How to rise above on clerkships

[StrongIslandDoc]

I have seen general advice passed around on, what to do to get a good letter, how to not piss off residents/nurses/attendings, but I'm wondering if there are any takers that can share their wisdom on how to excel above others on the rotation? I would like to be clear, I am not trying to f**k anyone else over or "gun" anyone down, but I believe there has to be more than "come early, stay late". I am out of the running for Junior AOA, but my pre-clinicals have put me high enough in the 2nd quartile that doing exceedingly well in 3rd year clerkships (and obviously shelves) may help me to tap into the 1st quartile and secure senior AOA - and I would eat the poop hot dog for the AOA distinction.

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[Psai]

lol

 

[BlueJay25]

Here are some more tips:

1. Be nice to everyone and treat everyone in the hospitals with respect (housekeeping staff, nurses, secretaries...) EVERYONE. Everyone in the hospital talks, probably more than you'll ever realize. Everyone knows you'll be nice to those who are responsible for your eval.
2. Ask for work, when they say "you can come for this call on saturday, but it's really not necessary" thats your cue to say "I'd love to have that experience, when should I get there?"
3. Always, always, always act interested even if this is the 900th time you've seen this case. Remember that you can learn something from every case and always try your best to be interested.
4. Read up on things you get wrong or cases you've had so you're never getting the same pimp questions wrong twice.
5. Be collegial with your fellow med students, PA students etc. working well in a team is a huge part of rotations
6. Take that extra minute to make sure you have the best bedside manner possible. Feel free to go stop by the patients you rounded on earlier with your team and say hello again, see how they're doing and make sure everything that needs to be done is getting done.
7. Be well dressed and well groomed. Sometimes you see people stop caring about this, don't be one of them.

That's all I have for now, I'm not sure if this helps but there's my $0.02. Nobody expects you to be the most intelligent or experienced with all the right answers but they do expect you to be an active member of the team.

 

[StrongIslandDoc]

lol

gfdi @Psai lol

 

[StrongIslandDoc]

Here are some more tips:

1. Be nice to everyone and treat everyone in the hospitals with respect (housekeeping staff, nurses, secretaries...) EVERYONE. Everyone in the hospital talks, probably more than you'll ever realize. Everyone knows you'll be nice to those who are responsible for your eval.
2. Ask for work, when they say "you can come for this call on saturday, but it's really not necessary" thats your cue to say "I'd love to have that experience, when should I get there?"
3. Always, always, always act interested even if this is the 900th time you've seen this case. Remember that you can learn something from every case and always try your best to be interested.
4. Read up on things you get wrong or cases you've had so you're never getting the same pimp questions wrong twice.
5. Be collegial with your fellow med students, PA students etc. working well in a team is a huge part of rotations
6. Take that extra minute to make sure you have the best bedside manner possible. Feel free to go stop by the patients you rounded on earlier with your team and say hello again, see how they're doing and make sure everything that needs to be done is getting done.
7. Be well dressed and well groomed. Sometimes you see people stop caring about this, don't be one of them.

That's all I have for now, I'm not sure if this helps but there's my $0.02. Nobody expects you to be the most intelligent or experienced with all the right answers but they do expect you to be an active member of the team.

Thank you for taking the time to piece together such a meaningful response.

7 was never going to be a problem - I've got the aloe gel moisture mask on this pretty visage right now ;-)
Interestingly, a classmate was complaining to me that they are always being told "You can go home if you want" and it had been keeping them from doing the "Stay late" thing - so I told them to take it upon themselves to individually round on their patients again before leaving - status check, "is there anything I can do before I leave - new socks perhaps?" that kinda **** - maybe people will see you going the extra mile for the patient, maybe they wont - but the patient will feel great, you may get some more important info from the patient relevant to the case, etc etc. I think much of what you wrote, to me anyway, is intuitive - maybe except for the part on reading up on pimp stuff and also #2....that being said, I think maybe it can be easy to lose sight of what it means to be a nice person when swamped with work, so we'll see how I make out with this. Thanks again

 

[cbrons]

It depends on what ur clerkship is like. At many schools, all you do is shadow. If you want advice on how to shadow, id say buy dr. Scholls because its hard standing up doing nothing for 8 hours per day everyday.

Sent from my SM-N910P using SDN mobile

 

[mcloaf]

2. Ask for work, when they say "you can come for this call on saturday, but it's really not necessary" thats your cue to say "I'd love to have that experience, when should I get there?"

Ugh. So glad I'm not an M3 anymore.

 

[Phloston]

Be an all-around good person and genuinely listen to and help out those on your team. Help out the intern especially. Be an ace for him or her on pre-rounds and make his or her day easier.

Arrive early and stay late. If they tell you to leave, tell them you're keen to stay if it's okay with them because you want to learn. Sometimes they'll bring you on board if you do that. Only when they say, "no seriously, you can leave," should you leave. Either way, use your best judgement, but what will make you stand out is being one of the rare few who is actually there to help people and to learn the medicine, not just to 'do well on rotations.'

A lot of 'doing well on rotations' is luck to be honest. Teams are so different in their composition and function. Sometimes no matter how stellar you are there's not much you can do to shine. That's another reason why attitude is #1, because even if you aren't able to contribute to the raw functionality of the team, you at least are someone everyone is glad to see.

So yeah, in summary, just be of good character, put in long hours, show you're keen. Hope that helps.

 

[DrBowtie]

Buy Surgical Recall. Become a Hammerhead.

 

[lymphocyte]

Thank you for taking the time to piece together such a meaningful response.

7 was never going to be a problem - I've got the aloe gel moisture mask on this pretty visage right now ;-)
Interestingly, a classmate was complaining to me that they are always being told "You can go home if you want" and it had been keeping them from doing the "Stay late" thing - so I told them to take it upon themselves to individually round on their patients again before leaving - status check, "is there anything I can do before I leave - new socks perhaps?" that kinda **** - maybe people will see you going the extra mile for the patient, maybe they wont - but the patient will feel great, you may get some more important info from the patient relevant to the case, etc etc. I think much of what you wrote, to me anyway, is intuitive - maybe except for the part on reading up on pimp stuff and also #2....that being said, I think maybe it can be easy to lose sight of what it means to be a nice person when swamped with work, so we'll see how I make out with this. Thanks again

You're going to be great, as a clinical student and as a doctor. I hope you never lose the attitude of caring for your patient even when you think nobody's looking.

Everybody can only tell you the obvious things, but ultimately it comes down to three factors: 1) who you are, 2) how much you know, and 3) dumb luck. 1 and 3, you have no hope of changing--at least not in a healthy and sane way. You already seem to appreciate the value of hard work and all that jazz. 2 is the whole point of your clinical training. So if you stay hungry for learning, you'll be alright.

I can't speak to what the AOA requirements are at your school, but I suggest you talk to your seniors now. Get the lowdown on different attendings and teams. They'll be in the best position to know how to prepare.

 

[FiveOClock]

There is nothing you can really do to control your grades. Everyone "goes early, stays late." Everyone reads on their patients and tries to present "updates" to the team (which no one really cares about). There is no secret to getting honors from what I have observed beyond pure luck. I would try your best but put more eggs in the "Shelf" basket. It is guaranteed to help your grade.

 

[PL198]

Here are some more tips:

1. Be nice to everyone and treat everyone in the hospitals with respect (housekeeping staff, nurses, secretaries...) EVERYONE. Everyone in the hospital talks, probably more than you'll ever realize. Everyone knows you'll be nice to those who are responsible for your eval.
2. Ask for work, when they say "you can come for this call on saturday, but it's really not necessary" thats your cue to say "I'd love to have that experience, when should I get there?"
3. Always, always, always act interested even if this is the 900th time you've seen this case. Remember that you can learn something from every case and always try your best to be interested.
4. Read up on things you get wrong or cases you've had so you're never getting the same pimp questions wrong twice.
5. Be collegial with your fellow med students, PA students etc. working well in a team is a huge part of rotations
6. Take that extra minute to make sure you have the best bedside manner possible. Feel free to go stop by the patients you rounded on earlier with your team and say hello again, see how they're doing and make sure everything that needs to be done is getting done.
7. Be well dressed and well groomed. Sometimes you see people stop caring about this, don't be one of them.

That's all I have for now, I'm not sure if this helps but there's my $0.02. Nobody expects you to be the most intelligent or experienced with all the right answers but they do expect you to be an active member of the team.

if they say it's not really necessary then I wouldn't come in. they're basically setting you up to not have to come in. enjoy your life. You don't have to spend 15 hours a day in the hospital as an ms3 to do well. other stuff ya totally agree.

 

[PL198]

Thank you for taking the time to piece together such a meaningful response.

7 was never going to be a problem - I've got the aloe gel moisture mask on this pretty visage right now ;-)
Interestingly, a classmate was complaining to me that they are always being told "You can go home if you want" and it had been keeping them from doing the "Stay late" thing - so I told them to take it upon themselves to individually round on their patients again before leaving - status check, "is there anything I can do before I leave - new socks perhaps?" that kinda **** - maybe people will see you going the extra mile for the patient, maybe they wont - but the patient will feel great, you may get some more important info from the patient relevant to the case, etc etc. I think much of what you wrote, to me anyway, is intuitive - maybe except for the part on reading up on pimp stuff and also #2....that being said, I think maybe it can be easy to lose sight of what it means to be a nice person when swamped with work, so we'll see how I make out with this. Thanks again

no. this is totally wrong. dude if someone tells you to go home. you go home.

This is the creepy stuff that for some reason SDN propagates. "rounding" again when someone tells you to go home is weird. it bothers the patients for something that will not affect care at all.

Live your life outside the hospital!

All you have to do is show up on time, do the work they ask you to do. Be polite, study a reasonable amount (maybe 30 min-1 hr or even more per day depending on rotation difficulty) and do well on the shelf. If you do that stuff, it's going to be hard to mess up. You don't have to buy people food or do extra rounds or any of the other weird **** I constantly see here. there's no secret.

 

[PL198]

the patient isn't going to feel any different because the medical student that they won't even remember because 30 people come into a patient's room per day, stopped by an extra time to see them for absolutely 0 reason.

 

[lymphocyte]

the patient isn't going to feel any different because the medical student that they won't even remember because 30 people come into a patient's room per day, stopped by an extra time to see them for absolutely 0 reason.

I disagree. Pre-round on patients, explain what's going to happen, and then stop by afterwards to explain what happened. Actually sit at the bedside, and actually be a real, normal human being. Not saying this is what you need to do for AOA. I frankly didn't/don't care. In my experience, it helped with their quality of care and families in particular seemed to appreciate it. Those 30 people might be anonymous, but you don't have to be.

 

[PL198]

pre-rounding is normal. an afternoon extra rounds is not unless the team does it. unless your attending and residents suck, they shouldn't need a medical student to answer their questions. and if you try to for questions they still have after real rounds, they are going to have a bunch of questions that are above your pay grade to answer to which all you can say is " idk" or "ill check"

 

[StrongIslandDoc]

pre-rounding is normal. an afternoon extra rounds is not unless the team does it. unless your attending and residents suck, they shouldn't need a medical student to answer their questions. and if you try to for questions they still have after real rounds, they are going to have a bunch of questions that are above your pay grade to answer to which all you can say is " idk" or "ill check"

Homeless patient was beaten by her husband, fractured zygoma, liver failure, all sorts of awful, awful things. Team examined patients legs and feet for edema - could barely get her socks back on after. Team leaves, and patient has cold feet still. I went and got the patient a pair of new socks - I'm pretty sure I made that patients f**king day, ffs how jaded can you be man, smh.

 

[PL198]

Homeless patient was beaten by her husband, fractured zygoma, liver failure, all sorts of awful, awful things. Team examined patients legs and feet for edema - could barely get her socks back on after. Team leaves, and patient has cold feet still. I went and got the patient a pair of new socks - I'm pretty sure I made that patients f**king day, ffs how jaded can you be man, smh.

ok that's a 1 in a million story. congrats. has nothing to do with being jaded. just being realistic

 

[lymphocyte]

ok that's a 1 in a million story. congrats. has nothing to do with being jaded. just being realistic

It's not 1 in a million. Moments like this--where compassion and sensitivity to suffering make a meaningful difference--are probably much more common if we just bothered to look. All I have to offer are anecdotes (and I have a lot of them where this issue is concerned), but that doesn't even matter to me, because I strongly believe in being who you are regardless of who's looking.

For people reading this, don't get the wrong idea. You should never fake who you are. Don't try to be "likeable," "compassionate," "nice"--whatever. Doing so is a kind of manipulation of others, and it's an obnoxious and exhausting game to play. Some are susceptible to this manipulation (attendings included), most think it's a little odd (but can't quite place their finger on why), and more than a few are outright allergic. (It's like how some women feel about "the nice guy," which is a topic for another forum). Focus on learning, developing competence, and working hard. Forget about gaming rotations. Let authenticity flow from who you actually are as a person. What if "you" is not so great or conducive to the medical context? Then quiet professionalism is probably your best bet.

From another thread, this stuck me as outrageously good advice for all med students:

You can be a memorable med student for two reasons:
1. Being well-prepared, hard-working, and capable of doing a good history and physical and then presenting it
2. Being an obsequious jackass who tries to game rotations

Don't be #2.

 

[Amygdarya]

Regarding how much time to spend with individual patients (for patient's sake, not for your grade): it depends. Most patients just want to get some rest I.e. prefer to be left alone, but some patients and families do need some extra attention, more information, more patient-friendly explanation of what's going on etc. One of the services/teams I've been on seemed to be determined to spend as little time with patients as possible (and that was not even on surgery as some may expect but on internal medicine!), so patients and families were often left frustrated because they didn't really know what was going on, and in some cases this lack of understanding actually affected patient's condition (as a patient who was given heroic doses of Lasix to get fluid out of his lungs and legs, and his wife kept bringing him no less heroic volumes of beverages and ice - a simple explanation of the necessity of fluid restriction made a difference in I/O and lung sounds by literally the next morning).

I agree that afternoon "sock" rounds (as in: "Anything we can do to make you comfortable?") are useless. In addition to hardly ever improving patient care (aside from the example mentioned), two more things to consider:
1) I mean absolutely no offense to these professions, but you're a medical student, which means you're learning to be a physician not a nurse or a nurse assistant. Sure, it shouldn't be below doctors to make their patients more comfortable by eg. putting their socks back on while they're in the room, or adjusting a patient's position in bed if a patient requests it when the team is in his/her room while on rounds and stuff like that. But making *separate* rounds to ask if a patient needs a glass of water or a new blanket is thoroughly not a physician's job, and medical students shouldn't be doing that either. Get out of the premed hospital volunteer mode;
2) Attendings most likely won't notice your "Anything we can do to make you more comfortable?" rounds, and if any of your residents notice them, they will either not care or consider them a waste of time for the above reason: you're learning to be a physician I. E. you're learning to be them, and task prioritization is one of the most important things to learn.

Now, checking on a patient with something active going on (eg. a new migraine since this morning, just came back from a CT scan or getting ready to go in for endoscopy etc.) is a whole different matter, and not only will you give some attention to the patient but your residents will appreciate an update on what's going on with that patient.

Bottom line: I'm a far from exemplary student to answer OP's question (I'm doing solidly well and try my best to help out the team and take care of my patients and to learn, but so do most if not all of my classmates, and it's hard to stand out) but I think that being able to adjust to different situations and having common sense helps. As for grading - ask your upperclasspeople, since information about clerkships is passed by word of mouth, eg. which grades rely more on shelf or on clinical evals, which sites/services/attendings are better etc. Clinical evals are, by their nature, subjective and thus a cr*pshoot and depend mostly on how well liked you are by people evaluating you (and you don't really have control over that) but the pattern that emerges from all of your evals matters.
With all of that said, for G-d's sake try not to game the system for the sake of AOA because, even if your superiors don't notice it, your classmates will hate you.

 

[Amygdarya]

You should never fake who you are. Don't try to be "likeable," "compassionate," "nice"--whatever. Doing so is a kind of manipulation of others, and it's an obnoxious and exhausting game to play. Some are susceptible to this manipulation (attendings included), most think it's a little odd (but can't quite place their finger on why), and more than a few are outright allergic. (It's like how some women feel about "the nice guy," which is a topic for another forum). Focus on learning, developing competence, and working hard. Forget about gaming rotations. Let authenticity flow from who you actually are as a person. What if "you" is not so great or conducive to the medical context? Then quiet professionalism is probably your best bet.:

Couldn't agree with this more! If you're an authentically decent human being who's trying his/her best, you'll be fine with most people*.

* - unfortunately one of my attendings who thoroughly disliked my reserved/quiet personality (and also has a bias against people of my ethnic origin, but I'm not even going to get into that) kept telling me that, for the sake of clinical rotations, I should change (never mind *nobody* else had a problem with my personality on any of my rotations) or, if I couldn't change overnight, that I should *perform* (this was the exact word he used, and more than once) in a way that he likes (I.e. more outgoing etc). Needless to say, the duration of my interaction with him was the most miserable 4 weeks in medical school so far, and I received what I believe to be a hugely unfair evaluation and grade from him. Ugh. I'm saying this to: 1) vent (obviously) and 2) point out that there are exceptions to pretty much every rule.

 

[lymphocyte]

Couldn't agree with this more! If you're an authentically decent human being who's trying his/her best, you'll be fine with most people*.

* - unfortunately one of my attendings who thoroughly disliked my reserved/quiet personality (and also has a bias against people of my ethnic origin, but I'm not even going to get into that) kept telling me that, for the sake of clinical rotations, I should change (never mind *nobody* else had a problem with my personality on any of my rotations) or, if I couldn't change overnight, that I should *perform* (this was the exact word he used, and more than once) in a way that he likes (I.e. more outgoing etc). Needless to say, the duration of my interaction with him was the most miserable 4 weeks in medical school so far, and I received what I believe to be a hugely unfair evaluation and grade from him. Ugh. I'm saying this to: 1) vent (obviously) and 2) point out that there are exceptions to pretty much every rule.

Argh. Unfair attendings do exist (a surprise, I know). I'm sorry you had that experience. "Luck"--though unlucky in this case--plays such a huge role sometimes.

 

[lymphocyte]

Regarding how much time to spend with individual patients (for patient's sake, not for your grade): it depends. Most patients just want to get some rest I.e. prefer to be left alone, but some patients and families do need some extra attention, more information, more patient-friendly explanation of what's going on etc. One of the services/teams I've been on seemed to be determined to spend as little time with patients as possible (and that was not even on surgery as some may expect but on internal medicine!), so patients and families were often left frustrated because they didn't really know what was going on, and in some cases this lack of understanding actually affected patient's condition (as a patient who was given heroic doses of Lasix to get fluid out of his lungs and legs, and his wife kept bringing him no less heroic volumes of beverages and ice - a simple explanation of the necessity of fluid restriction made a difference in I/O and lung sounds by literally the next morning).

I agree that afternoon "sock" rounds (as in: "Anything we can do to make you comfortable?") are useless.

Solid advice. And just to be clear, I wasn't suggesting "sock rounds." I meant 1) common compassion and kindness if that's consistent with who you already are in the first place (the little things really matter to me), and 2) circling back, if appropriate to the circumstances, in terms of patient care. At this stage, I'm 100% okay with saying, "I'll have your nurse get X or Y," because I now know what's appropriate to ask the nurses (or whomever) for. Still, some things I would just do myself regardless, because it's simply more efficient--drawing semi-urgent bloods is one example from my hospital.

The problem with my offering advice is that it's coloured by my own experience, my own luck, and the specific hospitals I worked in. Some of what I did ended up as extremely positive feedback on my evaluations, so naturally it seems like a good idea. Others might have done the same thing and gotten, "Why are you doing that"? That's why I say just stick to who you are (as a sanity-preserving measure at the very least) and what you can actually control, like how well you prepare, how hard you work, etc. And no gaming rotations. Lame on so many levels.

 

[NWwildcat2013]

the patient isn't going to feel any different because the medical student that they won't even remember because 30 people come into a patient's room per day, stopped by an extra time to see them for absolutely 0 reason.

pre-rounding is normal. an afternoon extra rounds is not unless the team does it. unless your attending and residents suck, they shouldn't need a medical student to answer their questions. and if you try to for questions they still have after real rounds, they are going to have a bunch of questions that are above your pay grade to answer to which all you can say is " idk" or "ill check"

Agree so much. Patients want to sleep and not have redundancies in their care. I currently have a patient that experiences the follow assault in the AM (this excludes nurses, PT, OT, and other ancillary staff):

Primary team:
MS3, sub i, intern, resident, team during rounds
Consulting team:
MS3, sub i, intern, resident, team during rounds

Thats being woken up ~10 times in a span between 4am and 8am and being asked the same questions. Its even worse if they are sharing a room with a patient who is also being rounded on that much. That is why I try to limit how often I see a patient in the afternoon. Unless there is a problem or I am there to communicate something specific I try not to bother patient and family.

 

[SRWOLFE]

I've done these three things and have done well on rotations so far:

1) Smile more to people/patients
2) Know your patients better than anyone else
3) Ask for feedback

Disclaimers...

1) You don't want to appear fake. Smiling more makes you feel better as well. Makes you look/appear friendly, and over time you might even become more friendly/approachable. On rotations where I smiled more (whether on purpose or not) I got evals saying I was very approachable.

2) Just look up your patients the night before or in the morning. Depending on the rotation. Look up past visits. Write down information you might think is useful. Such as contact info for relatives (this was helpful in psych when certain relatives were conservators etc...). Be interested in them and find out stuff about them no one else would. 90% of the time you won't use that information, but the 10% of the time where a question is relevant you will have the answer. You want to be "the" source of information on your patient. Not a megaphone. Wait for the right moment to answer questions and it will be noticed.

3) Ask for feedback. You probably know this or do this but the key is the ask for SPECIFIC feedback. Don't ask how you are doing in general. Be specific. How can I improve my notes as it pertains to etc.. The more specific you are asking for feedback the better the answer will be from the attending/resident. This was always highlighted in my evals by docs, and they used examples etc.. It's important that once you get this specific feedback to actually work on what they told you!

Best,
SRWOLFE

 

[Jabbed]

Most interactions that you'll have with the resident/fellow/attending fall into one of these three areas:

• Patient presentations
• Learning opportunities
• Pimping

i.e., your presentations should be solid, be attentive and ask questions when they're trying to teach you, and know your **** on pimp questions. Combo this with a non-irritating personality and you're golden.

Helping out with scut and staying extra-late is secondary imo. It won't turn a mediocre eval into a stellar one, but it might give you the benefit when you're between "great" and "excellent".

 

[MediCane2006]

Buy Surgical Recall. Become a Hammerhead.

You beat me to it....

 

[The Anhedonia]

Don't be that douche who pre rounds on all 24 patients on the floor (had a m3 gunning for neurosurgery do this during my surgery rotation....)

 

[Mad Jack]

Be likable and don't be weird.

 

[cbrons]

2. Ask for work, when they say "you can come for this call on saturday, but it's really not necessary" thats your cue to say "I'd love to have that experience, when should I get there?"

"Ok cool, see you Monday."

 

[Señor S]

pre-rounding is normal. an afternoon extra rounds is not unless the team does it. unless your attending and residents suck, they shouldn't need a medical student to answer their questions. and if you try to for questions they still have after real rounds, they are going to have a bunch of questions that are above your pay grade to answer to which all you can say is " idk" or "ill check"

This, 100%. For every 1 homeless woman you get a pair of socks you'll be needlessly annoying another 100 sick people who are just trying to get some rest.

 

[Psai]

Don't be that douche who pre rounds on all 24 patients on the floor (had a m3 gunning for neurosurgery do this during my surgery rotation....)

Just why? It's a pain in the ass to even cross cover 24 patients

 

[jqueb29]

2. Ask for work, when they say "you can come for this call on saturday, but it's really not necessary" thats your cue to say "I'd love to have that experience, when should I get there?"

Would disagree with this one very much. If you are specifically told you don't have to come in, don't do it. You'll be living in the hospital enough as it is during MS3.

 

[joeDO2]

Staying extra hours does not translate into a better clerkship grade. When residents tell you to go home you should do it. I always question the motives of the "lingerers". Go do something outside the hospital to make your next conversation more interesting. If given the choice between a med student who stays late after their shift just to "be there" vs. someone who goes and does something interesting in the community, I'd take the second. Its nice to know a future resident actually does things outside the hospital, shows interest in the community they might be staying in, and knows how to function as a human being. Personality > medical skill/knowledge when it comes to clerkships. We see plenty of smart people rotate through; a much smaller number of those people we would want to hang out with for 2-4 years.

 

[nlax30]

Obviously some of this will just completely depend on the team/intern/resident you're with and if you happen to be with someone who just wants to make your life hell and not be pleasant then there's probably not going to be much you can do.

I tend to be pretty laid back and up front/honest with any med students on service with me. I also understand you have exams to study for and patients to read up on and I really don't need you stuck to my side for 12 hours while I'm in the hospital. So if it's the afternoon, nothing new is pending and I tell someone that they can go then I really mean it, go home. We're not trying to test you to see if you'll beg to stay but rather we're completely fine with you going home. And honestly I need that time just to sit and probably catch up on documentation/orders or other busy work.

Beyond that just be someone that's easy to get along with and talk to. During resident interviews I tell them that they don't have to be the smartest but they do need to be someone I wouldn't mind working with for a few years. I'd rather have someone middle of the pack knowledge-wise who is easy to get along with who has normal inter-personal skills as opposed to one who can regurgitate every random medical fact but makes each interaction awkward, draining or just painful.

If you need some actual practical things you could do I guess these might be a few, in my opinion:
- If I mention something to look up or read up on, then do it and feel free to ask questions if there was something you didn't understand. We don't need to spend an hour going over something but if you took time to read and then came back with a couple questions about it then that's solid in my book

-If I'm talking to or examining a pt please don't interrupt and start asking your own questions. I have my standard questions and approach in a certain order I use and it just throws me off and usually I'm trying to re-direct the talkative 80yr grandma anyway and that just makes things worse. Trust me, I will take time at the end to see if there's anything you'd like to ask.

-Somewhat similar, don't interrupt the intern/resident on rounds. Don't be that gunner jumping in with some little fact unless of course the attending or whoever asking is directly asking you or opens it up to everyone. Certainly jot down a question or notes and feel free to ask afterward if there wasn't time or a chance to ask during rounds.

-Whatever rotation you are on, focus on learning/reading about the basic bread and butter of that specialty. I'm in a field with a ton of guidelines, landmark trials and really good basic reviews on various topics so don't show up and try to start talking about the article published the day before on using CT to evaluate prosthetic valve leaflet thrombosis..... Look for the classic landmark trials in the field and good basic review articles to go through.

 

[Unico]

One thing I have not seen mentioned is how you interact with your peers. This is pretty critical in my experience because how you treat other medical students on your rotation is a reflection of how you're going to treat your fellow residents some day -- and the residents/nurses etc take notice of this.

For example, if you're asking for more work but it's obvious that the rest of your student team wants to leave, be discrete. Don't ask for extra work when it will make the other students look bad -- this makes you an insensitive jerk. If you really want to stay behind, let everyone else leave and then circle back alone to ask if their is anything else you can help with because you want more experience and exposure.

Also, never correct your peers in front of staff or patients. Pull them aside later and have a conversation that shows them that you care about their education. This falls under the gunner category. It's a slippery slope fallacy, but an attending or resident could see you doing that to them in the future.

And this is just my little thing but I think it's worth sharing. I'm not the smartest student on any rotation, I'm just an average student at my school -- but I'm always the friendliest and most genuine student on every rotation. I'm not seeking approval, I'm truly trying to get to know each and every resident on a human level. I've had residents open up to me about their spouses cancer treatments, their mothers psychiatric care, their ****ty work days, etc. etc. Certainly we can't click with everyone, but the point is to be yourself and show that your the type of person that others would want to be on call with for 12 or 24 hours. Again, the best way to do this is to support your fellow students and then the residents pick up on this and open up to you.

One last thing is showing staff management skills. A great example is where I had a rotation and one person on our team was consistently a wanker -- never picking up extra work, ditching duties, and just being a bad team player. Every student on the team really hated this person, and so did the residents. Instead of jumping on the bandwagon I decided to help this person and figure out their strengths. This person was punctual, extremely smart (261/264 on steps 1 & 2), and genuinely kind -- they were just oblivious. I made it a point to help bring out their strengths and by the end of the rotation this person was valued by the residents and less hated by fellow students. While I believe the most important thing was helping my peer, it's worth mentioning that the residents knew that I was the reason this person excelled and the level of respect I received from them was something I'm still humbled by. They treated me very differently from the other students, less like another kid on their service and more like an extension of their team within the ranks of the students.

The management skills also include recognizing when people are having bad days and taking them aside to talk and work things out. Praise your fellow students sincerely for a good job. Recognize your deficits and find people on your teams who can fill in your knowledge gaps, especially those who are shy or not very talkative -- this helps them build communication skills. Etc etc etc.

So yeah, be a good person and that will take you so much further than just being the brightest bulb in the room


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[Señor S]

I'm always the friendliest and most genuine student on every rotation.

The most humble too.

 

[Unico]

The most humble too.

Hahaha ... yeah, got me there

It's funny that I read and re-read that post so many times to not come off like an a** ... oh well.

 

[sliceofbread136]

The best thing you can do is have a good assessment and plan. Actually think through a solid differential and always have some sort of evidence to back up your plan. Other than that sit back and pray. The majority of what people are putting here is stupid.

 

[npappasan]

As a Clinical Professor precepting medical students, what impresses me the most is when a student knows the answers to the questions being asked. If you display a conscientious effort with regard to preparedness, that gets noticed IMO. If you go into surgery, know the anatomy around where you're operating. I mean c'mon, you have to know that you're going to get asked. I always tell my students, if you give me 100%, I'll give you 100%. If you give 50%, I'll give you zero. Everyone is "nice" for the most part. We want to know you can cut it in the real world. Forget about most of what is written above. It's fluff. Read read read and know the answers. That's the key. It also helps if you're not too much of a dick I suppose.

 

[Unico]

If you go into surgery, know the anatomy around where you're operating. I mean c'mon, you have to know that you're going to get asked...

This blows my mind. Are there really students who have the audacity to walk into the OR without reading up on the procedure they're going to whiteness?? Seriously?! That's unacceptable. Please tell me you kick them out.

It also helps if you're not too much of a dick I suppose.

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[mcloaf]

This blows my mind. Are there really students who have the audacity to walk into the OR without reading up on the procedure they're going to whiteness?? Seriously?! That's unacceptable. Please tell me you kick them out.

**** happens. Sometimes you get reassigned to a different OR by the chief right before the case and have no chance to read up on the patient or the procedure. Seems over the top to kick a student out of the OR and deprive them of a learning experience they're paying for just because they aren't as prepared as you'd like.