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Studying to be a good clerk

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How does one prioritize what to study to be good on the wards, in clerkship someday? I feel like what I'm being taught in pre-clerkship feels all over the place, and isn't going to make me good on the wards. I feel that a lot of what we study (the minutiae for example) is over-tested and unclinical, but things like taking a BP/auscultation are under-tested and unappreciated. Would studying for the USMLE be a better way to know my knowledge is comprehensive?

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5 minutes ago, JohnGrisham said:

Be present. Be prepared. Be a positive person to be around. That is all a good clerk is. Its not hard, and you'd be surprised how often people are late or unreliable for assigned tasks or just not pleasant to be around.

Gotcha! How is one prepared? Simply having the required tools?

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Show up on time.

Really the only way I felt that helped prepare me for clerkship was shadowing lots of doctors. I did a lot of surgery shadowing and by the time I started, I was very very comfortable in the OR whereas some of my classmates had never stepped in the OR. Just an example in surg, but if you do it in other specialities it'll be good too

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All that said, don’t stress out about shadowing. I personally did ZERO shadowing because, sincerely, I knew I was going to do clinical work for the rest of my life and also knew that I was NOT going to have the luxury of just going to classes and studying and having free time. Pass your exams. Enjoy life  

As stated above, be a person that team members want to be around. Do a search of this site, this question has been asked often. 

Good luck!

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9 hours ago, LostLamb said:

All that said, don’t stress out about shadowing. I personally did ZERO shadowing because, sincerely, I knew I was going to do clinical work for the rest of my life and also knew that I was NOT going to have the luxury of just going to classes and studying and having free time. Pass your exams. Enjoy life  

As stated above, be a person that team members want to be around. Do a search of this site, this question has been asked often. 

Good luck!

Agreed.

Got comfortable in the OR after 2-3 shifts. Never set foot in one before, or scrubbed before. Its not rocket science.  Got honours, not because i was smart. Because i got along with staff/residents well, and was useful and reliable. Things that needed to get done, got done without hand-holding.

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On 2/20/2019 at 3:13 PM, FutureERDoc said:

How does one prioritize what to study to be good on the wards, in clerkship someday? I feel like what I'm being taught in pre-clerkship feels all over the place, and isn't going to make me good on the wards. I feel that a lot of what we study (the minutiae for example) is over-tested and unclinical, but things like taking a BP/auscultation are under-tested and unappreciated. Would studying for the USMLE be a better way to know my knowledge is comprehensive?

USMLE step 1 material is the same, just even more. lol. 

Step 2 material is what's useful as you rotate but I'd save that until clerkship in terms of studying.. Focus on obtaining a good history that's very thorough but not redundant. Then select relevant systems and do your physical exams on those. In combination, develop your differential Dx of 5 possible etiologies based on that information. Then you think of which diagnostic tests (if any) you want to do to rule out anything dangerous and also confirm the most likely Dx. And be able to interpret common tests... know how to read an xray, be able to interpret an EKG including uncommon findings. Treatment wise you start off by learning general treatments for common dx. Ex. treating COPD, CHF, PNA. sepsis guidelines. MIs. etc etc. 

Certain things are also very academic and not that pertinent to real life. Ex. appendicitis is a clinical diagnosis in academic medicine but no surgeon is taking an adult to the OR without a CT. Also, keep in mind certain physical exams have very poor sensitivities. You're not going to measure the spleen with percussion on a morbidly obese dude. 

 

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On 2/20/2019 at 3:13 PM, FutureERDoc said:

How does one prioritize what to study to be good on the wards, in clerkship someday? I feel like what I'm being taught in pre-clerkship feels all over the place, and isn't going to make me good on the wards. I feel that a lot of what we study (the minutiae for example) is over-tested and unclinical, but things like taking a BP/auscultation are under-tested and unappreciated. Would studying for the USMLE be a better way to know my knowledge is comprehensive?

Tbh if you really want to study for the wards, i'd read Toronto Notes. It is pretty clinically relevant. 

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Don't kill yourself studying material. It is great if you know how to do relevant histories and physical exams and being able to produce a short differential, and can display that you're doing some reading on your own time. Its best to be a keen student who residents and staff enjoy working with than the clerk that knows everything but doesn't get along well with others, doesn't do work that is asked of them, and has a bad attitude. 

Take every opportunity thats given to you within reason, even if it may be outside of your comfort zone. It will show that you're keen to learn/practice. In my experience, if I've said "I've never done that before but i would absolutely like to learn", my senior has taught me how to do it 100% of the time. 

Shadowing is not necessary. If you're worried about the OR, ask a classmate to show you how to scrub and BE NICE TO THE SCRUB NURSES. The OR nurses have bailed me out more than once and have always been happy to answer my questions about sterile technique because it means they won't have to replace equipment you contaminated because you didn't ask. 

 

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