London Med Student

Five things doctors shouldn’t say to med students

1. “I’m sorry, but we’re really busy today.”

We know you’re busy. Everyone is busy. We won’t find one doctor in the entire hospital that isn’t busy… unless perhaps they’re a rare disease specialist on an off day. We’re not expecting you to hold our hands and talk us through our syllabus, but you can take one minute to point us in the direction of an interesting patient or even pull up some blood results for us to look over. If we’re not completely useless we can even save you time … you can let us clerk patients further down the list before you get to them (the worst that will happen is you have to do it yourself fully anyway) or even set us to taking blood/doing cannulas (but please, not every day!).

2. “What do you want to learn?”

This one grates on me when it comes from someone I have timetabled clinical teaching with. You should know I’m coming, you should have at least some idea of what year I am in and the rotation I’m on, and therefore the kind of thing you might be going through with us. I also know that you’re getting paid more for teaching me, so the least you could do is think about it for a few minutes sometime before I arrive.

I’m not asking for a ready-made powerpoint presentation complete with handouts and details of 3 patients with relevant signs (although I’d probably cry with joy if you had that), but hitting me with “what do you want to learn” smacks of laziness. I’m not sure really, as you’re the expert. Asking a group of students divides us into the one who saw a rare condition and wants to know all about it, the one who hasn’t quite understood basic anatomy yet, and some vague responses from the others. Best answers to this question: All of this rotation? How to cure cancer? All of medicine, ever?

3. “Will you fill out my feedback form?”

I once got asked this by a hungover F1 who spent half an hour explaining the SBAR phone message system then went back home for a nap. (Not sure why he was even in the hospital to be honest, probably just came in for something he left and seized an opportunity). If you’re honestly going to go to the effort to give us a decent hour of your attention and some good concept/bedside teaching, sure. We’ll be happy to help you out, write some nice things, and it becomes a good reciprocal relationship. If you’re just going to point at an orthopaedic patient’s swollen knee and hand me a tick-box sheet, it becomes you taking advantage and I don’t like it.

4. “You can’t see so-and-so, they’ve got a psych problem/are dying/have a genital complaint.”

I’m not for one second suggesting that there are situations where it isn’t appropriate to bring un-needed extra people into the consultation. I understand that. But I am also painfully aware that one day I’m going to be the DOCTOR having to see these people, maybe before they see anyone else, and keeping me away from as many of these patients as possible makes me even more nervous and unsure about how to handle the (already sensitive) situation when I’m without backup.

It also feels a bit backwards when, for example, I’m happily invited into a psychiatric hospital to clerk patients, and then a few months later I’m kept away in A&E. You can always ask us what we’ve already done and we’ll tell you if you’re unsure.

5. “Get out while you still can!”

A favourite of stressed F2’s and early year middle-grades, this only serves to use us as someone to vent your current frustrations on. It doesn’t inspire or even warn us. Either we’re pre-clinical, in which case we’re still amazingly optimistic that we’ll always be happy being a doctor and we’ll NEVER get grumpy folk, or we’ve seen enough medicine to realise what the lifestyles are like and are carefully planning our careers around what we can cope with.

Alternatively, you could take me to the pub and start your rant, as I’ll happily listen to you moan for a while for a free drink (not only have I completed psych, I am also very poor).

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11 Responses to “Five things doctors shouldn’t say to med students”

  1. BFolder says:

    I have a feeling you’re going to have a great time working in the NHS….

    How about the following solutions:

    1. Speak to the ward sister, ask to see patients they think are suitable. Learn about their experiences. Spend time with other healthcare professionals e.g. physiotherapists, play-specialists, dieticians. Learn about what they do. You can always learn from someone.

    2. At the start of your rotation make a list of core competencies or knowledge you want to know. Thus, your group will be readily prepared when asked.

    Your statement “I also know that you’re getting paid more for teaching me”, does not deserve comment.

    3. Feedback forms are becoming a core component in teaching. If you don’t feel comfortable completing it, then don’t! You are aware that you’ll be submitting many feedback forms as a junior doctor?

    4. Diplomacy and patience will open many doors.

    5. Perhaps by listening to your seniors, you can learn from their (good or bad) experiences.
    Make it a conversation, ask questions, learn about their difficulties and you could avoid the same issues.

    A positive, proactive attitude will get you far in life. Good luck.

  2. joshek says:

    dear med student: the number 5 point of advice is the one you should take seriously. it is the best advice you are likely to get, it is NOT a way to vent anger at you.

  3. Malcolm Morrison says:

    I am amazed! I hope this is not ‘typical’ of life at medical school, these days! It sounds as though the student is on a ‘DIY course’!!!

    We (the doctors) are supposed to know what students NEED TO KNOW; and I would have thought that there was a ‘timetable’ for the students to attend – at all stages of their training – which would include lectures, deemonstrations, and ward rounds (as there was ‘in my day’!). If this is NOT the case, then how do students ‘cover the curriculum’?

    Of course there will be times when a student wants to ask a doctor something (outside of the schedule of planned teaching); and they must choose an opportune moment to do so. But students should be encouraged to ask questions’ – that is how we all learn!

    There may be many difficulties and problems in medicine today – and in the NHS in particular. Students should be made aware of them – with, hopefully, some advice about how to deal with them; but, despite these, most doctors think medicine is a good and worthwhile job. So far as I know, it is the only job that allows one the privilege of seeing and treating poeple from all walks of life.

    Retired Orthopod

  4. waffles says:

    “I also know you’re getting paid more for teaching me” – this sort of abrasive and belligerent attitude to medical colleagues is sadly all too common nowadays.

  5. LondonMedStudent says:

    Two annoyed comments at me pointing out knowing doctors in teaching hospitals are paid more for being expected to do more teaching! Neither of which actually explain why that comment has upset them, so please do elaborate.

    My main frustration at this is that the so-called “teaching” hospitals are actually the worst for teaching… The doctors are busier, much more used to us and hence dismiss us a lot more, whereas DGH’s will welcome their few students with open arms and a great deal of enthusiasm.

  6. Dr Patronising-Voyce says:

    Dear young student.

    If I may clarify things for you.

    The ire you have provoked is because the doctors are not being paid a bean to teach you; no one below consultant grade will get even any recognition for at all (they will just get behind in their work). Consultants on NHS contracts providing teaching may well have been fortunate enough to secure some time specifically for teaching but won’t have an extra session for this, they will simply have had to drop something elsewhere, like say audit, teaching junior doctors or research, or more likely end up doing these thing on their own time. Academics also don’t get paid extra, they have a contractual obligation to teach, but also have many more obligations than any mortal can fit into a working week and I bet your university does not value their teaching output as highly as their ability to bring in grants, publish, or pump another phd from the pipeline.

    It is the trusts who get the money from medical schools to provide teaching. This should trickle down to departmental level but generally it doesn’t and just gets absorbed into a deficit shaped hole somewhere. The only place i have worked where the department actually saw the money was one of those small DGHs you speak so fondly of. There the SIFT money provided a shiney new pc for every consultant and a spankingly chrome coffee machine in the senior’s lounge. No wonder they were keen to teach.

  7. Mr Grumpy Surgeon says:

    “Get out while you can”

    If you were an A-level student, I would advise that you did a different degree.

    You’re not. You shouldn’t quit medical school, you have a lot of time invested already – you need to complete your studies and get your degree. MBBS can, however, be used for far more than clinical medicine.

    Clinical medicine itself is great, it’s just the NHS that you need to avoid. It’s a slowly sinking, politically driven ship. Unfortunately it has a near monopoly on clinical practice in the UK. Think about what you want to do in 20 years, as the landscape will be completely different. You’ll have 5 spaces for stars on your name badge, just like they do at McDonalds.

  8. London Med Student says:

    Dr Patronising-Voyce- that’s such a shame! It seems there is very little motivation for anyone to teach us these days. I realise I need to be pro-active and get myself involved, but sometimes it feels like I’m fighting a losing battle!

  9. OldTimer says:

    Maybe some comments that should be made…

    Why the hell didn’t you turn up to my OP clinic / wardround / seminar?

    Have you clerked a single patient on the ward?

    Can’t you dress properly to look potentially professional?

    Have you actually studied any anatomy and physiology?

  10. LondonMedStudent says:

    All potentially relevant complaints, I’ve seen some of my fellow students do these things and more. (I think/hope they don’t apply to me!)

    I will say that I’ve had doctors completely ignore me during “teaching”, for example expecting me to follow them silently around a ward round (and even snapping at me for asking questions). And have then been questioned by the same doctor about why I didn’t turn up again… (Clearly I went to do something more worthwhile with my time).
    It boggles my mind when they didn’t want to engage with me in the first place!

  11. VascReg says:

    Following on a ward round is not a waste of your time, any more than “standing around in theatre” is a waste of time. You need to actively observe. Think. Whatbdid the patient present with? What has been done. What needs to be done. Why as they asking about such and such a result, why requesting such a test, what do they what to find out? How will it guide further management? What needs to happen before the patient goes home.

    It seems like you’re just drifting along with your mouth open expecting others to come up and spoon feed you knowledge. This isn’t kindergarden.

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