Getting Pimped

[tooty]

 

Do we get pimped in rotations at Canadian schools? I'd like to do well during clerkship and I fear that surviving pimpage may be a big part of that.

 

Would any of you share your views on the culture of pimping in Canada and your own experiences of getting pimped?

[Lactic Folly]

Most often, it's just a method of interactive teaching. In my experience, it's rare that the questioner intends to foster competition or humiliation (how it is perceived may be different).

[Jochi1543]

Considering I got pimped during my CBE AND resident-student shadowing (which you'd think would be the last place for pimping), I think you can expect that. I don't mind it, though, keeps you on your toes.

[Jochi1543]

Most often, it's just a method of interactive teaching. In my experience, it's rare that the questioner intends to foster competition or humiliation (how it is perceived may be different).

 

I agree. I don't see anything humiliating about it. My CBE preceptor asked me to name the 30 different types of arthritis in front of the patient, I was like, "I haven't done MSK yet, but here are 3 that I've heard of," listed them, and just shrugged it off, lol.

[ontariostudent]

My resident tutor seemed to indicate that there's no pimping here of the calibre of US pimping. It seems that clerkship here is a lot more hands on so I think there's less of a need for it. Residents are too busy to waste their time on pimping when there are patients to see.

[A-Stark]

Oh, my elective preceptor always asks me questions that I don't know the answer to. I think he does it because he likes giving explanations. On Tuesday the resident helped prepare me for questions during a hernia repair by reviewing the relevant anatomy. It *still* wasn't enough.

[moo]

As someone who did med school in the US and residency here, pimping is nothing compared to what I experienced in the US. And as for the poster who gave the excuse that things are more hands on here, that's BS too. I did way more procedures in the US as a student than as a resident here. For example, at the VA, we were expected to do our own blood draws after hours. Routinely at most hospitals we were expected to do our own ABGs, blood cultures as well. I started tons of lines while on our mandatory ICU rotation in the US as a 4th year student. I only did 2 lines my whole residency in Canada. In addition, patients in Canada (at least in FM clinic) never wanted to see "residents" even though it was a teaching clinic (I'd estimate at least 20 percent). I never had this problem in the US.

 

It's an urban myth that things are more hands on in Canada.

[ontariostudent]

As someone who did med school in the US and residency here, pimping is nothing compared to what I experienced in the US. And as for the poster who gave the excuse that things are more hands on here, that's BS too. I did way more procedures in the US as a student than as a resident here. For example, at the VA, we were expected to do our own blood draws after hours. Routinely at most hospitals we were expected to do our own ABGs, blood cultures as well. I started tons of lines while on our mandatory ICU rotation in the US as a 4th year student. I only did 2 lines my whole residency in Canada. In addition, patients in Canada (at least in FM clinic) never wanted to see "residents" even though it was a teaching clinic.

 

It's an urban myth that things are more hands on in Canada.

 

I don't speak from personal experience, so I could definitely be wrong, but I'm inclined to think that there's probably a lot of variability in the US with respect to the role of clerks. I have a friend in 3rd year medical school in the US and a friend in 3rd year here and their clerkship experiences are VASTLY different with respect to clerk responsibilities, with my friend in Canada having MUCH more responsibility. That doesn't mean that all schools are like that, though.

[tooty]

As someone who did med school in the US and residency here, pimping is nothing compared to what I experienced in the US. And as for the poster who gave the excuse that things are more hands on here, that's BS too. I did way more procedures in the US as a student than as a resident here. For example, at the VA, we were expected to do our own blood draws after hours. Routinely at most hospitals we were expected to do our own ABGs, blood cultures as well. I started tons of lines while on our mandatory ICU rotation in the US as a 4th year student. I only did 2 lines my whole residency in Canada. In addition, patients in Canada (at least in FM clinic) never wanted to see "residents" even though it was a teaching clinic (I'd estimate at least 20 percent). I never had this problem in the US.

 

It's an urban myth that things are more hands on in Canada.

 

I remember you posted something similar to this a long time ago moo

 

how did you handle US clerkship pimpage? did it matter in your final evaluations?

[moo]

You handle it by being prepared and reading around your patients. Sometimes, however it wasnt feasible to read around your patients (such as when you just admit a patient and present to your attending). And if I looked stupid, I looked stupid. I remember one time we were rounding on IM, standing outside the patient's door and my friend presented his patient. He spent over 45 minutes getting pimped. Even the interns (jr residents) started pimping him! I felt sooooo bad for him then.

[Laika]

Would any of you share your views on the culture of pimping in Canada and your own experiences of getting pimped?

 

This article was in JAMA, but was written by Mt Sinai's physician-in-chief.

[Jochi1543]

This article was in JAMA, but was written by Mt Sinai's physician-in-chief.

 

I LOL'd so hard. The muffin trick is priceless.

[national]

this just goes to show that training is different at every school, in every country, within every program. as a 4th year clerk, i've done lots of bloods cultures/ivs/abgs/lines. patients never protest to seeing a med student or resident..

 

to say it's a canada/us difference is a load of crap. it's individual experiences.

 

As someone who did med school in the US and residency here, pimping is nothing compared to what I experienced in the US. And as for the poster who gave the excuse that things are more hands on here, that's BS too. I did way more procedures in the US as a student than as a resident here. For example, at the VA, we were expected to do our own blood draws after hours. Routinely at most hospitals we were expected to do our own ABGs, blood cultures as well. I started tons of lines while on our mandatory ICU rotation in the US as a 4th year student. I only did 2 lines my whole residency in Canada. In addition, patients in Canada (at least in FM clinic) never wanted to see "residents" even though it was a teaching clinic (I'd estimate at least 20 percent). I never had this problem in the US.

 

It's an urban myth that things are more hands on in Canada.

[blinknoodle]

this just goes to show that training is different at every school, in every country, within every program. as a 4th year clerk, i've done lots of bloods cultures/ivs/abgs/lines. patients never protest to seeing a med student or resident..

 

to say it's a canada/us difference is a load of crap. it's individual experiences.

 

Absolutely. Ask anyone moving between universities for medical school and residency... there are differences between Canadian medical schools, the programs in the university and even the hospitals within each program. Third year clerks at Toronto go home at midnight, or after seeing their 1 new patient, when on call for IM... At UWO as a clerk, I was doing 1:3 calls with every third admission and all the floor calls. The varying responsibility is huge.

[ploughboy]

This article was in JAMA, but was written by Mt Sinai's physician-in-chief.

 

As my peers have occassionally discussed over coffee, the follow-up letters to that article are priceless -- specifically when Stone and Lipkowitz call Detsky out for not realizing that Brancati entirely fabricated the historical origins of the word "pimping"...

[Laika]

As my peers have occassionally discussed over coffee, the follow-up letters to that article are priceless -- specifically when Stone and Lipkowitz call Detsky out for not realizing that Brancati entirely fabricated the historical origins of the word "pimping"...

 

Hahahaha... those letters are hilarious. Thanks for mentioning them.

[hungryjoe]

good discussion and links!

 

I have a hypothetical for pondering...

 

The other day I was in the OR when my elective preceptor asked a resident a surgical anatomy question, which I knew the answer to. I was thinking "dang.. wish he'd asked me that", I kind of like the pimping process (not bragging or anything.. i get nowhere near all of them right). Turns out the resident didn't know, and the next person my preceptor asked was me! This took me by surprise - usually they start with the least experienced person in the room and work their way up with the questions. I had a moment of terror - I didn't want to potentially anger the resident, but I also wanted to show my preceptor that I knew the answer...

 

What would you do?

[future_doc]

Answer the question. It is not about showing up the resident, it is about showing your knowledge and not faking it to kiss a**. My 2 cents. And if the resdient were a decent person, he/she would respect you.

[ploughboy]

good discussion and links!

 

I have a hypothetical for pondering...

 

The other day I was in the OR when my elective preceptor asked a resident a surgical anatomy question, which I knew the answer to. I was thinking "dang.. wish he'd asked me that", I kind of like the pimping process (not bragging or anything.. i get nowhere near all of them right). Turns out the resident didn't know, and the next person my preceptor asked was me! This took me by surprise - usually they start with the least experienced person in the room and work their way up with the questions. I had a moment of terror - I didn't want to potentially anger the resident, but I also wanted to show my preceptor that I knew the answer...

 

What would you do?

 

If your resident doesn't know the answer, you don't know the answer (even if you do).

[future_doc]

Are you suggesting retribution to do otherwise?

[Lactic Folly]

It's more about putting yourself in someone else's shoes, considering their feelings, and being a team player - while at the same time, not selling yourself short.

 

I take the middle approach - start by giving the senior person some credit for the part of the question they already got right, or something they taught you.. then answer. I might add (truthfully) that I am merely guessing, or that it was fortuituous that I recently encountered this situation, or was told to read about it.

 

People who ignore (or worse, interrupt) other trainees and focus all their energy on impressing the staff run the danger of being perceived as being out only for themselves. It would be very poor form for seniors to retaliate, but they may not be as motivated to make the effort to put in a good word for you when CaRMS comes..

[future_doc]

Thank you, Lactic Folly, as always, putting matters in perspective. Another learning experience thanks to you. Seasons Greetings!

[Satsuma]

Turns out the resident didn't know, and the next person my preceptor asked was me! This took me by surprise - usually they start with the least experienced person in the room and work their way up with the questions. I had a moment of terror - I didn't want to potentially anger the resident, but I also wanted to show my preceptor that I knew the answer...

 

What would you do?

 

Don't feel bad. Preceptors and residents are quite aware that basic knowledge is lost/forgotten as you go on. Might be why the staff went with the resident first...realizing that as a clerk this information is more fresh in your mind and you are more likely to know it!

 

Getting pimped isn`t about showing off. I don`t really care if I don`t know the answers when asked questions...if I don`t know them, then it gives me something new to go learn about, or it gives me something to go review if I already knew it at one point. That's all.

[A-Stark]

I think it's fine to answer the question - the key is being polite about it and *certainly* don't take it as a chance to show up the resident or something like that. (Not that I'm suggesting that was ever a possibility!)

 

I frequently don't know the answers to my preceptor's questions. I'm quite sure, though, that he doesn't expect me to know how cautery works or details about familial stomach cancer, but he sure would like to tell me...