Wednesday, March 14, 2012


About a week and a half into my first month of internship, Jessica the Horrible said that it was time to do FEEDBACK. I was really looking forward to this, as you can imagine. And we did it while on call, which made it like twice as painful.

Anyway, I knew she wasn't going to say anything that great, because she'd been so nasty to me all along. She acted like she'd been doing this feedback bullshit her whole life, instead of this being her very first time. She started off by saying to me, "Well, how do YOU think you're doing?"

I said very honestly that this was the first inpatient rotation I'd done since my sub-I a year ago (yes, I took it easy fourth year and had no regrets) and it was a bit of an adjustment. I'd forgotten a lot and I had to get used to a new hospital where I’d never worked. I also had to get used to dealing with 30 hour calls and living far away from my family and friends. But I said I thought I was getting the hang of it now.

She nodded and agreed with everything I said. Then we had this patronizing discussion about what was I doing to improve this or that. Let's not forget that one month ago, she was a freakin intern too. She did this really irritating thing that my brother does. He always says, "No offense, but..." then says something really, really offensive. She said that she felt my knowledge wasn't much better than a sub-I. I was like, "Yeah, no fucking kidding, I just TOLD you I haven't taken an inpatient rotation since my sub-I." Considering I had just told her that, I thought what she said was needlessly hurtful (and a crappy thing to say in the middle of a 30 hour call). Besides, even though my practical skills were a little rusty and undeveloped, I knew my knowledge base was fairly good because I had great board scores and I would hope there's at least some correlation. (I didn't say that, maybe I should have.)

My biggest problem was probably lacking confidence in the field, and she just killed what little confidence I had. What I really wanted to say was that one way you gain knowledge is by asking questions and she made me completely intimidated to ask any questions.

Over the course of intern year, I got feedback from many, many other senior residents. And every single one of them ended our session by asking for my feedback on them. Interestingly, Jessica was the one resident who didn’t ask me for any feedback on her. I wonder why she didn’t do that. Did she forget? Did she think she was so perfect that she didn’t require feedback? Did she think I sucked so much that I couldn’t possibly have anything relevant to say to someone as wonderful as her? If I had given her feedback, it would have been to say that she should try to remember what it was like two weeks into residency at a new hospital when you don't know everything yet.

Anyway, I basically stormed off to my next patient and didn't speak to her again until I absolutely had to.


  1. I had a similar thing. We had to give weekly presentations (like a mini-grand rounds) and those were graded by my preceptor's intern, a chick who was one year ahead of me and that I used to hang out with (we weren't "friends" but we often were in the same place, etc). She was a bitch to me the entire rotation. She would cut me down every chance she got, and let me have it in every presentation I did, asking me questions that were so off field from what I was saying that I don't even know where she came up with them and then being a real condescending bitch when I said I didn't know. I never spoke to her again. I thought, "Man, you were just here in my same spot and now you're being some hoity-toity know it all bitch."

    Later I bumped into her in real life and she apologized. I found out that her "grade" was based on her being the bad guy in the rotation, more or less, and our preceptor yelled at her when she was too nice to us. She said she was under so much stress and so afraid she'd fail that she just freaked out on all of us...but managed to pass. Then I felt bad for wishing bad things would happen to her, hehe.

  2. Of COURSE she discouraged questions - she didn't know any answers...

    Sadly, happens all the time. And you should see it in the classroom with people who are newly degreed teaching when they don't know how. I pity their poor first classes because they aren't allowed to ask questions without being disparraged. The new teacher is afraid that if he (or she) says, "I don't have the answer to that right off the top of my head, let's look it up (or let me check that and get back to you next class period) they will get HORRIBLE evaluations and not be hired back...

  3. As a professional pilot and flight instructor (who is looking to become a doctor) I have to give feedback a lot. I am also a flight instructor-trainer, meaning I teach people how to become flight instructors. One thing I have seen over the years is that people think that because they can do a task (i.e. fly an airplane) that they must also be good at teaching/training someone else how to do it. In essence, the biggest part of any training is showing the person where they went right and guiding them in discovering where and how to improve. If you don't start out with telling the person where they did well, they will not trust your analytical skills enough to be receptive to constructive criticism.

    As a mature student going back to school to get a foundation in the basic sciences in preparation for medical school, it was very hard to be evaluated by a grad student in first year biology on a 3-slide PowerPoint presentation, when her presentation skills were severely lacking (likely because no one taught her how to teach a subject) and I literally teach people how to do presentations on a daily basis.

    It boils down to this: when people don't get taught how to teach, it's uncomfortable for everyone and way less effective (sometimes to the point where it's a useless exercise).

    Fizzy, thanks for your blog and regular updates. It's a pleasure reading it, you make me laugh, and I've learned a lot.

  4. Dear Fizzy,

    My 10 year old daughter "accidentally" took your book in to school (I'm not convinced it was an accident at all) today and became the most popular kid in her class before school, during recess and on the bus. Only by the grace of God did no teachers see anything questionable or really attempt to look at the book; and now I have to hide it from her before there's a repeat performance and she gets thrown out of school.

    You should tour elementary schools. You'd be a rock star.

  5. Amanda: Interesting story, but I definitely don't think that was the case here...

    Christie: I can't honestly say that Jessica didn't know her stuff. She did. It was just that she had such a bad attitude. And when she *was* wrong, she absolutely refused to admit it.

    Inspector: I don't know if it was that she was bad at teaching so much as she felt it wasn't her job to teach. She expected us to know everything immediately.

    Code Babe: Thanks! I loved that story! I don't think there's anything SO bad in that book that could get a kid kicked out of school :)

  6. I didn't think so either, Fizzy, but her excitement over it lead me to believe that maybe I might have missed something when I read it. Besides, it's a Catholic school. She gets detentions for forgetting to bring her dress shoes to change into after gym class. The patient with the "onion belt because that was the style at the time" could be found offensive in that joint.