Decoding Attending Feedback: What They Really Mean

Introduction: The Art of Reading Between the Lines

If you’ve ever walked out of a feedback session with your attending physician wondering whether you were just praised or politely dismantled, welcome to the club. The language of attendings is a dialect all its own—a peculiar blend of coded praise, constructive criticism, and, occasionally, academic riddles that could stump even the best interpreters.

Understanding what your attending really means when they say, “That’s an interesting plan,” can be the difference between growing from feedback and spiraling into self-doubt. In this guide, we’ll dissect the hidden meanings behind the most common phrases used by attending physicians, explain why they say what they say, and teach you how to survive and thrive in the world of clinical feedback.

Chapter 1: Why Attendings Speak in Code

Feedback in medicine exists in a strange limbo—it must be helpful without being demoralizing, honest without being harsh, and brief enough to be squeezed into the five minutes between rounds. Attendings are often juggling patient care, teaching responsibilities, and administrative chaos. Their language is shaped by:

• Time constraints
• Professional decorum
• The need to build resilience in trainees
• Institutional expectations

The result? Feedback that sounds supportive, vague, or even flattering... but might actually be a warning sign.

Chapter 2: The Feedback Decoder

Let’s examine some of the most commonly heard phrases in clinical feedback and what they might actually mean.

1. “You have great potential.” Translation: You’re not there yet. This is often used when your attending likes you as a person and believes in your long-term growth, but your current performance isn’t up to par.

2. “You’re very enthusiastic.” Translation: You ask too many questions, or you’re all over the place. Dial it down.

3. “That’s an interesting approach.” Translation: This is not the approach I would take, and I’m mildly alarmed. Proceed with caution.

4. “You’re very independent.” Translation: You don’t check in enough, and I’m concerned you’re going rogue.

5. “You’ve improved a lot.” Translation: Your initial performance was lacking. The fact that I’m pointing this out means it was noticeable.

6. “You’re a team player.” Translation: You don’t stand out academically, but you’re not a problem.

7. “Keep reading.” Translation: Your fund of knowledge needs work.

8. “You’re very personable.” Translation: You have good bedside manner, but your clinical acumen might be lacking.

9. “Try to think more broadly.” Translation: You missed key differentials. Don’t anchor on the first diagnosis.

10. “You’re doing fine.” Translation: I don’t have time to go into specifics, or I don’t have anything positive to say.

Chapter 3: When Silence Speaks Volumes

One of the most unnerving forms of feedback is none at all. If your attending isn’t saying anything, it could mean:

• They’re satisfied, but not impressed
• They’re too busy
• They’re unsure how to give feedback
• They want you to initiate the conversation

Silence isn’t always bad, but it’s rarely a good sign. Learn to open the door by asking, “Is there anything I can work on?”

Chapter 4: How to Ask for Real Feedback

If you want honest, actionable feedback:

• Be specific: Ask about your clinical reasoning, note-writing, or presentations.
• Be receptive: Don’t argue. Absorb first, react later.
• Be proactive: Ask early and often. Don’t wait until the end of the rotation.
• Be reflective: Share what you think your strengths and weaknesses are.

Sample script: “I’d really appreciate any feedback you have on how I handled that patient. Was there anything I could have done better?”

Chapter 5: How to Interpret Feedback Without Losing Your Mind

Medical training is emotionally intense. Feedback can sting. Here’s how to manage it:

• Detach your ego: Criticism of your work is not criticism of your worth.
• Find the grain of truth: Even vague feedback usually contains something useful.
• Ask follow-up questions: Clarify what was meant.
• Create a growth mindset: View every critique as a step toward mastery.

Chapter 6: The Feedback Spectrum by Specialty

Yes, feedback styles vary by specialty. Here are some generalizations (not always true, but often enough):

• Surgeons: Direct, sometimes brutal. Thick skin required.
• Internists: Thoughtful but may overuse euphemisms.
• Pediatricians: Supportive and gentle. Feedback often wrapped in kindness.
• Emergency physicians: Fast, blunt, occasionally chaotic.
• Radiologists: Minimalist. You’ll have to chase it down.

Chapter 7: Feedback from a Cultural Lens

Cultural and generational factors play a role too. In some cultures, indirectness is the norm. Older attendings might lean toward the “tough love” approach, while newer ones may prioritize psychological safety.

Be aware of these dynamics. Don’t assume intent. Ask.

Chapter 8: When Feedback Crosses the Line

Feedback should be professional and aimed at your growth. It’s not okay if:

• It’s personal or belittling
• It includes discriminatory language
• It consistently lacks clarity or direction

If this happens, speak to a trusted advisor or educational supervisor.

Conclusion: Learning the Language of Feedback

You won’t become fluent in attending-speak overnight, but you will with time, humility, and curiosity. View feedback as a puzzle, not a verdict. Ask questions. Seek clarity. Reflect. And remember, even the most cryptic comment might contain a lesson that elevates your practice.

Every phrase is a breadcrumb on your journey to becoming a better clinician. Learn to follow the trail.