Way to kill it
@bananafish94 what was your secret during rotations that lead to better performance?
First of all, in terms of evaluations, you have to accept the fact that most of it is independent of your performance and is decided by the particular grading style of the evaluator. A friend of mine likened grading to tipping at a restaurant. Some people are just super generous and always tip 25%, and some people are tools and tip <10%. Most people are somewhere in the middle. If you get really extraordinary service, you might bump it up a little, and if you get horrific, shockingly bad service you might give less. At the end of the day, someone who is known to give straight 2/4 will not give you straight 4/4 no matter how good you are. That's not the goal. Your goal should be for them to maybe bump you up to 3/4 for a couple of items and hope that in the
long run you come out ahead with the grading even if you lose a couple battles in the short term.
In terms of doing well on the wards, I think the overwhelming majority of it comes down to common sense. In no particular order,
-Be professional always. I don't think I was ever once late to anything and I wore a freshly ironed shirt and tie everyday.
-Be a normal, pleasant person to everyone you interact with, with no exceptions. Know how to read the room. I probably err on the more conservative side of this than most people (eg, some of my classmates are comfortable swearing and making more casual jokes in front of residents which can work depending on your personality, but risky).
-To that end, don't try to be someone that you're not. Insincerity is obvious very off-putting. Pretty much everybody can be a pleasant, professional person within the confines of their actual personality.
In terms of actual clinical performance:
-I've found that it's less about knowing things and more about how much you contribute to the team. You will be asked questions that you don't know the answer to. That's fine. Always try and study a little bit each night but don't beat yourself up if you get "pimp" questions wrong.
-That said, recognize that there are some things that you must know. If you are in a surgery, you must know the patient's history, what the surgery is, and what the indication is. If you don't, that's a bad error. If you're following a patient as an inpatient, you should know basic updates on their hospital course and should be able to give a brief one-liner about what's happening and why they're in the hospital. Things like this.
-Be
proactive. Is there anything that you can help with that would make life easier for the residents? Do these things. For surgery rotations, basic stuff like coming in to make the list, dressing changes, etc. For psych, you can spend time talking to family and outside doctors and get collateral. For pretty much everything, you can get medical records, call certain consults, talk to nursing about updates, etc. When we run the list, I make checkboxes for each patient's to-do list and if it's something that I am able to do I tell the residents that I will do it.
-Ask for feedback on a semi-regular basis. Doesn't need to be fancy, just something like, "Hey, I've really been enjoying the rotation, please let me know if there's anything I can improve on."
-Hone your presentations. Presentations are one of the only things that people will remember. Be confident and tell it like an interesting story. Try to do much of it from memory to avoid reading off the paper. When I was first starting out, sometimes I would go find some empty corner before rounds and do the whole presentation just to practice it and work through any kinks. It felt a little ridiculous and probably was, but I've consistently been told that presentations are one of my strong suits.
-Control things that are modifiable. For example, if you are asked to give a five-minute talk on something, this is one of the very few opportunities you will have on the rotation where all eyes are on you and you get to shine. Don't just give some tired recitation of UpToDate guidelines, try to organize a well thought out presentation, memorize it if possible, and relate it to the patient in question. I don't say this to brag, but just to offer an example. On my surgery rotation each student was asked to give a formal powerpoint presentation on an assigned topic at a weekly conference with the attendings. I poured my heart and soul into this presentation, had the librarian pull actual books, etc. and practiced it beforehand. Afterwards, one of the attendings asked me if I could send it to her so she could use it in the future, and literally every person that evaluated me on that rotation mentioned the presentation - just goes to show that a little work can carry you very far in these types of situations!
-Finally, don't ever, ever, ever, ever, ever, ever be a weird gunner or try to screw with fellow students. Don't do odd things like bring in papers unprompted or pimp other students or anything like that. I've learned that if people like working with you, it's obvious to everyone and makes everyone look better. And if people don't like working with you, it's even more obvious. My motto is that everyone should be trying to make everyone else look good at all times.
Hope that helps a little bit. Third year can be a wild ride but I had a lot of good times. If you have any specific questions about anything in particular I'd be happy to answer.
