How Can I Earn Residents' Trust?

Daniel J. Egan, MD

Disclosures

September 04, 2012

Question:

As a medical student, I get the feeling my resident doesn't trust me and has nothing for me to do. What can I do to prove that I'm trustworthy and get more responsibilities?

Response from Daniel J. Egan, MD
Associate Residency Director, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York

This is a great question. In fact, your resident shouldn't trust you and should be verifying everything on his or her own. I say that mostly in jest, but there is also some truth to it.

Although medical students are valuable members of clinical teams in the hospital, there are many aspects of patient care that require residents to check for themselves and verify. I often supervise resident physicians and routinely will ensure that they interpreted EKGs and laboratory results correctly. It's necessary for patient care.

That said, it is critical for you to gain the trust of your resident. It is important not only for your academic success in the clerkship, but also to gain additional learning opportunities and chances to participate in more aspects of your patients' care.

I would say up front that if you are in a situation where you feel like there is an absence of trust or a problem between you and your resident, you should ask. One of the most mature things a learner can do is solicit feedback from his or her educator.

Although confronting your resident is difficult if you are anticipating negative feedback, it can only help improve his or her opinion of you. Residents can give you insight on problem areas as well as suggestions for improvement. I suspect that your resident will also respect your insight into the situation and bravery in taking the high road and asking for the feedback.

However, maybe it is too late for this rotation, and you are looking for suggestions to have better success on your next rotation. At the beginning of each rotation, it is always helpful to ask your resident what his or her expectations of you are. This will give you clear goals and guidelines for what he or she wants.

Ultimately, you can show your value to the team by presenting patient data accurately and completing the tasks assigned to you. For example, informing your resident of patient data -- such as vital signs, laboratory information, radiology reports, and consultant notes -- in a timely fashion will show your dedication to patients and ability to gather data. Most of your job as a student is to collect and report data. Most often, if you can do this in a way that makes your resident's life easier, this will work to your advantage.

The quickest way to sever any possibility of trust is to make up an answer. If your resident asks you whether you read about a topic, the answer should be "yes" only if you did. If you have not looked in the chart for a consult note, the answer should not be that the consultant has not yet arrived.

Beyond the day-to-day "scut" work of being a member of the housestaff team, the obvious other way to gain others' confidence is with knowledge. As a supervising physician, I immediately trust a student more if he or she can answer my questions correctly or present me with an organized assessment and plan. Following up on your patients by reading about their condition and knowing answers on rounds the next day will only improve trust.

In addition, watch the interns carefully. The more you function like an intern on the patient care team, the more likely it is that your role on the team will not be minimized. Increased responsibility will happen with trust, and trust happens with accurate completion of tasks.

The last piece is social interaction. We all know that some residents will be more difficult to work with than others, but getting along with all members of the team will help with gaining trust. Even if you are the smartest student to have ever graced the halls of your medical school, if you are not likeable, then no one will welcome you onto their team and "trust" you.

Everyone has gone through the stage you're in right now. So try not to question tasks, avoid saying "no" when you are asked to help, and embrace any offer of involvement in procedures. Any perceived lack of interest will result in a lack of interest on the part of your teacher. You may interpret that as a lack of trust, but it could all come down to basic interpersonal issues.

In summary, if you feel like you aren't getting enough responsibilities or sense a problem between you and your resident, ask for feedback. In the beginning of your rotation, ask for advice and expectations. Work hard (and play little) in the hospital. Be nice. All of these things will help you succeed.

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