USMLE Step 1 score and performance during your third year of medical school are the two most important factors in going to the residency of your choice. Being an MS3 is notoriously difficult because you are constantly rotating between hospitals, working with different teams, and often are without a clear role. Also, grading is very subjective and often out of your control. With all these factors working against you, how can you be an excellent third year medical student.
Be professional and kind
This should go without saying but unfortunately too many third-year medical students do not follow this rule. Remember, each rotation is like starting a brand-new job. You need to dress appropriately and look like a student doctor. Introduce yourself to the team including staff such as nurses, techs, administrators. Be quick to smile and apologize if you make a mistake. Be early to everything. Lack of professionalism despite doing well in every other category can easily drop you from an honors grade to a pass.
Take initiative without becoming annoying
Most medical students are pretty good at doing what they’re told. The mark of an excellent medical student is one that can find out what needs to be done and do it. Before you do this however, you need to first find out what the extent of your responsibilities can be. Are you allowed to call consults? Take initiative and ask if you can do it. Does the team need patient lists in the morning? Get there early and print one for everyone. Is there an interesting patient in the emergency room that you’d like to evaluate first and follow as an inpatient? Ask if you can do so. Challenge yourself with more complex patients so that you have an opportunity to shine. You don’t want to be annoyingly and overly eager but all residents and attendings would rather have an overly eager medical student than an uninterested one.
Know your patients better than anyone
Medical students normally take care of less patients than residents or attendings. Typically, when you first start out on the inpatient wards, you are asked to follow one or two patients. As you do a good job with the few patients that you have, your personal census starts to increase. In order to demonstrate that you are ready for more responsibility, you need to truly know your patients better than anyone else on the team. You should not only understand their medical conditions (it is a given that you know thoroughly know their medical history and their medical needs) but also their non-medical situations as well. Where do they live? What makes them anxious? What motivates them? Are they in a relationship? Who is their support system? What is their favorite food? If the patient views you as their primary provider because you have such a powerful relationship with them, it will really impress your residents and attendings.
This is one of the hardest aspects of being a medical student. You work a full day at the hospital or clinic and then you are “expected” to go home and study more. This can be exhausting. However, at the end of the day, you signed up for this when you decided to become a physician. A good physician is one that is constantly learning and studying. Therefore a good medical student is one that does the same. Go home and read more about your patient’s condition. What are some recent research papers that can relate to why your patient is in the hospital? Not only do you need to study to impress on the wards, you need to study so that you can do well on clinical exams at the end of your rotation. Often times, no matter how well you do clinically, if you don’t score high enough on your exam, you cannot get honors.
Humble yourself and be receptive to feedback
You can be the smartest, hardest-working, and most professional medical student but if you are not teachable, you are a nightmare to work with. The point of being a medical student is to learn. However, if you are not teachable, your purpose is pretty much gone. Too frequently medical students will interrupt their residents and say “I know, I know, I know” or not pay attention while their attending is trying to teach them something. Being teachable is ultimately connected with being humble. If you recognize that you do not know everything and you are eager to learn, it’s OK if you get a pimp question wrong or you fail to understand a disease process. Most residents and attendings would rather have a teachable medical student who has a weak fund of knowledge than an unteachable one who is very smart. Keep in mind, the word “unteachable” is essentially the kiss of death on your Dean’s letter.