Hey Y'all,
did a search and wasn't able to find too much info on my question. How does one go about honoring a rotation? I know that there is a shelf exam that you take after each rotation and you also get graded by whoever you preceptor. Are both grades weighed equally? Is it school dependent? Also, how do y'all approach studying for the shelf exams?
This is highly variable.
In terms of how to do to it, at my school, per rotation, we have a clinical commendation and a academic commendation. Score 85% or higher in evaluations which consist of residencies/attendings rating you 1-5 in 12 competencies and you receive clinical commendation. Score above the set point each course director sets (usually 0.5-1 SD above mean) on the shelf and receive academic commendation. Achieve both and that's honors. Some rotations have more to do like for Surgery there's an Oral Exam and Written exam which comes to play. Sometimes, there are also assignments you have to do and if done well (happened to a friend) they'll bump you up if you're close in some areas, but otherwise will just be completion.
In terms of advice, for the shelf there are so many threads on SDN/Reddit that outline the main consensus for the materials and they're pretty good. I would say daily studying trumps cramming. Honoring shelfs is not easy but not super difficult either and Step 1 isn't necessarily the best predictor so have confidence in yourself. Everyone will have different opinions on shelf difficulties based on personality and order. I personally thought IM was not bad and that FM was the easiest and that OB was the hardest. Others disagreed.
For achieving clinical commendations, this is super subjective. For some of the nicer residents, just be a good person to work with (common sense like no complaining, don't interrupt them, etc.). With most residents/attendings you should also know your **** so you appear knowledgeable when pimped which comes from daily study, and before each Clerkship starts I would say come up with a way to organize your patient presentation. This requires you to figure out what's pertinent to ask for the patient population you're about to examine (GPs for OB, milestones in kids, etc.) and also importantly what order it is presented in because whether it's fair or not, organization is the most common criticism in med student presentations. Some will say this is overkill/a waste of time, but on more than one occasion this has helped me make a solid first impression which reflected in my eval. That's about all I can think of that's worth doing.
A quick note that may be common sense but is still frequently done:
Take criticism humbly! When you work hard to do all the above and your resident/attending doles out constructive criticism that you know is wrong or that you don't agree with, it's sometimes hard to resist a little "yeah I said that at the beginning" when the attending tells you you missed something or "I thought it was like X because we learnt this in lecture" but just learn to keep your mouth shut to preserve your likability and because there's a good chance that there's some element of truth to what they're saying even if they're technically wrong. For example, if the attending didn't hear the PMH maybe your organization needs to be changed (hint in IM, it's right after their name and chief complaint as opposed to after HPI and ROS). I have never seen disagreeing with your resident having a positive impact and don't do it unless it's potentially immediately about to harm a patient as in the resident grabbed the blatantly wrong drug to administer. Even something you think you know from Step 1 like a medicine contraindication can be discussed as an aside later with the pharmacist/resident while rounding because you'll find Clinical Medicine often differs from Exam Medicine for many reasons.
