Tell Me What You Want!
I’ve been contemplating writing this blog post for a few days now. I wanted to write it, but thought I should wait until I had calmed down a bit, so that it didn’t sound like a huge ranting session. I guess I might as well just tell the story. I think it might help release some of the stress.
Let me begin with some background. I have no idea how to say this without sounding conceited, so I’ll just say it anyway. Echoing the thoughts of Jeff Wonoprabowo in his recent post, I have also always struggled to be the best. I have always maintained a very high GPA. I have always excelled in my exams. I am a bit of a perfectionist. I am a natural leader, and I always try to do everything to the best of my ability. I am generally not lazy, and I am good at “getting things done.” Okay, I hope I don’t sound too full of myself. I am certainly “not good” at many things (singing is an excellent example), but there are some things that I’m really good at, and making good grades has always been one of those things (as is common with most med students).
I did very well during the basic science years of medical school. I maintained a high GPA and performed well on both written and oral exams. I also did very well during my first two clinical rotations. My third and fourth clinical rotations, however, have been a bit different.
Okay, so now I’m going to come right out and say what I’ve been beating around the bush about. I received a “B” in my surgery rotation. Now, I know there are probably many people out there who are thinking, “seriously, SERIOUSLY, she’s complaining about getting a ‘B?!’ What’s wrong with this girl?!” But I’m hoping that many of you are still reading, and maybe there are even a few of you out there thinking, “hey, I understand!”
Here’s the thing. My surgery rotation was very tough. The hours were grueling, and the work was at times quite challenging. But I rose to the challenges. I stayed late when no one else would. I offered to do consults and other non-required tasks. I scrubbed in when no one else wanted to. I went out of my way to help my patients. I spent more time with them then I had to. I got along well with “most” of the nurses, residents, and attendings. I always did what my residents asked of me, and tried to always go above and beyond their expectations. I also did comparatively well on all the exams and quizzes. I can honestly say that I think I deserved an “A.”
I think the main problem with the surgery rotation was that we were never really told how we were being evaluated. Unlike my first two rotations, which provided clear guidelines on how students were graded, we were basically in the dark. When I got my grade, I didn’t even know who actually gave it to me. I also don’t know what I could have done better to earn an “A.” I certainly can’t think of anything shy of actually performing the surgeries myself.
Unfortunately, my current internal medicine rotation seems to be going similarly. I don’t really feel like I know what is expected of me. And this time, I really don’t know if I’m even doing a good job because I’m not sure what a good job is!
So, that’s my rant. I know it seems like such a silly thing to be upset about, but I just don’t like the feeling of “not knowing,” I guess.
I’m wondering if this lack of information about expectations has to do with the hospital, or the rotations, or the attendings, or something else. I’m actually very interested to know if anyone out there has experienced anything similar. Do you always know how you’re being graded during your clinical rotations? Or have any of you also experienced what I’m going through? Also, have you ever received a grade on a rotation that you thought was not a true reflection of your performance?
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My name is Kendra and I am a newly minted doctor about to begin my residency in Psychiatry at 
i dont know if the system has changed since i was there 2 years ago. but, the grading was based on your chief students’ recommendations.
sorry kendra, it sucks to work 100 hours a week and then end up with a B. but honestly, the clinical grades are minor compared to the USMLE when it comes to ‘the match’ so try not to grieve about it too much! have fun with internal, i heard its really laid back. should be a vacation in comparison huh.
ps, group D all the way.
Have you got a home for the puppy yet?
the chief’s recommendations? so basically buying erik all that beer was useless…lol….i kid i kid!!
i feel you though…we were worked very hard but alas…what ya gonna do right?
Hi Kendra – boy I could really relate to this post. My masters program, no matter how great it was, was so frustrating in that each class had UTTERLY RANDOM criteria for grading. My epidemiology class had two exams that had nothing to do with my final grade. My environmental health class had three HUGE assignments that involved enormous amounts of incredibly frustrating group work that also had little to do with the final grade (not to mention our prof tried to convince us all to take our midterm grades b/c he didn’t want to mark a final exam).
I know that clinical work is different but I think that no matter what context, I think it’s just plain good manners (and good practice) to be clear about expectations. in the “real world” as a doc you probably aren’t going to have someone lay out what each patient or attending expects from you, but they will at least respond when you ask. formal education is called “formal” for a reason – they provide formal frameworks for learning and teaching. Thus, the whole “real world” excuse doesn’t count. They are expecting something of you, and they should tell you (or at least guide you) as to what that is.
Hang in there – perhaps these rotations are there partly to teach you how to use your spidey senses to determine how to reach expectations that arent’ clear – or maybe this time is there for you to learn that sometimes, you can only do your finest work and let the chips fall where they may. Keep at it!
Jocelyn
http://www.disadventure.com