Doctors in training

A family member sent this article to me, and there's a link within the article to another related column.

They basically talk about the culture of negative reinforcement for medical interns and residents. It's fairly common for residents to get yelled at or chewed out by attending doctors for various things in the hospital. Moreover, these episodes can often be about relatively unimportant things, or things that are in no way the fault of the intern or resident, and the attending if often venting their anger and frustration on those that are beneath them. As the article points out, I think most people can agree that such public displays of anger and criticism are not useful or constructive in any way. As the second article explains, positive reinforcement and constructive criticism is much more useful. However, this doesn't stop certain attendings from taking out their anger on their subordinates, which clearly isn't right and can often drive interns and residents out of the medical field altogether.

Being an intern, I've definitely seen plenty of things like this first-hand, although thankfully I've very rarely been on the receiving side. I think the best way to deal with people like this is to simply provide the best medical care you can, and, to be perfectly honest, ignore the attending for the time being! Obviously, if something should have been done differently, either medically or otherwise, you take that lesson with you, but if someone is yelling at you unnecessarily and unhelpfully, you would probably make the situation worse if you speak up about it at that time. It can be a very difficult position as the attending has a lot more power and influence than you and it can be very intimidating. If you feel very strongly about it, there are usually avenues you can follow (such as taking the issue to a program director or an ombudsman) to address it later. I think the best lesson to learn from an episode like that is how you do not want to be an attending like that in the future, knowing how it made you feel as an intern or resident. I think also, that interns and residents should have a thick skin and be prepared to shrug things like that off as long as the abuse was truly unwarranted.

For what it's worth, I think certain specialties are more prone to this type of abuse by attendings, and I also think the incidence is declining as programs and doctors become more aware of it and interns and residents are more outspoken about it.