Pre-clinical vs Clinical years

[FailureToThrive]

What are the similarities and differences between life during pre-clinicals (M1, M2) and during clinical rotations (M3-M4)?

Also, do you spend more or less time studying during the clinical years?

[Edict]

During your pre-clinical years, life is mostly like undergrad. You go to class, you have tests and you shadow/research/ECs for the rest of your time. During your clinical years, life is mostly like work, you show up on time, you go to your classes when you have them, you write tests and you generally have less time to do research/ECs/shadowing. 

I spent a lot less time studying during my clinical years, it isn't ideal truthfully, but depending on your clerkship experience, you may have less time to study. Generally speaking you study less during clerkship. 

 

[Birdy]

In preclerkship, life is pretty relaxed, at least it was for me. It was a lot like undergrad, the schedule was pretty chill, I got to decide where I’d spend my time a lot of the time (eg. Never went to lectures.)

In clerkship, you’re working 40-100 hours a week (I had several weeks with three call shifts in them.) You’re often needing to be up very early and stay up very late. Your working hours tend to be more unpredictable because you stay until the work is done, not until a specific time. You’re also constantly having to figure out how new teams work and reorienting yourself to the preferences of a new staff doc sometimes every single shift. There’s a lot more uncertainty about what is expected from you. 

 

I spent far less time doing dedicated study sessions when I was in clerkship, but there was a lot more studying organically through the day when I heard something interesting or needed to learn something specific to care for my patient. 

[ameltingbanana]

Agree with all the above^. Clerkship will range from predictable 35-45 hour works that are 9-5 (typically outpt rotations: family clinic, subspecialty clinic, peds clinic, etc), random hours (e.g. ER) to 80-100 hour work weeks on inpatient wards +/- overnight call depending on your institution (general surgery, internal medicine ward, etc). Best way to learn is to really understand your fundamental pathophys as a preclerk and then transition into focusing more on management and developing "approaches" to various things in your clinical years (e.g. approach to chest pain, shortness of breath, lower extremity weakness, and so on)

I'd definitely say I studied less in my clerkship years, but I also tried to learn how to study smarter (question banks, Anki for question cards).

[goleafsgochris]

17 hours ago, Birdy said:

In preclerkship, life is pretty relaxed, at least it was for me. It was a lot like undergrad, the schedule was pretty chill, I got to decide where I’d spend my time a lot of the time (eg. Never went to lectures.)

In clerkship, you’re working 40-100 hours a week (I had several weeks with three call shifts in them.) You’re often needing to be up very early and stay up very late. Your working hours tend to be more unpredictable because you stay until the work is done, not until a specific time. You’re also constantly having to figure out how new teams work and reorienting yourself to the preferences of a new staff doc sometimes every single shift. There’s a lot more uncertainty about what is expected from you. 

 

I spent far less time doing dedicated study sessions when I was in clerkship, but there was a lot more studying organically through the day when I heard something interesting or needed to learn something specific to care for my patient. 

 

I strongly agree with this, but it may be school dependant (I also went to Mac).

I found pre-clerkship easier than undergrad, and certainly less stressful.  It was social, pressure was there at times but pretty minimal, I was as free to see friends as I was in high school really.  Also if you didn't want to work, the minimum effort required to "coast" through and pass was really low (not that I recommend this).  I maybe "worked" 50 hours a week most of the time, including studying.

Clerkship was way different for me.  As mentioned above, some rotations are 40 hours/week, some are 80-100.  But on top of that you still have to study!  So even on those light rotations there are still exams, and I would say the light rotations are still more work than pre-clerkship; with the heavier rotations really being almost all consuming.

[FailureToThrive]

52 minutes ago, goleafsgochris said:

 

I strongly agree with this, but it may be school dependant (I also went to Mac).

I found pre-clerkship easier than undergrad, and certainly less stressful.  It was social, pressure was there at times but pretty minimal, I was as free to see friends as I was in high school really.  Also if you didn't want to work, the minimum effort required to "coast" through and pass was really low (not that I recommend this).  I maybe "worked" 50 hours a week most of the time, including studying.

Clerkship was way different for me.  As mentioned above, some rotations are 40 hours/week, some are 80-100.  But on top of that you still have to study!  So even on those light rotations there are still exams, and I would say the light rotations are still more work than pre-clerkship; with the heavier rotations really being almost all consuming.

Doesn't McMaster use the reverse classroom method where there are no professors and you have to read all the textbooks? I go to a school with a similar pre-clerkship design and I'm seriously struggling. I feel burnt out and definitely spend at least 80 hours per week studying just to pass. 

How does the content change from per-clerkship to clerkship? Do you have to start learning drug doses, etc.?

[NLengr]

19 minutes ago, MDinCanada said:

Doesn't McMaster use the reverse classroom method where there are no professors and you have to read all the textbooks? I go to a school with a similar pre-clerkship design and I'm seriously struggling. I feel burnt out and definitely spend at least 80 hours per week studying just to pass. 

How does the content change from per-clerkship to clerkship? Do you have to start learning drug doses, etc.?

You don't really need to learn doses ever. You just use an app if you need to know and you dont have them memorized from repeat usage. 

[F508]

In clerkship, the emphasis is on doing a complete history and P/E, developing your approach to presenting symptoms and working through differential diagnosis. Knowing which medication to use and at which doses is more emphasized during residency.

[goleafsgochris]

1 hour ago, MDinCanada said:

Doesn't McMaster use the reverse classroom method where there are no professors and you have to read all the textbooks? I go to a school with a similar pre-clerkship design and I'm seriously struggling. I feel burnt out and definitely spend at least 80 hours per week studying just to pass. 

How does the content change from per-clerkship to clerkship? Do you have to start learning drug doses, etc.?

Somewhat, but there are still lectures, and there aren't really "tests" in a strict sense (theres some "evaluations" that are effectively tests but you cant really fail them).  Youre mostly evaluated by how you talk in the PBL sessions.  Its quite east to coast. 

[Birdy]

13 hours ago, MDinCanada said:

Doesn't McMaster use the reverse classroom method where there are no professors and you have to read all the textbooks? I go to a school with a similar pre-clerkship design and I'm seriously struggling. I feel burnt out and definitely spend at least 80 hours per week studying just to pass. 

How does the content change from per-clerkship to clerkship? Do you have to start learning drug doses, etc.?

We didnt have to read textbooks or specific resources, typically. There were recommended resources but largely we were free to find educational resources that worked for us. I used a huge variety of different types of media in preclerkship; whatever helped me learn the material best. 

Content doesn’t really change so much preclerkship to clerkship, it’s more the application aspect of the knowledge is built on top of the foundations you built. You’re not thinking so much of the basic pathophys (usually, but always good to keep first principles in mind) but you’re developing your ways of approaching certain presentations using the information you have learned. You always need to be able to break up the components of a process so that you can understand how not to kill the patient, but you end up with a lot of rapidly navigable mental algorithms just by seeing stuff repeatedly. 

Youll learn some medication doses just because you see them a lot, but you wouldn’t typically be tested on them, at least I don’t really recall that being the case, but I’m five months pregnant so my memory is crap right now. 

[indefatigable]

On 6/11/2018 at 9:16 AM, MDinCanada said:

Doesn't McMaster use the reverse classroom method where there are no professors and you have to read all the textbooks? I go to a school with a similar pre-clerkship design and I'm seriously struggling. I feel burnt out and definitely spend at least 80 hours per week studying just to pass. 

Try to talk to other people and look out for shared study notes.  Most people don't study mainly from primary sources in my experience (takes time to figure out where to look, can be very wordy, ..)- I often did because it helped comprehension and my personal language issues of learning only in French (which when I tried found difficult, although did help improve fluency).  But study notes would cut down your time a lot.  

[Mithril]

Pre-clinical years were a breeze. I had friends and I had family. I barely studied since a lot of the blocks in pre-clinical years were review from undergrad.

Clinical years were a nightmare. I rarely saw friends and my family. I lost my identity and sense of self. I felt like a cog in the wheel, like I was slowly being encased by cement. The days blurred together and I woke up every morning numb and devoid of any joy. It was the worst two years of my life.

But once I had more skills and knowledge I felt more confident in myself. My family practice residency was a very fun two years and now I thoroughly enjoy (most aspects of) my job.