What do we need for 3rd year?

[JP2740]

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I've had pretty much 0 advice for 3rd year in terms of everything pretty much. What materials to buy? How best to succeed? Things like that. I was hoping for a thread of suggestions for everything and anything related to 3rd year. I don't want to get too in depth with a bunch of textbooks and all that.

What are the quintessential (is this a word?) materials? (like first aid for step 1, netter's for anatomy)

 

[tco]

I've had pretty much 0 advice for 3rd year in terms of everything pretty much. What materials to buy? How best to succeed? Things like that. I was hoping for a thread of suggestions for everything and anything related to 3rd year. I don't want to get too in depth with a bunch of textbooks and all that.

What are the quintessential (is this a word?) materials? (like first aid for step 1, netter's for anatomy)

Each rotation has its own books that are the best for the shelf. There are dedicated threads on that topic in the Clinical Rotations subforum.

As for what you'll need - on most rotations I carried a stethoscope and reflex hammer. Most just carry a stethoscope. However, I have a pet peeve that says you'll never get two consecutive reflexes the same with a stethoscope, so I carried a hammer just in case...

It depends on the rotation as to what you'll need.

FM - Stethoscope, reflex hammer, microfilament
IM - Stethoscope
Surgery - Stethoscope
Psych/Neuro - Carry a stethoscope just because it's stupid when psych doesn't even listen to their patients heart or lungs. Neuro you'll need a tuning fork, reflex hammer, and monofilament as well.
OB/GYN - Stethoscope
Peds - Stethoscope with a tiny stuffed animal attached. 😛

As for what to expect: Expect to always be in the way, no matter how hard you try to be helpful or out of the way, the fact of the matter is that you're always there and never helpful. Just accept that. With that said, be as happy and enjoyable to be around as possible, especially with the residents. I don't mean kiss up to them, just talk to them when they have down time, always be available, and joke around with them if you have a team that is receptive to that kind of thing. You'll get the feel for third year after a rotation or two. People will disagree, but in the grand scheme of your future responsibilities, no one expects ANYTHING out of you in third year, doubly so for the first couple of rotations.

 

[yearn4ivy]

Purchase one of these:

First Aid for the Wards - buy an old edition, saves you $$$
OR
Success on the Wards

These two books will discuss expectations for each clerkship and how to do well, or at least appear that you know what you are doing.

 

[sonofva]

I did pretty ok 3rd year, and I only used:

-Blueprints for OBGyn, peds
-Step up to medicine
-stethoscope

you shouldn't really need any other diagnostic equipment at any doctors office. why fill your pockets with things that will be available to you already? books are personal preference.

 

[evilbooyaa]

If you're not talking about study materials, your stethoscope + a penlight should be more than enough. Reflex hammer if you want it.

I would recommend the MGH internal medicine pocket book (I had the green version but they may havce come out with an update) so you can quickly look up the basics of whatever you're diagnosing.

Shelf wise- I would go to each shelf exam thread (over in clinical rotations) and read stuff from the past 2-3 years. Don't look at the poll, as most of it is from many (5-6) years ago and not super useful. If you still can't find a synopsis of resources from those threads, shoot me a PM with whichever rotations you can't find out stuff on.

As to what's expected, not a lot. Hopefully your H&P skills aren't terrible. Be amicable, don't annoy the residents. Conventional thinking is split between hang around your residents all day or peace as early as possible to go home and study. Hard to judge. Know the grade is subjective, and your level of enthusiasm will (most likely) play a role in your grade. Most schools won't let you honor, however, without rocking the shelf, so try to do that as well. That last bit is what I didn't do so hot on this year, so I ended up with a bunch of high passes instead of (possibly) honors.

 

[JP2740]

Thanks I bought the pocketbook. Those threads in the rotation subsection were really helpful in terms of what I need for shelf. I'll just try to stay out of the way and not annoy anyone lol

 

[D elegans]

Prepare to feel clueless no matter how well you did your first two years/Step 1 and let your lack of knowledge slide off your back (well, I mean, you should learn, but if you don't know the answers when being pimped, it's ok).

This is based on exactly two weeks of trauma service and an average 4 hours of sleep/night

 

[alpinism]

Prepare to feel clueless no matter how well you did your first two years/Step 1 and let your lack of knowledge slide off your back (well, I mean, you should learn, but if you don't know the answers when being pimped, it's ok).

This is based on exactly two weeks of trauma service and an average 4 hours of sleep/night

This. 👍

Be a team player, volunteer to do stuff, ask questions, and try to read up on all your patients every night (their condition(s) and management). You'll feel pretty useless starting out, but just remember you're there to learn.

Carry some healthy food (granola bar, dried fruit, etc...) in your coat pocket for when you don't get lunch or dinner (esp for surgery). Get comfortable shoes for standing and rounding all day. Accept that you will be constantly sleep-deprived on some rotations.

 

[MrBeauregard]

Stethoscope.
Fine point pen.
A good attitude.

Sometimes more, but never less.

 

[evilbooyaa]

Stethoscope.
Fine point pen.
A good attitude.

Sometimes more, but never less.

Oh yeah, definitely have LOTS of pens on you. Enough to hand out to anyone who needs a pen at a moment's notice. One day on Trauma, I went from 3 pens in my front white coat pocket to 0 over the course of a day. Don't expect them back from your superiors, either. If they give it back to you, it's a bonus.

Also this is the basic rule of pimping:
If you get pimped and get it wrong (as long as it's not super obvious) that is relatively OK. Now one of three things can happen:
1) The superior tells you the right answer. This is the best scenario for the med student, as you now do not have to look it up. Although looking it up in better relation to your patient, etc. etc. may not be a bad idea.
2) The superior tells you to look it up. This means that you sure as hell better look it up sometime during the day or when you go home at night. They will 75-95% of the time not ask you the same question again, but if they do, and you don't know the answer (or at least AN answer, as some attendings want you to read their minds), then you'll look like a clown.
3) The superior does not tell you to look it up. This is a trap. Look it up just like in number 2.

If someone is doing a true 'pimping session', this is what will happen. They will generally start off with easier questions, then get into harder ones. They want you to screw up at some point so you have something to self-teach. Sometimes the first question they ask is a topic I was unfamiliar with, so I felt really dumb. In a group setting (say IM rounds) let whoever the question is directly asked to (even if it's an intern/resident) have a shot at answering it first. Of course, if there is no direct person that is asked, feel free to offer your thoughts.

Basically, don't be a dick to your team or make them look bad, and the residents/interns will hopefully do their best to make you look like an all-star. IM Pre-rounds (with the resident) were the biggest help to make me look like I somewhat had a clue of what the hell was going on before Attending rounds.

 

[JJMrK]

I've had pretty much 0 advice for 3rd year in terms of everything pretty much. What materials to buy? How best to succeed? Things like that. I was hoping for a thread of suggestions for everything and anything related to 3rd year. I don't want to get too in depth with a bunch of textbooks and all that.

What are the quintessential (is this a word?) materials? (like first aid for step 1, netter's for anatomy)

1. Don't be annoying: This means don't complain about anything in front of people, especially how tired you are---the residents have had less sleep than you. Don't ask to go home early, don't ask for special favors. Don't try to make other med students look bad. Don't ask 1000 questions; if you don't know something, try to figure it out for yourself before asking a resident. If someone is directly asked a question, don't answer for them. Don't quote literature unless someone specifically asks, "Has anyone read such and such paper?"

2. Work hard: This means be on time, be accessible (don't go hang out in the call room when the rest of your team is doing work), don't complain about getting extra work.

3. Ask before you do anything crazy. For example, as an MS3 you should not be doing things like: Calling APS/CPS, calling consults, taking out sutures, pulling out drains, telling nurses to give patients prn meds, etc without specific instructions to do so, or double checking with the resident. Also, if there is some new development/something going on with a patient tell the resident before you tell the attending.

4. Don't be annoying.

5. Don't be annoying.

You might think these are normal people things, but I've seen all of these rules broken. If you want to honor clerkships, the best way to do it is to be a normal, likeable human being who works hard and does well on shelf exams.

6. Study for your shelf exams. Pick 1 or 2 SDN-approved resources and read them as many times as you can. This is a good overview: http://forums.studentdoctor.net/showthread.php?p=13890453#post13890453