1st day of rotations advice

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Doctor4Life1769

Doctor4Life1769

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I tried to do a search but maybe I didn't search with proper key words ...

Anyway, it's my 1st day. It's Fam Practice. Any advice? What to take with me (besides dress well, white coat, steth) and what I should do?
 
You're going to do something stupid. You're going to have no idea whats going on. You're going to have no idea what you should be doing.

Embrace it, we all go through it.
 
make sure you introduce yourself to everyone [nurses, lab staff, etc] and be sure they know its your first rotation (xpectation level will drop real quick).

I started with family too and jumped right it. Keep your H&Ps really focused and only do concise presentations.
 
Richspiders07 said:
make sure you introduce yourself to everyone [nurses, lab staff, etc] and be sure they know its your first rotation (xpectation level will drop real quick).

I started with family too and jumped right it. Keep your H&Ps really focused and only do concise presentations.
Click to expand...

Thanks for constructive advice!
 
Flirt with the cute receptionist. That was my favorite part about family medicine. Actually, the only part I really liked...
 
That and be quick with patients. They'll love you if you take no more than 15-20 minutes for non-complicated patients, though they'll understand if it takes much longer, especially for your first rotation. With exams, just listen to heart, lungs, feel abdomen, pulses, and then whatever pertinent physical exam for their specific complaints. But I always felt they liked quickness more than being thorough. But do ask about any red flag symptoms.
 
I start rotations in a couple weeks. And it seems like I'm pretty terrified about this major transition into the real world. I guess it's normal to be anxious, but man, I just don't know how to give myself some slack/have a little faith in myself. I know it's going to hold me down once I start rotating, I can't walk around and be so insecure about everything.
 
Richspiders07 said:
make sure you introduce yourself to everyone [nurses, lab staff, etc]
Click to expand...

THIS.

Many times, you will be playing the role as middleman in communications between your attending doctor and the rest of the staff. Get to know all their names and faces fast! This speeds up your adjustment to the group, takes the awkwardness out of the first couple days, and allows you to get friendly enough with them so that they'll all terribly miss you when it's your last day.

Go out of your way to make their lives easier, and they'll make yours easier in return.
 
On the first day of rotations, I make sure to really look sharp to make sure people know I am on my game. I wear black tuxedo pants, ruffled shirt, black bow tie and a cumberbun. I skip the tuxedo coat in favor of my white coat, but make sure that my shoes are shined. I think it really just depends on what you can pull off though, not everyone looks natural in a tuxedo. Other people prefer scuffed up shoes with wrinkled khakis but I find that totally unprofessional.

After the first day, I don't wear the tuxedo pants because they don't have pockets, but I think it is worth it for a good impression on the first day.
 
tfom08 said:
On the first day of rotations, I make sure to really look sharp to make sure people know I am on my game. I wear black tuxedo pants, ruffled shirt, black bow tie and a cumberbun. I skip the tuxedo coat in favor of my white coat, but make sure that my shoes are shined. I think it really just depends on what you can pull off though, not everyone looks natural in a tuxedo. Other people prefer scuffed up shoes with wrinkled khakis but I find that totally unprofessional.

After the first day, I don't wear the tuxedo pants because they don't have pockets, but I think it is worth it for a good impression on the first day.
Click to expand...

you serious clark?
 
Dress nice and treat everybody in the office/hospital as if they are each doing you a favor by letting you be there (they are). And then introduce yourself and mention it is your first day, first week, first month, first year, etc. 😀
 
Don't go ape loading your pockets with every cool reference manual under
the sun......hurts the neck after a while.

You'll probably only need a pocket pharmacopeia, some form of reference manual (scutmonkey, Mass General manual (little red book), doctorsintraining.com Resident's Handbook), stethoscope, 2 or 3 working pens.

I've purchased a clipboard from whitecoatclipboard.com. Folds up and fits in your whitecoat. Great for having a decent writing surface on you all the time and has all sorts of nifty info shellacked to the exterior surface (lab normal values, DTR stuff, EKG stuff, etc). Got it at the end of 3rd year and wish I'd had it all year long.

You'll hear about snacks, water bottles, reflex hammers, hand lotion, etc. If you've got time to use all that, you're doing something wrong and missing out on something. Plus your white coat would basically turn into an ALICE pack or LBE....

Oh, yeah, something to study. Case Files usually fits in the coat pocket, 5x7 flashcards also go great.

Good luck - don't stress. Enjoy every patient - they're making you a better doctor each time you do an H&P....remember, an expert is someone who does the basics well......
 
Anyone have advice on what to wear several days in after observing that your preceptor wears khakis and button-ups without a tie while you've been wearing dress pants/khakis and dress shirt w/tie? Should I dress down to match my preceptor, or continue to wear the dress shirt w/tie because I feel more professional in this attire and think my patients take me more seriously? Thanks.
 
Mortal_Lessons said:
Anyone have advice on what to wear several days in after observing that your preceptor wears khakis and button-ups without a tie while you've been wearing dress pants/khakis and dress shirt w/tie? Should I dress down to match my preceptor, or continue to wear the dress shirt w/tie because I feel more professional in this attire and think my patients take me more seriously? Thanks.
Click to expand...

I always opt for the latter.
 
FutureSurg said:
Dress nice and treat everybody in the office/hospital as if they are each doing you a favor by letting you be there (they are). And then introduce yourself and mention it is your first day, first week, first month, first year, etc. 😀
Click to expand...

A favor which costs you 25 - 40K per year?
 
KeyzerSoze said:
A favor which costs you 25 - 40K per year?
Click to expand...

A tuition for a field that YOU have chosen to enter, rather than getting a job and starting a different career path......whether we like it or not, we're lower whale excrement right now and should try to make the best of it. Life's too short.....

Sorry - I've recently had a 'come to Jesus' meeting with myself. I had a chance to talk with
a premed about osteopathy and getting into school and it really reminded me
of how excited I was to start this and what I really wanted to do AFTER
residency and how fortunate I was to be one of the 160 selected out of the
1500 applications received each year. Not to mention the sheer privilege
of being able to work with people in some of the most distressing
times in their lives and quite possibly the very last moments of their lives......

Having to 'pay' for it.....doesn't seem so odd.....
 
Better get good at people-skills, because that's all clerkship is based on. If you're competent and intelligent, that's a plus. But you need to be sexyhot, personable, and confident if you're gonna nab those Hs.

The smartest guy in the world isn't going to enthrall his evaluators unless he gets along with them.
 
Telling a resident or attending that you are NOT going into their field will yield you a lower grade. Lie. Just tell them that you are in love with whatever rotation you are on.
 
I agree with not telling an attending, resident, etc that you are not interested in their field, because some may lower your grade (unlikely but possible), but more likely they may not teach you as much due to your announced disinterest. I would not tell every attending that you plan on going into their field. If they figure out you're lying about it, it looks a lot worse than any perceived benefit from saying you want to go into their specialty. You don't want to get a reputation for being the student that tells everybody they want to go into whatever rotation they are on. I was able to tell on one rotation that a 3rd year medical student was pulling that act and this girl didn't even go to the same medical school, so I'm sure attendings and residents can pick that out pretty easily. Just act interested and keep an open mind.
 
No. It goes like this:

Person Grading You: What do you want to be when you grow up? (I don't know who started asking this but they all word it this way.)

You: [option a] I don't know yet.
[option b] This. I want to do this...for ever.
[option c, best answer] I don't know, something with a mix of clinical stuff and procedural stuff and maybe some research.
note: none of this works if you can't act like you care.

More advice:
Also, don't ask questions. 90% of the time the answer will be "why don't you look this up and come back and tell us all". ugg. The other 10% of the time you learn tons. If you find an attending or resident who is in the 10%, stay near them always.
 
I think being honest with your residents and attendings when they ask you what speciality you are interested is more important. I knew from the start of medical school I wanted to go into pediatrics and I that is what I was said when I was asked. All of my clinical subjective grades in 3rd year were >90. What is important is working hard. Even if you do not want to go into that speciality, show enthusiasm and be interested in learning.
 
i carry steth, iphone, pen light, notebook, couple pens, gum, and random crap i find around the hospital (tongue depressors, alcohol swabs, candy)
 
Substance said:
Better get good at people-skills, because that's all clerkship is based on. If you're competent and intelligent, that's a plus. But you need to be sexyhot, personable, and confident if you're gonna nab those Hs.

The smartest guy in the world isn't going to enthrall his evaluators unless he gets along with them.
Click to expand...

👍
We had two M3s on our team this month. Student A was very intelligent, can only remember him missing a couple basic science pimp questions, but he was pretty much disengaged from the team. He used a computer on a different floor to type his notes, would use his iphone a lot during rounds (turns out he's looking stuff up but the attending doesn't know that), and often his A/P would only show up after the resident note was typed and would look pretty similar. The guy even walked slowly. He was cordial and joking, got along well with everyone, but his actions spoke of disinterest.

Student B would show up early and get crosscover issues from the nightfloat, have notes in promptly, coordinate the plan with us prior to presentation so that we didn't spend an extra 5 minutes backtracking with the attending, etc. I could leave for clinic knowing she'd f/u on my patient's consult recs or call the lab for abx sensitivities, whereas with the other guy I'd have to sign that stuff out to the call team. As the month wore on she was able to step it up from simply reporting data/rattling off memorized info to applying knowledge to the actual management of patients. She became a real contributor to the team this way and not just someone shadowing and making extra work for us poor 'terns.

I guess the bottom line is you don't have to be a kiss-ass to appear enthusiastic and interested. You don't have to be 'golly gee wow an abscess!', nor do you have to buy everybody food and charm them with anecdotes and charisma. You just gotta be around and be involved. And the more you're around the more opportunity we have of sending you home to study for that shelf.
 
Advice...it sucks. Its going to be hard, it will make you a bitter person but I guess everyone gets through it right? Thats what keeps me going. And definitely agree with the above poster, it seems as though personality gets you much farther than real knowledge. Its not so much what you know but how you say it and how you act. Easier said than actually done though!!!!!
 
It's going to be your first day of rotations for a long time coming. I'm an intern now and every month I'm still rotating through a new department in a new hospital. Over time you realize that what you need more than anything is the ability to prove to people that you are interested, willing to adapt, and able to make their lives easier. This requires some humility in the beginning. What makes every start hard is that you are truly incompetent at the given subject and it takes some time to rebuild your confidence enough so you can become a helpful member of the team. To best prepare, I would get advice from people who have rotated through the department before and make sure you read about subjects you were confronted with that day. I find that if you have a cheerful attitude and a willingness to get your hands dirty this will take you far. To read more about my rotations http://emupdate.blogspot.com/
 
Also, find out exactly who is grading you. I've spent hours and hours working with one attending only to find vague comments from the other attending on my eval and none from the person I worked with the most.
 
-Keep a good attitude, stay involved. If you absolutely hate a rotation, at least give the appearance that you are somewhat interested.

-You do not have to know everything at this point and if you don't know simply say "I don't know." Then read about what you don't know that night. That's called active learning.

-Show up a little early or at least on time for your rotations. I cannot tell you how many times I see someone roll in very late. Once in awhile if you have a compelling reason, it's completely forgivable however if it's a pattern, it shows laziness and disinterest.

-If I ask you to do something, at least give it a try. We know you may not get it right on the first go, but hey, exposure is learning. Might as well learn now before you start intern year where you are expected to have some level of competency.

-Three things you should ABSOLUTELY LEARN during your 3rd year:
  • How to write a good, concise progress note.
  • How to do a complete History and Physical in a timely fashion
  • How to interpret common labs like CBC, CMP, UA, Cultures, etc.
Why? because you are expected to know how on your first day of internship. I've seen interns who have never done an inpatient rotation ask me how to write a progress note or do an H&P. It's one of your skills you need for the rest of your life, learn it! 😱

-Above all, learn to take care of yourself.
  • If you are sick, please don't show up to work sick but a simple phone call letting us know your sick would be nice, that's called professionalism. 😎
  • Get plenty of rest when you can.
  • Call your family and take care of your wife/significant other while going through this process, as they are instrumental in your career more than you know. You need their love and support

-Lastly, remember, no matter how bad the night can get on call, they cannot stop the clock. :laugh:

Best of luck and remember YOU CAN DOOOO ITTTT! *Rob Schneider voice*
 
Update:

As an MS3 who's already busted out a bunch of rotations, one more piece of advice:

More than anything else, keep your eyes and ears open on the first day of the rotation.

Resident, attending, course director, etc. will say a bunch of things. Then they'll never repeat them again. Listen, and listen again. Don't just nod after every sentence. Get off your ass and process the information... Nothing sucks more than blushing when you have to ask where something is, what should be done, etc. a second or third time 10 minutes after they already told you.

Secondly, your other peers from your class that you're very excited to see again and work with on this rotation are some of your biggest assets. They are coming from different rotations that you haven't even done yet, so look carefully at what they've stuffed in their white coat pockets, what they're carrying, or what they're doing - they probably have bits and pieces of practical information they got elsewhere about little tips for the new rotation. It doesn't require asking them questions or being a pain in the ass - just keep your mouth shut and look/watch.

Regarding your classmates, also be sure you all have a powwow after the first day to talk about particulars of the rotation schedule and duties, especially if they will be working on your team.
 
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