Dear Ms. N*,
I wanted to stop by on Friday to talk to you about something after I gained the courage to actually speak up about it, but I couldn’t find you so I thought I’d send you this email. On Tuesday I was assigned to a staff who clearly was too busy and was not interested in teaching so he assigned me to one of his residents, which is generally perfectly fine. However this resident also couldn’t be bothered by me and had no interest in taking 20 seconds every once in a while to teach me something. In fact he did not look at me once during the 4-5 hours that I spent with him. He completely dismissed my questions and would ignore me every time I would take initiative to ask questions or to ask to see something with the slit lamp. He never once introduced me to anyone who entered the room and went about as if I simply did not exist, even though I was sitting a mere foot away from him. As you can perhaps appreciate, I did not only feel like I wasn’t part of the team, but I was consistently treated like a nuisance, disrespected as a human being, and made to feel like I was not worthy of teaching. My colleague who was with me (assigned to the same staff but to a different resident) also felt the same way. It was a complete waste of our time and an insult to our dignity. It was a toxic learning/working environment to say the least.
My colleague and I then decided to kindly approach the staff and show him the list of objectives we must accomplish before the end of the week. He asked the residents to let us try to measure the pressure. Since the staff was there, the residents let us try once. After that, we were completely dismissed as we were before. We tried to approach the staff one more time to ask if we can practice the slit lamp under his supervision and he said that he needed the room (he was not seeing patients) to answer his emails because he was a very important person as head of some organization. He sent us to some other empty room (where we wouldn’t be in his way) for the rest of the afternoon. My colleague and I tried to practice the slit lamp alone there.
When we asked the staff to fill in the evaluation forms at the end of the day, he said he was rushing because he was late for some important meeting, grabbed the papers, ticked off everything in a straight line and ran off.
Everything about what happened that day was entirely unacceptable. It is not much to ask to be treated with respect and dignity as a learner.
I send you this email with the hope that such issues are brought to your attention so that you may assign the students only to physicians who are interested in teaching. This way, the students can learn in a healthy environment during their short time at the clinic. Perhaps there should be a way that students can evaluate their teachers or a way that they can vote for the best teachers they’ve had so that you can reassign students to these teachers.
From the short time I was at the clinic, I can say that the residents Dr. A and Dr. M are fantastic (as well as the resident with Dr. W on Friday whose name I cannot remember). Dr. W and Dr. D are also great.
Thank you for taking the time to hear my plea. I pray that no other student should ever experience what I experienced that day.
(*Note: Names have been changed to protect the privacy of the persons involved.)
Unfortunately, situations such as this one are more common than they should be across several professions, even at university teaching centers such as the one I was assigned to. In fact, I find that it’s quite deplorable.
What do you do when you’re in a situation where you’re assigned to a mentor or a supervisor who simply does not have any interest in teaching you? When you’re quite literally at the bottom of the food chain, what can you do without compromising yourself? How can you ensure that you still continue to learn and are able to attain course objectives, despite this?
I can’t pretend to have the answers to these questions…but perhaps I can provide some insight into what I wish I had done.
For starters, I wish I had the courage to calmly and politely confront the resident directly. I wish I had asked to speak to him between patients. (This would have, at the very least, forced him to actually look at me and acknowledge my presence.) I would have asked him if he prefers that I request that the site coordinator assign me to someone else if he was not comfortable having me in the room. (That way I indirectly hint at how I feel unwelcome.) I would emphasize that I know that he was busy, that I respected that, but that I too had valid learning objectives that I am required to attain during my short stay at this clinic. I would have also asked that he give me a moment to introduce myself to the patient if he does not wish to, so that I am not regarded as an impostor in the examination room. I would have emphasized that I was there to learn, and to help, not as a nuisance, and that I would be happy to help in any way. I imagine it would have been hard for him to continue as he did, after I had been so forthcoming. After this, I would have continued to be proactive in asking to be involved in the patient’s care. There’s a fine line between being proactive and being straight up annoying and disruptive. I suppose this is where personal judgement comes into play.
Of course, everyone has their own style. A physician at another rotation was giving one of my colleagues a hard time. He confronted the physician with something along the lines of: “I know my being here is very inconvenient and a total pain… Just tell me what to do so that I can help you get home one hour early.” By the end of that rotation the physician was sad to see this student go because they ended up getting along splendidly.
I would like to think that in the future, even if the person giving me a hard time was a staff physician, I would still have the audacity to say something in the same polite yet straightforward manner.
If despite this polite confrontation I still felt completely neglected and disregarded by the person in question, I hope that I would reach out to the staff physician much sooner or, in this case where the staff physician couldn’t care less about what happened to us, to the site coordinator. I hope that in the future I would be more proactive in requesting to be placed with another physician who was known to be interested in teaching.
I think it would also be worthwhile to speak with the site coordinator about your experience and to request that they try their best in the future to not assign students to the physicians who were simply not interested in any form of teaching. You’d be surprised how fast word travels around among us students.
When I sent the email above to the site coordinator she replied saying that she will pass the message to the head of the department without my name on it. To be honest though, I’m not sure what became of it.
Many weeks after the incident I received emails asking me to fill out evaluation forms for the physicians I’d been assigned to. I was surprised and thankful for this opportunity. I would recommend that you take the time to fill these out so that your voice can be heard! (Assuming the faculty actually reads these.)
On another note, students feeling like they’re not being taught and that they’re just thrown to the wolves is really a systemic problem at many university hospital centers. The causes are quite complex: overworked residents who are too exhausted to bother with students, a lack of a system of accountability for those catering to students, employing staff and residents who notoriously have no interest in teaching, etc. This list goes on, really…
Hopefully being thrown into these situations makes us more attuned to the struggles of learners in the healthcare system so that when we are older and wiser we treat our students with dignity and respect and make our expectations of them clear. Simple things go a long way…
Let me know if you were ever put in a similar situation and how you dealt with it!