Studying during Clinicals??

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ChuckC

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I was wondering how much studying is needed during the MSIII and MSIV years. I know the basic sciences is when you are studying all the time and very busy with the plethora of information that is given to you. Is it the same way in your clinicals? After a full day of going through your rotations and being on call, do you still go home and study a good amount like in MSI and MSII? Any input would be appreciated.

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My only studying consists of looking up things that I may have seen on my rotation that day that I didn't understand or had never heard of. I don't study intensely like I did during years 1 and 2. I read a lot for medicine, not too much for surgery (too tired), and am reading some now on Ob/Gyn. It depends on the rotation as to the amount of studying you will do.
 
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I would totally agree with dotobe....
1st two years...studying like crazy....never even turned the tv on...did I have a tv???
3rd year more like...looking up things here and there...refreshing about various triads...and recememnting in gaps and cracks...but nothing like the 1st two years.
I fly home after every rotation(~2hrs) for the weekend...and come back for my Monday start....
On the weekends now....I am reviewing for Step II in Aug...but not nearly the severity or intensity of my 1st two years...

...keeping in mind I was not a science major undergrad...so I really had to study like the world was ending just to keep up...and now...

Life is Beautiful....
 
That's interesting. By the hour, I probably study less then I did in my preclinical years, but it definitely felt like I was working harder to get my studying completed during third year. After spending long hours in the hospital, sometimes it was difficult to find time to open a book to read when you got home when all you want to do is eat, veg out, or sleep. During some rotations, I did most of my studying while working in the hospital though. Some of those shelf exams were really hard. I usually didn't feel like I knew enough just from looking up stuff on patients that I had seen for the rest of my rotations, there was always extra studying that was required in order to pass those shelves. Fourth year is awesome. You learn what you want to learn, and the only real time you have to study is when you want to take step II. I've actually found that I learn much better when I don't feel like I'm studying for a test and don't think of it as work.
 
3rd year is different because you're studying for two different types of evaluation. the first is subjective evals by attendings and residents. some of it is personality, which you can't (really) control, but they use pimp questions to evaluate you as well. Most of their questioning centers around your patients and the conditions they have. For this you need to know your patients well and have read at least something basic about their diagnosis (like in CMDT, e-medicine.com or something similar). Attendings are known to be tangential in this type of setting though so it's basically impossible to prepare for every question they'll ask. However, in a way this is the most important part of studying since not knowing the basics during rounds can make you lose a lot of confidence. (At least this happens to me.) So I usually try to read something about the diagnoses my team is working on at any given moment. If I'm super tired or don't feel like working I read something brief like the emedicine entries. If I want to put more effort in I will read Harrison's or look up a review article. I usually don't bring my studying home with me because it's hard for me to get motivated to read once I get home from the hospital, so i try to read during lunch or other downtime during the day.

The good news is that if you read about your patients you will learn a lot about their conditions, at least in Medicine-ish fields (i.e. Medicine, Peds, Neuro) and this will help prepare for the other evaluation -- end of rotation exams. I did not find this to be as true in Surgery or Ob-Gyn. For example if you rotate in an adult medicine unit you WILL see patients with pneumonia, diabetes, hypertension, heart failure, PE, etc. If you rotate on Peds outpatient, you WILL see asthma, ear infections, ADD... Common things are common, and they're also what make up the bulk of the shelf exams. So if you read about your patients, you are also studying for exams. For me at least, it's easier to concentrate on reading if there's a real clinical case to think about in connection with it.

Anyway these are just some thoughts I had about what 3rd year studying has been like. I found it much more tolerable than studying during preclinical years, when I just felt like I was cramming random facts into my brain.
 
I think there's two kinds of studying for 2 kinds of rotations: rotations with exams, and those without. For those without, definitely reading up on patients you see and reading/bringing in relevant articles is the way to go. for rotations with exams, however, I've found that this just isn't enough. The national shelf exams and the home-grown exams tend to require pretty detailed, board-like information that you just won't get from Harrison's or articles. It's a little insulting, I think, but I've found that I really have to go back to memorizing lists and tables and a lot of BS like in years 1 and 2 in order to do well on these exams. As noted above, this is in addition to doing all the things you need to do in order to do well on the wards, and, unfortunately, the two have very little in common. That is, the things you'lll do for the ward will be of very little use on the test, and vice versa.
 
The good news is, you get lots of "on-site training," i.e. learning during downtime via residents' lectures, reading up on patients, discussing cases, etc. The bad news is, many times, you're just too tired when you get home to crack open a textbook to study.

I found one of the biggest challenges of third year was to be able to study whenever you had free time, in little chunks. Normally, I was used to setting aside a good 2-4 hours at a time to study. Now, however, I'll carry around a simple review book (like Blueprints) and just read a few pages here and there, whenever I have a few spare minutes. VERY different mentality.
 
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