How to shine at an elective rotation?

[vanfanal]

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So I have an elective rotation coming up this summer. I'm really really nervous because of how important it is that I do well to get a strong LOR. Coming from the UK, I'm not sure how different things are going to be as I've heard that things are more intense in North America.

I was hoping some people could provide with advice on how to do well, and maybe deal with these nerves!!

 

[Shikima]

Self talk - Self soothe.

 

[Nasrudin]

So I have an elective rotation coming up this summer. I'm really really nervous because of how important it is that I do well to get a strong LOR. Coming from the UK, I'm not sure how different things are going to be as I've heard that things are more intense in North America.

I was hoping some people could provide with advice on how to do well, and maybe deal with these nerves!!

Just keep sounding like the Geico lizard. Most Americans are Anglophiles. And will afford you with intelligence and sophistication you may or may not possess.

You'll be fine. You're going to have the same difficulty as any visiting student using a new system and not knowing where anything or who anybody is.

 

[vistaril]

So I have an elective rotation coming up this summer. I'm really really nervous because of how important it is that I do well to get a strong LOR. Coming from the UK, I'm not sure how different things are going to be as I've heard that things are more intense in North America.

I was hoping some people could provide with advice on how to do well, and maybe deal with these nerves!!

Above all else:

1) be a cool guy that people like to work around
2) be someone with enough work ethic that is going to do their work and not dump on other people

Those two things are 99.9% of what people really want.

 

[Jorje286]

People generally don't care how many facts you know. They will be a lot more impressed with you if you can establish rapport with patients, if you show psychological mindedness and show good judgment and reading of patients' emotions. The best way to be good in those things is to get more and more exposure. If you haven't done a psych rotation in a while, shadow some of your attendings.

Can't be surprised at Vistaril's cynical assessment.

 

[Indodo]

Bedazzler

 

[shan564]

Work hard. Come in early, stay late, offer to do extra work wherever possible, ask to take on more patients (but only to the extent that you're able to handle it), know EVERYTHING possible about your patients, spend time with your patients, ask questions. And definitely be friendly.

Also, no need to be coy about the fact that you're looking to impress and/or match there. On day 1, tell your supervising resident what your goals are, and ask him/her what the best way it is to accomplish that.

As has been said already, nobody expects you to know a lot of stuff. Of course it helps if you're more knowledgeable, but that's not what's expected of a student... after all, you're a student, and you're there to learn. So don't be afraid to ask questions due to a concern that it'll make you look less knowledgeable. You'll learn so much in residency that it'll pale in comparison to what you knew as a student... so the student with a lot of knowledge will eventually balance out with the student with a bit less knowledge after residency, and that's why residency programs aren't necessarily looking for a person with the most knowledge, as long as you're interested in learning and you're hard-working, since that shows that you'll develop quickly as a resident.

 

[Dogdaysofsummer]

Work hard. Be one of the first to get there in the morning and the last to leave. Be nice and courteous to everyone- your attending, the residents, the nurses, the janitor. Try to be helpful to your residents when you see an opportunity. It's great to ask questions and show your interest but don't ask millions of questions all day. Take some initiative and look up things that you can. Halfway through the rotation ask for feedback from your resident and attending. This will give you a chance to correct things if needed but most likely they will give you a positive review. And, maybe most of all, relax! No need to put so much pressure on yourself. Psych people tend to be nice and happy to help out medical students who are interested in following in our path. Good luck!

 

[vanfanal]

Thank you everyone.

 

[novopsych]

Everyone so far has given you advice on how to blend into the background as someone who is perfectly pleasant, but no one has answered your question of how to shine. The fact that you want to shine already makes you much more appealing that many of your milquetoast peers.

Discover what it is about you that sets you apart. Med management can be learned fairly quickly, so the question is: What more do you bring to the table? In the US we called this a Value-Added Reseller. I’m not sure what the term in the UK is. Here’s the basic idea: If everyone is selling bread, what can you as a bread seller do to *add* *value* to the bread? Sprinkle it with cinnamon, perhaps?

In my case, I’m a dancer, so I offer dance therapy to my clients. I also offer Botox injections, which almost anyone can do—but very few psychiatrists do.

Be confident. Find what is already unique about you. And lead with it early on. If you love to play the guitar, bring it with you and have some jam sessions with the patients. Are you good at make-up? Give the patients make-overs. These are the intangibles that make you unique. Make yourself indispensable.

 

[Jorje286]

Be confident. Find what is already unique about you. And lead with it early on. If you love to play the guitar, bring it with you and have some jam sessions with the patients. Are you good at make-up? Give the patients make-overs. These are the intangibles that make you unique. Make yourself indispensable.

This is way over the top, especially for a student. I think what separates students who shine in electives from those who are just good is what separates great from good psychiatrists in general. These basically are communication skills, intuition, how well can you establish rapport and how good is your judgement. In other specialties, it's a lot more about how many facts do you know but psych is not heavy on facts and knowledge to start with. People will not be that impressed if you know your anti-psychotics. They will be a lot more impressed if you were able to calm the agitated psychotic patient or if you are able to decipher a patient's emotional state (granted this is very subjective, but that's the nature of psychiatry). Exposure is the best way to get better in these things. Book reading will be very limited in establishing those skills.

Working hard and getting along with people are prerequisites to do a decent job. They do not allow you to stand out.

 

[vanfanal]

I thought I would update everyone on my elective so far. I've completed 3/4 weeks. It's been good so far. Ive gotten along well with my attending a resident. I'm leading the interviews on some of the simpler cases. I've gotten involved in every way I think I can, so I hope I've made a good impression. I think I like psychiatry career wise. It;s nice that I finish quite early. It's a more "humane" pace and the patients are interesting. Although I've gotten used to it quite quickly, and now I'm considering whether I should give IM, neurology or anesthesiology another chance. Ughh, I'm so easily distracted.

Anywho, my question for everyone was if there is specific way to ask for a LOR? I was just planning on asking my attending on the last day if he felt I did well enough that he would write one for me. Should I provide him with my CV or list of what I feel were my strengths and weaknesses on the rotation?

 

[Armadillos]

I thought I would update everyone on my elective so far. I've completed 3/4 weeks. It's been good so far. Ive gotten along well with my attending a resident. I'm leading the interviews on some of the simpler cases. I've gotten involved in every way I think I can, so I hope I've made a good impression. I think I like psychiatry career wise. It;s nice that I finish quite early. It's a more "humane" pace and the patients are interesting. Although I've gotten used to it quite quickly, and now I'm considering whether I should give IM, neurology or anesthesiology another chance. Ughh, I'm so easily distracted.

Anywho, my question for everyone was if there is specific way to ask for a LOR? I was just planning on asking my attending on the last day if he felt I did well enough that he would write one for me. Should I provide him with my CV or list of what I feel were my strengths and weaknesses on the rotation?

I think the kinda typical thing is at end of rotation to say you really enjoyed the rotation, are excited to do psych and were wondering if they would be willing to write a letter of recommendation for you. Then ask what he needs from you, which will probably just be a CV so they can make some sort of narrative connecting what they saw from you on your rotation with what they see on your CV. (Like maybe you have lots of research experience and found a couple good articles related to clinical questions during the rotation or whatever)

I wouldn't suggest the list of strengths and weakness, thats not something I've personally heard about people doing in this context. (Unless other people have a different experience?)

 

[Doctor Bagel]

As others have said, knowledge is less important than attitude and work-ethic. You can learn more stuff, but being a jerk or lazy is harder to modify. I agree with the advice above about getting along with everyone (and recognizing that everyone is important). You also have two primary different people to impress -- your attending and your resident. Doing presentations, bringing in reading, etc. might the type of stuff attendings are impressed with. Knowing your patients really well is critical for both. For your resident, don't show them up. Also be respectful of the fact that they're really busy on inpatient units (and maybe a little stressed out). Think about what you can do that can help your resident with their work. If you can write notes that count, great. If not, things like calling family members, getting collateral information and regularly checking in on patients who need close/extra monitoring are helpful.

 

[vanfanal]

Based on what you've mentioned doctor bagel, I'm expecting a very strong letter. 🙂

I plan on applying to the 2016 match. Do you think that the letters I get now will be too old (I also have a strong one from an orthopaedic consultant from January)? My worry is that if I ask for the LOR at the time I apply, they may have forgotten about me and may not be able to write as strong a letter commenting on what I did well. Are most attendings okay with/capable of writing a strong letter for a student that rotated with them a few years ago? Or would they be able to update the letter they've written for me now when it comes time for me to apply, when they load it to ERAS? Also, does it matter if I upload the letters myself and therefore don't waive my right to see it? The alternative would be to contact the attendings and asking them to upload it.

 

[Bartelby]

Be confident. Find what is already unique about you. And lead with it early on. If you love to play the guitar, bring it with you and have some jam sessions with the patients. Are you good at make-up? Give the patients make-overs. These are the intangibles that make you unique. Make yourself indispensable.

OP, you've gotten some good perspectives here. Just wanted to clarify the above so that you (and others) don't actually try this. Coming in with a guitar to the inpatient unit and corralling a sing-along or trying to do makeup with patients would most likely make your team see you as lacking in professional boundaries, lackadaisical, and maybe even disruptive or desperate to impress. I think novopsych (based on his/her post history about dancing around a patient having an MI) is likely a troll.

 

[vanfanal]

So apparently you can upload your own personal copy of a letter, but the programs can see who uploaded it. Does this matter?

So splik, are you saying that it's okay if I ask someone to write a letter now, and then ask them to essentially update it and change the date to 2015 when the 2016 application window opens? Are attendings okay with this? Is a letter dated 2014 definitely too old? So did you ask your attendings to write you a letter 3 years after you rotated and they were okay with it?

I'm not sure about the FY1 year because I'm unsure if I'll be able to attend interviews during FY1. That would require a lot of time off. The alternative would be a year off. What do you think?

 

[vanfanal]

We did a lot of clinic for orthopaedics. So my attending has made strong comments on history & examination, relationship with patients, and general work ethic.

 

[Nasrudin]

"Mad, bad and sad."