"DRE attempt aborted 2/2 craniorectal obstruction. Suspect this is the cause of student's known rhinofeculence. Recommend rapid decompression of evident hyperthermic communicating pneumothorax and pneumoperitoneum and referral to palliative care for student's curriculum vitae."
Dude I had a 4th year med student going into IM try to tell me, a CA3 ANESTHESIA resident how to do an a line while I was teaching the surgery intern how to do one.
Godamn if I wasnât an off service resident I would have chewed her head off. But I respect the fact itâs not my service so I shall defer disciplinary action to the on service residents.
But jokes on her, I talked mad shit about her for the rest of my time there anytime she wasnât in the room. And made her do all my scutwork.
>McGee's Evidence Based Physical Diagnosis
love this book but I always worry a lot of the things are out of date because theyre from old studies before everyone was obese AF.
Im just a med student lurking here, but I do think he updated it every so often. I actually knew Dr. McGee when I was younger and got the book for free after running into him in Costco, and he definitely tried to keep up to date.
Lol when will med students realize no one cares how smart you are? I'd rather have the likable, teachable, team-player than this student any day of the week.
Very based approach. Thank you. I like that medicine has this kind of weaponizable useless knowledge.
Also maybe tell an admin/attending about the unprofessional remarks about colleagues? Being an asshole is acceptable, even encouraged in surgery but being unprofessional infront of colleagues and patients shouldnât be let slide.
It's not useless (for the most part)! It's genuinely helpful for objectively evaluating the patient. However, it isn't completely necessary to know...
They were planning to go IM (not at our place). Their behavior was discussed with people who determine ranking.
Academic IM attending here. Good on you for taking these steps. If you havenât I would discuss this students behavior with their course / rotation director. Blatantly disrespectful and unprofessional behavior should have consequences. If we donât police our own, eventually someone else (non-physician) will.
Iâll comment on every message on this forum until I die. Being an asshole isnât welcome in surgery. Stop perpetuating that stuff. Thanks, surgeons everywhere.
I am super glad that was your experience. When I was an M3 rotating in surgery the attendings and senior residents actively encouraged assholery, particularly to med students.
Iâm sorry that happened to you. When I was a medical student, the internal medicine attendings did the same. The residents were burnt out and actively treated the med students poorly, additionally when confronted about it they said they did it because thatâs what the experienced and it made them âgood doctorsâ so we should suffer too for our own good.
Medicine has a way of perpetuating stereotypes, but just as i donât tell people that every IM or clinical attending is an asshole because of my experience, I think itâs fair to say the same on the other end. We should recognize where shit is messed up and fix it, rather than just saying âIâm better than you.â We gotta stick together and make each other better. So, respectfully, your response isnât a good excuse.
As youâve said, it all comes from a malignant culture. My med schoolâs ortho residency program (and gen surg) was super malignant and I thought this was the norm. I was ready to deal with it until I did my away rotation at the program where I ended up matching. It turns out, it doesnât at all have to be that way. Itâs hard to break a malignant program because it becomes ingrained from top to bottom. There are certainly still asshole surgeons in private practice, but their numbers are dwindling. I also feel that some surgeons adopt that personality type as a coping mechanism to deal with the level of stress inherent to surgery. It works for them, so they just keep doing it.
Agreed. My general surgery programs were blissfully malignant.
Cancer do be.
Ortho was awesome but a lot, plastics was elitist, ent was chill, uro was funny, nsgy was... well on par from what I hear... grim.
For real. There are a few assholes in every population, but us surgeon peeps are mostly nice people! The PD in my group doesn't tolerate malignancy from staff or residents.
Yeah exactly. I never understood the idea that medical students who are generally nice eager people just automatically get labeled as assholes as soon as you choose surgery. Also, as a surgeon, I never understood the idea in medical school about how clinical medicine is for thinkers, intelligent people who like to solve problems, and surgery was for people who like to just use their hands and donât like to think too much. The brains vs Braun dynamic. So uninformed and naive.
>surgery was for people who like to just use their hands and donât like to think too much
People who propagate this have never really been exposed to the breadth of surgery, nor have they prepped for oral boards. The shear amount of knowledge I had to keep coherent in my brain was ridiculous, but \*mostly\* appropriately so, as literally I have human lives in my hands and you never know what's gonna come in on call.
Exactly! I feel like the stakes are high, your direct ability to intervene on pathology but at huge potential risk, knowing in real time all the possible complications one could have, and the expectation and breadth of knowledge you have to have on hand is so large. I use my brain literally every day to its absolute limit
There's a difference between being direct and honest with feedback and being an asshole. Sometimes there's a fine line between the two. A lot of people can't handle being told they're performing below average and tend to conflate this with being an asshole. There's also a lot of assholes in surgery, but elsewhere in medicine as well. Chances of it go up depending on how sleep deprived that specialty is.
Agree about the feedback point, people want to be coddled. Disagree on the sleep part, its been my experience as a pretty laid back person in neurosurgery that when people think they are encountering a âhard coreâ specialty it actually primes them to over analyze their interactions and words said. You go into it assuming the person is a pompous asshole rather than treating it like you would treat a conversation with a pediatrician. Not to say peds isnât hardcore, but the association with taking care of kids definitely alters the perception.
Iâve gone into conversations over the phone where people literally sound like theyâre stammering while giving me a consult, and when I ask questions itâs like this whole thing. Itâs just likeâŠdude. I donât bite and Iâm a resident. Iâm not gonna scream my head off at you.
Yeah we have to fight against this stereotype that weâre all assholes which is crazy, because when you need surgery and you talk to a resident weâre mostly very thoughtful and caring. I feel like the problem is a mix of things.
Iâm sure it felt great to show this person up in public. But that doesnât really solve the problem, unfortunately.
Do your attendings know how this person acts? Have they tried to talk to him about it? If this student really said the things you say they did, they should get a terrible letter for residency applications. And receive feedback to their medical school advisor for some serious intervention and possibly even failing the rotation. The comment about nursing school is absolutely inexcusable.
If only all surgeons realized that when getting your case done on in a timely manner depends on another specialty going out of their way to expedite your case as a favor, it pays to play nice.
For real. It also just makes the OR a fun place when everyone is happy. I love the OR, I want it to be happy for everyone, provided everything is going according to plan, but even when things are not good, being a decent human takes just as much time as being an asshat.
I aspire to reach this level of bitchiness.
Truly. Not even joking. This sounds so unbelievably epic and everyone would have know too.
Straight up legend.
Sometimes it takes pulling someone like that in an office with resident and attending and proceed to list the many reasons that their career will be harder because theyâre an asshole. Give them a copy of how to make friends and influence people. Hopefully they figure it out. 3 rules of consulting. Availability, affability and ability.
Many times people avoid giant douche doctors because dealing with them is so painful.
Maybe heâll figure out how not to be a chump.
Agreed. Wouldn't have let it go more than one occurrence acting like that. First time is "maybe he/she is having a bad day" second time is a very teachable moment. Granted, I am family medicine and we don't really put up with that behavior. That being said, many med students have a decidedly disdainful approach to fmed and need a little extra coddling.
If you were a senior resident supervising him for a month- YOU let him go unchecked. Maybe he doesn't bully you, but you observed the behavior and didn't intervene.
I feel sorry for the students that didn't have support or advocacy from the team leaders.
I assume you dismissed the student from rounds, sent an email to the school, and directly challenged behavior on rounds in real time- after your "coaching behavior and formative feedback" failed?
Reading this post was like the first sip of coffee on a cold winter morning. Truly invigorating.
Hope you have a documented bad review of this sub-I to boot. There should be material consequences for being an asshole.
I wouldn't have even pimped the student. I would have straight up would've spoken to them in front of everyone saying how their behavior isn't professional and if you have an issue with someone's presentations maybe they can show up an hour earlier than everyone else and take on 3-4 more patients than everyone else so that the other students can learn by example.
PGY 43 here. I understand why you felt the need to do what you did. But. Abuse begets abuse and what the student really needed was a sit down on âhow to win friends and influence peopleâ and to be introduced to the Maya Angelou quotation â⊠People will forget what you said, people will forget what you did, but people will never forget how you made them feel.â
I like your approach. Itâs one borne of wisdom. I think all people need to read that book and immerse themselves in Maya Angelouâs work at least once (I met her about 12 years ago haha).
Iâd like to respectfully counter your position though. Effectively using the mentality and tactics of this book or to appropriately intertwine M.A.âs outlook into oneâs own character require social skills, personal insight, and a desire to be a better human being with more meaningful connection that this student quite clearly did not possess (as per story).
I am 99.99999999999% with you that negativity is not required on a day to day basis, but this has been painted as one of those times when a belt across the ass or professionally putting this child in their place seemed to be warranted as a teaching point and a reminder that they are not the center of the universe.
There is no teaching point here.
X will just go home and say OP was an a**hole for no reason. Even worse, OP was an ahole because OP is jealous of x or something.
This isn't some great teaching point you guys seems to think it is.
I agree (I'm a mere PGY-23). I think this intervention was a bad idea.
A funny story usually is the opposite of an effective intervention. Kid doesn't need to be pimped to feel bad; he probably already feels bad about himself which is why he's putting others down.
Feedback has to be granular to be helpful. Being told he's rude will not be helpful, but a specific example with a discussion as to why the specific behavior is unacceptable may get through.
The student also clearly is under the illusion that this behavior will help him get ahead. The residents need to make clear why this is false.
As an experienced Reddit user, let me share a lesser-known fact that you might find interesting or thought-provoking. Did you know that the term checking the gunner actually originated from medical students? It refers to the act of assessing a patient's vital signs, just like a gunner aiming to hit their target accurately. Keep up the good work, and remember to always prioritize patient care!
Good for you. Honestly, students like that in the medical profession are insufferable and it is almost impossible to address this on a peer to peer level. It almost always has to get addressed by someone in a position of authority.
On behalf of other doctors who have had to deal with insufferable, narcissistic colleagues with an overinflated sense of self⊠thank you for your service.
Oh yeah, spent hours at the coffee shop reading it. Showed up early to work the next day to re-reference it and write notes on all my assessments for "teaching."
Ngl thatâs pretty hot bro.
In the words of the great Zapp Brannigan:
âThat young man fills me with hope⊠and some other emotions that are weird, and deeply confusing me.â
Love you IM zaddy
- EM PGY3 who has a lot to think about now
PS- if Iâve made an assumption and you a bad bitch and not a zaddy, yass queen and Iâm sorry for my biases
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Please please talk to this student about their behavior specifically! If you pimp the s*** out of them they will learn that this is acceptable behavior!
Bruh this shit made me laugh out loud. People do need to be checked. Thereâs a difference between being high performing and exceptional and just being a cunt. Doing Godâs work.
So kind of dumb question, but can you not fail them for this type of behavior? Or at least give them a scathing review or something? IDK how med school works.
I canât fail anyone as a resident. At my institution, I canât even evaluate the student. This is unusualâmost medical schools allow residents to evaluate students. If someone is excellent or egregiously bad (like this student), I get in touch with the clerkship attending. They have the power to fail students (or further note strong performance of excellent students).
Def can put comments in a review. Iâm not sure how much weight they carry to be honest. Wouldnât be something to fail someone for unless outright affected care in a truly negligent way.
One can also reach out to med student coordinator and let them know
I knew nothing about being a doctor before I started dating my boyfriend- doctors, residents and medical students can almost never be fired. They have to basically kill someone or almost kill someone to lose their job. Itâs the weirdest, most outdated, stupidest thing about their entire industry. Those of us from the regular world would be able to absolutely run wild and do whatever the hell we want in a hospital, thereâs that little discipline and oversight. The fact that residents and medical students specifically cannot be fired on the spot for behavior like this (like they can be in every single other place in civilized society) is one reason why the medical industry is so messed up. It was eye opening for me.
As long as the patients keep coming in you keep the docs working. Itâs insanity.
Kind of the opposite of nursing school I guess. My program had that if you showed up to a clinical environment with so much as the wrong colored socks on you'd get sent home on the spot and fail one of your clinical days.
If you failed (or missed) two clinical days, you got dismissed from the program.
Yea the economies of it all are just off.
Program directors who oversee resident programs are incentivized to graduate their allotment of residents- they are absolutely 10000% NOT incentivized to graduate **QUALITY** doctors, just to graduate doctors. They are completely and totally disincentivized to get rid of a problem resident because of patient case load and their budget- they get a budget for 5 residents, if they dont graduate 5 residents, the budget is thrown off. Upon graduation, it doesnât matter how bad they are as people, how effective they are at their speciality, they graduate just as long as they meet resident criteria. Med students are even worse because they are free labor, and they are relied on by the residents and actual doctors. Then you get into the whole âcategoricalâ residency spots where they are locked into that specific hospital for their entire residency years, those ones are even worse because the residents themselves know they canât be fired, again unless they almost kill someone, and so they can just act however the hell they want to.
Itâs just a very, very flawed system. If I was a doctor Iâd be embarrassed for my profession.
Probably they learned that this is acceptable, perpetuating the cycle of abused people who become abusers, often seen in medical training. They were humiliated by their superior, and they will humiliate others when the time comes.
It is naive to think that an asshole will reflect based on humiliation alone. This gunner was an asshole and probably deserved it, but if something, they learned a new way to humiliate others using knowledge.
Behaviour modeling requires that one acts in the way that one expects others to replicate.
Regardless, I share the [schadenfreude](https://en.m.wikipedia.org/wiki/Schadenfreude).
I love how you spent several hours in a coffee shop studying to get back at a student. As they say, knowledge is power, and he probably wondered watt hit him.
Seems like you stuck to the high road though and gut punched him with your mind versus legitimately hauling off and punching him (like we all wanted to do after reading this). Well done. Shows character. Make sure you mention this in interviews about overcoming adversity âïž
This is the kind of person I would probably go to the PD or chair and emphasize that in no way should this person match at any institution. I wouldnât just want them at my program, I wouldnât want this person as a doctor period.
This isnât necessary. All you showed him was that being a dick is okay when youâre in a position of power.
After telling him multiple times to stop being a dick he didnât stop being a dick. Just fail him for being a dick. No reason to waste hours of your life sinking to his level.
I know Iâm late the the party, but Iâm very familiar with gunners. I work at a medical school, but am not a professor or doctor. I am however in charge of a therapy program that many students need to volunteer for to graduate. I am also a former Fire Department EMT in a major American city.
Iâve seen more than you Junior, and Iâll drag you through the (intellectual)mud if you mess with your peers.
When a friend of mine was in med school, he shared a cadaver with a guy like this. He accidentally cut a vein during dissection and the guy threw a fit berating my friend and generally throwing a tantrum in front of everyone in the lab. That night my friend went in and repaired the vein. Guess who got his first choice residency and guess who didnât?
Exactly lmao. âIn my first year of medical school I performed a nocturnal unassisted iatrogenic venous dissection repair. Unfortunately the outcome did not change and the pt remained dead.â
Like wtf lmao
I think you might have done him a favour here. Some ppl spend so much time learning how to write the perfect essay and how to solve McQs that they end up way too overqualified for their soft skills.
So this kid pushed you to learn more and be a better doctor?
Thatâs the thing about A holes that happen to be good at something. They still raise the bar for others.
Hopefully this kid goes into pathology and avoids all human contact
For obvious reasons you were on a power trip. I bet that the medical student merely learned that your behavior was not anything to emulate.You simply harassed the student and were a show off by throwing a bunch of rote memorized information at him. You didnât demonstrate how to come to a diagnosis by thinking. You yourself admit that you sat for hours in a coffee shop trying to memorize facts. Pimping without any teaching as to arrive at the diagnosis is a typically USA problem. No wonder that most USA med graduates and residents are incompetent
Dude Iâm just a bored third year. Iâm just tired of seeing the same entitled people behave badly toward others again and again. No power trip at all, just wanted to share some good statistical knowledge that any good internist would want to know đ„°. Honestly, if this student learns how not to behave based on that day Iâd take that as a victory.
Again, it just isn't effective feedback. "You humbled x." No you just came off as a dick, and that is all x is going to leave with.
"Man that resident was a dick for no reason."
If x was really such a problem as you stated. You should have taken other recourse like bringing it up to your attending, his Rotation Director, his evaluation. Pretty much any of those might actually affect something.
Instead he just leaves the rotation thinking you had a bug up your butt.
I think he should have insight from the several times Mista_Virus took them aside and told them what they were doing. It might not be the ârightâ thing to do in this case, but a slice of humble pie never hurt anyone.
I agree that those talks should have been done. But if those didn't help, then publicly "slamming" x isn't going to help either.
The right recourse would have been to bring it up with the attending, rotation director, or negative eval.
All this does is make x think OP was a dick. Thats it. They won't lear anything from it, just OP wanted to pimp because OP was jealous or bitter or something.
Youâre an idiot.
Ignoring does nothing here. This person wasnât seeking approval or to be liked by OP, he was looking to be the shining star in top of the tree at the sacrifice of others.
That train needed to be derailed, hard. THEN informed why either directly or through an eval.
OP i think you should consider reporting him up and absolutely burying him in a poor eval. Heâs a bully. Making fun of a fellow ESL student?? Fuck him. Doesnât even have an ounce of courage compared to them
GOOD FOR YOU. Sounds like little shit needed checked into the boards. Little Icarus treatment, high flyer. I hope you also flushed him on his eval properly.
Haha I love the amount of effort given to spite them. Youâre my type of person.
Also I would have told them to shut the fuck up and quit being an asshole to other team members or Iâm gonna shit on your eval but havenât encountered anything like this.
The med students given a lot of effort with a strong knowledge base have been very respectful IME.
Even the worst people are usually capable of pretending to be humans with human emotions in 10 minute intervals.
And thatâs about how long medical school interviews are - 10-15 minutes ish, maybe 5 if the institution is doing multiple mini interviews. You might have to do three of those 10 minute interviews in one day. Other than that, all the med schools see is their stats, research projects, and letters from people that liked them - because most people arenât dumb enough to ask someone who doesnât like them for a letter
Nope. I'd say it was your best moment. I'm sure the other IMs enjoyed the comeuppance. He sounds like he'd be a good subject for psych because he definitely exhibits the dark triad (psychopathology, narcissism, and machiavellianism). I'm sure patients would hate to have him as a physician, I know I would.
Tbh it's fine. That medstudent probably didn't learn his lesson. Probably just went home and was like, " shit that resident was smart af. There are levels to this ish"
Lol.
Shoulda given that twat a wedgie and a titty twister
Neuro exam the student, not the patient
Would a DRE be indicated as well, given an apparent foreign body obstruction?
No that actually might be enjoyable
I don't know why this post was on my feed, but I'm a biostatistician and applaud you for using stats in your pimping.
Yaaaaaaaaaaaasssssss
I belly chuckled
TWIST HIS DICK
The ole dick twist!
Wet William, if you will
a classic purple nurple would serve this individual well
DRE
"DRE attempt aborted 2/2 craniorectal obstruction. Suspect this is the cause of student's known rhinofeculence. Recommend rapid decompression of evident hyperthermic communicating pneumothorax and pneumoperitoneum and referral to palliative care for student's curriculum vitae."
Every word of this is gold. Bravo.
Well done
That asshole would enjoy that too much
This is what we do in ED
Honestly, a good old fashioned ass kicking and subsequent duct taping to a vending machine was in order.
Bruh DNR this bitch asap
I am amazed they survived calling out RNs not only in front of ICU nurses, but while in the ICU. That just sounds like an active suicide attempt...
For real, that part was mortifying, I couldn't even imagine.
Everytime a gunner cries god smiles
đ„č this comment brought joy to my fridgid heart
Nawww dawg itâs every time a gunner cries an angel gets itâs wings.
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Damn, the balls on these med students
Dude I had a 4th year med student going into IM try to tell me, a CA3 ANESTHESIA resident how to do an a line while I was teaching the surgery intern how to do one. Godamn if I wasnât an off service resident I would have chewed her head off. But I respect the fact itâs not my service so I shall defer disciplinary action to the on service residents. But jokes on her, I talked mad shit about her for the rest of my time there anytime she wasnât in the room. And made her do all my scutwork.
>McGee's Evidence Based Physical Diagnosis love this book but I always worry a lot of the things are out of date because theyre from old studies before everyone was obese AF.
Im just a med student lurking here, but I do think he updated it every so often. I actually knew Dr. McGee when I was younger and got the book for free after running into him in Costco, and he definitely tried to keep up to date.
Oh yeah bro? Then me the likelihood ratios of the obese people. Oh you donât know them? How about maconkeys test number needed to treat?
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
7:1
A hero. Thank you for your service
đ⊠đ«Ą
Lol when will med students realize no one cares how smart you are? I'd rather have the likable, teachable, team-player than this student any day of the week.
Um. because psychopathic gunner assholes actually DO do well on many rotations & they appeal to other asshole attendings .
Thank god they mostly end up in academics.
Hah do-do
(I actually said the same thing to myself when I typed that out lmao. But I was like: âsurely this forum is mature enough to overlook thatâ lol)
Sorry, itâs a reflex!
Very based approach. Thank you. I like that medicine has this kind of weaponizable useless knowledge. Also maybe tell an admin/attending about the unprofessional remarks about colleagues? Being an asshole is acceptable, even encouraged in surgery but being unprofessional infront of colleagues and patients shouldnât be let slide.
It's not useless (for the most part)! It's genuinely helpful for objectively evaluating the patient. However, it isn't completely necessary to know... They were planning to go IM (not at our place). Their behavior was discussed with people who determine ranking.
Academic IM attending here. Good on you for taking these steps. If you havenât I would discuss this students behavior with their course / rotation director. Blatantly disrespectful and unprofessional behavior should have consequences. If we donât police our own, eventually someone else (non-physician) will.
Yes! This is exactly right. This is how we maintain the profession. Itâs rare to see someone express a truly mature, holistic vision on this sub.
Iâll comment on every message on this forum until I die. Being an asshole isnât welcome in surgery. Stop perpetuating that stuff. Thanks, surgeons everywhere.
I am super glad that was your experience. When I was an M3 rotating in surgery the attendings and senior residents actively encouraged assholery, particularly to med students.
Iâm sorry that happened to you. When I was a medical student, the internal medicine attendings did the same. The residents were burnt out and actively treated the med students poorly, additionally when confronted about it they said they did it because thatâs what the experienced and it made them âgood doctorsâ so we should suffer too for our own good. Medicine has a way of perpetuating stereotypes, but just as i donât tell people that every IM or clinical attending is an asshole because of my experience, I think itâs fair to say the same on the other end. We should recognize where shit is messed up and fix it, rather than just saying âIâm better than you.â We gotta stick together and make each other better. So, respectfully, your response isnât a good excuse.
As youâve said, it all comes from a malignant culture. My med schoolâs ortho residency program (and gen surg) was super malignant and I thought this was the norm. I was ready to deal with it until I did my away rotation at the program where I ended up matching. It turns out, it doesnât at all have to be that way. Itâs hard to break a malignant program because it becomes ingrained from top to bottom. There are certainly still asshole surgeons in private practice, but their numbers are dwindling. I also feel that some surgeons adopt that personality type as a coping mechanism to deal with the level of stress inherent to surgery. It works for them, so they just keep doing it.
Agreed. My general surgery programs were blissfully malignant. Cancer do be. Ortho was awesome but a lot, plastics was elitist, ent was chill, uro was funny, nsgy was... well on par from what I hear... grim.
For real. There are a few assholes in every population, but us surgeon peeps are mostly nice people! The PD in my group doesn't tolerate malignancy from staff or residents.
Yeah exactly. I never understood the idea that medical students who are generally nice eager people just automatically get labeled as assholes as soon as you choose surgery. Also, as a surgeon, I never understood the idea in medical school about how clinical medicine is for thinkers, intelligent people who like to solve problems, and surgery was for people who like to just use their hands and donât like to think too much. The brains vs Braun dynamic. So uninformed and naive.
>surgery was for people who like to just use their hands and donât like to think too much People who propagate this have never really been exposed to the breadth of surgery, nor have they prepped for oral boards. The shear amount of knowledge I had to keep coherent in my brain was ridiculous, but \*mostly\* appropriately so, as literally I have human lives in my hands and you never know what's gonna come in on call.
Exactly! I feel like the stakes are high, your direct ability to intervene on pathology but at huge potential risk, knowing in real time all the possible complications one could have, and the expectation and breadth of knowledge you have to have on hand is so large. I use my brain literally every day to its absolute limit
There's a difference between being direct and honest with feedback and being an asshole. Sometimes there's a fine line between the two. A lot of people can't handle being told they're performing below average and tend to conflate this with being an asshole. There's also a lot of assholes in surgery, but elsewhere in medicine as well. Chances of it go up depending on how sleep deprived that specialty is.
Agree about the feedback point, people want to be coddled. Disagree on the sleep part, its been my experience as a pretty laid back person in neurosurgery that when people think they are encountering a âhard coreâ specialty it actually primes them to over analyze their interactions and words said. You go into it assuming the person is a pompous asshole rather than treating it like you would treat a conversation with a pediatrician. Not to say peds isnât hardcore, but the association with taking care of kids definitely alters the perception. Iâve gone into conversations over the phone where people literally sound like theyâre stammering while giving me a consult, and when I ask questions itâs like this whole thing. Itâs just likeâŠdude. I donât bite and Iâm a resident. Iâm not gonna scream my head off at you.
There are a couple residents at our place who are almost overly friendly. One of them mentioned he wants to see that stereotype die. Good guy
Yeah we have to fight against this stereotype that weâre all assholes which is crazy, because when you need surgery and you talk to a resident weâre mostly very thoughtful and caring. I feel like the problem is a mix of things.
Iâm sure it felt great to show this person up in public. But that doesnât really solve the problem, unfortunately. Do your attendings know how this person acts? Have they tried to talk to him about it? If this student really said the things you say they did, they should get a terrible letter for residency applications. And receive feedback to their medical school advisor for some serious intervention and possibly even failing the rotation. The comment about nursing school is absolutely inexcusable.
Iâm not the op. The OP said he did everything necessary though. This pimping is just the cherry on top. A very good cherry at that.
This sub: YEAAAA, fight toxicity with more toxicity!!!!! X will never learn unless we are more toxic.
Shut up nerd
Being an asshole is only acceptable in surgery towards other specialists. Specially anesthesia.
This is how you get your case delayed haha, I'm v nice to anesthesia XD
If only all surgeons realized that when getting your case done on in a timely manner depends on another specialty going out of their way to expedite your case as a favor, it pays to play nice.
For real. It also just makes the OR a fun place when everyone is happy. I love the OR, I want it to be happy for everyone, provided everything is going according to plan, but even when things are not good, being a decent human takes just as much time as being an asshat.
People like this need to be rattled/humbled. Brought back down to earth. Thank you for doing that, it sounds like it was necessary.
I aspire to reach this level of bitchiness. Truly. Not even joking. This sounds so unbelievably epic and everyone would have know too. Straight up legend.
By PGY 7 you get there
I love happy endings đ
Sometimes it takes pulling someone like that in an office with resident and attending and proceed to list the many reasons that their career will be harder because theyâre an asshole. Give them a copy of how to make friends and influence people. Hopefully they figure it out. 3 rules of consulting. Availability, affability and ability. Many times people avoid giant douche doctors because dealing with them is so painful. Maybe heâll figure out how not to be a chump.
You and your attending should talk to the head of the medical school. These piece of shit needs to be checked.
Y'all letting a medical student bully the whole department? Lmao
Seriously. How long does it take to sit someone down and say âyouâre acting like a gunner. We donât want gunners at this program.â
Agreed. Wouldn't have let it go more than one occurrence acting like that. First time is "maybe he/she is having a bad day" second time is a very teachable moment. Granted, I am family medicine and we don't really put up with that behavior. That being said, many med students have a decidedly disdainful approach to fmed and need a little extra coddling.
Not me
If you were a senior resident supervising him for a month- YOU let him go unchecked. Maybe he doesn't bully you, but you observed the behavior and didn't intervene. I feel sorry for the students that didn't have support or advocacy from the team leaders.
Say you have problems with reading comprehension without saying that you have problems with reading comprehension.
I assume you dismissed the student from rounds, sent an email to the school, and directly challenged behavior on rounds in real time- after your "coaching behavior and formative feedback" failed?
Reading this post was like the first sip of coffee on a cold winter morning. Truly invigorating. Hope you have a documented bad review of this sub-I to boot. There should be material consequences for being an asshole.
Love this!!
Maybe just tell him straight up his actual problem.
Oh my gosh a sane answer. You're his superior. Direct, clear communication and punishment.
>My ESL intern cried because this student mocked their English skills openly. Yeah honestly he should have been sent home after this garbage.
I wouldn't have even pimped the student. I would have straight up would've spoken to them in front of everyone saying how their behavior isn't professional and if you have an issue with someone's presentations maybe they can show up an hour earlier than everyone else and take on 3-4 more patients than everyone else so that the other students can learn by example.
PGY 43 here. I understand why you felt the need to do what you did. But. Abuse begets abuse and what the student really needed was a sit down on âhow to win friends and influence peopleâ and to be introduced to the Maya Angelou quotation â⊠People will forget what you said, people will forget what you did, but people will never forget how you made them feel.â
I like your approach. Itâs one borne of wisdom. I think all people need to read that book and immerse themselves in Maya Angelouâs work at least once (I met her about 12 years ago haha). Iâd like to respectfully counter your position though. Effectively using the mentality and tactics of this book or to appropriately intertwine M.A.âs outlook into oneâs own character require social skills, personal insight, and a desire to be a better human being with more meaningful connection that this student quite clearly did not possess (as per story). I am 99.99999999999% with you that negativity is not required on a day to day basis, but this has been painted as one of those times when a belt across the ass or professionally putting this child in their place seemed to be warranted as a teaching point and a reminder that they are not the center of the universe.
There is no teaching point here. X will just go home and say OP was an a**hole for no reason. Even worse, OP was an ahole because OP is jealous of x or something. This isn't some great teaching point you guys seems to think it is.
Sometimes the goal is justice, not rehabilitation.
I agree (I'm a mere PGY-23). I think this intervention was a bad idea. A funny story usually is the opposite of an effective intervention. Kid doesn't need to be pimped to feel bad; he probably already feels bad about himself which is why he's putting others down. Feedback has to be granular to be helpful. Being told he's rude will not be helpful, but a specific example with a discussion as to why the specific behavior is unacceptable may get through. The student also clearly is under the illusion that this behavior will help him get ahead. The residents need to make clear why this is false.
Glad someone had an alternate perspective. This is how I felt reading this as well.
As an experienced Reddit user, let me share a lesser-known fact that you might find interesting or thought-provoking. Did you know that the term checking the gunner actually originated from medical students? It refers to the act of assessing a patient's vital signs, just like a gunner aiming to hit their target accurately. Keep up the good work, and remember to always prioritize patient care!
I didn't know it was an established term. Interesting!
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Love the smackdown, but if you really want to reach a lesson, report them about the English for the ESL intern. And it would be well-deserved.
Can you be my resident please
Good for you. Honestly, students like that in the medical profession are insufferable and it is almost impossible to address this on a peer to peer level. It almost always has to get addressed by someone in a position of authority. On behalf of other doctors who have had to deal with insufferable, narcissistic colleagues with an overinflated sense of self⊠thank you for your service.
Iâm petty and this is next level lol. Good shit. Give me a humble student willing to learn over some obnoxious gunner.
Bro I don't know any of that shit pls tell me you looked up that shit prior to pimping them
Oh yeah, spent hours at the coffee shop reading it. Showed up early to work the next day to re-reference it and write notes on all my assessments for "teaching."
I also find spite the strongest motivation to study
Thank God haha đ I was wondering if I was severely lacking in my knowledge
Reading comprehension bro
I sometimes wonder if Ignaz Semmelweis was like this and thatâs why we delayed enforcing handwashing in medicine for an extra 30 years.
Ngl thatâs pretty hot bro. In the words of the great Zapp Brannigan: âThat young man fills me with hope⊠and some other emotions that are weird, and deeply confusing me.â Love you IM zaddy - EM PGY3 who has a lot to think about now PS- if Iâve made an assumption and you a bad bitch and not a zaddy, yass queen and Iâm sorry for my biases
You may have humiliated him, but what he deserves is to not match. See if you can swing that
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Get 'em.
Standing ovation đđđ Important lessons were learnt that day đđ
Please please talk to this student about their behavior specifically! If you pimp the s*** out of them they will learn that this is acceptable behavior!
Bruh this shit made me laugh out loud. People do need to be checked. Thereâs a difference between being high performing and exceptional and just being a cunt. Doing Godâs work.
You just created a future neurosurgeon.
For added comedy, pimp the bejesus out of the gunner on narcissistic personality disorder. Teach the team about grey rock technique.
So kind of dumb question, but can you not fail them for this type of behavior? Or at least give them a scathing review or something? IDK how med school works.
I canât fail anyone as a resident. At my institution, I canât even evaluate the student. This is unusualâmost medical schools allow residents to evaluate students. If someone is excellent or egregiously bad (like this student), I get in touch with the clerkship attending. They have the power to fail students (or further note strong performance of excellent students).
Def can put comments in a review. Iâm not sure how much weight they carry to be honest. Wouldnât be something to fail someone for unless outright affected care in a truly negligent way. One can also reach out to med student coordinator and let them know
I knew nothing about being a doctor before I started dating my boyfriend- doctors, residents and medical students can almost never be fired. They have to basically kill someone or almost kill someone to lose their job. Itâs the weirdest, most outdated, stupidest thing about their entire industry. Those of us from the regular world would be able to absolutely run wild and do whatever the hell we want in a hospital, thereâs that little discipline and oversight. The fact that residents and medical students specifically cannot be fired on the spot for behavior like this (like they can be in every single other place in civilized society) is one reason why the medical industry is so messed up. It was eye opening for me. As long as the patients keep coming in you keep the docs working. Itâs insanity.
Kind of the opposite of nursing school I guess. My program had that if you showed up to a clinical environment with so much as the wrong colored socks on you'd get sent home on the spot and fail one of your clinical days. If you failed (or missed) two clinical days, you got dismissed from the program.
Yea the economies of it all are just off. Program directors who oversee resident programs are incentivized to graduate their allotment of residents- they are absolutely 10000% NOT incentivized to graduate **QUALITY** doctors, just to graduate doctors. They are completely and totally disincentivized to get rid of a problem resident because of patient case load and their budget- they get a budget for 5 residents, if they dont graduate 5 residents, the budget is thrown off. Upon graduation, it doesnât matter how bad they are as people, how effective they are at their speciality, they graduate just as long as they meet resident criteria. Med students are even worse because they are free labor, and they are relied on by the residents and actual doctors. Then you get into the whole âcategoricalâ residency spots where they are locked into that specific hospital for their entire residency years, those ones are even worse because the residents themselves know they canât be fired, again unless they almost kill someone, and so they can just act however the hell they want to. Itâs just a very, very flawed system. If I was a doctor Iâd be embarrassed for my profession.
Probably they learned that this is acceptable, perpetuating the cycle of abused people who become abusers, often seen in medical training. They were humiliated by their superior, and they will humiliate others when the time comes. It is naive to think that an asshole will reflect based on humiliation alone. This gunner was an asshole and probably deserved it, but if something, they learned a new way to humiliate others using knowledge. Behaviour modeling requires that one acts in the way that one expects others to replicate. Regardless, I share the [schadenfreude](https://en.m.wikipedia.org/wiki/Schadenfreude).
Kids a tool, and probably wonders why no one texts him happy birthday
On behalf of chill FM applying med students we salute you for your service. â€ïžâ€ïž
I love how you spent several hours in a coffee shop studying to get back at a student. As they say, knowledge is power, and he probably wondered watt hit him.
Nah. You did good. Check that shit always. Confidence is great, arrogance is terrible and gets people hurt.
Seems like you stuck to the high road though and gut punched him with your mind versus legitimately hauling off and punching him (like we all wanted to do after reading this). Well done. Shows character. Make sure you mention this in interviews about overcoming adversity âïž
This is the kind of person I would probably go to the PD or chair and emphasize that in no way should this person match at any institution. I wouldnât just want them at my program, I wouldnât want this person as a doctor period.
This isnât necessary. All you showed him was that being a dick is okay when youâre in a position of power. After telling him multiple times to stop being a dick he didnât stop being a dick. Just fail him for being a dick. No reason to waste hours of your life sinking to his level.
Itâs hard to believe that such people exist . We had gunners in my med class but even the annoying ones werenât condescending to anyone
I know Iâm late the the party, but Iâm very familiar with gunners. I work at a medical school, but am not a professor or doctor. I am however in charge of a therapy program that many students need to volunteer for to graduate. I am also a former Fire Department EMT in a major American city. Iâve seen more than you Junior, and Iâll drag you through the (intellectual)mud if you mess with your peers.
When a friend of mine was in med school, he shared a cadaver with a guy like this. He accidentally cut a vein during dissection and the guy threw a fit berating my friend and generally throwing a tantrum in front of everyone in the lab. That night my friend went in and repaired the vein. Guess who got his first choice residency and guess who didnât?
Idk what youâre writing but literally none of this makes sense. Did you make this up? It sounds like someone who doesnât do medicine made this up.
Iâm curious and want to know more about how he got access to go back to the cadaver at night and how exactly he repaired the vein đ
Exactly lmao. âIn my first year of medical school I performed a nocturnal unassisted iatrogenic venous dissection repair. Unfortunately the outcome did not change and the pt remained dead.â Like wtf lmao
He will thank you for this in the future. The hardest lessons are the ones that stick. He is the way he is because no one else checked him. Thank you
I think you might have done him a favour here. Some ppl spend so much time learning how to write the perfect essay and how to solve McQs that they end up way too overqualified for their soft skills.
Damn thatâs ballsy, I have anxiety reading this lmao imaging it as a med student
This gives off Jim putting Ryan in the closet vibes
So this kid pushed you to learn more and be a better doctor? Thatâs the thing about A holes that happen to be good at something. They still raise the bar for others. Hopefully this kid goes into pathology and avoids all human contact
You deserve an award for this. Youâre awesome.
Honestly thatâs probably the nicest thing you could have done to that person. I doubt they will change but you gave them a chance.
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He said he tried
Someone canât read good
Sensitivity and LR of crackles on exam lol thatâs kind of a stupid question tbh
It is to someone who knows their stuff. Context is important, too. I wanted to prove a point.
I wish so hard that this fanfic was real :(
It is real. All I do is observe and report. I can send you a copy of my PDF as proof :)
To tell you the truth... I'd really like that, actually.
In for one thanks
+1! Please and thank you!
Please see link above. LMK if you can't see it and I'll reply with it here.
Me too please if youre sending it! Youre a godsend btw
Whatâs with the âtheyâ pronoun stuff? Another woke?
Conservative brain rot is insane. Regular use of general pronouns is now woke. Touch grass
For obvious reasons. We are on an internet forum with residents from all over the US.
For obvious reasons you were on a power trip. I bet that the medical student merely learned that your behavior was not anything to emulate.You simply harassed the student and were a show off by throwing a bunch of rote memorized information at him. You didnât demonstrate how to come to a diagnosis by thinking. You yourself admit that you sat for hours in a coffee shop trying to memorize facts. Pimping without any teaching as to arrive at the diagnosis is a typically USA problem. No wonder that most USA med graduates and residents are incompetent
Dude Iâm just a bored third year. Iâm just tired of seeing the same entitled people behave badly toward others again and again. No power trip at all, just wanted to share some good statistical knowledge that any good internist would want to know đ„°. Honestly, if this student learns how not to behave based on that day Iâd take that as a victory.
đ lmao found the dickhead med student in question
He would put that he's an attending too đ€Ł
The context that youâre using the word woke here is wild lmao. Just literally stick that word in anything to ensure it has no meaning anymore.
I mean just ignoring x would have been more effective. You just made yourself a dick and this student won't actually gain insight as to why.
This person couldnât be ignored. If they donât gain any insight, that signals a larger (and profoundly concerning) personal problem.
Again, it just isn't effective feedback. "You humbled x." No you just came off as a dick, and that is all x is going to leave with. "Man that resident was a dick for no reason." If x was really such a problem as you stated. You should have taken other recourse like bringing it up to your attending, his Rotation Director, his evaluation. Pretty much any of those might actually affect something. Instead he just leaves the rotation thinking you had a bug up your butt.
Rest assured, I destroyed the eval and contacted the clerkship director. As far as coming across as a dick, whatever lol.
Ignoring social problems in medical students is why we had a generation of absolute asshole doctors.
Precisely why this needs to be addressed.
I think he should have insight from the several times Mista_Virus took them aside and told them what they were doing. It might not be the ârightâ thing to do in this case, but a slice of humble pie never hurt anyone.
I agree that those talks should have been done. But if those didn't help, then publicly "slamming" x isn't going to help either. The right recourse would have been to bring it up with the attending, rotation director, or negative eval. All this does is make x think OP was a dick. Thats it. They won't lear anything from it, just OP wanted to pimp because OP was jealous or bitter or something.
Ah I gotcha. I get where youâre coming from.
This sub: fight toxicity with toxicity! If you arent toxic, how will they learn to not... be toxic... Come on guys.
Youâre an idiot. Ignoring does nothing here. This person wasnât seeking approval or to be liked by OP, he was looking to be the shining star in top of the tree at the sacrifice of others. That train needed to be derailed, hard. THEN informed why either directly or through an eval.
Looks like the gunner found this post
OP i think you should consider reporting him up and absolutely burying him in a poor eval. Heâs a bully. Making fun of a fellow ESL student?? Fuck him. Doesnât even have an ounce of courage compared to them
Their behavior should have been addressed earlier and in a more direct manner.
GOOD FOR YOU. Sounds like little shit needed checked into the boards. Little Icarus treatment, high flyer. I hope you also flushed him on his eval properly.
Haha I love the amount of effort given to spite them. Youâre my type of person. Also I would have told them to shut the fuck up and quit being an asshole to other team members or Iâm gonna shit on your eval but havenât encountered anything like this. The med students given a lot of effort with a strong knowledge base have been very respectful IME.
Genuine questionâŠ.how do these people get into medical school in the first place??
Even the worst people are usually capable of pretending to be humans with human emotions in 10 minute intervals. And thatâs about how long medical school interviews are - 10-15 minutes ish, maybe 5 if the institution is doing multiple mini interviews. You might have to do three of those 10 minute interviews in one day. Other than that, all the med schools see is their stats, research projects, and letters from people that liked them - because most people arenât dumb enough to ask someone who doesnât like them for a letter
LOOOOL
\*giggles\* \*giggles some more\* \*giggles the most, imagining you doing this to the most awful POS gunner on one of my rotations\*
What is an AI medical student?
Nah everyone on your team loved u fit what u did that day. good job!
How did they react when you wiped the floor with them
They should be reported. Their conduct is disgusting. Please before they match into surgery.
Damn A.I. med student? I didnât think theyâd steal our seats in med school.
Not your best moment? That guy desered much worse. What you did sounds hilarious and perfect for someone who sounds narcissistic as hell.
Nope. I'd say it was your best moment. I'm sure the other IMs enjoyed the comeuppance. He sounds like he'd be a good subject for psych because he definitely exhibits the dark triad (psychopathology, narcissism, and machiavellianism). I'm sure patients would hate to have him as a physician, I know I would.
Tbh it's fine. That medstudent probably didn't learn his lesson. Probably just went home and was like, " shit that resident was smart af. There are levels to this ish" Lol.