The third year is tough. It is the most physically, emotionally and mentally exhausting year of medical school. However, it is also one of the most formative and rewarding years. From giving patient presentations to assisting in surgeries, third year is when you finally get to dip your toes into what it’s like to be a doctor. While it is an incredible year of learning, it is also one of the most demanding and challenging of years of medical school. To help you out, I’ll be sharing my 10 tips for excelling in (and honoring) your third year clerkships below!
1. Focus on being a valuable team member.
Taking care of patients in the hospital is a team sport. While you should try to impress your attendings and residents, don’t lose sight of being a valuable team member. Be a person others like to have around. You don’t need to sabotage your fellow medical students to stand out. Your team will benefit if you can all work effectively together– you’ll provide better patient care, be more efficient at your work, get done sooner, etc.
Trust me, this works. Some of the best feedback I’ve received was from team where medical students and residents worked very well together. We ALL received exceeds expectations on our evaluations.
2. Start studying on the first day of your clerkship
Most clerkship grades are determined by a combination of shelf exam scores and clinical performance evaluations. To get a high grade in your clerkships, you need to impress your attending AND have a solid knowledge base to do well on shelf exams. This was one of the biggest struggles for me as a new third year medical student.
The biggest tip I have for doing well on your shelf is to start early. Start studying on your first day. This is when you’ll likely have the most time and energy. You can find a list of the resources I felt were the most helpful during my rotation here!
Before your clerkships, figure out which resource you’ll use. Create a schedule by determining how many days you have and how many Uworld questions or book chapters you need to get through to finish it by the end of your rotation. Then (the hardest part), stick to your schedule!
3. Be your patient’s advocate
While residents are handling patient care tasks for 15+ patients, you have 1-4 as a med student. This means you can spend 15-20 minutes with your patient before rounds (while residents may have 2-3 minutes). Use this time to develop strong relationships with your patients and their families. Spend time with them throughout the day if you have a chance and check in on them before you leave.
Be their advocate. Let your team know about any concerns your patient has that may have been missed during hectic morning rounds. If they’re having a scary procedure, ask if you can accompany them. If they need to schedule a follow-up appointment, make that call. If they have family members that want an update, offer to speak to them.
4. Know your patient better than anyone else
You will be an all-star student if you can do this. Again, as a medical student, you have the most time to spend with and get to know patients. Beyond knowing their medical history, you should get to know your patient’s life. What do they do for work? Where do they live? What do they like to do for fun? Do they prefer to cook at home or eat out? Although they may not be directly related to your patient’s medical history, these things can be helpful pieces of information for the team.
5. Be proactive, not annoying
On your first few days on a new rotation, diligently observe the day to day tasks your team handles. As you feel more comfortable, begin to offer to do some of these tasks. From writing a progress note to helping prep a patient for surgery, there are many simple tasks medical students can do help with. If you’re unsure about what you can do to be helpful, ask your resident. As your competence processes throughout your rotation, you can shine by initiating tasks without being asked (be sure to ask the resident first). For example, you could say, “Hey, during rounds Dr. X mentioned that we should call the lab to check on Y. I can call them now if that’s okay with you.”
6. Be curious and always ask “why”
You will learn and remember much more if you learn from your patients. You should constantly be asking, “why?” Why are we doing this treatment? What are the side effects my patient may experience? Why are we choosing that antibiotic regiment? Look up these answers on your own on UptoDate or ask your residents and attendings, when appropriate. Your team will recognize and appreciate your curiosity.
7. Ask about expectations
Ask your resident and/or attending what is expected of you within the first week of a new rotation. Ask about presentation tips, workflow, who you can direct questions to, schedule, etc. Some attendings will have very specific guidelines. For instance, I had one attending who didn’t like to hear the assessment portion of the patient presentation. I’ve had another who liked a one-liner on how the patient is doing and another who like a full, complete presentation.
You can also ask about what other successful medical students have done to stand out. One of my attendings suggested that students on his service give a short talk on a relevant topic. This was a great opportunity for medical students to show our competence beyond a patient presentation. If you have an interesting patient, you can offer to give a short talk after during your research.
8. Seek feedback on your performance
Try to do this during the middle of your block. If your school makes feedback sessions mandatory (like mine), then this makes your life a little easier. If not, request to meet with your attending or resident to figure out how you are doing.
If they give you a blanket statement like “you’re doing good,” try to push them to give you more individual feedback. Ask them for specific ways you can improve or be more helpful to the team.
9. Be open to constructive criticism and improve yourself every day
We all have room for improvement. It’s better to learn now how to be receptive to feedback, even if it’s harsh. Remember that their criticism or feedback is to help you become a better medical student, not to make you feel less worthy. Try your best to improve on specific things your upper-level residents or attending mention. If they tell you to have more concise presentations, then make it your goal to improve on that every day! Most attendings will grade you on your progress. So, even if you started off rocky, you still have a chance to get a solid grade and evaluation.
10. Dress the part
First impressions matter to your patients and team. Dress professionally. Brush your hair. Clean your white coat. And don’t ever wear jeans and T-shirts to the clinic or hospital when seeing patients.
Good luck!! Feel free to leave your questions in the comments below!