Med Students: How to Annoy an OB/GYN Resident

I have recently realized how much of a difference it makes when the student working with me on L&D does a good job. I get third year students for a week at a time, so there isn’t much opportunity to “train” them. I have had two students this year who have functioned almost like mini-interns. We talked in my last post about what made them so special and how to be a helpful student who your residents will love working with. Today’s post is a bit more light-hearted. Today, I present to you How to Annoy an OB/GYN Resident. These are all actual interactions I have had with medical students.

Step 1: When given specific instructions, do something different.
I had one student who never did what I asked her. I said “please bring me the exam light from triage” and she brought me the wand that controls the overhead lights, from the nurse’s station. I asked her to collect a patient’s OB history and write a complete admission history and physical. She wrote a note that included the HPI and Gs & Ps. This student was halfway through her third year, and I had already told her three times what I expected to see included in a full H&P.

Step 2: Disappear
Most students figure out pretty quickly that, on labor and delivery, the student’s job is to be the intern’s shadow. I tell my students that if I get up to go to the bathroom, I should have to tell you not to follow me – you should automatically follow me everywhere I go unless I say otherwise. Why? Because when I go to the nurse’s station to refill my coffee, half of the time they tell me that room 41 is feeling pressure or 33 is asking to be checked. I don’t have time to go looking for my student. If you aren’t with me, you miss out.

Step 3: Miss a delivery
I LOVE delivering babies. It’s a big part of why I chose OB/GYN. So it’s a big deal to me to share what I love by teaching students how to do a delivery. As a corollary to Step 2 above, sometimes that patient who is feeling pressure ends up being a P4 who is ready to push, and again, I don’t have time to go looking for you. If you aren’t with me, you miss it. And if you miss a delivery, we assume you aren’t interested.

Step 4: Forget everything I taught you
Teaching slows me down when I have 15 other things on my to-do list. I love to teach, but if I take my time to teach you something, I expect you to remember it. I expect you to read about it at home. I expect you to appreciate that taking time to teach you something probably meant that I didn’t get to eat my lunch, and I’m probably going home late. A student once told me “I don’t think I’m responsible for remembering everything anyone ever teaches me.” Actually, you sort of are – if I take the time to teach you something, you are responsible for remembering it, at least for the rest of the week that you are working with me.

Step 5: Decline to scrub on a c-section
Surgery is a big deal to us. We cut people open for a living. When we invite you to participate in something that is that important to us and you decline, it’s a big insult.

Step 6: When you don’t know an answer, make something up
I sent a student to collect a history and physical on a new admission. I saw in the chart that the patient had an allergy to cephalosporins, so I asked her what the reaction is. She promptly said “anaphylaxis.” The actual answer, I later discovered, was nausea. Big difference.

Step 7: Pull nonsense out of thin air to answer questions
A student recently told me she had learned how to read fetal heart rate tracings. She proceeded to describe a strip to me.
“The rate is 115-13 and the rhythm is, um, normal?”
No. Just no.

Step 8: Ask to do procedures, but don’t prepare for them at all. 
This conversation happens a lot:
Student: “Can I close the skin after the c-section?”
Resident: “Have you ever sutured before?”
Student: “Well, we had this one-hour suture lab a month ago.”
Resident: “But have you practiced?” (We have practice supplies in our workroom available to students 24/7.)
Student: “No.”
Resident: “Then no.”
Another student asked me, while we were gowned in the delivery room on her first day, if she could deliver the baby. When I asked her the steps of a delivery, she couldn’t tell me. Yeah… About that… No.

Step 9: Sit down on the computer when I ask you to go talk to the patient
The downside of Epic is that when I tell a student to “go talk to her and see what’s going on,” there is at least a 50% chance that the student will spend the next 20 minutes buried in Epic. I told you to go talk to the patient. If I wanted you to dig through Epic, I would have told you to do that. When I told one student to “No, really, go talk to the patient” he countered with “But this is better for my learning.” Bad move, buddy.

Step 10: Complain about how hard you work as a student.
I work 70-80 hours a week. I get 20 days of vacation a year. Internship is literally the hardest I have worked in my entire life, and I had a newborn and a side job during my medical school clerkships. Earlier this year, I didn’t get to see my child for three days because she was still asleep when I left for work and she was already in bed when I got home. But please, tell me again how how hard you work and how little free time you have.

 

Ok, residents, what’s the worst thing students have done to push your buttons?  Students, what cringe-worthy moves have you and your classmates been guilty of?

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