How to do well in 3rd year - A message to incoming students from a veteran

[kikibukas]

Kiss up, then kiss up more, and even more if you can pucker up enough. THE KEY is to remember that you are NOT judged clinically on how much you know, how well you communicate with patients or how good your diagnostic skills are (REMEMBER THIS)! But on how much you kiss up, how much scut you can do before anyone else, how many donuts you bring in in the morning, how much you smile and crack jokes, how many useless articles you can look up on a obscure and trivial topic brought up on rounds, how much energy and enthusiasm you have (EX: PLEASE, PLEASE give me another 90 year old septic nursing home patient at 3 AM, with big smile). Dont show off your knowledge either because in some cases this will make the residents feel stupid. You will lose in evals no matter what. Do all your work but not add any comments during morning rounds and you will be labeled as quiet and uninterested, should participate more. Talk to much and people will think you are loud, arrogant, trying to show people up.

Things that worked for me:
(1) BEST SUGGESTION: Study your butt off for miniboards. If you do well you are assured at least an above average grade. Get some decent evals and you might get an honors
(2) Try to stay late. This shows an interest? You would be better off reading at home but thats how life works.
(3) Constantly ask if there is anything else you can do to help the team out? Usually entails scut that a 3rd grader could do
(4) Just because residents or attendings are nice to you DOES NOT MEAN that you will get a great eval. I think this is a function of their mood on any particular day, their standards, and how bitter they are in deep inside. A lot of times you wonder why you worked so hard to get their average eval
(4) Help out on call. Dont go to sleep at 11PM if the resident is being swamped by consults in the ER. Help out! You can actually learn good stuff on call some of the time (foleys, iv lines, blood draws etc)
(5) Dont ever talk about anyone. It gets around fast
(6) Be a team player and take jokes all the time from more senior members who harass you. Dont have conflicts with anyone. Smile and go on or go to the bathroom and pretend to talk back...
(7) In general nurses are bitter, overworked, and would prefer to ignore or be condescending to med students. Ignore this also and be nice. Remember that soon you will be giving them orders ( clean up Mr. Jones in room 754 stat)
(8) Work hard! Dont sit around talking to classmates if there is work to be done
(9) If you really want honors from evaluators then I suggest that you try to anticipate any problems before they happen and try to come up with solutions. Run the lab specimens over to micro/hematology, make calls to radiology too see if the ct scan has been done yet, arrange the ID consult, attend to Ms. Jones problem before the resident sees her, do a medline search and give them an article on an obscure problem (IN OTHER WORDS BE A GOOD ADMINISTRATIVE SECRETARY) Like I said before none of this involves your patient management skills, knowledge, or communication with patients.

All this is coming from someone in the top 15% of her medical school class with top board scores. I just hate to have somebody else go through this blindly. I would love to hear from others. My intention is not to offend, but to give a truthful non-politically correct account of my
opinion.

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[SW-Adrian]

I have to unfortunately agree to many of the points made above. Being a good administrative secretary for the intern is what makes you valuable to them.
As an MD-PhD student, reading a paper from an obscure journal is quite routine. I was amazed at how much impact you can exhibit by bringing a copy of that paper to everyone and discuss it.
One more thing I would suggest on top of the great advices given above, is to try and enter all orders and make sure they are executed for the intern. Basically, try to be more independent and act as a Sub-I and report to the intern. You will be SO much appreciated.
Obviously, don't forget to read to score well in the exam too!

------------------
Adrian Zai
Scutwork.com

 

[spunkydoc]

i believe that the above advice deserves some clarification.

while i cannot completely disagree with all of the comments made above, i think it could perhaps be toned down quite a bit.

1. your job as a student is NOT to be the donut machine. remember, as a student, you are the one PAYING them to teach you--take advantage of that. being the scutmonkey and only the scutmonkey will get you nowhere in your education or in life..it is better to be able to be independent than to be someone elses punching bag.

2. your primary job is to learn and on clinicals one way to do this is by following the examples of your upper levels. you need to learn how to do all the paperwork you will be doing in your internship and that is partially accomplished by scutwork.

3. ASK QUESTIONS---read up on your cases, be able to answer pimp questions, and be able to ask intelligent questions..this is what will impress--not schmoozery..anyone can schmooze..not too many can back it up..many attendings and residents will adore you for bringing them food and kissing their feet, but they will also see through it..when push comes to shover, performance is the key..if by the end of your third year you still have no idea what to prescribe for pneumonia or otitis media and WHY, you have not been doing your job and will not gain the respect of your upper levels.

4. kissing butt is basically an empty way of getting to the top and you will find yourself without skills when you are finally left to your own devices that first nite on call of your internship--regardless of your % position in your class.

good luck!

 

[kikibukas]

What you say is great and probably exists in a perfect world. I can tell that you are probably a doctor far removed from your med school days or a premed without a clue.

If you are gunning for a competitive residency in Derm or Otolaryngology, getting top grades and ultimate election to AOA is far more important than knowing how to treat Otitis Media or Pneumonia (which most nurse practioners can do, and can be looked up in most pocket books). Also most of what you need to know can be learned during residency training. After the vacation known as fourth year of med school most med students probably can not recall many specifics anyway. I think you missed the point of my message. Achieving a top ranking in your class can not be done simply by kissing ass. My message is to bright hardworking students who need to be warned that the success of the first two years will not carry over unless they do what I say.

While learning should be a priority for any student it often is not. Impressing overworked residents is often a matter of making their life easier. They don't want to hear the differential diagnosis of Afib at 1:20 AM. They do not want you asking what the workup for fever of unknown origin is.

 

[spunkydoc]

well, k--

actually i am not far removed or in my clueless premed days..i am a 4th yr student in the midst of residency applications for Emergency Medicine--a very competative residency--and i speak from my experiences and communications with dozens of residency program directors across the country.

to each their own on how best to get through it all. my suggestions are not limited to the bright or the bottom of the barrel med students--when all is said and done #1 and #200 are both called doctor at graduation.

i think it is very helpful to keep everything in perspective..

when all is said and done, there is never one way to skin a cat..i have not yet met a residency director who did not see through the donut and coffee machine that some students turn themselves into.

performance is key..studying, asking questions, and interacting are what i have found impresses upper levels and attendings..bringing coffee and donuts may get you a great eval--lets face it, residents know what directors want to hear...but isn't it better to have that backed up with truth and fact?

look at how many folks in your class went to PODUNK U for undergrad, went to another podunk for med school, and landed a competative, well known residency and are making gizillions of $$, have a great life, and feel as though they made it to the top. They did it by performing, not kissing up..

sure networking is very very important and a big part of the game of landing a residency...but, for every firm handshake and smile you give when schmoozing, you must back it up with ability.

clawing tooth and nail to the top is the pre-med attitude we all took in this very competative world of medical education...when you apply for a residency, you are applying for a job..if you can't perform because all you did was kiss up, you are worthless to anyone and a detriment to your patients in particular. this was simply the message i wished to get across--it would be unfair for upcoming 3rd yrs to read your post and think that it was the ONLY way to get to the top.

for those reading, just take whatever is said on these boards with a grain of salt--not as the hard and fast gospel..we all have a very wide variety of experiences, attitudes, and styles as i am sure is evident just in this thread...you as the student need to find your niche and figure out what style works best for you.

good luck!

 

[HeatherR]

Come on guys, staffmen and residents aren't stupid. They see right through slacker asskissers, and are not impressed with them. They are more impressed if you show some interest, are hard working and easy to get along with.

I'm in fourth year, and have never sucked up, yet I consistent get great evaluations. That is because I never complain when given scut to do, although I will refuse to do more than my share. I ask lots of questions, do lots of reading, take my responsibility seriously, I work hard and have a good attitude. That is all you need to do to do well in your clerkship.

If you are trying to get into a competative residency then you do have to try and get to know the "right people" Try to get on the same team as the program director. Arrange your call so that you're on-call with important doctors, or so that your on-call with the same doc each time so they can actually get to know you; but never do any deliberate sucking up. Ask questions about the specialty so that they know you're interested. Read like crazy when you are doing a rotation in an area you are interested in. You should be able to answer any question thrown at you.

Never do anything that will make a resident or another med student look bad, even if it makes you look good. Word will spread, and nobody will want to work with you, therefore they won't want you in their program.

Take all your rotations seriously - even if it's in a field that you're not interested in. You still need to know that area for boards, and you would be amazed at how doctors will talk about a slack clerk, and word may spread to the department you want to get into.

Clerkship is a lot of fun, but is a lot of work. You'll be amazed at how much you're learning in such a short period of time, and amazed still and how much more you need to know.

Goodluck

 

[DO DUDE]

I'm in fourth year, and have never sucked up, yet I consistent get great evaluations.


That's because you're a female.

 

[HeatherR]

Dear DO Dude,

Being female will not help you get a good evaluation. Women make up almost 50% of medical students, and we certainly do not recieve any special treatment - at least not at my university, I don't know about yours.

Get a life pig.

 

[DO DUDE]

Now, must we resort to name calling Heather R? It doesn't matter that 50% of the students are female, only that more than 50% of the PRECEPTORS are MALE. Which, I would be willing to bet, is true, even in your case. (Oink.)

[This message has been edited by DO DUDE (edited 07-24-2000).]