“I start my first clinical clerkship in medical school tomorrow. Any last minute advice?”
I stared at the text message from my cousin as I rolled my first patient of the day back to the operating room. I chuckled to myself.
I try to take myself back to those days and relive them a bit. As hard as they were and as challenging and frustrating the experience may have been, medical school was some of the best days of my life. Medicine and what it means to me has morphed and changed throughout my career. It is a fluid experience. I liken it to a white water river rafting trip that never ends. The trick is not to fall out of the raft. It would be so cold and unsatisfying. Sometimes the raft hits moments of calm and those are times to sit back and enjoy the ride. Other times, you are holding on for dear life and may question as to why you are in the raft in the first place.
So, back to my cousin. How can I set him up for success? What pearls of advice can I give him so that he is not only a “mediocre” student, but rather a “superstar” or a “gunner”?
We have residents and medical students rotating in my clinical practice. Some are phenomenal. Some are average. Others just suck. Occasionally one passes through that is going through a really tough time. Bright, motivated and determined does not always equal success, especially when family or personal tragedies interfere.
Remember. Medicine is a journey. It is a marathon, not a sprint.
Here are my top ten DO’s and DON’Ts of third year medical school clinical clerkships:
- Come early. Pre-round and get to know all the patients before the team arrives.
- Always offer to help – this includes the attending physicians, residents, advanced practice clinicians and your fellow medical students. You never know, the med student working next to you could end up being your boss someday.
- Learn to present in SBAR fashion (Situation, Background, Assessment and Recommendation). If you continue to write and communicate in this way, you will always be well understood and respected.
- Be humble and respectful to the nursing staff – they can make or break you. Be sure to introduce yourself to everyone so that they know who you are. They are often asked to report back to the attending and resident physicians about their interaction with you.
- Get the cell or pager number of your supervising providers and check-in frequently to let them know where you are and what your progress is at all times. Text is always appreciated.
- Read every day. We don’t expect you to answer all our questions, but we expect to see a progression in your learning. We do expect you to grow throughout the rotation.
- Ask questions. Inquiring minds are appreciated, though don’t be annoying and overdo it .
- Thank your patients. Always show appreciation and gratitude for the opportunity to care for them. They will truly appreciate this and it will not go unnoticed by your supervising providers.
- Familiarize yourself with the best apps out there for medical school: some of the best I’ve seen are Up To Date, Epocrates, Docphin, Dynamed, etc. There are so many of them, but these four are the essentials.
- Have fun!
- Guess- if you don’t know the answer to a question during rounds or a pimping session, don’t guess. Just say “I don’t know, but I promise to look it up.”
- Look like a scrub- present yourself well groomed and fashioned.
- Cannibalize your fellow medical students – they are not your competition. Trust me. They are not your competition. Ingratiate yourself with your colleagues and you will build and develop a network of a mini-empire.
- Touch anything you are not supposed to touch. Keep your hands to yourself and always ask permission before doing anything.
- Make-up stupid excuses to leave clinical duties early. We all know what is going on and it’s not cute or unnoticed.
- Show up late. Never come late. Enough said.
- Take it personally if someone reprimands, berates or belittles you. It is all part of the process and just take a deep breath and think happy thoughts. You will get through it.
- Tell us your sob story. We all have a sob story. Unless it is a good friend, you should probably keep the drama to yourself.
- Date your attending or senior resident while on rotation. This happened with a few of my classmates and it didn’t work out so well for them.
- Lie about your specialty preference. If you are on the Psych rotation and you know you don’t want to be a psychiatrist, it is perfectly acceptable to tactfully state that you “want to learn as much as you can on this rotation so that I can apply the knowledge and understanding to help me in my practice of ‘X’”
And if you want to be an absolute superstar. Here are some tips to “wow” the team:
- Stay late and come on the weekends when you are not expected.
- Ask the attending or resident team if you can give a 10 minute presentation on “X” topic.
- Offer to write up a case presentation for any unusual or off the wall case that you see on rotation.
I have to say. The medical students and residents that have knocked my socks off haven’t always been the ones with the highest shelf exam scores or board scores. They aren’t always the walking-dictionary. Clinical clerkships can even the score for those with high standardized test scores and a lack of personality versus average scores and an infectious personality.
But, if I was going to give one last piece of advice in this whole essay, it would be this:
Medicine is an important part of your life. It is an amazing journey and endearing career. You are so lucky and privileged to be a part it. Medicine is not your entire life. Take time for yourself. Take care of yourself. And have lots of fun.
You only get to travel this part of the journey once!
Bio: Dr. Eve Shvidler wrote “Burning the Short White Coat” while still single and in her medical school and residency training. She is now a practicing physician specializing in obstetrics and gynecology. Dr. Shvidler is married, and they have three children.
In “Burning the Short White Coat: A Story of Becoming a Woman Doctor,” author Dr. Eve Shvidler narrates the humor and heartbreak in love and medicine through young medical student Elle Gallagher. A medical chick-lit novel, “Burning the Short White Coat” exposes the personal battles that single women must overcome in balancing a demanding profession and the desire to find a trusting and loving relationship.
To learn more: https://burningtheshortwhitecoat.wordpress.com
Photo credit: By Tulane Public Relations (Medical School-122 Uploaded by AlbertHerring) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)%5D, via Wikimedia Commons