How Can I Recover From a Bad Evaluation?

Alisa R. Gutman, MD, PhD

Disclosures

September 26, 2011

Question

I received negative feedback from my most recent rotation, and I'm trying not to freak out. What should I do?

Response from Alisa R. Gutman, MD, PhD
Psychiatry Resident, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

It's no secret that medical students are used to doing things right, so there are few things as difficult as being told that you've done something wrong. Even worse is getting serious negative feedback in writing. Here are some tips for learning from a negative evaluation without letting it rewrite how you see yourself.

Reality-check it. Before reacting, pause and ask yourself whether the criticism makes sense. If it's something that seems off the wall, you might want to ask a friend or mentor whether they think that there's merit to the feedback. There's always the possibility that someone is being too critical or harsh. I've had students tell me about feedback that's downright mean and unprofessional. That being said, it's likely that as you learn anything new you will get some things wrong. If it seems as if there's an element of truth, try not to discount a perspective that could make you a better doctor.

Address it. Although we all like and need a pat on the head once in a while, receiving negative feedback and becoming aware of our mistakes is the only way to grow as clinicians. If it's during the rotation, ask for specific ways to address the criticism. For example, if you receive feedback that you're behind on your knowledge base, ask your resident for advice on appropriate reading for your level (eg, article summaries as opposed to full-length journal articles).

If the feedback comes after your rotation, I would still recommend tracking down the evaluator to get a better idea of the deficits and what can be done for remediation. Feedback without follow-up or advice just serves to hurt your feelings without helping your career.

Don't take it personally. I know that this is easier said than done. However, when it comes down to it, feedback isn't a personal critique; it's professional advice. As a medical student, you should be learning and growing with each clinical experience. Try not to get up in your head about any one piece of feedback for too long and try not to catastrophize. One person's opinion about you shouldn't cause a shift in your identity; you're more than just a medical student.

Avoid the surprise next time. Solicit verbal feedback often as you rotate through your clinical rotations. After your first week or midway through the rotation, ask your resident or attending whether they have time to give you some criticism so that you can improve for the rest of your time together. (Use common sense and choose an appropriate time, ie, not post call or in the middle of rounds.) This is an excellent strategy to convey -- that you're trying to learn and be part of the team. It's also probably the best way to take each rotation seriously enough to get the most out of your clinical clerkships.

I recall giving a student some difficult feedback early in a rotation. She thanked me because I was directly addressing a criticism that she had received in a written evaluation. Unfortunately, the previous feedback was given after the rotation without giving her the chance to learn from her mistake. If you ask for feedback early in a rotation, you might avoid that outcome and have time to show your team that you can quickly incorporate their suggestions. This will go a long way toward a good grade and excellent written evaluations!

Hearing that you've been doing something wrong is bound to sting at first; I don't know whether it ever gets any easier to hear criticism about ourselves. However, opening yourself up to feedback gives you the chance to grow as a person and as a young physician. It's worth taking the time to pause, evaluate the suggestions, explore ways to improve your work, and move on with your life and education. When all else fails, venting to a fellow medical student might help you realize that you're not the only one who's being critiqued. We all need help identifying our weaknesses as we transition from the classroom to the hospital.

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