How to Make the Most of Your Medical School Experience

What do you want to be when you grow up? And I was like, I don't know, like, I'm thinking like medicine. He— because he was about to hand me like the knife, he was like, oh, never mind. I was like, just kidding, I want to do surgery. I want to do surgery. Hi everybody and welcome to the podcast. This is Generations MD. My name is Stephanie and I'm joined here by my colleague Dr. Sarah Davis, who's also my mother and I'm going to go get pregnant.

Can we not lead with that?

Why? That's funny. No, guys, I'm kidding. I'm kidding. We just talked to Dr. Reid, fertility doctor. That'll be our next episode that we drop. So it was a really great conversation. So keep, keep on the lookout for that.

But yeah, a lot of good, a lot of good information that applies to So many of us in the medical field.

Mm-hmm. Yes. Yeah, but it was great. But, um, I am just finished my gen surg rotation. My last day was this week, so I did 4 weeks of that. And, um, yeah, I want to talk about it. I want to reflect on this the past 4 weeks.

So do you want to be a surgeon now?

I loved it. Like, I am just shocked by— I really thought that I was not gonna like my surgery rotation at all. I was really scared. I was dreading it. I've heard horror stories about general surgery and, um, and just the surgeon culture and all of that. And listen, it's, it's, I'm not gonna say that there's, you know, it's all sunshine and rainbows and everybody is so sweet and all of that. Like there's definitely like that culture is present, but I don't know. I, I just, it didn't, it didn't really affect me as a medical student and learner. So I ended up just having like a really great experience. I like got emotional on my last day when I was leaving. Oh, I was just really sad to leave everyone. And I told people, I said, oh, this is my last day. And people were like, what, you're leaving? Like, what do you mean? Like, it's already been a month? Like, no.

So yeah, that's so nice.

Yeah, it was really nice. Uh, and I have talked about this before a little bit, but, but yeah, I, I think a big component of my experience and why it was really good was because I really just asked to do stuff. I really just threw myself into it and I was like, I just wanna make the most out of this experience and I wanna try to do a lot and get involved. And, um, sometimes that led me getting too involved in situations, but I think that, I mean, overall, I, maybe I was doing too much, but like, it's just kind of funny because it's not like I was doing so much because I wanna do surgery and I was trying to impress anybody. I just genuinely was like, if I'm here, then I wanna be doing something. And there was always something to do. Those, those surgeons, they, they're busy. Yeah. So yeah, like one of the, I'll read one of my reviews that I got. Again, we have to go around and just ask people to leave us reviews.

And like, and, and I think you said like you actually like give 'em a QR code to scan or something. Is that right?

Yeah, that's on OB/GYN, but on, oh, okay. General surgery, we have this like paper that we just give to them. So on the last day I was just walking around and I was like, I was like, how much? Um, if you fill this out for me, we were like 50 bucks. I was like, no, no. Um, but yeah, I was just kind of handing it out. It felt like I was turning around an iPad and asking for a tip. But I still was like, but it, that's what it was really nice. It was like, I was kind of just like, I was kind of making a joke about it, just handing it to people. 'Cause it's awkward asking someone to give you feedback, you know? But I would just hand it to them and be like, and I'd be like, feel free to use the front and the back piece of the page. You know, go on and on about how great I am. But I, I did hand it to some people because also if I didn't like what they wrote, then I did not have to send it to the program director. So she told us, she was like, if you don't like it, don't send it. To me. Um, so, so I was— I handed it to some people that I had not really worked with that closely, just kind of. They ended up writing some really nice things that I was like, that really meant a lot to me. Yeah, they didn't have to do that, you know.

Yeah, wait, so let's, let's, uh, let's read the highlights.

I want to hear. Well, um, this one, this is— was a super nice guy. He's a PGY5 chief and Uh, he was like, he said, keep up the great work. She has such a great attitude and is always eager to try new things and is clearly in love with the medical field, and her potential is incredibly broad. I saw her intubate a patient on the rotation because she spoke up to the anesthesiologist and just asked if she could learn. She also takes any opportunity to practice skills like suturing and even uses the cautery with glee. Uh, great student will make an excellent physician in whatever field she chooses.

That's really nice. That's a Great.

I mean, he's— yeah, he's a super nice guy, but he was in also in one of these, uh, procedures that, first of all, for some reason it was just like an incision and debridement of, um, this wound. And the surgeon on call that day was this like classic old, you know, old white guy surgeon that is just like— he is, you know, bread and butter surgeon, like what you think about. I was loving him, but, um, but he, uh, so he was like on call and these like incision and debridements, normally they'll just— normally the resident just kind of does it. Like the, the surgeon doesn't scrub in. Um, they're just like on call, they're just there, especially something simple. It was like a super simple back wound. Um, the guy I think had some— he might have like had some glass in there that they were trying to get out, which was ironic because this was also the day after my glass window or glass door sporadically shattered. Um, but anyway, just a, like, a wound. Um, and the resident who was this guy who wrote this review, he wasn't there. Like, everyone was ready to go and I was just there scrubbed in, and like, it was just me. And I was like, am I just gonna have to do this thing? And then the, the attending walked in and he was like, who's supposed to be doing this? And I was like, I guess it's you and me. And he was like, "Okay, but who is supposed to be doing this? Like what?" I was like, "I think it's so-and-so, the chief resident." And he was like, "Okay, whatever." So then he ends up, the attending ends up scrubbing in and he's like just kind of standing there and he's like, "What do you wanna be when you grow up?" And I was like, "I don't know, like I'm thinking like medicine." 'Cause he was about to hand me like the knife and I was like, and then he was like, "Oh, nevermind." I was like, "Just kidding, I wanna do surgery. I wanna do surgery." And he was like, That's when the other resident walked in and he heard me say that. Then he was like, okay, fine, here you go. And he got— it was a super simple thing, but like he gave me the bofi and, um, I just like kind of just got to go for it. And we just like cleaned out the wound and we didn't find any glass in there. Um, but, and then I sutured it up and yeah.

Nice. Ah, that's great.

The two points about this story is, one, you gotta just like do it, you know? And you gotta just be like, well, you and me are doing the surgery, here we go. Like, sometimes you just kind of gotta put yourself in there. And also, two, people always told me, don't lie about what you want to do on your rotations. Don't say you want to do that rotation just because you're on that rotation. Now I'm going to go on the record saying this, and it's gonna make me look bad. But like, I do think that there is something to at least saying that you have some interest in it. Yeah, because people take a lot more interest in you if— yes, you say that. So yeah.

Well, and to be fair, I mean, you are considering every single thing as you go through. Like, I mean, you shouldn't be— I mean, you've only been doing surgery for 4 weeks. How do you know if you want to be a surgeon or not? Like, it should be like Yeah, this is a possibility for me. I'm seeing if I like it. Yeah, I think that's completely fair. I mean, I think it's disingenuous if you are just really lying and saying, oh yes, I've always wanted to be a surgeon or blah. But like, I don't think you necessarily have to say like, oh yeah, I know for sure I don't wanna do surgery. No, and everybody, I mean, we've experienced this on the podcast as well. For whatever reason, even if you don't think your specialty is that good, for some reason you just feel good when other people say they wanna do it.

Yeah. And because then I realized that with anesthesia, we don't really get exposed to anesthesia at all. And sometimes I would walk in the room before, like when, before they intubated. And, um, that's when also this resident saw me do this, which was, I like, I walked in and then, you know, anesthesia was, uh, starting, was about to intubate. And I was like, hey, can I do it? Can I intubate? And they were like, sure. And I was like, you're gonna have to walk me through it. But then I did. I put the gas mask on and I hand ventilated, and then I took the— it has a little camera thing, the, um, the— so that, like, to pull the— I don't know, I don't know what I was doing. Yeah, well, you read about the different, like, levels that it should be at, right? And I was like, um, remind me. Um, I had done it once before. Somebody talked me through it like a week prior. So it wasn't my first time ever doing it. Um, but then yeah, I just stepped in there and then, uh, but then they, they showed an interest in me and this anesthesia just then started being like, you know, just kind of then talking me through the anesthesia stuff, being like, this is how we do this, this is how we do this. And he was like, well, why anesthesia? Why do you want to do that? And then I was kind of like, oh, I mean, I'm not for sure, but I'm like considering.

And you know, I'm just kind of like at that point just working it, right?

I'm just working it because what am I gonna say, oh, I don't want to do anesthesia?

Then they're gonna be like, did he know that you weren't even on an anesthesia rotation, that you were in surgery rotation.

Oh, well then he goes, oh, here, come with me to the next case, like, let's go. And I was like, I actually have to scrub in and do this. And he was like, oh yeah, coming with me is not going to help your evals. And I was like, okay.

But I bet very few people do that.

Um, oh yeah, no, there was a fourth year there who, she was like, what are you doing? And I was like, I don't know, I'm just here to have fun, guys. I'm just here to have a good time.

Yeah, you did say, uh, you know, you talked about being the personality hire. Yeah, personality hire, exactly. I'm just there to have fun.

No, but really, like, I, I'm really trying. And, you know, again, this is— I'm, I'm the third month in. Maybe my motivation will get— will decrease. But right now I'm like, I'm paying to be there. I want to make the most out of my education. I don't want to— I want to be able to, to have, you know, I want to graduate and be like, okay, yes, I've done these things. You know, I'm not going to be— maybe I'm not going to be intubating patients every day, but like, I want to know that, like, I've done it. And with all of these things. So, yeah.

Well, I think that's good. And I love that you are confident enough to just jump in there and do that. I never would have done that. I was just too scared. I was very intimidated by the people. And like, if I had been in that surgery case, I would have been just sitting there kind of cowering in the corner.

I'm, you know, I don't know. I'm always— see, that's the— and then sometimes I do too much and, you know, But at the same time, it's like, I'm not trying to— I'm not— I'm doing it for myself.

Yeah.

I— and like, just to grow as a, as a learner. Um, and I don't know, I think like, it's— I do understand the fact of cringing at medical students when they're doing too much and it seems like, you know, they're just kind of being performative and stuff. Like, I get it. And I can see how somebody could see me doing all this and just being like, what are you doing? Like, what? But like, I don't know, I don't really care. I'm kind of— right, I'm just like, I wanna— I genuinely wanna learn. If I— why would I— I would rather learn a skill than sit there cowardly in the corner and not say anything.

Yeah, no, I think that's— I think that's way better. Um, and there really is a difference between somebody acting like they know stuff and doing things to impress people and doing stuff just because you want to get in there and do stuff. And I think people can tell the difference between those things. I think most people can.

That's good.

I wonder if that's just, you know, is that just your whole personality or do you think that somehow this is going to come back to me? I mean, do you think having parents as doctors makes you a little bit less intimidated by a doctor? Yeah. Yeah.

Yeah, I think so. I think my friends who, or even like you, you know, you didn't know any doctors growing up, right?

Yeah.

So like, I don't— I feel like it's not that— I think it's— I don't know, you're just more used to it and stuff.

And you just know that, you know, doctors are regular people. Yeah.

Yeah. And I guess you start to kind of grow into that as then all your friends are doctors and everything like that. But maybe right at the beginning it's a little more intimidating. But also like so much is on the line. I do understand that. I don't think I would be acting the same way if I wanted to do— if I knew like I was going to want to Piedisurgery. If I was on my surgery sub-I, right, and I'm like there, and yes, I want to do the most, but you also, you don't want to overstep. There are— you do have to know the boundary, and I do think the boundary is asking, um, because there are sometimes when, like, I've seen people get into situations where they, they don't ask, they just do. And sometimes that's, that's the right thing if you know it's within the, the boundaries of, of being a student, um, but I still think that there's no harm in asking to do something, you know. Like, I'm not just gonna go up there and debate the patient again, you know? Like, I'm not asking you. And that's also why for orders, we can pen orders so it goes to them, but we can't place them, which I think is like a perfect reflection of that. It's like we can think ahead and just be like, okay, we need to, you know, these electrolytes need to be replaced. I'm gonna go ahead and pen all of those. But like, you know, if they don't, if we are wrong, then there's no consequences to it. You know what I'm saying?

Yeah, no, I think that's perfect. Uh, but that's good. I do think part of it's your personality though. You're just a little bit more of a, hey, I'm just gonna get in there and do this. I'm gonna just try.

I'm just gonna try. And yeah, that's also the thing. If I wanted to— if I was really concerned about people looking at me and, and making an impression of me for my future career, I would be a lot more hesitant to try because I wouldn't want to mess up.

Yeah.

And also just the overstepping thing. You just don't want to— it's so hard. Like, I, I just know people on their sub eyes right now, and it is really hard, or like away rotations. It's like one— the whole thing is really just getting these people to like you, and one wrong step, one mistake could just derail your whole career.

That's crazy. I mean, I understand it's true.

Yeah, it's just—

it is just ridiculous.

Yeah.

But I don't know, I think that if you're gonna err, being more enthusiastic is always going to be better.

Yes, that's what, uh, yeah, I knew somebody who had an experience like that where they were on their sub-I kind of standing there, you know, want— not wanting, not wanting to be in the way because, you know, so much of being in the OR is like you don't want to be in, in the way. Um, but then this doctor took them aside and was like, hey, I like— you gotta be— you got just jump in, just start doing stuff, because I would rather have a student who errs on the side of doing too much than somebody who is out of the way.

I think that that's— I just think about that as somebody who, you know, when you supervise other people in the workplace or something thing. It's much easier to say back off than to say jump in. Interesting. Yeah, I think that that's—

yeah, that's true.

It's— that's an easier correction.

I have messed up many of things in the OR, okay? Not anything like— don't get me wrong, I'm not out here doing everything perfect. The amount of times that something has happened and I say, oh guys, the med student messed it up, is what I say. Like, I really— what was it? It's like, um, Oh, like, okay, like, like we finally closed everything and, you know, I'm like closing these, the laparoscopy sites, like the incision sites. So small closures. But, you know, it takes me forever to close like this tiny thing. So you need to do like, like under the skin subdermal closure. So, you know, I'm taking a long time to do it. They're being patient with me. And then finally the last step is like just taking the Dermabond and the glue, like you put it over the sutures Okay. And like, that's, you know, super easy. You're just, you just break the glue.

You're just gluing it.

And I, and I just grabbed the Derma Bond because I knew that's the next step. You know, it's just like, that's the easiest thing, you know. You do wet to dry, you grab the Derma Bond, you go. And I grabbed the Derma Bond and I tried to squeeze it and it flew out of my hand. And like, and then the resident was like, uh, we're gonna need another Derma Bond. And I was like, um I was like, yeah, the med student messed it up. Oh, also something that I did was— I don't know if I'm gonna leave this in because maybe this is bad, but I do want to tell you about it— is that we were doing a lap coli, and you know, at this point I've seen a lot of lapolis. I can go my whole life without seeing another lapoli, like, I will be happy. But, uh, part of the, uh, so laparoscopic cholecystectomy, and you— so at the end, after you get the gallbladder, so you're taking the gallbladder out, after you get it out, then you put a bag in their stomach and then you take the gallbladder and you put it in the bag and then you pull the gallbladder out because you get in there with holes in their stomach. So it's not like you're—

Okay. Yeah. Did you not do—

was laparoscopic not a thing back in the day?

It was really not yet invented. Oh, really? Okay. Honestly, it, um, it was just starting to be like— I mean, people were doing them, but it was like, it was only like the super simple ones that you could do it that way. And, and a lot of surgeons hadn't even been trained yet in lap coles. So yeah, it was, um, but yeah, now I mean, you never do it.

Don't ever do an open. Yeah, you would never open. So for like, for if something's laparoscopic, then you have like a couple incision sites and then you put a camera and you inflate their stomach and then you put a camera in there. Um, so a lot of med students' job is you're driving the camera around and then people put their tools in there. So you're just watching a screen as they like get in there and cut out the gallbladder. Um, so then at the end, then you have to like pull the gallbladder out. Through one of the incision sites.

Okay.

So you have to put a bag in, in there and then you take the gallbladder and you put the gallbladder in the bag and then you zip the bag up and then you pull it out of their stomach. So that's the last step. And I— and then I asked to do it because I—

because of course you do.

They were— well, at that point I had done a lot of other stuff. I like— I was vibing with this chief and then they're like, okay, now the bag. I was like, can I put the— can I put the gallbladder in the bag and pull it out? And they were like, sure. And so But I couldn't figure out the mechanics of the bag, and I ended up kind of like putting it in, and I broke the bag after I had already put it in, um, which was okay, it was fine, it wasn't that big of a deal. But then the bag wouldn't open, so then I had to pull the bag out, and then we had to get a new one. At that point it was like, okay, the med student messed it up, we're gonna get a new bag. But then we got a new one and he let me still do it, and I put the gallbladder in the bag and I pulled it out.

But yeah, good for you, like that's I think that's great. You, you messed up, but then you got another chance, and then you were able to do it. And, and I think that's great that he let you redo it.

Yeah, well, I didn't think he was. I was like, uh, my one job and I messed it up. I was like, oh, I'm sorry. Um, and again, also these situations, you have to read the room. Like, this gallbladder was so simple. It was, it was really quick procedure. Like, there was time for me to do something and mess it up at the end. Like, it wasn't like it was, it, you know, like, it wasn't like this is taking forever, everyone's tired, and it's like, yeah, you know.

Yeah, yeah.

Also, even if so, then they just would have said no, and then I'm like, okay, that's fine.

Yeah, yeah, yeah. I don't know, other people just have a harder time asking for stuff though.

It's— I—

and, you know, getting kind of rejected, told no, I think that's just— I think that's a personality thing that is hard for a lot of people.

Yeah, yeah. And also, like, with my asking these people for the evaluation, you know, if everyone was saying like, um, she was doing too much or that, you know, or people were kind of giving me that feedback, or I knew that the vibe was that like people didn't like me, then I would be like, okay, I don't recommend other people doing this. Um, but I just, I do want to share that. I do feel like it's, I like, I feel like that's just a good way to be. I don't think there's, as long as you ask to do things, then I don't think there's overstepping in, in that regard.

Yeah. And I think people, people appreciate that. And even if they say, even you know, if you had asked to do the bag the second time, or if you'd asked to do something and the answer is no, I do think that when they come up with something later that, yes, that they are comfortable, they're quick to say like, oh, but you, you know, no, you can't do that thing, but yes, you can do this.

Yes, exactly. Which maybe they wouldn't have said that if you didn't ask for that earlier thing.

Yeah, yeah. So I'm proud of you, baby girl.

Thank you, thank you. Um, but yeah, I guess a part of that also, and I made a TikTok about this, was that I was getting very involved with the patient care and I just ran into some situations where the, so like patients didn't end up getting what they needed. And I do my rotation, I, we do our rotations at two hospitals mainly, but one of 'em is a community-based hospital and you know, a lot of patients come in uninsured and, uh, so much of it is these social issues of getting them funded and then finding them a place to go after the hospital. And all of these different things that it's, there's so many barriers to getting people what they need. And at every hospital there's case management and there's social work and, and there are these people that, that handle these situations. But sometimes as the medical student, you are the one who really is at the forefront of, of pushing the, those people to do what they need to do in order to get this patient care. And there can just be a lot of emotional burden on the students for all of this. And I just found that kind of just hard to deal with.

Yeah.

That's—

and yes, you have social workers, but you know, they're overworked too, just like everybody else.

They're so overworked. Yeah.

So yeah, I mean, they're gonna drop the ball or they have— there's just something else that is more pressing that they're spending time on. And, but if you can kind of tee it up for them and tell them, okay, wait, we just need this one thing, then sometimes they can help you get that done. Um, so I think that was very nice that you worked hard to try to get those patients the help that they need so that they could safely leave the hospital. But it's just, it's very depressing when you do everything you can and it doesn't work out for things completely beyond your control.

Yeah, and I guess that was kind of my first exposure to that because people obviously always talk about, oh, our healthcare system is messed up and like how people don't get the care that they need. And, you know, I can understand that at like a cerebral level, but then when you're actually in it and you see it, it's just, it's very disheartening. And I can understand why people don't like— why people do get burnt out, or I don't, I don't know. It just makes me think about job satisfaction as a whole. 'Cause I think just being like an attending at this hospital for forever would be really hard.

Yeah.

Yeah.

And And then people wonder, like, okay, well, why do these doctors seem so hardened and like they don't care? Well, if you care that much all day, every day, it's just— it's just not physically possible.

Yeah, it really isn't. But it's just like how to find the balance of caring but not like getting so involved in these situations that you can't control, like protecting yourself.

Mm-hmm.

Great answer.

Well, that's, that's a, you know, an ongoing thing, right? Like all, and you see that in, in every field and there's always a patient comes in and there are certain things that they have asked you to do, or, you know, there's certain things that's like, okay, I need, this is like, this is the bare minimum. This is pretty good. This is like, okay, now I'm really taking care of them. And then you get so far out there where you're like, okay, now I'm getting into stuff. It's like, this is not my job. This is like, I, I have expanded this and I can't take this on either because I just, I don't have the bandwidth to do that. Or really, I'm just really kind of overstepping what, what my role really is. And you see that lots of different doctors. I mean, sometimes you see a doctor doing something well, like, so for example, I mean, this is not the same as the social issues, but I remember I texted this specialist about this one patient and he called me right back and he was, we were, excited about these results of something. And, and then he's like, okay, well, so I'm actually on vacation right now. And I was like, oh gosh, you did not have to call me. You were on vacation. And so like, now again, we were kind of— we were excited because we had put this plan together and the plan worked. And so he was, he was somewhat happy to celebrate that. But at the same time, he did not need to be checking his phone. He was with his family. He had a small baby. And so sometimes I see physicians do stuff that I'm like, Okay, well, I appreciate that and you were very helpful to me and to my patient, but that's not good for you to be like not having your own personal time and things. And so, um, yeah, you just kind of have to figure out all those different things. But in certain specialties, I think especially things like emergency medicine, you know, they always talk about there being lots of burnout in emergency medicine. And you know, these people come in, they patch them up, they send them out, they come right back. Um, and you know, there's— they've got underlying problems like alcohol use disorder, drug addiction, and they can't get these people to help for those things, or the people don't want to get the help, whatever it is. And I mean, that's just so hard. You feel like you're just banging your head against a brick wall every time that stuff happens. Yeah. So you start to detach some. That's just— that's just part of the game. So you, you eventually figure out like, how much can you take?

Yeah. True, true. Just figure it out.

But I think that was very nice of you to go above and beyond for those patients.

Ah, just wish I was a little less empathetic.

Yeah, yeah. Okay, so back to me again, um, and maybe I raised you with too much empathy.

Yeah, I guess. Um, oh, what was your TikTok that you said Gen Z is terrible?

Well, okay, so you know you have to do a little bit of rage bait when you want to get people to watch your TikToks and share and all of that.

It's too ragebaiting. That's gonna be the title.

Um, yeah, so I just— I made a TikTok where I opened with, Gen Z, you are killing me, you are killing me. Um, and said, you know, that you guys take your mental health so seriously and you're all into the self-care and blah blah blah, but you can't just not show up to things. Um, And so I was talking about students shadowing, which to be fair, students sometimes ask to shadow. Most all of the time they do show up and they're on time and they're dressed appropriately. Really, the majority of the time that is all true. But it's shocking to me that it ever happens that they don't do those things.

I'm just confused why you're saying that this is a Gen Z thing. Like, you don't think people back in the day just like no-showed to things and people showed up dressed unprofessionally? Like, I don't understand.

Um, okay, now obviously I don't have any statistics or literature to, to back up my claims, but the one thing that I think is different is that yes, you always had people that would flake out about stuff, and although the pre-med people were generally pretty hardcore, the people who made it through—

but what about all the people who no-showed to all of these shadowing things and now are not doctors?

I mean, yes, maybe, but at that time nobody thought that it was an acceptable excuse to— I mean, I'm just saying some of the excuses that people come up with, people did not try to say those excuses because you couldn't say anything.

Because what were you gonna do, write them a letter?

Like, you couldn't just say you called them, you know, if you called them on the phone.

And I think people just flaked and ghosted more rather than—

wasn't even a term like that. Didn't— we didn't even have a word for that.

Exactly.

Because the, the standard was the ghost.

Like, there wasn't— yeah, like, if you, you know, because then it's like, oh no, you're not expecting communication because now there's so many different communication outlets. Like, you can, you can really check what— like, you expect a checkup, you expect all these things. But back in the day, like, if they didn't call you on the phone, then that was it.

Yeah, I mean, I'm just—

you don't have to make an excuse back in the day, is my point.

Okay, so now again, I'm not necessarily— I don't know about the whole pre-med thing. But I mean, I did lots of jobs when I was a teenager, in college, uh, you know, lifeguarding, working in ice cream store, that kind of stuff. And people did not just not show up to work. Uh, you know, I, I don't remember that happening, and I would have kind of remembered if that were a regular thing because that would have made more work the rest of us. We would have had to cover that, and that's just not something that people did. I mean, you came to work when you were sick. Some of this stuff maybe isn't great, but you know, even harder— what's that?

Work them harder, right? Just people gotta come to— you gotta go to, uh, what, Baskin-Robbins. You don't show up, people—

city of Sacramento will crumble. Imagine what if you had to just close up the store and then everybody would be beating down the door saying, we need ice cream!

Exactly. Get those people to work.

Yes. And there were times, yes, that, you know, people maybe didn't take care of their mental health, and that's not great. But this idea that like, well, I'm just really tired, or I had something kind of traumatic happen to me 3 days ago— and not traumatic like somebody died, like traumatic like, you know, your hamster was sick, uh, that's not a reason for you to not show up somewhere. And to think that that's actually a valid excuse is what I think is, is different. Nobody would have said, I can't come to work at Baskin-Robbins, um, because my hamster died 3 days ago.

I don't know, I think there's always irrational—

That did not happen! That did not happen!

I don't know, there's always irrational people.

But those people just like—

people didn't have to. I don't know, I think fine, people maybe are getting more creative, okay? But because other people just like— you didn't— you just didn't say anything. I don't know, because now there's so many modes of communication, texting, like all of that. I think people feel the need to because you're— everyone is very easily accessible.

And okay, but let's just talk about the fact about taking care— self-care. Well, we talked about that on, on our recent podcast, she was talking about how, you know, she wished she had done more self-care. And that is obviously very help— very important. Taking care of your mental health is really important. But you have to admit there are people now that will use those things that they say that they, you know, that they need a mental health day or whatever.

Yeah, for sure.

For sure.

Yeah, I agree. I agree. No, I was—

you know, people did not used to do that.

Uh, yeah, I mean, I don't know about in regards to the workplace. I think that that also is just a reflection of the same types of people who do that, like, with interpersonal relationships and, like, you know, not showing up for a friend and stuff like that. So, like, I don't know. I think that— but I guess my assumption, I don't know anything differently, is that, like, there's always been people who flake out and don't show up to things. And I don't know, I mean, there's—

yes, flakingness is not a new concept. Um, Feeling justified in the flakiness is a new concept, or is— well, maybe— okay, or maybe not new, but more prevalent.

Yeah, yeah. I think there is a little bit more of a push now to— I think like the pendulum has, has swung a little bit, at least like what I see about like, okay, you gotta take care of yourself, but you gotta show up for your job, you gotta show up for other people, like you gotta— I don't know, I've seen more of that because yeah, you're right, like the pendulum did swing so far. Being like, okay, we're all so self-centered. If we're all so self-centered, then, you know, who's taking care of the Baskin-Robbins?

You know, who's scooping the ice cream? And, you know, you think about that of like going to a party. I mean, maybe you don't have this, but I mean, I feel like so often I've made plans and right beforehand I think to myself, I don't really want to go. Like, I don't want to get ready. I just, I don't feel like going. I go. I'm always glad that I went. I had a great time. You know, and I always, you know, if you're not having a great time, you just leave. But I think there are— I think lots of people feel perfectly justified saying, you know what, I had kind of a hard day at work, I'm tired, I'm just gonna cancel.

Yeah.

Um, and you know, like, normalizing that being okay is, is a relatively new thing.

Yeah, I've seen a lot of stuff. We— so like the app that people use for invites, like they used to have eBite and stuff, you know, for if somebody has a party. Now people use Partyful, and on there you are, so be yes, no, maybe. And, um, I've just seen some discourse about how, like, if you RSVP yes on the Partyful, show up. Because there's kind of this idea of people being like, you know, RSVPing days before and being like, yeah, I'll go. And now— and then they don't show up. And it's like, I plan for 20 people to come over. Like, if only 3 come, that totally changes the dynamic. That changes how— like, I planned for this. Like, just show up if you say you're— if you say you're not going to show up, that's fine. If you— that's why also there's a maybe. Be on there too, you know?

Yeah, yeah, yeah. And that's— I mean, it's so rude to RSVP yes and not show up. Yeah, that is just like— it's just terrible manners. Like, okay, I was counting on you coming. I bought enough food and drinks and everything else for this many people. Um, I mean, we now, you know, I guess there's always been— sometimes people don't show up to things. I mean, you know, even weddings, you get people that, you know, cancel at the last minute, like crazy. Right. You're just like, mm, okay. I mean, cancel, but you understand I've already paid for this. Yeah. But, but yeah, that's— well, that's good. I hope that, I hope that your generation is getting better about that. So yes. So I made another TikTok. Okay. So I made that TikTok kind of bagging on Gen Z for that. And a few people came on there and said, you know, one person said like, well, did you send them a dress code? And Luckily, somebody else responded to that saying, no, you don't have to send somebody a dress code. Now, if somebody has a question about what they should wear, then they should ask. There's nothing wrong with asking, you know, what's appropriate attire to wear. But, you know, don't just like—

I—

it's the burden is not on me to tell you how to dress in a professional setting like that. To me is fairly obvious of it's a doctor's office. You're coming there to see patients. You dress professionally. Um, I think, and so you're like, what about wearing scrubs versus—

because I know you don't like scrubs, but like other people don't care. And I have been in a lot of situations where, yeah, I'm going to go to clinic or go somewhere else, and I don't know if I'm supposed to be business professional or if I can wear scrubs.

And I addressed that in my TikTok, that now a lot of times scrubs are acceptable. Um, and that to me is just— is a question that you can ask, like, should I wear business casual or scrubs? Scrubs. I think that's a perfectly legitimate question. And sometimes when I've had students shadow, even though I don't love scrubs, but the only thing I like about scrubs is that it is, you know, it's going to be consistent. Yeah. Everybody knows what that means.

Yeah.

Whereas for some people I say business casual and they just don't quite know what it means, and then they show up and I'm just like, oh no.

Business casual is different from business professional though.

Okay. Yeah. Okay. What do you consider business casual?

Business casual is like You can— like, jeans are business casual.

Okay.

Business professional is like slacks, dress shirt, like, you know, long— I mean, like floor length, like a, you know, sundress situation. Uh, like, so what you wear to work, you wear business professional to work.

Okay, that's kind of a new term. See, it— I mean, business casual used to mean like a business per— well, again, I never even heard until right this minute, I've never heard the word business professional. Um, there's business, and people would wear suits. Like, that's what a man would wear is like business attire. You wear a suit. Business casual is like tie and shirt and like khakis. That would be considered business casual.

Yeah, no, cat— or business casual, guys, that can be button-up khakis, polo khakis, no tie. Business professional, tie, and like then you go like jacket, no jacket.

So, okay, now what if you're supposed to wear a suit? What's that?

Business professional with coat.

Okay. Okay.

For guys, guys, it's a lot easier. It's a lot more straightforward. But girls, like, yeah, it's, I mean, I think that, yeah, business. I mean, they talked about this even when I came, when at med school, it was like, they, they showed us like, this is business casual. This is professional. Business casual was like, was jeans and like a sweater, like appropriate, but not like in a professional setting. Yeah, yeah.

I mean, I think that's all right. The— my main things were just, you know, you don't— don't wear something low-cut, don't wear something too short, don't wear sandals. I did say like nobody wants to see your feet. Um, the— and okay, but backing up, what— so when I did that thing bagging on Gen Z, then, then somebody said, well, you know, instead of just insulting this, you know, this generation, um, maybe people have never learned these things. So why don't you educate them? So I was like, all right, you know, I'm going to assume that you really have never been told all this stuff. So I made one that said shadowing etiquette and I went through and said, okay, number one, show up. Number two, show up on time. Number three, show up dressed appropriately. I mean, it just kind of like really basic, basic stuff. And there were a lot of people that said, I can't believe that this needs to be said. But a lot of people saved that video and said, thank you for saying this.

Like, I mean, if these are college kids, like, it's their freshman year of college, they wore school uniform all of, um, all their life, and then they— this is like, you know, they haven't had really a job, they were a lifeguard or stuff like that.

I feel like you're talking about Stephanie Davis here.

Well, I'm just saying, like, I— like, how— there's been zero situation when you would have ever had to, like, dress in that upsetting.

And I wasn't just talking about the clothes. I was just talking also about, you know, just like basic common sense like that, like, you know, showing up on time and that kind of stuff. So, so, you know, like, alright, that's fine. I'll just— I will, if nobody else is going to tell you what to do. And then so I also— people did not like this one at all, where I said that you should not call patients by their first names unless you—

yeah, I saw that on a first name basis.

No. All these people came in and said, "No, no, old people like to be called by their first names." Did anybody say I am an old person who likes to be called by their first names?

No. Yeah.

No.

Yeah.

That's what actually I was like, you know, you kind of just sit on your hands. I mean, you can't, you know, whatever. These people know everything, right? But I was just thinking to myself, wow, it must be so nice to be 25 years old and you know exactly what an 85-year-old wants to hear. It's like, I mean, that must be a great feeling to know everything.

Classic TikTok being like, like just being like, oh, this hypothetical person that I don't know then would like this thing. Like, I don't know.

Right. And so, and they kept saying like, no, people like to be called by their first names. It's friendlier. And I was like, you know, I am an older person and not a geriatric patient, but I'm like, I don't want to be called by my first name by somebody I have just met. You know, I— maybe that makes me old-fashioned, whatever it is, but people my age and older, we have been called either Dr. or Ms. or Mr. like for a long, long time in our adult lives, and that's what people we don't know call us. And I think that that is an appropriate thing to do. Now again, if I want somebody to call me by my first name, I just say, oh, please call me by my first name, um, and that's a much easier direction to go. But all these people were I mean, really, like 90% of the comments told me I was completely off base and everybody wants to be called by their first name.

You know, technically, so for our Aussies, we get graded on this. Um, you walk in, that's the first thing you say. Like, you walk in the door and you say, say, hi, my name's Stephanie, I'm a third-year medical student here to take your history and physical. Um, can you confirm your name and date of birth for me? Oh, hi, I'm John Smith. Okay, uh, thank you, Mr. Smith, and how would you like to be addressed? And they say, please call me John. That is the exact— like, that is word for word exactly like the script, what we get graded on. You say, how would you like to be addressed? So technically you're supposed to— like, that's what they teach, you're supposed to say that, which is—

and that's perfectly fine if you want to ask them. I think that's perfectly fine. But to assume that everybody wants to be called John is just like— because if you don't want to be called by your first name, what are you supposed to say? Like, don't call me that? Nobody's gonna say that. That would be really rude.

Yeah, yeah.

And so I'm just like, I just found that super annoying. I'm like, you guys think that you know everything and you've been— well, and they can't stand the fact that they probably have been doing this wrong and calling patients by their first names. And you are offending some people.

We always call patients— I don't— like, we always call patients by their— we always say Mr., Mrs., whatever.

Mr., Mrs. Yeah, yeah. I said that to Dad.

Unless it's like a kid.

Yes.

Or even like a 20-year-old.

Like, I don't know, right?

But even like me, like when I go to the dog doctor, they always say Miss Davis or whatever.

See, that's nice. Don't you think it's nice?

Like, no, it makes you feel older, right?

I don't mind feeling older. Like, that's— I don't, I don't get this thing that like somehow like I'm whatever age and, you know, I want to somehow have people act like I'm younger than I am. No, like, yes, somebody, I don't know, being more familiar with me doesn't make me any younger. To me, it just seems a little more disrespectful. So Yeah, people did not like that at all. So I don't know, I'll try to make some TikToks that are a little bit nicer. But of course, when people disagree with you, that's when you get engagement. Yeah, social media is all about— Thank you guys.

Thanks for listening, guys. You know where to find us at Generations.md on TikTok, at Dr. Davis PGY30 on TikTok, and on Instagram at Generations.md. And you can email us at askgenerationsmd@gmail.com. Md@gmail.com, and we'll talk to you guys soon. Bye! Bye!