Like many medical professors, Dr. SNL likes to quiz students. This is often referred to as "pimping" the student. Now, most professors like to pimp students on topics of importance either from the basic sciences or the clinical years (usually they focus on the clinical sciences since that is what will be covered on our next set of boards). The professors also like to focus their "pimping" on a patient and a disease that the student has been following. Not Dr. SNL. He likes to jump around all over the place. Dr. SNL is questioning a students on heart sounds and in the midst of the line of questions, he declares, "What is Kussmaul?" My brain doesn't work that fast, so I am sitting there trying to figure out what Kussmaul has to do with heart sounds when thankfully some other student asks, "Do you mean Kussmaul's breathing?" Then Dr. SNL confirms that is what he was talking about and obviously we do not know what Kussmaul's is so we must look it up (Kussmaul's breathing is hyperventilation and can be caused by many things, but is often seen in diabetic ketoacidosis). A student gives a dissertation on Kussmaul's breathing for Dr. SNL on the spot, but Dr. SNL says, "You had to think about it, and you cannot stop to think you must just know." A few hours later, Dr. SNL told us that we didn't think about things enough and that you cannot just burst out the answer without thinking. I am still confused about the whole thing. One hour he declares that we do not know the information if we have to stop and think for a second and later that same day, he declares that we don't think enough and we don't know the information well enough because we cannot think. I am telling you, it was like a game of medical Trivial Pursuit with the game's host being a character from an SNL skit.
I don't mind being questioned because it will point out my weak points (which is embarrassing) and make me a stronger student; however, his questions got a little absurd at some points. One question was "Think about the number 125. Tell me everything related to medicine that has to do with the number 125." I was flabbergasted. Usually, professors will ask questions like, "A patient presents with abdominal pain, give me the differential diagnosis." I have no idea what the purpose of asking about the number 125 was. He has a math degree and likes to think about numbers so he would just say things like, "I am thinking about the number 24. What does it mean." Then he glares at the students like we are idiots for not knowing what he was thinking about. It really would have been funny, if I were not the one getting glared out. He also asked us for the four types of cardiomyopathies, but we could only name three. He told us to look it up and find the fourth. There are only three cardiomyopathies--he just wanted to test us.
Anyway, we finally got to go see some patients. Dr. SNL wasn't very clear about what he expected other than that we go see the patient then report to him. My patient came in with a cold and after a line of questioning, I found that he had a psychiatric issue that I thought was very important. Every doctor wants things presented in a slightly different manner and Dr. SNL wanted things differently than the physicians that I had been reporting to the last few weeks. Some doctors are better than others about telling the students what they expect, and Dr. SNL was not very clear about his expectations. I tried to start presenting my case and I got stopped so many times I couldn't remember what I had told him and what I hadn't. Even thought my patient came in complaining of a cold, I thought he psychiatric issue was more important and tried to make that the main problem. Dr. SNL didn't like that and told me just to talk about the cold. I finally got through my case and in my assessment and plan, I wanted to send the patient for a psych consult. Dr. SNL was upset with me because I didn't talk to him about the psychiatry issue. I was so frustrated because I had tried to tell him and I finally just said, " I am so sorry I am not doing this as you want, but I don't know how you want me to present my case to you." He told me, "that is okay, I am here to teach you," and I got to present the case to him for the third time in less than 10 minutes!
The icing on the cake was when Dr. SNL asked student #1 to think of the hardest question he could think of and ask student #2. Student #1 asked a question about diabetics and blood pressure (the goal is to keep diabetics blood pressure even lower than the normal population because they are at risk for heart diseases). Student #2 didn't know the difference in the blood pressure scales, but that wasn't enough for Dr. SNL. Dr. SNL asked student #1 how difficult he would rate the question on a scale from 1-10. The student said a 4 or 5, but it is extremely important. Dr. SNL then said, I didn't ask you for an important question, I asked you for a hard one!
I think the main problem is that English is Dr. SNL's second language and I don't think he is 100% comfortable with it. I think that we, as students with English as a primary language, speak too quickly and he can't process everything we are saying because of the language barrier (He wasn't happy with any student's case presentation to him and he missed things that other students said too). After thinking about the day, I think that Dr. SNL really wanted to help us and teach us rather than being picky just for the sake of being picky. However, I think if there was a camera in the room, it would have looked like the Medical School edition of Candid Camera. The best part of the day was when he looked at the us, five medical students who looked like we no longer knew up from down, and told us we could go home then he declared, "Okay. Good, good. I love you all."
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