Starting Third Year of Medical School? Here’s How to Make the Best of Your Clinical Rotations.

Tips For Clinical Rotation

The third year of medical school is pretty busy, a big step forward in the budding doctor’s life. Clinical rotations are meant to give students their first taste of “real” medicine, and experiences during this time often define the career path a doctor chooses.

Here is some practical advice that will help third-year medical students make the most of their clinical rotations.

Participate, Don’t Observe

The importance of learning the vocabulary of medicine from textbooks cannot be undermined, but practical experience is what teaches you to actually be a physician. It can be likened to reading about flying a plane and sitting in a cockpit and watching a pilot fly a plane. Clinical rotations offer students a chance to observe and learn firsthand. However, this can only be accomplished if you’re in the cockpit, not in the back of the plane with the passengers.

You can make the best of your clinical rotations by taking the initiative and being an active participant in patient care, not a mere observer. Ask a resident to show you how to write an admission order. On a surgical rotation, ask if the anesthesia resident will give you a demonstration of intubation or let you have a go. If you’re seeing a baby in the emergency room, pretend you’re the only doctor making decisions. Look up the condition on the computer, formulate a treatment plan in your mind, and compare it to what actually goes down.

Read more: 10 Tips To Listen Effectively To Patients

But don’t be overly aggressive.

A pushy attitude can sometimes backfire, so it’s important to stay engaged without being unreasonable. If an emergency situation does not permit more assertive participation from a medical student, you can mentally play out the scenario in your head and ask yourself what you would do next and why certain decisions are being made. Make a mental note of any questions you want to ask once the smoke clears.

Define Your Own Learning Objectives

Pre-defined learning objectives are not always helpful. They have to be done well for them to work. Defining your own learning objectives can help you throughout your professional life. Learning to do this early in your career, during core rotations, will improve your skill set. Nonetheless, whatever learning objectives are given to you as part of the course, you should read and accomplish.

Remember that textbooks are written with practicing physicians and residents in mind. You are not expected to know everything in a textbook, but you will do well to understand an overview of all the topics.

Time management helps.

Your strategy should be to get recommendations on the best textbooks for each sub-specialty from residents and other students. You should then skim the major topics in these textbooks and make “big picture” notes that outline the material without going into details. Divide up the work. If your rotation in a sub-specialty is for two months and the textbook has 60 chapters, you should aim to cover one chapter a day. These notes will be indispensable for your shelf exam. Finally, don’t read the chapters in the same order as the textbook; rather read relevant chapters as you see patients with different diseases and conditions.

Practice Professional Behavior

The habits you form at this early stage in your professional career will likely stay with you until your last day in a hospital several decades later. For a doctor, it is vital to be professional in all interactions – with patients, staff, and other physicians. Not only is it the correct way to behave, but bad interactions can have a negative effect on patient care. Make professional behavior a learning objective for yourself. Observe physicians you admire and how they conduct themselves. When you see an example of bad behavior, think about what you would do differently in a similar situation.

Read more: Seven Commandments Of Positive Patient Interaction

Remember, Patients Are Teachers

Every single patient you see will teach you something about medicine. You may think the 25th patient with appendicitis on your rotation has nothing more to offer in terms of knowledge, but you can use the opportunity to learn something about the patient’s comorbid conditions, such as hypertension or diabetes.

It’s a good idea to make a notebook entry or write a 3×5 card for every patient you see. Make it a habit to read up a little on the patient’s condition(s). Read your textbook, review your notes, and read what’s new in the field on PubMed or UpToDate. Then write down three new things you’ve learned on the card or notebook entry you created for the patient.

Be a Doctor to your Patients

You may only be a third-year medical student, but there’s nothing to stop you from mentally acting like a patient’s doctor. When a patient is assigned to you during rotations, think about what you would do if you were the only physician caring for them.

Ask the residents to show you how to write notes and orders. Then get a resident to critique your note writing skills. When a drug is ordered, make sure you know why. When an x-ray is obtained, see the images for yourself. For every patient assigned to you, you should be able to present the case as the patient’s only doctor. This means staying on top of the patient’s presentation, past medical history, social issues, lab results, procedures, and hospital course.

Prepare for Teaching Conferences

Every service has a predetermined topic or case that will be discussed at the weekly teaching conference. Find out what the topic will be from attendings or residents and use the same strategy as above to prepare for the conference. Consider the case that will be discussed as a “vicarious” patient assigned to you and read up on the condition, so you can make the most of the discussions.

Show Up, Don’t Show Off

It is human nature – people who are team players are appreciated more, and in turn, taught better. Make yourself useful to the service. Show up 10 minutes early and look up labs before morning rounds. But remember, nobody likes a know-it-all. It’s okay to say, “I don’t know, but I’ll look it up.” Volunteering to do scut work and making the residents look good will earn you brownie points. Sometimes, you may know more than the residents, but don’t give in to the temptation to show off in front of the attending.

The residents are your best teachers, so whenever you can, make them look good. Teamwork means doing what it takes to get the work done so that everyone looks good. If you find yourself sitting in a lounge with nothing to do, remember, the hospital never sleeps. Go see a patient, attend a conference, do rounds, or look up labs!

Learn to Live a Balanced Life

As practicing physicians know only too well, physical and mental fatigue can set in pretty quickly with a doctor’s busy life. Clinical rotations during the third year of medical school are a good time to learn to balance work and play. Take care of yourself, socialize with friends, and stay connected with family. This work-life balance skill is as important to a successful professional career as the practice of medicine.

Read more: Prioritizing A Healthy Work-Life Balance

Enjoy Being a Doctor

Clinical rotations are a special time in your life. They give you a taste of what your future will be like – the joy and privilege of practicing medicine. Enjoy this phase and maybe even journal some of the funniest, saddest, and mundane experiences of hospital life. You will capture some extraordinary human emotions and some horrendous examples of bad behavior. But when you read your journal decades from now as a seasoned doctor, it will no doubt bring a smile to your face. There will be a string of firsts documented for posterity – the first fracture you fixed, the first murmur you heard, the first baby you helped deliver.

Take notes, record stories, and click lots of photos with your team (not of patients, though – be aware of HIPPA!). These unique sights and sounds of a hospital will be memories for a lifetime.

Ariel Jacoby
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