ADHD (or just general organizational) survival tips for clerkships?

[Bloobury]

Looking for any tips on staying organized/attentive during clerkships, especially from ADHD folks. I realize this is probably highly personal, but even knowing I'm not alone would be helpful.

I'm doing great hyperfocusing in the OR, but I'm struggling to keep it together on inpatient IM rounds, or in clinic when you have a zillion things going on, multiple notes in progress, etc. I also really struggle with being effective when I have to switch tasks rapidly. For example, switching gears to study mode during slow times seems ~impossible~. Some of my classmates can watch a lecture over lunch or do flashcards when there's nothing else going on, but I just seem to get paralyzed/ switch manically between 400 things without making progress on any of them. Anyone else relate?

For IM - I've tried a variety of "scutsheets" templates, but none have really stuck. I also have one of those little H&P notebooks, which is okay for keeping me organized while I'm getting a history and I'm going to try to stick it out to keep me on track until I get my own format figured out.

For boards studying - my schedule is all over the place so it's hard to capitalize on my own natural cycles of attentiveness but I'm trying to schedule an hour a day in my calendar to "study", with larger chunks of time on weekends (although sometimes this gets time gets co-opted by previewing patient charts). I've been told to try and identify a disease process or something to learn about each day, but I'm having a hard time getting myself to proactively plan that out. Any tips here?

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[annoyedpsychiatrist]

for rotations: develop a routine on each rotation. Sometimes hard to do if you're at diff places during the month or two. Look at attending expectations, try to decipher what they're looking for and objectively see how much time it would take you to prepare for whatever that is. Mentally establish tasks that need to be done for that day, and give them a heirachy of importance, and work your way down. Progress notes dont have to be beautifully written, they just need the pertinent information. You will slowly learn what that is. Look at your attendings notes to see how they're doing it, or resident notes. Adapt your process to people who are more efficient than you. For rounds, establish a procedure when it comes to your patients. Look at why they are there and figure out what information would be useful to present (why they're there, interval history, what happened overnight, etc). Use logic to come up with a reasonable plan/dispo, and just do your best, you're not expected to be a star at this

for boards/shelf: less is more. Look at what resources are commonly used/most essential and focus on those. Eliminate extraneous reading. Do questions (great way to learn). If you find yourself going in 500 directions then perhaps you need to narrow down the things that are actually important at the time.

 

[deleted1139416]

I think it might help to come up with a rhythm to things. If you get into a routine of, for example, chart check - pre-round - write note - repeat for next patient, it may be a lot easier. Alternatively,
you could just chart check every patient, then pre round every patient, and then write notes for every patient. Whichever routine is better for you, just do that one. But having a routine helps a lot.

 

[Gilakend]

I had for similar issues. For IM I would start with my presentation, deciding what info I wanted in what order. This would make my "template" that I would them use to pre-round and prep for my presentations. I would fold a piece of paper in half and on one side I would write down:

Pt:
One liner:
Yesterday/Overnight:

and so forth for new consult notes, labs, vitals, I/Os, nursing concerns, plan, etc. and then maybe just and "other" column.

I would use this same template for every patient. So by the time I was done pre-rounding I would have my presentation info as well in the same order I am going to present it.

Then I on the other half of that side of paper I would write a check boxes. By each check box I might write "Note" "Update family" "Update patient" and would also write any orders I needed to change, updates to the plan, tasks for the day etc. The trick is to write down the task the second you think of it, don't expect yourself to remember. Then just check the boxes off as you do each task.