Learning From Residents Including the Difficult Ones

Residents often teach medical students more day-to-day medicine than anyone else.

They are close enough to remember the transition from student to physician.

They are also managing patients, orders, pages, admissions, documentation, handoffs, supervision, and their own learning.

That combination makes resident teaching powerful and uneven.

A student can learn a great deal from a resident who teaches explicitly.

You can also learn from what you observe when the teaching is limited.

The important skill is deciding what deserves to be copied, what deserves to be questioned, and when the learning environment needs another source of support.

Tell residents what you are trying to learn

Residents cannot always infer your goals.

If you want to improve patient presentations, say so.

If you need more experience forming plans, ask to present the assessment before hearing theirs.

If you have not yet performed a supervised skill that belongs within the rotation, let the team know.

Specific goals make teaching easier.

“I want to get better at presenting” is broad.

“Could you listen for whether my assessment is prioritized and give me one thing to change after rounds?” is easier to act on.

Ask focused questions

Residents often have limited time.

A focused question respects that reality.

Instead of asking for a complete review of an organ system, ask about the decision in front of you.

“What made you decide this patient could be discharged today?”

“Why did you call cardiology before repeating the study?”

“Which finding made you less concerned about the diagnosis I was considering?”

These questions reveal the reasoning behind workflow.

They also create teaching from the patient already in front of the team.

Become someone residents can trust with supervised responsibility

Follow through.

Know your patients.

Write down tasks.

Report results.

Tell the resident when something is incomplete.

Prepare for the opportunity you asked for.

Residents are more likely to invest time in a student when the investment produces reliable behavior.

This does not mean performing beyond your role.

It means becoming dependable within the responsibilities you are given.

Observe workflow when explicit teaching is limited

Some of the most useful learning on a rotation is not delivered as a lesson.

Watch how residents organize the patient list.

Notice which overnight events change their priorities.

Listen to how they call consultants.

Watch how they prepare before speaking with the attending.

Notice what information they include in a handoff.

Observe how they triage pages.

Pay attention to how they turn a long chart into a short clinical summary.

These are hidden cognitive and workflow skills.

They can be studied deliberately.

Ask why after you observe what

Observation becomes more useful when you test your interpretation.

You saw the resident stop what they were doing and go directly to one patient’s bedside.

Why?

You noticed they repeated one examination before rounds.

Why?

You heard a consultant request framed around a specific question.

Why was that question chosen?

The explanation may reveal a risk threshold or workflow rule that would otherwise remain invisible.

Learn the distinction between style and principle

Residents have different styles.

One may write a detailed patient list.

Another uses a very compressed system.

One rehearses presentations.

Another thinks aloud.

One is highly direct.

Another is more relational.

Do not assume that difference in style means one is wrong.

Look for the underlying principles.

Are the patients safe?

Is the information organized?

Are tasks closed?

Is uncertainty communicated?

Is supervision appropriate?

Is the team respectful?

Copy the principle before copying the style.

Difficult does not always mean harmful

A resident can be stressed, abrupt, disorganized, or poor at teaching.

That can make the rotation frustrating.

It does not automatically mean the behavior is mistreatment.

You may still need to adapt.

Ask questions at a better time.

Use another team member for some teaching needs.

Clarify expectations.

Seek feedback more directly.

Observe the useful parts of the resident’s workflow even if their teaching style is not ideal.

This is part of learning inside imperfect systems.

Imperfect teaching does not need to become your model

You will also see behaviors you do not want to carry forward.

A resident may communicate poorly.

They may avoid difficult conversations.

They may speak dismissively about a patient.

They may create unnecessary tension on the team.

Observation includes negative examples.

Ask yourself:

What is the effect of this behavior?

How would I want to handle the same situation differently?

What would a better version look like?

The hidden curriculum teaches through imitation.

You can interrupt that process by observing deliberately.

Know when the situation crosses a line

“Learn from everyone” should never be used to normalize mistreatment.

Demeaning behavior, discrimination, harassment, retaliation, unsafe supervision, or other serious concerns may require formal support or reporting.

Use the medical school’s and clinical site’s established pathways.

Depending on the situation, that may involve a clerkship director, student affairs, an ombudsperson, a mistreatment-reporting process, or another institutional resource.

Patient safety concerns should be escalated through the appropriate clinical chain.

A difficult teacher is one problem.

An unsafe or abusive environment is another.

Seek more than one teacher

No single resident has to provide your entire education.

Learn from interns, senior residents, fellows, attendings, nurses, pharmacists, therapists, and other members of the healthcare team.

Different people can teach different parts of the work.

A resident may teach workflow.

A nurse may teach you how the patient has changed over the shift.

A pharmacist may reveal how medication decisions are actually made.

A physical therapist may change your understanding of discharge readiness.

Clinical education is distributed across the team.

Use the 5P Approach™ to Clinical Reasoning as a shared language

When you work with a resident who enjoys teaching, make the reasoning visible.

Use the 5P Approach™ to Clinical Reasoning.

Ask which clue they would Prioritize.

Give your Paraphrase of the case.

State what you Prognose should happen next.

Make a Pick.

Then compare the outcome in a Post-Mortem.

This creates a teachable sequence.

The resident can correct the exact part of the reasoning that diverged.

Ask for a micro-debrief

Residents may not have time for a long teaching session.

Ask for sixty seconds.

“What is the one thing you would change about how I presented that patient?”

“Which diagnosis should I have considered earlier?”

“What made you decide the patient was ready for discharge?”

Small debriefs accumulate.

They are often easier to fit into the service than formal teaching blocks.

Learn how residents manage uncertainty

Residents are an especially useful group to watch because they are still developing expertise while carrying real responsibility under supervision.

Notice how they say they are unsure.

When do they look something up?

When do they call a senior resident?

When do they contact the attending?

How do they present an uncertain plan?

How do they recover after a wrong assumption?

Those behaviors are part of the transition you are preparing to make.

Give good residents feedback too

If a resident teaches you well, tell them.

Be specific.

“The way you asked me to predict the next step before explaining it helped me understand the case.”

“You gave me one presentation change each day, and that made it much easier to improve.”

Specific positive feedback reinforces good teaching and may help the resident document their educational work.

Teaching is part of their development too.

The learner’s job remains active

A clinical rotation does not guarantee that teaching will arrive in the form you prefer.

Your job is to participate actively.

Communicate your goals.

Ask focused questions.

Observe workflow.

Follow through.

Seek other teachers.

Use feedback.

Protect the distinction between adapting to an imperfect environment and tolerating inappropriate behavior.

Residents are powerful clinical teachers precisely because you work beside them so closely.

That proximity is worth using deliberately.

Next step: On your next rotation, choose one resident workflow behavior to observe, one focused question to ask, and one piece of feedback to request before the week ends.