Returning to Clinical Rotations After a Year LOA

[tco]

I took a quick look through related searches and saw nothing that could really answer my specific question.

I've been away from school for a year, doing a post-sophomre fellowship in pathology. I'm now three months from returning to clinical rotations (starting with Family Med), and I have quite a bit of spare time. The year, in general, has been very easy, so I'm actually looking to get back into the swing of studying, and wanted to know from experienced MSIII's if it would be more advantageous for me to get to where I was before Step I (mastery of basic sciences), or advance my knowledge through independent study?

Since my fellowship was in pathology, I've been exposed to many areas of the field, and just glancing at Goljan leaves me feeling highly confident that path will be no problem. However, my pharm cards are proving most difficult, so I'm planning on focusing most of my time there, with physiology, and with reviewing my knowledge of the physical exam.

The MD/PhD students that I've talked to have told me that the general stuff will return quickly, but the more esoteric facts that I knew before Step 1 will be lost. This leads me to believe that I should review First Aid again.

Let me know what you think. Thank you in advance.

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[LMarie_MD2b]

I was in the same boat as you are back in 2010. I don't know what your PSF has been like, but I spent two of my last three months on Surg Path, and had no time to study anything except my cases. I had 6 days between my last day of work and MS-3 orientation; during that time, I did nothing but sleep, eat, and unpack boxes in my new apartment.

If you are going to be rotating in the hospital(s) at which you've worked as a fellow, you will start third year at least head-and-shoulders above your new classmates simply because you know the layout of the hospital, the computer/record-keeping system, and should be at least somewhat familiar with the clinicians and surgeons who will be your attendings for the next two years. And, believe it or not, you have probably picked up a lot more clinical information in the pathology department than you might imagine, especially if you've been going to interdisciplinary conferences. Bottom line: I don't think you necessarily need any sort of review (especially at the level of Step 1 preparation) prior to starting your clerkships. You will be a valuable resource to your teams because of your knowledge of the pathology and laboratory system--something woefully few residents (and virtually no interns) understand, because there is so little exposure for most students prior to graduation.

However, if it will make you feel better, especially for Family Medicine, you could do some general pharmacology review (disease-based, think HTN, DM, hyperlipidemia, antibiotics) and possibly look at some peds topics (immunizations, development milestones, etc.) while you're waiting to start third year. I personally learned best when I was placing information into a context of an actual patient, so you could probably acquire the same amount of information in a shorter amount of time if you're in a busy clinic. Besides, you'll likely be studying for a shelf exam anyway, which is at a more appropriate level than going back to the Step 1 minutiae.

TL;DR: As someone who has done this before (I started with Surgery as an MS-3) you don't NEED to do anything now. Everyone starts third year as a bumbling fool--you will be much less foolish by already having a year of experience under your belt. If it makes you feel better, review what you perceive as your weaknesses, but for the love of gods, do NOT pick up First Aid for Step 1 again!

 

[PTPoeny]

I second the don't bother with step one material. If you are really bored and itching to do something maybe read a case from case files each night or something like that but don't push it.

 

[tco]

I'll actually end with 3 months of "research."

I've got a project to finish up and a couple of ppt presentations to give, but other than that, I don't have much. Most of my days are spent on the internet, waiting until 5.

I'm thinking of picking up a case report or something in ortho pathology.

 

[cabinbuilder]

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