tips for externs

[mildoc2016]

1. Be aware of your surroundings and whom is around you. * You are being watched by attendings, staff, and residents. Anything you say or do is noticed. Directors will often ask staff for their opinions about externs.*

2. Be confident but *not offensively cocky. If you dont know the answer to a question simply say "I dont know, but I will look up the answer and get back to you." * Dont lie and make something up.*

3. Be willing to work. You are paying alot of money to be there so get your money's worth.*

4. Communication is key... Ask if you are unsure. Follow the chain of command.*

5. Always protect patient privacy.*

6. When you encounter anyone new... introduce yourself.

7. Always keep a card with everyones contact number on your person, another in your car, and another in your white coat. You *never know when your cell phone will be out of commission. If your late CALL someone.

8. Be on time.*

9 Avoid topics that may stir trouble in conversation such as politics.*

10.Leave personal matters at home.*

11. Always stay busy. Have something to read if there is down time.*

12. *Never make a negative comment about anyone *period. *Dont talk about other residents, externs or classmates. You will just dig yourself a grave.

Examples of what not to do:*

Scene: *430 pm Friday last day of the rotation. You are waiting patiently for all residents and attendings to arrive before giving your presentation. Everyone is present except for one individual whom is in an important meeting. *.... Do not *call that person and ask them to come "right now" so you can hit the road to your next stop .

Scene: Your waiting for a resident to arrive so you can staff a consult. Its been 30 minutes and the resident hasnt arrived yet. *

When the resident finally arrives and is out of breath ... Do not say "Where were you? You are wasting my valuable time!"

Call the director a jerk after *they critique you about a mistake.*

Talk about anything that could portray yourself as irresponsible or what you did while you were out last night.

I have seen all of the above happen. *This is just my two cents as a current resident.

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[flyhi]

Great information! Thanks for this post, it will come in handy someday. I'm appalled that the 'what not to do's' have actually happened. Unbelievable.

 

[347932]

This is a great list, and applies just as much to residents and attendings as it does to externs.

Externs are being just as watchful, and are sometimes put in VERY uncomfortable positions by residents/attendings who just don't know how/when to shut up.

Remember that externs are the future of the programs they are visiting.

 

[Paulywog]

One of the best pieces of advice mentioned earlier is treating the staff and non-podiatry staff with respect. At a couple of externships, I had the cast tech, medical assistant, and receptionist comment on how nice and respectful I was to them and the patients. The residency director told me about this on my last day as we reviewed the month. There are so many things you should do right. At this point in your career, it should be seconds nature. All of the new Podiatry students should be practicing the previously mentioned skills on a daily basis with classmates and school clinics. Good luck everyone on externships.

 

[Adam Smasher]

1. My first few months out, I've learned a ton from scrub techs and nurse anesthetists, probably just as much from the residents and attendings. They're really cool and I think they get a kick out of teaching us stuff.

2. It's easy to say on paper what constitutes bad behavior. But in my experience, the residents and attendings do a wonderful job of making you feel comfortable for the month, and then it's sooo easy to let slip a poorly worded joke about certain functions of human physiology. So far, I've had some minor slip ups but I think I've avoided doing anything incredibly stupid. But when you're a genuinely honest and hardworking person, you don't need to worry about acting like you're honest or hardworking.

 

[Podophile]

There's a lot of great advice in this thread already, dang. But I shall try to contribute.

Try to be as consistent as possible in everything that you do. Don't ever be "streaky", good or bad, just make yourself get into good habits. Just make it a habit to be on time (15 minutes early) every single day. Try not to be negative (but also don't be annoyingly cheery). Try to be yourself, unless you're a d*** in real life. Get in the habit of looking things up (this is something that you can start before externships), ESPECIALLY when you are not told, and at some point you will get asked about it out of the blue, and you will look like a baller. Also, get back to residents with things that you look up, but don't show off or make it a big scene. Try to make it more of an academic conversation, that could possibly lead them to them asking you another question, that you then look up again and talk to them about. This shows the residents that you're teachable and interested, which are great qualities that they would want in a co-resident.

If you are assigned a topic to present during your month, GO ALL OUT. This is a major way you will be remembered and will leave a lasting impression of your work ethic. Students come and go, and I'm sure it's very difficult for residents and directors to remember everyone and this is a very good way to set yourself apart.

But more important than anything is to remember that this whole year is a GAME. If you always remind yourself of that, and try to win every program over, you will do very well. Even the programs you're not crazy about. The "best" students are the ones who try to get every single program. Treat every single program like it's your favorite, and more than likely the residents will pick up that you really want it. The best way to show that you're really interested is to REVISIT. This will show more than anything that you want to be there. It's tiring and inconvenient and expensive, and the programs know that. So if you show up a second time, when you don't have to be there, that will help you much more than any pimp question that you answered 4 months ago. If you want to be a serious contender at a program, you should revisit it, especially if you're not a superstar (and I certainly wasn't). That is my greatest piece of advice for externs trying to land a program.

The point above is where I failed miserably. I knew that I should have revisited several programs in order to have my pick of the litter, but I ended up making every excuse and only revisited the place that I really wanted. HUGE mistake on my part.

I also don't recommend leaving any earlier than you absolutely have to (I made this mistake as well). You are going to miss your wife/husband/infant child/grandma, but call him/her every night and tell them that you have a job to do, and that is GET A PROGRAM and your/their future depends on gutting it out. Leaving early (even by a day so you can see the family) can only give off negative vibes, and at best be neutral.

 

[arez10]

The point above is where I failed miserably. I knew that I should have revisited several programs in order to have my pick of the litter, but I ended up making every excuse and only revisited the place that I really wanted. HUGE mistake on my part.

What is the protocol for revisiting programs? I wouldn't want to take away any time from the externs currently at that program.

 

[Podophile]

I'd like to know this as well. How the heck do you get time away from your other externships or core rotations to head back to a program? Especially if its very far away? I can see how this is feasible if you are doing programs in close proximity to each other.

The best time IMO to visit would be during the time you hopefully are allowed for Christmas break or even right around New Years. This is perfect as it's right before interviews and you'll be reminding them that you're still very interested. This is when I would visit my top choice program. Around Thanksgiving is another possibility, depending on your rotation schedule.

Finding other times to visit without blowing off the program you are at can be tricky and will require a judgment call. There are opportunities, but they may only be a day here or there. It will be very tempting to rest and take the day off. But if you plan ahead, you can sneak a in a day or two visit a few times and this certainly will be one of the most fruitful ways to increase your chances at scoring a program.

 

[Podophile]

What is the protocol for revisiting programs? I wouldn't want to take away any time from the externs currently at that program.

As far as protocol goes, I felt like most programs would be very receptive to (and seemed to encourage) a revisit, IF you give enough notice: obviously don't just show up unannounced. Ask a resident about the best time to come back.

Don't feel like you're taking away from the externs who are already there, because you won't be doing much of anything. Introduce yourself to them and act professionally and let them scrub any and all cases. If they react negatively to you, it will make them look awful and will not go unnoticed (I have heard stories of over competitive externs ruining their chances by acting shady towards visiting students).

You are there basically just to show your face and your interest. Hopefully the residents will get you a bit of face time with the director and/or attendings. As always, try to get a heads up on what cases and/or attending you'll be with on your revisit and prepare accordingly.

 

[podo trest]

Do you advise being at all forward about the fact that you're very interested in a certain program while you're there (or even before)? Would it be better in your opinion to tell the residency director directly that this is "the program" you're shooting for, or just plant that seed with a current resident you get along with?

 

[Adam Smasher]

Do you advise being at all forward about the fact that you're very interested in a certain program while you're there (or even before)? Would it be better in your opinion to tell the residency director directly that this is "the program" you're shooting for, or just plant that seed with a current resident you get along with?

It all depends. When you play poker, do you play with your hand face down or face up?

All joking aside, over the course of your externships, you will discover that a program you were really shooting for might not meet your expectations, and a program you were going to just because you couldn't find anyplace better for the month was quite underrated. So you are best off keeping an open mind and not starting off being married to a single program.

Also, there's a lot of deception out there about someone telling someone else they're ranked #1 (both programs telling students and the other way around).

Bottom line: if a program is your #1 choice, don't tell them, show them!

 

[347932]

Also, there's a lot of deception out there about someone telling someone else they're ranked #1 (both programs telling students and the other way around).

Bottom line: if a program is your #1 choice, don't tell them, show them!

Very true and excellent advice!

 

[165007]

It all depends. When you play poker, do you play with your hand face down or face up?

All joking aside, over the course of your externships, you will discover that a program you were really shooting for might not meet your expectations, and a program you were going to just because you couldn't find anyplace better for the month was quite underrated. So you are best off keeping an open mind and not starting off being married to a single program.

Also, there's a lot of deception out there about someone telling someone else they're ranked #1 (both programs telling students and the other way around).

Bottom line: if a program is your #1 choice, don't tell them, show them!

I agree with working your butt off, but you NEED to tell them. Trust me

 

[Podophile]

Bottom line: if a program is your #1 choice, don't tell them, show them!

Sixteen x 1000. (Yes, that's sixteen thousand thumbs up.)

 

[SuperFeisty]

16,003 vs 1... Cmon gentlemen, I'm running out of fingers here!

 

[mildoc2016]

Another tip.........
When surgical schedules are arranged for the next day do not question resident and case assignment. As an extern. One must realize that being able to scrub cases at each program is a privilege and not a requirement....each opportunity no matter how "simple" the procedure is a learning experience.

 

[g squared 23]

Another tip.........
When surgical schedules are arranged for the next day do not question resident and case assignment. As an extern. One must realize that being able to scrub cases at each program is a privilege and not a requirement....each opportunity no matter how "simple" the procedure is a learning experience.

+1. I don't want to overhear a student complaining about how the case they're going to be watching is "just hammertoes" and how they as a student have already done several.

 

[densmore22]

There's a lot of great advice in this thread already, dang. But I shall try to contribute.

Try to be as consistent as possible in everything that you do. Don't ever be "streaky", good or bad, just make yourself get into good habits. Just make it a habit to be on time (15 minutes early) every single day. Try not to be negative (but also don't be annoyingly cheery). Try to be yourself, unless you're a d*** in real life. Get in the habit of looking things up (this is something that you can start before externships), ESPECIALLY when you are not told, and at some point you will get asked about it out of the blue, and you will look like a baller. Also, get back to residents with things that you look up, but don't show off or make it a big scene. Try to make it more of an academic conversation, that could possibly lead them to them asking you another question, that you then look up again and talk to them about. This shows the residents that you're teachable and interested, which are great qualities that they would want in a co-resident.

If you are assigned a topic to present during your month, GO ALL OUT. This is a major way you will be remembered and will leave a lasting impression of your work ethic. Students come and go, and I'm sure it's very difficult for residents and directors to remember everyone and this is a very good way to set yourself apart.

But more important than anything is to remember that this whole year is a GAME. If you always remind yourself of that, and try to win every program over, you will do very well. Even the programs you're not crazy about. The "best" students are the ones who try to get every single program. Treat every single program like it's your favorite, and more than likely the residents will pick up that you really want it. The best way to show that you're really interested is to REVISIT. This will show more than anything that you want to be there. It's tiring and inconvenient and expensive, and the programs know that. So if you show up a second time, when you don't have to be there, that will help you much more than any pimp question that you answered 4 months ago. If you want to be a serious contender at a program, you should revisit it, especially if you're not a superstar (and I certainly wasn't). That is my greatest piece of advice for externs trying to land a program.

The point above is where I failed miserably. I knew that I should have revisited several programs in order to have my pick of the litter, but I ended up making every excuse and only revisited the place that I really wanted. HUGE mistake on my part.

I also don't recommend leaving any earlier than you absolutely have to (I made this mistake as well). You are going to miss your wife/husband/infant child/grandma, but call him/her every night and tell them that you have a job to do, and that is GET A PROGRAM and your/their future depends on gutting it out. Leaving early (even by a day so you can see the family) can only give off negative vibes, and at best be neutral.

I disagree. At my program, that causes more problems and hurts you. If you spent a month with us, we know who you are, that's MORE than enough time to show us who you are, what you're about and your work ethic. It's more about knowing the program you want and if this is something they look for, then go for it. Residents are extremely busy, call or email them rather than waste the time and money. Again my opinion.

Here's some things I've seen over my 2+ years thus far:

-Rolling your eyes when asked to do a mundane task like get a cast bucket ready or participate in pt transfers from the OR bed to the gurney.

-After a marathon day and there's consults to see at the end of it, don't ask the resident if we're going to get to seeing the pt when they haven't sat down, let alone eaten for 14 hours and you got to have lunch and dinner and were sitting when you weren't scrubbed in on the surgery. 10 more minutes won't ruin your life, promise.

-Don't try and show up the resident. Even if you know more than them about a particular subject, they're the resident at that program, you're not and likely that won't bode well for you come interview time.

-Don't answer every f***ing question asked to a GROUP of externs before anyone else can even process the question or even worse, cut the question asker off to answer before they're even done asking the question.

-Just don't be a douche, in general. You can't teach common sense so if you don't have it, you won't acquire it magically so fight all of your natural urges to be a gunner.

-Stating the obvious and repeating what others have said, but a hardworker who has above average knowledge is a gem, so aim for this.

-Don't complain that you don't get to do anything during surgery while scrubbed in.

-Know as many classifications as you can, cold. I hate them, I rarely use them, but they're easy pimp questions for residents and attendings to ask, they're really not hard to memorize and know and you WILL get asked about them a lot during rotations and interviews. It's just how it is and there's no excuse for a 4th year student to not know them. There's an entire manual floating around for free that EVERY school has access too (or at least students at every school have it, so ask around) that has all of them that are pertinent.

-When asked to work up a pt (real or mock) for educational purposes, don't freeze up, it's a simple task that you're taught early on and should be able to do. If you're attractive, don't give me a smile and a wink and think that will suffice because it won't (yes, this has happened....many times).

-Get along with your fellow externs. If I find out you're having problems with others you are with that month, game over. Team players and selflessness lands residency spots, hands down.

-Show genuine interest in Foot and Ankle Medicine and Surgery. Like what you do and own it, it's going to be your career so enjoy talking about it and learning about it.

-Be enthusiastic, but not overbearing. Be confident, but not cocky or arrogant. Be helpful, but not in the way. It's a fine line to walk to balance these and every program will be different.

There's more, but I think you get my point.