Intern

I was talking to my friend the intern a few weeks back. She was complaining about a med student on her service who followed her around, listened to her talk to the patients, and then made a photocopy of her note to present on rounds.

He literally did no work of his own. He just took what she'd already done and presented it with no additional thought or input as his own thoughts.

This made my friend understandably incensed.

It made me think back to my med 200 rotation almost three (3!) years ago. I remember trying really hard to get better at doing patient interviews and coming up with my own differentials. The intern I worked with was completely amenable to this since I didn't get in his way, I talked to patients on my own, and wrote his progress notes for him. I tried really hard to just use his note as a crib sheet to check my work once I had already tried myself.

However despite my best efforts, I did a lot of things wrong. I'd forget to ask my patient some really obvious question, or leave something important off my differential. You know, the kinds of things that med students who are learning do all of the time. I thought I was doing ok, and that I improved steadily over the course of the month. My presentations got tighter, and I got more things right the first time.

The other med student, by contrast, managed to look perfect from the get-go. I was really impressed with her. I mean sheesh! How did she know all of this stuff already? It was as though she had emerged from her mother's uterus with Kochar's Concise Book of Clinical Medicine already tatooed on her brain.

Needless to say, the attending loved her. And hated me. And made no bones about ostentatiously comparing the two of us during rounds. "Oh Margaret," she would effuse, "That was so wonderfully interesting." And to me when I presented a recent JAMA article I'd found on Endocrinopathies in patients post-Sub-arachnoid hemorrhage that directly related to my specific patient, she waved her hand dismissively and told me, "You just got lucky."

And then one day we switched interns.

And I discovered that Margaret's intern wanted me to follow him at all times, and to listen to HIM conduct the patient interview. He wanted me to remain completely silent. And then he wrote the admission note. When he was done, he gave it to me to photocopy for myself.

Now, I'm not going to say that Margaret was actually incompetent. She still did well when she actually had to do some work herself too. But the difference was noticeable. By that point it didn't matter though, since it was the last day of the rotation and all the attendings thought she walked on water.

Anyway, I guess I can take solace in the fact that I learned a lot on that rotation. Still, whenever I see that attending or that intern I get a bitter taste in my mouth. It all just seemed so unfair at the time. I'm hoping that when I go back to the hospital I'll be able to let bullshit like this go and just concentrate on re-learning how to be competent.