Basic sciences have their place for research, etc, but besides anat, path, and pharm, those are mostly ancient history after you pass pt1 and start clinics. I don't mean to discount the didactics, and you certainly need biochem to understand path/pharm, histo to understand physio/micro, physio to understand pharm/path, etc. However, to excel in the transition from classroom to clinic, you need to start reading more on diagnosis and treatments for the pathologies we see most. Pay good attention in pod med, pod surg, physical diagnosis, radiology, etc... and you can never know/review too much anatomy.
As for getting put on the spot and freezing/blanking, that's just your personality and learning style. You will probably get more comfortable as you go along and gain knowledge, but a lot of students in medical fields are at least somewhat type A with crushing self defeat. Try to view attending questions as your chance to show what you know (or learn more if you don't know). You can be always quiet and reserved until you are more accustomed to clinical settings, but don't take that to the extreme where you look like a disinterested wallflower in clinic/clerkships. Never be afraid to say "I will look that up," jot a note, and do go look it up that night. I'm actually the opposite where I love to ask/answer questions, but that's just my learning style, which, like any style, has its own downsides too. It's all a matter of personality and how you learn well; you know what's gotten you this far.
With patinet interactions, you don't have to "fake it," but the best thing to do when you are green in clinic and talking to pts is to give pts broad, general statements and/or "let's ask Dr. X about that pain when he comes in, he sees a lot of these" until you get more comfortable. You will never go wrong deferring diagnosis and treatment questions to the attending/chief resident, etc (until the near future when you are a resident and on night/weekend call 🙂 ). The main thing to get from 3rd year is just a fundamental understanding of a good history and physical exam as well as the diagnosis and treaments of common pathologies in the lower extremity (heel pain, diabetic/neuropathic foot care, sprains/strains, bunions/hammertoes, PAD, bact/fungal pathology, neuromas, etc). You might not be able to make many confident diagnoses early on, but at least be able to tell the attending what the patient is complaining of, what meds they take, what medical problems they have, and how the basic physical exam looks (hint: use medical terms: "1cm focal necrotic posterior calcaneal ulcer with no palpable pulses and no constitutional symptoms," not "cut on the heel with some black stuff, looks bad." Attendings and residents are your backups, and most like (and are paid) to teach/help students; they have seen better/worse students than you, and they know what to expect. However, don't test their patience too much by not getting all the details you can and doing a systematic pt history and full lower extremity physical exam before presenting the case to them.
The less common stuff (pes planus/cavus, Charcot, neoplasms, rare derm stuff, fractures, etc) will be tough at first, but the good students will go find text/articles and read to learn from later that night while avg/poor students will just scratch their heads. The old Harkless saying "you see what you know" holds true, so get good at diagnostic exams and read up on common and not so common pathologies and their treatment options. Pocket Podiatrics is a good 2nd/3rd year pocket book, but then you need to move on to the PI manual, Chang/McGlamry texts, well chosen peer reviewed journal articles, ortho texts, etc.
GL, we've all been there 👍
