Behavior in OR

Hey man, basically, crap rolls down hill. If the attending throws something out there, as a student, I'd give the residents a chance to answer first. If they don't know, you'll get your turn. Obviously, if the attending asks you specifically, game on.

There is, like you said, a fine line between impressing and pissing people off. Just relax, if you act normal and fit in you'll do fine.

I've noticed that in most cases attendings are good about pimping up the chain of command.... starting with the students and then PGY1, 2 etc. That way, no one has a chance of making an upper level look bad. Although, I found myself in this situation plenty of times. My rule is that residents and want-to-be residents make each other look good first, then impress attendings. This also goes for taking a few hits when something doesn't get done right. Attendings don't expect much from students.... so it's difficult to make yourself look bad. Residents that you protect will always remember the good that you have done and will return the favor.... remember, they have a lot more one-on-one time with the attendings than you do... and their impact with the attendings is almost always greater than anything you can do. Obviously this is just my opinion... and many of my co-students that used the "the more you show you know... the more you impress" philosophy are doing just fine as ortho residents at other programs.

I'm a 4th year student, and if an attending pimps the residents and I know the answer right away I don't say a word. If you blurt out an answer while the resident is thinking or before they have a chance, they yes, you're going to piss them off and make yourself look bad. But if they say they don't know and the attending turns to you and asks, then it time to speak up and answer correctly if you know. From my perspective, any resident who gets mad because you knew something they didn't when asked by an attending is a joke.

I guess the moral of the story is, be respectful of the residents and don't be "that guy" who constantly answers every question asked immediately. But another point to stress is that this doesn't just go for residents, it goes for other med students too. If you're on rounds and you've gotten the last couple questions right, maybe it's time to slow play one and allow someone else to answer. But again, if asked by the attending after they've had a chance, don't ever sandbag one and think you're looking better. Always give as many correct answers as you can...there will surely be many later that you won't know and wish you did!

rwbrhp29

as an MS1 I dobt your gunna have that problem too much. Just remember that residents are really busy and dont get to read and just hang out and study as much as u do. SO if you just had anatomy you might remember some little tid bit that they once knew and forgot too.

I have generally found that student know more cause they had the luxery of resding about it the night before while the resident was getting killed in the ER on call, so just be mindful when judging based on pimp knowledge. Also the redients dont really care, they are in and you arent so think of that too.

So be cool and just have fun.

From a residents standpoint, we want med students that work hard, come early and stay late, are interested in what we do and when we have the time to teach.
We like it when a student has enough initialtive to pull an article on a specific surgical approach and copy it for everyone involved in an upcoming case.
Students rotating are not there to prove how smart they are....but being prepared and knowing your anatomy is expected. Usually, pimpin goes UP unless its a upper level question, or if its obvious the resident SHOULD know but doesn't.

Pimping is for teaching purposes...when asked in a situation you will remember much more that reading alone.

I agree with the person that said that a resident tshouldn't get offended when a student or someone lower than them answers a question correctly...but BE CAREFUL. If you do this too much, it can backfire on you. Many attendings have LITTLE say in the selection process. Every resident has SOME input (varies on the program). Rub the residents ( or even 1 resident) the wrong way, and you wont get a spot.

Work hard, don't overthink the small issues, don't be a jackass, seem interested. Easy, isn't it?

About behavior in the OR:


help Move the patient on and off the table

help hang the films, make sure the resident or you have the films ready

write your name on the OR board and introduce yourself

get your own gloves and gown

Write the op note basic shell before the case begins

If you can, after a while write the orders BEFORE the case (ask the resident if these look good)

Scrub longer than the attending and residents, gown and glove after them, and be patient if they are draping the patient....the scrub nurse will get to you

Be aware of the lighting. If you can help and the surgical field has moved, move the lights.

Thank the attending for letting you scrub in, especially if they taught you something.

Carry a journal, and after EVERY case write down 1 or 2 things you learned. You'll be AMAZED at how helpful reflecting on how a case went will impact the learning you can achieve.

So....there are TONS of other things to work on then to worry about whether or not you should answer a question you know the answer to....