Internship & Residency
Your Attending And You

Dr. Karl Newman

Attending physicians provide interns and residents with invaluable mentorship and teaching, and can motivate and inspire like few others in the healthcare community.

Nonetheless, the stressful hospital environment often places a heavy strain on the relationship between attendings and house staff.

In this issue, Q Fever! I&R correspondent Dr. Karl Newman offers advice on making the most of the special bond between Your Attending And You.

The attending. I ask you: friend or fo'? Or some kind of wacky mixture of the two (that'd be a fro'. Get it?!)?

The attending's your boss, your mentor, your teacher, and, sometimes even the guy/gal who grabs you by the waistband of your briefs and yanks. At least that's been my experience! How can a house officer make the most of this complicated, nuanced relationship? It's like my senior resident always told me:

"The attending's dee boss,
So do what dey say.
Put yo' self in dey's shoes,
Or wear dey socks, for a day"*

*Whenever I'm having "attending problems", I think back on those words, and I realize that my resident didn't mention panty hose. It's not a big deal, but I think it's worth a comment.

Avoiding conflict with attendings can make residency a whole lot easier on the both of yas, and may even provide you with someone who one day agrees to write a letter that starts with the magic words:

"I have the greatest respect for Dr.______. All allegations against him/her are based on hearsay and innuendo, and I have no hesitation in recommending him/her to you as a competent and caring physician, albeit one who should be closely supervised when examining reproductive-aged women and small children."

Play your cards right and your attending can give you a big jet-propelled boost up life's greasy pole! But all right, all right, I hear ya hollerin': how do I keep the old (wo)man on my side?

Just follow these simple rules, and (s)he'll be snackin' out of your hand before you can say "why don't you admit her, she's yo' gard-dam' patient!!"

1. Show 'em How Much You Know.

HUH??!??! That's right… let 'em know you know medicine, and you ain't afraid to tell the world. If your attending is making a teaching point, interject with lines like "That's not what you said on Tuesday," or "Where do you GET this crap?". That'll let them know that you're a critical thinker, one who doesn't roll over and ask to have his/her belly stroked when presented with medical dogma.

If you disagree with something your attending says, break away from rounds and go to the library. A MEDLINE search should provide you with some ammo, even if it's a case report from the Balkan Journal of Physiatry or something like that. Get back to rounds and shake that abstract in your attending's face - let 'em know it's something you feel strongly about!

2. Let 'em Know You Appreciate The Doughnuts.

SAY WHA'??!!!??!??!! Sure. Attendings are like you and me, only wealthier, and often much more competent. They like to get acknowledgement for the "little things" they do to improve morale. Like bringing in doughnuts for weekend rounds. You can show them how much you appreciate this by complaining loudly on days that they neglect to bring in doughnuts, or asking why they don't bring in doughnuts on weekdays too. Do it in front of as many people as you can - they'll thank you later!

3. Make Sure They Know How Hard Ya's Workin'.

WHA' DA??!!!!?!!?!!? Uh-huh. Sometimes attendings forget how tiring residency can be. Remind 'em by pretending to nod off when they're talking to you. Make them understand the depths of your fatigue by refusing to do even little favors for them, (lending them a pen, handing them a chart, etc.). Tell them repeatedly that you hope rounds are over soon, because you need your beauty rest! All this will bring back memories of how hard their residency was, and it'll create a bond between you and them that's thicker than the blood on an emphysematous polycythemic!

Whooaaah! Looks like we're outta time, kids! Next time, we'll continue our Internship & Residency series with some anectodes my neighbor's brother told me last week 'fore they hauled him off to the Big House again... Till then, keep your settings on single chirp, and keep reachin' for the snooze!

Just tell 'em Dr. Karl sent ya!