by David Johnson, DO and Jacob Triplet, DO
Pimping in Orthopedic Surgery is a longstanding tradition. It’s a way for residents and attending surgeons to judge your knowledge, character and preparedness. The idea is simple, the student or resident is asked a series of questions that serves as a platform for teaching, but also as a way to compare students’ abilities. Having gone through this myself, answering pimp questions is definitely an art, and in my opinion, there is a right way and a wrong way to do it.
What Is Pimping?
It should go without saying, but the slang term “pimping” is in no way related to the term as it refers to the time-honored tradition in medical education. In surgery, it is the process of judging someone’s knowledge by asking questions about a patient, case, or x-ray. Typically, these questions come from someone more senior than yourself and gradually work their way up the ladder until answered correctly. Truthfully, it’s a game.
How many rounds can you, the student, last without getting stumped?
Each question tends to get progressively harder and more detailed. However, if you can outlast your peers, you’ll be sure to turn some heads and get noticed!
The rules of the game are simple:
- Only answer questions directed to you. This holds especially true if another student or resident is struggling to answer questions. Even if you know the answer, keep quiet, your turn will come. Answering someone else’s questions shows that you’re not a team player, and draws undue negative attention to yourself, especially if you get it wrong!
- If you don’t know the answer, say “I don’t know, but I will look it up”. Don’t guess, unless it’s a very educated one.
- If you say you’re going to look something up, look it up. Nothing looks worse than getting caught the next day still not knowing the answer. You should never miss the same question twice.
- Always be prepared, no matter what.
When will I be pimped?
Pimping can occur at any time—but you will most likely be pimped when:
- Reviewing imaging
- During surgery
- When seeing consults
- Between patients in the office
Always get the list of cases that you will be involved in the next day so that you can prepare. As for fracture conferences and new consults, just remember, common things are common – infections, hip fractures, distal radius fractures, ankle fractures etc. You should be prepared to answer questions on these topics, but more on that later.
What types of questions will I be asked?
This is probably the most common question that we get asked about pimping, and it’s the one that’s most important because it can lead to your success or demise as a student. We’ve found that for particular cases and scenarios the same questions are predictably asked at every institution all over the country – mainly, because it is what is most important. This concept is also what lead to the creation of Pocket Pimped: Orthopedic Surgery, a collection of the 1,500 most commonly asked pimp questions that you WILL be asked.
The saying, “Anatomy is King” most definitely holds true. Every surgery starts with an understanding of the anatomy. More importantly, anatomy doesn’t change, so you can expect to always be asked about it – intervals for approaches, innervations, dangers, and anatomic structures are all commonplace. These are the basic questions and the ones you can’t miss. For instance, in every ACL case, the student will likely be asked what are the bundles of the ACL? What is the ligamentum mucosum? More difficult questions, and the ones that will set you apart from your peers, will apply to the surgery itself – biomechanics, implant positioning, starting points etc.
When seeing consults or during fracture conference you will be asked to read radiographs (which is done a very specific way) and to classify particular fractures. You might also be asked about initial management, potential complications, associated injuries or treatment options.
While this information is vast and the potential questions are endless, the commonly asked questions are predictable, mainly because it’s what is important. This makes preparing to be pimped difficult for students – you don’t yet know what is important or what you’re expected to know. This is where the Ortho Jump Start Course and the Pocket Pimped book can be helpful.
Finally, once you’ve answered all of the orthopedic questions correctly, you might be asked who is singing the song that’s currently playing or which movie that same song was in. If you make it to these questions after answering the orthopedic questions correctly, you’ve won.
This is where the art of pimping truly comes into play, it’s a game, and you have to play smart. Don’t answer questions willingly that you know you’re going to be asked. For instance, if you read an x-ray, just read what you see, don’t offer the classification system because you know that it’s the next question. This gives you one more easy question that you know you’ll get right. Similarly, if you don’t know the answer, don’t try to circumvent the question with another answer or question because then you’ll get asked about that topic. Don’t argue if someone says you’re wrong or disagrees with your answer, but definitely look it up again to make sure you have the correct information going forward.
Always be prepared – no matter what. This comes down to having the right resources and knowing the game. You should always have something with you to be reading. This will not only show that you are a hard worker, but will increase your knowledge exponentially and reinforce concepts as you see them. Make friends with the students on service with you and learn from each other, seeing how you work with other people is part of your audition. When asking questions, don’t ask a question that you could easily find the answer to on your own—and don’t ask questions that you already know the answer to in an attempt to look smart, it’s obvious to spot when this occurs, and it will likely backfire.
Be confident in your answers and speak up. A wrong answer isn’t any less wrong if you whisper it.
If you miss a question, write it down and learn from it because you’ll probably get asked it again by someone else. Remember, that you’re ultimately going to get stumped, it’s inevitable. Don’t get down on yourself, keep reading, keep learning and one day you’ll be the one asking the questions.
Written by David B Johnson, DO and Jacob Triplet, DO, authors of Pocket Pimped.
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