The Difficult Radiology Attending
If you ever apply for a residency, fellowship, or a full-fledged radiology position, and the interviewers claim all the staff are perfect, run away, and run away fast! (Of course, our program is perfect!!) Just like any other profession, school, or body of people, not all people are pleasant. Anyone that tells you otherwise is sincerely lying. Fortunately, most individuals in the radiology profession have stable friendly personalities. But, in any room of 100 people, you will have psychopaths(1 out of 100), narcissists, borderline personalities (6 out of 100), in addition to other difficult personality types. And, radiology is likely no different. During your radiology residency, these issues are magnified because you have to sit for a concentrated amount of time with this person. In fact, it could be for hours at a time. So, you need to learn coping mechanisms to deal with these difficult people.
Ironically, I found that some of these most difficult attending personalities gave me my best and most intense learning experiences. It’s where I learned to develop a thick skin, become more of an independent radiologist, tightened my dictation style, and learned to listen. These were the formative years for me. If you think of the tough individual as another link in the chain of learning experiences, most of these days, weeks, or months that you sit with this difficult attending will seem to have more relevance to your overall education. Your time spent will certainly not be perfect but will be much improved. This segment is going to go through 12 different difficult personality types that you may encounter during your residency program. And, we will also teach you how you can use each difficult personality type to add to your body of experience and build you into a successful and excellent radiologist.
Everyone knows this individual. I personally always think of that main character from Dragon’s Lair(Dirk the Daring), always with the perfect hair, the expensive clothes, and showing off their skills (or lack thereof!!!) to the world. As they say, “God’s Gift to Humanity”. These difficult individuals will often appear overconfident and some will make fools of themselves. It’s going to be the attending that never uses liver windows because he says he can always easily detect all liver lesions in soft tissue windows. He’s just too good to make that extra effort. What’s great about working with these sorts during your residency training? When you are done with a rotation with this individual, you will learn how to avoid being overconfident and look more carefully in places that the narcissist will miss due to overconfidence. Most important, it is a great time to learn how to be humble, an important feature of a good radiologist. Radiologists cannot always be right!!!
The Know It All
If you were in school, this would be the talkative kid that is always raising his hand. Or think of Hermione from the Harry Potter series. This person can be extremely annoying but smart and well versed. The know-it-all gives the resident a distinct learning experience but usually takes the thunder away from something that another attending or you may have discovered. As a resident, you have a lot to learn from this person. He or she will teach you all sorts of things in radiology that others will not and give you a sense of humility.
The Absent Attending
You know this type of individual, always leaving the department at the drop of the hat. He/she expects you to do all the work for them during the day. And, the person is rarely available when you have important questions. I have found that this experience is probably one of the best learning experiences you can have as a resident. It allows you to take charge of a rotation that you normally would be merely following. You will need to look up lots of information on google and ask other residents/attendings what to do. In fact, when you are done with the rotation with this sort of difficult attending, you will be able to run the department because you will be able to handle most of the day-to-day issues on your own, related to your experience of having the unavailable attending!
The Smitten Attending (With Someone Else!)
So, you are working in your interventional rotation and your co-resident or medical student is very handsome or pretty. Your attending does not seem to want to listen to anything you have to say. The “boss” always goes to the other resident to teach them and ask them questions and forgets about you. What do you do? Well, the answer is simple. You work twice as hard to get their attention. Working hard on this rotation, may not pay off in terms of getting a recommendation from this individual, but it will allow you to put your heart and soul into your work and make the rotation an intense work experience, one that may be more similar to actually living and breathing the subspecialty rotation. When you go into practice, you will be thankful for the extra time and experience that you may not have had otherwise!!!
The Obsessively Detail Oriented Attending
When you come back from dictating a case, this is the sort of difficult attending that will mince every word and tell you why each word and phrase should have been different. Don’t take offense at this sort of mentor. Most of the time they mean well. But, the experience of having to write the same dictation over and over; overcorrecting every statement until you make it the way he/she wants can be painful. But, dictation is one of the more difficult elements in radiology to master. So, this experience can be invaluable for honing your reports and making them much stronger and exacting. Believe it or not, consider this person a resource to make your future reports that much better!
Watch your back! He/she will typically seem to be the nicest radiologist in the whole department. In fact, this difficult attending often times will tell you exactly what you want to hear. Until, wham! You find out at the end of the month that your evaluation from the program director is not what it originally seemed. The sociopath will not tell you about what he/she thought of you at the time of your rotation and takes pride in stealthily making the lives of the radiology resident miserable. The good news is the rotation will seem to be just fine when you are there. It is only the afterglow that causes the misery. But your experience with this sort of attending will teach you an invaluable experience, never assume that everything is ok. Always, ask and find out what you can improve and how you can do things better. This experience is a wake-up call for the naive resident!
Out of all the radiology personality types, believe it or not, you will find this one to be one of the most interesting. I can remember one of my former attendings telling me about a mentor who was constantly drooling when he spoke and whose eyes were incessantly tearing. He stood at the mere height of 4 foot 3. But, when you actually spoke to this person the passion for teaching and his profession shone through everything. These attendings tend to have some of the most diverse backgrounds and interests. When you actually treat these folks as mentors/teachers, you find that they have very memorable ideas and behaviors that you would not learn from the more typical personality/appearance. I have incorporated many of their teachings into my daily practice and have found that their teachings tend to stick because of the unusual delivery and presentation. Typically, you will remember fondly the days that you work with these people and have good stories to tell as well!
You will find this difficult attending demanding and tough. He treats all his staff with an iron fist. This radiologist will appear unreasonable at times and expects everyone- nurses, technologist, residents- to bow toward every whim. Unfortunately, you will need to do the same or expect his wrath. The environment may at times be unpleasant and you will need thick skin, but I have found that these attendings make the residents more rigorous in their approach to running a department, adopting search patterns, and learning radiology. Use this opportunity to incorporate the dictator’s demands into your routine, and I can assure you will become a much better radiologist!
You will have some of the best conversations with this attending and will learn about every character in the department. This person talks a lot and can prevent staff from getting their work done, And, some of the information you may or may not have wanted to know. However, listen to this person very carefully because they can be a great source of information about what is really going on in the department, a very valuable commodity. My advice to you is to reveal only what you want revealed to this attending or else your story may become publicized as well!
The Inappropriate Attending
Most people know this type of personality. He/she may yell at the patients, make off-color jokes with the wrong sorts of people, or may be a little too touchy/feely. To this day, I use these uncomfortable situations to be instructive of what not to do as an attending radiologist. In fact, I use these experiences as ways to remember to model good behaviors to my residents by the allegories/stories that have occurred!!!
Many residents feel the need to get instantaneous feedback from their attendings. This difficult attending will not only not give you feedback, he/she may not even talk to you during your shared time. You may be “pulling teeth” to get this attending to teach and talk to you. You may feel like you are being always being observed and assessed, but with no response. Remember that the world of radiology is not always a specialty of instantaneous feedback. You may find out what you have done right or wrong months or maybe years afterward. This attending personality type truly prepares you for the real world!
The Unintelligible Radiologist
Most residents know this type. It’s the attending with tons of typos in their reports. And, clinicians are constantly calling this attending to figure out what he reported in his radiology impressions. So what is the big advantage of having an attending like this? Well, you are going to need to learn how to field the clinician’s questions about his cases in a thoughtful intelligent manner without incriminating its author. It’s a great way to solidify your radiology impressions and learn to communicate with the clinicians!!!
Bottom Line About The Difficult Attending
There are all sorts of personalities that radiology residents will encounter during their 4 years of training. I have probably just scratched the surface. Tough personalities can lead to trying times on a daily, weekly, or monthly basis. However, the experiences that you will have can be invaluable in the development of the radiology resident. Use these personalities to enhance your reputation and skills as a radiologist. Don’t let these difficult attendings get the best of you!!!