Importance of knowledge and getting questions correct on rotation

[garceyues]

Hey everyone, I just wanted to discuss the importance of getting pimping questions correct on rotation. In general, I have been told that soft skills, professionalism, punctuality, etc. are far more important than the knowledge piece. In terms of knowledge, preceptors generally want to see that you are improving during your rotation, not getting questions repeatedly wrong on the same topic, etc. more so than just having a high knowledge base and getting questions right in general.

While I concur with the above overall, I can't help but think that the importance of getting questions correct on rotation is downplayed somewhat, at least by the medical school itself. I would think that older attendings/boomers who generally went through medical school at a time when grades played a much bigger role would on average hold the knowledge component of clerkship with higher regard than many younger people/gen Zs. With exams being pass-fail now, clinical knowledge on rotations would seem to be one of the few ways that attendings can assess a student's academic standing. I don't want to come off as though I'm overgeneralizing too much or unfairly making assumptions about any particular group- I recognize that there is a ton of heterogeneity in terms of how people feel on this issue regardless of background. Would love to hear people's thoughts on this. 

[1D7]

I am very impressed if a M3/4 student is decently knowledgeable about my specialty or consistently demonstrates good knowledge of medical student level trivia that happens to be relevant to the patients/cases being discussed. From what I've observed over the years, a strong general medical knowledge base in clerkship translates into strong work ethic, resilience, and a better attitude towards the job.

That said, standing out in this way is like 2-5% of students at most for me, so it doesn't really make any sense to select based on this. If a student doesn't know the answer to any specialty specific/higher level question I asked throughout the day, I don't judge them negatively. People mostly only care if it was something directly taught, required to function as a clerk on rotation (e.g. late M3 who cannot reliably obtain basic routine information from the chart when asked), or something that makes the student dangerous (e.g. M4 who cannot recognize when to call for help for an obviously acutely decompensated/dying patient).

Soft skills are more important because it generally stands out more negatively if you are late, unreliable, make inappropriate comments, lack self-awareness, etc.

[Bambi]

Do not underestimate the importance of soft skills.

When I was selected as resident for a competitive surgical specialty, I had the least knowledge of any of the interviewees. I was considered a 'good fit', and I was.

[shikimate]

I'd say it's an 80-20 balance between general medical knowledge vs specific knowledge. Most medical students probably have better general medical knowledge than their attendings (esp subspecialized academic centers), and this shows up when rounding on patients, gathering information from chart, taking a history etc. I mean just history taking/information gathering alone probably already reflects half of a student's skill and knowledge base I'd say. 

Then the 20% area-specific knowledge can probably reflect the level of enthusiasm for the specialty. Obviously there are "high yield" things you could learn from books like First Aid series but nobody expects the med student to go through that entire book in a 2 week rotation. If a student have above decent knowledge, I'd think they really tried hard to read about the specialty, which is a plus. Even if you don't remember the answer, you could always say that you've seen it in the book and it was in the chapter about such and such etc.

Also you know what the funniest things is when a boomer pimps you thinking they know more but then you show them that their knowledge is actually way out of date (like your classification is from 15 years ago and the terminology doesn't even exist anymore lol). If an attending is smart, then they would use the fact that medical students are tech savvy and up to date to help them find sources of info. 

[bearded frog]

Agree that it's a reflection of interest in that specialty more than anything. We always consider where you're at in your clerkship as well. If you're doing a 4th year elective/selective though you should probably know more than the 3rd ear clerks you're rotating with...

[attempt2]

My experience as a new graduate:

Year 4: There is a soft expectation that you perform at the level of a PGY-1 for your specialty of interest. I have found that this expectation usually requires good soft skills, answering most pimping questions right (some are meant to be educational if too esoteric, but impressive if you get them correct) and strong specialty specific knowledge on differentials and management.

Year 3: Soft skills, teamwork and attitude were more important than knowledge in assessments. I was typically pimped more on preclerkship material rather than those specific to a specialty (especially for anesthesia, certain surgical rotations, etc). If you mention you are interested in their field, everything becomes fair game. However, some staff will absolutely comment on evaluations if your knowledge falls below an expected threshold, or if you are above average.