We talk about ethics for treating patients. Are there also similarly thorny issues in medical education? Would love to hear what both learners and educators think about these scenarios.
Here is one for starters:
It is the social night out at a residency interview. A candidate got extremely drunk, vomited and passed out on the bar stool. Should that behavior be included in the assessment by the selection committee?
PLEASE EXPLAIN YOUR REASONING in the Comments link below. We'd love to hear your thoughts.
For those who answered YES, should we tell candidates explicitly that they will be watched during this social event?
I voted yes - I think it demonstrates poor judgement to get that drunk at a 'work related' function. I don't think I'd specifically say 'your conduct at social events will be assessed' or it'd be a very awkward evening, but perhaps in the initial material sent with the details of the function, something like 'although this is a social event, we expect attendees to behave in a professional manner'. I wouldn't be scruitinising candidates' behaviour, but outstandingly unprofessional behaviour would be noted.
ReplyDeleteThat said, I'm not familiar with the US residency application process, so there may be nuances to it that I'm unfamiliar with.
I know plenty of people who are great at what they do. These same people also get a bit out of control when they drink.
ReplyDeleteAnyone can be a victim of over consumption at a work related function. In fact, this is encouraged in some cultures.
I vote 110% YES (that it should count). I do not debate the fact that really smart/great physicians can also sometimes be great at partying. The part that I question is judgment. Interviewing for a residency program slot is a short 1-1.5 day process. This is really the only time you are interacting with the program's staff, residents, and faculty. Is being so drunk the lasting impression that you want to give? From the residency standpoint, the social events are merely a way to see if you have normal interpersonal and communication skills (and to see if you slip up with alcohol on board).
ReplyDeleteAlso, especially because the EM residency application process is so competitive these days, I believe that residency leaders are often just looking for ways to drop people from their top rank tier. Everything is fair game for assessment... at least in the US.
My 2 cents from when I used to be behind the scenes...
I have to say I agree with Michelle - I think professionalism (particularly when you are interviewing) should be part of the assessment.
ReplyDeleteMy dilemma is, however, whether that should be communicated to the candidates - or it should be a 'common sense not to make a big fool out of yourself during the interview social' thing.
Interested to see what the learners think, because when I interviewed years ago, a social was just a social.
Absolutely yes. If they have the poor judgment to get completely toasted at a residency function, that's not a great sign.
ReplyDeleteShould they be informed of this? I don't think so. If they also lack the street smarts that the residents are going to report back to the program director about someone they really liked or really didn't like, that counts for something too. Also, outright informing them "YOU WILL BE WATCHED/EVALUATED AT THE PARTY" will either make people not go to the party and/or be really awkward there.
God bless America, you're allowed to drink til you pass out and still be a great doctor. But doing it at a residency interview function shows terrible decision-making. It'd be similar to an applicant deciding to tell a racist joke at a party. Bad decision.
@ Anonymous: Well-put. A lot of emergency medicine has to do with tact, diplomacy, judgment, and "street smarts". I agree - I wouldn't explicitly announce that we are evaluating them during the social event.
ReplyDeleteHow could you not factor it in? why have the social if you're not looking at their interactions with your current residents? Of course, if this is the culture of the program, it might be a plus. "He rocked it hard, sign him up." Maybe?
ReplyDeleteIt should be _Part_ of the whole assessment, and don't kid yourself, I'm going through the process now, and we all know (or should) that we're on from the first interaction, be it email, phone, face, or facebook.
The behavior should be considered in any decision. If someone has the poor judgement to get plastered at a residency program social event that they are interviewing at that is a problem. There is a degree of professionalism that should be considered for behavior at an interview trip. A lack of professionalism and self control is a problem, there was that paper a few years back, "Unprofessional Behavior in Medical School Is Associated with Subsequent Disciplinary Action by a State Medical Board".
ReplyDeleteI don't think you have to explicitly state to someone that their actions will be noted and could have consequences. If they are not professional or bright enough to realize that behaviors are as important as board scores then there is a problem.
i would also mention that it would also be inappropriate and problematic if a resident got plastered and passed out at one of these interview socials too.
Absolutely should be a part of the assessment and the prospective residents should be told that the entire interview process will have an impact on their application.
ReplyDeleteInterestingly, some prospective residents don't realize that even their interactions with the admin staff are also a part of the process. If they are rude/condescending in their interactions with them, they will make sure the Program Directors are made aware of these possible "problem" residents.
Now, when other attendings imbibe a little more than they should at a staff event...that should be ok. ;-D
Sincerely,
One of the Attendings that works with Dr Yiu =D
@Steve: So true. Every public interaction/ public face that you have is accountable -- which includes social media!
ReplyDelete@Jason: Good reminder about that paper. Unprofessional behavior is a predictor for future unprofessional behavior.
@Hans: Oh no, you let out the secret! Yes, EVERY interaction with the applicant is fair game... and this includes nurses and administrative staff. As for Dr. Yiu, hey - she's already got the job!
Anyone would be hard pressed to ignore someone who gets pooh poohed at a social event. Everything the applicant does is evaluated on some level, whether concious or otherwise, from eye contact, strength of handshake to how much food they put on their plate. It's what we do as humans I think, incorporate information and observations to form and opinion and evaluate.
ReplyDelete@ERJedi: Excellent point. I have heard of candidate wearing a leopard-print suit for interview. Even though there are no check boxes for attire, I am sure that went into consideration.
ReplyDeleteThanks for all the comments!
I think learners should take heed and realize that they will be watched. Yes, we are looking for good clinicians, but we are also those we can work with one day.