For the third years and beyond, What determines if you get a strong LOR from clerkship directors?

[TraumaLlamaMD]

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I wish there were more men in nursing, not to sound sexist but men usually don't get into playing stupid little mind games.

Case in point on self censorship. You're in for a long 4 years.

 

[mcloaf]

not to sound sexist but

This is usually a reliable phrase to identify sexism.

 

[Ismet]

I wish there were more men in nursing, not to sound sexist but men usually don't get into playing stupid little mind games.

Stop.

 

[giantswing]

I wish there were more men in nursing, not to sound sexist but men usually don't get into playing stupid little mind games.

When you get to third year please know it's ok to address female attndings by their first names. Only females tho. They like the familiarity.

 

[redpanda]

I wish there were more men in nursing, not to sound sexist but men usually don't get into playing stupid little mind games.

Ahahahahaha. Social niceties are not a mind game. Next thing, you'll tell us that only men are capable of making decisions without being clouded by their emotions, because wiminz and their emotions dirtying everything up.

 

[Meh.meh]

I wish there were more men in nursing, not to sound sexist but men usually don't get into playing stupid little mind games.

...........................................................................:troll:

 

[DermViser]

But what if the nurses aim is to make your life a living hell just because?

You are going to get along smashingly on the wards.

 

[DermViser]

Some nurses here are known to be that way

Your much bigger concern with respect to bad interactions should be with med students willing to throw you under the bus, and your interaction with interns and residents. The nurses, as a whole, will be the least of your problems.

 

[DermViser]

I can't even.

He's the URM version of Ark.

 

[DermViser]

Stop.

I can't wait till EMDO2018 has to interact with the residents on OB-Gyn.

 

[fancymylotus]

He's the URM version of Ark.

Truth

 

[DermViser]

Truth

Him and Ark on OB-Gyn. LOL!

 

[alicealicealice]

Read around your patients. Know not just them but their disease and medications inside out. This is the detail stuff. Diabetic? Even if not related to their CC know which insulin are rapid, short, intermediate, and long acting. Know the orals and their MOA (eg on sitaglipton...know How does it work). Know which one cause hypoglycemia and which don't. Know if any of the meds could be contributing their CC via side effects. Be able to explain every abnormal lab value, just in case. Don't let things like hyponatremia, anemia, Etc go even if the patient is at "baseline" without having an explanation. Then Ask yourself not just whats the diagnosis and treatment but WHERE the patient is going clinically. Take in the 3000 foot view. Sure its a CHF exacerbation consistent with prior. But the honors student will not just say that...they will say this is the patients 6th admission in the past year and here is why I think she is decompensating so often and here is my attempt at a plan to fix it. Have an article ready that provides the evidence for your plan.
Don't just say continue abx started in the ED, say I'm using X abx to cover Y bugs that are most likely because they are the most common causes of Z infection and I plan to continue them for X number of days. Know if and when you can transition to PO abx and which ones you would choose. If not will this patient have to go home with a PICC line or can they get Home services? You don't need to get all this right but if you show this is how you are thinking...then the seemingly random pimp questions won't seem so random and you'll be getting an excellent letter. It's possible to do all this bc you will have max 3-4 patients maybe 5 as a sub I. So read till you know it inside and out. After working with an attending you get to know their interests. For example a cards attending may gloss over the diabetes stuff but an endocrine or generalists may spend more time on that.

Sure an attending may still crush you w pimp questions that really are random. But in general you will perform well, and it's the average performance that matters. You remember that one q you got wrong because you didn't know what a hamptons hump is, but your attending will remember you as a solid student who did what was expected and then some.

Expectations are adjusted for your level, but you can always exceed them by covering the basics as well as you can (no literature search will make up for a crappy h and p) but look towards your interns and residents to see how people at the next level think and as you feel comfortable start saying in your mind, if I had more responsibility like them what would I do, what would I need to know? You will NOT get it all right but attempting and attempting using a rational evidenced based approach is how you will learn and how you will impress da most.

Good luck

 

[DermViser]

But what defines "acting better than them". I'm nice and respectful to people but I am naturally sort of standoffish, I don't like small talk and kissing people butts.

What do you mean you're standoffish? You're a med student. On the wards your level of contribution to everything overall is nothing.

 

[TraumaLlamaMD]

I have seen students who are naturally quiet, who are more likely to research questions on their own rather than ask aloud or offer to present information, get mistaken for being uninterested. You don't have to be the life of the party on the wards, but don't let this happen to you.

 

[Pacna]

Read around your patients. Know not just them but their disease and medications inside out. This is the detail stuff. Diabetic? Even if not related to their CC know which insulin are rapid, short, intermediate, and long acting. Know the orals and their MOA (eg on sitaglipton...know How does it work). Know which one cause hypoglycemia and which don't. Know if any of the meds could be contributing their CC via side effects. Be able to explain every abnormal lab value, just in case. Don't let things like hyponatremia, anemia, Etc go even if the patient is at "baseline" without having an explanation. Then Ask yourself not just whats the diagnosis and treatment but WHERE the patient is going clinically. Take in the 3000 foot view. Sure its a CHF exacerbation consistent with prior. But the honors student will not just say that...they will say this is the patients 6th admission in the past year and here is why I think she is decompensating so often and here is my attempt at a plan to fix it. Have an article ready that provides the evidence for your plan.
Don't just say continue abx started in the ED, say I'm using X abx to cover Y bugs that are most likely because they are the most common causes of Z infection and I plan to continue them for X number of days. Know if and when you can transition to PO abx and which ones you would choose. If not will this patient have to go home with a PICC line or can they get Home services? You don't need to get all this right but if you show this is how you are thinking...then the seemingly random pimp questions won't seem so random and you'll be getting an excellent letter. It's possible to do all this bc you will have max 3-4 patients maybe 5 as a sub I. So read till you know it inside and out. After working with an attending you get to know their interests. For example a cards attending may gloss over the diabetes stuff but an endocrine or generalists may spend more time on that.

Sure an attending may still crush you w pimp questions that really are random. But in general you will perform well, and it's the average performance that matters. You remember that one q you got wrong because you didn't know what a hamptons hump is, but your attending will remember you as a solid student who did what was expected and then some.

Expectations are adjusted for your level, but you can always exceed them by covering the basics as well as you can (no literature search will make up for a crappy h and p) but look towards your interns and residents to see how people at the next level think and as you feel comfortable start saying in your mind, if I had more responsibility like them what would I do, what would I need to know? You will NOT get it all right but attempting and attempting using a rational evidenced based approach is how you will learn and how you will impress da most.

Good luck

The fact that you'd give such a complete, honest, helpful response to this person after their comments, with no mention of even excusing them, is truly admirable. If more people like yourself contributed to these boards, SDN would have a better reputation. Thank you.