The Case of the Mysterious Ward Mark

I’m curious…

How do our clinical supervisors (Registrars/Consultants/anyone) assess us? Not, like, ‘what is the criterion’ because usually that comes with the study guide for the rotation. Granted, the criterion is usually quite vague (shows enthusiasm, clinically competent, works well with team, brings treats to last day of rotation) but at least it’s in writing.

But my question is how? As in, when they sit down with that rubric and a list of students who rotated with them for the past month, and it dawns on them that not only have they never taken the time to learn the students’ names but frequently confused them with each other or with—I kid you not—their patients, HOW DO THEY GRADE SOMEONE THEY BASICALLY HANDED OVER TO THE NURSES OR INTERNS TO TEACH?

Because it baffles me.

In some rotations, like Obstetrics, you actually get to see them sign your assessment and can know your practical grade long before it’s submitted. And the consultant fills in one evaluation, while the matron/sister in charge fills in another identical one. So you get assessed by someone who actually spent time teaching you (a nurse) as well as someone who may have grilled you over a couple of ward rounds.

Then you get other rotations like Internal Medicine, where you have a very high chance of getting an OSCE on a patient with some rare condition you only heard of once during Cardio, so there’s no banking on that mark. But you never know where you stand with your practical mark for ward work. You may even feel confident, but then you go through two registrars who couldn’t be more different, hardly ever see your consultant and somehow they still think they can comfortably grade your competence?

I swear my ward mark for my Internal Medicine module was higher than my one for Family Medicine. And the guy in Family Med loved us. He took us to his practice. He offered to pre-read and edit our portfolios (which he would be marking, mind you). He told us we worked too hard, we should take lunch breaks. The guy from Internal Medicine? Hated us. I’m pretty sure he threw away the cupcakes we brought to thank the team at the end of our rotation.

So how do they assess us?

Furthermore, I’m pretty sure our registrars could never tell us apart. The number of times I got called by my clinical partner’s name in the same hour while wearing my nametag was ridiculous. And it isn’t like the registrar just couldn’t be bothered to try. Most of our group had first names in our mother tongues which are difficult to read, let alone pronounce and remember, so I’ll excuse that. But he chose one of our ethnic names and decided that this would be the name for every member of our group. Because we are all clearly one person.

So how do they assess us?

If we got any kind of feedback instead of just a percentage next to our student number, I would feel more comfortable about the idea of someone who never knew my name to begin with—or my face, before someone gets started about how Internal Medicine gives the consultants and registrars our pictures—putting a grade next to that name.

So how do they assess us???

Our first Reg in Internal actually joked that if the consultant asked him, he’d just start at 80% and then go down in alphabetical order less 10%.

He laughed very loudly at how clever and funny he was.

This was neither clever nor funny to me.

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