Another problem I've noticed is this.
Where I did residency, the attendings as a whole (not specific individual ones) placed far more importance on a resident's clinical performance. While good knowledge and clinical performance go hand-in-hand, some signs of a better clinician do not.
For example good note writing, writing faster, admitting or discharging patients quicker, getting the agitated patients injected faster, attendings and nurses all attribute this to an excellent resident, but what if that resident doesn't know much outside of that?
Residents should also occasionally be able to detect very odd etiologies (e.g. antibody induced psychosis, shared delusions, be able to clearly distinguish delusional disorder from other psychotic disorders). Some can be considered good but don't have a strong knowledge base.
I'm not talking about zebras that have no clinical usefulness but zebras that occasionally happen and if missed could lead to seriously bad outcomes. Personally I found the PRITE filled with the zebra stuff that was not useful, but I did think the board exam had several useful zebras and things most residents aren't solidly taught but are very useful such as Maslov's pyramid. But getting to my original point, some attendings don't care if the resident doesn't have much knowledge so long as the day went well with that resident, and see making extra attempts to teach as an added chore.
Where I'm currently at U of Cincinnati, I'd say somewhat over 50% of the clinical attendings really care about the resident doing studious activities and will work extra for residents needing extra supervision. Where I was in residency I'd say it was less than 10%, and they scored the resident mostly on the resident's ability to make the attending's life work-free. The sad thing is at U of C, the attendings work much harder and it's a bigger pain and chore to give the extra supervision for greener residents-and this only reflects that the attendings at U of C are far superior to where I did my residency.
If a program were to have board prep, I'm all for that, but I'd be against PRITE prep because the PRITE is not a well written exam- do not memorize old PRITEs.
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PRITE Exam Study...
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