Lies that attendings tell

November 4, 2007 at 11:53 pm (Clinical rotations)

As a medical student, you’ll hear lots of one-line clich‚s that attendings tell to break you into the system. Unfortunately, all of these pearls are lies. Here are just some of the half-truths I’ve run across this year:

“The hierarchy in medicine is just like the military” — Always stated by someone who never served in the armed forces, this lie is meant to justify the way attendings and residents treat students. Apparently, watching the media depiction of boot camp is enough to make physicians tell others, “You’re going to kill someone one day if you don’t pay attention enough,” and other clever insults.

“Pimping is a good way to learn” — Apparently, using the Socratic method is a great way to teach. According to this time-honored tradition, a resident or attending will pommel a student with questions repeatedly until the student finally answers something incorrectly or states, “I don’t know.” Then, the teacher will proceed to humiliate the student further until the day’s lesson is presented. I was once asked during a surgical case about the cause of a woman’s liver adhesions. The attending berated me for having not studied gynecology. Considering that surgery was my first rotation, I don’t know why he would have expected me to know that STD’s cause a sticky liver.

The reason why this statement about pimping is so untrue is that the very purpose of teaching is violated. In order to learn something, you must first be ignorant. If a student shows up to rounds not knowing something, he’s going to get his ass handed to him by the residents. To shine on rounds, the student will instead have to learn on his own and then present that knowledge on the following day’s pimp session. In effect, the teaching session is therefore redundant and not necessary since the student will already know the answers to the question.

Another variation on this statement is “Pimping leads to the knowledge gap.” I have one professor who is fond of telling us that by harassing us with questions, he knows where to pick up the day’s lesson.

“I’ve got an opportunity for you that no one else will receive” — You’ll never get opportunities during third year, only grief. This phrase is meant for attending to force a student into some task that isn’t related to learning medicine at all. My opportunity this week is to sit in on a hospitalist meeting where we discuss patient safety goals and how we can prevent medication errors. My guess would be to have pharmacy techs draw up all of the day’s medications, put them in a plastic bag with the patient’s name and dispense time on the outside, and then drop them off at the nurses’ station. That way, nurses will merely have to pick up Mr. Jones’ 5pm bag of Flomax and bring it directly to his room at the appropriate time. Unfortunately, medical students don’t speak at these meetings, our job is to learn about the process of meetings. Other opportunities that have no bearing on your future abilities as a physician include grand rounds, resident report, and morbidity and mortality conferences.

Feel free to share some of the lies that you’ve heard around the hospital.

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1 Comment

  1. mo said,

    The biggest lie ever told: rounds will start at 10 or my favorite “I’ll be there in a few minutes”.
    The second biggest lie “we’re just going to do a quick round”
    I am an RN in the CVICU and I swear some of our staff can and do round for more than three hours on 10 patients half of which have already been discharged to the ward and are only waiting for their bed to be ready.
    It killed me because at that time our fellows couldn’t leave until after morning rounds.
    On occasion I became very loud and more than a little rude about this when I knew my fellow or resident had been up all night trying to stop someone hell bent on dying and then they were forced to wait around for his majesty to show up and then have to listen to this yappy chihuahua go on and on about the research on when we should start tube feeds on the living dead.
    We now have 7am handover/ speed rounds with the surgical team and if the staff doc doesn’t make it no one waits for them.
    No one can learn anything when they can’t keep their eyes open which should be obvious to anyone,well except for staff docs.

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