Sadly this doesn’t stop at the med school level either. As a resident and even now as an attending we get shit on for prioritizing our own health and wellness. As a med student and resident it’s the asshole attending. As an attending it’s other docs or hospital admins looking at nothing but the bottom line. Medicine is a toxic and screwed up culture.
Literally said "Is there anything else I can help you with?" today and the senior clinician replied "No, you should go home." haha I love that this is just a universal unwritten code
Applies in probably all fields of work. It's a question I ask at the end of my shift - sometimes so that I can get in more hours, honestly. But just as often to go home.
Just make sure you do so without asking a basic question "that you could have easily looked up." But also don't ask anything so obscure that you are "missing the point" or "quizzing experienced doctors." But make sure you don't avoid asking questions at all or else you risk "Seeming unengaged."
Truer words have never been spoken. EVERYBODY, literally everybody, knows that “is there something else you need me to do” means “I’m on the verge of going home but I don’t want to give a bad impression so please, as the one with authority, validate that action”
A couple of months ago, I had a rotation with an M4 who made it his mission to draw attention to my presence and see if I could leave on my behalf every evening. He's a goddamned hero.
Just recently happened to me. Attendings logins werent working so she kepted us till 8 pm to type her notes while she was preparing her conference call. And then she had the audacity to call us lazy bc we wanted to go home. “I have a conference that 1000s attendings want to learn from me, and ur missing ur chance” as we are dead tired and didnt learn a single thing.
This is why my fellow Urology consultants in my hospital think that I am too "laissez-faire". I believe in live and let live as long as my resident's and students have a "proper attitude" to work and learning.
I love that it's 7pm and the attending had just finished morning rounds. My husband had a massive brain tumor and the neurosurgeon was asked to see him in hospital. We heard all day that the specialist is in the hospital and "will see you soon". He finally saw my hubby at 8pm, by which time hubby had lost all use of the left side of his body. Neurosurgeon then yelled at a doctor that the patient should have been seen earlier! 🙄 Anyway, it all ended well. He was operated on the next day and the baseball sized meningioma was removed. It was benign, thank God.
@@danshort10 That's what I thought but I just wish they'd tell us the real story instead of stringing us along. It actually creates more anxiety. Hubby is a man in charge of IT for a very large company and, any of us, but especially a person like him, gets very agitated when he sees "inefficiency" in the hospital. It also didn't help that the surgeon then yelled at the doctor, as if it was his fault. Anyway, like I said, he did a brilliant job. He couldn't believe the meningioma got so large without any symptoms. He went to the doctor for a flu shot.
Got labeled unprofessional because I went home sick at the same time they released all the other med students and I had already used my 12 days for the whole year taking care of my wife with ER visits and craniotomy (the day before surgery shelf exam). And since a resident forgot to track attendance they said i wasnt there when all my classmates saw me swaying in the stool on rounds trying to not fall over from being sick... so I got to go to the professionalism review board for missing too many days and get chewed out for making excuses when I literally rounded on patientsmultiple times that year while my wife was in the ER with neurological symptoms
Peds department had no understanding at all and I never did another peds rotation again until anesthesia (much more enjoyable way to take care of kids)
@@jeffreysdavis You can pick your rotations? Either way I'm so sorry that happened to you. You did not deserve to get chewed out. Let's say you got covid for goodness sake, would they still expect you to come in even if your 12 days were used up?
Sorry that happened to you man. Best we can do is bow to change the shitty culture once we’re in power, I vowed to say something if I see something and not look the other way like it’s not my problem. If I see a colleague (attending/resident/nurse/anyone) yelling at a student I won’t stand by like most attendings do. No one gets to yell at anyone, this isn’t fucking primary school. And if the other students saw you, they should’ve believed you, and not treated you like a child.
"You don't have the authority" alright doc, you can make the follow up appointments for your discharged patients yourself. And no passing it off for the residents to do either!
I'm Non medical but I went through something similar. Ms Monster kept me working through the day only to dispose majority of my work down the bin at the end of the day, never let me have a lunch break but had hers in front of me while I worked, scoffed at me if I requested a bathroom break, kept insulting me about my looks and finally, wanted me on my feet running around at a conference after I'd already done my 12hrs. Ordered me not to sit down. I was shaking with hunger and fatigue. I sent in my resignation the next day.
"We had just finished morning rounds." At 7pm. On a Friday. I'm not in the medical field personally, but I've been hospitalized enough times to understand how real this quote is.
After one particularly bad night as an intern at the hospital, I barely made it back to the ward with a tray of food after dashing back and forth to the cafeteria, and started gobbling it in the team room, when the attending popped in and started chewing me out for "being late for rounds". I calmly but firmly said approximately this to him: "I have been up all night. I didn't get to sleep, I didn't get to eat, I didn't get to shower, and I didn't get to take a dump. I am currently hypoglycemic, so I am going eat this first and then visit the bathroom. If you want to start rounds without me, feel free." Then I went back to eating my sandwich and after he picked his jaw up off of the floor he walked out.
every time a med student gets sent home early, an angel gets its wings every time a med student gets told that there IS something else they can help with, a gene somewhere takes its second hit
If you think the new generation needs to suffer because you had to and you turned out OK, you in fact did NOT turn out OK. In addition to being hilarious, your videos are always so thought provoking. The practice of medicine today is nothing like the way it was when I trained 30 years ago, therefore the training itself also needs to adapt to the times, and become more humane.
In context, yes, medical practise - and probably all of modern life - is way too much of a machine into which humans are inserted like cogs and worked to death like Charlie Chaplin in Modern Times. Not least those in the Third World in sweatshops who make so many of our goods, especially clothes. If you feel worn down, imagine how weary they are. Feudalism is still alive and well, and we don't live in it. The people we buy cheap shirts from do, and their weavers and tailors are the serfs. While you demand more humane work conditions for yourself - which you should do; slowing down the manic pace of work in this country has to start somewhere - thank the Lord you had a choice, and that yours comes with air conditioning. It's a bad world, but we ought to show gratitude to God we can complain about it, etc.
That’s funny until you realize half of them mistake a friendly jibe for “abuse.” Sending the apprentice for the board stretcher will never not be funny, and it only works a time or two, so it can’t be abused.
It's because more undeserving are getting admitted to med school. Previously only those who can withstand the grind usually ended up getting through. If you make military training soft it will not produce good soldiers.
Once we were following our Neurosurgery Chief around in the afternoon doing rounds. We were never dismissed and he went through literally 3 different wards. In the end when everything was finished he turned around and - I shit you not - asked us why we were still here. Yes. He also introduced himself with "We have too much to do right now, so you kind of have to learn by yourself". Not hard to see why neurosurgery is by far the most hated department in our uni clinic.
Ah yes, the old "We had to suffer ridiculous workloads/bullying/sexual harrassment/abuse when we were students, so now the next generation should suffer too." Which is like saying that nobody should ever be treated with antibiotics, because in the past people with infections had to suffer, so subsequent generations should, too.
Your criticism makes sense in context. But honestly, one way or another, as a general principle, people suffer. If it's not from working in sweatshop conditions, it's just from angst that just bubbles up within. Seeing the resiliency of people who work so hard they're too tired to wonder if things should be better - compared with the whiny, useless natterjacks of my generation - I almost wonder if it was better working ourselves to death. Almost.
This hit too hard. I took a day off one day as an intern because I rolled my ankle the day before and decided that limping around the ward was not it for me, and I was reported to my program director by one of the attendings and reported for "unprofessionalism". And who did my PD advocate for in that situation? Not me 🙃
My last couple weeks of surgery were with an attending that had me stay until 8 every day even though most of his surgeries were done by 4 in the afternoon. The reason: to personally hand his radiologist wife her lunch and dinner that I got when it was available in the physician's lounge. Oh, and I couldn't get any food for myself :)
@EKGsandPianoKeys yeah straight up, if an attending is being like this you have to report them to your rotations office. I’d be on the phone the first time it happened.
It is ridiculous the number of hours med students/residents/et. al. are forced to work without sleep. I'm a software developer and have to work 60-80 weeks sometimes, but at least if my sleep-deprived brain makes me do something terribly wrong, people don't die. Well, at least not immediately.
in my country its the other way around. We also can't ask to go home ofc, but the residents and attending go one step further and they would 'try to send us home' by saying things like "oh you can go now if you want" and we're supposed to reply with "no no, I want to stay" or "it's fine, I'm free anyway." If we ACTUALLY LEAVE then they would mark us down as lazy/not a team player/impolite. 🙄 The few good ones that actually want us to leave on time will follow the sentence with "I'm not trying to test you. Go. There is literally nothing left for you to do. Just leave."
As a vet student I asked to go home having not slept for over 24hrs due to assisting with an emergency. In the end I stayed for another hour helping my colleagues remove the shoes from a horse in preparation for surgery. I was still branded lazy for the rotation.
It should be obvious, but if the continued protocol for doctoring inherently lacks self-care/self-compassion as a guiding principle, how would doctors ever have same for others? Insanity.
It’s honestly WAY easier to care for others than ourselves. That’s why doctors are awful patients. It’s why everyone has to keep saying “what would you tell your patient to do?” to us re: self care.
@@PhoenixRoseYT I hear you, but I think that if one is "forced" by standards, to harm themselves, and is willing to do so, then unconsciously there's almost invariably thoughts and feelings that others should "stop complaining, suck it up, etc." , and this is a large part of the adherence and continuation of the lunacy. It's much like Intergeneration Trauma where, because what happened to me sucked, but I'm unaware, I do the same (expect the same) to/from you, unaware.I know how it seems, but that's where we're stuck; it's deeper than it seems. If I don't value my life, I may project value onto yours, but eventually, I'll burn out and be resentful. When I start to value my life, my health, naturally, yours also has value.
A guiding principle. A guiding principle. Balanced with why you care for yourself: SO that you can better care for those you love and those who depend on you.
I'm really glad you are doing these short videos. I am not in the medical community. I had no idea exactly how awful conditions had gotten for doctors. I'm so sorry.
it's always been this way tbh. we're treated like dog shit by everyone at every step of training until suddenly we're the attending in charge and now you suddenly have to be nice to the doctor
Oh, this is an improvement over how it used to be! The hour/week cap for students and residents is 80hrs/week now. In my grandfather's day, you were on when they said you were on, and stayed until someone sent you home. There wasn't a cap on the number of 24 shifts in specific period of time, either. Fortunately there is now. Sort of.
It varies by country, by service (here, the specialty is presented as an extreme consistently throughout the videos), and by school. It's a tough problem that Dr. G hits nearly perfectly: you have to learn how to practice somehow, but many situations are not going to be relevant for you (e.g., if you don't practice the specialty, only the basics will be helpful) and the endless busywork is DEFINITELY not helpful for anyone. But we have to all do it, and the question is how much do we do together vs. how much do we just do as attendings. The right answer is to keep the educational mission in the forefront while letting them see the reality of the specialty so they can choose wisely.
Not a med student but worked in a couple factories that tried to say they were "professional" one tried to say I couldn't poop when I needed to the other fired me for getting sick. What's bad is the one that said I couldn't poop when I needed to was probably one of the best jobs I'd ever had.
Asking to be sent home is almost as bad as asking to be shown a procedure once more, because it's the first time you're actually doing it on a patient. How dare we can't perform perfect lumbar puncture!
ahh yes I can remember doing 4 hours overtime as a med student when I asked this question still traumatized but helping with the camera in an emergency laparoscopic surgery was at least a nice experience
“What educational opportunities did you bestow upon your med student at *7 PM on a Friday?”* “We had just finished morning rounds -“ This made me laugh so hard. XD
@@bossdunkz No clue! But the neurologist is #2 second only to neurosurgeon. Hopefully the tribunal gets those guys and stones them. lol (J/k. No actual hate on doctors!)
@@CorwinFound I don't know. I recently had an interaction with an anaesthesiologist that I WISH I could forget. (see what I did there?) But it's based on a real story.
Honestly, as much as I love to learn... My biggest pet peeve was when they wouldn't let us go home. And yet, in my evaluations I supposedly spend too much time with my patients? Like... What the hell do you expect me to do with this time?!?!
My brother left med school in his 3rd year. When sent ‘to examine the liver in bed 3’, he found a rather interesting elder from a different culture and they had a good chat. He never got to examine the gentleman’s liver. My brother is now a journalist.
My Dad was an IM professor and attending (and had his own practice). I remember going to the hospital in the early morning and all the baby doctors following him around doing rounds on the weekend, like little ducklings with their chart clipboards. Did he still school the chief resident of the ED and diagnose MRSA on my face when he was on vacation on a boat in Ecuador? Also, yes. The dichotomy of internal medicine.
It is not the attending who needs help, it is the struggling intern who will be grateful if you help clean up tasks at the end of the day, The intern will be more willing to teach in return and will give a good evaluation to the attending who will be grading you. Don't view this as perfunctory. Medicine is a team sport.
This happened to me when I was a resident. The defendant was a cardiologist. I missed a very important appointment so we could round between 7 and 9 pm.
This is a good argument for making medicine a second career. When you've already had one successful career, and are now pursuing your dream of being a doctor, you are older, more confident, and less susceptible to workplace politics + manipulation.
And then you finish training in your 40's or 50's with hundreds of thousands of dollars in debt (unless you had a very successful first career indeed).
I remember being in ICU at UofL 23 yrs ago next month. 5:30 am the Dr who'd rebuilt my leg would come by with a gaggle of other Drs. I'd gotten into a fight with a bridge. So he rebuilt my right leg with rods and screws. I'd crushed 6" of thigh bone and compounded the tibia and fibula. I think it was a new procedure Cause he's come and say how's our miracle today.
The med student is lucky he or she even got to ask the question. In some hospitals, it's don't talk unless spoken to. Being sent home is a privilege. If your resident forgot about you, tough luck. Make yourself visible and pray the resident gets the hint.
I can't wait to see the other specialties brought in front of the med student court council. I feel like Palliative care might be able to help their cause.
I know this video takes up things that are more real than they have any right to be but I giggled a bit thinking about this in comparison to my last neurological internship. The doctors at that clinic used to delegate leading rounds and compete with each other about not having to lead rounds. The two neurologists in question were both soft spoken and somewhat introverted Swedes which was a bit comical at times. However, It also filled a real purpose. Them taking a step back allowed for more Peoples input to be considered while also giving them more room to adress bigger picture decision making. I have not learned more during 8 weeks at any point before or after. I respected them so much. They were so Good at their jobs and they made everyone else better too. I did however question my sanity the first time I lead a patient planning meeting with the head doctor sitting next to me😅
"I don't need any help right now, but stick around and I'll come get you when I do." Message from attending 3 hours later: "You can go home if you want."
This is why my grandfather told me not to attempt medical school with my minor health problems. It's funny though, to this day people ask me why I am not a doctor because even though I did not go to medical school, I've studied biology so heavily over my lifetime that I solve medical mysteries and come up with successful treatment plans for a variety of life forms from people to exotic animals, plants to pets. It makes me wonder how many people with the wiring to solve medical conundrums fall through the cracks because minor disability makes medical school impossible. I'm a software engineer now, I just solve zebras when they find me. I'll never be able to put full time into medicine, it just seems to haunt me in my limited free time.
"they're med students of course they're gonna overthink" Rounds... Attending: what's your diagnosis? med student: rapidly replaying every embarrassing past conversation and interaction with that attending while speed-clawing through tangled neural pathways with his disconnected body doing a perfect deer-caught-in-headlights imitation without breathing. 😷
About whiteboard presentations. I spent a week as a patient in thr cardiology ward as i just needed 7 pumps. In every room, there were 3 whiteboards - 2/3 of the space on one wall was covered by 2 white boards (non-electronic and an electronic whiteboard installed 7 years before). - a small whiteboard on a different wall was patient and nurse info. Every nurse and every specialist on rounds confirmed that they had never used electronic whiteboard, and very very rarely used the non-electronic one. Instead, they drew on a piece of paper, or pointed at a picture on the computer that was wheeled on the rounds This computer was also placed in the doorway, which unintentionally blocked catering, orderlies, cleaning from entering.
First day of my final year starts tomorrow. Been fantastic overall, but I will place the med student council on speeddial as my backup... just incase 😎
"you don't have the authority!" Oh, you think the med student who makes coffee runs for everyone isn't the *UNDERLORD* of that organization? 80% of the staff there survives solely due to coffee. Good luck getting any work accomplished if the patrons stonewall ya or if that supply runs dry.
Oh man, this resonates so much with me. I'm not a med student, I'm actually studying radiography, but during our clinical practicums it's a very similar dynamic. They expect you to: a) learn how to conduct over 100 imaging routines in x-ray and fluoroscopy (and most of the x-ray routines have at least 2 and sometimes 3+ part positions/projections, all of which frequently have to be adapted based on the clinical history and the patient's actual condition and abilities); b) learn everything else concerning the theory of radiography (including all of the anatomy that can be visualized with x-rays,* all of the pathology that can be diagnosed with x-rays** plus the physics of x-rays, the engineering of tubes and detectors, the quality control procedures to ensure tubes and detectors are working as expected, the impact of radiation on human biology and how to minimize it, other safety measures related to the job such as how to prepare and use a sterile field environment, and the LAWS regarding the use of radiation in workplaces***); and c) master the difficult task of constantly assessing a patient while they're in your care, so that if they do have a medical emergency, you can quickly identify it and act to help them, as well as finding potential problems that could become medical emergencies, and mitigating them. On top of all of that though (and that is MORE than enough), they expect us to do ALL of the grunt work, from stocking rooms and cleaning equipment after each patient, to taking out the laundry, doing all of the paperwork (which is mostly computerized now, thank goodness...still takes a bunch of time though) and sometimes even getting our own patients (usually just within the ER; porters handle the rest). Fortunately, their accreditation depends on certain things, and one of them is a strict schedule - we're not allowed to work overtime, or to work through breaks, so asking "is there anything more I can do" will only be answered "yes" if in the context of a normal, 8-hour workday. Of course, there's ALWAYS something to do, and they want us to do it all. *And it's extremely detail-oriented anatomy - for example, you don't just learn "this is the humerus" you learn about its head, anatomical and surgical necks, the greater and lesser tubercles, the intertubercular sulcus, deltoid tuberosity, lateral and medial supercondylar ridges and epicondyles, coronoid fossa, radial fossa, and capitulum; then you learn which of those can be visualized from what specific x-ray projections, and how the proximal and distal parts of the humerus articulate with the glenoid fossa and the ulna and radius. Pretty much each bone in the body has at least some topography, and we learn it all. **Including x-rays in a CT scanner or fluoroscopic context. ***Those laws govern things like how to build and shield an x-ray suite and who is responsible for what in a diagnostic imaging department (and a lot more).
During my IM rotation they had a holiday so coming in was optional. But preferring to play doc rather than do UWorld questions I came in anyways. First 30 mins no docs were on my floor. When the senior physician shows up with another doc he scold the other doc for not being there early like me. Then I ask if I can help with anything. He says no, and that I should go home. I insist and he says I should go to urgent care if I really want to do anything bc the holiday would not be best for rounds. So I go to urgent care. Same thing. Urgent care asks why I'm there and to go home. Lol. I insist and they say go to the ED. I do. I go to ED and they told me to bike home. I didn't have a bike but at this point if even ED wants to dismiss me, I figured I should go home. Lol.
With a severe flat foot and standing for a long periods of time, I could not ask for a chair to relax that now my back muscles problem became chronic 10 years after graduation
Ah yes, good ol' internal medicine "morning rounds". Once when I was on an internal medicine rotation, we had to interrupt the morning rounds at 2:30pm so we could eat before the hospital cafeteria closed, and went back to it to finish around 5pm
If you are a second year med student in Belarus, you still have so called practice, where you just try to find something to do or see in the hospital. Mostly students give up trying, because nurses usually say there's nothing to help with, because we have no skill yet. We have opposite situation, we suffer from boredom rather than tiredness. But my friends and I were stubborn enough to find opportunities even in such conditions. We were in the lab and were taught how blood and urine analysis are made. We found a great nurse who taught us how to make intravenous infusions through catheters and allowed us to do everything by ourselves. We even got to see some operations, gastroscopy and to entertain babies in an ICU. It was fun 😊
One time I was waiting like a good boy for the attending to finish talking with his colleague so I could ask to be dismissed, and he then turned to me and asked "you want me to give you a sock Dobby ? " and I was like "Yes, so I can finally be a free elf!!!" Chillest attending i've ever had
I see a lot of people talking about how they need to request bathroom breaks; you're grown ass adults, and if you need to piss, go piss. If anyone calls you on it, offer to do it on their desks if that's their preference.
A Neurologist did this to me. I was writing OPD letters until 8:30pm without dinner, or education. 10/10 would not recommend, and obv have not become a neurologist.
