I was briefly at the "Young Practitioners' Forum," which is supposed to be how to get a fellowship, how to get your first trauma job, how to keep your first trauma job, etc etc etc. Anyway, I kept on having to leave for stuff, but while I was there I heard one of the traumatologists giving a talk on 'things that you don't think matter but actually do.' I've heard this particular traumatologist speak before and he's really funny and his talks are always entertaining, even if they're about nonunions or something. (I've seen him on webinars and I've heard him speak at courses. I have no idea what he's like in real life, but as a speaker, he freaking rocks.)
He said some stuff that i agree with, like never walk through your own waiting room late because then it looks like you don't care. Don't park your porsche in your patient parking lot. Don't tell patients you're going on vacation, say you're going to a conference. Stuff like that. He also said a lot of stuff that I try to do, like do your own dressing changes, which is something I always try to do myself. First off because otherwise I might never see the incision, and also because I think patients appreciate it. A guy who graduated a few years ago used to take the bandage off and write an order for the nurses to replace it and that drove me crazy. I mean, some attendings like Dr. Smile and Dr. Chatterbox take the dressing on postop day #2 and leave the incision open to air, but it seems really half-assed to me to take off a bandage and make someone else put another one on. Anyway.
He then showed a picture of a med student texting in the OR while the patient was being moved on to the operating table. If you've never done that, usually it takes a few people to move the patient, you need the anesthesiologist at the head (although I've done it once or twice) and then you need someone on either side of the patient and someone to get the feet. If the patient's really heavy, you need more people. So if you're in the OR when the patient is getting moved (and you should be), then you should be helping. PD once got bitched out for not helping to move the patient (he was doing orders at the time) and it even showed up in his mid-cycle evals that he wasn't helping move enough. So really, this is a little thing that has potential to be A. Big. Deal. My personal ritual is to do orders while the patient is waking up, help move the patient, and then thank everyone in the room and walk out.
Back to the story, the traumatologist said it was inappropriate and unprofessional for the med student to be texting when people around him were doing work. He then said that the med student had gone to him for a letter of rec and he showed the student the photo and said he wouldn't write a letter for him. The med student didn't apply to ortho.
There was a lot of murmuring around me after that story, the guy in front of me seemed to think that was excessively harsh and the guy behind me seemed to think it was appropriate, but I wasn't totally sure how I felt. Part of me kind of agrees. I don't think you should have your phone out in the OR. And unless everyone else's med school is very different from mine, it's almost impossible that he was texting anything important about a patient. (this would also imply everyone else is a different resident from me because I wouldn't trust a med student to do something important for me. I mean yes, I'd trust them to do dressing changes and stuff like that, but for the most part if it's important, then it needs to be done by someone who has the ability to write orders. Feel free to disagree with me) So then yeah, it looks like he didn't care about being helpful in the OR, which is a red flag. We had a med student last year who I thought was lazy and yes, I did say something when his application was being discussed because if you're lazy as a med student on an audition rotation, I don't want to be your coworker when you become a resident. But if it was a one time thing and he was texting then I don't think he deserves to lose the ability to be an orthopod over that. If it's a pattern, sure, but if he just happened to have his phone out, then OK, it doesn't seem like that big of a deal. Also, if you're a med student, it's not like you're doing all that much to begin with. The guy was probably bored after a long day of watching people do stuff. So yeah, he had his phone out, but if texting had been invented when I did my third year rotations (it was. I just didn't do it because it was back in the days when typing the letter C involved hitting 1 three times and really, that was a lot more trouble than it was worth for any message longer than "hi") I probably would have texted more.
So I have mixed feelings on the subject. I don't know what else the student was like. I guess he really screwed up in front of the wrong person though.
In the interest of full disclosure, I was once seeing a patient and she was looking away from me and talking with her eyes shut so I took out my phone to read a text and reply to it. She opened her eyes and looked at me and said "Oh. I'm sorry. I see you're busy." I still feel guilty about that because it was really inappropriate and unprofessional and actually just plain rude to text in front of her like that. I have never done that again, I do not answer my phone in front of patients unless it is that patient's attending calling, I do not read or answer texts in front of patients and for the most part, I do not pull out my phone in front of patients. I don't answer pages in front of patients either. Someone once told me that the most important patient is the one in front of you so really, I think everything else can wait. Otherwise it's pretty freaking rude. And apparently can cost you your dream. And i got really lucky that my patient never told anyone because i definitely deserved to get in trouble for that and I didn't.