Improving medical students

Pimping: How to Cope

Posted by medliorator on April 27, 2008

More pointers from Someonetc at Orthopaedic Residency

it is more important for the student to understand the classic defense strategies to stymie the master pimp. When using these tactics, the student must be careful not to anger the questioner making the situation worse.

  • The stall – this is commonly used in x-ray conferences. The student typically looks at the study squinting, and bring their face so close their nose almost touches it. Then the study characteristics are described. “This is an AP, Sunrise, Notch, and lateral in a skeletally mature patient dated January 5, 2007.” The next step is to describe what is not present. It is important [to] interject pauses, face holding, and pointing, as diverting gestures. The hope with this technique is that the questioner will fatigue and ask someone else.
  • The dodge – this is a way of avoiding the question and wasting time. The most common ways this is applied are by answering the question with a question and/or answering a different question.
  • The Bluff – (3 classes)
    • Hand gesturing – this is making reference to hot topics in medicine without supplying either substance, detail, or explanation.
    • Feigned erudition – answering as if you have an intimate understanding of the literature and a cautiousness born of experience. For example, “To my knowledge, that has not been addressed in a randomized prospective controlled study.” These statements are usually made after clearing the throat, standing professorially, and while holding something, coffee cup, glasses, etc.
    • Higher authority – this is done by referencing someone higher up in the hierarchy or another institution. Using a senior attending as a reference is common. “In my discussion with Dr. x, he stated ….” It is also common to mention another institution where the student may have trained. “At Duke we …. “

Just as problematic as improper use of a defensive tacts is not having good control of the “Brain Mouth Filter.” …Once a novice learner gains some experience and knowledge, they begin to overstep their understanding and bring up other topics and controversies without being asked. …a running dialog of thoughts opens [the door] to more questioning. …Filtering their thoughts prior to speaking is a must.

In the end, the pimping phenomenon is a game. The educator is the game master controlling the many of the parameters of play. With time, a learner will develop both a knowledge base and thought process. They develop there own styles of processing and answering “pimp” questions. Hopefully at end game, education occurs.

Brain mouth filter … [Orthopaedic Residency: The attending perspective]

Correlate: Survive OR Pimping

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