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Word of the Day: Roundsmanship
by fiona
I forgot to mention the hottest of the hot tips that was gleaned from my meeting with my new third year coach. Tom mentioned this as an afterthought, but he said it was the most important thing to remember for all of the next two years: Roundsmanship.
- Roundsmanship: The code of ethics that guides personal interactions during rounds.
- Rounds: the event of going from bed to bed in hospital to check in on the patients that your team is in charge of. This is known as rounding. It happens one or two times a day, from what I can tell. During rounds the resident or medical student presents a patient to the group, which is comprised of medical students, residents, and an attending.
- Attending: the fully acredited doctor (aka all grown up) whose job it is to teach, supervise, and completely belittle the residents and medical students. During rounds, it is the attending's job to make sure that the patient is being properly cared for, to discuss clinical decision making, and to pimp the team on various topics of his or her chosing.
- Pimping: the act of singling out one person of the group and testing their knowledge by asking them a series of intense, difficult questions in front of everyone. Some people have a problem with the term "pimping," as it implies some sort of relationship with prostitution and the denegration of women. I have no idea where it came from, but it is universally used.
- Roundsmanship: The code of ethics that guides personal interactions during rounds. Its like sportsmanship, but for doctors. Medical school is, after all, a competition.
I don't really think that.
Rule #1 of good Roundsmanship: Never make your high-ups look bad. Never ever ever. This kind goes back to the "never make your fellow students look bad" rule that I highlighted earlier, except this one is apparently much more important. Never show up your superiors. If a resident is being pimped and is asked a question that they don't know the answer to and you do, you should never say it. If the resident gives an answer that you know is wrong, you should never point it out. If the attending then turns to you and asks if you know the correct answer, you should not say it, even if you do.
Why? This was a bit shocking to me. It goes against every fiber of my selfish, grade-hungry being. Why not, in this cutthroat world of medicine, where we are pitted against eachother for the attaiment of the illusive Honors, why would I not show my knowledge?? Because, Tom pointed out, the residents grade you. They evaluate you at the end of the service and they can punish you. Do not make them lose face.
Besides, in its purest form, it is simply bad roundsmanship.
Comments
.....also, this sounds a little like "Scrubs."My gosh, it's really that accurate a picture of modern medical practice-who knew?
Posted by: fifi at June 8, 2005 9:08 AM
Well, theoretically, the attending knows the answer. They are asking the students and residents to test/evaluate them. And also, theoretically, at the end of the torture session the correct answers are dutifully revealed so that everyone can agree that they've learned a great deal from the experience.
And yes, I think a lot of this happens at the patient's bedside, and a lot of it happens out in the hall, and I assume that some amount of decorum and tact is utilized, but I can not be sure. All of this is pretty much a mystery to me now. But in a few short weeks, I will know all too well.
And Scrubs is by far my favorite medical-based television show, because by appearing ridiculous and making fun of things that actually happen, Scrubs prvoes to be more realistic than most of the fast-paced hospital drama crap shows that are on right now. Many people who know me are aware of my aversion to such programs as "House M.D." and "Medical Investigations" because they are total and absolute bull crap. Scrubs mostly deals with relationships, really, and the weird hierarchies and antagonims that they base their comedy around exist in real life.
Posted by: fiona at June 8, 2005 1:17 PM
Sorry, I typed attending, when I meant resident! Not being familiar with the vocab, I should read carefully!
Posted by: fifi at June 9, 2005 1:21 AM
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Posted by: Iguzki at June 17, 2005 1:57 AM
Ey! well my comment maybe will not have any conecting whit your last coment, but I was surfing by the net, and just I find this interesting web site. I was amazing with your comments.
I'm from Pamplona-Iruñea, and also study in the University of Navarra. The Valleys nexto to the Pinineos are really wonderful. You must to visit the 'carnaval' of Lantz (in February) the Sanfermines (in july) of pamplona or the sanfermines of Lesaka, the ancient and beatifull palace and castels of the Ancient Kingdom of Navarra, there were also in France, and in Spain. I think you will enjoy so much. Our basque culture is so amazing and strange, it's nice that you were interented in our culture. Dramaticly, in Navarra, the navarra's language, the basque (euskera) are very damaged, and it is the oldest language of europa, thats ist a very important cultural tesaure that we must to care.
Respect to the jamon, I think it isn't our tipical type of food. In the basque country In Navarra and also in all the basque contry, we have a lot of vegetables: like asparragus, artichokes, tomato, peppers, string beans, etc... In the basque coast we have a lot of very good fishes. There are good vegetarian restaurant and the street San Nicholas. In any case if you want to eat Basque traditional food visit one traditional restaurant in pamplona, or visit one "sidrería-sagardotegia": a good plate of codfish or meat of calf and cider. And of course you must eat a little bit of cheeses of ewes of the valley of Baztan or cheeses of the western of Navarra, from the aralar mountains and barranka-burunda, idiazabal cheese.
Woh! I was like a chef. jeje. Any way, enjoy in pamplona-Iruñea, enjoy whit our culture, enjoy and discover our country.
AGUR ta ONGI IZAN!!
Posted by: iguzki at June 17, 2005 1:59 AM
So, if the attending gets the answer wrong, or doesn't know, you produce a giant comedy clothespeg(?), and clamp your lips shut with it, in front of everybody, right?
Does the patient get to hear all this stuff? Does it worry them slightly that the doctor appears not to know the answer, and that some of the students are wearing invisible clothespegs to keep from answering?
Posted by: fifi at June 8, 2005 1:51 AM