If you’ve ever watched the pimping that happens to interns on Grey’s Anatomy, you may be wondering how to deal with a tough attending in medical school. I’d like to say that some of those are exaggerations, but there are some tough attendings out there.
As a medical student, you’re in a tough position because you are reliant upon their feedback in your evaluations. This means as much as you want to put them in their place, or tell them off, or leave, the repercussions may be too grave. I don’t say this to condone the system or the abuse that takes place in the medical profession. However, until there is a major overturning of what’s acceptable and what’s not, you’ll have to learn to work within the system. Here are my tips for how to deal with a tough attending in medical school.
Always be prepared
One of the ways I’ve learned on how to deal with a tough attending in medical school is to try my best to always be prepared. Not all physicians are the most gracious, and will give you many passes of not being ready. The medical system moves fast, and they are not waiting on the medical student. Therefore, you do not want to be the kink or hold up in the system.
If you know what case you are seeing, try to have some background on it. Know the anatomy, overview of the procedure, and even have a couple of questions prepared. If it’s a case you have seen multiple times with your attending, then you should know more and more about it, and be able to answer questions.
Always have your basic tools on you. This includes something to write on, stethoscope, a pen, and other tools relevant to your rotation. Use the bathroom during times when it’s slow, and eat when it’s appropriate. If you see your physician put on gloves, then have gloves near you. These are all things that you learn on the job, but try and be more proactive than not. The less opportunities you give these attendings to yell at you, the better.
Don’t take all interactions personal
Although it’s not okay, some physicians are just jerks. They are not very personable people, or don’t like working with medical students. That’s not a reflection on you. If you have done everything that was expected of you, then their negative interactions with you are just a part of their personality.
It can be really hard when you’re trying your hardest, and it still doesn’t seem good enough. However, there has to be an intrinsic voice that compliments you when there is no external voice to do so. As you are figuring out how to deal with a tough attending, self-reflect on how the situation could have been avoided. If you find minor mistakes or changes you could have made, but overall were not at fault, then brush off that interaction and move on.
Understand your physician’s quirks
Another tip for how to deal with a tough attending in medical school is to know your physician’s quirks. Do they like their rooms set up a certain way? Do they need rooms to be absolutely silent during procedures? Are they particular about verbiage when you’re explaining something? All of these can be annoying little quirks that you find odd and/or unnecessary.
And you wouldn’t be wrong, but it’s just not your call to make. One thing you could do is ask why they like things that way. Their response may give you insight into why they like things the way they are. Having an understanding of their quirks can help you be more tolerant of them, as well as influence how you practice in the future.
As you learn your physician’s quirks, try to not do the very thing that irritates them. Even if you like to talk and ask questions, learn when is the best time for you to do that. If you see other healthcare team members getting yelled at for something, take note and don’t do that same thing yourself. Conflict avoidance from the very beginning is going to be your key to success.
Find commonality
Negative interactions with your attending can make you not want to speak to them unless necessary. And in some cases, this may be absolutely appropriate and necessary for your wellbeing until the end of your rotation.
However, keep in mind that a lot goes into physician’s interactions with their healthcare team. Things could be happening in other parts of their lives or job of which you are unaware. Again, not that this gives them the right to degrade you, or disrespect you. But, it’s just something to keep in mind so your relationship with them is not so tense.
In an attempt to ease the tension, try and find some commonality between you and your physician. I’ve found that even the toughest attendings and I have something we can talk about. These interactions help me take their negative interactions less personal because I understand they like me as a person, maybe just not what I did, or the situation in general. I also think that it helps them be a bit less harsh in our interactions as well.
So overcome that desire to retreat from them, and meet them where they are. At the end of the day, they’re a person too. They put their scrubs on one leg at a time, just like you.
Know your resources
Some physicians are just undeniably tough. There’s nothing really you can do to break the ice. Everyone is aware that they are tough, and even their own staff stays out of their way. You’ll spot these physicians early. People will make vague, or even pointed, comments about them, and there will just be no mistaking that they are just a tough person to be around.
In those cases, it may not be worth it to put yourself in the line of fire by interacting with them more than you have to. The best way to learn how to deal with a tough attending in medical school in these cases is to know your resources, the other members of the healthcare team. These are your nurses, physical therapists, physician’s assistants, certified nursing assistants, licensed practical nurses, receptionists, medical assistants, etc. They will help you navigate the physician, the ways of the practice, and help you be successful. Get to know them because they will be your saving grace in situations like this.
Determine your boundaries
Everyone has to have a boundary for how they are going to be treated. As medical students at the bottom of the totem pole, your boundaries in that situation are going to look a bit different than with your friends and family. There may be some things that you let go that you wouldn’t normally let go in these interactions.
But, you have to know what your boundaries are that you are absolutely not going to stand for. These are situations that degrade you in a physical, mental, or even sexual manner. Just because there is a power difference doesn’t mean that they can treat you however. Certain acts are just not appropriate, even if they are the physician.
These include harassment, racist remarks, sexist remarks, physical touch, sexual advancement, threatening, and anything else that you think threatens your safety, integrity, or dignity. These can only be determined by you, and you shouldn’t let anyone walk all over these clear divisions that you’ve set for yourself in this professional environment.
Address the issues
If you feel that your boundaries have been crossed, it’s important to address the issue. The most direct way for how to deal with a tough attending is to address the issue with them. Find an appropriate time to talk to them about what they did, and why you felt it was uncomfortable or inappropriate. Now, there is no guarantee that some physicians will not blow you off, or even retaliate against you for raising these concerns. That is the risk that you take for standing up for yourself against someone who clearly demonstrates poor regard for others.
If you feel uncomfortable addressing your physician, or you have experienced some of the aforementioned reactions, then you’ll need to find your resources for reporting the physician. You should have a clinical education coordinator, or member of your university who is responsible for handling these situations. They are there to protect you so you do not have to take on someone as powerful as a physician. Learn who this division is and escalate it until you have the desired result.
Going through that process can be a long and disheartening battle. You have to decide how important it is to you to address the issue, and how far you’re willing to go to do so. There may even be long-term consequences for you career. I don’t mean to scare you, but I want to be realistic about the system that you are coming up in. It does not blindly protect medical students. Plenty of students have shared stories about retaliation after speaking out against abusive attendings. So, ensure that you have all the facts before making your decision on how you want to handle your attending.
Key Takeaways
Working with physicians can come with it’s fair share of challenges. These challenges are further exacerbated by the fact that your attending may just be a jerk with a lot of annoying quirks. Your only responsibility is to try getting through the rotation while learning as much as possible. If your attending’s behavior is so disruptive that you cannot do that, then find ways that work for you to circumvent those disruptions.
You have to look out for yourself, and it’s easier to do this when you have clear boundaries and a plan of action. If you’re a medical student or doctor who has dealt with tough attendings, then please share how you dealt with them in the comments!
One strategy I learned was to ask the attending if they have other rotations for one-on-one instruction or if there is a good time to follow them through their day to learn more. Sometimes these guys get into a rut seeing all of the medical students who “have to” go through his/her /their rotation and feel as if these students are not there because of interest but because they are made to. If they feel their educational time is not wasted with you, the interaction sometimes turns 180 for you. But sometimes, as my old internal medicine attending used to say, ” a turd, is a turd, is a turd.” Don’t let it get you down, your entire life will be filed with unhappy people: learn now that, in your profession, you are meeting literally no one who is at their best. They are all having some form of dis – ease, or they would not be there. This applies to your sleep deprived and stressed colleagues as well. Your attending is one of these, and just because they have survived into practice does not mean they have learned self-care and reflection. What people do to you is a product of their genetics and experiences, primarily, and those have nothing to do with you. Learn your self-care and reflection so that you can take that breath and give that grace to the dis-eased before you. Also, I like to end my encounters with colleagues with the question – is there anything else I can do or is there anything I could have done that would make this easier for you or do in future that would help the next patient? And I don’t get mad when they answer. Attendings like these questions too – they are your future colleagues. And pass on their answers to your fellow students! Good luck.