You are a third year medical student doing a clinical rotation in surgery. The surgeon you are working with is abusive towards everyone, constantly yelling at patients for disobeying his orders, criticizing nurses for failing to "do things my way in my OR", and having unreasonable expectations of you then calling you an idiot who shouldn't be in med school.
You feel offended, humiliated, and lost. What would you do? Your rotation is coming to an end and your evaluation is in one week.
Hey, just want to say thanks so much for posting these prompts. I have an MMI coming next week and this practice is really helping out.
ReplyDeleteDo you think I'm on the right track with my analysis?
I think that I would first try to talk to the surgeon. There might be something going on his life that's causing him to act this way, and I want to know the whole story before jumping to any conclusions. I might start the conversation by saying that he seems stressed lately and if anything is wrong.
If that doesn't work, I would try to understand specifically what he thinks of me and the job I'm doing. If there's anything I can do to ease the tension, I would want to play my part first before looking to any outside help. Maybe there really are things that I'm doing wrong, and I should fix those issues.
That being said, if patients and nurses are being abused, then I feel a certain responsibility to try and help them. Whether or not the surgeon is going through something personal, patients and nurses have a right to be treated with respect. Even though my evaluation is certainly important to my career, the abuse that the both myself as well as others are taking is a serious issue that needs to be confronted. To this end, I would try to talk with nurses in the OR to learn more about the surgeon himself, how they feel about their treatment, and if they think something needs to be done to change the situation.
I have to look out for myself in some way, so I'll probably try to talk with the OR nurses, then the surgeon to try to figure out if I can ease the tension between us. If a number of nurses feel that they are being abused, then I think that I have a responbility to report the problem to some governing body in order to help their situation.
I think your answer seems pretty good. I am not sure if it lacks anything
ReplyDeleteThe problem here is if I should consult the hospital committee or management committee to report of the surgeon?
ReplyDeleteReasons not to is my rounds are almost done in a week with him as the evaluator. I would be inclined not to report and cause an altercation. A confrontation could cause to have a poorer evalutation.
I will talk to other personnel there to figure out why the surgeon is acting that way? Is it the hospital culture, did something of concern happen to him.
Reasons to report is that you can see serious misconduct by the supervising surgeon towards patients and to yourself. Doctors are not supposed to erode a patient or another's autonomy by using verbal coercion. A patient can refuse treatment and a doctor's duty to provide the pertinent risks and benefits to treatment to give patient's an informed consent. It is not an automonous choice if one feels emotionally threatened.
As for what he said to you, that is a very unprofessional manner, especially in a surgical ward. His manner can threaten the safety of proper treatment cause mistakes or harm to done. His cajoling morally and ethically wrong and he is emotionally compromised. On a side note, you can expect him to fail you on the evaluation anyways. I would report him to the hospital's governing body because he egregiously insulted you so this cannot be easily remediated.
I would talk to the surgeon in a non-work setting and see if he’s still acts the same. Perhaps work stress or even stressors outside work is causing him to act erratically. I would tell the surgeon directly his attitude is unreasonable and negatively affecting everyone around him including the patients. This could compromise the quality of care and treatment that is being given because it’s adds another source of stress to an already stressful environment. I would tell him as a medical student I’m trying my best to learn and his behaviour is not conducive to learning. I would ask him if he really thinks I’m an idiot and should not be in medical school or did he just say those things in the spur of the moment.
ReplyDeleteI would also talk to the nurses and other people who work the hospital to see if the surgeon has always been like this or only recently. If the surgeon has been problematic for a long time I would consider filing a complaint with the other workers to the hospital administration as everyone should be treated with respect, particularly the patients who are being yelled at.
As a surgeon he should be acting more professionally and setting a good example for the students and colleagues working at the hospital. If the surgeon’s attitude doesn’t change I’d appeal to the school administration and tell him about the situation. The evaluation is obviously going to be very important and I’d want it to be an accurate reflection of my abilities.