Although doing well academically is an important part of becoming a physician, there is no
substitute for clinical experience.
Here’s how to crush your medical school clinical rotations.
Dr. Jubbal, MedSchoolInsiders.com.
The third year of medical school is an exciting time.
You finally get to move out of the classroom and into the clinic to do what you went to
medical school to do: take care of patients.
That being said, it can also be one of the most challenging times for that same reason.
Here are 5 tips to help you crush third-year clerkships.
If you’re looking for advice regarding a specific clinical rotation such as internal
medicine, psychiatry, neurology, and more, be sure to check out our Clerkship Review
Series on the Med School Insiders blog - link in the description.
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The first step to doing well in your clerkships is to know how you’ll be evaluated.
Although many medical schools have moved to pass/fail curriculums for the preclinical
years, third-year clerkships are always graded.
The four grades that you can achieve are honors, high pass, pass, and fail, or some similar
combination.
There are generally two main components to your clerkship grade: your shelf exam score
and your evaluations from preceptors.
Shelf exams are subject-based tests designed to assess a medical student's mastery and
practical application of medical knowledge within the clinical setting.
They are generally taken after core rotations in various specialties such as internal medicine,
surgery, OB/GYN, neurology, psychiatry, family medicine, and pediatrics.
These exams are licensed by the National Board of Medical Examiners – the same organization
responsible for the USMLE Step exams.
They are called shelf exams because they are composed of expired USMLE Step 1 and Step
2 CK questions that have been “shelved” by the NBME.
Although shelf exams aren’t necessarily a requirement for medical licensure, most
schools factor these scores into your clerkship grades.
The evaluations you receive from your supervising resident and attending physicians are the
other component of your clerkship grades.
You will be assessed on qualities such as professionalism, communication, work ethic,
knowledge, and competency.
Depending on the school and the rotation, how these components are weighted with respect
to each other will vary.
For some schools, 80% of your grade may be based on your shelf score and only 20% on
your evaluations.
For others, 60% of your grade may come from your evaluations and only 40% from your shelf
score.
Understanding how you will be graded is key to knowing how you should prioritize your
time.
The best place to start is by reading the syllabus.
Although it sounds obvious, many students fail to do this.
The syllabus will often break down exactly how you are graded, what is expected of you,
who to contact in certain situations, and other details specific to that rotation.
Although it’s helpful to get advice from upperclassmen and other students who have
completed that rotation before you, you shouldn’t rely on that advice alone.
It should be taken into account only after you have read through the syllabus and understand
the grading rubric.
Next, be kind to everyone.
During your clerkship, you’ll meet all sorts of people, from doctors to nurses to techs,
plus patients and their families.
One of the best ways to build a good rapport with those around you is to be kind to everyone
you meet.
This includes those who do not offer the same courtesy back.
Medicine is a team sport, and the moment you step into your first clinical rotation, you
become a part of that team.
As such, it is in your benefit to start honing your ability to work with others early in
your training.
Something that has helped me be more kind to others is to remember that there is something
to learn from everyone.
During my clerkships, I was inspired by physicians with great bedside manner who were able to
put patients at ease while remaining professional.
Even when patients were less than respectful, seeing the attending or resident act with
grace set a positive example and inspired me to incorporate these into my own clinical
repertoire.
One of the great things about clinical rotations is that you get to see how many different
physicians practice and interact with patients.
From these experiences, you can decide for yourself how you want to practice and what
kind of doctor you want to be.
But if that isn’t reason enough, medicine is also an incredibly tight-knit community.
You never know who’s watching or who that person might know.
Being rude to a tech, receptionist, or janitor can easily make it into your evaluation and
negatively impact your grade.
Never make enemies while on your clinical rotations.
This may sound obvious to many of you, but you’d be surprised at how many people forget
the “golden rule” from Kindergarten: treat others the way you want to be treated.
Next, most students don’t take advantage of asking for feedback from their preceptors.
By asking how you’re doing and how you can improve during your rotation, you have time
to make adjustments and improve on your weaknesses before grades are set in stone.
If you wait until the rotation is over to find out how you’re doing, it’s already
too late.
It is important to note that this is not the time to become defensive or argue for a better
grade.
Doing so is a sure-fire way to hurt your final grade.
Instead, listen attentively to what your preceptors are saying and be receptive to their feedback.
Look at their criticisms as a chance to grow and improve as an individual.
Remember, you don’t go to medical school to be a doctor.
You go to medical school to become a doctor.
During your clinical rotations, it’s also important to take advantage of your downtime.
Step 2 CK is generally taken at the end of your third year, and since Step 1 has transitioned
to pass/fail, Step 2 CK is now going to be more heavily weighted on your residency application.
As such, you need to make sure you’re taking the time to prepare adequately.
That being said, it can be difficult to find dedicated time to study between clinic, research,
and all of your other responsibilities.
To be successful on Step 2 CK you need to be creative with your studying.
Two things that worked well for me when I was preparing for Step 2 during medical school
were to study in the morning and to do flashcards whenever I had downtime.
Although I’m not naturally a morning person, I convinced myself that I was during my third-year
clerkships.
I would get to the hospital early, get everything prepared for the day, and then study with
whatever time I had left before rounds started.
It’s easy to tell yourself that you’ll study when you get home, but after a long
and challenging day, studying is often the last thing you want to do.
By getting the bulk of my studying done before my shift, I ensured that it wouldn’t get
missed and cut down the work that I needed to do at the end of the day.
I also strived to make the most of whatever downtime I had throughout the day.
My strategy for preparing for Step 2 CK relied heavily on the use of flashcards and spaced
repetition.
I even created my own deck covering every single topic that would be tested on the exam.
To learn more about how I prepared for Step 2CK be sure to check out my video covering
how I scored in the high 260s on the exam - link in the description.
I would spend every bit of downtime I had throughout the day going through flashcards.
Whether it was a couple of minutes here or there while waiting for the resident or attending
physician, or downtime between cases, I would pull up Anki and start going through flashcards.
It may sound excessive, but a few minutes here and there can add up quickly.
I didn’t just do this while I was in the hospital either.
If I was at the grocery store, waiting in line, I would go through flashcards.
If I was doing my morning stretches, I would go through flashcards.
Even if I got stuck at a red light while driving, I would go through flashcards.
Okay, maybe not that last one.
Please don’t Anki and drive.
The point is, you don’t always have to set aside large chunks of time to study.
Little bits of studying throughout the day add up.
If you do this, you’ll be surprised at how much you know come exam time.
My last tip for crushing your clerkships is to focus on being instead of doing.
Oftentimes when we’re trying to do well at something we focus too heavily on tactics.
We think “what can I do” or “what can I say” to look good to my preceptors, but
you don’t want to spend so much time worrying about how to come across as a good medical
student that you miss out on the opportunity to be a good medical student.
For example, if you’re on your OB/GYN rotation and know for a fact that you don’t want
to go into obstetrics or gynecology, that’s okay.
But instead of trying to act like you’re interested in it to look good to your preceptor,
try to keep an open mind and find genuine interest in the specialty for what it is.
Be curious, ask questions, and have fun learning about the specialty, even if you have no interest
in going into it yourself.
When I was in my third year of medical school, I tried to approach clerkships from the perspective
that “I’m here to learn – not just get my grade and move on.”
By having this mentality, I was able to lean into the aspects that I found interesting
and show a genuine curiosity.
For instance, while I was on my general surgery rotation during medical school, there was
a patient that needed to have a Whipple procedure.
For those of you who are unfamiliar, this is a pretty major surgery.
It’s often done to treat pancreatic cancer and involves removing a part of the patient’s
pancreas, small intestine, gallbladder, and bile duct.
In short, it’s extremely complex and difficult – even for seasoned surgeons.
Even though I knew I wasn’t going into gen surg, I had never seen one done before and
wanted to take advantage of the opportunity, so I asked the surgeon if I could scrub in.
The surgeon could tell that I was genuinely enthusiastic about the case and agreed.
My enthusiasm and eagerness to learn contributed to my evaluation and ultimate honors on that
rotation, but I also got a special experience that I’ll always remember.
If you adopt this mindset, not only will you be a better, more engaged medical student,
but you’ll also learn more from the experience and become a better, more knowledgeable physician.
You never know when that obscure fact you learned during your clerkships will come up
again and how that might help you years or even decades down the road.
If you go on Reddit or SDN, you’ll find most students asking the “how”, the checklist
they must do to ensure a top grade.
These students ultimately find themselves frustrated and have mixed results.
It’s no surprise, since most blogs, resources, and tutors focus on the same thing – the
tactical actionable list of things to do, rather than changing the inner dialogue and
perspective in becoming a top student.
My focus with Med School Insiders has been to deliver the maximal value to our clients.
That means getting beyond the parroted cliche advice and into the actual substance that
separates top students from the rest.
That includes not only the nitty-gritty details, but the mindset and perspective you must adopt
to realize your potential.
When you shift your way of being to align with your goals, you accomplish what you want
with far less friction and effort.
Things almost seem to naturally fall into place.
And as I like to say, reality is in our perception, not in events.
At Med School Insiders, we’ve been empowering a generation of happier, healthier, and more
effective doctors since 2016.
And as a younger company led by an optimization-obsessed physician, yours truly, we do things quite
differently than the rest of the industry.
If you want to become the best, you need to learn from the best, not those that got through
in the middle of the pack.
By recruiting the top talent and pioneering a systems-focused approach to our services,
we’ve become the fastest growing company in the space with industry-leading customer
satisfaction for one simple reason – we deliver results.
If you want to honor all your clinical rotations, ace your shelf exams or USMLE, match into
the most desirable residency programs, and become the best doctor you can be, visit us
on MedSchoolInsiders.com.
For a limited time, use the coupon code “Clerkships2022” for $50 off our admissions and tutoring services.
Thank you all so much for watching.
If you enjoyed this video, be sure to check out How to Crush USMLE Step 2 CK or this other
video.
Much love, and I’ll see you guys there.