I'm about to start residency and I just realized that there will be fresh M3s looking to me for direction.
So what is it ok for me to do? What is useful for me to do?
Should I encourage them to pick up patients and write some notes? Should I let them follow me as I flounder on my first week as a resident?
Advice/reassurance would be greatly appreciated.
The short answer is that your senior is in charge. Your role is different on every service and, honestly, with every senior on the service. My general advice:
1) Your senior is normally the only one who should be dismissing students. You can ask to send the students home but don't just send them unless your senior has previously told you that's OK.
2) What students do on wards is generally a policy set by the service. Do students present on rounds or do you? Do you cosign their note or write your own? Can they do DC summaries? Place orders under supervision? There are all ward policies. Just ask on the first day (or the day before the first day) and then do whatever you're told.
3) If students do present on rounds, the nicest thing you can do is briefly preround with them so that they're presenting your plan, and they're presenting it coherently. Always prioritize patient care, though.
4) If you're trying to teach (which is always awesome to do, if it doesn't get in the way of the other work) remember to emphasize the basics at the start of third year. So far I have had to explain to medical students what a central line is, why you can't bolus w/ dextrose, how different kinds of insulin work, what a good differential for respiratory distress is, etc.. Medical students have lots of resources to help them memorize zebras and classic exam findings, and often know them better than the new Interns that have been away from multiple choice questions, but I find they need a lot of teaching on more basic clinical knowledge (I did, anyway).
5) Personal opinion: figure out early if you evaluate the students or not. If you don't, make sure they know that. If you do, maintain a little professional distance so that they don't feel obligated to engage you in small talk. If you're responsible for their grades, remember that they will act interested in you no matter what, and odds are no one actually cares all that much about your favorite band, wedding, child, or cat.
6) Last but not least: remember you are an Intern first. Ultimately the MS3s are a seniors' responsibility and an Intern's hobby. Focus on your own work, then your own learning, then help the students out. Anything that you do to help during your first year is above and beyond, its only poor form if you're still ignoring them as a senior.
Odds are if you're thinking about this at all you're going to be a well liked resident.
