I just crawled out of Step 1 solitary confinement. My first rotation (Family Medicine) is in a week and my school is already e-mailing me about signing up for Step 2. I have no clue as to what I'm supposed to use to study for my shelf and for Step 2. How do I split my study time? Can someone explain 3rd year to me like I'm a complete idiot?
How to approach 3rd year?
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Here was my Facebook status the other day, "MSIII and MSIV are like 'Who's Line is it Anyway?' where the scores are made up and the points don't matter."
That's how you should approach it. It's a giant game that's a total waste of time. Everyone from here out is going to say, "act like you're interested." That's exactly what it is...Acting. Acting like your evaluator's profession is THE most interesting thing in the world because to them, it is. If you ARE actually interested, even better...Try to learn as much as you can, don't be annoying, and don't step on your classmates toes. Try to figure out what you want to do with the rest of your life. Those are the goals of third year.
When I started going caring less about what was going to be written on my evaluation and more about having fun and learning, I started learning more and having more fun. Amazing how that works. Also, my evaluations didn't change. It's always, "Good student. Good rapport with patients. Writes solid histories. Etc." No one is going to go out of their way to write a bad evaluation unless you're truly bad, or you make them mad for some reason.
That's how you should approach it. It's a giant game that's a total waste of time. Everyone from here out is going to say, "act like you're interested." That's exactly what it is...Acting. Acting like your evaluator's profession is THE most interesting thing in the world because to them, it is. If you ARE actually interested, even better...Try to learn as much as you can, don't be annoying, and don't step on your classmates toes. Try to figure out what you want to do with the rest of your life. Those are the goals of third year.
When I started going caring less about what was going to be written on my evaluation and more about having fun and learning, I started learning more and having more fun. Amazing how that works. Also, my evaluations didn't change. It's always, "Good student. Good rapport with patients. Writes solid histories. Etc." No one is going to go out of their way to write a bad evaluation unless you're truly bad, or you make them mad for some reason.
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I'm a new 3rd year myself but I'll pass on some advice a 3rd year resident gave me the other day. According to him, there are three objectives to third year.
1) To study and learn the material for the shelf exams so when Step 2 rolls around you are ready.
2) Learn to take a great history and perform a good physical. He says that by the time you become an intern, it's really too late to go back and learn these things really well because there are soo many other things interns need to accumulate quickly to do their jobs.
3) Start to narrow down your career choices so you can plan 4th year accordingly.
1) To study and learn the material for the shelf exams so when Step 2 rolls around you are ready.
2) Learn to take a great history and perform a good physical. He says that by the time you become an intern, it's really too late to go back and learn these things really well because there are soo many other things interns need to accumulate quickly to do their jobs.
3) Start to narrow down your career choices so you can plan 4th year accordingly.
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For Internal Medicine (and its subspecialties), the residents/fellows/attendings all have read MKSAP and base all of their pimping based solely on MKSAP.
How? As a student I was a top notch test taker and review book reader but always ran into certain topics I never learned about.
Now that I am a resident and I am reading MKSAP16, i find this is exactly where they get their pimping material from;
good luck
How? As a student I was a top notch test taker and review book reader but always ran into certain topics I never learned about.
Now that I am a resident and I am reading MKSAP16, i find this is exactly where they get their pimping material from;
good luck
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Is 15 any different from 16?
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Bend over, grab your ankles, and enjoy the ride......🙂
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If you learn on the wards/clinics, and prepare for your shelf exams, CK will be in the bag. As far as finding time to study, you can squeeze time during the day when there is downtime. Unless you are in the rare moment where you are running left and right(i.e. heavy patient load in the clinic/ED), you can find an hour or two to read. IM and Peds inpatient for example, has some downtime after morning rounds that you can knock out some reading. Same with OB...there might be some downtime that you can read a bit. In the outpatient settings or in the ED, if there is a lull in patient charts, take out a book and read about a topic. Surgery and GYN can have a good amount of downtime despite these rotations having tough hours.
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My perspective now as an ER newly minted PGY2...
No matter what you do as an MS3/4, you really have no significant impact on the medical aspects of patient care. You'll feel like you do, and that you're going to screw up and the patient will be affected.
This is not going to happen. So don't focus on making "decisions" and focus on making the patient a case study about their disease.
Learn how to make the patient comfortable with what's going on. Imagine what it would be like talking to an auto mechanic when you don't even know what a "V8" actually means. You've heard the term before and know it means something about power and the engine. You can nod and agree to things and say you understand, but that doesn't mean you really have an idea about what it all means.
Think about it from a patient's perspective. How would you explain something like new onset a-fib to your mom, dad, or grandparent? Think about the things that a patient wants to know but may not be able to verbalize.
"Does this mean someone is going to come take some blood? How is this going to change my life after I leave this hospital room? Am I going to see you again tomorrow? Am I allowed to eat dinner today?"
Learn how to actually sit down and talk to your patients about things that aren't in a computer template.
I'm sure you're make it through, but don't lose focus on the non-textbook parts of being a physician.
No matter what you do as an MS3/4, you really have no significant impact on the medical aspects of patient care. You'll feel like you do, and that you're going to screw up and the patient will be affected.
This is not going to happen. So don't focus on making "decisions" and focus on making the patient a case study about their disease.
Learn how to make the patient comfortable with what's going on. Imagine what it would be like talking to an auto mechanic when you don't even know what a "V8" actually means. You've heard the term before and know it means something about power and the engine. You can nod and agree to things and say you understand, but that doesn't mean you really have an idea about what it all means.
Think about it from a patient's perspective. How would you explain something like new onset a-fib to your mom, dad, or grandparent? Think about the things that a patient wants to know but may not be able to verbalize.
"Does this mean someone is going to come take some blood? How is this going to change my life after I leave this hospital room? Am I going to see you again tomorrow? Am I allowed to eat dinner today?"
Learn how to actually sit down and talk to your patients about things that aren't in a computer template.
I'm sure you're make it through, but don't lose focus on the non-textbook parts of being a physician.
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Excellent advice. I'll try to keep that in mind.
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Agreed. Unless you're actively messing with things you shouldn't be around (pulling out lines, etc), you're not going to impact the medical care, but as the person with the most time on the team, it's very nice when you can just talk to the patient. Doesn't necessarily have to be about their diagnosis, though you can certainly do your best to answer their questions, but just treating them like human beings. Go play with your peds patients. Reassure parents (just remember... you are on their side, both trying to make sure their kid is getting better). Talk to your adult patients. Try to learn about them and how their disease impacts their life. When I acted as AI, I had one patient that was there a good chunk of my time on service, and I'd just check up on her during the day, talk to her family... they appreciated that as much as the actual medical care that she was getting, and even when I went off service, I went to check in on her, and her family still looked to me with their questions. You can make a huge impact by just talking.
As far as studying goes... ask what people at your school use. There are a variety of resources available for each clerkship. For FM, the AFP has questions available if you sign up as a student member. There's Pretest if you like questions (MKSAP for Medicine), Case files if you prefer cases, and Blueprints if you like a more text-book format. When you get a new patient, read up on what's going on with them. Figure out what the differential might be based on what's going on. What labs you might've wanted early on to narrow the diagnosis. What the labs tell you. Up-to-date is a good resource, but there are others, and don't be afraid of review articles. Peds in Review has a lot of really good review articles that go through diagnoses pertinent to peds.
Step 2 focuses on diagnosis and first-steps when you have a complaint of something. The good news is that you do this during your clerkship, and you take a mini-Step 2 each time you take a shelf, so by the time you finish the year, you should be a pro at it. That's why the national average for Step 2 jumps up about 10 points.
I would try to get an much information about all your clinical sites and residents from upper class man before you start. Also make sure you understand who exactly is responsible for your evaluation and if anyone else has an "input". That allows you to optimize time with those people who actually matter because it's easy to just stick with the nice intern, but most times they aren't the major players in your grade. ALSO, get as much patient contact with your assigned patients as possible. Take time to ask them stuff about their life and just give them time to tell their story. Often times, the patient will advocate how nice and great you are to your resident and/or attending and this can make a huge difference on how they see you and in your evals.
Also, you can never tell which nurses will be nice or mean. Always thank them if they help and help the out as well. Never think that because you're a med student, you're somehow superior to them in any way. Just be humble and move along.
Also, you can never tell which nurses will be nice or mean. Always thank them if they help and help the out as well. Never think that because you're a med student, you're somehow superior to them in any way. Just be humble and move along.
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