Best prep for Medicine clerkship?

[Cards21aceking]

So It's that time of year again when second years get to rank their options for the 3rd year clerkships. As for now, I'm pretty set on going into Medicine, and I was wondering if anyone could give any advice which clerkships would best prepare me for medicine?

I've heard from everyone, and read all over the forums, that medicine is the best preparation for all the other clerkships, but I'm having trouble finding any solid advice for the flip side, for people who are interested in IM.

So far, all I know is that I don't want medicine first, and I want surgery after medicine. Any other thoughts would be MOST greatly appreciated!

Thanks!

edit: I have posted this in the clerkship thread as well, but I was hoping for a different audience by posting it here. Please do not close the thread because of posts in multiple forums.

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[NYMd2008]

Everybody's opinion will differ...

i actually did surgery, fam med, and peds before IM. The lottery at my school just worked out this way. at first i was a little pissed but then i realized it wasnt too bad.

if you take surgery, peds, etc. before medicine, you are taking it with ohter students who have not taken IM either, and the residents know this and you are graded accordingly (at least in my school).

and by the time I got the IM, i allready knew the hospital layout, computer system, how to properly write a SOAP note, etc....so I was far more efficient by taking IM midway through the year.

 

[0382938]

If you have a good neuro rotation at your school, this is very much like medicine (and good prep in that way) while also being a smaller body of knowledge to master as a med student (and thus allows more time to get to know the systems in place at your hospital, etc). Really, though, regardless of when you do your medicine rotation you can do a great job just by being there, being interested, and knowing your patients well. Everyone knows how far along in the year you are so expectations are set accordingly.

 

[mirrortest7]

Really, though, regardless of when you do your medicine rotation you can do a great job just by being there, being interested, and knowing your patients well. Everyone knows how far along in the year you are so expectations are set accordingly.

I agree 100%. I'm a current 3rd year, going into IM, and I, like you, did not want to do IM first. I ended up with it first, however, and it was absolutely fine that way. Just work hard and show interest, and you'll do well, regardless of when you take it. After having gone through most of 3rd year, my impression is that we stress out way too much about the order of rotations. It really doesn't matter much in the end.

 

[Dr. Don]

read, read, read......I felt like surgery and medicine where the rotations where I had to constantly keep reading because the information is so much.

Step Up to the Medicine is an awesome book. Good luck!

 

[velo]

read, read, read......I felt like surgery and medicine where the rotations where I had to constantly keep reading because the information is so much.

Step Up to the Medicine is an awesome book. Good luck!

You've already done the best prep for medicine, which is 2nd year of medical school.

Past that you should do MKSAP for the boards and READ ABOUT YOUR PATIENTS! I actually disagree with the poster recommending books like Step Up. I bought it and didn't get too far through it. I felt like the information was too cursory. It would only allow me to tell my team little tid-bits they already knew without allowing me to wow them with any deeper knowledge.

The best thing to do is to come up with EBM questions on as many patients as you can. Do PPIs decrease the risk of Esophogeal CA in patients with Barretts? What's the sensitivity/specificity of JC virus PCR in diagnosing PML in your HIV patient? The rheum consult asked us to order an anti-CCP--what the hell is that?

Do this on your patients, of course, but also for other patients on the team (provided that patient isn't followed by another med student! gunner...). The best questions are one's posed by your attending on rounds. Make a note of it, look it up, and the next day you can say "so I looked up the evidence for xyz..."

Now, it is possible to have this turn annoying for your team. But if you do it right it won't be. Just gently remind your resident that you always have something to present sitting in your hip pocket, and when there's time on rounds ask if you can slip it in. Be prepared to sit on some things for a week or more...rounds are often busy, and some teams will give you more time than others for these, but the point is that you're doing them. Actually I think if they don't let you do them it helps you more...it comes time to grade you and they think "yeah, he looked up a lot of stuff, more than I had time to let him present."

If you make easy to digest, bullet-pointed, NO MORE THAN ONE PAGE handouts about these all the better. Our interns loved these. As a med student you have time to look things up, they often times don't, and if you can teach them little things in a very efficient manner they'll think you're an awesome med student.

 

[juicebox]

You've already done the best prep for medicine, which is 2nd year of medical school.

Past that you should do MKSAP for the boards and READ ABOUT YOUR PATIENTS! I actually disagree with the poster recommending books like Step Up. I bought it and didn't get too far through it. I felt like the information was too cursory. It would only allow me to tell my team little tid-bits they already knew without allowing me to wow them with any deeper knowledge.

The best thing to do is to come up with EBM questions on as many patients as you can. Do PPIs decrease the risk of Esophogeal CA in patients with Barretts? What's the sensitivity/specificity of JC virus PCR in diagnosing PML in your HIV patient? The rheum consult asked us to order an anti-CCP--what the hell is that?

Do this on your patients, of course, but also for other patients on the team (provided that patient isn't followed by another med student! gunner...). The best questions are one's posed by your attending on rounds. Make a note of it, look it up, and the next day you can say "so I looked up the evidence for xyz..."

Now, it is possible to have this turn annoying for your team. But if you do it right it won't be. Just gently remind your resident that you always have something to present sitting in your hip pocket, and when there's time on rounds ask if you can slip it in. Be prepared to sit on some things for a week or more...rounds are often busy, and some teams will give you more time than others for these, but the point is that you're doing them. Actually I think if they don't let you do them it helps you more...it comes time to grade you and they think "yeah, he looked up a lot of stuff, more than I had time to let him present."

If you make easy to digest, bullet-pointed, NO MORE THAN ONE PAGE handouts about these all the better. Our interns loved these. As a med student you have time to look things up, they often times don't, and if you can teach them little things in a very efficient manner they'll think you're an awesome med student.

and now the award for 'biggest tool in all the land' ......

 

[0382938]

If you make easy to digest, bullet-pointed, NO MORE THAN ONE PAGE handouts about these all the better.

OK, fine idea, but if there is more than 1 med student on the team it's courteous to at least give the other student(s) a heads up about approximately what your plans are for entertaining the team with presentations, especially if there are handouts involved. Not only is this good manners, but residents will notice if you are playing nice with your classmates.

 

[velo]

and now the award for 'biggest tool in all the land' ......

 

[velo]

OK, fine idea, but if there is more than 1 med student on the team it's courteous to at least give the other student(s) a heads up about approximately what your plans are for entertaining the team with presentations, especially if there are handouts involved. Not only is this good manners, but residents will notice if you are playing nice with your classmates.

Oh naturally, that's just basic etiquette. As I said, never look anything up on other student's patients. And with regard to your concern above, I completely agree, the way we always worked it out on rotations was to make sure we did roughly the same number of these things and would never tell the resident about a lit search we had to present unless both students had one.

Bottomline, you want to avoid a moment where the attending says, "Thanks med student #1, that was great. Med student #2 do you have anything for us?" ..... "um, no."

With regards to the tool comment in the other response. We were required to do at least one EBM write up with a concise handout as described above per month at my school. If you pick topics well, the team really appreciates them and they can, often times, be a way for you to impact treatment plans. Therefore a lot of us got in the habit of doing several a month. I don't see how you'd be a tool for doing them.

 

[HiddenTruth]

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[orientedtoself]

to the op- try to have medicine as your third clerkship, so you have had a couple of rotations to warm up as a third year. however, like other posters have said, the order of your rotations really doesn't matter that much.

regarding tools (btw i do not think velo is being a tool for helping the med stud learn how to shine). when i was an ms3 on my neurology rotation, we were asked to prepare a 5 min talk on a neuro topic of our choice with a handout. i prepared a 5 min talk with a handout on ocp's and stroke. the other student in my group prepared a 20 min powerpoint including histo slides demonstrating neurosarcoidosis. that other (gunner) student really made me look bad. he drove me nuts. however, i think everyone on the team could see what was going on, and people appreciate not having their time wasted (if they ask for 5 min, give them 5 min. people have work to do). just don't put your fellow students in that position.