Med Student Life: evaluations, board exams, and carmel corn bribery | The Short Coat 416
By David Etler
June 7, 2022
0:00 / 01:16:53
Dave Etler00:32

the challenge with feedback is that not all of it's useful.

And some of it is even downright harmful, I guess you could say,

Abby Fyfe00:40

hopefully someday I'm like about us female attending and I would still probably appreciate if the med student was like, you look fired it

Dave Etler00:48

I did find one question that you could practice your, communication skills with.

Abby Fyfe00:55

I'm so excited. It's my last show. And I get to do my first Yahoo.

Dave Etler00:59

welcome back to the short coat podcast. The show that gives you an honest look at medical school, a production of the university of Iowa Carver college of medicine. I'm Dave Etler with me today in the SEP studio. What a special treat it's MD/PhD student Alene, sand duke. Hi, I'm in awe. When I say that we're joined by, MP3, Eric Bozart I too am in and I'm deeply honored by the presence of the newly graduated, Dr.

Abby Fife MD. And I know you don't have to say Dr. And empty, but you know, you

Abby Fyfe01:35

earned it like you have.

Dave Etler01:40

And in the form of ones and zeros, I'm freaking out because we're joined by MP3 Morgan Kennedy. I'm freaking out because it's been a while. Morgan, it's been awhile. you're here joining us when you're supposed to be studying for step two.

that important board exam that according to the national board of medical examiners, assesses and examined his ability to apply medical knowledge, skills, and understanding of clinical science, essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention.

And I would like to point out and BME if you're listening. And I know you are that that sentence could use a period and a comma somewhere in there. Semi-colon I mean, come on Dave. I mean, how am I supposed to trust you in your medical testing abilities, if you can't even. allow me to breath of the life, the breath of life between phrases.

Aline Sandouk02:34

I put you in it and you're going to need ALS

Dave Etler02:36

Houma. By the time I'm done reading your how's it going? How it goes to the studying? Where are you?

Morgan Kennedy02:42

I am doing my study block from Nashville, Tennessee. which sounds more fun than it is. I'm not doing a lot of fun stuff, but my fiance lives here. So it's nice to kind of have some flexibility in the schedule. yeah, I mean, all it took for me to come back to the podcast after two years was to, you know, try to procrastinate my step two board studying. So it's going super well. I just a couple of days ago and you know, I feel a little burnt out already, but, you know, it's going to be okay. It's the last one before graduation,

Dave Etler03:18

I had a psychic flash, where I saw, I saw you, you know, studying on a beach somewhere in a lounge chair under her Palm trees, surrounded by study materials.

And being waited on by a attentive cabana person, who is providing for your every need. I thought for sure.

Aline Sandouk03:39

That was a true thing. I really happened, Morgan. Don't joke. That sounds

Abby Fyfe03:43

too. Yeah. Yeah. That

Morgan Kennedy03:44

that's, that's what I'm doing right

Dave Etler03:46

now. Now I, and Morgan, what if Morgan was bullshitting us? She was like, oh, I'm in Nashville.

It's

Abby Fyfe03:50

terrible. How can we know that the background is not fake? Yeah,

Morgan Kennedy03:56

it is. You, you can do a lot of fake backgrounds these days on zoom.

Aline Sandouk04:00

So it looks so real.

Abby Fyfe04:02

The world will ever know.

Morgan Kennedy04:07

I mean, it's, it's fun. I I'm like going to concerts and stuff and eating good food. And so it's been, it's been a nice change of scenery.

Dave Etler04:16

Perhaps they have Palm trees in Tennessee.

I don't think I've ever been to tennis. Do their Palm trees in Tennessee,

not south, not south enough.

Morgan Kennedy04:26

I did plant the garden. No, I did that too.

Dave Etler04:30

Yeah. Stop it.

Aline Sandouk04:33

Look at this med student being a real person with the oil interests. This is why they shouldn't have made step one, pass fail. This is what you would get because all of us being a little bit happy in our lives and the

Dave Etler04:46

limited step to see us.

So

Abby Fyfe04:48

mistakes might come back.

Dave Etler04:52

There is a rumor out there.

Abby Fyfe04:55

I think, I think there's no way that it could affect you. Okay.

Dave Etler04:59

Thank you. Yeah, no, they eliminated it during COVID because it was hard to, I mean, hard to do in person exams

Abby Fyfe05:07

in any way. Right. Then they

Morgan Kennedy05:10

decide though that it was stupid also. And that's

Abby Fyfe05:12

why,

Dave Etler05:13

but then they're like, but, but, but we could, we could make it, we could make it better.

Yeah,

Abby Fyfe05:20

but I just don't understand why they don't have enough money. I mean, I had to pay another $70 to get my step transcripts sent to the licensing board.

Dave Etler05:34

You know, those electrons, those electrons don't come for free Abbey. There is, somebody at the NBME who is responsible for crafting each electron that gets sent what's

Abby Fyfe05:47

their salary.

It's got

Aline Sandouk05:50

each individual, keystroke actually is what you pay for. You're charged by keystroke. You're charged by, people who have to point their eyeballs at your paperwork. And so they just like pass it around the department. They're like, all right, we got to 70, send the bill.

Dave Etler06:07

Ridiculous. Boy.

That's a lot of bitch and we did about that.

Abby Fyfe06:13

I can go all day. I can start it.

Dave Etler06:18

It's all past, you know, you never have to do another, a, another exam again, right? Nope. Oh gosh. I didn't. I did not know that your next one will be step three.

Abby Fyfe06:29

Right? What is step three? It's

Dave Etler06:31

just another knowledge exam,

Abby Fyfe06:32

right? It's up to part two.

but I'm going into pediatrics. So like it covers like 5% pediatrics super relevant for my, that sucks,

Dave Etler06:47

but you're going to ACE it. You're going to use it. Yeah, but you're going to it. I mean, you're going to, you're going to ACE it anyway.

Abby Fyfe06:55

I'm going to chain ticket soon. Like probably November, because I'm just hemorrhaging adult knowledge these days.

Dave Etler07:04

Yeah. He started to leak out. so, Dr. Fife you're headed to New Mexico is I believe we've discussed on the show before. and in less than a month, you will begin your, your residency. my understanding of this time period in your life is it's all about paperwork.

Yep.

Abby Fyfe07:28

I've done a lot of paperwork. and, and

Dave Etler07:31

you know what, I just want to say that the best podcasts are all paperwork based. You know, like where we just discuss paperwork. That's why I bring it up.

Abby Fyfe07:46

I had to fill out a form to get a form. And then I had, yeah, I filled out a lot already, but I'm sure that, during orientation, if you send me another mountain full, but really I've mostly been just doing a lot of art and reading a lot of books and baking a lot of baked goods and taking a lot of naps.

It's been really re like,

Eric Boeshart08:10

it sounds really

Dave Etler08:11

awesome place to live in New Mexico.

Abby Fyfe08:17

Yeah. I do have a place to live. I got Wi-Fi setup. That's the key. there's a cost

Aline Sandouk08:25

a hundred dollars a month. And like it does, and I was

Abby Fyfe08:27

sitting in, it's going to cost $20 a month for the first year. See

Aline Sandouk08:34

a Savage re here, I'm

Abby Fyfe08:35

sorry, $30 for the second year, which I'm like, just charge me $25 then do we want to

Eric Boeshart08:43

switch from NBME to media com pitching?

Is that

Aline Sandouk08:49

it's ridiculous. Internet costs a fortune in Iowa city. I don't know if it's like a Midwest thing, but yeah, it's craziness.

Abby Fyfe08:56

I actually found out though that, so I qualify for Iowa Medicaid because, I don't have an income current, I, my parents' insurance allowed me to stay on until I graduated, but now I like don't have that anymore.

Cause it, I graduated. So I have like, have I got the Medicaid to cover that gap, but I found out there was like a federal program that will pay you $30 a month for internet. If you like quote, meet certain qualifications. And one of the things you can do to qualify is be eligible for Medicaid. So I might get like six months of free internet.

So.

Morgan Kennedy09:35

That's where we stopped talking about internet. I don't want to brag you guys, but I have Google fiber here in Nashville,

Abby Fyfe09:41

bitch. Get

Aline Sandouk09:41

out. I hate you so

Abby Fyfe09:44

much.

Morgan Kennedy09:46

Really great. Except for like twice every month when they're doing like construction on the corner and they like dig up the Google fiber, a lot of them don't have internet for a couple of days.

But other than that, it's

Abby Fyfe09:58

fantastic. I remember

Aline Sandouk10:00

when they, when they first put it in Kansas city, like a few years ago, right? Sorry, is that what you're going to say?

Abby Fyfe10:05

Oh, no, no, no.

Eric Boeshart10:06

I was going to say, I literally got home last night from the ed shift where I saw you. And my wife's like, you know, the dogs woke everybody up in the house and my wife had the internet on and she's like, I'm pretty sure our router needs to be set, you know, reset or something fi coming to find out at like one in the morning that like media comms just had a nationwide outage.

Oh, that explains it.

Dave Etler10:29

yeah, they're get put in five. It's not Google, but they're putting fiber in my neighborhood too. Yeah.

Abby Fyfe10:32

My neighbor had too. They gave us a Scott caramel corn to try and get us.

Dave Etler10:40

fucking caramel corn.

Abby Fyfe10:43

Where's my internet. I forgot to

check

Aline Sandouk10:45

the caramel

Abby Fyfe10:46

box. Did you already sign up because we haven't signed up.

Oh, well I did

Dave Etler10:51

fill out their online form. Yeah,

Abby Fyfe10:53

no, we haven't. We've just been completely ignoring them. And we got like a brochure and a bag of Carmel. You achieved,

Dave Etler11:02

you achieved level two in the customer service queue of things that we need to do to get.

Abby Fyfe11:08

So if you, if you ignore them long enough from this point, maybe you'll get your own caramel corn.

Dave Etler11:15

What do you think? What do we think? Level three is level three. Like one of those

Aline Sandouk11:19

cookies, muffins or something? Coffee,

Abby Fyfe11:22

coffee, coffee.

Aline Sandouk11:24

wow. Well, enjoy your nice internet Morgan. How nice for you?

Morgan Kennedy11:29

Thank you so much. I also, just in case anyone hates awkward conversations, if you're trying to get out of internet service to get into the fiber business, there are like discrete steps you can say so that they can't offer you their internet service again.

like basically you have to tell them you're moving out of the country to a certain location where they don't offer their internet service. and it did work.

Abby Fyfe11:53

What's a friends episode. I'm moving to Yemen,

Eric Boeshart11:59

going to Yemen

Abby Fyfe12:00

drastic measures to

Morgan Kennedy12:01

avoid confrontation, an awkward conversations with the Mediacom at T and T internet

Aline Sandouk12:08

providers.

How Midwestern have you?

Dave Etler12:12

I just kept saying, I just keep saying no until I get frustrated and hang up. Yeah. And then I don't get what I want because I hung up.

Abby Fyfe12:21

So choose

Morgan Kennedy12:22

which method you

Abby Fyfe12:23

want. I don't know which one sounds more effective.

Aline Sandouk12:27

what's on the docket for today. All right. You

Abby Fyfe12:29

know,

Dave Etler12:30

all I can say is. I was, I was my, my son graduated from high school,

Abby Fyfe12:36

last weekend, Mr.

Dave Etler12:37

Adler, on, on ASSP behalf. Thank you. Is there, and so, yeah, we had graduation stuff. My mother was here for a few days and so I didn't come to work.

And then we had a, student affairs retreat at lake McBride on Wednesday. And then I came here yesterday and had a whole bunch of medical student performance evaluations to do for, for people. And, and then when I sat down to prepare for the show, I realized I had nothing

Abby Fyfe13:03

to do. The MSP is, yeah, I

Dave Etler13:06

may have written yours.

I don't really remember

Abby Fyfe13:08

Terry Thompson.

Dave Etler13:11

I mean, she did. The final paragraph.

Abby Fyfe13:15

Oh, you are the work horse. I assume

Dave Etler13:19

me and me and another person assembled them. And then we call them writers because

Abby Fyfe13:29

I don't know, I don't know some hot tea here,

Eric Boeshart13:34

giving credit where it

Dave Etler13:35

read it. I, you know what, here's the thing when it comes to the MSP, I've said this on the show before, when it comes to the MSP, I'm just a glorified mail-merge. I mean, you know, I'm just choosing things to go into the, you know, it's already been written basically.

So I'm not doing anything other than transforming, disconnected phrases perhaps into a sentence or, or, correcting the egregious grammatical errors submitted by your attendings and

Abby Fyfe14:02

residents. I read a lot of evils and, pick the good ones. Well,

Dave Etler14:07

I pick the ones that tell us. if the story is a bad story, then I could end up in your MSP.

I'm just saying, look, I tell you,

Abby Fyfe14:17

this is

Dave Etler14:17

easy. This is, oh, I'm sorry. Hang on. Morgan, somebody has to thank

Abby Fyfe14:21

me. I just said the one that I want to thank you for not putting the one Eve out. And that said that I was argumentative and bad at getting interrupted.

Dave Etler14:30

Oh,

Abby Fyfe14:33

bad at being interrupted. Like I don't possess the right skills that when someone interrupts me, I don't do that correctly.

I don't allow them to interrupt me in the proper manner. I

Dave Etler14:45

see. I see.

Abby Fyfe14:45

I had a

Aline Sandouk14:46

bizarre piece of feedback is

Abby Fyfe14:49

really bizarre. Very strange. Really learn

Morgan Kennedy14:52

how to correctly be interrupted. If anyone has any

Abby Fyfe14:56

knowledge. I don't know what I could. I mean, just like

Dave Etler15:00

when somebody is like, No you're wrong. And you just like plow forward.

Aline Sandouk15:04

You probably just kept talking when someone was like, Hey guys,

Abby Fyfe15:08

what I had been doing that rotation was they would interrupt me and then I'd let let the attending and the fellow, and sometimes like, whoever else have their conversation. And then I would be like, are you ready for me to keep calling?

Aline Sandouk15:22

That sounds like the perfect, like, if I could think of a perfect way to be interrupted, that would be it to like allow the person to save whatever

Abby Fyfe15:31

it wasn't from the people who were interrupting me.

It was from the resident who was watching this occur. And I think she didn't like that. I handled that with such like a plum. Yeah. And that she thought that I. Should just wait for them to ask me to keep going. But yeah, I don't know. I guess we're going to talk about weird evil

Morgan Kennedy15:58

and for me, Dave, like, do you remember weird things

Dave Etler16:00

like this?

You know, we used to keep a document of the ridiculous bits of feedback that we found in, in peoples. but then we decided to get rid of it because I don't know, maybe that wasn't an approved use of, I always wanted to do a segment on the show of like sh like ridiculous evaluation quotes,

Aline Sandouk16:19

if it's self reported.

Like, if we submit though, if students submit those

Abby Fyfe16:23

then, and my classes frolics, we did like, it was like, mean tweets, but it was. The feedback that actually phenomenal areas. And so he had like all kinds of bad, like, okay. So like I did the bad at being interrupted. Well, I didn't read it. But anyway, like had that one, somebody was told like on her first day of the OB rotation, they told her like she needed to be anticipating the attendings every move so that he wouldn't wait for her to hand.

So we had ones like that. And then like every few ones, someone would be like read more

all the time.

Aline Sandouk17:06

I'll take a read more over, you need to read my

Abby Fyfe17:09

mind. Oh yeah. Yeah.

Eric Boeshart17:11

Especially on the first day of a rotation to when you still have no idea what's going on.

Abby Fyfe17:17

Yeah. Somebody was told cheesy is your eyebrows for Emma. Yeah.

Aline Sandouk17:23

Emma does have kind of a, like a flat affect, I don't even

Dave Etler17:27

think it's that flat. It's just not like super expressive, like, well,

Aline Sandouk17:32

if I take myself as a baseline, everyone has a flatter effect, very

Dave Etler17:37

kinetic. And I have cultivated this podcast, personality, I guess at this point, after so many years of doing this where I'm like welcome back to the short code.

So if I was on the, if I was, you know, like in the clinic, I'd be like fake you for coming and bringing me your open

Abby Fyfe17:52

wound.

Morgan Kennedy17:55

You would definitely get some feedback on that.

Aline Sandouk17:59

He uses his eyebrows too much

Eric Boeshart18:03

all over the damn.

Dave Etler18:05

I mean, look, the, the problem that evaluators face is that it's, it's sometimes difficult for them to know how much you know, or how much your, your, yeah. Basically how much, you know, unless you're like talking and expressing yourself and all this kind of stuff. and I guess to some extent, they want to know how enthusiastic you are about, about, what you're learning.

Although, I mean, I don't know if expressing enthusiasm is a strong measure of actual learning, but yeah, but you know, they've got a, they've got a job where they have to, they have to decide whether, you know, the things that you need to know.

Aline Sandouk18:48

The evaluations are not so much about evaluating knowledge.

They're about evaluating, like the soft skills of being a med student.

Abby Fyfe18:57

Soft skills are a big part. I think it's not necessarily like rote knowledge, but like, can you use your knowledge to yeah. Which is also hard to, I think, especially if you have an attending that doesn't give you any opportunity to use your knowledge, then then they tell you to read more.

My favorite,

Dave Etler19:18

my favorite bit of feedback was, perhaps we should both avoid telling the patient they have cancer when they don't. So, you know, so

Abby Fyfe19:28

yeah.

Aline Sandouk19:29

I also hate, how I handled that situation. Yeah.

Dave Etler19:33

That's actually good feedback. I like that feedback because at least it shows like, okay. Yeah. I'm also vulnerable to.

knowing how to do things. Sometimes

Abby Fyfe19:43

I had a really fun one once. he told me that I, think too highly of my patients. I don't know. I mean, I think like I was like, it was like an internal med rotation and, or there's a hospitalized patient who had like S there's, like she had some like psychosomatic things, but also had real semantic things.

And I like worked really hard at trying to elucidate, like this is psychologic and this is not. Kind of defended her a little or like tried to help her, not defendant, but I tried to help her express that to the team am I think that they just wanted to dismiss it all as psychological. So I wouldn't be proud that to get that comment.

Know it's kind of a, an honor, like someone told me I, should I put that on my CV and just under awards or something? No,

Aline Sandouk20:39

Abby should be treating patients like the swine that they all are.

Abby Fyfe20:42

Now. I know I shouldn't be for, are there obstacles in them getting appropriate

Aline Sandouk20:47

care, mental? I believe someone gave you that feedback

Dave Etler20:51

while well, some people, I mean, you know, the challenge with feedback is that not all of it's useful.

And some of it is even downright inappropriate, harmful, I guess you could say, like, if you were to take it as it, you know, As it's given. so, you know, part of, and you're going to, and, you will get a lot of feedback. Not all of it will be helpful. and your job is to just, you know, take it in, decide what to do with it, make your decision and move on.

You've probably already gotten feedback in your life. That was like, oh, this is bullshit.

Aline Sandouk21:28

What every pre-med should do before starting med school is get a job waiting tables or serving coffee. Like there's, there's nothing more

Dave Etler21:40

or customer service

Aline Sandouk21:42

or be a telemarketer. Yeah. It's, there's something about learning how to make people like you immediately when they are at their worst.

And there's no group of people that are more difficult to deal with than hungry people who are also giving you money. So they feel super entitled for you. To kiss their ass to the utmost. And if you can find a way to like, make them happy and like the feedback is immediate, your tip is your feedback.

Right. But, and I'm not saying it's right, but that is kind of like healthcare is a customer service job like that a patient is a little bit of a customer and you are the person trying to satisfy them. You know, as the provider,

Abby Fyfe22:26

I feel like it's way harder. Often the pleas, that team, the attendance, I was

Dave Etler22:32

going to say, the other problem that you face might be that, you know, they, they feel a responsibility to point out things that you could improve on and, you know, to leave it, to leave that field blank just feels like a missed opportunity to give you that feedback.

So maybe they are just sort of nitpicking sometimes, but.

Abby Fyfe22:52

I mean, and like I have gotten good, not in the evils, the only like good constructive feedback I've gotten in evils has been feedback that was like delivered to me also in person,

Dave Etler23:05

most of the feedback you're going to get is probably

Abby Fyfe23:07

in person.

Right. And so generally in the eval, either they will say something, you know, completely bogus. They will say that's like one option. They'll say keep reading, or they'll either reiterate what they said slash like, be like, just like keep improving. So they don't like that section of the evil is just not super helpful because I don't know.

I just don't think I've ever gotten feeding. Only in that Eva that really like was helpful, you know, but we'll

Dave Etler23:42

put it in your

Abby Fyfe23:42

MSP. Yeah. I feel like the MSPE and giving a subjective grade is the only point of the written evils. But, and I

Eric Boeshart23:52

think that's something too that I think kind of shakes out a little bit because like, you know, in the grades, there's kind of that weighted aspect of like, how often did you work with this person?

Like how long? Like how many half days, whereas, okay. The actual content of the eval is a completely different

Abby Fyfe24:09

thing. Right. I always feel like I don't necessarily mind the idea that a grade comes from an evaluation. Like I, I don't have. It's a little sketchy, but I do think there is a point to it of like, are you doctoring?

Well, are you talking to the patients while are you applying? You're like, we need to grade that in some way. I had a fellow on one rotation and she was like, Abby, I wanna, I want to evaluate you because I'm going to give you a really good one.

And she gave about half threes, half fours. And then that costs me honoring that rotation, um, which is like, not that big of a deal to not honor it, I near honored or whatever, you know? Um, and then I actually was on another rotation leader with this fellow and she came to me and she was like, Abby, the med student just asked for an eval, but he told me that if I give him all threes, he would fail is that trail.

And I was like, I don't think he would necessarily fail. But you would get a really bad score from that. And she was like, really? And she was like, and so then I told her about this, like what she had done to me, like, because it was kind of a situation where I felt like enough time had passed. I had matched, it was fine.

Um, and she was horrified that she had done that, that she had cost me honoring a rotation because in her mind, the Eva, she was giving me the scale

Dave Etler25:37

of between one and five. I mean, you would think three would be,

Abby Fyfe25:40

you have a fridge. Yeah. And so in her mind, she was saying, Abby is above average because she had given me several fours.

Aline Sandouk26:03

I think, when we talk about doctors getting in trouble, this is the kind of stuff we mean. Doctors don't usually get in trouble because like they don't know enough.

It's the soft skills, like being bad at teaching students or just being. You know, a bad teammate or being disrespectful to like allied professionals and things like that. This and this is one of those skills I giving effective, timely, constructive, actionable feedback is a soft skill that I think med students now are getting trained to be better at.

But I think the problem now is that like, we're kind of in between generations where you have this older guard community of doctors that just were never trained to do that. And so they're evaluating students based on like really subjective things that they can't really like, you can't change the shape of your eyebrows.

Like that's ridiculous, but they're being told to evaluate students and they don't know how to, so they have that, but it does seem like it's getting better. So you have this like kind of hybrid community with younger people like us who are gonna do a much better job. Cause

Dave Etler27:08

we've yeah. In theory, you've had more, you've also had some teaching.

You've had some it on how to do that, whereas yeah, like you said, Folks may not have, or they may have learned incorrectly or so. Yeah. Yeah.

Aline Sandouk27:22

The second comment I wanted to make, I w I would like to offer a piece of feedback to listeners that I think is really useful, which is, let's see. Well, let's see. I don't know.

And audience, let me know if like this isn't helpful, but, this is helpful for like, asking for evaluation, but like, at, at their level is premeds like asking for letters of recommendation. when you go to ask someone for. Make sure that you specify, like ask them outright. Do you feel comfortable writing a very strong letter for me?

Like, don't just ask for a letter, be clear that you want a great letter. And then in the same, you know, email or whatever conversation, feel free to be like, Hey, if you don't feel comfortable writing a strong letter, what can I do to deserve a strong letter

Abby Fyfe28:06

from you?

Eric Boeshart28:07

And that's

Abby Fyfe28:09

super

Aline Sandouk28:09

helpful, right? Like, because this happens,

Dave Etler28:13

this happens.

I just happened to me in the last couple of years where. not a student. So a former coworker had asked for a letter of rep. I had not asked for a letter of recommendation and just put me on the list. And I got a call and I was like,

Aline Sandouk28:28

I can't

Dave Etler28:29

do that. So like this person,

Aline Sandouk28:33

I was going to say, like, you, you have to think about how the request comes up. Also. It's on the person receiving. The request to be like, to be honest about like, Hey, I'm not sure. I know you well enough to write a good letter. And there's a polite way to be like, I'm sure there are people in your life that understand you much better than I do that.

Know your strengths. Like that's something I've said is like, Hey, we haven't worked enough together, but there's time. If you want to work together more than I can get to know you better and write a good letter, but it's also on that person to recognize that they, that like, Hey, there's something at stake here.

And if you aren't able to support this person in whatever the thing is, they're applying to be honest and say, Hey, I'm not sure I'm comfortable. Maybe you should ask, like, I'll do it, but maybe ask someone else who knows you better. And then come to me as a last resort. But so like, there's an art to asking for someone to endorse you and, and how to handle a request for an endorsement.

And I think it's getting better, but I wanted to throw that out there because I think giving the person a heads up that you're going to need an evaluation, making sure they know kind of what you need from them, which is like, Hey, I need you to tell them I'm awesome. And, and if they're not comfortable with that, figure out what they need to hear from you to be able to say that.

You're awesome. So I hope that's helpful. I've learned that the

Dave Etler29:55

hard way. I think that sounds helpful. I was thinking, you know, while you were saying that, that one of the problems with that advice might be that, you know, in our, in, in the case of these clinical evaluations, I believe you can correct me if I'm wrong, that you J sickly, just put somebody's name into a, into a thing, into a computer and they.

A message saying, you know, so-and-so wants an evaluation firm.

Aline Sandouk30:17

Never do that. You're not asking

Dave Etler30:18

them for doing, you have to. Oh yeah. So I was going to say, and that's what I realized is that, well, just because of that's the system doesn't mean you have to do it that way. I mean, you have to make that performance, but you can also ahead of time, as you said, I

Abby Fyfe30:31

started out asking and pretty quick abandoned that you

Morgan Kennedy30:39

too Abby, it just like stuff is so much anger.

And I just realized it wasn't feasible and no one else was doing it and it wasn't going to affect, you know, their, my evaluation they're expecting them. Cause I used to spend so much time being like. You know, will this person write one for me? Is this going to be awkward? What if they say no? And I asked them, you know, like, how was this scenario going to go?

And it just wasn't worth it.

Dave Etler31:06

But definitely do that. I mean, there is a point where you have to do that, which is like, when you're getting ready to apply, right. When you

Abby Fyfe31:12

actually get a like, and then when I was like spring of my, three years, so it was new, the MSP was coming up. I did a couple of times be like, he, I don't need another eval.

Like I have enough, but would you be willing to do one? Like, and like letting them know too that I actually won like some comments on it for like letting them know it was for the purpose of the MSPE. And then I was like, I'll do one for you. Cause the residents do like need evils too. And so I was like, I'll do one for you.

Would you be able to like take time to do a good one for me? And those are people who I was pretty competent. Like we're going to have nice things to say about me ultimately. So, but yeah, I think if I, like, especially if it's an attending, even a resident, like as part of their job here at the university to like do those evils and teach us.

And so I generally just sent it because I was like, okay, I'm still

Eric Boeshart32:19

in the boat of asking granted, I'm only halfway through my eyes, my core year. So it's like, I still come at it from a point of like, especially if it's a resident that I've been working with, like frequently it's, it's one of those things where it's like, it's kind of like an end to the relationship a little bit.

It's like, Hey, we we've worked with, we've worked together for this long. Would you be open to. Reflecting on how I did it. And I've had a couple of days, or I've, I'm not sure if it was a resident or if it was a staff, but a staff member like pulled me aside and was like, Hey, you know, it, it wasn't, it wasn't a turndown, but it was like, it was, just kind of making me aware of how other staff might approach the situation.

But it's like, you know, I don't give out evaluations unless I'm confident that the person is, you know, at that level where I can give a good evaluation, kind of like what you guys were saying where it's like, not

Dave Etler33:19

really the point of the evaluation.

Abby Fyfe33:21

Right? It's not,

Eric Boeshart33:23

I think that it's understandable and it is anxiety provoking, but it's one of those things.

And maybe it's just something that I've been working on myself, but it's like, I'm trying to open myself up to that feedback. So it's like, even though it's anxiety provoking to ask for it, I'm not going to get it unless I ask, you know, like, and sometimes the most constructive feedback that you get is when you ask

Dave Etler33:45

and then to finish the relationship, you give him a little kiss

Eric Boeshart33:50

just on the resident feedback form, just a little boom

Abby Fyfe33:53

spray,

Aline Sandouk33:54

spray it with perfume, put it in the mail.

Morgan Kennedy33:58

so I, I got told no for feedback without asking one time. it was really hilarious. It was in my core rotation, it was on an inpatient service and they like the attendings were switching over. And so I had mostly been working with one attending and it was like the last day and someone new came on and unbeknownst to me.

Like for the rest of the services. I think we requested like evaluations for who we wanted, but for this one week of inpatient, the course director just like automatically sent requests to these attendings. And so a request got sent to this attending like that morning before I had even met him. And so I'm like in the like room we're doing, you know, patient presentation.

I do my patient presentation in front of everyone. And he's like good presentation, but I'm not going to do an email for you. Cause I don't know you and I

Abby Fyfe34:50

have no context to that. I was so confused.

Eric Boeshart34:54

Yeah. I have an idea on which rotation this is and it,

Dave Etler35:01

this explains some things that I have seen on comments where they're like, I don't know who this person is.

Morgan Kennedy35:06

It was literally just like I, cause I didn't even, no one got sent to him. I get where he was like, wow, that was presumptive of this medical

Abby Fyfe35:12

student to ask for

Morgan Kennedy35:14

an evaluation. But like there's some

Abby Fyfe35:15

disconnect there where like he thinks I'm trying to get an evaluation from

Morgan Kennedy35:19

him. I was like blindsided. Like, sir, I would never ask you for an evaluation

Aline Sandouk35:25

you for, I won't go on a date with you.

And you're like, I didn't ask. I'm not even coming

Abby Fyfe35:29

on.

Morgan Kennedy35:30

That is exactly what it felt like. It

Aline Sandouk35:32

was hilarious. Yeah, that's mental. That's great.

Abby Fyfe35:38

I was going

Eric Boeshart35:38

to throw that in there just to kind of like the little twist of like some rotations, they do send them out on your behalf.

Abby Fyfe35:45

That

Aline Sandouk35:46

that is, the caveat, I think to my method.

And I think neurology is one of them where they,

Abby Fyfe35:52

they initiate them skirting around it. But yeah, I was gonna say,

Aline Sandouk35:58

yeah, so. Well, anyway, we can talk about, because it's, that's kind of Iowa specific, but for anyone who hasn't, that's a good, that's a good thing for people to know ahead of time, because you might end up in a situation where someone gets an evaluation.

You don't even know. So what I did when I found that out is, so I try to initiate as many as I could before the end of the week. So that like, cause when they see that you have them, I think they don't send them out. But if you have none, they're like, oh, we'll just do this for you. And so when I did miss it, a couple of times I reached out to the people who got, you know, had them initiate and I was like, Hey, just a heads up.

You might be getting an evaluation about me. So, let me know, you know, and then try to like preempt, you know, with my spiel. But yeah,

Dave Etler36:40

so intentional. So intentionally I

Aline Sandouk36:43

like to be in control of the way that other people are looking at me. Good luck with that. And,

but it's, it's, you can't control everything, but you do the best that you can. So that. An accurate picture of who you are, you know,

Abby Fyfe37:01

I

Morgan Kennedy37:01

love it. This is what the show has turned into today. They're super weird, for anyone else listening. Yeah. Spend less time crying and stressing about them, I think. And, not that I've done that

Abby Fyfe37:20

I don't ever cry.

Dave Etler37:23

Let's see if we can. We'll see if we can change that. If we can change

Abby Fyfe37:26

that by the time it

Aline Sandouk37:27

shows this. Oh, no,

Morgan Kennedy37:28

I, I try frequently. I cry at work. Not at work

Abby Fyfe37:33

it's

Eric Boeshart37:33

I wish I did more.

Abby Fyfe37:36

I wish I was Abby. Oh, I thought you're asking about my crying habits. No, ever going to go around and say how frequently you cry.

I cry all the time yesterday. I was at my friend's.