Saturday, June 4, 2011

Weekly Whine: Annoying sub-I

In med school, I had a friend named Olga. She was a bit of a fair weather friend in that she was never really there for me in any times of crisis. But then again, she never did anything to make me dislike her.

We were reasonably good friends during the first two years, but of course, things changed during the clinical years when everyone's real personality came out. Olga was going out for a moderately competitive field and she was worried about her mediocre pre-clinical grades, so she wasn't messing around.

I heard some stories about Olga being somewhat difficult to work with on rotations. But she wasn't one of the huge gunners and she didn't do anything egregious. So I was pleased to be assigned to work with my friend during our sub-internship.

(For those who don't know, a "sub-internship" or sub-I, also called an AI (acting internship), is a rotation you take during your fourth year of med school where you basically act like an intern who can't sign orders. It's a great opportunity to see how incompetent the real interns are and therefore feel more confident about yourself.)

Anyway, I'm fairly sure this rotation killed our friendship.

A few choice offenses that Olga committed:

1) When the attending was quizzing (i.e. pimping) me, she would mumble answers to the questions as I was answering them. It sounded like she was giving me the answers or something. I mean, they were easy questions and I certainly didn't need her to mumble the answers.

2) Olga would keep going on and on about how proud she was of all the work she did and how amazed she was at how productive she was. She actually commented to me in front of the third year med student, "Why am I so busy and you always have nothing to do?"

My response was to look at the med student and say, "You see what she says to me? Can you believe this?"

3) She would treat me like I was her student or something. I remember she said to me one morning, "I have such an interesting patient. I want you to take a look at her neck." I want you to? When she did become the boss of me?

4) One day, I was helping our senior resident put in a difficult peripheral line on one of my patients. Olga saw I was helping him and she she decided to help too and completely took over everything I was supposed to do. Everything the resident asked for, she was like, "I'll do it." And she was even saying comforting words to the patient. WTF? She stayed with us doing this for like 40 mins, after telling me how much important work she had to get done.

5) During rounds, she would write orders on MY patients before I could do it, then ask the attending questions about my patients. At one point, she ended up doing a presentation on one of my patients. It was kind of ridiculous.

6) She laughed hysterically at everything our attending said, then nudged me and repeated the joke, as if I wasn't just standing there and heard it myself.

7) During patient assignments, she would always jump to decide which patient she wanted before I could say anything. I just ended up taking whichever patient she didn't want.

8) At one point midway through our rotation, I wanted to sign out for the day at 4:30PM. I only had one patient who was completely stable. Unfortunately, the evening person was at clinic at the VA thirty minutes away and had only just left. So I approached Olga:

Me: "Olga, are you leaving any time soon?"

Olga: "Well... not for a little while at least. I have to take care of some things with my patients."

Me: "Oh good. Because the sign out guy isn't here yet and I was hoping you could sign out my one patient for me. He's totally uncomplicated, no issues."

Olga: "But I have to leave too!"

Me: "But you just said you were staying..."

Olga: "No, I just have to write this up, then I'm going."

Me: "But we can't leave until the signout person.... All right, never mind..."

Olga: "No, it's OK. I'll do it. Tell me about the patient."

I tell her about the patient, taking all of thirty seconds.

Me: "Are you sure it's OK with you?"

Olga: "Yeah, I'll do it... but one day this week, you're going to sign out for ME."

I didn't like the way she said that. It sounded like some kind of threat, like she was going to wait for a patient to be on the brink of crashing them sign him out to me and go home. She was acting like this was such a big deal. So I told her to forget the whole thing and just sat around for thirty minutes for the signout person.

Anyway, it wasn't just me. All the other people in our class who were sub-interns at the same time thought she was being obnoxious too. They were all doing impressions of her, along the lines of: "Oh, my patient is so sick! Why do I always get these patients?"

That's right. Her patient. Singular. She only had one through most of the rotation, yet somehow she was more busy than even the interns.


  1. I think my answer to No.2 would have been "Probably because I do my work quickly and efficiently, instead of wasting my time whining about it."

  2. Haha. You're lucky that she was a socially incompetent gunner. It's her incompetence, not her gunnerliness, that did her in.

  3. The phrase "cut a bitch" certainly applies in this situation me thinks.

  4. Is it still a sub-internship if you only have one patient? Sounds more like a super cake rotation to me. As an intern, my first sub-i was confident, reliable, and very helpful when she had 2-3 patients. Unfortunately, she fell apart when our attending told her to step up to 50% of an intern's load. She told me it showed her how hard internship would be.

  5. I don't understand why you would call her "friend". A better term would be acquaintance. She was not even a bad friend. (i just retired from practice. beware of all doctors.

  6. Snarky: I am never able to say those kinds of things to people. All I can do is snark them on my blog years later.

    PGYx: Yeah, it was relatively easy for a sub-I. We did work weekends, but didn't even take any call.

    HealthTrain: She used to be a friend during our pre-clinical years. She kind of blew everyone off after second year.

  7. OMG your "friend" is very similar to a current classmate of mine that I've had to interact with for the past two months...she's going for a competitive specialty so I would definitely call her a gunner.
    One time we were doing a paracentesis on one of my patients, and she literally took over the whole thing, while I was still there. I don't know if she does it on purpose, or if she's just totally naive about what other people think of her...

  8. For some reason I read Singular as Singulair and thought maybe she was having some kind of mental problem from Singulair.

    Sounds like Olga was really excited.