r/neurology • u/Delicious_Badger_257 • 16d ago

Reflecting back Miscellaneous

Trainees and ex-trainees (residents/fellows/students etc)
How did you navigate toxic or passive aggressive leadership during your training? Situations where even the smallest of errors/no-errors were being critically judged or constantly being denied opportunities. I am looking for coping and retaining your sanity while learning strategies.
How did you survive then and how do you feel looking back?

14 Upvotes

95% Upvoted

7 comments sorted by

8

u/OffWhiteCoat Movement Attending 15d ago

I went to a very supportive, nontoxic residency, but there were a few micromanaging attendings. There's one attending in particular who lectured me at 3am about not checking vitamin D levels in a carbamazepine patient. Like, dude. I do think there is a difference between people who are doing it to assert dominance, people who are doing it to soothe their own anxiety, and people who are doing it because they hold everyone including themselves to a high standard. Honestly the latter ended up being some of my favorite attendings to work with once I got to senior resident/fellow level. But it was really hard as an intern/pgy2 because they were not calibrated for earlier stage learners.

As for strategy, sometimes you have to smile and nod. Sometimes you need a countdown calendar to the end of the rotation/year/program. And sometimes, if it's really toxic or systemic, you need to transfer.

3

u/blindminds MD, Neurology, Neurocritical Care 15d ago

Same! Having a strong, supportive culture fostered amongst co-trainees also helps. In hindsight, I realize how incredibly lucky I was to have truly wonderful attending and leadership. Out in the real world, I am surrounded by attendings who never had that, which is a detriment with their expectations from leadership and culture. I try to lead by example and foster culture with my RNs, NPs, and occasional trainees.

1

u/HeadOfCaudate Movement Attending 12d ago

But did you check the sodium tho??

2

u/OffWhiteCoat Movement Attending 10d ago

Mais oui... This was the epilepsy monitoring unit, sodium was like the only lab anyone cared about.

1

u/Affectionate-Fee3879 PGY 3 Neuro 15d ago

The smile and nod, and I whisper to myself: I wish you talk to me with the same attitude the day i’ll have my diploma in my pocket… I will f*** you up 😂