preparing for core rotations

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Are there any good books out there that can prepare me for my rotations and get me thinking in a more "clinical" way? Would preparing for the written exam for the rotation BEFORE entering the rotation be helpful? Just trying to figure out the best way I could prepare. Thanks.

 

[Amy]

No, not really. I think the clinical experience is what gets you "thinking in a clinical way."

Don't get too ahead of yourself! Enjoy your time off between 2nd and 3rd year.

 

[ckent]

The best preparation for the clinical years is just studying hard for step I. These days, there are a lot of clinically oriented questions on that test, so if you know the answers to them, you should do well during your clinical years. Also, I've noticed that during third year, you can sometimes impress attendings with 1st and 2nd yr knowledge that your attendings are residents have long forgotten about but are still clinically relevant. If you know your first third year rotation, I don't see anything wrong with doing a little bit of preliminary reading either as it will help you during your rotation and for your exam that you will probably have at the end of your rotation. I do agree with the previous poster though in the experience is the best preparation for the wards, so you really just need to get in there and get the hang of it. Until then, there's nothing wrong with having a little relaxation.

 

[njbmd]

Hi there,

Pick up a copy of First Aid for the Wards and First Aid for the Match. First Aid for the Wards will help you focus on the important topics for each clerkship and First Aid for the Match will help you prepare for getting that residency application underway.

Pick up review books for the shelf exams as you go. Use your learning style as a guide. You most important things are learning to do a good history and physical; learning to help the team and presenting patients.

Try to volunteer for every procedure that you can. Learning to draw blood, do ECGs, and insert lines can make internship less stressful for you no matter what you go into. The nurses will teach you IVs and the technicians will show you how to draw blood and do ECGs. Good residents and interns will help you with presentations if you ask.

njbmd🙂

 

[supercut]

In the couple days prior to starting a new rotation, take a little time to do some light reading regarding the core of the rotation you are about to start. If you are doing OB/Gyn, for example and you know you start on OB, read about the labor/delivery process. If you start gyn, review the STD section. You might want to look at your pelvic female anatomy as well (lots of hysterectomies).
If you know you will start surgery on a vascular service, for example, you might want to give a light read of the vascular surgery chapter in your text first. For peds, review your developmental stages.

Then spend the first day or so getting familiar with the things unique to that service that need to go in your notes. Eg for OB/gyn the G's and P's and how to use the pregancy wheel is important. For surgery (and pts with gyn surgery) post op day, wound checks, and in's and outs broken down into urine and each tube/drain the pt has (listed individually) is important.

Once you've got these things down, start reading based on the pts you've seen. Then start filling in with the major areas of the field that you haven't seen.

Learning clinical thinking is a process, which will continue to evolve throughout your training. Some things are fairly easy (eg replace electrolytes when they are low). Some things are a lot harder (like the timing of an operation in a pt with multiple medical problems). And for a lot if it there is no single right answer. You'll find what two different attendings may do in the same situation varies somewhat.

Most of all, try to find some value in each rotation, even if you dislike the field in general. Each specialty has something worthwhile for every physician.