Entering 3rd year, what was your confidence level...

[Mr. Peanut]

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I'm asking because at 6 months from entering clinicals I'm finding I have next to no practical medical knowledge... at least it seems that way. I do pretty well on our preclinical tests and I know this stuff in a way that'll be fine for step 1 multiple choice (I hope anyway), but I have trouble answering even basic open ended practical questions.

I'll be spending the next few months in our school clinic and reviewing for step 1, so I'm expecting to be in better shape going forward... but, I don't know what I could offer any patients at this point.

Anyway, just wondering if I'm the exception or if this thinking is par for the course. How incompetant do they expect new 3rd years to be?

 

[raspberry swirl]

as a third year, you're not expected to know anything. rejoice. use it to your advantage "oh im just a third year" became my mantra. its inbetween third and fourth year, suddenly in one night you're suddenly supposed to know stuff. you'll find that you become more confident once you've studied for and taken step I. as a third year, you really only need to be responsible for that basic material, as someone may pimp you on something. and usually its not that big of a deal if you get questions wrong. you're certainly not expected to manage patients all by yourself, but if you can make some educated guesses and recommendations, it will work in your favor. i was a bumbling idiot my first few months of third year, and haven't gotten a bad eval yet (knock on wood). relax, dont worry about rotations, and focus on studying.

 

[Adcadet]

I feel like a total ***** almost every day, and I feel like I know waaaay less than I did when I took Step 1.

 

[orientedtoself]

Yeah, there's really no good way to prepare for third year other than just being thrown into it. It's tough because what is expected of you changes with each rotation. And once you have figured out exactly what you need to do and how to do it, it's time for another core rotation.

Must haves in a 3rd year's coat pocket:
* PDA with Epocrates +/- Taracson Pocket Pharmacopoeia
* Maxwell Cards
* Sanford Guide to Antimicrobial Therapy (table on p. 52 is key)
* Penlight
* Stethoscope

I would also recommend looking over the "How to be a Truly Excellent Junior Medical Student" pocket book before each rotation to see templates of what your notes should look like.

 

[sophiejane]

Yeah, i liked that little book, although reading it certainly doesn't make you excellent, it helps you focus on what's important.

Basically, if you are organized, on time, try hard, are pleasant to work with, and read a little every day, you will be a success on the wards. Don't get bummed when you get questions wrong--just remember that pimping is a time-honored (though maybe not terribly effective) means of TEACHING. See it that way and not as a personal insult and you are ahead of the curve.

Also, "your patients" are also being seen by at least one intern, resident, upper level resident, and attending. You are not alone and you don't really have anything to offer them, you're right. You CAN take an excellent history, do a satisfactory physical exam, and advocate for good care for your patients. If you do all that, you are WAY ahead of the curve.

Third year is a humbling experience. The sooner you are okay with that, the sooner you will get on to the real business of the year, which is soaking up all you can.

 

[Dr Alo]

Don't sweat it. None of us really know anything. We will be students of medicine for our entire lives. Be humble and always try to learn. People will coddle you and walk you through everything. Just enjoy the ride!

 

[Mr. Peanut]

Thanks for the responses. If they expect me to know very little... then they'll be getting about what they bargained for 🙂. Good to hear that I won't be alone in this.

 

[oompaloompa]

maybe we should start a thread about people 6 months into their third year and still feel like they have next to no practical medical knowledge, 'cause that's definitely how I feel. Ditto to the person who feels like a ***** every single day. Is this really normal, or am I just a friggin idiot? (you can be honest) also is it a bad sign when have less of an idea of what you want to go into than you did before?

 

[serenity head]

Try your hardest to get IM, Peds, or family practice for your first rotations. I had peds and had an awesome transition from boards to clinicals. It is especially rewarding if your preceptors throw all those zebras at you that we have studied for the past couple of years. Just step up to meet as many patients as you can, dont be passive or you wont get any of the good cases. I found I haved gotten very lazy in my interviewing skills because I just finished an ortho elective and gyne surgery....I havent used a stethescope in months. So obviously floor/primary care work will serve you best early on in your 3rd year.