Thread by @medicalaxioms

Teaching physicians at academic hospitals love super-capable residents because they make us look good with a minimum of effort and worry.

That part seems kinda easy and obvious. 1/

Now the hard part. 2/

When you start out teaching residents, the opposite is true:

“Less capable residents make us look bad despite a lot of hard work and worry.”
3/

See the word “love” back in tweet #1?

Young teaching staff have a tendency to feel these emotions, emotionally.

The love they have for “great” residents is counterbalance with a disdain or even hatred for “bad” residents. 4/

Their reputation is enhanced by doctors in training who do better than they could do.

They feel that their reputation is injured by residents who do worse. 5/

It’s good to recognize these feels. They are wrong or right. Like all feels, these feels are real. 6/

It’s also good to learn that these feels of “love” and “hate” don’t belong anywhere near your activity of coaching residents from wherever they are to one step better. 7/

Your reputation in the short term may suffer a ping when “your resident” makes a mistake. You shall have to get thine self over it. 8/

Your reputation is not actually attached to the people you teach.

They come to you with a certain set of skills and training and your job is to find them there, discover their current velocity, acceleration and trajectory, and move them along to improvement. 9/

If you get good at this, your reputation will improve.

Among the best residents and the worst.

Among your patients.

And in your institution. 10/

Being a good teacher for good residents is easy and lazy.

If you think you are hot shit, try to master being a good teacher—fair, respected and capable—for all residents.
11/