Opinion: Do You Really Want Your Trainee Doctor ‘Pimped,’ Hazed And Exhausted?

By Dr. David Scales

“What kind of gas do we use for laparoscopic surgery?”the surgeon asked me. It was my first laparoscopic surgery ever, during my gynecology rotation in medical school. We were inflating a woman’s abdomen for a tubal ligation, “tying her tubes” to prevent future pregnancies.

“Carbon dioxide,” I answered, having brushed up on this the night before.

“What color is the gas tank?” he asked.

Hmmm. Different gases have different color tanks? Clearly important, but it had been in none of my preparatory reading. I stared at him blankly, my own color draining from my face. I tried unsuccessfully to peek at the tank.

“Grey,” he said, deadpan. “What color is the oxygen tank?”

Blank stare again.


I was being “pimped” — asked to instantly recall medical facts (“pimp” is said to derive from the acronym for “put in my place”). My supervisor was proving his point: Not knowing the different tank colors, I might not notice if someone inflated an abdomen with oxygen, potentially causing a horrible explosion when a bleeding vessel was cauterized.

It clearly left its imprint — this happened in 2005. To this day, I remember that green is oxygen and gray is carbon dioxide. But it was also humiliating: How could I possibly have anticipated his line of questioning?

This week’s Journal of the American Medical Association has a panoply of articles on quirks of medical education like pimping. The studies raise serious questions and concerns about the health and well-being of medical students and doctors in training. Taken together, they raise one of the loudest challenges yet to the age-old medical culture of “no pain, no gain.” Continue reading

Daily Rounds: Sick Residents At Work; Lifetime Benefit Caps; TB Privacy; Dartmouth Teaches Delivery

Observations: Majority of medical residents have worked while sick “Residents may work when sick for several reasons, including misplaced dedication, lack of an adequate coverage system or fear of letting down teammates,” the authors of the new analysis wrote. The results were published online in a research letter September 14 in JAMA, Journal of the American Medical Association.” (

Health Overhaul Brings Ban On Lifetime Benefit Caps: Shots – Health News Blog “Starting late next week, new health plans or plans that are renewed, won’t be able to cap the dollar amount of benefits they cover. No more yearly caps either, though those limits will be phased out over three years, disappearing entirely in 2014.” (NPR) – TB Patient Tries to Revive Privacy Lawsuit Against Centers for Disease Control “A lawyer for Andrew H. Speaker, who made headlines in 2007 when he took a trans-Atlantic commercial flight while infected with a rare strain of tuberculosis, on Tuesday appeared before a federal appeals court panel in a bid to revive his lawsuit against the Centers for Disease Control and Prevention.” (

New college program zeroes in on health costs – The Boston Globe “The 18-month master’s program is intended mainly for mid-career professionals — generally hospital and clinic administrators, health care consultants, medical educators, or managers from health-related industries. [Dartmouth President Jim Yong] Kim, who announced the program in Boston last month, said he hopes Dartmouth’s effort will spark a new profession of health care delivery experts whose aim will be to make medical care simultaneously less costly and more effective. (Boston Globe)