ExamGuru Blog

The time has finally come. Step 1 is over (thank God) and your morning routine is no longer the walk to the library. It is time to wear that short white coat and put all of that medical knowledge to work…. But how?!

Unlike the first two years of medical school, memorizing every detail in the textbook and regurgitating it back out will not get you very far in the clinical realm. Yes, while it is important to have a good fund of knowledge to excel on your rotations, there are other more tangible skills that will help you shine. Now that I am a few short weeks away from completing my third year, I thought I’d share a few of my observations and some things I wish I knew before I started my 3rd-year clerkships.

1. KNOW YOUR ROLE. You are a student – meaning, you are there to learn first and foremost. If you knew everything, you’d be the resident. It is okay, and expected (especially in the first few rotations), that you do not know things. Do not hesitate to admit when you do not know something, but instead of asking for an explanation, look it up! Phrases like “I’ve never done this procedure before, would you mind walking me through it?” or “I don’t know the answer to that, but I will look it up and let you know tomorrow,” were some good go-to’s. As students, our job is to learn, to gather appropriate information and to effectively relay that information to the residents.
2. SUBJECTIVITY IS THE REALITY. Accept it. Realize that your experience is entirely based on the people you work with. The residents, the attendings, the nursing staff, your co-students. Everyone. You may draw the short straw and end up with the attending who believes in pimping the student until they melt into a puddle of self-doubt or the resident that refers to you as “med student.” Then again, you may get the nurturing attending who mentors you and the resident that teaches you everything. It’s a literal crapshoot, but that’s life. You can’t choose your patients either, so in some ways, it’s a good learning experience. Keep all of this in mind as you go through each rotation and do not let strong personalities sculpt your view of the specialty.
3. ADAPT. Given the above (2), it’s important you adjust to the situation. If your resident is a stickler about how you present pertinent lab findings, make note of it and adapt your future presentations to their liking. These critiques are never personal or malicious, it’s just the teaching style, so don’t take it to heart and use it as a learning experience.
4. EXUDE CONFIDENCE NOT COCKINESS. Confidence is a quality that goes far and will take you places, even if it’s feigned (as mine was). However, mind the line where confidence bleeds into cockiness. No one appreciates the arrogant, know-it-all MS3. Additionally, when you answer a question you are unsure of, answer it confidently – why? Let’s look at the outcomes when you answer timidly: you were correct but your tone suggests you weren’t sure of yourself – not great. You were wrong, and you kind of knew it – also not good. Commit to your reasoning and go with it. Even if wrong, the doc will appreciate your confidence.
5. SCUT. What is scut work? Scut work is that mindless day to day busy work that must get done but has zero educational value whatsoever. Some residents/attendings have a strict “no scutting the med student” policy while others will scut you to no end. It is unfortunate since we are paying to be there to learn and are doing menial work instead. I look at this way, you are helping your team and your patient. We will soon be those residents and will no doubt be exhausted, so if the med student is able to photocopy that stack of medical records and it will benefit the patient – why not?
6. MAKE CONNECTIONS. Tie in all the medical knowledge you spent hours learning to the living, breathing, patient in front of you. This can be hard at times, after a long shift in the hospital to go home and open up your notes from pathophysiology to recall what was going on with Mr. Jones in bed 6. That is how you actually learn the medicine and how it sticks, not memorizing page 246, but recalling Mr. Jones.
7. KNOW YOUR PATIENT. As a third year, you will likely carry 1 to 3 patients. It seems like a lot at first but then you realize your intern is carrying 10 times that. Know their vitals. Know their labs. Know what happened overnight. Know that they prefer to keep the lights off in their room when you round. After a day or two, you’ll quickly learn all these details and be able to present from memory without reading off your paper. Remember, we are there to learn but we are also there to help people get better. As medical students, we have the luxury of having the time to spend with our patients. Go hang out with them!
8. DON’T BE A PEST. It is ok if you aren’t doing something at every minute of the day. It can be extremely annoying to a resident if you constantly nag them if you can do something for them or asking how else you can help. Trust that they will let you know when you are needed.
9. GRADES. A word on grades- every school is different, some factor in the shelf exam, some do not. The clinical grade will likely be a composite grade from all the residents and attendings you worked with. In some cases, these attendings may have worked with you once and never got your name. It’s just how it goes. You may receive a grade that is not in congruence with your effort and your perceived performance. Let it go. Keep in mind that the subjectivity of these grades is something that can’t reliably be quantified and for that reason, it is not worth getting upset about it. What is important is detaching yourself from the grade and learning as much medicine as you can while connecting in meaningful ways with as many patients as you can.
10. HAVE FUN. I spent a good deal of my first couple rotations stressing that I was messing up, I didn’t know enough, or my residents thought I was an idiot – or worse – lazy. No one really cares if the med student messes up, in fact, they expect it. You are thrown into the deep end of the pool, but you’ve got your floaties on each arm. No one will let you drown, in fact, you’ll surprise yourself at how quickly you’ll swim. Enjoy!

At ExamGuru, we’re committed to helping third-year medical students honor their shelf exams.

About the author: Mike Natter is completing his third year at Sidney Kimmel Medical College and has inspired thousands of fellow medical students through his regular Instagram posts to his 37,000+ followers. We have organized a special discount code (NATTER20) for Mike’s followers to receive 20% off of any subscription, including the already discounted package of six shelf exams.