Great blog about how NOT to act as a resident

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Thanks...wow...great letter!
 
I don't understand this part.
I know you should have heard this feedback on Thursday morning, when you cornered me to ask why certain attendings didn't like you. But to be honest, 3am is not a good time to corner me if you want honesty. I was ~19 hours into ~30 hours of work and I would have said anything to anybody anywhere in order to get to my bed. I don't expect you to understand this, because you've never had to work for more than 12 hours in a row.
Is she saying that she works 30 hour shifts, but he doesn't? What residency is that?
The rest of the stuff is good though.
 
She worked a 30 hour shift because she is an MFM fellow and he is a resident. I had to read more to have it make sense.
 
amusing, but not surprising. what's frustrating is that this PITA resident made it to PGY-3 without someone laying the smackdown on him/her and pointing out to them how bad a doctor they are. making a mistake once is human - making the same one 5 times is inexcusable for someone in our profession.
 
She worked a 30 hour shift because she is an MFM fellow and he is a resident. I had to read more to have it make sense.

Still don't get it. He's a PGY-3 Ob/Gyn resident, who has never worked a 30hr shift? He's in charge of L&D, but doesn't do long shifts? Sounds sketchy to me.
 
I love Midwife with a Knife, and she wrote an eye opening open letter to a resident:

Eye opening? She rants about basic human decency, a good work ethic, not abusing junior residents ... the whole thing stinks of a self-righteous feel-good rant against a fabricated person.

Besides, the people who need to hear that message aren't going to suddenly "get it" because it's on a blog. :)
 
Something doesn't add up about that blog post...
 
Something doesn't add up about that blog post...

I had the same thought about the whole blog itself. What Obstetrician would willingly describe herself as "Midwife with a Knife"? It's like an Orthopod calling himself a "Nurse with a Power Drill". I wonder if she's actually an NP or something like that.
 
I had the same thought about the whole blog itself. What Obstetrician would willingly describe herself as "Midwife with a Knife"? It's like an Orthopod calling himself a "Nurse with a Power Drill". I wonder if she's actually an NP or something like that.

Exactly...I assumed the blogger was a nurse midwife and was confused when she claimed to be doing an MMF fellowship.:confused:

I mean its cute and it rhymes but why would you misrepresent yourself? A midwife is a valuable part of L&D for those interested, but its not the same as a fully trained Ob.
 
I had the same thought about the whole blog itself. What Obstetrician would willingly describe herself as "Midwife with a Knife"? It's like an Orthopod calling himself a "Nurse with a Power Drill". I wonder if she's actually an NP or something like that.

Exactly...I assumed the blogger was a nurse midwife and was confused when she claimed to be doing an MMF fellowship.:confused:

Ummm.....maybe you guys didn't notice....."wife" and "knife" rhyme. It's hilarious.

I also like that she whines about an incompetent resident in an online blog instead of confronting him. That way the supposedly horrible patient care continues......Maybe her name should be "OB-Gyn who loves to whine."
 
Still don't get it. He's a PGY-3 Ob/Gyn resident, who has never worked a 30hr shift? He's in charge of L&D, but doesn't do long shifts? Sounds sketchy to me.

I don't know if that's really sketchy-my med school's university hospital L&D shifts were done in 12's....a week of days and then a week of nights etc
 
I also like that she whines about an incompetent resident in an online blog instead of confronting him. That way the supposedly horrible patient care continues......Maybe her name should be "OB-Gyn who loves to whine."

Now that is f-ing hilarious. :laugh:
 
Maybe she was a midwife before she started medical school?

On the topic of the blogs:
Good way to express your personal opinions/thoughts, but never really have done this myself.

On the topic of the "critqued" OB/Gyn resident:
If what she states is true regarding the resident's behavior pattern, it is concerning that attendings are NOW voicing their discontent with his attitude and training. Then again, people with this type of attitude are seen in medicine in every field, and they manage to survive and practice. In this guy, compassion seems to be a missing element.

Whose duty is it to train someone with compassion? :confused: Is this a learned skill or an innate skill? Either, of course, would be influenced by the social/cultural constructs around us (ie, society/environment/culture). Any thoughts?

[On an aside, I admit that giving demerol in a pt with CRI is not the smartest thing, but it CAN still be given - just at a lower dose. Don't know about with pregnancy?]
 
if the resident in MWWK's rant is fiction or non-fiction, it is not far from the truth about some residents (ans med students).

truth is that i see more and more of this type of me me me behavior. it is not to say every resident is like this. in ortho, we get a lot of type A personalities with egos, so sometimes we just have to beat them down (just joke folks). as mentioned with the in the surgery section when many discussed how to deal w/ med students and how hard that was to get some med students to actually work or care. it is translating into residency.

as a resident, you must take care of your own. i get extremely agitated when i see a chief resident cherry picking or dumping on the juniors. most attendings are aware of this. the best chiefs are ones who get down and dirty with everyone. my chief recently have sent the juniors to the or while they did consults and patient notes. i respect that. it translates into practice as well.

the other most troubling thing to me is how many residents come to not emergent cases totally unprepared. meaning not read a thing about the case, patient, or specifics about the surgical approach (in ortho we have a tone of different surgical approaches). how the hell do you expect to learn if you don't put in the effort. WORK WITH ME PEOPLE. :)

i loved this rant. it was probably one of those things that she just had to get it out. most people can't be that blunt to someones face. kind of like when you tell a story and put in words that you thought but really never said.
 
Ummm.....maybe you guys didn't notice....."wife" and "knife" rhyme. It's hilarious.

I noticed it (see my later post) and it is amusing (not hilarious).


I also like that she whines about an incompetent resident in an online blog instead of confronting him. That way the supposedly horrible patient care continues......Maybe her name should be "OB-Gyn who loves to whine."

Now THAT is hilarious. I dare you to post a comment on her blog to that effect! ;)
 
I noticed it (see my later post) and it is amusing (not hilarious).

Oh, I thought her blog name was dumb and only moderately original. I've edited my previous post to put the sarcasm in italics.
 
truth is that i see more and more of this type of me me me behavior...as mentioned with the in the surgery section when many discussed how to deal w/ med students and how hard that was to get some med students to actually work or care. it is translating into residency.

While I could see students not caring, because they force you to go through rotations that you will never do for the rest of your life (think psychiatry and surgery, or vice versa, pathology, etc). However, if you act this way in residency, there should be a zero tolerance policy. You should just get fired if you don't care enough about surgery and you are in a surgery residency. Also, even on offservice rotations as a resident, you are still the doctor, so you should care. If I were PD, that would be my way of handling it. Fire my own, fail the offservice people. Maybe I spent too much time around the military.
 
While I could see students not caring, because they force you to go through rotations that you will never do for the rest of your life (think psychiatry and surgery, or vice versa, pathology, etc). However, if you act this way in residency, there should be a zero tolerance policy. You should just get fired if you don't care enough about surgery and you are in a surgery residency. Also, even on offservice rotations as a resident, you are still the doctor, so you should care. If I were PD, that would be my way of handling it. Fire my own, fail the offservice people. Maybe I spent too much time around the military.
it is interesting to get this response. cruising the forums here i get the feeling that this would not be a popular stance. i can tell you from my end it is not that easy to get rid of someone (at least in orthopaedics) and if some one is not up to snuff, there is a lot of discussion of how to deal with them. in every system there has to be a plan of "remediation". it is not as easy to fail someone as you may think and contrary to the forums, it is even harder to fire someone.

it is more common for people (more recently) to be more concerned with themselves than with "patient care." there are areas of every specialty that are not as glamorous as others. some people develop an subspecialty interest early and other areas become less interesting. as in medical school, the ACGME and each board require a certain number of months in the critical areas in the specialty. (in ortho it includes peds, spine, joint reconstruction, tumor, foot and ankle, hand, sports, and trauma.)

in our residency, it is not as much of a problem as a whole. they do tend to whine, but showing them the back side of my hand tends to quiet them (just jokes folks)

i think that viewing things in hindsight is a lot easier. looking at residents in the different years, i think about what would have helped me and what did help me. i try to give them the appropriate information the is correspondent to their year. sometimes they are not in agreement. most of the time they think they are more ready than they truly are.

i can say this because ortho tends to be closer as a program, because they are smaller programs with class sizes of 2-10, i believe that each resident year should give back to the year below them. they should treat them with courtesy and respect. everyone should be willing to step up or down to fill in where needed. no case is too small for anyone (attending included). the problem is the same problem medical students in their 3rd year complain about the interns, the interns having just graduated forget about how it was being a med stud and start treating them like crap.

MWWAK's rant was priceless because i have seen this more frequently than i should (especially with friken primadonna surgeons) and i was glad to see i was not the only one
 
Thanks PediBone. I have really enjoyed your insights on this.

I enjoy MWWAK's blog and have been reading it for a while. She not only was playing on the rhyme, but she says she uses some midwife sensibility in her Ob practice. I trained as a midwife for two years before med school.
 
Get it? She's like a midwife but she does surgery so...Midwife With a Knife.

I like her blog and the "letter" but the one crucial difference between being an attending and being a resident is that the resident is trapped like a frightened gopher while the attending is not. (Although MWWAK is a fellow, if I'm not mistaken)

Kind of gives one a different perspective on working long hours.

Still, as much as I complain there is no excuse for bad medicine or shoddy patient care.
 
Midwives rock, by the way. When I was at Duke doing OB they were very knowledgable and went out of their way to teach, something that the residents, although nice people, rarely had time to do.
 
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