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Why Do Attendings Verbally Abuse Med Students?

Anthonyrudine72x722_3Anthony Rudine -- I think it was Jerry Seinfeld who said something to the effect that it is just that little bit of arrogance in the medical community that we could all just do without. I have to agree.

I am not sure what your background is, whether or not you were raised around physicians, know physicians, or are one yourself, but it really doesn’t matter. I was not raised around any physicians, so perhaps my attitude towards the medical community is different that yours.

On my most recent rotation, where I will not use names, largely because I haven’t been graded yet, the arrogance was palpable. I have never in my life heard people speak to each other the way we students were spoken to by a few select physicians. Male or female, it makes no difference, the curse words and expletives and insults were rampant.

Now, some of you may expect this. I expected some of it myself. It wasn’t until I thought about the situation more fully that I realized how ridiculous it was to curse, scream, slam things, etc, at medical students.

First off, medical students are paying for their education. Yes, the public pays a large portion of the costs and fees, especially at a state school, but for the individual, like myself, who needs loans, the amount is substantial. Second, these physicians were once students themselves, although it seems that they have forgotten. I can find no valid reason why a self-respecting physician at an academic institution would speak this way to anyone, much less future colleagues.

I think that the very few physicians who I am talking about must have such a low self image and be so insecure that they must berate others. That is the only explanation. I have not noticed any correlation in intelligence of the cursers. There is nothing to explain why these doctors speak to us this way other than they are so afraid of life itself that they have no other option than to yell at those doing their best to help.

November 22, 2006 | Permalink


You can definitely learn swear words on the wards....

Posted by: | Nov 22, 2006 9:11:18 PM

Maladaptive coping abounds.

Posted by: Tom | Nov 23, 2006 3:58:15 PM

"patience is a virtue" remember? if they were to curse,scream etc who would suffer more? is them not you..so why should we bother if they were screamin or slammin things while giving orders etc?
it would be better to keep your cool..and just ignore..=)

Posted by: ;) | Nov 23, 2006 9:08:40 PM

I think it's because shit rolls downhill. I am a third year medical student and the first thing the MA said the first is; "This is like the army" meaning they use a ranking system. And the abusive goes down wards. To me is just a matter of do unto others kind of situation; where the people who are now the supervisors once got abused themselves. I do not mind it too much since I know it's nothing personal and for these people its standard procedure. What I do hate about is that sometimes you have to wonder "Is this person yelling at me and insulting me because I have done something wrong or because that's just what he does?" and then you don't know if you're being a good doctor or not. I think a bigger problem is the sexual harassment that I can do without.

Posted by: edward | Nov 25, 2006 7:08:01 PM

It's a power thing, no doubt. Makes people in power situations feel good and convinces them more of their power when they are able to abuse a helpless party without consequence.
Hard to ignore, I know. Hang in there... maybe it's just psychiatrists...

Posted by: jocelyn | Nov 25, 2006 11:45:01 PM

So, why are medical students so thin-skinned?

Posted by: Jared Solomon | Nov 27, 2006 7:08:30 PM

If you got your sh*t together and quit f***ing around you wouldn't get cursed at so much.

/poke ;)

Posted by: scalpel | Nov 28, 2006 11:59:38 AM

Anthony, it's too bad you are having such an experience. I don't know if these are residents or attendings who are acting like this, but you're right, such behavior is unacceptable. On a personal note, I always think back to what it was like to be a medical student when things get choppy. Good luck in the rest of your career and don't let this get you down. Whether its the medical field or somewhere else, you'll always find people without tact.

Posted by: Naveen | Nov 28, 2006 4:43:15 PM

I think people who are abusing towards others were similarly abused in their training. Fortunately this type of attitude is dying out, but seems to perservere in some parts of the country. I'm lucky enough to be in the Midwest where this is essentially now taboo and any attending who were to act like this would soon be out of the program. It's unfortunate that this persists, but if we--the new generation of physician--recognize it and don't replicate it then medical training and practice will be all the better.

Posted by: Brandon | Nov 28, 2006 4:53:31 PM

I'm a fourth year now; it's been better since my letters of rec and grades have already gone out, so I don't really give a shit what anyone thinks on some meaningless "mandatory" rotation. Relationships with attendings can be tenuous; either they ignore you or blame you for their problems which most of the time you have no control over or are not even cognizant of; half the time you get people who are professional and want to teach. take it all in stride.

As we work in this slave labor system where you pay them to work your butt off for a few years so they can stroll in and make quick decisions based on your work, keep in mind that one day when these attendings will be decrepit, old, and sick you might be the attending rounding on them. i find that it's not really the attendings i've had problems with, but residents who are somewhere in the middle who get pressured by the attending and then pass it on to you. people who don't have anyone to answer to (i.e. attendings) are more laid back/apathetic than the pressured residents.

Posted by: DVPMD | Nov 28, 2006 4:59:43 PM

ah, but what about when the militarism comes down to "you better start showing me more respect or i'll fail you!"?

Posted by: julie | Nov 28, 2006 5:00:27 PM

I was once called a mental midget, and america's answer to morrons, by a physician I was shadowing. This was in my masters degree before I got into Med school. He just expected a lot of me, and I just dealt with it. So, in conclusion just ignore them or you can kill them with kindness. (I am partial to ignoring them)

Posted by: Gary | Nov 28, 2006 5:00:38 PM

let it be and don't let them get to you. In the end it will all pay off. Good luck in becoming a sucessful and caring Doctor

Posted by: | Nov 28, 2006 6:04:32 PM

They do it because they can. We have no recourse, they essentially hold our futures in their hands. I find it very unprofessional and immature but there is not much you can do about it. I agree with one of the posts, I think they are either very miserable or lacking self confidence themselves. Whatever reason they hide behind it is very discourteous and I have little respect for the temper tantrums of a 2 year old in a white coat.

Posted by: CRE | Nov 28, 2006 6:05:42 PM

Attending meltdown is taboo in the midwest? First I've heard about it.

Posted by: Jeff | Nov 28, 2006 6:36:16 PM

anthony, dont feel bad. i had worse of the worse than your experience. because i was a female med student. in fact i am an attractive slim girl with long hair (hey i have the highest step scores in my school..i graduated number one from my school..i have brains too) i had attendings asked me to sleep with them.....explicit....just like that!! when i scrubbed in during general surgery rotation, several residents constantly told me to "suck here" when i was holding the suction aspiration. i had male attending told me that i got good evaluation is because i am attractive depite i passed all my exams and quizs with 100%. they dont care how many hours and how hard i worked each single freaking day. in addition to these devil horny attendings and residents, i even was "abused" by nurses and OR tech. because they think med students are the lowest rank in this medical world. one day, when i was scrubbing in during plastic surgery rotation, this OR female tech wouldn't gown me....after i waited about 20 minutes....i was standing in the operation room with both my arms up like a fool......she finally came over and gown me, gloved me and said "i just dont like you" what did i do????? nothing but being a student. about cursing??? that is just daily routine. i had an attending said to me "what the f--k you think you are doing???" anyway, i can go on and on and even write a book about this dark dark dirty harsh path we as med students have to put up with in order to be a resident!!!! i swore to myself during each single of my rotation that i will never cry and never let them put me down no matter how bad the situation was!! and i DID it. now i am a 1st year ENT head and neck surgery resident and i was offered multiple residency spots in OB and in internal med and family med by those attendings who really noticed my talent.....i was offered my current residency spot 3 months before i graduated from med school and before i even passed my step 2. the point is, it is so unfair the way they treat us but you will have to bite your tongue and try your best to ignore them!! i swear to myself that i will never turn into one of those bad abusive attending. now i treat all my med students with smile, kindness and i teach them without expecting them to know the answers. i dont let them go through any of those shit i have gone through. goodluck to you, you can write me and vent to me if you want. i understand how you feel 200%. and i have been there and done all that!!!!!!

Posted by: jennifer | Nov 28, 2006 6:39:55 PM

Like Callie said on Grey's Anatomy, doctors are "seventeen year olds with scalpels." Many of these doctors went to high school, then college, then med school, then residency and now they are attendings. They never had the chance to mature socially. Moreover, the training is such that it wears and tears you down, so that you lose any sense of empathy you may have had at some point in the past. I agree with Jocelyn above; it is a power thing. I believe that the system is broken; this is the practice of medicine, and there is no place for abusiveness toward others. This is supposed to be a caring profession and should not be compared with the military; our goals are opposite. I find it helpful to identify those very few attendings who have the self awareness and confidence to treat their patients AND their students/interns/residents with respect and COMPASSION. These are role models; the rest do not deserve my respect. As an intern, I have found it refreshing to treat attending physicians the way they treat me, and to challenge their lack of respect. By the way, nowhere has it been proven that abusive language and intimidation make for a better learning experience.

Posted by: Lauren | Nov 28, 2006 6:43:26 PM

I just wanted to add a simple reminder to all of you current medical students. I am a nursing student that has begun rotations this semester and as bad as you guys have it (I've seen first hand), remember we get it pretty bad too....even from other students....usually of the male physician in training persuasion. I, much like my colleagues choose to ignore as well....we all have to work together, so it's nice to hear the compassion I have found in the words of medical students posting here. And I would have to say....I've learned many different ways to describe how a person can copulate with their own family members in our hospital wards.

Posted by: Kelli | Nov 28, 2006 7:48:24 PM

I dont think getting anyone's "s***t together has anything to do with the verbal abuse that is rampant among attending physicians. I have seen some of the top medical students verbally shredded by inhumane attendings. But someone said it perfectly when they said that these attendings will get old and decrepid and lo and behold, they will be on the receiving end. So no need to let it get to you, ignore them because YOU and only you are the only one who decides who upset you.

Posted by: sedonte | Nov 28, 2006 8:27:38 PM

Listen.... unless you are an American studying medicine abroad you have nothnig, yes nothing to cry about because in the States there is always the lawyer factor. When you study abroad, where the same horror stories occur but usually in a foreign language, you have absolutely no one to hold on to for support except for another med student with you. Dont cry until you do a general surgery rotation in Tijuana. There everyone is absolutely arrogant and jealous at the same time because they knew that if I wanted to eat at Mc Donalds in San Diego I could do it and they were stuck there. Believe me, not fun staying for 36 hour call every 2nd day and getting yelled at by not just the attendings, who make fun of the way you attempt to communicate with them and then there are the residents, nurses. All of them ridiculizing you because you dont have a mexican accent. Think about that.

Posted by: Angel | Nov 28, 2006 8:38:15 PM

I am still torn about my experience with a particular attending who seemed to have the uncanny ability to see right down into the bottom of my soul and wreak havoc. On the one hand I felt he often went too far in berating me and my teammates. On the other hand, I have been just about unshakable since I completed that rotation with an "A" (and got a tremendous letter of recommendation to boot). It's the old adage - things that don't kill us make us stronger.

That said, I don't intend to use those tactics when I begin to teach medical students.

Hang in there!

Posted by: chip | Nov 28, 2006 8:47:45 PM

Hi there Anthony,

I understand you perfectly. When I was in medical school, I had a few attending physicians, but mostly residents, who behaved in such an unprofessional manner. At first, you wish they ceased to exist that very instant, just to put it very succinctly, because what you wish for them is a lot worse and ugly to describe. Nevertheless, only you know whether you are doing things right or not, and if you are doing them right, that is enough reason for you to disregard any offensive behavior towards you from anyone above you in the hierarchy.

It is the tendency of mediocre people to behave in such way to justify or to compensate for their inadequacies. Instead, they should recognize their flaws and learn from others to improve as human beings and physicians as well.

In the end, if your performance is outstanding, no one will be able to dispute it, it will shine through. Not even those who feel threaten by you will be able opaque your work.

There are always a few who feel so insecure about themselves that they need to canalize their fears by inflicting insults and disrespectful behavior on to others in order to feel good. Anyhow, they will always respect you if you are good. Some of them do it just to give you that little extra push you need because they know you can do better.

My advice, do your best and you will never have anything to regret. Remember, it is about you, not about them. Good Luck!

I would like to conclude by stating the following; I think that scalpel must be one of these mediocre individuals since his or her advice contains neither a constructive critic nor a positive message for improvement, and that is what separates the intellectuals from the mediocre. Remember, being a doctor of medicine does not place you above anyone in this world, it gives you the noble knowledge to humbly serve and aide others. And that is the most noble attribute anyone can posses.

Mr. Scalpel, you do not deserve to be called a true DOCTOR. You should try to get educated and try not to use foul language, unless you want to us it with your mediocre equals, when advising someone about something as serious as Anthony’s career. Since you do not know him, the best you could do is be objective. Your advice is based on an assumption that could be wrong, and that, my ignorant friend, is called prejudice based on ignorance, pardon the redundancy.

Best of luck to you Anthony

Dr. Rafael Feliz

Posted by: Rafael | Nov 28, 2006 8:48:22 PM

the funny thing i've noticed is not as much negativity from attendings as from residents, interns and even other students. it seems like the cool thing to do is bitch constantly about how long the hours are, how shitty patients are (f---g crackhead lowlifes, coming here and expecting us to help them!) and how everyone should always want to go home early and get into a a field with the shortest hours and biggest paycheck or else they are big fat gunners. like lauren said, many of them are stunted emotionally and isolated in a world they might not even want to be a part of, and it obviously f--ks with their heads.
luckily most of the attendings i've had are either done with those years or never had them because their generation just had a different perspective on what medicine as a calling means. they are kind, reasonable and love to teach without resorting to insults. when i'm given a hard time for choosing to enjoy my time instead of being miserable, it's the attendings that help me see that loving what you do in life makes all the difference in how you relate to others.

Posted by: my alias | Nov 28, 2006 9:56:54 PM

I am a 55yo physician; it was the same when I went through my IM residency. I experienced the exact same mental torture that present day students talk about.
My sister is a PA; exact same treatment while she was in her undergrad training, but the abusers were PA instructors. Arrogant instructors and attendings who are enthralled in the use of their power over weaker beings. It is really a very very sad commentary on the personality types who go into medicine
in the first place. People who get off on hurting others; I have seen it over and over and over again amongst my peers. Some of it is self-selection;
ie: the types who gravitate toward teaching are the types who also like to have the power; similar to the types who gravitate toward becoming a police officer;
they want to be in charge and show the "smaller beings"
in the room that they are in charge.
I think we need a psychologist to come into the discussion and give us a better understanding of the
reasons behind this phenomena; I slept through my psych
elective and never looked back.

Posted by: gray | Nov 29, 2006 9:35:53 AM

I wonder if this is more common in the US? I'm a 3rd year in Canada, and I've found the staff and residents to be generally nice people with a genuine interest in teaching us. Maybe being nice is just Canadian, Eh?

Posted by: Murray Yazer | Nov 29, 2006 10:05:48 AM

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