Now if med school were the military, the obvious answer is that you simply suck it up. And when I look back on my undergrad days from 20 years ago, I realized that mainly out of fear of being failed, people in positions of power said/did things to me that I wouldn’t think of tolerating today. I quickly realized that once people start to mistreat you, that’s what they’ll continue to do.
But this med school thing is different primarily because of the “ego’s” involved. Still, I can’t imagine too many serious nontrads tolerating much to become an MD, but then again I’m not sure. I’m reminded of an MD/PhD friend who was pretty clear that the reason she did average in 3rd year was because she never tolerated higher ups yelling and screaming at her, calling here derogatory names ect, things they seemed to do on the regular with the other, mainly traditional students. Going back even further than that, I recall my mother who is a retired Nurse, telling me the story when she was in nursing school of being cracked on the wrist by an surgeon when she didn’t pass an instrument to him fast enough.
So I’m curious, how do other over 30 nontrads deal with this or do you find it generally not a issue?
My mother was also a nurse. She combated the deferential treatment from physicians by becoming a physician herself.
For my own experiences, sometimes I speak up, sometimes I let it slide. More and more I’m learning to pick my battles, though. If someone actually violates my civil rights (which has happened with age discrimination to a certain extent in a class) I go to the higher-higher-ups. A snide remark or two though will just elicit a rolling of the eyes and a rant with my husband later.
Where I’m at right now, I’m my own boss, but things will change once I get into medical school.
- megboo Said:
Snide remarks, I'm fairl cool with. For example, my boss sent me an email at 5:00 PM Friday before last about me arranging to meet with 2 of her collegues the following week with no date specified. Monday morning at around 8:30 AM when I hadn't done what she asked, she snarled "I expected you to have taken care of that by now".
OK, things like this won't even blow my hair up, if you know what I mean and I'm more likely to chuckle to myself than anything else. But I had another boss, again a female, actually yell at me for not doing something she wanted me to do despite the fact that I didn't know she wanted me to do it. THAT is where I draw the line. I politely and sternly told her that the converstaion was ending immediately until we communicate maturely with each other. Then she REALLY started yelling and I mean the entire floor heard her. By the end of her rant, she was essentially yelling at herself because I had left the building by that time. She trained in a country where the low poeple on the totem stayed in their place which was unfortunately the reason I think my work with her was never the same. I would however been happy to receive the authorship I was promised though.
So as I'm getting more involved in clinical research I'm wondering to myself, suppose this had been an Attending during my first year of residency? Leaving is definitely NOT an option but I guess I'd rather not be uncomfortable for the next 3 years either.
These are times when I wish I was a man. Men can yell/disrespect each other one day and the next day be slapping hgih fives and sharing a beer. But if a woman says anything back to her superior, all hell seems to break loose!
How many “men” do you know in medicine? Things are the same across the board regardless of what field you’re in. There are men just as bad as women and vice versa. I’ve had the biggest issue with people who just seem to think that because of whatever reason they can talk to anyone anyway they want. I’ve used all kinds of different tactics but usually the best for me has been to just stare at them, nod my head, and grin. I’ve actually found that the best thing to fight fire with is water.
I think alot has to do with your given certain latitude because of size, sex, color, diction, age…and then there are those who will test you specifically because of those same variables. Pick your battles.
- croooz Said:
As for the fake grin thing, I learned to get that down pat many, many years ago but occasionally I find that fighting fire with water probably the worst solvent for fighting certain types of fires, can sometimes backfire too.
By “the same” I meant that there are toxic men and women regardless of where you work.
While I agree that no two people can have the same experience it basically begs the question why ask how another nontrad deals with a certain situation? Essentially my experience won’t be the same as yours and vice versa. My experience won’t be the same as OMD even though we’re both built the same…minus my higher levels of melanin…and ethnicity. Of course we all know that race makes absolutely no difference in medicine. 
In med school we will not be in the position to fight fire with fire. We’ll just have to grin and bear it…at least in the rotations that matter to our future. I’m not going into any specialty of medicine with too many toxic types. I’m sure there will be some but not like in certain specialties which seem to foster that “type”.
- croooz Said:
I'm not going into any specialty of medicine with too many toxic types. I'm sure there will be some but not like in certain specialties which seem to foster that "type".Funny thing is that perspective plays a strong role in all this because I think it would take a hellva LOT for someone to upset me during a Pathology rotation!
Hmmmm…an interesting thread heavily weighted in personal experience, bias & mucho baggage. I suspect each individual will learn how to be deal with these situations in a manner that is commensurate with their personalities, expectations & level of confidence. As Croooz points out, what works for me may not work so well for someone else.
In general, virtually all of medicine is highly hierarchy driven & there is a good reason for this. Teaching, in medicine, is done through the hierarchy. Ideally, those with more time in have more of value to pass along to those more junior to them. And, for the most part - at least in the context of patient care & clinical prowess - this precept holds true. The intentional layering of medicine is both a protector of the patients, educator of the trainees & a reward for putting in the time & effort required to advance. Of course, throw in a few non-trads with years of clinical experience & the pat little heirarchy can be somewhat upset.
The ‘world’ that I function within is a very alpha-male/pack-mentality realm…not to imply an absence of women. Lord knows they are equally steeped & adept in the ongoings & outcomes of ‘the game’. The OR is an admixture of the anesthesia & surgical personnas. Anesthesia is very non-hierarchiacal & surgery is probably the most obscessed with it. I suspect that is an outgrowth of as an anesthesiologist, independence as a practitioner is encouraged/mandated from very early on in our training & surgery employs many years of one-on-one training. Anyhow, surgeon’s very much rely upon pushing buttons - I call it ‘pissin on your shoes’ - to establish their pecking order. And, they naturally try to apply that to anesthesia.
How you react to this provocation has massive influence on how you are perceived as a colleague & your position on the food chain. If someone pisses on your shoes & you stand your ground in a firm, mature & professional manner - esp if the perpetrator is a staff-level physician - then you gain respect. If you cower, fold or wimp out - you run the risk of becoming a doormat, which is virtually impossible to recover from. If you react in a loud, belligerent or unprofessional manner, you can & will be black-labeled, your status discounted & are likely to be seen as less capable no matter what you demonstrate. This is also very challenging to recover from.
So, in essence, the answer in how to deal with provocation(s) from other physicians…or for the matter, other healthcare professionals (yes, you will be challenged by RNs, RTs, pts & admin folks) is highly variable. Yes, standing your ground is desirable; however, it is imperitive that it be done in a calm, emotionally detached, mature & professional manner. To do otherwise, regardless of your being correct/incorrect, is to dminish your position in the foodchain, potentially irreparably.
None of this is to imply that everyone in the profession ‘gets it’. And, those who do not get it are far from exclusively members of the traditional crowd. Yes, I concur that non-trads appear to be less likely to fall into this trap, but I have definitely seen non-trads make total asses of themselves as well as traditional-aged physicians being superb at interpersonal relations skills. Do not ass/u/me that being older gives you a leg up on the food chain. What it does give you is more insight in how to most appropriately cope with others who may not have your wisdom born of living life.
- OldManDave Said:
- OldManDave Said:
In the end, I end up just wishing people would watch more of the Cosby Show,
race and gender aside, I agree with what you’re saying OMD. Medicine is one of those careers where you have to suck it up to the max when you’re in training, and probably have to play a lot of politics when you’re employed, too.
There are a lot more factors that just a boss-employee relationship going on because healthcare is viewed now more as a “team”, regardless of where you practice.
As a future (cross my fingers) med student I except to be treated the same as my (much) younger classmates, but I’m sure there will be times that I’ll gain respect with the knowledge I have. For example, when and if rehab is covered, I can draw on my experiences as an SLP to know how to handle appropriate referrals and recognize when to refer. Plus, I’m hoping that physician H&P will come easier since I do it every day for rehab purposes.
In the end, student, employee, or boss (which I am currently), I have to pick my battles. If I let every little comment or even every big comment get to me, I wouldn’t be able to function. I have the experience to stand my ground professionally but I anticipate a lot of grueling work in the coming years. I also know that it’s easy to develop a reputation, and a bad one is not good to have as a student or resident.
And we do it because we love medicine, right? 
- megboo Said:
You can't put it aside. It's real and happens and we have to learn to deal with it in medicine just as in life. There will be issues that happen because of race & gender yet are neatly wrapped in some other veil.
I completely agree with OMD and say that race & gender also dictate how you will handle certain situations. Everything you bring to the table dictates how you will handle certain situations AND everything you bring to the table will dictate how you interpret how someone else handles a certain situation.
Maybe I am blind, but I actually didn’t see much truly provocative behavior either in med school or as a resident. One of the best lessons I’ve held to in my entire life is to “not take it personally.” Another good lesson is to have a good sense of confidence and a feel for how you are performing in a situation. This can be difficult in new situations such as those you’ll encounter in rotations, but if you are able to figure out what expectations are and work your butt off, you can think “what is their problem?” to an inappropriate dressing-down, rather than, “they are out to get me,” or “I am a screw-up” or any of the other internal messages that might sidetrack you.
I can think of ONE encounter I had during a rotation where I had to take it personally - I was quite wrongly accused of ditching responsibilities. It shook me quite a bit, because it was my word against a senior resident’s, and there was no way to redeem myself in that particular situation. I was still able to assure myself that, despite someone’s delusion to the contrary, I was working hard and doing what I was supposed to; and I was still able to say to myself (with a little bit of false bravado), “WHAT is their problem???” Fortunately it blew over, I didn’t work with that resident any more, and the residents I did work with for the remainder of the rotation sang my praises and I got an honors on the rotation. (SO THERE, ha!)
But those OR scenes where someone gets yelled at - even if the yelling is aimed at you, it’s still not personal. The surgeon is a d!ck, and/or stressed about this particular surgery, or his wife yelled at him before he left the house that morning. As a student, I was with a famously volatile attending who was routinely reprimanded for yelling at students. I got yelled at from time to time. I had NO trouble saying “sorry” or “I’ll make sure to do it that way next time,” or “Yes, I understand.” In other words, I did NOT engage or become defensive. I acknowledged the surgeon’s concerns, even if they were expressed somewhat inappropriately, and we both moved on.
As a student or a junior resident, if you do something wrong and someone tells you that you did it wrong, some people will have good people skills when they communicate that message and some won’t. Keep your mind open to the message and don’t take the delivery method to heart. The point is that you want to learn, and even someone who is a turd might have something to teach you.
Again, maybe I’m blind or deaf or weird in some way, but I have to tell ya, unless YOU are spoiling for a fight, this is not an issue you need to spend a lot of time worrying about.
Mary
- croooz Said:
This is a good point to make and the reason why it can't be assumed that everyone will intrepret a situation the same way. But I think the second part of your statement is somehow "lost" in this thread.
It would be good to be able to make a distinction between what is respect and what isn't, but the very definition will depend on race/gender and other things that make us individuals. In my mind, there's a huge difference between an Attending who yells at morning rounds, "I can't believe you missed that diagnosis" and one who yells, "what are you slow, how could you miss that diagnosis?!?". Maybe some of you would respond the same way to the 2 statements but I guarentee you that while I'll NEVER stoop so low as to embarrass or degrade myself, my response to the 2 statements WILL be VERY different.
Honestly this situation has absolutely nothing to do with taking things personal. Saying nothing makes you complicit and very lilely to be mistreated again as far as I'm concerned. Thanks, but no thanks, I'm gonna pass on that.
I'll have to admit that my expectation of respect is based in large part to what I saw/expereinced at the NIH. Were there Residents/students that got their a$$es handed to them on a platter? Of course, but there is a way to do that without degrading folks which I have not observed now that I'm back in an academic setting. All I'm saying is, I'm not down with that.
Interestingly, somehow I think the intent/message of this thread has been confused. No one is talking about being in an environment where people walk around with rosed colored glasses, welcoming each other with hugs and greetings of "be well, dear soul". I mean gimmie a break, would anyone with that expectation even be interested in medicine?
Now how many people intrepret that "gimmie a break" comment as defensive?
See whata mean!
- croooz Said:
Hey crooz I really appreciate you point of view in this thread. Honestly you bring up things I've never though of!
But this example, I almost choked on my grape juice when I read it. These situations are just plain funny and it's likely funny to me because I've lost count of the number of times something similar to this has happened to me. If I had a dollar.....
- croooz Said:
The idea for this thread came up because my current research advisor and soon to be former research advisor, ordered me to go into a patient database that I have absolutely NO authorization to access, hence I'm ain't doing it and I made that clear. Yet the traditional students I worked with and those before me, seemed perfectly OK with breaking countless numbers of FEDERAL laws regarding patient confidentiality/informati on.
In my mind, a person has absolutely no respect for you if they're willing to demand that you risk your career to help thier research study.I can't imagine anyone who's had a real life doing it although DH who does network security for the feds, tells me differently.
- pathdr2b Said:
In my mind, a person has absolutely no respect for you if they're willing to demand that you risk your career to help their research study.I can't imagine anyone who's had a real life doing it although DH who does network security for the feds, tells me differently.
I completely agree with you that someone who would ask you to do this is treating you disrespectfully. I guess I didn't envision this sort of scenario when you posted your original question. I do think that non-trads are more likely to speak up and say, "I'm not going to do that, it's wrong," and on the wards I can imagine a non-trad saying, "I need to have someone with me because I have never done that," for example.
I think non-trads also have a better sense of what's really important. I can easily imagine *some* traditional students cheerily breaking federal laws to help with research, but immediately complaining and bitching if they're asked to take one more patient than they are "supposed to."
Path, I sure hope no one faults you for your stance. You're not only right as in ethically and morally, but also from a self-preservation viewpoint!
Mary
- Mary Renard Said:
Tomorrow, I've decided to put in my 2 week notice since the named violation is just the tip of the iceberg. I guess that's what I get for doing research in another department instead of my own. But all is well, I've secured a golden parachute so to speak in the form of another and hopefully more ethical, research group.
- pathdr2b Said:
ABSOLUTELY! That is the beauty of this format. It provides a vehicle for discussion with a modicum of anonymity that seems to facilitate open discussion. There are no right answers to this question nor are there any correct ways to address the problem. In fact, in my opinion, it is a sad indictment of my profession that this discussion is even necessary. It is inexcusable that physicians treat other people this way - period. There is much truth to the assertion by some book a few years ago that "...all I needed to know to be a Doctor I learn [or should have] in kindergarten.
By the way, in looking over the construction of my response, I could see where you might have misinterpreted my comment as implying you had baggage or bias - that was simply a comments in general based on my experiences & in no way directed specifically towards you. Not sure if it came across that way, but I wanted to assure you that was not my intent.
- pathdr2b Said:
In the end, I end up just wishing people would watch more of the Cosby Show,
I agree that it is totally ludicrous that your ethnic background should make a difference. The fact that you are black (or purple or white or red or what ever) should not matter one iota. Believe me, I was raised in a very prejudiced part of the world and even though I was not on the receiving end, I was greatly saddened by my friends who were. And, since I have moved north, I have had the displeasure of experiencing prejudice on a much smaller scale. By merely having a southern accent, literally many other highly educated professions immediately discount my IQ & credibility as a physician. Interestingly, no one outside of the Ivy-league, blue-blood crowd - the normal folks a/k/a my patients - give two hoots about the accent except to be genuinely curious. Granted, it is far from what you & other minorities have to cope with, but the taste of the bile is still quite bitter.
The reason I say race and gender aside is that these are things that cannot be changed. If someone doesn’t like the fact that I’m a woman and do a better job, then THEY need to get over it. I’m not going to lose sleep about it. I’d do what I need to do to remedy that situation and move on.
But if an attending told me to disimpact a patient, with a snotty tone, I probably wouldn’t get my panties in a bunch about it.
I guess I’ve found out that as I have gotten older and have worked with medical professionals, especially doctors…is that they are really no different than anyone else…i.e. they are human. Everyone has baggage…however, some will let it become a part of their everyday life even though it doesn’t belong there and some will learn how to compartmentalize and leave it away from the office.
I personally show everyone respect until they such a point where they lose it. Crying and shouting and demeaning people only serves to make the person acting that way to look pretty bad not the person they are yelling at. If it is coming out of the blue for that person, I would like to give them the benefit of the doubt, and just let it go. If it is a case of constant deriding,I wouldn’t hesitate to call them on it, although I would time it so that it doesn’t escalate.