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Recent Critique of an R4
4th year here. Recently received an email from an attending regarding that my reports are too abbreviated and that I need to elaborate on my findings. I’ve been dictating this way for a while now, and have never received that kind of feedback before. In my reports I try to use as few words as possible to get a point across. I don’t cherry coat my reports.
As a 4th year it makes me a bit nervous as I head into fellowship. Its confusing since I have few attendings who stress the importance of being brief “if its ‘normal’ just say its normal.”
Now as a 4th year, I’m questioning my dictation style! What do I do? -
81 Replies
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If all the necessary information are in your reports, the shorter the better.
Private practice physicians hate long reports.
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Wordy non commital reports are bad for the reader, the referrer, the patient, and for those radiologists who have to read follow up studies.
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Opinions are like……, everyone has one. I agree with above. Succinct and informative while answering why it was ordered.
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Succinct reports are best. But as a resident/fellow, you unfortunately have to cater to your attending.
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Don’t miss critical findings. Dictate concise reports. Some academics like long reports. Don’t be like them.
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When I start with R1s readign ED PFs I say this
“Nearly all of your dictations should have 1 single clear and concise impression. Some complicated cases can have 2 impressions. … And if your dictation on a plain film has 3 or more impressions I’m sending it back to redo.”
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Then I see reports coming out of other sections with 13 impressions … or, even worse, the entire body of the report just copied into the impression again. … it’s maddening.
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Be accurate. Don’t miss. Make a diagnosis when possible. Provide a narrow differential when necessary and make appropriate recommendation. Make the report understandable and digestible for the referrer. Don’t be afraid to call normal things normal. If a specific clinical question was asked, answer it.-
All good. Glad you’re training residents that way.
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Well, I’d say take a deep breath then perhaps go back and look at some of your reports. Like others here, I like shorter reports and generally think that is a good thing. But if they took the time to email, at least do some critical self-evaluation and make sure you are giving useful information. The reports are for the clinicians so make sure it is useful to them. I’ve worked with folks who gave reports so short that I kept getting called to discuss what they actually meant…
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Nobody wants to read a long confusing report. Give an accurate and concise report with pertinent findings. There are some academic rads (at least where i trained) that you mention too much fluff. Its just mental masturbation that nobody cares about…. and other times, its done in an attempt not try and never be wrong, which doesnt help anyone.
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There was an article awhile back about reports from one of those academic journals.
They stress concise over verbose and ambiguity. Also try to minimize the mention a lot of radiology specific terms that add no meaning to referring docs but use words such edema. I cant remember the exact examples.
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Quote from radssss21
4th year here. Recently received an email from an attending regarding that my reports are too abbreviated and that I need to elaborate on my findings. I’ve been dictating this way for a while now, and have never received that kind of feedback before. In my reports I try to use as few words as possible to get a point across. I don’t cherry coat my reports.
As a 4th year it makes me a bit nervous as I head into fellowship. Its confusing since I have few attendings who stress the importance of being brief “if its ‘normal’ just say its normal.”
Now as a 4th year, I’m questioning my dictation style! What do I do?
Sounds good to me. Would you like a job?-
Use the criticism constructively. Some findings do need more elaboration- particularly in oncology and for certain subspecialists.
That said, your reporting style is likely fine. There is a very wide range of what’s acceptable. You may need to cater to this particular attending.
Yes, short reports are generally better in private practice.
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Well, I can tell you what not to do, which is what I did in residency oh so long ago…..
Had an attending that literally wrote the book on his subspecialty. Brilliant guy. But as a lowly resident, you didn’t get any of that. What you got was him sitting down with you and correcting punctuation and grammar on your dictations before he signed off.
So one time he felt that a sentence I’d dictated was too long. He removed the conjunction then asked me “See? Doesn’t that read better?”
To which I replied: “Dr. [Attending], the Russians have a saying that translates as “People always prefer a pretty lie to the ugly truth.” so, with that in mind, I think it looks FABULOUS!”
It felt good for about a second and he didn’t ever speak to me again (which was good), but the fallout was not pleasant to deal with. Should’ve just kept my trap shut and grinned but I’d just had enough. Hope you can be stronger than I was….
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When I was MSK staff I would have the residents memorize and use (as appropriate) my favorite dictation:
The bones joints and soft tissues are normal.
That saved boatloads of time.-
If the reports are too short. Try concise template reports. Each section may say normal or negative. Otherwise, you attending (or referring provider) may feel that you are leaving things out. This could lead to less addendum requests in practice.
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Add a few flourishes when with that attending. Make it fun and use a few $2 words. For all others, stay concise, say everything that need be said and nothing more.
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So, he wants you to “elaborate” on your findings. Does that mean describing abnormalities in greater detail? Or listing more pertinent negatives? Maybe he thinks too few words means you didn’t look at the study long enough? Hard to read his mind in absentia.
If adding something to the report would help the referrer or a rad who does a follow-up study, it’s worthwhile. But if all it does is give them more words to sift through, it’s probably not. -
Audience matters. A Report for a transplant surgeon Is going to be phrased differently than a report for a family medicine doc.
Your audience in academics is different than your audience in the community.
Also, Its good to learn the style and voice of different attendings, it doesnt mean you have to dictate it that way for yourself in practice, but it just means you can dictate that way of you ever want to. You can bet if Obama is lost in ghettoes of Baltimore, hes asking for directions as Obama the brutha, not Obama the constitutional lawyer.
Also Keep in mind: when you dictate a report as a trainee, it is your attendings name that goes on the report and unless you want to be an as5, you should make your life easier for your attending so that they have to make less edits rather than exerting youre creative license and forcing your attending to make more edits.
One of my classmates in residency had frequent disagreements with his attendings, yes that means that as a first year on MSK, hed disagree with the chief of MSK at a major academic center on the findings of a knee MRI and then when we went to dictate it he would make a report based on his own interpretation rather the attendings because he disagreed with the attending. So the attendings had to not just tell him what to say but had to convince him of it. He is a brilliant radiologist. But when he graduated, he couldnt find a job because the attendings and his coresidents all said the same of him when asked: yeah he is a great radiologist but I would never want to work with him.
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Thank you all for the feedback despite not being able to provide concrete examples. I try to stay to the point in my reports but after a discussion with my attending I was made to feel that I wasn’t including enough pertinent positives and/or descriptors. I went back to my edits and this attending added a bunch of pertinent negs as well. Findings and impressions were much longer and didn’t change the overall point. I’ll admit a miss here or there, but I don’t remember there being a major “miss” that would have changed clinical management. For someone who eventually wants to go into private practice, I just got worried. Thank you again to everyone who responded.
Its been difficult trying to accommodate everyone’s dictation styles (which I normally do) but maybe thats why I got an email because I tried to stick to my own style and not theirs which is laborious and time consuming.
Just as a hypothetical example (**this is NOT specific to any patient or dictated report with this attending):
Me
Liver: Normal. No definite lesions.
Attending
The liver is normal in density and size. Focal fat along the falciform ligament. No definite focal liver lesions within the limitations of a noncontrast examination. No perihepatic fluid. No intrahepatic ductal dilation. Portal vein cannot be assessed without contrast.
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That liver example, for me, would be absolute fluff except the bit about falciform fat (just cuz if you don’t say it, some yahoo will call you up demanding that you comment on the scary lesion they are sure you missed).
The only point I can think of in the attending’s favor there is maybe s/he’s concerned that if you don’t say all that stuff, you weren’t thinking about it as you reviewed the images. But really, if you wait till someone is an R4 to start shaping their search-patterns, you’ve missed the boat.
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Quote from radssss21
Me
Liver: Normal. No definite lesions.Attending
The liver is normal in density and size. Focal fat along the falciform ligament. No definite focal liver lesions within the limitations of a noncontrast examination. No perihepatic fluid. No intrahepatic ductal dilation. Portal vein cannot be assessed without contrast.
First one is better.
I will add a caveat about the lack of contrast if there is a clinical question that I believe would have benefited from using it. If you ask me ‘portal vein thrombosis?’ but order a non-con study, I add the caveat. If a urologist sends a patient for stone follow-up or flank pain and hematuria, I dont. -
Quote from radssss21
Its been difficult trying to accommodate everyone’s dictation styles (which I normally do) but maybe thats why I got an email because I tried to stick to my own style and not theirs which is laborious and time consuming.
Just as a hypothetical example (**this is NOT specific to any patient or dictated report with this attending):
Me
Liver: Normal. No definite lesions.Attending
The liver is normal in density and size. Focal fat along the falciform ligament. No definite focal liver lesions within the limitations of a noncontrast examination. No perihepatic fluid. No intrahepatic ductal dilation. [b]Portal vein cannot be assessed without contrast. [/b]
Read Clyde Helms stuff. This kind of crap will get you a bad reputation in the PP very quickly. Do you have to have an entire report full of disclaimers? Why waste your time? -
Quote from radssss21
Just as a hypothetical example (**this is NOT specific to any patient or dictated report with this attending):
Me
Liver: Normal. No definite lesions.Attending
The liver is normal in density and size. Focal fat along the falciform ligament. No definite focal liver lesions within the limitations of a noncontrast examination. No perihepatic fluid. No intrahepatic ductal dilation. Portal vein cannot be assessed without contrast.
Surprised you guys don’t use structured reporting with templates. Your normal template can basically cover what your attending wants without you having to do anything different, just toggle on to the next organ system and dictate only when you see an abnormality. For a normal exam you basically wouldn’t be dictating anything so probably more efficient. This also cuts down on typos which can give the impression of a sloppy report, particularly when the patient is the one reading it.-
Some rads think every single thing that crosses your mind needs to be on the computer.
Its really annoying. Your report is not your verbalization of your search pattern. I think people use this as a crutch.
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This is pretty good if someone wants an actual book on the topic.
[link=https://www.amazon.com/Radiology-Report-Communication-Radiologists-Professionals-ebook/dp/B013W7L93O]https://www.amazon.com/Ra…ls-ebook/dp/B013W7L93O[/link]
Structured reporting is the way to go. I don’t mean just pre-loaded phrases either. Like:
Liver: No mass. Normal morphology.
Billiary: No ductal dilation. Normal Gallbladder.
Pancreas: No mass. No duct dilation.
etc.
I’m surprised that there are residencies out there not doing this style.
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You are still in training? respond to the comments as an adult and factor them into your dictation.
Thank the commenter.
Graduate, get board certified, find a good job, work it for a couple of years, generate your own style and comfort level.
You are the trainee, learn, listen, adapt.-
Read Dergon’s post above, he instructs, his residents/fellows listen.
They do not go on AM to complain.
I think sometimes impressions need a bit more than 2 items only, at least in the pathology I see in my patients, but his dept. is his and his experience his folks learn from. I was in academics once, now in PP, and I extend my reports more, but in training a normal chest xray was this:
“Normal chest.’
Sometimes 200 times a day on a chest rotation!
But I never argued with Dr Roentgen, not even once.-
God no templates please. No one wants to skim through 15 different categorical lines of various forms of normal or irrelevant to get to the field with the useful information.
Put the relevant stuff (pertinent positives and negatives) first, put all the other normal or irrelevant chronic stuff in a lump at the end. Done. Easy.
If that screws up your search pattern fine, group things in an order you are comfortable with but just call things normal. No one cares about long winded negatives. If its a pertinent negative, it should be with the other pertinent stuff.
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The categorical lines are so they can jump right to the section they want to look at instead of having to find it in the middle of a long paragraph.
They dont have to look through normal categories to get to the abnormal one because the important stuff is in the impression, they can refer back to the section that pertains to the impression easily, and frankly they dont read the findings section anyway, ha.
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Shouldnt any pertinent findings be in the impression and then since they are doctors and big boys and girls they can read a paragraph and find where you are talking about the liver or etc?
I don’t understand the need to dumb down reports. Structured reporting feels unnatural and often constrains you to doing stuff ” see liver section for further details”
There are also inconsistencies like I’ve never once seen someone have a structured head CT report yet for body some people consider it standard?-
Also I haven’t seen structured xr reports
” Lungs: Clear
Mediastinum: Unremarkable
Bones: Normal ”-
Just because you haven’t seen them doesn’t mean they don’t exist.
[link=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825315/]https://www.ncbi.nlm.nih….c/articles/PMC5825315/[/link]
[link=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121011/]https://www.ncbi.nlm.nih….c/articles/PMC3121011/[/link]
Everyone is free to do what they want. Just providing some info.
As mentioned on here many times, we have to continue to show our value and I’m open to ideas of how best to do that.-
You realize this is pretty soft data right? So 3 radiologists, 3 fellows, 3 surgeons and 2 med oncs liked structured reports better?
I’m not disregarding that some may prefer structured reports but its touted like it’s a clear consensus opinion when it’s a few people.-
Template XR reports are the worst.
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I’m pretty anal about my reports. So I always expected residents to accurately reflect what we discussed. There was always some artistic license, but they had to be within reason; as it would be more work for me editing. It’s my name on that report.
Mostly it worked out.
I can remember one resident who seemed ok, but couldn’t put two sentences together. I used to end up dictating and he would watch. Gave up on him. Felt bad about it. You don’t want to be that guy.
On the other hand, had a resident who seemed out there, an FMG with what I thought questionable communication skills. I wasn’t sure he even understood me at first. His reports were amazing; he took what we said, made it concise and clear; better than I would have done myself. I loved getting his reports.
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Resident evaluation:
Head-WNL
Neck-could use some work
Torso-no comment, unremarkable
Pelvis-defered to impression below
Legs-WNL
Feet-running shoes, unremarkable
Appearance/demeanor/DSM category- unremarkable
IMPRESSION:
1. unremarkable
2. should be able to perform average radiologist functions WNL.
SIGNED: Dr X. -
CT A/P templates got the push from the ‘checklist’ manifesto stuff to ‘reduce errors’. The ease of reading thingee is somewhat convincing too if you compare a rambling long paragraph style to the template.
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Quote from MSK/SW
CT A/P templates got the push from the ‘checklist’ manifesto stuff to ‘reduce errors’. The ease of reading thingee is somewhat convincing too if you compare a rambling long paragraph style to the template.
I have seen plenty of errors introduced by the use of templates. Most of those are inconsequential such as organs reported as ‘normal’ that have been removed decades ago and abscesses reported as absent yet described in a separate free text paragraph etc. Where I really cringe is when I see that someone just signed their template and there are significant misses, particularly on Neuro studies. I know it can be busy and after the 10,000th head CT you can pretty much read them by ‘gestalt’, but several templated ‘normal’ nccts until someone reports the 20mm aneurysm don’t look good.
I just had another malpractice seminar, and coming across as uncaring and money-grubbing is one of the worst things that can happen to you in the courtroom. Also, we need to be mindful that PACS creates an audit trail of how long we look at a study, if your timestamp on the templated report is a minute after you opened the study, you gonna have to find an expert that explains that this is the community standard of care.
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Has anyone ever listed times per studies for a standard? How long should someone spend on a normal head CT? A minute?
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It depends on what TV show or movie I am watching while I read it.
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Dont change.
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Play the game… but when you finish up residency… keep it short in PP. Everyone hates a long report
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I just had another malpractice seminar, and coming across as uncaring and money-grubbing is one of the worst things that can happen to you in the courtroom. Also, we need to be mindful that PACS creates an audit trail of how long we look at a study, if your timestamp on the templated report is a minute after you opened the study, you gonna have to find an expert that explains that this is the community standard of care.
This is a very interesting concept Ive wondered about.
Not sure what it has to do with templates though, as I think length of interpretation is not necessarily related if you use them correctly. Still have to look at the images.
Court is mostly theater. How do you impress the jury?
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Template vs free dictation. The never ending argument.
Shall we discuss the use of the word infiltrate again?
Radiologists are a persnickety bunch.
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General question for tackling studies. For a CT a/p, r/o appy do most scroll through the whole study and start w/checking the RLQ or do most stick with an established search pattern (eg.lungs, liver/biliary, etc). I think the latter is likely better for cutting down on misses but may also be less efficient
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I always do the same search pattern and in general, I do the “meat last” approach whereas I do the most important part of the study last so I don’t forget to do the incidental stuff. For example, I do the lungs last on all lung CTs, etc. Just my approach though.
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Quote from jd4540
General question for tackling studies. For a CT a/p, r/o appy do most scroll through the whole study and start w/checking the RLQ or do most stick with an established search pattern (eg.lungs, liver/biliary, etc). I think the latter is likely better for cutting down on misses but may also be less efficient
I stick to a pattern. Try to break out the relevant abnormality into a separate paragraph.
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Quote from MSK/SW
Resident evaluation:
Head-WNL
Neck-could use some work
Torso-no comment, unremarkable
Pelvis-defered to impression below
Legs-WNL
Feet-running shoes, unremarkable
Appearance/demeanor/DSM category- unremarkable
IMPRESSION:
1. unremarkable
2. should be able to perform average radiologist functions WNL.
SIGNED: Dr X.Very clever. Kudos.
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That’s funny!
I actually had a resident once say to me after going over an oncology case, “Where’s the template? I cannot dictate a report without a template.” :/
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I would say the patience is what you need now. Wait patiently until you graduated. After that, you can say go to the hell. Anyway, Under their roof, their rules now.
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Quote from radssss21
4th year here. Recently received an email from an attending regarding that my reports are too abbreviated and that I need to elaborate on my findings. I’ve been dictating this way for a while now, and have never received that kind of feedback before. In my reports I try to use as few words as possible to get a point across. I don’t cherry coat my reports.
As a 4th year it makes me a bit nervous as I head into fellowship. Its confusing since I have few attendings who stress the importance of being brief “if its ‘normal’ just say its normal.”
Now as a 4th year, I’m questioning my dictation style! What do I do?
When I was in college, the only B’s I got were in English Comp. Why? Well, every quarter, the first essay would come back – “Sentences to short and choppy – C”. So I would lengthen them. End of the quarter – A’s – average – BNext quarter – first essay “Your sentences are too long, be more concise – C”, I shortened them. End of quarter – A’s – average B.
What I learned – it is entirely personal preference, there is no “TRUTH”. Learn what the instructor wants and do that. Then after the class, do whatever the hell you want.
and that is what you should do.
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Twain- ” when I was 17 I thought my father was the most ignorant human being on earth; when I was 23 I was amazed how much he had lerned!”
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Good quote. But Twain probably did not say it. Apocryphal.
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Let me interject an unfortunate dose of reality:
Patients have easy access to radiology reports through the “patient portals” that are essentially now required. Patients – and some “providers” – think there is a correlation between the number of words and anatomical structures mentioned in a report and “value.” In other words, an expert read by sub-specialty faculty of a CT with a few words and impression of “normal” will be viewed as far less “value” than that of an R-3 that goes on for pages and identified every structure imaged.
Guess which one is going to get the patient complaint sent down to them? “Why was I billed $300 for an MRCP when the report just has a few words?” Which one are the NP/PA going to say is the better radiologist?
In the ideal world, none of that should matter. Unfortunately, we do not live in an ideal world.
If you can figure out the perfect way to balance all this stuff, let me know. But keep in mind that on very rare occasion, a faculty member will emphasize something that goes against the grain because they have “real world” private practice experience.-
In 3 decades of MSK practice, 2.5 in private practice, I have never had a complaint about a report that was too short. However, several orthopods have expressed appreciation of concise decisive reports.
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Quote from spongiform
In 3 decades of MSK practice, 2.5 in private practice, I have never had a complaint about a report that was too short. However, several orthopods have expressed appreciation of concise decisive reports.
In many places Ortho doesn’t read radiology reports.-
Quote from Hospital-Rad
In many places Ortho doesn’t read radiology reports.
Yeah, because they are often too long.
If I order a CBC/diff, I am looking to get back 4+3 numbers, not a 2 pager describing the shape of normal erythrocytes and a philosophical dissertation about the magic of the immune system.
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‘Just the facts, maam, just the facts.’
TL/DR is a thing.
There was a paper in the AJR ages ago that polled referrers about reports based on wordiness, cxrs and abd US….ultra short (‘normal chest’, short (heart and lungs normal, etc), and ultra wordy. The results were pretty evenly split.
The sharpest docs (and it won’t take you long to figure out who they are) prefer short, to the point. The weaker ones, particularly those with a chip on their shoulder about it, the opposite. They just love templates. Noctors especially.-
That attending sucks and probably is an out of touch academic. I echo Helms sentiment. Also its good to clash with some people as a fourth year. The fact that you want to impose your own style suggests you have progressed appropriately as a radiologist.
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I dictate under the assumption that the clinicians have no idea what’s going on.
If I know the referrer is a sub-specialist then I will change the dictation style, not give recommendations to box them in, etc. -
Quote from Voxeled
That attending sucks and probably is an out of touch academic. I echo Helms sentiment. Also its good to clash with some people as a fourth year. The fact that you want to impose your own style suggests you have progressed appropriately as a radiologist.
Agreed. Attendings (all of us, myself included) are wrong all the time. There could easily be a gap in knowledge that a 4th year rad resident knows that an attending does not. Just be civil about it. -
I dictate according to my referrers.
It takes a couple of years to figure out who likes what. It drives referrals to your practice if you can accommodate individual preferences.
Rule 1: provide best care you can.
Rule 2: make your referring doc happy.
Never let Rule 2 overrule Rule 1.
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I got tired of getting called after I went home for the day out of the Ed for “you didn’t mention the bright thing in the spleen” or “you missed a head bleed” so now my ed a/p reports are now templated with all the normals and I’ll even impression point “hyperdense transverse sinuses, review of labs shows hemoconcetration” if the straight sinus is bright
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I dont see whats the problem with templated reports and short concise freetext impressions. Best of both worlds.
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Quote from fw
Quote from Hospital-Rad
In many places Ortho doesn’t read radiology reports.
Yeah, because they are often too long.
If I order a CBC/diff, I am looking to get back 4+3 numbers, not a 2 pager describing the shape of normal erythrocytes and a philosophical dissertation about the magic of the immune system.
Gentlemen, gentlemen, gentlemen!
You can’t fight in here! This is a WAR ROOM!
An ortho doesn’t read radiology reports because he can’t read……
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Quote from Dr. Joseph Mama
Gentlemen, gentlemen, gentlemen!
You can’t fight in here! This is a WAR ROOM!
An ortho doesn’t read radiology reports because he can’t read……
Orthopedic surgeons: Twice the strength of an oxen, 1/2 as smart.-
In my experience, orthopods tend to be bodybuilders and don’t train for strength. I doubt any in our hospital can squat 3 wheels.
On the other hand, a few of them are really good at reading joint MRIs. -
I agree with Flounce. Stick to your audience. Put yourself in their shoes and report what you would want to know about your patient. A busy primary care physician can’t spend the time reading about things he doesn’t care about… get to the point – short and precise. A neurologist with an MS patient being evaluated needs more detail. The referring physician is your client not your attending in residency. Make the referring docs respect you and all is right in the world.
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The referring docs respect ( as if 95% of them have any clue who the rads residents are ) doesnt mean jack if your attending redictates your report because they dont like how you word stuff.
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As a young registrar(27 years ago now) my consultant(neuroradiologist) made me hand write out my CT reports for him to verify. This followed 10 CT sinus reports where I had proudly demonstrated my newly learnt anatomical knowledge of turbinates and ethmoid air cells. I soon developed a concise reporting system to prevent writers cramp.
I am not keen on template reporting for a number of reasons. I don’t like the rigidity and am worried about the threat from outside teleradiology and AI systems. -
Quote from IR27
The referring docs respect ( as if 95% of them have any clue who the rads residents are ) doesnt mean jack if your attending redictates your report because they dont like how you word stuff.
THIS. Learn and develop your style, but remember that when you are dictating under an attending that you are supposed to make their life easier, not harder. They don’t ask for perfection because they see all sorts of dictations, but if your “style” is such that he/she has to mention something to you… don’t insist and make them have to re-dictate your work, you’re not impressing anyone at that point. -
Quote from Flounce
THIS. Learn and develop your style, but remember that w[b]hen you are dictating under an attending that you are supposed to make their life easier, not harder. They don’t ask for perfection[/b] because they see all sorts of dictations, but if your “style” is such that he/she has to mention something to you… don’t insist and make them have to re-dictate your work, you’re not impressing anyone at that point.
A resident’s main responsibility is to learn radiology. Making life easier for the attending is not.Let me also correct you. Many of them don’t ask for perfection but there are always some outliers.
I feel the academic centers have evolved over time in two ways:
1- Many have expanded in a way that the business side and the volume has become more important than education and research.
2- A lot of new hires don’t choose the job “to train the next generation of radiologists”. They choose the job because between corporate jobs on one hand and crazy high volume private practices, the academic job seems like a good balance. In many coastal cities the academic jobs are one of the better ones. -
You are technically correct, I’m talking realpolitik.
E.g. As a first year on rotation, yes you are there to learn and the attendings are supposed to teach you. But you will have learned more by the end of that year if you conform to the expectations of the attendings, if they want you to help answer the phones so they can focus on readouts with fellows and other residents, you do it. To argue otherwise – that it’s not actually your job to answer the phones but it’s their job and actually they should be spending more time teaching you – is technically correct but counterproductive. Whether in training or in practice, first you get along, then you can better get what you want. If an attending wants you draft reports that make it easier for them to get through their day, because otherwise they have to spend more time editing your draft or redictating – it’s common sense to help them so they can help you, whether in the form of spending more time teaching or putting in a good word to someone from your future fellowship or job inquiring about you. -
This is good advice and fits just as well or better in the “job advice” thread.
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Maybe it is different in community programs. Our sole existance as residents there is to make our attendings life easier (dictate with their templates) and let them get a good night of sleep (ridiculous amount of nightfloat and weekend calls). Teaching? What teaching. They are making their coffee rounds and having 1 hour lunch. No wonder we cant pass our boards
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+ 1. I would also tailor it according to the referring providers if you know them and they interact with you or give you feedback.
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Quote from radssss21
4th year here. Recently received an email from an attending regarding that my reports are too abbreviated and that I need to elaborate on my findings. I’ve been dictating this way for a while now, and have never received that kind of feedback before. In my reports I try to use as few words as possible to get a point across. I don’t cherry coat my reports.
As a 4th year it makes me a bit nervous as I head into fellowship. Its confusing since I have few attendings who stress the importance of being brief “if its ‘normal’ just say its normal.”
Now as a 4th year, I’m questioning my dictation style! What do I do?
Just tailor dictations to each attending. It’s a pain but part of training. You’ll develop your own style once you’re on your own.
