• Attending Physicians Prioritize Efficiency Over Pimping: Attendings generally do not “pimp” residents unnecessarily; if a resident demonstrates strong clinical reasoning in discussions, rounds are more efficient and educational questioning is minimal.
• Educational Gaps Trigger Questioning: When an attending notices a resident who appears unprepared or disengaged, they may ask assertive questions to ensure patient safety and verify the resident’s clinical knowledge.
• Knowledge Deficiencies Can Have Serious Consequences: Lack of understanding in critical areas—such as empiric antibiotic selection, renal and cardio-protective medications, and contraindications in pregnancy—can lead to serious patient harm.
Residents :your attendings don’t want to aggressively pimp you. A questioning here and there is part of residency. Pimping is when you get a sit down or extended public discussion about a specific topic. This wastes time— if the appropriate topics relevant to the patient’s care are demonstrated in rounds there is no need for the attending to pause and ask a ton of questions.
I’m sure you’ve seen a group of your program’s best residents rounding, the knowledge is obviously there with those residents, studies and mechanisms are discussed appropriately. Rounding may be much abbreviated as the attending is happy with the appropriate treatment of patients.
It’s when your attending notices an ill prepared resident: one who is just trying to get by and go home when one of these dreaded “pimping” session may arise. The attending may ask assertive questions In order to ascertain that the patient is in good hands.
Some examples of this seen over the years (program redacted and not necessarily my own) are the following:
- Renal protective blood pressure meds that diabetics should be on to inhibit diabetic nephropathy.
- Cardio protective meds post NSTEMI.
- Empiric antibiotic treatment for diabetic foot infection with and without purulent discharge.
- Community acquired pneumonia empiric antibiotics with and without aspiration: taking into account recent hospital stay, pseudomonas risk.
- Meningitis empiric antibiotics.
- Class D and X medication list to avoid in pregnant patients—major lawsuit if birth defect occurs.
These are omissions that can have significant morbidity and mortality.
Our platform allows for storage and rapid recollection of assessment plans, medication choices, key notes on medication side effects, studies, all easily shareable within program and beyond. Early users have access to review attending level assessment+plans for top IM admission diagnoses used during testing.
**This post and information contained in the platform is not a recommendation to treat specific patients. The information is useful to attendings, residents and students under supervision for educational reference.
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