First impressions

June 29, 2007 at 9:02 pm (Clinical rotations)

I started 3rd year this week with surgery as my first rotation—hence why I haven’t updated in a while. If first impressions are anything, I won’t be going into surgery. I been working 12-15 hours a day as a scut monkey for my resident. Somehow, we can’t get a nursing assistant to print lab results and transfer vital signs from the nurses’ tracking sheets to the medical chart. Instead, we need a medical student to transport patients, hold gauze until the resident needs it, and push the cart with X-rays all in the name of “learning.”

For my first day, I was scheduled to arrive at 7AM. Wanting to make a good impression, I got to the hospital at 6:50, found my team, and introduced myself as the new medical student. The resident replied, “Rounds started at 6. Put your bag up and get to work.” I knew immediately that I was in for a long month.

My team consists of 1 resident, 2 interns, and 2 medical students. We have any number of attendings; and at the beginning of this week, we had 18 patients that we were following. To make matters worse, neither of the interns want to become surgeons. They’re on the service only because they’re required to. Instead of assigning patients and pre-rounding, our service requires the medical students to be familiar with everyone on the census. Also, we’re the only ones that perform physical exams. I noticed on the first day that none of the doctors bother carrying stethoscopes. Therefore, the fate of a patient’s physical is up to two 3rd-years who are still inexperienced with catching subtle clues on the exam.

The service is very malignant. When rounding with the attending, he will only speak to the resident—and then only to criticize him. If the attending asks a question and the resident is wrong, prepare to get yelled at. If the attending asks a question and the resident is right, prepared to get yelled at, too. If you’ve ever seen The Devil Wears Prada, you’ll understand how the process works.

The worst part of it all is that I haven’t been in surgery at all this week. I’ve done so much scutwork that I haven’t seen a single surgery. I don’t even know where the OR is. I may very well be the first medical student to get through the clerkship without ever seeing a surgery.

Instead, I fill my time with useless conferences where the resident presents the week’s cases, and then a group of dinosaur attendings yell at him for two hours. They feel the need to participate in these conferences so that they can inflate their egos by belittling someone with less knowledge and experience. By the end of the conference, their egos have swelled so large that they begin insulting each other and the whole ordeal becomes an orgy with everyone trying to get on top by putting down the rest of the group. In addition to not learning anything during this conference, all hell broke loose on the floor during that 2-hour period.

I got back to find that one of our patients suffered a seizure and another had a pulmonary embolism while we were gone. As I was on the phone trying to get a consultant to come take a look at one of the patients, my intern walked into the nurses’ station and announced, “Some guy fell in the hallway out here… There’s a guy on the floor out here… He’s laying right over there.” The rest of that day and the next were filled with damage control to keep from being sued by every patient who gets annoyed with their nurses’ lack of lightning fast response.

To make matters worse, my attending just left to go on vacation. I probably won’t be in the OR next week, either. In addition, my resident’s wife had a baby this week. He left the service one afternoon so she could give birth and announced that rounds would start later the next morning. I got to sleep in until 5AM.

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5 Comments

  1. idcrossroads said,

    Sorry to hear your 3rd year clerkships started off on such a sour note. At least there’s no where else to go but up! I actually thought such malignant residency programs were extinct, but I guess not. So sad… hang in there, it’ll get better. Or at least the rotation would eventually end.

  2. REO SpeedDealer said,

    Surgery as a med student blows because nobody teaches anything and nobody helps you. Surgery as an intern is worse because nobody teaches anything and nobody helps you and you are responsible for everything including the med students.

  3. halfmd said,

    REO, you are right on with the statement that no teaching occurs. We have lectures, but all of the material is a repeat of 1st and 2nd year. Somehow, my resident’s telling me that a whipple involves a partial gastrectomy is supposed to be teaching.

    My interns have it bad. On rounds, my resident will throw out a string of orders without pausing for the interns to write everything down. They then have the responsibility of executing all of the commands, whether or not they caught it all. I’ve started writing down whatever I can so that we can compare notes after rounding to see what exactly the resident wanted.

  4. Miami_med said,

    Wow, that sucks. I’m on OB/GYN at a county hospital, and everyone’s been reasonably cordial to me.

  5. bookmeister said,

    >I may very well be the first medical student to get through the clerkship without
    >ever seeing a surgery.

    …may I be fortunate enough to be the second.

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