what type of medical student impresses you?

[aye]

hello attendings and residents.

I will be starting an away rotation next week at a hospital I'm interested in applying to. Besides being punctual, having a good attitude, and knowing everything about your patient, what are things that students can do to stand out and be memorable (in a good way)? I wanted some perspectives from the "other side" and not just what other med students have to say.

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[Winged Scapula]

Being on time, reading for the rotation, knowing your patients, being interested (without pretending you want to be a surgeon if you really don't) all go without saying. A good attitude is key - EVERY field has something to learn from that you can take to your future career. Try and figure out what that is. Do not roll your eyes when I describe the cases for the day because you have seen "lots of those"; do not be eating breakfast in the cafeteria when the patient is rolled into the room.

One of the things that impressed me about the student who just finished rotating with me was anticipation of events. When we would start discussing surgery with the patient, he would get the surgery booking sheet out and start completing it, the pre-op testing forms, etc. He would hang the films and even attempt to educate the patient on their problem. Most students don't IMHO. It was something little but it showed initiative, attention to detail and a willingness to be a team player - no student is above doing paperwork, moving the patient from the bed, putting on a Bovie pad, etc. because its all work that needs to be done and if I will do it, so should you. I've seen some students who act like because they are paying X amount of dollars for tuition they shouldn't be doing "tech" or "nurses" jobs.

That, and it was obvious he was reading, looking at the OR schedule ahead of time, the office schedule, etc. He didn't just stand around waiting for me to tell him what to do. He was practicing his suturing at home and it was evident as his skills got better. He was prepared, asked questions when he needed more information or to clarify his fund of knowledge. This from a student who has no intention of going into surgery.

In short, he was prepared and he made me more efficient (although I am always slower in the OR and office with a student/resident), so I could spend more time teaching.

Now not every attending will want you to be doing such things, but I think at least making the effort - get the forms out, know where they go, making sure that you know the schedule and read in advance for it (even if its just a few lines about the case), goes a long way.

Oh... and he brought me lunch on several occasions when he thought I wasn't eating enough.

 

[surg]

As you said: punctuality is key. Surgeons are nearly pathologically impatient. Waiting for you (a student) isn't going to happen and you having to interrupt me by paging me to find out where I am, isn't going to improve my mood. Be the first one to the OR. Get it set up, etc. Help move the patient to the OR, etc. Even if this means leaving breakfast early. That used to be the expectation where I was as a student. Now I find it is the rare student that makes it to the OR before I do. About 1/3 to 1/2 of them are even late (i.e. arrive after the patient is asleep).

Know your patients you are following and know the patients you are going to scrub in on. The next time (which isn't infrequent) a student asks me what operation we are going to do or why, I'm probably going to have a melt-down. It's not that I don't want you to ask questions. Really, I do. I expect your questions to show that you have already read to learn the basics and then use your questions to refine your knowledge. Bad question, "So why are we doing this colectomy?" Good question, "I read that this patient had colon cancer and a liver metastasis, but we are going to do a laparoscopic colectomy, but I know sometimes people do the liver resection at the same time. What makes you choose to leave it in this time?" Then be prepared to discuss indications for liver resection for colon cancer mets. [same question, better phrased to show that you aren't just asking me to spoon feed you]

Always be present or close by and thinking about the next steps whenever there is patient care to be done if you aren't off on an errand. I am not going to spend the time to track you down if something interesting is happening. And probably one of the things that impresses me the most is when I tell someone to do something and they were already prepared for it or on it (they've taken the time to find all the dressing supplies they will need for a wound we are going to round on and left it there before hand. They already have the films pulled up that we will have to review, etc.) I don't expect you to always know exactly what I want, but if you consider the range of options, and are prepared for the most common ones that will go a long way.

Don't complain, be as cheerful as possible and when it's not, work even harder. When everyone else is having a bad day, it's nice to see someone trying hard to get the day done as quickly as possible.

Be ready to show your stuff. I'll let students sew and do things if I feel they are doing well otherwise. If you do well, you'll do more. The more I see you aren't slowing me down ridiculously, the more you'll get to do. So practice your technical skills (sewing, tying, cutting in a straight line (you'd be surprised how few people can do that!))

Learn how stuff works as quickly as possible. I don't want to have to tell you how to find a film 5 times. After a while it's easier to do it myself. The more I depend on you, the better you must be doing.


Most of these are ideals. You won't hit any of them perfectly. One of the best evaluations I can give is: "Student X functioned as an intern on my service. I'd be happy to see him as an intern and resident on my service in the future. I hope we do."

When you think about it in those terms, it's easy to figure out what would impress me.

 

[MossPoh]

This is some pretty solid info here. Thanks all.

 

[45408]

Keep lots of information on you. You can never have enough vitals/labs on your patients. Keep an OR schedule in your pocket, have everyone's pager numbers, an extra pen, and if you've got big pockets, keep some gauze/paper tape/suture removal blade (it's a lot smaller and thinner than a scissors, and it's a single-use blade).

Nothing looks worse than being late for morning rounds unless you're already in the OR or seeing a consult or something. And never lie. It's one of the few unforgivable sins. Say "I don't know," or "I'll look it up."

 

[nbd13]

Wow, great info here! Thanks for taking the time to post.

I had one quick question, what is the best way to practice suturing at home? I know how to tie the basic knot, but I'm not sure what to use to practice on at home. Let alone how do I obtain suturing material? I would love to practice this when I have some down time, so any info would be greatly appreciated.

Thanks,

Nick

 

[opr8n]

Wow, great info here! Thanks for taking the time to post.

I had one quick question, what is the best way to practice suturing at home? I know how to tie the basic knot, but I'm not sure what to use to practice on at home. Let alone how do I obtain suturing material? I would love to practice this when I have some down time, so any info would be greatly appreciated.

Thanks,

Nick

buy pigs feet and keep them in your freezer, sounds kinda weird, but its the best approximation for sewing human skin
if yuou dont want to do that oranges are ok for stitches that are not subq

 

[Winged Scapula]

Pigs feet or chicken works well.

ORs usually have a stash of outdated suture material that they often keep for medical mission trips. Ask one of your attendings or residents to get you some; you may even be able to get a needle driver and forceps to practice with. I've never had a problem getting ORs to loan me stuff to allow students to practice at home.

 

[former military]

this is all good advice.
One thing that strikes me is presenting a patient on rounds.
Often I am rounding with a resident/medical student team at the end of the day. I am usually tired and always impatient. I may be covering call for the night on another staff's patient which I know nothing about or my own patient I know everything about.

A good presentation let's me know everything I need to know in less than 90 seconds.
who is the patient?
what problem did they have?
what operation did they have?
what is their post op course with appropriate issues?
what is the formulation of the plan?

I don't want to know about extraneous issues, non factors and irrelevant crap. I can tell that the presenter knows the patient, has identified the problems, potential problems and has covered the issues and has the forsight to anticipate problems. it is a lot of how trust is based when I communicate with the residents.

At the resident level it is the difference between waking up in the middle of the night, hearing the story, and going back to bed vs worrying about things, not sleeping, or coming in from home.

roundsman ship when done well by the medical students makes the residents look good or bad and they judge you by this. It is a skill that needs to be practiced and theoretically you can do this at anytime not just when you know it is coming on rounds.

 

[opr8n]

1. be early
2. know the patients
3. read always
4. show interest
5. show respect
6. be early
7. know something about the case you are scrubbing
8. ask appropiate questions
9. dont complain, ever
10. be early
11. if you want to do somehting, ask
12. be visable

 

[45408]

11. if you want to do somehting, ask

And if asked to do something, say yes. Usually.

 

[SuitcaseLife]

Great info! Thanks a lot!

 

[glade]

My two rules for medical students:

1) If you're a chick, look above average.
2) If you're a guy, don't stand in front of the chicks who are looking above average. In fact, don't stand in my eye sight ever.

 

[jinx520]

My two rules for medical students:

1) If you're a chick, look above average.
2) If you're a guy, don't stand in front of the chicks who are looking above average. In fact, don't stand in my eye sight ever.

Yay! Glade's back. Again.

Marry me before you get banned.

 

[glade]

First things first: are you above average in looks?

 

[jinx520]

Truthful answer: Of course I am!!

Nice girl answer: I look okay, I guess.

 

[glade]

Sweet. Time for me to .

If I pass out on our honeymoon, you can resuscitate me like this: .

 

[Sleeve]

Dr. Cox has this one nailed. But I'll reiterate: Be on time.....no, be early every single day. You should be waiting on the attending or resident and never vice-versa. Know your patients completely and read about their problems every single day.

I won't go into all the others that they've said already except for one. The student who goes above and beyond looks like a superstar even if they aren't. Anticipate what will need to be done and do it if it's not above your level. If a dressing needs to be changed, have the stuff to change already waiting. If paperwork needs to be done that you can do, do it. If an X-ray needs to be looked at, have it pulled up and ready (same for labs). In the O.R., pretend you work in the O.R. Get the patient, move the patient, place grounding pads, foleys, scds, whatever. Not only will the surgeon appreciate you, the O.R. staff will love you and be more patient while you are sewing. Be interested. Be aggressive...but not too agressive. Maybe assertive is a better word. Don't ask stupid questions or questions that you already know the answer to just to look smart. We've seen it before and it's annoying.

Come early, stay late, don't thing about eating

 

[yougotit]

Any advice of the best time to do a 4th year audition elective? I am only doing one away. I start my 4th year in March with a surgery AI and Wondering if June or July are a good time for an audition elective at my top choice.

 

[Winged Scapula]

Any advice of the best time to do a 4th year audition elective? I am only doing one away. I start my 4th year in March with a surgery AI and Wondering if June or July are a good time for an audition elective at my top choice.

Audtions are generally done between June and late September/early October, to allow for an LOR to be written and uploaded to ERAS. IMGs/FMGs should do it earlier to allow for ECFMG processing.

It does not make a difference whether the rotation is done in June/July or August/September.