Tuesday, September 26, 2017

Contradictory evaluations cause trouble, consternation

Two weeks ago I blogged about a resident who had been told she must repeat her fourth year of training. She countered with a lawsuit claiming that the surgery department and the medical school did not follow their policies in mandating her remediation.

She said written evaluations by faculty during her fourth year of residency were generally very good, but some oral feedback she received was negative.

From my experience as a surgical residency program director, I know inconsistent, vague, and unhelpful evaluations from faculty are common. For example, a medical student on Twitter recently posted the following:

The tweet prompted many comments from others; the best of which are these [names changed]:

That he seems well read and has a good depth of knowledge deprives him of good learning opportunities.

John sometimes stands too close when he presents.
3 months later. I don't understand why John stands so far away when he presents.

Tends to scare off new people./Makes everyone feel welcome & appreciated.

Dr. Doe, don't be too hard on the juniors. One week later. Dr. Doe, don't be too friendly to the juniors.

And my favorite

Jane should be aware of how she holds her shoulders. It changes the energy in the room.

Do you have similar evaluations to share?

Thanks to Natalie Wall (@nataliemwall) for allowing me to use her tweet.


Anonymous said...

My dad was an English professor. One year he got evaluations for the same class saying, "this guy has no sense of humour" and, "this is the funniest professor I've ever had, great lecturer." Either you got/appreciated his deadpan delivery or you didn't, I guess.

I can't comment on what sort of energy he created in the room. ��

Pascale Hammond Lane said...

My teaching evaluations.

Jack Williams said...

Welcome to the GME system. Just to put it in perspective, this is the same system that gives those directors the power to pick winners and losers in the acceptance into the residency.

Macha said...

My favorite: "seems intelligent".

Skeptical Scalpel said...

Anon, that's a classic.

Jack, what is your solution to the GME system?

Macha, "seems intelligent" implies that it may be an illusion. That's faint praise indeed.

Unknown said...

2nd rotation of general surgery internship: "her height will be a hinderance to a successful career as a surgeon". Like there's anything I can do about that...

Skeptical Scalpel said...

Deanna, thanks for commenting. I note that you managed to overcome the problem. I hope the same will be true for "Jane" and her shoulders that change the energy in the room.

Unknown said...

Well my height didn't change (4'11") but thankfully there are OR step stools and adjustable beds. Wearing 3-4" heels in the OR would not be comfortable.

Skeptical Scalpel said...

The other extreme can be a problem too. When I was a resident, my 6'4" chairman operated with the table at about the level of his lower chest. Everyone else had to stand on one or two stools. We had to steal them from other rooms to have enough.

Anonymous said...

A current intern is facing remediation with no prior notice for "failing to meet outlined milestones" and "not meeting expectations." When asked for specifics, the PD said only:"the categories are very broad." These "outlined milestones" were never provided. The PD promised they would be provided in a few months. The only specific feedback given was "asks for help too often" and, you guessed it, "doesn't ask for help enough."

Skeptical Scalpel said...

Anon, thank you for that brilliant story. It illustrates exactly what is wrong with the way we deal with residents who have real or imagined problems.

Anonymous said...

A 3rd year was placed on remediation for "communication issues." Remediation had no specific intervention, just "be better." No specific instances cited. Zero nursing complaints, zero patient complaints, zero errors due to miscommunication. Instead, broad statements about "unafraid to share opinions" "unaware of hierarchy" "speaks to superiors as equals." If there is an issue, it is with perception of hierarchy, and more specific guidance would be needed, probably with someone better at articulating it than most surgeons. A great example of a program recognizing social friction but an inability to discern whether it is 1. important enough to address and 2. the best tools to address it.

Skeptical Scalpel said...

If that third-year resident ends up being dismissed from the program based on what you wrote, the program would not be able to justify the dismissal if the resident sued.

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