For many residents and junior faculty, presenting at rounds can be an unnerving and stressful experience. Nevertheless, it is often an expectation. While there may be little you can do to avoid being asked to present once, it is within your power to ensure you never get asked again. The key is to turn your first rounds into such a complete disaster and upset so many people in your department, that no one in their right mind would ever invite you to present on anything for the rest of your career. Achieving this, without anyone realising your true intent, and thereby avoiding the “not a very good effort — needs more practice — let’s schedule her again for next March” response takes some expertise. It requires more than just mumbling, overrunning the allotted time or cramming too much information on a slide. To make sure that your rounds are memorable for all the wrong reasons, here are a few tips drawn from many years of observation.
Choice of topic
Choose the most eye-catching title you can conjure up, but then change the topic the day before to something of interest to no one other than your immediate family. Blame it on an administrative error in the education office.
Organising the presentation
There are many opportunities here for achieving your goal. Start the presentation with your findings and introduce your topic no sooner than 20 minutes into the talk saying casually “oh, by the way, the reason we thought we would do this …”. Make sure you don’t introduce the literature review until after you have presented your key findings. Read your entire presentation, preferably in a monotone, without ever taking your eyes off your script. Use plenty of jargon and never explain an acronym.
Begin with a couple of very lengthy and totally uninteresting stories, always prefaced by your saying “you’ll really enjoy this,” or “that reminds me one of the funniest things I’ve ever heard.” An off-colour joke or an overly personal reference to a colleague’s secretary that leaves members of the audience squirming can be guaranteed to set the right (wrong) tone for the rest of the talk.
Timing of the talk
This is almost too easy. Show up late, using illness in a family member as the reason. The later you are, the more serious the problem needs to be. If you have 40 minutes to present and 15 minutes for discussion, don’t start talking about your findings until the 45 minute mark. Alternatively, wrap up your presentation in 20 minutes and leave the discussant who has prepared five minutes to fill 25. Keep using phrases like “I know we are running out of time but…” or “I’ll get to it in just a few minutes.” The audience will probably leave one by one well before the end of the hour. Your ultimate triumph is to still be talking when everyone but the department chair and your discussant have left the room.
Literature review
State early on that you don’t really agree with the concept of evidence-based practice, adding the phrase “and other kinds of scientific mumbo-jumbo,” and throw in plentiful anecdotes from your (usually limited) clinical experience to illustrate any point you want to make. These anecdotes should be at least 120 seconds in length, completely pointless and always end with you asking “now where was I?”
Priorise articles that are more than 20 years old. Don’t worry about the accuracy of your references. Incorrectly citing an article makes it less likely anybody will be able to check it. Don’t waste time searching for articles to support your hypothesis. Make them up, ideally also inventing the journal in which they were not published. All invented journals (preferably foreign language) should be referred to as influential or groundbreaking, with sweeping titles such as “The European Journal of …” and non-existent URLs.
Describe all your findings as “potentially significant” and make up new statistical analyses to demonstrate the significance of your findings, claiming that the test was referred to in an article in last February’s CMAJ. Naming the test after a former member of your favourite sports team is a nice touch.
If a member of your department has published a key work on the topic, ignore it. If there are articles that disagree with the findings of local experts or criticise their work, highlight them and agree wholeheartedly with their findings.
Use of PowerPoint
Always use bad colour combinations (purple on blue, for example) and mismatched fonts, preferably in the same word, and read every slide with your back to the audience. You’re not mis-performing well enough, however, if you don’t introduce at least 12 slides with the phrase “You won’t be able to read the data on this slide but …”. Include the maximum possible information and a couple of irrelevant diagrams on the slide you introduce as the “key conclusions” and move on to the next slide before anyone has a chance to attempt to read it.
Make sure your slides are in the wrong order and intermittently throw in a slide from another presentation that has nothing to do with your topic, to confuse the audience. Only use animations that distract or that introduce the information painfully slowly — introducing your slides letter by letter can extend the duration of the rounds by many minutes.
Question and answer session
Questions offer a final opportunity to alienate the few remaining audience members who may be willing to give you the benefit of the doubt. Begin your response by saying either “That’s a really good question,” or preferably “I think you probably weren’t listening when I mentioned that earlier,” but never answer a question directly. Point out that the question reminds you of something you didn’t have enough time to include, try and go back (unsuccessfully) to find the slide you think refers to this, invent an answer, or point to a junior faculty member or student who knows nothing about your topic and invite them to offer an answer.
Other tips
If all else fails and one or two people actually seem to be enjoying your presentation, the situation may call for more desperate measures, such as:
-
Accidentally spilling your bottle of water on the hospital’s laptop.
-
Making off-hand references to inappropriate behaviour by a senior faculty members wife at the recent department Christmas celebration.
-
Leaving your cellphone on, arranging to be called at least once during the rounds, with a ringtone that plays something annoying by Lady Gaga at full volume. Answer it with feigned irritation and end the call by stating “you know how much time I’ve spent working on these rounds and I asked you not to call” before apologising to the audience and then explaining exactly why it was that your aunt needed to call you at nine in the morning.
Summary
If you follow these tips, you may endure a torrid 60 minutes (although a healthy dose of narcissism will allow you to reassure yourself that your audience just wasn’t ready for the innovative ideas you were putting forward) but you can be certain you won’t even be asked to attend a round again, let alone to present.
Acknowledgement
The author acknowledges the 1988 article by Phillip Home in the Journal of the Royal College of Physicians of London 1988;22:48-50 entitled “Techniques for ensuring that your next paper is quite unsuitable for publication,” which provided the inspiration for this paper. This paper has been prepared with Dr. Home’s permission.
Footnotes
-
Competing interests: None declared.