- Joined
- Apr 7, 2005
- Messages
- 91
- Reaction score
- 0
- Points
- 0
Current 3rd years
- Thread starter zion
- Start date
- Joined
- Mar 15, 2004
- Messages
- 1,113
- Reaction score
- 3
- Points
- 4,531
- Location
- Baltimore
- Website
- www.studentdoctor.net
- Attending Physician
There are other threads discussing this topic. Briefly, I'd recommend enjoying your summer before 3rd year. Research during that time is good if you're thinking about something competitive. 3rd year is entirely different than 1st/2nd year. It's all about how well are you clinically and not so much how much do you know. Practice your H&Ps and presenting a patient!!!! I was told this and didn't believe how important it is. You'll be doing H&Ps and presenting to your attendings/residents almost daily. I'm enjoying 3rd year very much although you'll find those who aren't. It beats sitting in front of books/powerpoints all day long.
- Joined
- Dec 12, 2006
- Messages
- 3,884
- Reaction score
- 3,661
- Points
- 5,251
Sounds cheesy, but I found it helpful to read through a couple of those general 3rd year guides like, "How to be a truly excellent junior medical student", "150 Biggest Mistakes", and the into to Surgical Recall. When you read their suggestions, you think to yourself, "Well, duh, of course I need to make sure I have all my patients' labs readily available on rounds." But the truth is that, when you are tired and over-worked, it is easy to forget the simple things.
Also, keep some lidocaine gel in your pocket at all times, and apply it liberally to your rectum. It makes the year hurt less.
Also, keep some lidocaine gel in your pocket at all times, and apply it liberally to your rectum. It makes the year hurt less.
- Joined
- Jan 6, 2003
- Messages
- 1,641
- Reaction score
- 14
- Points
- 4,641
One thing I figured out very late in the year is that attendings and residents make judgements about students very quickly.
Doctors are trained to walk into a room, look at a patient, and come to a quick decision about what's going on with them. What I finally realized is that they apply this same evaluation process to us. In your first few days with any team, any new attending, or any new residents or interns, do your best to be on time, give your best presentations, and work as hard as possible. Then you can relax more later. If you make a bad impression on the first day, it is nearly impossible to recover later.
Doctors are trained to walk into a room, look at a patient, and come to a quick decision about what's going on with them. What I finally realized is that they apply this same evaluation process to us. In your first few days with any team, any new attending, or any new residents or interns, do your best to be on time, give your best presentations, and work as hard as possible. Then you can relax more later. If you make a bad impression on the first day, it is nearly impossible to recover later.
- Joined
- Apr 22, 2006
- Messages
- 331
- Reaction score
- 4
- Points
- 4,571
- Location
- Somewhere only we know
- Resident [Any Field]
Don't worry, hundreds of med students have done it before and you can too. Just be patient because it takes a little time to get in the groove of things. It's always good if you're close to one of the residents or someone that can help you overcome the learning curve quickly.
Try your best to be prepared at all times. Be ready for the questions (read when you can) and know your patients in case they suddenly ask you to present or something. Then understand that all the preparation in the world means very little. They'll alwaws find the one thing you weren't able to complete. It's not the end of the world. Oh and try to toughen up your skin. Most people are generally nice but some people are just pricks. Don't give them the satisfaction of getting to you.
Try your best to be prepared at all times. Be ready for the questions (read when you can) and know your patients in case they suddenly ask you to present or something. Then understand that all the preparation in the world means very little. They'll alwaws find the one thing you weren't able to complete. It's not the end of the world. Oh and try to toughen up your skin. Most people are generally nice but some people are just pricks. Don't give them the satisfaction of getting to you.
- Joined
- May 17, 2005
- Messages
- 243
- Reaction score
- 0
- Points
- 0
The things that I thought were most important were
1) As a 3rd year.. your not expected to know anything- your only expected to try hard
2) Be 5 minutes early to everything
3) Get the BRS physiology book and read each section that your on the weekend before you start that rotation. (Respiratory before pulm) for example
4) Be (or at least appear) interested at all times and try to get in on procedures
5) Read each night. (I only did 45 min or so)
this is all I did and 3rd and 4th year were smooth as a baby's a$$
1) As a 3rd year.. your not expected to know anything- your only expected to try hard
2) Be 5 minutes early to everything
3) Get the BRS physiology book and read each section that your on the weekend before you start that rotation. (Respiratory before pulm) for example
4) Be (or at least appear) interested at all times and try to get in on procedures
5) Read each night. (I only did 45 min or so)
this is all I did and 3rd and 4th year were smooth as a baby's a$$
- Joined
- Jul 7, 2003
- Messages
- 2,782
- Reaction score
- 19
- Points
- 4,641
- Location
- Where'd Your Pleasure Go?
- Medical Student
Some good advice above.
1. In general, a well-developed sense of diplomacy is necessary to get a good grade, but it's more about playing good political defense (i.e., not pissing off the wrong people, knowing how to placate an inflamed and fragile ego, etc.) than it is about kissing ass (which backfires all the time).
2. Try to retain as much M1-M2 info as possible. this is the stuff that everyone else forgets, so it impresses people if you can apply it in the clinical context. Esp., in surgery, where you know very little about the technical aspects of the job, demonstrating a solid knowledge about the anatomy, physiology, and pathophysiology really goes a long way.
3. Don't eat too much cafeteria food.
4. Don't correct anyone's mistake (from the attendings to the interns to the other students) unless it's immediately relevant to a patient's outcome (Good: "I believe that patient's allergic to PCN." Bad: "actually, that patient's BUN was 9, not 8.") . If it's really important, BTW, someone else will usually catch the mistake, too. If nobody does, put a bug in the ear of the intern--it's usually better to come from them than from you.
1. In general, a well-developed sense of diplomacy is necessary to get a good grade, but it's more about playing good political defense (i.e., not pissing off the wrong people, knowing how to placate an inflamed and fragile ego, etc.) than it is about kissing ass (which backfires all the time).
2. Try to retain as much M1-M2 info as possible. this is the stuff that everyone else forgets, so it impresses people if you can apply it in the clinical context. Esp., in surgery, where you know very little about the technical aspects of the job, demonstrating a solid knowledge about the anatomy, physiology, and pathophysiology really goes a long way.
3. Don't eat too much cafeteria food.
4. Don't correct anyone's mistake (from the attendings to the interns to the other students) unless it's immediately relevant to a patient's outcome (Good: "I believe that patient's allergic to PCN." Bad: "actually, that patient's BUN was 9, not 8.") . If it's really important, BTW, someone else will usually catch the mistake, too. If nobody does, put a bug in the ear of the intern--it's usually better to come from them than from you.
Do not give in to the urge to eat the hospital pizza, especially when you're on call. It will take revenge later when you're trying to sleep, I promise.
Advertisement - Members don't see this ad
- Joined
- May 8, 2004
- Messages
- 4,269
- Reaction score
- 1,996
- Points
- 5,796
- Attending Physician
The following advice is from "p53", couldn't find a link to the post but I saved this info and found it valuable during the past year. and yes you'll have more time in third and especially fourth year to spend with the spousal unit!
HOW TO SUCCEED IN 3RD YEAR
1. If a resident asks you to do something. Say "Sure" with a good attitude. I've seen many students say they will do it but then they have a look on their face like they don't want to do it. HIDE THIS. Practice this if you can. Make it look like in your attitude you want to do it even if you don't want to do it. THIS IS ACTING BUT YOU HAVE TO MASTER THIS.
2. Analyze the daily preceedings of an intern or resident. Then, rather than ask if you can do something. DO IT. For example, if you notice the intern struggles to get the lab values for patients in the AM. Get the lab values for him/her. BE PROACTIVE. A 3rd year by definition is an observer. If you become proactive and anticipate things to help out the residents you will stand out.
3. Hang out with the residents if you have down time. Don't leave their side unless they tell you to go and study. If they complain about their day, use active listening techniques to console them. Don't use reciprocity to say "I know what you mean and then start complaining". Listen, paraphrase, and empathize. Be a good listener.
4. Reading. I agree with this. However, just keep in mind. You can read every night of the week and the attending might not know it if you are reading if you are the quiet type. Then again, you can say I read blah, blah, blah last night and that doesn't come across impressive either. The best technique is to tie a reading concept with something about your particular patient. Such as "I was reading about _______, last night and was wondering if we have to consider ________ for our patient. Don't do this in front of the residents and interns. Just with the attending.
5. Never blurt out facts to impress the attending during rounds. If a patient has pneumonia, and you blurt out would you consider a Legionella Urine antigen. This shows you might know your stuff, however if it isn't your patient and the resident hasn't ordered that test, you make the resident look bad. Bite your tongue. Only talk when someone is talking to you or if it if your patient. Believe it or not. If you studied hard for Step 1 you will know more than an attending on some things. The key is to not come across as someone that is trying too hard to impress. The time to show your knowledge is during oral presentations of patients, or a discussion of a topic during a research presentation. If an attending asks you a question during rounds you can answer the question. Don't blurt out the answer. Say something with some thought. If an attending asks you a question it is likely about your patient.
For example, if an attending asks what are some causes of a low sodium value. You can blurt out SIADH, Drug Induced, polydipsia etc. Or you can say the most common causes of hyponatremia on the wards is diuretics. He is currently on Lasix. But you have to consider other causes, with our patient he doesn't seem to be hypovolemic because his vitals are stable, mucuous membranes are moist and capillary refills are brisk. The patient doesn't appear to have edema to suggest hypervolemia. The LFT's rule out liver failure, BMP rules out renal failure and hyperglycemia. We could try water restriction to correct the problem, or we could modify the dose of lasix.
6. Never kiss a resident's butt with compliments. This is transparent. Impress them with actions by doing things, not with words. If you are sincerely impressed and want to give someone a compliment do it through a third party. This will eventually get to the target and it will payer greater dividends. Plus, you will not be in trouble for insincereity since you are not the one that told the target.
7. Show up early. Do your job. Smile with Patients. Help the team members. Don't complain. Read during down time. Never show frustration. Console the residents. Don't hang out with whining, complaining medical students, this will bring you down too. Have a beer after a hard day, and relax. Enjoy you day off by doing something fun.
HOW TO SUCCEED IN 3RD YEAR
1. If a resident asks you to do something. Say "Sure" with a good attitude. I've seen many students say they will do it but then they have a look on their face like they don't want to do it. HIDE THIS. Practice this if you can. Make it look like in your attitude you want to do it even if you don't want to do it. THIS IS ACTING BUT YOU HAVE TO MASTER THIS.
2. Analyze the daily preceedings of an intern or resident. Then, rather than ask if you can do something. DO IT. For example, if you notice the intern struggles to get the lab values for patients in the AM. Get the lab values for him/her. BE PROACTIVE. A 3rd year by definition is an observer. If you become proactive and anticipate things to help out the residents you will stand out.
3. Hang out with the residents if you have down time. Don't leave their side unless they tell you to go and study. If they complain about their day, use active listening techniques to console them. Don't use reciprocity to say "I know what you mean and then start complaining". Listen, paraphrase, and empathize. Be a good listener.
4. Reading. I agree with this. However, just keep in mind. You can read every night of the week and the attending might not know it if you are reading if you are the quiet type. Then again, you can say I read blah, blah, blah last night and that doesn't come across impressive either. The best technique is to tie a reading concept with something about your particular patient. Such as "I was reading about _______, last night and was wondering if we have to consider ________ for our patient. Don't do this in front of the residents and interns. Just with the attending.
5. Never blurt out facts to impress the attending during rounds. If a patient has pneumonia, and you blurt out would you consider a Legionella Urine antigen. This shows you might know your stuff, however if it isn't your patient and the resident hasn't ordered that test, you make the resident look bad. Bite your tongue. Only talk when someone is talking to you or if it if your patient. Believe it or not. If you studied hard for Step 1 you will know more than an attending on some things. The key is to not come across as someone that is trying too hard to impress. The time to show your knowledge is during oral presentations of patients, or a discussion of a topic during a research presentation. If an attending asks you a question during rounds you can answer the question. Don't blurt out the answer. Say something with some thought. If an attending asks you a question it is likely about your patient.
For example, if an attending asks what are some causes of a low sodium value. You can blurt out SIADH, Drug Induced, polydipsia etc. Or you can say the most common causes of hyponatremia on the wards is diuretics. He is currently on Lasix. But you have to consider other causes, with our patient he doesn't seem to be hypovolemic because his vitals are stable, mucuous membranes are moist and capillary refills are brisk. The patient doesn't appear to have edema to suggest hypervolemia. The LFT's rule out liver failure, BMP rules out renal failure and hyperglycemia. We could try water restriction to correct the problem, or we could modify the dose of lasix.
6. Never kiss a resident's butt with compliments. This is transparent. Impress them with actions by doing things, not with words. If you are sincerely impressed and want to give someone a compliment do it through a third party. This will eventually get to the target and it will payer greater dividends. Plus, you will not be in trouble for insincereity since you are not the one that told the target.
7. Show up early. Do your job. Smile with Patients. Help the team members. Don't complain. Read during down time. Never show frustration. Console the residents. Don't hang out with whining, complaining medical students, this will bring you down too. Have a beer after a hard day, and relax. Enjoy you day off by doing something fun.
- Joined
- Jun 9, 2004
- Messages
- 2,204
- Reaction score
- 0
- Points
- 0
- Location
- hiding from a code
- Resident [Any Field]
- Joined
- May 1, 2006
- Messages
- 2,179
- Reaction score
- 26
- Points
- 4,626
- Attending Physician
My third year was divided into two epochs...
The Time Before I Bought Clogs With Arch Support and a Heavily Padded Heel.
and the much more appealing
Time After I Bought Clogs With Arch Support and a Heavily Padded Heel.
The Time Before I Bought Clogs With Arch Support and a Heavily Padded Heel.
and the much more appealing
Time After I Bought Clogs With Arch Support and a Heavily Padded Heel.
- Joined
- Mar 10, 2000
- Messages
- 169
- Reaction score
- 51
- Points
- 4,661
- Location
- Houston, TX
- Website
- www.thesuccessfulmatch.com
- Attending Physician
This is great advice. Oral case presentations of newly admitted patients and updates on old patients are very important. New third years tend to underestimate their importance.
The literature has shown that faculty members often don't observe students during a history and physical. Yet attendings are asked to evaluate their students' ability to do an H & P. So if faculty often don't observe students, how then do they rate students in these areas?
What happens is this - attendings will draw conclusions about your skill in taking a history and performing a physical exam from the quality of your oral case presentation (and write-up). For example, if your attending feels that your presentation on a particular patient was complete, then he may conclude that your history and physical was complete as well.
- Joined
- May 8, 2004
- Messages
- 4,269
- Reaction score
- 1,996
- Points
- 5,796
- Attending Physician
based on the above post, check out this link throughout your entire 3rd year
http://medicine.ucsd.edu/clinicalmed/
(A Practical Guide to Clinical Medicine)
and if you have a PDA I suggest you turn this into an iSilo document so you can refer to it often (much easier than carrying Bates around).
-J
http://medicine.ucsd.edu/clinicalmed/
(A Practical Guide to Clinical Medicine)
and if you have a PDA I suggest you turn this into an iSilo document so you can refer to it often (much easier than carrying Bates around).
-J
- Joined
- Feb 4, 2000
- Messages
- 5,910
- Reaction score
- 42
- Points
- 4,626
- Website
- www.pcom.edu
- Resident [Any Field]
My advice to a soon-to-be 3rd year student...
AKA "JPHazeltons 25 tips for MS3 Success"
1. Show up early
2. Stay late
3. When you get something wrong, look it up that night
4. Don't make excuses...for anything, ever
5. Don't touch things that beep, drip or zap
6. Offer to help and assist
7. Don't nag to help and assist
8. Use legible handwriting in your notes
9. Don't write "AFVSS"
10. Avoid using slang terms like "gomer"
11. Do things the way the attending tells you to, not the way they do it
12. Do things the way the resident tells you to, not the way they do it
13. Do things the way the intern tells you to, not the way they do it
14. Be nice to everyone in the hospital...the walls have eyes and ears
15. Pee before medicine rounds
16. Pee before the OR
17. Don't pee on your way out of the hospital...this is the way to cause a code
18. Don't ask questions at an innapropriate time
19. Learn when is an innapropriate time
20. Don't talk about patient in the elevator...their families live there
21. Read
22. Study
23. Learn
24. Observe
25. Care
Good luck.
AKA "JPHazeltons 25 tips for MS3 Success"
1. Show up early
2. Stay late
3. When you get something wrong, look it up that night
4. Don't make excuses...for anything, ever
5. Don't touch things that beep, drip or zap
6. Offer to help and assist
7. Don't nag to help and assist
8. Use legible handwriting in your notes
9. Don't write "AFVSS"
10. Avoid using slang terms like "gomer"
11. Do things the way the attending tells you to, not the way they do it
12. Do things the way the resident tells you to, not the way they do it
13. Do things the way the intern tells you to, not the way they do it
14. Be nice to everyone in the hospital...the walls have eyes and ears
15. Pee before medicine rounds
16. Pee before the OR
17. Don't pee on your way out of the hospital...this is the way to cause a code
18. Don't ask questions at an innapropriate time
19. Learn when is an innapropriate time
20. Don't talk about patient in the elevator...their families live there
21. Read
22. Study
23. Learn
24. Observe
25. Care
Good luck.
- Joined
- Dec 24, 2006
- Messages
- 296
- Reaction score
- 6
- Points
- 4,551
i have a question that's been bugging me a while.
you all say to stay and hang out with residents, come early, stay late, etc. do your residents actually tell you to go home? how do you know when it's time? i don't want to clock out on the hour and appear uninterested, but i don't want to stay 20 of the 24 hrs and then not get any reading done. how do you draw the line?
also, how much reading must you do each night to do well on the shelfs? and how do you study for the shelfs? do you guys buy those pretest books or "surgical recall" or those wards books?
in summary, i guess what i don't get is how much are you supposed to read each night to be in excellent shape (ie honorable on shelfs) but how long are you supposed to stay in the hospital to get great evals, and with those two, is there time for sleep?
this has been bugging me for months now...thanks in advance
you all say to stay and hang out with residents, come early, stay late, etc. do your residents actually tell you to go home? how do you know when it's time? i don't want to clock out on the hour and appear uninterested, but i don't want to stay 20 of the 24 hrs and then not get any reading done. how do you draw the line?
also, how much reading must you do each night to do well on the shelfs? and how do you study for the shelfs? do you guys buy those pretest books or "surgical recall" or those wards books?
in summary, i guess what i don't get is how much are you supposed to read each night to be in excellent shape (ie honorable on shelfs) but how long are you supposed to stay in the hospital to get great evals, and with those two, is there time for sleep?
this has been bugging me for months now...thanks in advance
some residents tell you to go home when you're done. they are the cool ones. some residents seem to enjoy forcing you to stay a long time and pretend like you're busy. these are the sucky ones. it's a tossup.
as far as how much you have to read at night, it depends on how fast you learn, how well you retain info long-term, and how much you learned the first two years. however, if you read for an hour a day, you'll probably be in great shape. (can be harder than it sounds)
Advertisement - Members don't see this ad
- Joined
- May 8, 2004
- Messages
- 4,269
- Reaction score
- 1,996
- Points
- 5,796
- Attending Physician
regarding reading there are a few different approaches...
1. read on what you see
2. read straight through whatever book you have for the shelf/rotation
3. combo of the above
i tried to do 3 as much as I possibly could but typically would start the rotation more with 1, once comfortable get to 3, and then before the shelf all number 2.
an hour or two daily should put you in really good shape, don't forget to do practice questions!
-J
1. read on what you see
2. read straight through whatever book you have for the shelf/rotation
3. combo of the above
i tried to do 3 as much as I possibly could but typically would start the rotation more with 1, once comfortable get to 3, and then before the shelf all number 2.
an hour or two daily should put you in really good shape, don't forget to do practice questions!
-J
- Joined
- Aug 29, 2004
- Messages
- 109
- Reaction score
- 0
- Points
- 0
Unless you are some kind of super human, don't expect to follow advices of everyone in this thread all the time. There will be times when you are late, don't have all of your patients' vitals, have a facial expression that is not too enthusiastic, blurt out a fact that your resident doesn't know, etc. Don't freak out every time that happens. You won't kill anyone and your grade will probably not suffer unless those things happen repeatedly.
- Joined
- Mar 10, 2000
- Messages
- 169
- Reaction score
- 51
- Points
- 4,661
- Location
- Houston, TX
- Website
- www.thesuccessfulmatch.com
- Attending Physician
Of course, no one is perfect. Despite your best efforts, things will happen. You may be late for one reason or another. But it's how you handle the situation (do you apologize, do you say nothing, etc) that sets one person apart from another.
It's also about the track record that you have established. If you have shown yourself to be consistently on time, done high quality work, and gotten along famously with the team, then showing up late on one occasion may not be an issue. However, if there have been other problems, tardiness may not be so easily forgotten.
- Joined
- Mar 19, 2006
- Messages
- 958
- Reaction score
- 4
- Points
- 4,551
- Age
- 43
- Location
- Boston
- Medical Student
How does free time work?
I was told that aside from the major holidays, we pretty much have no days off.
So if we were to schedule doctor visits, etc... etc..., all this has to be done on weekends (assuming we have off that particular rotation on weekends) or major holidays?
I was told that aside from the major holidays, we pretty much have no days off.
So if we were to schedule doctor visits, etc... etc..., all this has to be done on weekends (assuming we have off that particular rotation on weekends) or major holidays?
- Joined
- May 8, 2004
- Messages
- 4,269
- Reaction score
- 1,996
- Points
- 5,796
- Attending Physician
yeah that's the bummer about third year, you are expected to be there all the time, and it's extremely difficult to plan anything more than a month ahead of time. your schedule will constantly change month to month, possibly week to week.
most docs are cool and understand if you need to leave for a doctor visit but it can be a real pain.
most docs are cool and understand if you need to leave for a doctor visit but it can be a real pain.
- Joined
- Mar 19, 2006
- Messages
- 958
- Reaction score
- 4
- Points
- 4,551
- Age
- 43
- Location
- Boston
- Medical Student
- Joined
- Feb 4, 2000
- Messages
- 5,910
- Reaction score
- 42
- Points
- 4,626
- Website
- www.pcom.edu
- Resident [Any Field]
- Joined
- Feb 4, 2000
- Messages
- 5,910
- Reaction score
- 42
- Points
- 4,626
- Website
- www.pcom.edu
- Resident [Any Field]
Plan as early in advance as humanly possible.
If you can, plan out the committments BEFORE the rotation starts and make sure you send correspondence to the rotation director, DME or attending as soon as you know when you will be out.
Are most attendings easy going about a doctors appointment? Absolutely.
But you dont want to be in the position where you end up with a grumpy doc who wants to screw you over because he/she is having a bad day.
- Joined
- Jan 6, 2003
- Messages
- 1,641
- Reaction score
- 14
- Points
- 4,641
lots of great advice here.
one other thing I thought about: the walls do have eyes and ears, and you will learn that your residents and attendings may find out about anything and everything you do in the hospital, with patients, nurses, and doctors.
Be polite to everyone even when they are rude to you, never badmouth your attending or resident, and never say something that you would not say if a certain person was in the room with you. If your attending goes on about Dr X for being a bad doctor, you do not participate in this discussion or repeat this to anyone else. If a patient thinks Dr Y is mean and heartless, even if you think it's true, you never agree with them, or you will find Dr Y lurking right outside the room where you are having that discussion. If your intern says resident Z is a real a**, you deflect the comment and grunt supportively, without giving your own detailed opinion.
one other thing I thought about: the walls do have eyes and ears, and you will learn that your residents and attendings may find out about anything and everything you do in the hospital, with patients, nurses, and doctors.
Be polite to everyone even when they are rude to you, never badmouth your attending or resident, and never say something that you would not say if a certain person was in the room with you. If your attending goes on about Dr X for being a bad doctor, you do not participate in this discussion or repeat this to anyone else. If a patient thinks Dr Y is mean and heartless, even if you think it's true, you never agree with them, or you will find Dr Y lurking right outside the room where you are having that discussion. If your intern says resident Z is a real a**, you deflect the comment and grunt supportively, without giving your own detailed opinion.
- Joined
- Feb 4, 2000
- Messages
- 5,910
- Reaction score
- 42
- Points
- 4,626
- Website
- www.pcom.edu
- Resident [Any Field]
Advertisement - Members don't see this ad
- Joined
- Dec 12, 2006
- Messages
- 3,884
- Reaction score
- 3,661
- Points
- 5,251
Actually not bad advice for incoming MS3s. But let me rephrase it for you.
1) Give up your humanity. You are not a person, you are a piece of furniture.
2) Never express an opinion, unless you obtained it from an attending.
3) Do not complain about abuse. Think of yourself as "Mr. Slave" from South Park.
4) Suck **** at every available opportunity.
So sad.
- Joined
- Mar 10, 2000
- Messages
- 169
- Reaction score
- 51
- Points
- 4,661
- Location
- Houston, TX
- Website
- www.thesuccessfulmatch.com
- Attending Physician
There's a lot of useful information in this thread that soon-to-be third years should really take to heart. So far, I haven't seen anyone comment on the importance of the first few days of a rotation. I'm a big believer in using the first few days of a new rotation to your advantage.
In my book, I spend an entire chapter on the first few days of a new rotation. Why? Because I truly believe students can't do their best work until they are comfortable in their new environment. If you think about it, most rotations are about a month. Some students are able to adapt to a new rotation sooner rather than later. In my opinion, that's a major factor in how well a student does. The sooner you get comfortable, the more time you will have to show everyone how with it you are. Those that reach this point later in the rotation may find that it's too late.
Below I have included one mistake from this chapter which I feel is very important.
Mistake # 60 - Staying in observation mode
During the first few days, little is expected of students beyond familiarizing themselves with the rules, responsibilities, and expectations of the new clerkship. Team members sometimes assume that the best way for students to gain this familiarity is to simply observe.
While observing does have its merits, you can't truly reach a comfort level until you start doing what you are expected to be doing. In other words, you must begin the work of patient care. For this reason, you should ask your intern, resident, or attending to assign you a patient from day # 1 of the rotation. Once you are assigned a patient, you can proceed to perform the daily tasks involved in patient care.
You will see that many team members, in an effort to ease you into the rotation, will not assign you a patient. These well-intentioned team members may not realize that observing rather than performing delays students from reaching a comfort level that allows them to do their best work. If you find yourself in this situation, you should inform your team that you want to get your feet wet right away. There is no better way to do so than by picking up a patient on the first day of your rotation.
From Page 61 of 250 Biggest Mistakes 3rd Year Medical Students Make And How To Avoid Them
In my book, I spend an entire chapter on the first few days of a new rotation. Why? Because I truly believe students can't do their best work until they are comfortable in their new environment. If you think about it, most rotations are about a month. Some students are able to adapt to a new rotation sooner rather than later. In my opinion, that's a major factor in how well a student does. The sooner you get comfortable, the more time you will have to show everyone how with it you are. Those that reach this point later in the rotation may find that it's too late.
Below I have included one mistake from this chapter which I feel is very important.
Mistake # 60 - Staying in observation mode
During the first few days, little is expected of students beyond familiarizing themselves with the rules, responsibilities, and expectations of the new clerkship. Team members sometimes assume that the best way for students to gain this familiarity is to simply observe.
While observing does have its merits, you can't truly reach a comfort level until you start doing what you are expected to be doing. In other words, you must begin the work of patient care. For this reason, you should ask your intern, resident, or attending to assign you a patient from day # 1 of the rotation. Once you are assigned a patient, you can proceed to perform the daily tasks involved in patient care.
You will see that many team members, in an effort to ease you into the rotation, will not assign you a patient. These well-intentioned team members may not realize that observing rather than performing delays students from reaching a comfort level that allows them to do their best work. If you find yourself in this situation, you should inform your team that you want to get your feet wet right away. There is no better way to do so than by picking up a patient on the first day of your rotation.
From Page 61 of 250 Biggest Mistakes 3rd Year Medical Students Make And How To Avoid Them
- Joined
- Dec 8, 2006
- Messages
- 90
- Reaction score
- 0
- Points
- 0
- Resident [Any Field]
My best piece of advice would be this: decide what your M3 facade is going to be.
No, I'm not advocating that you walk through the third year 'faking it', but you should be the 'meet your girlfriend/boyfriend's parents for the first time' version of yourself. That means be more conservative than you might be otherwise in both dress and speach. Especially in the first few days of a rotation (ie guys you should shave, gals dry your hair before getting into work). It may seem like it sucks, and it does in some cases, but a lot of third year is subjective and you just have to role with it.
Plus there is no reason to get burned just because you decided to wear blue nail polish.
No, I'm not advocating that you walk through the third year 'faking it', but you should be the 'meet your girlfriend/boyfriend's parents for the first time' version of yourself. That means be more conservative than you might be otherwise in both dress and speach. Especially in the first few days of a rotation (ie guys you should shave, gals dry your hair before getting into work). It may seem like it sucks, and it does in some cases, but a lot of third year is subjective and you just have to role with it.
Plus there is no reason to get burned just because you decided to wear blue nail polish.
This is a great point. Being proactive is a huge part of doing well..
Others have also commented that if you can show (know and make others aware in a non-annoying way) that
a) you're knowledgeable about the patient
b) you've done work to know what do for the patient
c) you know the pathophysiology of their disease and how their comorbities interact
d) you're getting things done (calling radiology to know if the patient can get his CT scan today)
e) asking smart (not bad) questions often (non-annoying) to the attending
f) giving CONCISE and not sleep inducing presentations
you will help yourself a lot.
One can do a-c and not show it... as far as asking bad questions be aware but don't be "quiet" -- I was dinged on one rotation for being too quiet.
Others have also commented that if you can show (know and make others aware in a non-annoying way) that
a) you're knowledgeable about the patient
b) you've done work to know what do for the patient
c) you know the pathophysiology of their disease and how their comorbities interact
d) you're getting things done (calling radiology to know if the patient can get his CT scan today)
e) asking smart (not bad) questions often (non-annoying) to the attending
f) giving CONCISE and not sleep inducing presentations
you will help yourself a lot.
One can do a-c and not show it... as far as asking bad questions be aware but don't be "quiet" -- I was dinged on one rotation for being too quiet.
- Joined
- Mar 10, 2000
- Messages
- 169
- Reaction score
- 51
- Points
- 4,661
- Location
- Houston, TX
- Website
- www.thesuccessfulmatch.com
- Attending Physician
First impressions are very important. During the first few days of a new rotation, your objective is to connect with team members in such a way that you establish comfort, trust, and rapport. A good first impression can set the tone for a successful experience.
Some other things that make 3rd year smooth:
Make sure that you do get in on as many floor-work-procedures as early in the year as possible. This is because by the end of the year, residents may send you to do floorwork that you would have been more "supervised" with in the beginning of the year. I mean things like changing dressings, assessing wounds, removing staples & applying steri-strips etc... you may be doing these things alone very quickly. This also applies to closing surgical incisions & 1st assisting in the OR- try and do it as soon as you can.
Another thing to do is ask your resident/intern (at the right times) if there is anything else you can do to help them out. If you read people well, it's pretty easy to tell if you should or should not be "hanging out" with them. So, instead of hanging around, you just ask "is there anything else I can do to help you/the team"? Then you excuse yourself to study, go to clinic, whatever...but usually they will excuse you 1st, because you have asked. You can read nearby if appropriate and they know you are there. This rule only applies to the ones who will not scut you incessantly, but even those usually run out of things for you to do (because to an extent we often slow them down). Asking if you can help is a great way to kind of retain your dignity during third year, because instead of trying to read someone's mind (who isn't even thinking about you) or wait around for for something that might not ever transpire, you can (kind of) organize your time.
I think that all of the comments in this thread are basically correct, and this is why, as my other posts suggest- I think third year is somewhat ludicrous. You will learn a lot as the year progresses, but the structure, or lack of it, in which the learning transpires has been a let down to me. There is an enormous amount of wasted time, and you will be the one paying for it. I wish someone had told me this so I would have been more mentally prepared for it. It's just the way third year is right now. Somehow accepting that it's kind of ridiculous has made it mentally easier for me. And even though it's odd to be a third year, you will learn a lot.
Make sure that you do get in on as many floor-work-procedures as early in the year as possible. This is because by the end of the year, residents may send you to do floorwork that you would have been more "supervised" with in the beginning of the year. I mean things like changing dressings, assessing wounds, removing staples & applying steri-strips etc... you may be doing these things alone very quickly. This also applies to closing surgical incisions & 1st assisting in the OR- try and do it as soon as you can.
Another thing to do is ask your resident/intern (at the right times) if there is anything else you can do to help them out. If you read people well, it's pretty easy to tell if you should or should not be "hanging out" with them. So, instead of hanging around, you just ask "is there anything else I can do to help you/the team"? Then you excuse yourself to study, go to clinic, whatever...but usually they will excuse you 1st, because you have asked. You can read nearby if appropriate and they know you are there. This rule only applies to the ones who will not scut you incessantly, but even those usually run out of things for you to do (because to an extent we often slow them down). Asking if you can help is a great way to kind of retain your dignity during third year, because instead of trying to read someone's mind (who isn't even thinking about you) or wait around for for something that might not ever transpire, you can (kind of) organize your time.
I think that all of the comments in this thread are basically correct, and this is why, as my other posts suggest- I think third year is somewhat ludicrous. You will learn a lot as the year progresses, but the structure, or lack of it, in which the learning transpires has been a let down to me. There is an enormous amount of wasted time, and you will be the one paying for it. I wish someone had told me this so I would have been more mentally prepared for it. It's just the way third year is right now. Somehow accepting that it's kind of ridiculous has made it mentally easier for me. And even though it's odd to be a third year, you will learn a lot.
