Asking a question on my physician girlfriends behalf

  1. She needs to be forthright, when resident says " I will do the procedure" she needs to immediately say clearly"No you won't , this is my patient and I will do the procedure. I need more experience in this." If there is hesitation on part of the attending then she needs to add "If you are not comfortable with me doing this then please help me and teach me". Sounds like GF is conflict-avoidant but that will not get her to learn procedures. The attending wants the experienced resident to do the procedures or they would say something.

  2. It’s plausible that the resident is just being eager and likes procedures. That said, she needs to politely just say “no, I’m doing this one”. She has seniority here. It’s not nice to play that card, but it’s a real card to play if necessary. I’m guessing this is some sort of EM fellowship and it sounds like there’s plenty to go around here and I’m guessing based on my own experiences that she cares less about lines and lac repairs which are typically widely available and she has probably done many of by now if she is a fellow. She can just make it clear that she is going to take most thoras, paras and airways because she needs to build those skill sets more and the resident can have the other stuff.

  3. She absolutely needs to be forthright and get more experience doing procedures, even if it means taking them away from residents.

  4. Agree with most others. She’s a fellow and gets priority over the resident. In medicine especially FM and IM in general we tend to be less confrontational because we have been in a learning position for so long. We needs to break that cycle, voice up and transition to a more assertive mindset. Residents, nurses, administration and even patients will be second guessing / questioning her especially as a woman. You only get one fellowship! Good luck to you both!

  5. Residents should be first. Fellows supervise. They had completed residency. In order to complete residency you have a quota on procedures. Fellows had their chance during residency and now is the one supervising the residents.

  6. If she needs the procedures then she needs to speak up, she gets first pick since shes the fellow.

  7. Ya dude, just tell her to speak up. She outranks the resident. She could just tell the resident to go suck a G-tube to his face and there's not much anyone could do to stop her from doing the procedure. Probably not the most diplomatic way, but it would work. The resident should be deferring to the fellow anyway.

  8. What field? In most fields these would all be considered intern level procedures except maybe intubations which would still be junior. In most fields a fellow would expected to be teaching these procedures not doing them. Is she in family medicine?

  9. There’s a bunch of comments about fellows “outranking” residents but that may not be the case in a FM doc doing an EM residency for a couple of reasons about procedures.

  10. This is definitely not a medicine-specific challenge. (BTW it is not clear if there is a gender or race difference going on here, just throwing that out). It immediately reminded me of experiences I had in high school and beyond. I grew up an an introverted kid with social anxiety and avoidant tendencies. I was a smart bookworm who did all kinds of clever and interesting things by myself but around other people?--even if I wanted to be the person to step forward, my anxiety and hesitation tripped me up. Also in classroom settings and work where I would be paired with another person--and especially if said person was a guy--I'd end up letting them take the lead and then frustrated because I was not learning by doing and then want to be the person to jump in but paralyzed when the opportunity came. It took me a long time to get over it, time I don't think your gf can waste by going to the program head (which sounds too much like being in 4th grade and going to the teacher--and if the program head DID do anything wouldn't that be even worse for her in the larger scheme?).

  11. She just needs to tell the resident to calm down and it’s her procedure. I can’t ever imagine a resident telling me I couldn’t do a procedure when I was a fellow - it was always the other way around, I would supervise them or do it myself if we were busy.

  12. uncool that this is not being handled by attending/PD; as the trainee this is not her shit to fix. personally i'd pull data - procedure log, whatever, and get a grip on what's she's done and when. then firmly bring the data - it's been X weeks since i did a tap, and i will do this one.

  13. Well…tell her to speak up faster and call the procedure before the resident. She isn’t necessarily “owed” anything.

  14. As the fellow she should definitely get first pick. But she does need to speak up and say Im doing this procedure.

  15. She has to speak up because when she goes to get a position after Fellowship, depending on where she goes they may ask for procedure logs case logs Etc

  16. Fellow- that means she already had a chance to do all the procedures when she was a resident. Residents has quotas on procedures to complete their residency.

  17. The procedure should be done by whoever is taking care of the patient. The resident shouldn’t be taking procedures from a fellow’s patient. That being said, a fellow doesn’t have the right to butt in and take procedures from a resident’s patient, either, as a fellow’s training is not supposed to impede on a residents training per ACGME rules. In EM we have to hit certain numbers of procedures and it’s not an EM residents job to give away procedures on their patients to make up for an inadequate FM training experience. If she feels like she needs a lot of these procedures it makes me feel her EM experience while an FM resident was lacking. I don’t see how it’s appropriate for someone with that little of experience to go on to practice EM with only a year of fellowship. At least in PEM they go on to do 2.

  18. Just be straight up and say I actually need to practice this procedure, I’ll do it. That’s my approach as a nurse (can’t pull rank on doctors) and Iv done almost all those procedures In the last month

  19. Like others have said, just have to tell the resident no. The fellow gets priority. I've had to do this many times with residents as a former ICU fellow where alot of procedures happen.

  20. A fellow only gets first dibs on their own patients. It would be completely inappropriate for an EM Fellow to take away a procedure on a residents’ patient and vice versa. I didn’t do EM residency to watch other people to do procedures on my patients.

  21. I found out that this med student is actually an FM resident from another state, doing an elective rotation because he wants to apply for this same fellowship.

Leave a Reply

Your email address will not be published. Required fields are marked *

Author: admin