Wrath of the Medical Affairs Department from the 4th Year’s Perspective

As you may or may not know, I’m a 4th year medical student at a Caribbean school, Saint George’s University (SGU). SGU is affiliated with multiple hospitals in and around NYC which allows us to complete the clinical rotations of our third and fourth years of school. This is a beautiful thing because being affiliated with these hospitals makes it much easier for SGU students to choose electives more freely. This is not the same story at other Caribbean medical schools in which the number of elective spots are limited and students have to fight for them. However, this rant is not about how great SGU is, rather, it is about how disrespectful the employees in the medical affairs departments can be toward students.
Below is the email interaction that occurred between the medical affairs coordinator and myself in which I was inquiring about 4th year electives. For discretionary reasons, I must edit the names of the people and the hospital. The words enclosed by *’s indicate names that I changed.

Sent 9/15/11 at 9:36PM
Dear *Medical Affairs Coordinator,*
I am a 4th year SGU student currently rotating at *blah blah Hospital*. I would like to know if you have any available radiology electives during the months of December, January, February or March. If not, then do you have a list of medicine electives that have not been filled during those same months?
Thank you very much for your time.

*Nonmaleficence*

Response 9/16/11 at 9:01AM
*Nonmaleficence,*
We do not offer Radiology.

*Medical Affairs Coordinator, with some BS degree*
*Some ridiculously overzealous job title*

Notice in this exchange that the amount of time that passed between sending an email and receiving a response is shockingly quick. This made me a little happy to know that they respond to emails with a fast turn around. However, this happiness was short-lived considering she only answered one of my questions. This is apparently a common occurrence when emailing such departments. They only seem to answer part of an email, and totally neglect everything else. Thus, I asked the question again.

Sent 9/16/11 at 3:56PM
Do you have a list of open electives for the months of January, February and March?
Thank you.

*Nonmaleficence*

Response 9/16/11 at 5:00PM
Please note the attached. Peds is full til April.

*Medical Affairs Coordinator, with some BS degree*
*Some ridiculously overzealous job title*

At this point, I was even more shocked that I actually was able to have two responses from a hospital in the same day. However, if she wrote more than 9 words in her response (I did not include her actual sign out title and position with the department title and department name and everything else, but suffice it to say, her sign out is much longer than 9 words), then I would have understood why she sent me the hospital orientation packet for medical students. Confused by this, I inquired further.

Sent 9/20/11 at 2:28PM
Hi *Medical Affairs Coordinator, with some BS degree,*
I’m not sure what happened, but somehow you sent me what looks like the orientation guide for rotations.
I was actually asking to see what open 4th year electives you may have in Internal Medicine and the subspecialties of Internal Medicine during the months of January February and March.

*Nonmaleficence*

Response 9/29/11 at 1:27PM
Hello *Nonmaleficence*:
Page 5 of the student guide, indicates possible rotation. You are required to provide me with a time frame and then I will advise.

*Medical Affairs Coordinator, with some BS degree*
*Some ridiculously overzealous job title*

Okay. I can admit that it was my fault for missing the 1/2 page of listed electives that was in the 25 page orientation packet. I’m a medical student, I should have looked at every inch of that packet and understood what I was looking for using her lengthy prompt of, “Please note the attached. Peds is full til April.”
Also of importance in this particular email exchange is the length of time between my inquiry and her response. It took her 9 days to articulate 2 lines of information to help me. At some point in that prolonged time period, I began to get annoyed. Unfortunately, the medical student is NOT allowed to express such negative feelings toward any individual in the medical community (no matter how despicable that person may be) without receiving repercussions and threats of hurting our career.
After finding the list of 7 electives that obviously could not be typed (or copy and pasted) in an email, I could then request the dates and electives that I was interested in. With my experience from dealing with medical affairs departments, I knew that often times an elective is full, which leads to another set of email interactions taking place in order to settle on an elective and time that is available. Thus, I indicated that I was not picky about the order in which the electives occurred so long as the dates did not change.

Sent 9/30/11 at 7:52AM
Dear *Medical Affairs Coordinator, with some BS degree,*
The dates that I am interested in are:
1/2/12 to 1/27/12
1/30/12 to 2/24/12
2/27/12 to 2/23/12

The rotations that I am interested in are:
Cardiology
Endocrinology
Pulmonology

Any combination of dates or specialties would work.
Thank you for your prompt response.

*Nonmaleficence*

Response 10/6/11 at 5:34PM
*Nonmaleficence,*
Please align service with time so there is no misunderstanding. Thanks.

*Medical Affairs Coordinator, with some BS degree*
*Some ridiculously overzealous job title*

My thoughts at this point: seriously? 6 days to tell me that!?
I tend to think of myself as a patient person, but this really pushed me. Again, the medical student is NOT allowed to say how he/she feels. Therefore, I did not respond to her immediately and waited ’til the following day so that I did not say anything inappropriate.

Sent 10/7/11 at 8:16AM
*Medical Affairs Coordinator, with some BS degree,*
I’m sorry my email was too confusing for you. Below I specified 3 of the 9 possible permutations that I was alluding to when I stated that any combination of the three different dates and three different specialties would be great.
Cardiology from 1/2/12 to 1/27/12
Endocrinology from 1/30/12 to 2/24/12
Pulmonology from 2/27/12 to 2/23/12

Thank you again for your continued effort in this matter.

*Nonmaleficence*

Response 10/19/11 at 4:00PM
Hello *Nonmaleficence*:
In healthcare less is more. It is vital ALL communication is clear and not subject to interpretation. Please note the memo that clearly delineates *blah blah Hospital’s* requirements.

*Medical Affairs Coordinator, with some BS degree*
*Some ridiculously overzealous job title*

Apparently, her last email required 12 days to generate. I’m not even sure if she attached a memo and I don’t care to check/read it. This exceedingly painful process spanned more than a month (9/15/11 to 10/19/11). My story didn’t even end there because I had been accepted for an elective at a different hospital during the month of January, which I had to cancel. This inevitably caused even greater frustration for me. Fortunately, my electives are all set up and I look forward to meeting this wonderful human being in January…

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