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Hi SDNers,
Just trying to learn from the experiences of all you sages
cheers,
sunflower79
Just trying to learn from the experiences of all you sages
cheers,
sunflower79
What do you wish you had known when you started med school?
- Thread starter sunflower79
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Don't go to class unless attendance is requried. I wish I hadn't . Your exams will mostly focus on the most irrelevant trivia from the handouts. Spend your time memorizing as much of that as possible. If you spent from 8-5 studying (go somewhere else, don't stay home), then you'd have much more free time to go out, work out, whatever.
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Before starting medical school, I wish I'd known that:
I could still do well without going to class. (It would've made my first semester more fun. )
I could study for like 10 hrs the day before an exam and feel like a slacker because I knew some classmates were putting in 15 or 16 hours.
Pre-clinical honors grades aren't worth the sleep you sacrifice.
Buying most books is a waste of money.
AOA would be sooooo hard to get. (Am I the only one who feels this way?)
Medical school is like drinking water from a fire hydrant.
You're never really done studying in medical school.
You may be dumber than some of the people all of the time, you may be dumber than all of the people some of the time, but you will never be dumber than all of the people all of the time!
Time management is crucial to maintaining one's sanity.
How awesome my classmates were going to be!
I could still do well without going to class. (It would've made my first semester more fun. )
I could study for like 10 hrs the day before an exam and feel like a slacker because I knew some classmates were putting in 15 or 16 hours.
Pre-clinical honors grades aren't worth the sleep you sacrifice.
Buying most books is a waste of money.
AOA would be sooooo hard to get. (Am I the only one who feels this way?)
Medical school is like drinking water from a fire hydrant.
You're never really done studying in medical school.
You may be dumber than some of the people all of the time, you may be dumber than all of the people some of the time, but you will never be dumber than all of the people all of the time!
Time management is crucial to maintaining one's sanity.
How awesome my classmates were going to be!
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I would love it if you all elaborate on any time management techniques you've picked up
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My advice, written in the 2nd person, because I'm still trying to tell myself to do it.
Give up SDN, and other distractions. (Obviously, I am procrastinating and that statement is something I'm far from accomplishing).
Do a consistant amount every day, so that you stay on top of the work.
Take one day off every weekend (except if you have exams on the following week), it will keep you sane.
If you try to cram, you will burn out, and you will have to relearn it all for the boards. Better to study slower and focus on big concepts. Depending on your school (the 2nd years will be a great resource when you get there), testing may be on conceptual knowledge with some required details, or mostly details. If you want to do above the median, you will have to study to the exam style. If you want to learn the material so that you know it by the time you hit the wards, focus on understanding, not memorizing. At some schools (like mine) these are not mutually exclusive, but the above posters seemed to indicate that they were at their schools.
Schedule in wellness time for yourself, both physical (exercise and eating well) and mental (time with non medical people, church or meditation or whatever you use to feel balanced). Recreation is also important, but not exactly what I'm getting at here. You need to make time to take care of yourself, or you won't do as well, or be as happy. Oh, and get enough sleep. Sleep deprevation will make you inefficient.
Trade notes with classmates, and try to foster a cooperative feeling if one isn't there already. It really helps if you don't have to study alone.
I actually think going to class helps. But if you don't need the structure, skipping lectures might free up more time to be efficient. It really depends on how your curriculum is scheduled.
Time management:
If you memorize something right before you go do something like cooking, you can review while you cook, cementing it into your head.
Some things are easy to do simulataneously. For example, I have found that I can think a lot of things through about my personal life while showering so that they don't distract me later.
I like scheduling something clinical the night before exams, like volunteering in the homeless clinic or working at my preceptor's office. That makes me realize that I can't put stuff off until the end, and the clinical interactions keep me motivated when I'm starting to feel overwhelmed by the volume of material.
Live within walking distance to school, or if you have to commute, try taking the bus or train so you can read while commuting. Driving is a waste of time unless you like to use the commute time to unwind.
If you cook, make extra and use tupperware to store meal sized portions for lunches later in the week. Saves you making lunch, and generally, you can eat healthier than buying lunch.
Good luck, and don't forget, despite what everyone says to scare you, medical school is a lot of fun, and passing//learning enough to be ready for the wards is manageable. Honoring (if you school does that) may be a different matter.
Give up SDN, and other distractions. (Obviously, I am procrastinating and that statement is something I'm far from accomplishing).
Do a consistant amount every day, so that you stay on top of the work.
Take one day off every weekend (except if you have exams on the following week), it will keep you sane.
If you try to cram, you will burn out, and you will have to relearn it all for the boards. Better to study slower and focus on big concepts. Depending on your school (the 2nd years will be a great resource when you get there), testing may be on conceptual knowledge with some required details, or mostly details. If you want to do above the median, you will have to study to the exam style. If you want to learn the material so that you know it by the time you hit the wards, focus on understanding, not memorizing. At some schools (like mine) these are not mutually exclusive, but the above posters seemed to indicate that they were at their schools.
Schedule in wellness time for yourself, both physical (exercise and eating well) and mental (time with non medical people, church or meditation or whatever you use to feel balanced). Recreation is also important, but not exactly what I'm getting at here. You need to make time to take care of yourself, or you won't do as well, or be as happy. Oh, and get enough sleep. Sleep deprevation will make you inefficient.
Trade notes with classmates, and try to foster a cooperative feeling if one isn't there already. It really helps if you don't have to study alone.
I actually think going to class helps. But if you don't need the structure, skipping lectures might free up more time to be efficient. It really depends on how your curriculum is scheduled.
Time management:
If you memorize something right before you go do something like cooking, you can review while you cook, cementing it into your head.
Some things are easy to do simulataneously. For example, I have found that I can think a lot of things through about my personal life while showering so that they don't distract me later.
I like scheduling something clinical the night before exams, like volunteering in the homeless clinic or working at my preceptor's office. That makes me realize that I can't put stuff off until the end, and the clinical interactions keep me motivated when I'm starting to feel overwhelmed by the volume of material.
Live within walking distance to school, or if you have to commute, try taking the bus or train so you can read while commuting. Driving is a waste of time unless you like to use the commute time to unwind.
If you cook, make extra and use tupperware to store meal sized portions for lunches later in the week. Saves you making lunch, and generally, you can eat healthier than buying lunch.
Good luck, and don't forget, despite what everyone says to scare you, medical school is a lot of fun, and passing//learning enough to be ready for the wards is manageable. Honoring (if you school does that) may be a different matter.
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Mainly, that it can be a lot easier than the common perception. You can be Frank the Tank (from Old School) or an obsessive-compulsive know it all and still become a doctor. Decide what you want to be before you start, do you want AOA, a great residency in derm., etc? If that stuff doesnt matter then treat med school as a job, study four hours a day and relax. If you do want to be tops in the class, realize that you are competing against the grading scale, not your classmates. The lowest A looks just like the highest grade in the class on a transcript.
Other tips: sleep as much as you want--all nighters dont help you
keep friends outside of medicine
skip all of the classes you can
don't take yourself too seriously
Other tips: sleep as much as you want--all nighters dont help you
keep friends outside of medicine
skip all of the classes you can
don't take yourself too seriously
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Hey Dermatome,
So if I understand you correctly, you're saying that studying a solid 4hrs/day (assuming you've attended all lectures/labs/PBL sessions) is the anti-hardore approach...Yikes, not to sound like a gunner but let's just say for the sake of argument that I would like to make an attempt at honoring- maybe even AOA...are there enough hours in the day
Doc
So if I understand you correctly, you're saying that studying a solid 4hrs/day (assuming you've attended all lectures/labs/PBL sessions) is the anti-hardore approach...Yikes, not to sound like a gunner but let's just say for the sake of argument that I would like to make an attempt at honoring- maybe even AOA...are there enough hours in the day
Doc
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Originally posted by Doc Ivy
Yikes, not to sound like a gunner but let's just say for the sake of argument that I would like to make an attempt at honoring- maybe even AOA...are there enough hours in the day
Simply put: the answer to your question is "no". Good luck, gunner!
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I agree with the others - my best advice is to NOT to go to class unless you have to for some reason - mandatory quiz, presenation, etc - otherwise you will have a lot more time studying your required handouts and notes... and be able to keep your sanity.... it took me a semester to finally figure this out....
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If you are smart, and can memorize useless facts efficiently, there are plenty of hours in the day. If you are a workaholic type, I feel for you in your quest of AOA. But, my point was skip all of the classes you can, study hard from 8 to 12 everyday, and then you have tons of free time. Not a bad life, if you can accept being an average Joe MD.
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What I wish I had known?
-That you are not going to change your essential being just because you are in medical school. If it is not your current habit to study regularly every day, keep up with everything, and generally avoid the need for cramming, you are not going to turn into such a person just because medical school would be easier if you did. I have berated myself all year for slacking off the first couple of weeks, when in reality, I have ALWAYS been "deadline driven" (ahem), and no amount of wishing I were an organizational machine is going to change that. I definitely DO NOT study a regular 8-12 hours a day.
-That sifting through/rereading emails can be an enormous time-waster. Once I figure out how, I'll read them once a day, reply as needed, delete as needed, write things in my calendar, and move on.
-That it is a good idea to wait a couple of weeks before buying the books, and yes, it is okay to skip class. (notice a theme in these postings?)
-That telling guys you're a medical student is a surefire way to get them to stop talking to you. No need to make up a fake phone number - they'll never ask!
-That you are not going to change your essential being just because you are in medical school. If it is not your current habit to study regularly every day, keep up with everything, and generally avoid the need for cramming, you are not going to turn into such a person just because medical school would be easier if you did. I have berated myself all year for slacking off the first couple of weeks, when in reality, I have ALWAYS been "deadline driven" (ahem), and no amount of wishing I were an organizational machine is going to change that. I definitely DO NOT study a regular 8-12 hours a day.
-That sifting through/rereading emails can be an enormous time-waster. Once I figure out how, I'll read them once a day, reply as needed, delete as needed, write things in my calendar, and move on.
-That it is a good idea to wait a couple of weeks before buying the books, and yes, it is okay to skip class. (notice a theme in these postings?)
-That telling guys you're a medical student is a surefire way to get them to stop talking to you. No need to make up a fake phone number - they'll never ask!
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Sorrento,
That is too true. The moment I tell a guy I meet in a bar that I'm studying medicine, you'd think I told him I had infectious hepatitis, leprosy, or SARS
It's a good thing I have a significant other going in...or it would be a long 4 years
That is too true. The moment I tell a guy I meet in a bar that I'm studying medicine, you'd think I told him I had infectious hepatitis, leprosy, or SARS
It's a good thing I have a significant other going in...or it would be a long 4 years
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The only two universal requirements are:
1) Must be in the top 25% of the class.
2) The school cannot elect more than 1/6 of the class.
Some schools also include other factors such as community service. Some schools also have elections by faculty/current members of AOA, others do it based solely on academic standing.
Different schools determine academic standing differently. Mine uses step I scores and third year grades.
The major benefit is that it is the most recognized (and as far as I know, only) medical honor society. Resideny program directors know this, so it helps with residency applicantions.
Some chapters have lectures, do community service, etc.
1) Must be in the top 25% of the class.
2) The school cannot elect more than 1/6 of the class.
Some schools also include other factors such as community service. Some schools also have elections by faculty/current members of AOA, others do it based solely on academic standing.
Different schools determine academic standing differently. Mine uses step I scores and third year grades.
The major benefit is that it is the most recognized (and as far as I know, only) medical honor society. Resideny program directors know this, so it helps with residency applicantions.
Some chapters have lectures, do community service, etc.
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bump
thanks for all the replies!
thanks for all the replies!
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I understand what you all are saying about skipping class to have more time to study, especially since I know from undergrad. that so many lectures are pointless. But, thinking about it, there just seems to be something inherently wrong with skipping MEDICAL school class. Like getting your drivers licence after only a few hours of practice....not the best analogy, but maybe you can get my idea.
Is this the way all people feel pre-medical school and then you wise up or lose your idealism once you get there, or are there people in your classes that feel the same way? How do your profs feel?
Is this the way all people feel pre-medical school and then you wise up or lose your idealism once you get there, or are there people in your classes that feel the same way? How do your profs feel?
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Regarding study techniques:
Do what got you here, not what others tell you works for them or wont work for you.
Memorize handouts. The more lines you have memorized verbatim, the better youll be.
When it comes to medicine, it is about the big picture. When it comes to exams, there is no big picture.
Thats about it so far, im only a first yr
Do what got you here, not what others tell you works for them or wont work for you.
Memorize handouts. The more lines you have memorized verbatim, the better youll be.
When it comes to medicine, it is about the big picture. When it comes to exams, there is no big picture.
Thats about it so far, im only a first yr
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1. Falling asleep in class at 8AM is not as comfortable as sleeping in your own bed at 8AM.
2. Don't buy books. You don't even need to sign them out super early. You just need to pick up the last copy from the library.
3. Grades from first two years don't matter at all. You don't remember them, and people who gave you the grades don't remember them. Instead, spend time studying for Step 1.
4. Clinical years can be hell if you don't arrange your rotations carefully. Avoid call cuz you don't get called for **** as a med student, and you usually end up sleeping in a hospital bed all night and finding out in the morning you missed 4 codes (again, your own bed is still the best).
5. Many of your classmates are *****s. Don't worry about what they say or what they do. Find a few good friends and stick with them. Don't attend too many of those get-to-know-your-classmates things.
6. Don't give up your hobbies. They'll be your relaxation and salvation.
7. Don't date someone who doesn't understand that med school takes up a lot of time.
8. Don't date your classmate who wants you to be their shoulder to cry on. She'll do great in school and you'll be sleep deprived.
9. Impress the right people, forget about the rest.
10. P = MD. No AOA is a-okay.
2. Don't buy books. You don't even need to sign them out super early. You just need to pick up the last copy from the library.
3. Grades from first two years don't matter at all. You don't remember them, and people who gave you the grades don't remember them. Instead, spend time studying for Step 1.
4. Clinical years can be hell if you don't arrange your rotations carefully. Avoid call cuz you don't get called for **** as a med student, and you usually end up sleeping in a hospital bed all night and finding out in the morning you missed 4 codes (again, your own bed is still the best).
5. Many of your classmates are *****s. Don't worry about what they say or what they do. Find a few good friends and stick with them. Don't attend too many of those get-to-know-your-classmates things.
6. Don't give up your hobbies. They'll be your relaxation and salvation.
7. Don't date someone who doesn't understand that med school takes up a lot of time.
8. Don't date your classmate who wants you to be their shoulder to cry on. She'll do great in school and you'll be sleep deprived.
9. Impress the right people, forget about the rest.
10. P = MD. No AOA is a-okay.
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It is true that most lectures are pointless, but you need to decide for yourself if lectures work for you. I have consistently performed better in the courses which I decided to attend. At my school, there are certain courses where they explain things in lecture which are not fully explained in the notes. They also give you some 'hints' at what they might test on, and they put emphasis on certain topics which are not obvious (to me) from the notes as the most significant. I would even attend lectures for classes that have good notes and poor lecturers, because I like to have things explained to me. I am definitely in the minority on this issue, though.
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kcrd, I'm right with you, and I know there are a bunch of people in my class there too. I like the lectures to clarify things, as well as really get a sense of what will be on the test. The simple fact is that they can't test EVERY minute point in the notes, and I think that they're much more likely to hit stuff they've also hit in lecture.
Other thoughts:
Do try to keep up. It will help a lot come exam time.
Above all, remember that if those who came before you can do it, so can you.
Other thoughts:
Do try to keep up. It will help a lot come exam time.
Above all, remember that if those who came before you can do it, so can you.
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In addition to all the above, choose your battles. You cannot possibly know everything. You pick up on what's important pretty quick. So study what you know will be on the test. If you can do well without memorizing all the tiny miniscule details, you'll be much happier.
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Everything in medical school is like getting your drivers license after only a few hours of practice
. What matters is what you can cram in those few hours. Efficiency is key; get it any way you can. If you learn best by hearing the material, then lecture is for you. If reading transcripts does it for you, then class may be a waste of time.I skipped most lectures in memorization type classes where lecturers simply read minutiae off slides (biochem, cell, etc.) because they wasted my time. I realized that I was taking about an hour a lecture to digest transcripts regardless of whether I went to class so I made the decision to skip.
I went to lecture in thinking (concept driven) courses like phys and pathophys. Concepts were reinforced in lecture, so I felt that I got a better understanding of the material by attending.
A lot of it is lecturer dependant. If a lecturer in any course is horrible, taking that time to sleep, study, or run errands is in you best interest.
It is all dependant on how you learn. Experiment a bit and see what works.
Good Luck!
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I go to the same school as kcrd... the best "class picture" ever taken was of my class during a pathophys lecture: there were a total of 36 students in attendence. We had a class of 215 at that point.
The first 2 years of med school are not all that much harder than college. In fact, several of my college classes were more difficult (Biochem, Cell Biology) than their med school equivalents. My advice:
1. Relax, its only med school!
2. P=MD, once this attitude is achieved, the pre-clinical years become much more enjoyable.
3. Go to classes where you learn something. Skip the ones you sleep in.
4. Repeat #1 as often as necessary and don't freak out.
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I just thought of some good advice I was given at the beginning of 2nd year. I think it applies more to 2nd year than 1st.
Stay on top of things from the very start of the year - no 2 week initial slacking off period allowed! Second year is a lot more work than 1st, and it is almost impossible to cram for path, pathophys and micro exams.
Stay on top of things from the very start of the year - no 2 week initial slacking off period allowed! Second year is a lot more work than 1st, and it is almost impossible to cram for path, pathophys and micro exams.
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kcrd, your class has managed to freak us M1's pretty well over next year. Is it really *that* bad? At the very least, can you do well if you do keep up with the work every day? I'm not even thinking so much about honors, but having enough time to absorb all the info for the boards.
Is it really *that* bad? At the very least, can you do well if you do keep up with the work every day? I'm not even thinking so much about honors, but having enough time to absorb all the info for the boards.- Joined
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I didn't mean to scare you! It isn't *that* bad. I just did a fair amount of slacking off 1st year, and that's not possible 2nd. You don't need to study every single day if you are just looking to pass, though. (You just have to do more work a few weeks before exams.) If you study every day, you'll do very well.
The amount of detail is not any worse than in anatomy, it's just that you need to be more self-motivated, because you aren't constantly reinforcing the material with labs and conference. In micro, for example, they will present a ton of detail about a group of bacteria in lecture, and then you won't see it again until the exam. And they expect you to know the most minute details about those little guys. Path is similar, but you will have conference to go over the details. The path department does an especially good job at preparing you for the boards - we just took the shelf exam monday, and the consensus was that it was easy.
The nice thing about 2nd year is the material is much more engaging than the 1st year material. I found it much easier to sit down and study a group of diseases than to study a biochem pathway. I was much happier this year than last year.
You'll do fine
The amount of detail is not any worse than in anatomy, it's just that you need to be more self-motivated, because you aren't constantly reinforcing the material with labs and conference. In micro, for example, they will present a ton of detail about a group of bacteria in lecture, and then you won't see it again until the exam. And they expect you to know the most minute details about those little guys. Path is similar, but you will have conference to go over the details. The path department does an especially good job at preparing you for the boards - we just took the shelf exam monday, and the consensus was that it was easy.
The nice thing about 2nd year is the material is much more engaging than the 1st year material. I found it much easier to sit down and study a group of diseases than to study a biochem pathway. I was much happier this year than last year.
You'll do fine
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Thanks kcrd! It wasn't you specifically, but a fair amount of M2 students I've spoken to over the past year. But it sounds like it'll be ok as long as I go in expecting a lot of work from the start. Anyway, I have to get through physio first!
I'm glad that the path instruction is good for the boards - I feel pretty confident about physio (providing I know the material that is!) and biochem, so it sounds like a good foundation.
Anyway, I have to get through physio first!I'm glad that the path instruction is good for the boards - I feel pretty confident about physio (providing I know the material that is!) and biochem, so it sounds like a good foundation.
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To all you above posters from Temple, I was wondering if you could tell me if you feel that your experiences are representative.
There was a poster on the interview experience site who said that at temple you're in class more/have more work/need to know more irrelevant stuff than other schools.
He/She also said you were losing your children's hospital. Is that true? I hope not because I've seen that hospital and it seems like a great place.
Would you chose Temple all over again?
There was a poster on the interview experience site who said that at temple you're in class more/have more work/need to know more irrelevant stuff than other schools.
He/She also said you were losing your children's hospital. Is that true? I hope not because I've seen that hospital and it seems like a great place.
Would you chose Temple all over again?
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nor will you ever be done studying in your medical career.
I second these comments by MD2b06.
8
8744
No truer words were ever written.
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i completely disagree with the person who said "skip class" I attended every single class, memorized all their minutia and got in the 250s for USMLE Step 1 and Junior AOA. All the Junior AOA (the top 2% of the class, one of whom got in the 280s on Step 1) all attended class regularly.
To crush Step 1, you got to know some of the little things that are not in the BRSs and First Aids.
To crush Step 1, you got to know some of the little things that are not in the BRSs and First Aids.
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Congrats on you ##'s ... quite impressive. If you can learn by listening to a lecturer read medical trivia pursuit, then I envy you. I was on our schools transcript committee, which uses a well organized system utilizing students to transcribe lectures in a standard format. With the scripts, I skipped class, "memorize(d) all their minutiae," and did purty well.
My point is that everyone learns differently. In medical school, you must figure out what works for you, and go for it!
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And if what you're doing isn't working, change! This may sound like a no-brainer, but I've seen people simply continue what they were doing in undergrad and do poorly, but make no attempt to adjust because "it worked for me before."
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Yeah, I think the toughest thing after moving on to med school (or any other type of university program) is that horrible feeling that you can't ever get a good grip on anything - but that's fine, ok and normal. I wish I'd known that. Then I wouldn't beat myself about it so much...
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Ive heard nothing of losing the Children's Hospital. Philadelphia is weird in that there are lots of other hospitals that constantly change affiliation with medical schools. But AFAIK the new Children's next to the main hospital is ours to stay.
Having a roommate at Jefferson, I dont think there is that much a difference in the amount of time each of us has scheduled for class. And it seems to me that we are both learning the material at the same level of detail.
I am quite happy with Temple thus far, and have experienced nothing that would change my mind about coming here.
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here are some thoughts:
1) don't believe people that tell you pre-clinical honors don't matter. at most schools, they determine Junior AOA vs Senior AOA. Junior AOA is more prestigious. Also, for more competitive fields, surgery, radiology, ortho, the top medicine programs, they really DO matter.
2) don't cram!!! better 2-3 hours/night consistently than 15 hours before the exam. your memory retention begins to deteriorate.
3) have FUN. don't study all the time. 2-3 hours/day only.
4) for your clinical years, the key rules are:
* never make your intern or resident look bad.
* never generate more work for your intern or resident
* always be helpful and do scut work. this is the most appreciated role of the med student.
* bring in review articles.
I'm a graduate of Temple Med, Junior AOA, trained at Harvard for internal medicine.
1) don't believe people that tell you pre-clinical honors don't matter. at most schools, they determine Junior AOA vs Senior AOA. Junior AOA is more prestigious. Also, for more competitive fields, surgery, radiology, ortho, the top medicine programs, they really DO matter.
2) don't cram!!! better 2-3 hours/night consistently than 15 hours before the exam. your memory retention begins to deteriorate.
3) have FUN. don't study all the time. 2-3 hours/day only.
4) for your clinical years, the key rules are:
* never make your intern or resident look bad.
* never generate more work for your intern or resident
* always be helpful and do scut work. this is the most appreciated role of the med student.
* bring in review articles.
I'm a graduate of Temple Med, Junior AOA, trained at Harvard for internal medicine.
Thanks jay c for your advice for the clinical years! It's scary that the grading for the third year can be so subjective... I desperately want to hear more advice. One more question, why do you need to bring review articles?
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I agree with pretty much everythin Jay said. On the junior vs senior AOA thing, your best bet is to find out early on what your school's policies are. At my school, it is board scores and third year grades for both junior and senior AOA...preclinical grades do not factor into the equation. However, your residency program will see your transcript and it couldn't hurt to have as many honors as possible.
As far as third year goes...again, I agree with Jay. It is subjective. Here are my thoughts:
1) Work hard. This, in my mind, is number 1. It was my experience that residents are more willing to forgive gaps in knowledge if you are working hard than to forgive sloth even if you know everything. And, in my experience, residents' evaluations of you carry a fair bit of weight (again, this is school specific). Arrive early and preround. Do not look for ways to duck out of work or try and leave the hospital early.
2) A corrolary to #1 - Do scut and, when possible, do it before you are asked. If you are at all unsure if something should be done, ask. If the answer is yes, volunteer to do it.
3) Know everything about your patients. This rule rivals rule #1 in terms of importance. You are the expert on your patients. If anyone (nurse, PA, resident, fellow, attending, consulting physician, etc) has a question about your patient, you should have the answer. Preround and be ready to present your patient on rounds. Know all lab results before anyone else. Follow up on films. You will likely be carrying fewer patients than the interns and residents, so you have the time to do all this.
4) Yes, bring articles. You do not need articles on every patient. Be somewhat selective, but find times to bring in stuff. Review articles are particularly nice. If the disease is rare, you can even stick an article in the chart. Many attendings will have conferences with their team. You can present at these conferences.
5) Find time to read up on your patients' problems. This is the best way to learn. However, remember that you will not see patients who represent every disease you need to know about, so you need to leave time to read up on the stuff you do not see.
6) Have a life. It is healthy to do stuff outside of school/work. However, do not let your effort in the hospital suffer as a result. You can strike a balance.
7) Despite its order in this list, this rule is not to be forgotten. Never never never make your classmates look bad. This is poor form. It will drive your classmates crazy and they will start to hate you. Hopefully, you will have residents who see people who do this for what they truly are.
Hope this helps. I will ammend the list if I think of new ones.
As far as third year goes...again, I agree with Jay. It is subjective. Here are my thoughts:
1) Work hard. This, in my mind, is number 1. It was my experience that residents are more willing to forgive gaps in knowledge if you are working hard than to forgive sloth even if you know everything. And, in my experience, residents' evaluations of you carry a fair bit of weight (again, this is school specific). Arrive early and preround. Do not look for ways to duck out of work or try and leave the hospital early.
2) A corrolary to #1 - Do scut and, when possible, do it before you are asked. If you are at all unsure if something should be done, ask. If the answer is yes, volunteer to do it.
3) Know everything about your patients. This rule rivals rule #1 in terms of importance. You are the expert on your patients. If anyone (nurse, PA, resident, fellow, attending, consulting physician, etc) has a question about your patient, you should have the answer. Preround and be ready to present your patient on rounds. Know all lab results before anyone else. Follow up on films. You will likely be carrying fewer patients than the interns and residents, so you have the time to do all this.
4) Yes, bring articles. You do not need articles on every patient. Be somewhat selective, but find times to bring in stuff. Review articles are particularly nice. If the disease is rare, you can even stick an article in the chart. Many attendings will have conferences with their team. You can present at these conferences.
5) Find time to read up on your patients' problems. This is the best way to learn. However, remember that you will not see patients who represent every disease you need to know about, so you need to leave time to read up on the stuff you do not see.
6) Have a life. It is healthy to do stuff outside of school/work. However, do not let your effort in the hospital suffer as a result. You can strike a balance.
7) Despite its order in this list, this rule is not to be forgotten. Never never never make your classmates look bad. This is poor form. It will drive your classmates crazy and they will start to hate you. Hopefully, you will have residents who see people who do this for what they truly are.
Hope this helps. I will ammend the list if I think of new ones.
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I should qualify my statement by saying you should not intentionally make your fellow students look bad (just in case someone argues that your own success may unintentionally reflect poorly on others).
One example I can think of from my own experience is pimping your classmates in front of senior residents and attendings. And not just asking some simple question about the status of the patient that the person should know the answer to, but asking difficult questions that the pimper knows that the pimpee does not have the answer to. The pimper then turns around and answers his/her own question.
I am sure other seasoned veterans have more examples...would they care to share?
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some more thoughts on third and fourth years:
GENERAL RULES:
1) as stated earlier, never make your co-student look bad. i've had some med students on my service that have pimped other students. this will drop their grade dramatically. always work as a team, and don't be cut-throat. we (housestaff, fellows) can see this. it's pretty obvious.
2) when i was a resident, one of my favorite students would ALWAYS be doing scut for us, WITHOUT us asking. he would listen during work rounds, make a list of things i told my interns to do, then he would go and run off and do them!! amazing. also, he would get all the charts as we rounded.
3) know everything about the patient. another one of my favorite students was with me on the GI consult service (i am a GI fellow). we had 25 patients on the service. he would go and see 10-12 consults with me per day, and knew EACH AND EVERY PATIENT as well as i did. that kid walked on water.
both of them are now doing their residency at Harvard.
4) bring in articles, and teach the intern/resident about cool stuff. for example, if a patient with a rare disorder (say, polyarteritis nodosa, or celiac sprue) was admitted, bring in articles, teach the housestaff during rounds, so they can look good during attending rounds. you will be rewarded by the housestaff giving you a good evaluation, and telling the attending how great you are.
a few words about grading:
the housestaff have the greatest input into your grade. in most institutions, the intern and resident grade the student, and the attending will meet with them, and discuss the student's performance. so having the housestaff on your side is a big bonus.
5) don't show off.
6) for internal medicine, be able to come up with an assessment and plan. most students are great at the history and physical; what impresses me most about students are the ones that can come up with a well-thought out differential diagnosis, and both a diagnostic and therapeutic treatment plan by integrating pertinent history and physical details.
for example, a patient presents with nausea and vomiting. the history is that the nausea and vomiting occur 30 minutes after food ingestion for three months, and the patient also complains of epigastric pain. No fevers, chills, no diarrhea, no pain radiation, no alcohol abuse
differential diagnosis should be stratified into:
most likely, less likely, and why, and the third group is "cannot miss cuz it will kill patient"
so for this patient:
most likely are:
biliary colic, cholecystitis, gastroparesis, gastric outlet obstruction.
ulcers
less likely are gastroenteritis, bowel obstruction, appendicitis, acute pancreatitis
will kill patient are:
mesenteric ischemia, bowel obstruction
diagnostic plan and why:
cbc - look for infection and inflammation
chem 7 - anion gap for ischemia
lft - look for cholelithiasis and gallstone pancreatitis (along with amylase, lipase)
either CT abd or abd obstruction series with ruq u/s to exclude obstruction and biliary source.
if all else negative, remaining diagnosis is gastroparesis vs ulcers: gets upper endoscopy and gastric emptying study.
not that all students should know this at time of admission or consult, but by doing a quick lit search overnight, can find a good review article by the AGA on w/u of nausea and vomiting.
j
GENERAL RULES:
1) as stated earlier, never make your co-student look bad. i've had some med students on my service that have pimped other students. this will drop their grade dramatically. always work as a team, and don't be cut-throat. we (housestaff, fellows) can see this. it's pretty obvious.
2) when i was a resident, one of my favorite students would ALWAYS be doing scut for us, WITHOUT us asking. he would listen during work rounds, make a list of things i told my interns to do, then he would go and run off and do them!! amazing. also, he would get all the charts as we rounded.
3) know everything about the patient. another one of my favorite students was with me on the GI consult service (i am a GI fellow). we had 25 patients on the service. he would go and see 10-12 consults with me per day, and knew EACH AND EVERY PATIENT as well as i did. that kid walked on water.
both of them are now doing their residency at Harvard.
4) bring in articles, and teach the intern/resident about cool stuff. for example, if a patient with a rare disorder (say, polyarteritis nodosa, or celiac sprue) was admitted, bring in articles, teach the housestaff during rounds, so they can look good during attending rounds. you will be rewarded by the housestaff giving you a good evaluation, and telling the attending how great you are.
a few words about grading:
the housestaff have the greatest input into your grade. in most institutions, the intern and resident grade the student, and the attending will meet with them, and discuss the student's performance. so having the housestaff on your side is a big bonus.
5) don't show off.
6) for internal medicine, be able to come up with an assessment and plan. most students are great at the history and physical; what impresses me most about students are the ones that can come up with a well-thought out differential diagnosis, and both a diagnostic and therapeutic treatment plan by integrating pertinent history and physical details.
for example, a patient presents with nausea and vomiting. the history is that the nausea and vomiting occur 30 minutes after food ingestion for three months, and the patient also complains of epigastric pain. No fevers, chills, no diarrhea, no pain radiation, no alcohol abuse
differential diagnosis should be stratified into:
most likely, less likely, and why, and the third group is "cannot miss cuz it will kill patient"
so for this patient:
most likely are:
biliary colic, cholecystitis, gastroparesis, gastric outlet obstruction.
ulcers
less likely are gastroenteritis, bowel obstruction, appendicitis, acute pancreatitis
will kill patient are:
mesenteric ischemia, bowel obstruction
diagnostic plan and why:
cbc - look for infection and inflammation
chem 7 - anion gap for ischemia
lft - look for cholelithiasis and gallstone pancreatitis (along with amylase, lipase)
either CT abd or abd obstruction series with ruq u/s to exclude obstruction and biliary source.
if all else negative, remaining diagnosis is gastroparesis vs ulcers: gets upper endoscopy and gastric emptying study.
not that all students should know this at time of admission or consult, but by doing a quick lit search overnight, can find a good review article by the AGA on w/u of nausea and vomiting.
j
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Okay, the only stupid question is the one you never ask.
What is SCUTWORK?????
Everyone talks about it all the time and I think I have a vague, intuition sort of understanding of what it might be, but what exactly is it?
Thanks
What is SCUTWORK?????
Everyone talks about it all the time and I think I have a vague, intuition sort of understanding of what it might be, but what exactly is it?
Thanks
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scut (skut): noun (also known as scutwork), as in "doing some scut" or verb, as in "scutting out"
1. work that is menial, but patient related. for example, checking lab results, drawing blood, starting IV's, checking Xray results, writing notes, etc.
2. to scut: to ask someone to perform scutwork.
cheech: verb, as in "cheeching me"
to ask someone in a lower position of power to perform work that is both meaningless and not patient related. for example, asking a student to re-write a note because of a spelling error, or to send an intern to draw blood for a useless, unrelated blood test that has no bearing on the diagnosis.
1. work that is menial, but patient related. for example, checking lab results, drawing blood, starting IV's, checking Xray results, writing notes, etc.
2. to scut: to ask someone to perform scutwork.
cheech: verb, as in "cheeching me"
to ask someone in a lower position of power to perform work that is both meaningless and not patient related. for example, asking a student to re-write a note because of a spelling error, or to send an intern to draw blood for a useless, unrelated blood test that has no bearing on the diagnosis.
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Somebody should find the definition of scut work in NMS Surgery. I think they define it as something a medical student does to distinguish him/herself from the rest, something a faculty would appreciate, etc... it's hilarious.
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I wish I knew beforehand how doable and enjoyable first year would be. I had some negative pre-conceived notions before I entered (i.e. first two years suck and you just have to "trudge through it", etc). I found the workload to be considerably more comprehensible than my undergrad pre-med courses and the support system to be phenomenal. Good luck with school and enjoy your experience!
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I agree with jay c and brewster but there are two more important items and that are:
1) don't take things personally! there are some SOB residents and/or attendings on certain rotations. don't take their demeaning comments personally. This is very hard to do. Just remember, you are more than a medical student. You have made it this far because you are intelligent and the admissions committee saw some potential in you.
2) make yourself happy. This does not mean that you should skip calls but do what you think are right. If you believe that you should stay 2 more hours just to see a resident putting a IJ tube into a patient, then go ahead. But if it is sunday afternoon and you are more productive by going home and study, then tell the resident that you have finished rounding with them and performed all the tasks, so can you go home?
The bottom line is at least, you can look back at the rotation and say that you enjoyed it and did what you thought were important. Evaluation is subjective and honestly, most residents and attendings do not care much about handing in an evaluation for med students (they have dictations to do, admissions notes to write, patients to see, get some sleep while on call all night long, etc.) so many many times, your evaluation will be generic or can be opposite of what you think should be. But by acting for your own good and be confident about who you are, at least you keep some sanity and actuall learn (instead of doing scuts all day long).
Lastly, many posters here talk about junior AOA and how to be the superstar on the ward. However, you gotta understand not everything in medicine requires junior AOA and stellar clinical grades. Most fields out there are not THAT competitive so that you HAVE to have AOA or all honors on the ward. Do what is compatible with your goal. Get a couple honors in basic science and a couple in your clinical year. But don't work yourself to death and be all cynical.
During third year, it is important to look into yourself and realize who you are. You are NOT a whipping boy/girl for the attendings/residents!!!
1) don't take things personally! there are some SOB residents and/or attendings on certain rotations. don't take their demeaning comments personally. This is very hard to do. Just remember, you are more than a medical student. You have made it this far because you are intelligent and the admissions committee saw some potential in you.
2) make yourself happy. This does not mean that you should skip calls but do what you think are right. If you believe that you should stay 2 more hours just to see a resident putting a IJ tube into a patient, then go ahead. But if it is sunday afternoon and you are more productive by going home and study, then tell the resident that you have finished rounding with them and performed all the tasks, so can you go home?
The bottom line is at least, you can look back at the rotation and say that you enjoyed it and did what you thought were important. Evaluation is subjective and honestly, most residents and attendings do not care much about handing in an evaluation for med students (they have dictations to do, admissions notes to write, patients to see, get some sleep while on call all night long, etc.) so many many times, your evaluation will be generic or can be opposite of what you think should be. But by acting for your own good and be confident about who you are, at least you keep some sanity and actuall learn (instead of doing scuts all day long).
Lastly, many posters here talk about junior AOA and how to be the superstar on the ward. However, you gotta understand not everything in medicine requires junior AOA and stellar clinical grades. Most fields out there are not THAT competitive so that you HAVE to have AOA or all honors on the ward. Do what is compatible with your goal. Get a couple honors in basic science and a couple in your clinical year. But don't work yourself to death and be all cynical.
During third year, it is important to look into yourself and realize who you are. You are NOT a whipping boy/girl for the attendings/residents!!!
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