10 Terms You Won’t Find in Your Medical School Textbooks
In medical school, you hear so many unfamiliar terms flying around, especially on the hospital wards, that you may start to feel like medicine has its own language. In a way, you’re right; however, you won’t find translations for the many slang terms used by physicians in those sources in a medical dictionary and in your textbooks.
Zebra. When you hear hoofbeats, think horses, not zebras, is a common saying in medicine. The idea here is that the most common diagnosis that explains a set of findings in a patient is the one you should consider first. A zebra refers to a rare diagnosis, which med students are known to favor over more garden-variety ones.
Gunner. Gunner refers to a med student who is bent on getting the highest grade and looking good in front of faculty no matter what it takes. Gunners do all of the required and recommended reading. They blurt out answers to the attending’s questions on rounds, even if the question was directed at another student.
They make it their mission to dominate discussion sections and are either oblivious to or don’t care about the fact that they’re annoying their peers (and often the faculty). Every medical school has a few gunners, and you’ll probably be able identify the ones in your class by the end of the first week.
Scut. Scut or scutwork is menial work that med students are assigned to do during clinical rotations. These duties usually don’t involve patient contact and have little or no learning value. The definition of scut varies; some students consider escorting patients down to radiology for imaging or doing blood draws to be scut; others say that any task that’s part of patient care, no matter how basic, isn’t scut.
Hit. A hit is an admission into the hospital. An admission requires taking a history and doing a physical examination, writing orders, checking test results, and performing the many other tasks it takes to get a new patient settled in.
GI rounds. Rounds involve discussing and visiting each patient on the service. During this time, the history, diagnosis, test results, and plan are mulled over and the attending or senior resident uses the cases as opportunities for teaching. However, GI rounds are different. This term actually is a way of saying that the team is getting ready to head off to lunch or dinner.
Of course, if you’re rotating on the gastroenterology service, GI rounds may mean the real thing, so check before you race to the cafeteria!
White cloud. Good luck seems to follow some medical students and physicians. For these white clouds, admissions are light during call nights, diagnoses are straightforward, patients don’t encounter complications, and discharges go off without a hitch.
Black cloud. In contrast to the white cloud in the preceding section, a black cloud is someone who seems to get constant admissions when he’s on call, ends up with the most difficult and complex patients, and can’t seem to catch a break.
404 error. A 404 error gets its name from the message that the server shows when a page can’t be found on the Internet. This term has been co-opted by medicine: A physician who’s digging for a lab result or a patient’s medical record may say that he or she is dealing with a 404 error or having a 404 moment.
Benign rotation. A benign rotation is one in which the attending physician doesn’t put students on the spot during rounds, the residents are friendly, and the overall environment is collegial. During a benign rotation, you may work hard, but finding time to grab a meal during your shift or get some rest on call isn’t a major ordeal. Scutting is kept to a minimum.
The word benign isn’t reserved for rotations; it also can be used to refer to residency programs that are known to treat their residents well.
Malignant rotation. Every so often, you may end up on a malignant rotation that leaves you counting the days until you switch to the next service. The attending’s idea of teaching is to ask medical students obscure questions in front of the rest of the team, and the residents seem perpetually cranky.
Sleep deprivation doesn’t bring out the best in people, so you may be seeing the results of a program whose participants are overworked and stressed out. If you’re interested in a specialty, don’t let one malignant rotation dissuade you. Do an elective in the same field at another institution so that you have another experience to judge from. That same specialty may be enjoyable at another hospital with a different team.