Every medical student is a bit apprehensive when he/she knows they will be assigned a new resident. The same questions always come up. Will the resident be nice? Will they understand my busy schedule? Will they make me do a ton of scutwork? Will they make me write all of his/her progress notes? And maybe most importantly, will they let me leave early to study for boards or enjoy the occasional night out?
After a year and a half of clinical rotations in various hospitals throughout NYC, I have learned that every resident can fit in to one of three general categories.
The amazing resident
The first type of resident is my favorite. He/she is the one that still remembers what it’s like to have freedom and no responsibility as a 3rd and 4th year medical student. They understand that the medical student is strictly there to learn some cool things and see some interesting procedures, then get out of the hospital to study. This resident is almost always cognizant of the fact that the medical student does not want to work through lunch to finish a progress note that should be done by the resident to begin with.
I have also noticed that this type of resident is usually more efficient and smarter than his/her colleagues. He/she is able to get their work done without a medical student, therefore does not have to rely on him for help. Since this resident is usually smarter than the average bear, they often times impart unique clinical knowledge to the student. The funny thing about this resident is that I am MUCH more willing to do the lowest of scutwork to help him/her out because of their teaching and understanding of the medical student’s role.
The horrible resident
On the other extreme of the spectrum is the resident that makes the student think that unless you work longer and harder than the resident, then you will ultimately be a horrible doctor and unworthy of the MD degree. The darkest of these types of residents will even taunt the medical student’s worst fears by threatening the notion of giving you a bad evaluation if you’re not breaking your back to make their life easier. This means that if you eat lunch before finishing scutwork for him/her despite the fact that you’re about to pass out from hypoglycemia, you are unworthy. This type of resident will berate you if anything goes wrong during their shift. This can include yelling at you for misplacing the central line in the carotid rather than the external jugular, despite the fact that you were only an observer during the procedure. And for your information, it will always be your fault, thus it is easier not to argue and merely accept the blame and state that you will never do it again.
This type of resident can either be smart or not so bright, but one thing is always true, their idea of “teaching” is very misconstrued. They think that making the medical student call another hospital to get medical records, or calling the primary care doctor regarding a patient that they know nothing about, falls under the category of teaching, Therefore, this fulfills their role as a “teacher,” resolving them of having to waste their time explaining the reasoning for ordering potassium levels q4h on the DKA patient.
On the other hand, I must admit that this type of resident is not entirely bad. I once had a resident that often left the building before me leaving some of his work for me to complete. He would ask me to get an ABG on his patient with respiratory distress, and then go home while I was in the patient’s room. Although this was incredibly annoying, I did become extraordinarily competent on many procedures. I can now do an ABG blindfolded and I don’t need any assistance other than a nurse to place an NG tube. Thus, I must thank that resident for being a bad teacher and leaving me to learn things on my own.
The okay resident
The last type of resident is markedly different than the others, but sometimes has traits of both extremes. I believe the primary problem that undermines this resident is that they aren’t aware of the fact that the student has needs such as going to the bathroom and eating. They tend to forget that the student actually exists and is more than just a fly following them around. This resident is not directly vicious (like the “horrible resident”), it’s that they are usually too overwhelmed during the day and just don’t know how to utilize the student effectively. This leads to a medical student that is bored and zones out because he/she is not engaged and is left to stare at the paint drying on the wall.
I don’t want to generalize this category of residents as being not smart, but they don’t get it like many of their colleagues. The fact that they are overwhelmed by work is because they don’t know how to manage their time appropriately and when needed, ask for help from the medical student. I have met quite a few of these residents that are very smart, it’s just that they tend to be thorough with their patients, which doesn’t allow any time for them to think about how to have the student interact. From my experience, it seems that their strict attention to details stems from their paranoia of making a mistake and somehow killing a patient. This leads me to believe they need to read Samuel Shem’s books and grasp the idea that less is usually better in the healthcare world and their meticulousness is hindering rather than helping.
“Nonmaleficence” is a medical student who blogs at his self-titled site, Nonmaleficence.
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