1. Don't make excuses. Ever. You will wind up peripheralized. Tell people your first day it is your first rotation, but after that, just start plugging away and don't use it as an excuse. Some examples:
EXAMPLE 1
Attending: "What, you don't know the eight causes of perdunkle syndrome?"
MS3: "Sorry, it's my first day" [LAME!!!! and an excuse. At best, the attending thinks you're just a dumb medical student; at worst, he looks down on you for not taking responsibility for your fund of knowledge]
--redo--
Attending: "What, you don't know the eight causes of perdunkle syndrome?"
MS3: "I'll look it up and get back to you tomorrow." [no excuse, but a plan of action to remedy your fault]
EXAMPLE 2
Resident: Can you get together Ms. D's discharge paperwork and scripts.
MS3: Uhh... I don't know how to do that, it's my first day. [Excuse.]
Resident: Oh, I totally understand. <smile> <procedes to do discharge summary while you watch... it's like watching paint dry... doesn't actually show you how to do it, however, because it's just faster if he does it>
[Congrads! You are now completely peripheral! And guess what, you still don't know how to do a discharge summary! AND, you made an excuse so the guy thinks you're just a dumb medical student at best, at worst that you're lame.]
--Redo---
Resident: Can you get together Ms. D's discharge paperwork and scripts.
MS3: Sure! <run off and find nearest RN, ask her where the discharge paperwork is... if she doesn't know, ask the intern where you can find the forms... fill in the blanks as best you can. Look up how to write a prescription on line and write them out. Then put it in a big pile and take it back to your resident>
MS3: Here you are. It's the first time I've done it, can you check it over for me?
Resident: <flips through scripts> Jeez, can't you even write a Rx? When I was a medical student...
MS3: Sorry, sir. <watch while he corrects your many mistakes>
Resident: Okay, now put that in the chart.
MS3: Thanks. <puts them in the chart>
Next time... "Hey, I already put the discharge paperwork together for Ms S who is going home today; could you check it over for me"
[Your resident now thinks you're a superstar.]
2. Be early, stay late. Be around when you're supposed to be around. Make sure you know who's 'in charge' of you (resident or intern), and make sure they know if you need to go to class.
3. Listen to what people are saying. Even if you don't understand exactly what is being said, you'll pick up a lot without realizing.
4. Silence is your best friend. Chime in every once in a while when you know the answer and it's obscure, but once people are convinced you're smart, just keep your mouth shut.
5. Count to ten before you ask a question. 9 times out of 10 you actually know the answer.
6. Mostly this year is a cross cultural experience. Try to fit in with the dominant culture of the rotation you're on. It'll make life easier for you, and more teaching/learning will occur.
7. Everything is your fault. The faster you internalize that, the less depressed you'll be. If nothing is your fault, you aren't responsible for anything, and you are at the mercy of fate and strange forces that run the hospital. You will go into learned helplessness mode and wind up depressed. If everything is your fault, sure you'll take an ego hit, and you'll wind up accepting responsibility for a lot that you really don't have any control over, but at the end of the day, you'll be in problem solver mode rather than learned helplessness mode. If you are responsible, things are your fault, but you also have control.