Hey all. I wanted to ask about you guys' experience as MS3/4 going through clinical rotations and maybe get some advice. It's my third month in and I'm having mixed feelings about working with residents and attendings. I had a great time with one of my surgery teams -- woke up super motivated every day and looked forward to going in even on weekends. I really felt like I was part of the team and was making contributions to patient care. But on both my other services, I've had a hard time feeling comfortable/accepted. I ask a lot of questions and am very motivated to help the team out, but when I wake up in the morning and think about being ignored or dismissed, I just want to give up. I called in "sick" the other day just because I didn't think I could handle a day of trying to suck up (and failing) to residents who were completely uninterested in me. I don't mind doing bitch work and I don't mind the hours, but this feeling of social rejection is really getting me down. I feel awkward and disliked at every turn, and the feeling sucks.
Is anyone else having this experience? Has anyone gone through this and have advice?
I thought third year of medical school was one of the longest and most depressing years of my life. That feeling of dreading going into the hospital every day is all too familiar. I too started third year with a great attitude, only to develop that "what's the point feeling" early in the clinical years. I am glad you managed to get through three months before it set it. I started on Ob/Gyn, so my soul was crushed within 4 hours of arriving at the hospital.
I am now the senior resident at my program, so I have run the full gamut of all the rotations. Some things never change no matter where you are, but I have come to realize that student, intern, and resident experience is more about hospital culture than anything else.
Some thoughts:
- Most of the residents are just trying to stay afloat themselves. The interns are brand new this time of year, so they are pretty much drowning. The junior residents are also new to that role and sudden uptick in actual responsibility, so they are preoccupied. The senior resident (like me) are now seasoned veterans of not being around unless necessary, so you don't see them as much. This is a tragedy because they are the ones who can actually teach a student something real.
- Interns are lousy sources of learning. They are newbies. You should beware of the intern who seems like they know everything (this is true if you are a patient as well!) Some of them are very smart, but all of them are inexperienced. Ironically, the medical students seem to spend most of their time paired with an intern, which is just stupid. It's like the blind leading the blind. Hanging around the intern all day is a guaranteed way to get the least out of your rotation. I mean...arn't you sick of watching them type progress notes already?
- The senior resident on the service is the person you want to pay attention to. Ask them to text you whenever anything cool is going on. Tell them you want to stay in the loop, but it's hard because students are often an afterthought. Ask them to go see any new patients first, and if you can present them to the senior separate from the intern, so you can get some practice. Not all seniors are approachable or available, and often that is just the way it is, but I had several amazing senior residents who I remember fondly to this day, and they really can turn a rotation around.
- you need to be reading....I am NOT talking about studying for exams ( you need to pass the exams too). I am talking making the connections between clinical practice and academic medicine. This comes from reading up about cases. This advice is is true when you graduate and are an intern, when you become a resident, and when you are an attending. You are still a newbie, but soon you will develop an eye for who is a good doctor or not, and the defining characteristic is that the bad doctors don't read, and are not up to date. If you are NOT reading, it will show. No one likes the medical student who is too stupid or lazy to read about something, and tries to cover up their knowledge by being buddy buddy, Drives me crazy. Don't be that guy.
- Start to focus on the Assessment and Plan. Identify the problems the patient has, and what interventions we are doing to fix them. Taking this step into the larger world is critical to making the transition into clinical medicine
- If you want skills, you need to be aggressive about getting them. If nothing is going on, see if you can go down to ER and start some IV's. I am now really good at starting IV's, because I have done hundreds. This required me asking a lot of nurses for help, I often got rejected. I often got laughed at. I made some damn bloody messes out of a few of them. Some patients had a less than good experience.....O well. Now I am the guy who can get any IV, especially with an ultrasound (havn't missed one in two years).
- Realize that it will take years to fully develop into what you want to be, the journey is hard, its depressing, but in the end totally worth it. I remember feeling just like you did. I remember thinking only about when it would end. I remember drinking too much. I remember being bored out of my F'ing mind, sitting in the library doing nothing while my team who paid students no attention was whoknowswhere. It's been 5 years since then, and now I make the calls. I walk in and the Attending says "Thank God your here, the department is a mess" It's kinda fun really. You will get there too.
