"The Devil You Know..." Lession #1: Pre-pimping

A definition for you non-Coms (for future reference I'm calling non-Coms anyone who is not a physician or on their way to becoming a physician, Com standing for "the college of Medicine" in the broader sense of the word college, just like we use catholic for the universal Christian church and Catholic for the Roman Catholic church):

"Pimping" in medicine is a notorious form of torture where attending physicians (or residents, or anyone else who thinks they are better than you, like janitors) ask medical students direct questions to assess the student's knowledge base.  Most medical students cringe at the idea of being pimped.  When they think they are likely to be pimped, their eyes become shifty, palms sweat, heart races and they jump at the slightest unexpected noise.  So far I have been fortunate enough to escape being badly humiliated through my own ignorance.  For example today we were in conference when my attending decided it would be a good idea to pimp his medical students about the arterial supply to large intestine.  He called on Bruce, then on Danny, and I was think, "oh crap!  I'm next."  But he kept asking questions to other people.  I made it through the hour without being pimped (and humiliated about the fact that I had no recollection of the arterial anatomy of the abdomen [try saying that three times fast!])  So now I'm thinking, what's worse: being exposed in public for the idiot that I am, or making it 3 weeks into a rotation with an attending who still doesn't KNOW MY NAME!

Walking out to our cars tonight I was discussing it with Bruce.  He asked, did he pimp you yesterday when you two were doing that colonoscopy?  (for non-Coms, there's no better way to befriend your attending than conversation shared while sticking a camera up someone else's arse.)  I admitted that I had made certain comments that made it clear I knew something about the colon.  He replied, "Yeah, you did that before when you put yourself on the spot by bringing up ICU psychosis.  Luckily you were able to answer his question with all that stuff you said."

Then I reminded him of the brilliance of pre-pimping.  Pre-pimping is a theory I've created to diffuse the dreaded pimping. MED-STUDENTS TAKE NOTE: The devil you know is better than the devil you don't know.  Pre-pimping is when you get your attending physician to ask you questions about a topic you already know something about.  For example, if the doctor asks a general question about a topic you're familiar with make sure you answer before anyone else.  Then, when the physician asks a rebuttal question specifically to you, you'll be better prepared to look good.  Or better yet ask the attending a leading question that will entice him to ask you a question that you're prepared to answer (an important distinction is that the question you ask MUST be sincere!)  So when I asked my attending if the patient was experiencing ICU psychosis, it was a sincerely interested.  He asked his rebuttal question, "Andrew, tell us about how to prevent ICU psychosis."  I was prepared to answer because I had spent two weeks working in the pediatric ICU (ICU is Intensive Care Unit, by the way), so I looked like a hero.

Pre-pimping does two good things for the medical student.  First, it makes the attending less likely to randomly question you, and more likely to ask another student.  Second, even if you get pimped and get the question wrong, at least you'll still look like you know SOMETHING.  The physician will think, well this kid has his knowledge deficits but he knows about that other stuff, so he's not that dumb.