For the new M3s...

[mules05]

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I was looking through the thread with the rant about lazy med students, and I'm sure I'm not the only one who would hate to have people thinking those things about me. So I'm wondering if residents have any pearls of wisdom for the new M3s (like me!) who will be starting on the wards in a few weeks. What should we know before starting?

 

[colbgw02]

Was it Woody Allen that said that 80% of success if showing up? It sounds overly simplistic, but truthfully, if you can just show up on time everyday, then you're well on your way to being a good MS3.

Also, never ask to go home, but if told to go, don't ever, ever stay.

 

[eastcoastyall]

Things that drove me nuts as a med student...

1. Never complain. About anything. Especially around the residents who are working way harder than you under more stress (whether or not you realize it).
2. Never make your fellow medical students look bad. In fact, do everything you can to help them and make them look better. You will get more out of the rotation as a team.
3. Don't show up your residents. If they are asked a question and don't know the answer, then neither do you.

 

[pillowhead]

Was it Woody Allen that said that 80% of success if showing up? It sounds overly simplistic, but truthfully, if you can just show up on time everyday, then you're well on your way to being a good MS3.

Also, never ask to go home, but if told to go, don't ever, ever stay.

Seriously, 90% of 3rd year is being in the right place at the time, being dressed appropriately, and not being rude or whiny or condescending to other members of your team. And never ever lie. If you don't know something or forgot to ask or exam something, just say so. Never say something is normal if you didn't look.

 

[elizabeth5863]

Skim through the relevant section in First Aid for the Wards before starting a particular rotation. (Other classmates of mine liked Boards and Wards and read a few pages here and there during down time on the rotation). Remember to read (If you can do 1 hour each day, that's great). Be interested and ask questions. Ask residents if there's something you can help with. Pay attention to how residents present their pts and always try to come up with a management and plan (even though it may not be correct. Residents and attendings like to hear that you're thinking). Follow-up on your pt's lab results/tests and let your residents know if there's anything abnormal. (They usually know beforehand but like to know that you care about your pts). Help your fellow colleagues and enjoy your time as a med student. Don't ever complain about how tired you are or how much work there is to do. Good luck!

 

[southerndoc]

Was it Woody Allen that said that 80% of success if showing up? It sounds overly simplistic, but truthfully, if you can just show up on time everyday, then you're well on your way to being a good MS3.

Also, never ask to go home, but if told to go, don't ever, ever stay.

I failed 2 visiting students during an off-service rotation. They were unreliable about seeing patients in the morning, would disappear without telling anyone during the day, and two days of the rotation they didn't show up and actually had the nerve to tell me they didn't feel like working that day!

 

[Smurfette]

Things to NOT do (true examples that I have had students do):

1. ask to go home, especially when on overnight in-house call
2. refuse to see a patient, especially if they are to be admitted onto your own service
3. tell your senior resident that seeing/admitting a patient is not educational for you, especially before knowing ANYTHING about said patient and why they are being admitted
4. make up vital signs
5. make up lab results
6. say you know how to do a procedure if a. you don't and b. you've never even seen it before
7. leave in the middle of the day without telling anyone or asking permission, especially when you have somewhere you are expected to be
8. lie about having a lecture and needing to be excused (as if when we see students on other services on the same rotation as you hanging around we will not figure it out?)
9. arrogantly tell a resident that you are smarter/more connected/ wealthier/more whatever than anyone else and are "guaranteed" honors or a supercompetitive residency spot
10. be a gunner. [yes, as a resident we may tolerate this behavior, but since we too were med students once, we recognize and don't appreciate it. And so do *most* attendings. Be helpful and on top of your game, but don't steal other students' accolades or show them up intentionally]

DO:
1. be eager to see, do and learn
2. fake it if you aren't actually eager (this is a life skill....)
3. be honest, especially with anything and everything having to do with patient care
4. pay attention to what residents do, what the plan for each patient is and so on. Even if it's not your patient. Consider it practice for 2 years from now when you are cross-covering 50 patients and are juggling a bizillion things...see how the residents do it, how they keep track of what they have to do, and what info about patients they are cross-covering they write down so they don't "learn the hard way". This doesn't mean you have to take care of these other patients, it's just another way to gain perspective and learn how different people multitask.
5. remember your residents and interns are learning too. We don't know all the answers and we make mistakes too.
6. listen to your residents telling you to read up on things or pimping you. Quite often, the residents KNOW what the attending will ask you about and are trying to make sure you look good to the attending.
7. expect to work long hours. It is what it is. Bring a pocket book to read if you may be spending time waiting around. Keep in mind that the hours you work as a med student are still shorter than the hours the residents work (when they send you home is not usually when they leave, they usually have more work to do).
8. Make sure your team knows where you are and how to get a hold of you while you are in the hospital. Because the one time you don't, you'll end up wishing you had.

 

[elizabeth5863]

Also ask for feedback on what you can improve on when it's mid-rotation or sooner.

 

[werewethere]

Also ask for feedback on what you can improve on when it's mid-rotation or sooner.

Second that thought! Make sure that they give you concrete suggestions and ideas. For instance, if your evaluators think you should be studying more, ask for an opportunity to look up and present relevant information to the team formally (assuming time allows, which is rotation dependent). The "you're doing ok/fine/excellent/great" is meaningless.

 

[Hoo\/er]

DO:
2. fake it if you aren't actually eager (this is a life skill....)

What a joke. Why should anyone "fake" being excited about something that they clearly aren't excited about? To impress the attendings, residents, or the "team?"

If you're not excited about it, the residents and attendings shouldn't care one way or the other. Only if you're overly concerned about a written comment or a slight hit to your grade should you be faking anything. Personally, I'd rather keep my pride versus 5 points on some stupid rotation. I didn't like my rotations, but I showed up and got my work done. That's all that should matter. They should be evaluating you on your ability to get stuff done instead of focusing on whether or not you're "enthusiastic."

I don't think faking eagerness is a life skill. This should more accurately be filed under the kissing @ss category. Kissing @ss will get you only so far in life. After that is when the real life skills come into play.

 

[loveumms]

Be real. Don't act like someone you are not. Have fun with your team but, maintain a professional attitude. You would be suprised about how much residnets hate students who can't act normal (just think about that gunner med student in your class - I'll be that many of the residents will secretly talk about that person).

Don't ever bad mouth anyone ... unless they have done something horrendous and you are afraid that it will come back to bite you in the butt. Then make sure you talk to your senior before going to the attending.

Don't read while on table rounds - yeah, some of my fellow med students actually did this and it looks SO unprofessional (not to mention rude).

If your residents tell you can leave early then make sure to ask if there is anything you can do before you leave. But, don't stick around after you have been told to go b/c you feel bad - they know you have to study.

Make sure to know your patients WELL. You don't have to have everything memorized but, keep a note card with all the important stuff on it. Your team will love you if you keep up with your patients.

NEVER, and I mean never step on your fellow med students. Working together makes you look so much better then working against each other. Make sure you at least know about your colleagues patients and if you see that they missed something or you know something about their patients that they don't make sure you don't ever throw it in their face. Mention it to them in private and don't be a jerk about it. Never make your colleague look bad on rounds and if they are presenting, go get the chart for them in case they forgot to get it. It makes you look like a team player - and in medicine that is very important.

You don't always have to be happy but, try and act interested when it counts. Resdients and attendings know (well, for the most part) that you don't want to do every aspect of medicine. But, showing up on time and acting like you care (even if you don't) will go a long way.

Get as much sleep as you can, study whenever you have down time (which is A LOT in the hospital) and just remember that the year will fly by!

And finally - like others have said, don't ever lie. Everyone in the hospital, down to the janitors, know you are a medical student and that you are learning. The team will think much higher of you if you admit that you don't know something then if you make it up and it later causes harm to the patient. Most of the time what you don't know, your resident will.

 

[raidermedic]

Things that drove me nuts as a med student...

1. Never complain. About anything. Especially around the residents who are working way harder than you under more stress (whether or not you realize it).
2. Never make your fellow medical students look bad. In fact, do everything you can to help them and make them look better. You will get more out of the rotation as a team.
3. Don't show up your residents. If they are asked a question and don't know the answer, then neither do you.

#2 and #3 are good advice on how to be a nice person but from what I've seen people who do show up residents and fellow medical students get stellar evals. I never did out of common courtesy but had I known being a prick was a good way to get high honors I may have sold out and done it.

 

[sophiejane]

#2 and #3 are good advice on how to be a nice person but from what I've seen people who do show up residents and fellow medical students get stellar evals. I never did out of common courtesy but had I known being a prick was a good way to get high honors I may have sold out and done it.

I've often wondered if this is why the people who land the most competitive residencies are sometimes the biggest a-holes.

Case in point: there is an individual in my class who got multiple academic awards, scholarships, aced all of her boards, rotations, etc.

On the day of our graduation, she was overheard in the bathroom making very derogatory and rude comments about another classmate, who actually happened to be in the next stall.

She landed a great residency in OBGYN, by the way. I pity her future colleagues.

 

[colbgw02]

I've often wondered if this is why the people who land the most competitive residencies are sometimes the biggest a-holes.


She landed a great residency in OBGYN, by the way.

If you're going to answer your own questions, then...




(Sorry, couldn't resist a chance to take a shot at the OB/GYNs)

 

[Coastie]

I've often wondered if this is why the people who land the most competitive residencies are sometimes the biggest a-holes.

Case in point: there is an individual in my class who got multiple academic awards, scholarships, aced all of her boards, rotations, etc. She had a way of making everyone think she was America's Sweetheart, and smart, too.

On the day of our graduation, she was overheard in the bathroom making very deragoatory and rude comments about another classmate, who actually happened to be in the next stall.

She landed a great residency in OBGYN, by the way. I pity her future colleagues.

An OBGYN gossiping? NEVER!



Be cool, study, know your patients, and , oh, be a cool person. MS3 isn't that hard, but certain interns and residents can make it so. Avoid those tools.

Good luck 👍

Coastie, M.D. - PGY 1 in June

 

[mlw03]

Be cool, study, know your patients, and , oh, be a cool person. MS3 isn't that hard, but certain interns and residents can make it so. Avoid those tools.

just finished MS3 - agree with the be cool part. just be a normal, decent person and that'll get you through the majority of the year. plus, if you scratch their back they should scratch yours. also agree with the know your patients part - and that doesn't mean anything crazy. just try and talk to them like a normal person and you'll pick up the relevant stuff. then when the attending asks, "can we discharge this person home before 11am today?" you can reply, "well, he's medically ready but his son can't get here until the afternoon" and that kinda crap makes you look really good for whatever reason.

coastie is also right about avoiding the tools whenever possible.

 

[CouchPotato]

#2 and #3 are good advice on how to be a nice person but from what I've seen people who do show up residents and fellow medical students get stellar evals. I never did out of common courtesy but had I known being a prick was a good way to get high honors I may have sold out and done it.

I never quite agreed with this one. I noticed many attendings get frustrated if no one on their team knows an answer, and I was never offended or took it personally if a fellow student knows the answer, I think it makes us look smarter as a group. If it works perfectly, the attending should ask the M3s first, and then ask the interns, residents, etc, so no one is showing anyone else up. I believed we were always graded as a team; if I did well so did the other people on my team, and vice-versa. It would need to be done tactfully, though. Also, I tried to spend a few minutes discussing key points with fellow students every day, so we shared more of the same knowledge base.

You do need a good relationship with your teammates (students and residents alike) first, so they don't take offense.

 

[ForbiddenComma]

As a note to the residents... please please PLEASE be honest and communicative to your students about how we are doing. Give us an atta-boy or two if we're doing well, and more importantly, let us know if we're screwing up.

Nothing worse than the resident who smiles and is really nice to your face... and then shanks you on the eval.

 

[Coastie]

just finished MS3 - agree with the be cool part. just be a normal, decent person and that'll get you through the majority of the year. plus, if you scratch their back they should scratch yours. also agree with the know your patients part - and that doesn't mean anything crazy. just try and talk to them like a normal person and you'll pick up the relevant stuff. then when the attending asks, "can we discharge this person home before 11am today?" you can reply, "well, he's medically ready but his son can't get here until the afternoon" and that kinda crap makes you look really good for whatever reason.

coastie is also right about avoiding the tools whenever possible.

Yes, and doing surgery at a certain VA is a great way to spend 3rd year.

 

[Blade28]

Things that drove me nuts as a med student...

1. Never complain. About anything. Especially around the residents who are working way harder than you under more stress (whether or not you realize it).
2. Never make your fellow medical students look bad. In fact, do everything you can to help them and make them look better. You will get more out of the rotation as a team.
3. Don't show up your residents. If they are asked a question and don't know the answer, then neither do you.

Good advice. 👍

 

[Hershi]

what are normal hours like for a ms3?

 

[werewethere]

what are normal hours like for a ms3?

All over the map, depending on the rotation and location. Try asking people at your school who have rotated at the sites you'll be rotating. As a guideline with my own experience in parentheses, Surgery (80-110) > OBGYN (60-80) > IM (50-70)>= Peds (45-65)>=Family(35-50)>>Psych(35-50, but just because I felt guilty. I could have made it 10 or less)