4th year, where should my skills be?

[Treehun]

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hello,

As a fourth year where should my base level of medical skills/ knowledge be?

some class mates seem like they are already Attendings, and some have been on fourth year vacation for the last 6months and couldn’t treat my cat!

But if one had to quantify an appropriate 4th Year skill set, where should I be as a 4th year about to graduate??

I’m concerned I’m far behind the powerball....but maybe I’m just surrounded by gunners?

Thank you!

 

[Treehun]

Also lmao, many fourth years seem extremely sure of their salariales as attendings, exactly what their work life balance will be, and that Their priorities are on working less for maximum pay....is this sure fire knowledge common place?

Does anyone else hear these things by most of their classmates?

 

[Berkboy]

4th year, you either give a S*** or you don't, and this variable tends to effect how "competent" classmates seem.

That being said, if you are not at an intern level (or close), that should be the goal. Can you efficiently eval new patients and accurately and easily relay this info to your seniors? Can you come up with basic ddx's and recognize "sick" vs. "not sick"? Do you understand how to write proficient notes, do presentations, but also start putting in basic orders (school's vary greatly in how much they let you do)?

I hated taking CS, but that's a good idea of what you should be proficient at, but most people pass which is it's just a waste of an exam, since mostly everybody is already able to do this stuff by 4th year. If not, work on it. Things like knowing how to contact social work or other services and get things done and organized for the team (while carrying more than 3-4 patients) is good, too.


Basically, look at what the interns do (near the beginning of the academic year) and you should be somewhat close to that by the end of fourth year, since you'll need time to adjust when you start intern year. In the end, ya'll should be around there by graduation, and some may get there earlier depending on clinical experiences.

 

[Seces]

The mitochondria is the powerhouse of the cell.

 

[Tenk]

hello,

As a fourth year where should my base level of medical skills/ knowledge be?

some class mates seem like they are already Attendings, and some have been on fourth year vacation for the last 6months and couldn’t treat my cat!

But if one had to quantify an appropriate 4th Year skill set, where should I be as a 4th year about to graduate??

I’m concerned I’m far behind the powerball....but maybe I’m just surrounded by gunners?

Thank you!

You need to chill out, relax, and not think about it because none of what you do right now matters. Do you remember that feeling where you started medical school and you opened first aid or whatever medical text for the first time and you were amazed/terrified at how much you didn’t know and had to learn. Prepare to reexperience that only instead of a book it’s a person, and they are dying, and you can’t remember anything, and your MS4 is on their phone, and you’re being paged, and everything is on fire, and you’re in hell. Welcome to residency.

 

[CherryRedDracul]

You need to chill out, relax, and not think about it because none of what you do right now matters. Do you remember that feeling where you started medical school and you opened first aid or whatever medical text for the first time and you were amazed/terrified at how much you didn’t know and had to learn. Prepare to reexperience that only instead of a book it’s a person, and they are dying, and you can’t remember anything, and your MS4 is on their phone, and you’re being paged, and everything is on fire, and you’re in hell. Welcome to residency.

Especially be prepared for everything to be on fire because it has happened in a dialysis unit in Albania.

Know your hospital's fire emergency protocols.

 

[deleted480308]

Attendings like students with skills, computer hacking skills, bow fighting skills, nunchuck skills...

 

[NickNaylor]

The transition to residency will be challenging no matter how competent of a student you'll be. Actually managing patients is just one aspect of the party.

As a graduating MS4, I would like to think that you can at least develop a somewhat reasonable plan for managing most common complaints and being capable of keeping a patient alive for a short period of time if **** hits the fan. Anything more than that is gravy IMO as you'll learn the particular skills of whatever specialty you're going into as you get into residency.

 

[MisterKitty]

The transition to residency will be challenging no matter how competent of a student you'll be. Actually managing patients is just one aspect of the party.

As a graduating MS4, I would like to think that you can at least develop a somewhat reasonable plan for managing most common complaints and being capable of keeping a patient alive for a short period of time if **** hits the fan. Anything more than that is gravy IMO as you'll learn the particular skills of whatever specialty you're going into as you get into residency.

lol at keeping patients alive when **** hits the fan. I can barely keep myself alive day to day

 

[curbsideconsult]

Attendings like students with skills, computer hacking skills, bow fighting skills, nunchuck skills...

And if all else fails, just make yourself a dang quesadilla.

 

[NickNaylor]

lol at keeping patients alive when **** hits the fan. I can barely keep myself alive day to day

By “keeping patients alive” I mean “alive enough until the attending comes.”

 

[Merely]

By “keeping patients alive” I mean “alive enough until the attending comes.”

As an m4 near the top of my class, that’s asking for a lot from a fresh intern lol

 

[Evidence Based]

Essential intern year skills:
1) Know when a patient is sick vs not sick
2) Know when to get your senior or an attending
3) Reasonable DDx and initial management for common conditions
4) Willing to learn and take feedback

Honestly knowing your limits and when you need help is probably the most important. Worse to be overconfident in the beginning than asking for a little help!