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Hey guys...just finished third year (assuming I passed my last shelf). I'm happy, relieved, and feel the need to babble/vent about the year.
There are a lot of books and lists like this spewing generic advice, with the promise of telling you everything you need to know before third year. In spite of this, I've never seen a book say one simple thing -
1.) It'll be ok. Seriously. With few exceptions, things aren't as difficult as we think they are going to be. It's arduous, tedious, and exhausting at times. Some days, everyone feels like they're not cut out for this, an impostor that will soon be revealed as not actually knowing anything. Other days, you feel competent and excited to be in this profession. Don't get discouraged by a bad day, week, or even rotation. Lots of people have done this before you.
2.) Your number one priority is to learn. Study for the shelf exams. Everyone does say this, but it'll reiterate it. Most of the time no one notices (well, your intern may notice, but certainly not the attending) when you do something beyond your assigned patient care responsibilities. They will not notice phone calls to the family, you bringing water or blankets to patients, or you spending time with your patient beyond the history and physical exam. These things are fine to do - and helped me keep my sanity this year - but you have to know that no one will notice. If you're finding yourself doing anything for any other reason beyond wanting to do it, don't. Go study.
3.) That being said, you need to know your patients, and know them well. Better than anyone else. Know everything you can find out about their past medical history.
4.) On most of my rotations, I found that I was graded well just for being myself. I'm not trying to boast, but I'm nice and play well with others. Try to maintain a sense of humor. It goes a long way. That said, no one will notice if you're the one (or not) who clamors the fastest to pick up a resident's pen that falls on the floor or if you're the med student who can provide a 4x4 the fastest. No matter what, there will be the occasional evaluation that makes it clear that the attending hasn't spent any time actually thinking about you. And that is frustrating and unfortunate, especially if you worked really hard and want to go into that particular specialty (and therefore, really care about the grade). And that brings me to...
5.) On your first day in a new hospital, get there early, and find three things - where you're supposed meet your team, the cafeteria, and a cry room. It's hard, not knowing what misstep may affect your grade. Some attendings can be moody, some may decide they don't like you just because, some are prone to throwing objects at others. Residents are overworked, some get irritated by med students hovering around, sometimes they snap. People can be difficult to read. In the end though, these are uncommon events, and it'll be ok (see 1.) Have a place in mind to go if you need to get away from it for a while. I have an abandoned phone booth at the VA. 😳
6.) This is said a lot but it's worth repeating, and certainly something that I need to work on more. Don't become just a med student. Keep doing the things that make you a unique person. I think maintaining the ability to relate to the outside world is worth making time for, and makes a better clinician in the end.
Anyway, this is not an exhaustive list. Read the other lists too. But I think the most important things to remember are that things will be fine and to be yourself. Unless you're like me, in which care you need to be yourself, just a lot less lazy.
There are a lot of books and lists like this spewing generic advice, with the promise of telling you everything you need to know before third year. In spite of this, I've never seen a book say one simple thing -
1.) It'll be ok. Seriously. With few exceptions, things aren't as difficult as we think they are going to be. It's arduous, tedious, and exhausting at times. Some days, everyone feels like they're not cut out for this, an impostor that will soon be revealed as not actually knowing anything. Other days, you feel competent and excited to be in this profession. Don't get discouraged by a bad day, week, or even rotation. Lots of people have done this before you.
2.) Your number one priority is to learn. Study for the shelf exams. Everyone does say this, but it'll reiterate it. Most of the time no one notices (well, your intern may notice, but certainly not the attending) when you do something beyond your assigned patient care responsibilities. They will not notice phone calls to the family, you bringing water or blankets to patients, or you spending time with your patient beyond the history and physical exam. These things are fine to do - and helped me keep my sanity this year - but you have to know that no one will notice. If you're finding yourself doing anything for any other reason beyond wanting to do it, don't. Go study.
3.) That being said, you need to know your patients, and know them well. Better than anyone else. Know everything you can find out about their past medical history.
4.) On most of my rotations, I found that I was graded well just for being myself. I'm not trying to boast, but I'm nice and play well with others. Try to maintain a sense of humor. It goes a long way. That said, no one will notice if you're the one (or not) who clamors the fastest to pick up a resident's pen that falls on the floor or if you're the med student who can provide a 4x4 the fastest. No matter what, there will be the occasional evaluation that makes it clear that the attending hasn't spent any time actually thinking about you. And that is frustrating and unfortunate, especially if you worked really hard and want to go into that particular specialty (and therefore, really care about the grade). And that brings me to...
5.) On your first day in a new hospital, get there early, and find three things - where you're supposed meet your team, the cafeteria, and a cry room. It's hard, not knowing what misstep may affect your grade. Some attendings can be moody, some may decide they don't like you just because, some are prone to throwing objects at others. Residents are overworked, some get irritated by med students hovering around, sometimes they snap. People can be difficult to read. In the end though, these are uncommon events, and it'll be ok (see 1.) Have a place in mind to go if you need to get away from it for a while. I have an abandoned phone booth at the VA. 😳
6.) This is said a lot but it's worth repeating, and certainly something that I need to work on more. Don't become just a med student. Keep doing the things that make you a unique person. I think maintaining the ability to relate to the outside world is worth making time for, and makes a better clinician in the end.
Anyway, this is not an exhaustive list. Read the other lists too. But I think the most important things to remember are that things will be fine and to be yourself. Unless you're like me, in which care you need to be yourself, just a lot less lazy.
