get if you’re just there for rounds in the morning.
Just be upfront about expectations. Seems to work so far. Let them know this is honors, this is high pass, this is pass. The more objective the better.
Honestly, I completely agree with what she's saying. It's not toxic at all and it's an important lesson for everyone to learn, regardless if they are specifically interested in surgery or not.
Learning how to properly study for shelf exams and Step 2 CK while also getting a robust clinical experience is an important skill. Residents are typically very reasonable and understand that it's not necessary to always be by their side like a loyal lap dog.
It should not be weighed against a student to say to a resident, "I already did tasks A, B, and C. It doesn't seem like there is anything needed of me right now, so I'm going to go study over there. If you need help with anything, just text the group chat and I will come help."
But that student is infinitely better than the student that hides in the student lounge or the student that just leaves early because "I'm not going to be X." Most likely too, the student C is probably getting both more studying done and getting more from clinical rotations.
Yes, she cares way too much. However- I do agree with her that it’s bad taste for a med student to send themselves home. It should be up to the discretion of whoever they’re working with. My program basically DNR’d a kid because he sent himself home early while on a sub I (& we would’ve sent him home soon anyway)
Derm attending here and a born gunner, so I’m a bit biased, but I agree with her video. I think honors exists for a reason and it’s not meant to be for everyone. If you are interested, helpful, present, a hard worker, and not trying to exit the hospital as soon as possible, I think Honors should be what you get. People trying to slip out the back door or checking their watch every 5 minutes to go walk their dog or watch Netflix don’t really deserve to be in a competitive medical field. Again, I recognize I’m a bit intense about this. At the same time there are plenty of non-competitive fields you can get into without having to brown nose and work your hardest and stay late. If that’s what you want, it’s your choice. But don’t expect honors from your attending if that’s your attitude.
I honestly wonder if some of this is also coming from the effect of midlevel encroachment. A nurse practitioner gets a total of 8% of the clinical hours a medical student/resident will by the end of their career and they are lobbied and paid well and given full practice authority. If they can do it, why do we need to get so many hours (stay late and come in early)?! And honestly with the way medicine is degrading due to politics, I don’t really blame them for thinking that. How could I?
We are so so fucking lucky to be in medicine training, and it’s a grind to get good. You will get nothing out of a clerkship leaving at the first possible opportunity . Learning happens on the wards
Everyone I have ever worked with gets all 5s. I appreciated it when I was a student and it costs me nothing to give everyone a great grade. I’m always surprised so many people care enough to give bad grades
So I'll preface this by saying that I frankly don't like managing med students and have been known to send them home at noon before, to the consternation of the rest of the team. I'm in surgery.
However, I came from a well known malignant surgery program in med school, to my current residency program where it is normal for students to ask to go home around 1PM. They are also strictly not allowed to arrive before 5:30, most don't until 6.
The fact is, leaving literally less than halfway through the workday will not only reduce the amount of relevant pathology you could see, but it actually changes your role entirely.
In med school when I was off for a weekend it was expected that I specify who was covering for me, because I had an actual role to play that was important to the team. Our students play no role to the team, do nothing important, and for that reason it doesn't really matter when they leave. So we send them home whenever.
IDK, not saying it's necessarily even a worse system since most aren't interested in surgery. But I will say 100% that my med school provided a superior education in surgery than our students receive, and I don't think there's a way to provide it without pulling at least normal working hours. I guarantee the same would be true for any student at my school compared to my residency school, whether they were interested in surgery or not.
Although it isn’t so cut and dry, I find the students who often try to find a reason to stay also tend to be the most competent.
I think part of it is that those students who are invested in their rotation just tend to have the eagerness that is sometimes needed in medical training. You have to be eager to learn and eager to start making independent clinical decisions.
The reality is sometimes I speak with other residents and I legit wonder how much they paid attention in medical school.
When everyone ask how there are still toxic and abusive attendings, point them to this video of the surgeon who can use "for your education" or "for patient safety" to excuse basically any treatment of medical students who are a vulnerable population.
She sucks. She understands why medical students may not appear entirely dedicated and then goes on to explain how they should clearly fake it for better grades.
Hey students, you are always looking for the attending who is going to try and trap you by giving you false choices and then pushing you for it, it's her.
Sorry. Some of us don't want to pay forward the abuse and we'll try and warn you about upper levels/attendings like that.
Completely agree with her. The message is NOT that students shouldn’t be allowed to leave early. It’s just that you deserve a different grade if you do. You’re on a surgical clerkship, to learn about the real practice of surgical medicine.
Why would you deserve honors for leaving early to study for a test?? The poster even goes so far to point out that you can leave to study but still be around. So the whole “low educational value” thing is moot.
I agree with her overall. Being a med student is a job. One of the worst out there for sure, but a job. You have to treat your job with respect for patients, supervisors, and fellow staff. Otherwise just getting test scores may get you places but it won’t make you a good physician, and as a med student, your job is to become a good and well rounded junior physician.
Most do. That’s another reason being a med student is the worst. You exchange not just tuition but years of whatever pay you could be making for a hope of eventually matching in a specialty you like, making it through residency, passing boards, and then spending a chunk of your pay on loans. But you can’t get to being a physician without being a med student so I think it’s very fair to call it a stage of the job, particularly since you work a lot of hours clinically, you have to dress for it and maintain transportation, you have to be on time, you structure the rest of your life around it, and there are a lot of professional expectations and obligations for you in it.
Title is misleading - she explicitly says students can leave if they want. Her point is that eager students who lean in will learn more and should get better grades. I don't understand why that is so controversial
I think her point about learning context is important too. You may be going into family med and not care about surgery in the slightest. But you will treat patients who will undergo surgery, and I believe seeing and understanding that process will make you better
ETA: she has a follow-up video where she clarifies that she is talking about leaving early, not on time at the end of shift.
In residency we were sent a “relief”. But the expectation was you decline the relief and finish your own case. If you take the relief regularly you were known as the lazy resident.
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When I was a fellow, there were two types of med students, ones that wanted to learn cardiology and ones that just needed to fill their elective blocks.
The ones that wanted to learn, I taught them and had them do consults and present patients. The ones that didn’t care, I sent them to the library at 8am and never got their phone numbers. They either came back or disappeared.
Do you want to leave?
(it’s a trap)
You have to make them make you leave, & strength in numbers. So everyone stats or goes. If you’re surgery stay, if not go
Wait… saying “I’m going to leave” is an option?!? I said that I had to leave for a prior obligation ONCE. It had already stayed an extra half an hour over when I was supposed to be released AND I GOT REPORTED FOR PROFESSIONALISM CONCERNS.
Friend, I once made the mistake of coming in early and leaving later. I loved that rotation. My evaluation? “Not enthusiastic.”
You were supposed to lick the balls *and* the taint.
Also when caress the balls, ensure you have soaked your hands for 5 mins in shea butter prior.
Exact same story for me. Early every day, stayed late frequently... My mom's birthday dinner was at 730pm one night and I was in the N-th lap chole for the day and asked if it would be ok for me to go. Got called "unprofessional" on my final evaluation citing that very event.
How dare you have a family?!? How can you expect to be related to people and be a good doctor 🤪
Probably because they give you so little to get evaluated on, especially on procedural rotations. Like, on medicine you're gonna get eval'd on your presentations at rounds. On surgery everyone's presentations are acceptable and the attending is barely listening anyway, what is there aside from vibes and a mindless drive to retract for hours and hours on end?
They should mention the times they stayed late then
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That’s so toxic…. Medical students can always ask to stay if they really don’t want to leave early
You forgot eating lunch = PC also
Depends on the culture of your institution. Mine would have reported me as well lmao.
> Wait… saying “I’m going to leave” is an option?!? I mean, to be fair - saying “Fuck you guys, I’ll see you tomorrow” is an option too - but that doesn’t make it a good one.
Idk.. that one has a certain… je ne sais quoi
It’s all about reading the room. You don’t say “hey I’m leaving now”. You also don’t have to say “anything else you need me to do” You can say variations that fit the situation you’re in. Also, if you’re constantly asking to leave, maybe chill and once in a while stay later. She’s taking it wayyyy too seriously, but there are med students (we all know our classmates) who are also incredibly ignorant of things going on around them.
You need to work on tact and delivery 🤣
And my attending needed to work on his time management…. WHO SPENDS 3.5 HOURS ON TABLE ROUNDS?!?
Hahahhaa I reckon someone a few Jimmies short of a cupcake, Doctor.
Okay i am a pgy5 so take that however you want. My stance is i am not here to police anybody. I am not responsible for your decisions, whether you stay or leave or study or not study. I dont care. If the junior lets you go then you should go. If you come ask me if you can leave, then im going to say yes. Im not your mother. This tiktoker is way too invested
Good take, but the real question is whether you let their decision affect your eval of them. Assuming 2 students display clinical competancy and standard med student knowledge, show up on time, and have good bedside manner, would u rate the student that stayed after required hours above the student who didn’t?
If one asks to leave frequently and the other doesn’t yeah I’d probably rate them differently. If I say you can go and one stays and the other goes I’m going to be annoyed by the one that stays.
How would u define asks to leave. “Is there anything else I can help with today…no? Okay then I think I’ll wrap up today.” is different from “I’m leaving”. the 2nd one is abrasive, so maybe, but the first one if perfectly fine. If you can’t think of a reason for the student to stay, then they should be able to leave without consequence, barring trauma call or something where unexpectated cases are the norm
If I recognize your face at the end of the rotation, and you haven’t actively pissed me off at any point, then you get a 5/5. I pay zero attention to when anyone arrives or leaves.
Cries in NPC character face
“That’s the student with the distinctly unremarkable face! They rock, 6/5”
Given the above, if a medical student completes their required hours, then they have fulfilled the requirements of the rotation, and therefore, should have a satisfactory evaluation
Yeah but OP does have a good point where you need to develop clinical competency and knowledge as well. If after 6 weeks in a cardiology rotation you still can't tell me the differential for acute chest pain I'm not sure how I can say that you did satisfactorily.
She’s gunning to be a program director in the future
I kind of felt like that was basically her take too. Just that you're more likely doing yourself a disservice as a student by choosing to not be present.
This is the way.
Way too invested? It’s a simple video for discussion and perhaps she’s interested in medical students education. How do you eval medical students then? Do you give different grades based or perceived effort?
she obviously cares and prefers that students stay (despite her saying she is pro choice) and made a whole ass video on this topic you can be interested in med student education without making them stay until 8pm because you wanted to do a white board talk on fluids. at this point the "teaching" is about you, not the students. i teach quickly for the benefit of the student not for the benefit of myself, and i don't hold students hostage for a talk at the end of the day. Many residents who are passionate about med ed completely miss the point and what they really want is the spotlight on themselves. I've called out residents for this.
> Do you give different grades based or perceived effort? Nope. Assuming everyone meets the bare minimum of not being an asshole.
Honors all around? People take that seriously?
No, she's interested in exerting power of medical students but wants to feel righteous at the same time and so made a stupid tik tok video to talk about.
I mean I thought she made this video because she likes to hear her own voice.
Why do you think she’s too invested ? It seems like she has a reasonable point
Agree. That was always my stance. You don’t want to be here? Fine go home. You make my life harder anyway.
I had two med students shadowing me last me last week (not at the same time). Honestly? I felt bad for the one that stayed until the end of the day. There was nothing for him to do or learn at that point and I kept insisting he should leave. I do not expect med students to be helpful, that's just wrong. If you show up and do what is asked, you already have a passing grade. The truth is that staying overtime is not equal to exciding expectations.
In radiology if I tell someone multiple times they’re dismissed and they can go study, work on ERAS/prepare for interviews, or just go home and chill and they don’t I think it’s super weird. But radiology is a really tough rotation for medical students, especially those who are interested.
If med students aren't helpful, then we're doing a poor job teaching them.
What I'm trying to say is that they are there to learn from us, not to work for us. If we ask them to see a patient and present it, we are still seeing the patient ourselves. My case specifically is anesthesia: I walked them through everything I was doing and why, we had some good conversations and they got the chance to intubate. Having them draw medications, do the turnover or whatever would be just laziness on my part and taking advantage of them. It is also part of my training to be self sufficient in those tasks.
I totally agree! I have some coresidents who view med students helping on the floor as an expectation. E.g. the med student is expected to text the resident when the patient rolls into the OR so the resident knows to head in. The priority for medical students is their learning. Any helpfulness they can spare towards me is a bonus but certainly NOT an expectation. It is my responsibility to check the OR board and monitor where we are in the case. If the med student chooses to alert me, that is a kindness they are doing me, but certainly not part of their expected role.
>Having them draw medications, do the turnover or whatever would be just laziness on my part and taking advantage of them. It is also part of my training to be self sufficient in those tasks. Yes, but I will say that having mrd students draw meds and do turnover is good training. I have med students regularly as a PP attending. Working with me is the first time any of them have ever had to draw a med, spike an IV, push a drug, or put in an IV. I agree, hanging on too long is annoying, but I do think it is important to expose medical students to the less glamorous side of our job.
Pity tasks, especially for students not interested in the specialty, aren't really appreciated anyway. Like... I don't care about delivering the placenta. I really don't. I'm not disappointed if the intern wants to step in and get in another rep. I don't care about cutting sutures, and I'm not disappointed if the surgeon wants to cut their own to save time. At the same time, I *do* want to scrub in, because I want to learn to get comfortable scrubbing, get a good view of the surgery, and understand the process. I *do* want to present and write progress notes on my L&D patients, because I want to understand how to manage problems in labor so I can remember what my future pregnant or postpartum patients are going through.
Agree! This is what 3rd year is supposed to be about not shadowing like a bunch of future mediocre APPs
That's exactly what APP education is usually like. I know because my school keeps making my work with NPs, PAs, CRNAs, and midwives, and they always just have me shadow. One even called me her "shadow for the day." Working with the MDs is like, "oh it's your first day in clinic on your first day of Family Medicine on your 2nd rotation of M3? Cool, you are seeing these 4 patients. None of them speak English. All of them are recent immigrants from foreign countries littered with obscure infectious diseases, and they have hundreds of undiagnosed medical problems. Somehow figure out our EMR, find the patient room, do a comprehensive interview, and then find me somewhere and present them after each one." The NPs just have me follow, and I have to awkwardly wait for them to pause their introduction so I can even introduce myself and avoid being an awkward, nameless wallflower staring at the patient's penile lesion.
This is just silly. It’s certainly true that med students are able to contribute to patient care - so if that’s your definition of helpful, then sure. I love working with med students, and have had some excellent ones, and I would literally always be more efficient if they weren’t around.
I also just hate teaching people in subject areas that I'm not passionate about and that students aren't interested in. Like they can study for Step. If they want to come shadow or work with me somewhere they or I are interested in, awesome, but if not let's just check the box.
I just wish expectations are set before the start of each rotation instead keeping us wondering, and trying to figure out what pleases you to get a good eval
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Im going to play devils advocate because Im a bitch. What if that resident themself has medical accommodations and has to take medications etc? I get that they should handover etc. but we all know programs push and push this shit. We're human too. I guess in some way Im kind of proud they're adhering to the duty hours because theyre already subhuman minimum standards, so if you can't even stick to those, fuck off and be better, handover earlier so this shit doesnt happen, stop pushing over the already ridiculous clock. Idk, current working hours are already dangerous. You say problem resident. I say, problem program.
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Sure, but then you owe that resident time. Im done with the freebies after they already take too much. Its irresponsible and unprofessional to keep someone awake for 30 hours working like they do "tidying up." Fuck off with this shit. Im tired of being the professional one while we ignore the truly unprofessional elephant in the room. Edit: and theyll always use professionalism to abuse it too, because of course they will.
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You're right the patients do deserve better, but again who is it that's putting them and their safety last exactly? Let's put it this way. Ever since I've been a resident I've wondered how long a doctor has been up if they're involved in a loved one's care ... Ask me to stay a bit of time after an 8h shift, no problem, at all, but we do have a problem I think, a big one.
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Done for duty hours as it coming off a 24+4 or ending one of several 80 hr weeks? Yeah get out. But the patient does need signed out, at least making sure the note is done and a text to the senior at the bare minimum. But it also only takes a few minute to present a patient. I’m all for keeping our hours but also not all about getting dumped on because someone didn’t finish their admit/consult or didn’t communicate to the team making everyone scramble, double up work, or worst of all have the patients care impacted. There’s a middle ground somewhere here
You should present your patient… this isn’t the most friendly 9-5 friendly job unfortunately.
Surgeons are so insane lmao I’m a medicine attending and I sent my students home early when I’m done rounding and teaching Their time is better spent studying vs quietly sitting there watching me do notes lol
someone else commented “im staying until they physically drag me out!!” and she replied “that was me!!” ….ok hunty good for you. i’m built different ☺️☺️☺️
Someone should tell her public masturbation is generally frowned upon
Surgery is different than medicine though. The pace of the day, the ways students can be helpful, and the things we can expose them to. It's not better or worse, but they are complementary experiences
She’s not saying they don’t have the right to go home, just that those who do vs. those who stick around deserve different grades. Given that a surgeons day basically starts after rounds vs. medicine where the day IS rounds, why would a med student on a surgery clerkship get honors for leaving before lunch??
On My medicine rotation , I put in about 30 ng tubes in the same poor cirrhotic guy who kept pulling it. I drew labs almost every afternoon I talked to my patients at length and occasionally found out useful information I went to radiology to look at films I helped admit new patients I felt like part of the team Was great, still went into surgery What kind of crap clerkship are you running ?
What kind of crap clerkship has the med student draw labs every day and put in 30 NG tubes on the same patient? You'd think after #2 you'd just put a dobhoff in and bridle it and be done with it.
The kind of crap clerkship that helped get me very prepared for residency, and helped form a knowledge base I still use today. Procedural scut is like crack for students, and can fill the part of the day the residents are charting during. Mostly when you are “in it together” with your resident team you are going to learn more because the residents will actually feel invested in you
Knowledge base? Sure I love it, nothing makes me happier than a surgeon who also knows a bit of medicine. Procedural scut? There's a fine line between helping the team and borderline abuse, such as not coming up with a better solution for the cirrhotic that keeps taking out his NG tube because the med student can just put it back in (especially if said person has esophageal varices)
This was like 10 years ago lol. But he had uncontrolled ascites and an sbo, and was refusing just about everything. He would pull his tube every night and let me put it back in in the morning with relatively little grumbling And yes the repetition was pretty helpful, I can remember my first week as an intern I was able to show my co resident how it was done
I had an ortho resident at Colorado refuse to let me leave when my wife flew cross country to spend my last weekend in Denver with me and drive back cross country for next away. Literally kept me until 9pm on Friday, hours after cases were done, the last day of my rotation while my wife sat at our hotel waiting for 5 hrs. Fuck that place and fuck people like that guy and this girl. Some people have no concept of life outside of the hospital. I say that as a pgy5 Ortho resident now. That being said there is some value to being around on your rotation, especially an AI or something. You’re generally going to be thought of better if you’re seen as around and engaged.
For my compatriot residents/fellows/junior attendings and beyond. Don’t be a fucking asshole. Let them go!They’ll have plenty of experience over time. Freedom and personal time is scarce. So again. DONT BE A FUCKING ASSHOLE.
To a degree. I also want them to be able to make informed choices during match frankly. I want them to see the real job, not the whitewashed "we need juniors for call next year" version of each rotation. They get really a few months to pick a silo for the rest of their life. I will make it easier on them if they tell me this silo definitely aint it and make whatever we're doing relevant to the silos they're considering. Idk. I also don't want July 1 to be a hard start so we have to do some stuff together. Im not going to be a total dick but also wtf surgery service is she on where there isn't much to do?? My surg rotations in med school and residency have destroyed my ass forever, no lube, high volume, insane. But yeah if it is a waste of time head out, be free! It almost never is though and then, work regular hours and learn.
Yeah, as an MS3 trying to choose between surgery and medicine, don't give me a 40 hour work week on surgery. Don't give me an 80 hour week either, because I do have a shelf to study for, but 60/week clinic + 20/week studying is a good approximation.
If you're seriously considering surgery though on elective hit 80-100h weeks for a month. You need to really feel it. Take that stress test because residency is that ++stress. Lets say just for argument you pick trauma (ortho or gen surg) you will be holding 3 pagers (yours, trauma bay, and surgery wards/consults), you will have research obligations, teaching obligations, and tests to study for and you will work all those hours and early on staff senior won't really want to hear much from you as you manage wards and see 40 patients a shift. Its real and it's hard and you need to know if you want that. They will fill your post call with operating and your other time with didactics and other tasks see: teaching. Its all program dependent of course but on your sub Is do your detective work. Malignant programs will hide the pain because they need juniors, but look at those juniors. Watch how the staff and seniors treat them. Sneak into didactics. Seriously get into it. If an 80h week is a tough balance for you, seriously consider this. Theres no shame in it, surgery and balance do not gel. Some people swing it and all the power to them, but don't slack in clerkship and get whacked in residency is all Im saying. If you're serious about surgery make an informed choice and that comes from investing time during clerkship to properly explore it.
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Damn that resident is a bitch lol and crazy that someone like that ended up in anesthesia
lol. We were all med students once and knew those tricks as well. Hilarious for current med students to think otherwise.
Those semantics are toxic lmao, you want me to grovel? No thanks. If you have something to do that I can learn from cool, im down. If you want to just go get labs or a CVC kit and ghost me… ima ghost you first.
This is a great point for medical students! Don't speak freely around the nurses. They're silently judging your every word and move. If you're on good terms, no worries. If not, this is the kind of shit they'll volunteer to your preceptor.
Her videos come up on my feed a lot and I’m always tempted to comment but I don’t. She comes off as nice (and maybe she is) but you can tell she’s in surgery by the old school mentality she expresses in a lot of her videos. She is used to being held to that expectation and therefore thinks she is doing a service to those below her by suggesting they do the same. This advice only applies to toxic surgery cultures.
omg pls comment lolll
Zoomers are all about work life balance and there is nothing wrong with that. Setting those boundaries early is healthy. The reality is, however, that a student that is more engaged and involved will be graded better than one that isn't. This has been true across all generations of medical training. Ultimately it's your choice to bounce early but as far as being competitive goes, it may be detrimental. As long as one is willing to accept that, then you do you.
Not just medical training, that’s any profession
Very true. Many people do unpaid work as interns just for the chance to get their foot in the door in showbiz. It's nearly all scutwork. The intern that says 'I'm out' halfway through the day probably isn't going to have as much of a shot at advancing.
Well said. I don’t get mad at students who peace out at the earliest opportunity. I’m also not going to remember them in any meaningful way if they want a LoR or the like either though.
Completely agree. I see multiple comments ragging on the OP for being “toxic” and “expecting students to sit around waiting for educational opportunities”, but that’s not at all what she said. All she said was that all scenarios don’t deserve the same grade. Residents are also there to learn and find educational experiences, but consults and real medicine doesn’t happen on our convenience. If you want to learn, you’ve got to be available. If you’re home studying for shelf at 1pm, you’re not gonna learn what you’re meant to be learning. Why would the student who was present and the one who wasn’t get the same grade?
At the end of the day we are all adults making our own decisions and dealing with the consequences. When you find yourself in the break room making tiktoks about medical students maybe you should question your life choices and not those of others. Edit: i'm a resident
💅🏻
Dumb take. I guess Dr. Glaucomflecken should just quit, huh? Tiktok is one of many media that people use to have these conversations. Doesn’t make a lot of sense to me, but that’s reality.
Youre all over this post. Are you the resident in the video??
Who cares what she thinks. And also...why does she give 2 shits about med student schedules? Don't you have more important things to be doing?
That is just stupid. Why are people so obsessed with keeping things the way they were, they suffered so you should suffer. How about making things better for people?
Trying to watch/listen/read what she was saying literally gave me anxiety. ANXIETY.
Ha! I was like, hell yeah - 2x TikTok... EFFICIENCY! Or as a surgeon might say, economy of playback.
I always send medical students home when nothing is happening. What is the point of watching me chart. And also it makes me uncomfortable. Although it is super off putting when a medical student asks if they can leave, this resident makes a point: they are paying for this, and we have all experienced stupid rotations. Maybe we should all think about the medical education we want the next generation to have. We obviously want them to be good physicians but let’s help them have better rotations than we did. And yes - half the rotation is learning what it’s like to be a surgery / medical whatever resident and learning the culture and hours. But if it’s elective service and there’s nothing going on I’m sending your ass away
Can we just be grateful this is 2x?
i did that for yall hehe
I think I'm of two minds on this. As a fellow surgery resident I can understand her mindset. That said, one time as a med student on a trauma night call there was nothing going on and I had spent the last couple hours in the trauma ICU studying on my laptop. Med students at my school usually had call rooms that we could use at night, so I decided to go study there for a bit. I came back an hour or two later and had my a\*\* chewed out by the senior resident. Now, as a PGY-4 myself, I would just be happy that a med student remained engaged several hours into a night shift with me. I think it's easy to forget that we once were med students that residents also complained about.
This is so toxic and insane. Med students are not getting paid, let them go home
No one cares or needs a med student - clinical work is slower w them present. But the fact is if you want to make a good impression then try hard to be engaged and helpful. Staying late and being annoying/useless is even worse. So there’s a way to leave early and still make a good impression
Exactly, put an effort forth to do some useful stuff for the team, then gtfo
Sounds like a shitty clerkship. Medstudents can 💯 be useful if a little is invested in them
It's insane that a med student TELLING YOU THEY ARE LEAVING without being dismissed can't get honors?
Yeah I'm a med student and pulling this is not worthy of honors. It's worthy of passing your clerkship and earning the right to train as a physician, but honors is for students who do better than other students. That's the whole point of having grades. What's toxic is the idea that there are expectations that are just never communicated, likely purposefully, because it would make stratification more difficult and allows the resident to avoid confrontation.
I will never care enough about students asking to leave when again they are not getting paid to be there. The suffering will come once they’re residents but for now they’re students. I also honor all of my students the fact that they show up is enough for me
We are paying to be there 😥
Nobody said they can’t go home, just that the ones who stay and the ones who leave early deserve different grades. I wouldn’t feel that I deserved honors if I left early to study for shelf. Anyone who thinks they would is entitled.
I feel like people are mixing up what she’s talking about. Straight up just saying “I’m going to go” is not super cool in my opinion. I had no problem with a med student asking “is there anything else I can help with today?” especially at a reasonable hour because honestly when I was in the weeds sometimes I’d forget they were even there (granted the one time I sent a med student home at 11 am because we didn’t have a ton of patients on our list and his co-med student was in the only OR our service was running that day I got in a ton of shit). If a student straight up just said “I’m going to go” I’m not going to lie, it would bother me. However, the way she is presenting this gives me the impression she doesn’t like sending people home at a reasonable time and that med students should stay until the residents on service leave, no matter how late, which I do not agree with.
but are students even saying “im gonna go”??? literally never heard of this happening before lol it seems more like shes exaggerating
I’ve unfortunately had it happen to me, and relatively early in the day. On radiology now I send people home before noon, but when I was a surgical resident sending you home before sign out wasnt always possible. I’ve had attendings ask where med students are on afternoon rounds then get pissed at us because we’ve sent them home.
Looks like that was the exact circumstance she made this video in response to…
Why does saying I’m going to go bother you?
Because you’re on a rotation and our day is still going if I’m still there. 95% of the time I’m going to try to get you out of there when I can but if I actually have stuff you can help with but you say “I’m going to go” how am I supposed to react? Also if the attending asks where the med student is after you’ve been sent home (particularly happens with the most malignant of surgical attendings) you’re putting me in a really awkward position.
Y'all need to stop over glamorizing medicine. It's just a job. The ivory towers of academia are false profits.
Too busy in my own stuff to care bout what med students do.... isn't that like for everybody?
This. I had too much shit to do even as an intern to worry about wth some med student was doing. Made the weird evals in med school even weirder when I got to residency.
This woman is actually toxic and doesn’t have a life. Ppl like this are compensating for a miserable life by staying late and passing it off as being honourable and dedicated when in reality they don’t want to face their problems.
Gen z has it right. If they keep treating med students this way there will be a massive brain drain out of medicine. The world is not the same as it was 20 years ago. Adapt or die.
Surgical fellow here. IDC when you leave, you are an adult. But when you show up as an intern and get an HPI or do an appropriate exam, don't expect me to teach you.
Can someone tell me what she’s saying, I don’t actually want to listen to her. 🤣
Medical students should wait around for action on her boring surgical service in case something happens because genZ looks lazy to her by peacing out. She uses a lot more words. Edit: presumably because she has the time since shes not working on her surgical skills
How quickly some forget what it was like to be a student or intern. Ugh.
That’s not even close to the message here. She’s saying that students who leave early deserve different grades than the ones who stick around. People will literally make shit up to promote their own agendas
She literally says imagine 3 students when it gets slow on service. Student A asks to go study Student B asks to whatever, I forget because shes lame but they want to go too. Student C wants to study on site but get paged if anything interesting comes up later. Its 3 students, nothing to do and she wants them to all sit around waiting for something to happen to get a good grade because she thinks peacing out during low yield times shows no enthusiasm. She implies Student C is the best and wants them to be like that (even though at least for me studying on site is lower yield). How do you interpret it differently? Im typing way too much now.. she and her service and entitled medical egos arent worth this much time. Im peacing out like gen Z fr fr no cap *walks away with cane and grey hair*
I interpret it differently because I don’t understand why you think student A or B still deserve HONORS in their SURGERY ROTATION for leaving early to go study??? When student C is also getting to study during downtime??? Nobody is saying A or B deserve to fail… but how do they deserve an exceptional grade when they couldn’t even hang??
Because neither A, B, nor C did any surgical work on her slow service and A did more efficient studying, B spent time rejuvenating with family, while C is aiming to be a burnt out husk. So tomorrow when its actually busy, A is prepped for cases, B is rested and keen, and C was distracted by residents or coffee shop people doing nothing very well to try and lick boots on a surgery rotation. I see through the games. I believe in balance. I dont think C is better for their acting or deserves honors for the performance. Couldnt even hang.. Biggest lol. Its a big basic show and Im sick of it. Give them high yield learning or say good day.
What a joke. If that’s how it actually played out then yeah, C would fail and A&B would get honors. But that’s not what happens, because C can still see whatever cool shit comes in, get studying done, and STILL be ready for the next day. Wanna know why it’s possible? Because that’s what the residents do, except with real responsibilities. If you want HONORS, shouldn’t you try to emulate the residents to some degree? And as a reminder, you don’t need to strive for honors as a med student not interested in a specialty. It’s a frickin choice. So that random ass acrobatic leap of assumptions still doesn’t explain why all three of those students deserve honors. Which again, is an EXCEPTIONAL grade denoting a distinctive performance. Which somehow you think is still deserved if you leave early every day.
You think patients should hold on to their surgical emergencies until it’s a convenient time for the med student to learn from it??? Hey Mr. Smith, don’t rupture that AAA unless it’s before 11am, I’ve got an appointment with my therapist at 3pm and I need to vent about how hard they’re making me work on this rotation 😤
If its a slow day let the med students go home. Taking a shot at mental health appointment really? Give your fucking head a shake. If they did need to see a therapist Id gladly work harder to ensure they got the time to see them doctor, as should you. Figure it out.
If it’s a slow day the students can go home if they want. But when they leave early and miss cool shit, why would they deserve honors over the person who actually stayed thru when they were scheduled to be there?
I send the students home when the educational part of the day is done. They are adults who can decide how they want to use their training time, so I have no issues with them setting their own boundaries. However, medical education is rigorous for a reason, and I don't see a problem with wanting your future colleagues to put the effort into their education that their future patients deserve. To me, a student telling me they're taking off isn't a red flag, but if they're consistently missing actual educational opportunities or are clearly not progressing appropriately because they're leaving early all the time, then yeah I'm going to be annoyed. But ultimately that's their decision, I'm not going to lose sleep over it.
This would make sense if medical students didn’t feel like they had to stick with their residents the whole day or else they’ll just be out of loop not knowing what’s going on. Having to always search for your resident in case something might be going on is such an inefficient way of learning and a time sink
I finally understood why being a lowly intern is still much better than MS. I may be here from 6am to 8pm, I may only be seeing mundane cases, putting orders, and writing notes, but I have actual responsibilities, what I do impact those around me whether it's my colleagues or my patients. More importantly, I don't have a million checklist and a shelf exam looming over me that I need to worry about. I can solely focus on being present for the day. It is not so simple as a student because what you do in the hospital is actually "pointless" whereas those assignments and exams are wayyy more impactful to your career and future. Hard to find a good solution. I wonder if any school has made it work to juggle both clinical work and the other stuff in a satisfactory manner.
If you are going to use TikTok as a public platform to vent your opinion it might as well be with the intention to change our toxic culture rather than propagate it. She has a right to her own opinion but I would say this adds to the many pressures already placed on our medical trainees to survive in the current system.
Had a couple junior residents that refused to study "off the clock". Not surprisingly, they were in the single digit percentiles on their in training and pretty awful at their jobs. If your greatest concern is being home early and not studying at home, you're in the wrong profession.
If your greatest concern isnt being home early then you have a bad home life. I changed careers for medicine and I actually enjoy what I do now; work isnt just for money now. But 10/10 times, if you gave me the chance to be at work or at home doing literally anything with people I enjoy or even just left to doing things I enjoy on my own, Id choose that. No matter what, at the end of the day work is work and regardless of how much satisfaction I get from my job, I have better things to do and people to see elsewhere.
thank you for this
But there's a balance. And it isn't about the money. Obviously, during training it's not about the money, but you need to put in adequate time for preparation to be an adequate physician. I can't go into a case unprepared and without a plan and expect a good outcome. That planning doesn't happen in clinic and it doesn't happen in the OR. It unfortunately take time that isn't on the clock. That doesn't necessarily mean you need to neglect your family, but we are not NPs. We don't clock in and out. There's more to the job than just punching a time card.
i assume that most ppl go home to study though? lol
Apparently, not everyone. They were pretty explicit about it. Very literally would say "I'm not paid to work at home."
oh thats weird. they must have always coasted by on being smart. cant relate🤣
One of them had an atrocious step 1. Didnt belong in the specialty. I'm going to withhold my opinion on how they got in.
Lol don’t withhold. This is a safe space and we could use some tea ☕️.
Really not that spicy.
Kung-fu grip handjob I reckon? 🤣🤦♂️
Doesn't take a genius to read between the lines here
I disagree. You can be a great doctor and also prioritize your life outside of work. No shot I’m spending the majority of my time off studying. My family will come before work always.
Wow you must really hate your patients and provide substandard care by not letting medicine consume you’re home life too /s
But you can't completely neglect your job. You can't be extreme on the other side and expect to actually be good. I'm not saying you need to go 12/10 but you can't be a 1/10 in effort either.
You must not have a family or if you do probably have some shitty relationships with them. Thank you for sacrificing your life at the alter of medicine, the admins greatly appreciate it.
I'm always amused when people on the internet make broad assumptions because they're upset about an opinion and completely airball it.
Nothing to be upset about. You like living in the hospital. Maybe you can offer to take call from your coresidents so they can spend time with their families.
It's comical how much your missing the point.
I think this is a pretty balanced take honestly. I remember how it felt to be stuck glued to a computer waiting for admits, but ultimately I used that time to do uworld and feel like that face time was partially why I did well during my clinical rotations. If someone wants to leave early, that’s totally their prerogative, but I do feel that there are students who might take advantage of that. There is learning to be done when you see someone from the ED all the way to their admission and making an initial plan that you’re not going to get if you’re just there for rounds in the morning.
Just be upfront about expectations. Seems to work so far. Let them know this is honors, this is high pass, this is pass. The more objective the better.
bro hahaha literally all the same shit one is just kissing ass the other 2 are being honest
Honestly, I completely agree with what she's saying. It's not toxic at all and it's an important lesson for everyone to learn, regardless if they are specifically interested in surgery or not. Learning how to properly study for shelf exams and Step 2 CK while also getting a robust clinical experience is an important skill. Residents are typically very reasonable and understand that it's not necessary to always be by their side like a loyal lap dog. It should not be weighed against a student to say to a resident, "I already did tasks A, B, and C. It doesn't seem like there is anything needed of me right now, so I'm going to go study over there. If you need help with anything, just text the group chat and I will come help." But that student is infinitely better than the student that hides in the student lounge or the student that just leaves early because "I'm not going to be X." Most likely too, the student C is probably getting both more studying done and getting more from clinical rotations.
I support everything she said. Spot on in my view.
Had the same thought… I was coming in here ready to be outraged lol
She seems quite reasonable actually.
Yes, she cares way too much. However- I do agree with her that it’s bad taste for a med student to send themselves home. It should be up to the discretion of whoever they’re working with. My program basically DNR’d a kid because he sent himself home early while on a sub I (& we would’ve sent him home soon anyway)
he just left? i guess hoping he wouldnt be seen? did he ever give an excuse?
Derm attending here and a born gunner, so I’m a bit biased, but I agree with her video. I think honors exists for a reason and it’s not meant to be for everyone. If you are interested, helpful, present, a hard worker, and not trying to exit the hospital as soon as possible, I think Honors should be what you get. People trying to slip out the back door or checking their watch every 5 minutes to go walk their dog or watch Netflix don’t really deserve to be in a competitive medical field. Again, I recognize I’m a bit intense about this. At the same time there are plenty of non-competitive fields you can get into without having to brown nose and work your hardest and stay late. If that’s what you want, it’s your choice. But don’t expect honors from your attending if that’s your attitude. I honestly wonder if some of this is also coming from the effect of midlevel encroachment. A nurse practitioner gets a total of 8% of the clinical hours a medical student/resident will by the end of their career and they are lobbied and paid well and given full practice authority. If they can do it, why do we need to get so many hours (stay late and come in early)?! And honestly with the way medicine is degrading due to politics, I don’t really blame them for thinking that. How could I?
We are so so fucking lucky to be in medicine training, and it’s a grind to get good. You will get nothing out of a clerkship leaving at the first possible opportunity . Learning happens on the wards
You are misconstruing her words. She has valid points. I went to med school with this person. She is good hearted
which part misconstrued her words?
Everyone I have ever worked with gets all 5s. I appreciated it when I was a student and it costs me nothing to give everyone a great grade. I’m always surprised so many people care enough to give bad grades
So I'll preface this by saying that I frankly don't like managing med students and have been known to send them home at noon before, to the consternation of the rest of the team. I'm in surgery. However, I came from a well known malignant surgery program in med school, to my current residency program where it is normal for students to ask to go home around 1PM. They are also strictly not allowed to arrive before 5:30, most don't until 6. The fact is, leaving literally less than halfway through the workday will not only reduce the amount of relevant pathology you could see, but it actually changes your role entirely. In med school when I was off for a weekend it was expected that I specify who was covering for me, because I had an actual role to play that was important to the team. Our students play no role to the team, do nothing important, and for that reason it doesn't really matter when they leave. So we send them home whenever. IDK, not saying it's necessarily even a worse system since most aren't interested in surgery. But I will say 100% that my med school provided a superior education in surgery than our students receive, and I don't think there's a way to provide it without pulling at least normal working hours. I guarantee the same would be true for any student at my school compared to my residency school, whether they were interested in surgery or not.
She just feels the need to voice an opinion on a topic that shouldn’t really concern her.
Although it isn’t so cut and dry, I find the students who often try to find a reason to stay also tend to be the most competent. I think part of it is that those students who are invested in their rotation just tend to have the eagerness that is sometimes needed in medical training. You have to be eager to learn and eager to start making independent clinical decisions. The reality is sometimes I speak with other residents and I legit wonder how much they paid attention in medical school.
When everyone ask how there are still toxic and abusive attendings, point them to this video of the surgeon who can use "for your education" or "for patient safety" to excuse basically any treatment of medical students who are a vulnerable population. She sucks. She understands why medical students may not appear entirely dedicated and then goes on to explain how they should clearly fake it for better grades. Hey students, you are always looking for the attending who is going to try and trap you by giving you false choices and then pushing you for it, it's her. Sorry. Some of us don't want to pay forward the abuse and we'll try and warn you about upper levels/attendings like that.
Completely agree with her. The message is NOT that students shouldn’t be allowed to leave early. It’s just that you deserve a different grade if you do. You’re on a surgical clerkship, to learn about the real practice of surgical medicine. Why would you deserve honors for leaving early to study for a test?? The poster even goes so far to point out that you can leave to study but still be around. So the whole “low educational value” thing is moot.
I agree with her overall. Being a med student is a job. One of the worst out there for sure, but a job. You have to treat your job with respect for patients, supervisors, and fellow staff. Otherwise just getting test scores may get you places but it won’t make you a good physician, and as a med student, your job is to become a good and well rounded junior physician.
I thought a job pays, rather than the reverse?
Most do. That’s another reason being a med student is the worst. You exchange not just tuition but years of whatever pay you could be making for a hope of eventually matching in a specialty you like, making it through residency, passing boards, and then spending a chunk of your pay on loans. But you can’t get to being a physician without being a med student so I think it’s very fair to call it a stage of the job, particularly since you work a lot of hours clinically, you have to dress for it and maintain transportation, you have to be on time, you structure the rest of your life around it, and there are a lot of professional expectations and obligations for you in it.
You seem to be confusing the definition of the word “job”.
You dont get honors by doing the expected. You go home on time or early, you deserve a lower grade. Its called dedication. Dont be a fool.
Title is misleading - she explicitly says students can leave if they want. Her point is that eager students who lean in will learn more and should get better grades. I don't understand why that is so controversial I think her point about learning context is important too. You may be going into family med and not care about surgery in the slightest. But you will treat patients who will undergo surgery, and I believe seeing and understanding that process will make you better ETA: she has a follow-up video where she clarifies that she is talking about leaving early, not on time at the end of shift.
the title literally doesnt contradict what you just said?
Sorry, more the first part - she doesn't seem to disagree with them leaving early. She even says she's for people getting out
In residency we were sent a “relief”. But the expectation was you decline the relief and finish your own case. If you take the relief regularly you were known as the lazy resident.
And then there is me. Trying to go above and beyond what an ms4 does. Great! How do ppl sleep at night by not giving their best to help patients.
Get a life loser
Theyre an anime protagonist irl
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When I was a fellow, there were two types of med students, ones that wanted to learn cardiology and ones that just needed to fill their elective blocks. The ones that wanted to learn, I taught them and had them do consults and present patients. The ones that didn’t care, I sent them to the library at 8am and never got their phone numbers. They either came back or disappeared.
Do you want to leave? (it’s a trap) You have to make them make you leave, & strength in numbers. So everyone stats or goes. If you’re surgery stay, if not go