By: Max Rusek
What should I know during rotations? How do I do well in my rotations? These are questions I had myself as I entered my clinical years and similar questions that I commonly answer for medical students. In my experience, there are a few key aspects that will help you succeed in your clinical rotations while still focusing on the learning experience!
Your Clinical Time
Likely, but depending on your institution, most of your time on rotations will be spent doing clinical duties, which vary depending on the rotation. Clinic, rounding, operating room, more rounding, etc. Reflecting this, the highest proportion of your grade on the rotation will be dependent on your clinical evaluations. To this end, first impressions matter, so be ready on your first day of the rotation. Watch a few of the OnlineMedEd videos prior to starting, and have a basic understanding of the medical issues you may be seeing.
As the rotation progresses, the primary means of evaluation is through your daily patient presentations. Know what questions you want to ask the patient before you go into the room when pre-rounding or in clinic. Have a system for getting all the lab values (when available) and know which are pertinent, and which are not. Develop an efficient system that works for you and be willing to adapt it to meet the attending’s preferences. In terms of the oral presentation, the more efficient and concise it can be, the better. I had to practice my presentations a lot before feeling anywhere near confident in my ability. Gaining confidence in your information gathering and assessments will improve your evaluation and allow you to learn the caveats of medical decision making as you progress.
Many clinical rotations still have cumulative tests associated with them, often times through rotation-specific NBME exams (National Board of Medical Examiners). While these exams can be difficult, they are also an opportunity to differentiate yourself in terms of your grade or make up for a perceived bad rotation on the clinical side. It is also the most objective part of your grade, which allows you the most control over a system during the clinical years that can sometimes seem random. Studying for the exam will provide you with medical knowledge you are expected to know in your clinical duties, so there is utility in effective studying beyond the end exam. Also, this material is important for your future patients! So, in summary, thoroughly preparing for these exams now is worth it so that you can reap the full benefits of your efforts.
With the wealth of study material out there, in my experience, it is best to find a few resources that you learn from effectively. You only have so much time to dedicate to studying, so choosing ones that you like and can get through is important. For me, at the beginning of a rotation I would watch all of the OnlineMedEd videos to get a broad understanding of the concepts I may be expected to know. Then throughout the rotation, I would utilize the Step 2 UWorld Qbank for learning content on a deeper level. I would try and utilize the CaseFiles series at the end of my rotation to again capture the breadth of material I should know. CaseFiles also does a good job at providing you the necessary ‘buzzwords’ that NMBE exams like to utilize. Finally, I would purchase an NMBE exam from their website to prepare myself for the language of the test. Whatever resource you choose, make sure that you gain a concrete understanding of the material in order to ace the exam and use this knowledge in the future.
Read More: Starting a New Clinical Rotation
Clinical rotations can be a stressful time, so it is important to take time to promote your own health, which will benefit you more in the long run. Make sure you continue the things that make you feel healthy – your relationships, exercising, good nutrition, and sleep. This is easier said than done, but you will be a happier person for it and it will be reflected in your clinical activities. As a happier person, you will be enjoyed more by your attending, your residents, hospital staff, your fellow students, and your patients. There will always be more clinical things to know and more things to do. Do the best you can, do the things you need to do for yourself, and realize that this is a process.
Finally, and perhaps most importantly, LEAVE THE HOSPITAL WHEN YOU ARE TOLD YOU CAN!!! You will have time during residency and as an attending to stay. Now is the time to utilize your student status to do the things that make you healthy, study, and get ready for the next day.