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Bookmark311

I feel that I am underperforming.. not sure what to do?

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I am just beginning  second year at Mac and I started shadowing in a surgical specialty, and I often get asked questions that I cant answer.... For instance, I got asked about toxicity from local anesthetics  and I didn’t know the answer so I guessed palpitations and Nervous system dysfunction, and I always get asked specific questions and sometimes I don’t know the answer. How can I deal with this? How can students do better? I have always done well in my school exams but it seems that I can’t do well when shadowing..

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Sounds like you just started post-MF4. Don't worry too much right now, knowledge bases are built over time and part of the utility of that block is to help you direct your studying in more "high yield" clinically relevant areas, and also since this is also your first real clinical exposure there is a bit of a learning curve to how pimping questions can be asked. 

 If you don't know an answer you can try to reason it out loud (some preceptors want to see thought process) or you can say that you don't know but that you will look it up – just make sure to actually look it up and get the question right when they ask again (or find a way to demonstrate to them that you took the initiative to read around the topic)

Feel free to PM me

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22 minutes ago, Bookmark311 said:

I am just beginning  second year at Mac and I started shadowing in a surgical specialty, and I often get asked questions that I cant answer.... For instance, I got asked about toxicity from local anesthetics  and I didn’t know the answer so I guessed palpitations and Nervous system dysfunction, and I always get asked specific questions and sometimes I don’t know the answer. How can I deal with this? How can students do better? I have always done well in my school exams but it seems that I can’t do well when shadowing..

I try to approach these experiences as the times when I learn what I don’t know. And then at least some of the time when I get home I read around the things I didn’t know (and ignore the things that seemed irrelevant or unimportant to actually memorize). See enough and read enough and eventually you actually learn it and expand what you really know.

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Agree with all the above comments!

At least to me, there are essentially 2 types of pimping questions:
1. The dead easy ones. You gain no brownie points for getting these right. But it would look pretty bad if you got them wrong! E.g. what is Charcot's triad for cholangitis
2. The ones you're not supposed to be able to get until like...PGY-4. E.g. what structure am I pointing to on this blah-blah-weighted shoulder MRI

In clerkship, very rarely will there be a question that is appropriate to your level. But at least in my experience, the residents and staff really don't mind/care if you get them right/wrong. The fact that you're reading around the questions asked and trying to do better is great. Hope you feel a bit better, OP!

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Don't feel bad. You're shadowing and learning.

With time, I realized that pimping questions, depending on the person, can mean something completely different.

Some people just want to make you feel like crap and to show off they know more than you - rare but they do exist

Some people want to gauge your level of knowledge

Some people don't know how to teach. They pimp a lot and uselessly, and stress out the learner and don't realize it. And as mentionned above, will often pimp you on stuff way above your level of training. 

Never feel ashamed or embarassed to say ''I don't know''. If someone judges you for that, then, they just aren't a good teacher. Likewise, you should never feel judged as a bad student to say ''I don't know''. And quite honestly, the more you know, the more you realize that there is just too much to know. It also becomes easier with time to say ''I don't know''.

And quite honestly, the vast majority of people don't expect the student to know much.

Just focus on learning and becoming a better clinician!

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