what's the norm for trying to impress as a clerk?

[Egg_McMuffin]

MS3 here. Was recently chatting with a FM resident, who told me they find residency to be less stressful than clerkship because in clerkship they were trying to impress everyone on every rotation vs now as an off-service resident the expectations are different...this led me to ponder: are clerks generally always in the 'aiming to impress' mode? Is that the norm? What has been/was your strategy in this aspect during clerkship? Does it matter?

I wouldn't describe myself as a slacker by any means, but I also consciously don't go the extra mile to make sure everyone loves me (e.g. laugh at all their jokes, vehemently agree with them on everything, being the first one to answer a question, always show how much I know whenever I can) because I find that stuff disproportionately exhausting/draining, not anthentic to my temperament, and want to direct the little energy I have left elsewhere and avoid burn-out.

For the most part I don't care if not doing that stuff makes me seem like a slightly weaker clerk. I've always wanted FM only so the pressure to impress isn't as strong, and for the most part I'm treating this stage as "what can I take away from this rotation to make myself a great FM doc". I've gotten some positive feedbacks on my work ethic. But a part of me still wonders what the norm is and how might I come across.

Thoughts?

[bread]

I’m only MS4, but I found MS3 stressful in that you’re always getting evaluated, + there’s the stress of studying for exams and always getting used to a new rotation on top of that. My mentality was to be myself and try my best every day - show up on time/early, get the work done, and be a good member of the team. Like you, it would feel inauthentic and disingenuous to me personally to be laughing at jokes, jumping to answer questions, etc. To me, being yourself, working hard, being genuinely interested, and being a nice person to work with are much more important and will take you farther. And my evals were fortunately always good  

[zxcccxz]

4 hours ago, Egg_McMuffin said:

MS3 here. Was recently chatting with a FM resident, who told me they find residency to be less stressful than clerkship because in clerkship they were trying to impress everyone on every rotation vs now as an off-service resident the expectations are different...this led me to ponder: are clerks generally always in the 'aiming to impress' mode? Is that the norm? What has been/was your strategy in this aspect during clerkship? Does it matter?

I wouldn't describe myself as a slacker by any means, but I also consciously don't go the extra mile to make sure everyone loves me (e.g. laugh at all their jokes, vehemently agree with them on everything, being the first one to answer a question, always show how much I know whenever I can) because I find that stuff disproportionately exhausting/draining, not anthentic to my temperament, and want to direct the little energy I have left elsewhere and avoid burn-out.

For the most part I don't care if not doing that stuff makes me seem like a slightly weaker clerk. I've always wanted FM only so the pressure to impress isn't as strong, and for the most part I'm treating this stage as "what can I take away from this rotation to make myself a great FM doc". I've gotten some positive feedbacks on my work ethic. But a part of me still wonders what the norm is and how might I come across.

Thoughts?

What you've described here is a suck-up not someone who will impress (doctors aren't idiots you know... if someone is not being genuine it shows). Someone who impresses is more likely the person who shows up early to their shifts, offers to stay late or help out with extra work when they don't have to, is enthusiastic, is polite to the patients and staff, etc.

And yeah if you also happen to have done extra reading on your own and are well versed in a particular speciality beyond what would be expected from someone at your level, then that's a plus too (although this is probably less important). If you're going for a primary care speciality like FM, personability is probably most important. They're gonna be less concerned with how many obscure diagnostic criteria you've memorized or retrospective chart reviews you've pumped out, and more concerned with whether you are someone they can imagine having as a colleague for the next several decades.

[bearded frog]

It's wildly different depending on if the med student is interested in the specialty, and even more different if its a core rotation vs elective. As a resident I know that the vast majority of people coming through on their core are not planning on going into my specialty, and that's great. I usually ask what they are interested in though because if they are considering my specialty, they might want a letter from the staff, and I usually try to work with them to make happen if possible, otherwise I will make sure they know what they need to know about my specialty to pass their MCCQE1 and NMBE exams, and hopefully provide exposure to something related to what they are interested in (ie if they want urology I will let them see the patient with the broken penis, etc.).

That being said, you still have to show up and manage your patients because you're learning how to interact with patients and other health care staff and that's the literal act of practising medicine, writing orders, progress notes etc. And if you are obviously phoning it in then you're gonna have a problem come evaluation time.

If you are interested, or here on elective, then you can tell they are usually like OP describes, but just so everyone knows, its definitely possible to overdo it and rub people the wrong way. Half the battle of residency is getting along with people and showing that you would be a good "fit" in their program, especially smaller programs where you will be working close along side people for up to 5 years so if there's any possibility that people would not be overjoyed to work with you that can be a problem. My job as the senior resident is to set [high] expectations for elective students, and also give them early feedback so they can put their best food forward to staff. Staff also ask us for our opinions but for the most part if we get along we try to provide an optimistic view.

[1D7]

19 hours ago, Egg_McMuffin said:

MS3 here. Was recently chatting with a FM resident, who told me they find residency to be less stressful than clerkship because in clerkship they were trying to impress everyone on every rotation vs now as an off-service resident the expectations are different...this led me to ponder: are clerks generally always in the 'aiming to impress' mode? Is that the norm? What has been/was your strategy in this aspect during clerkship? Does it matter?

Most students who want FM are pretty relaxed about clerkship. I've met a few exceptions, and they are usually either those who are exceptionally type A (not that common in FM) or want to work somewhere where they may not have much backup (rural/military). It's more of a personality type than anything tbh. If you truly just want FM just work extra hard on your FM rotations in M3 and 1-2 other core blocks for letters. For your others you just need to survive (that is, still be on time, work hard, do a bit of reading, etc. but you don't have to go the extra mile).

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I wouldn't describe myself as a slacker by any means, but I also consciously don't go the extra mile to make sure everyone loves me (e.g. laugh at all their jokes, vehemently agree with them on everything, being the first one to answer a question, always show how much I know whenever I can) because I find that stuff disproportionately exhausting/draining, not anthentic to my temperament, and want to direct the little energy I have left elsewhere and avoid burn-out.

I agree with the other poster... the person you're describing is a bit of a tool. I mean a bit of sucking up might help but what you described is pretty excessive.

I was on time, showed good work ethic, read around my cases/studied, and did my best to be normal and follow the social norms of medicine (which can be surprisingly hard when you're chronically tired and thrown into new environments). That was good enough for me to get letters from half my core rotations, which gave me enough letters to back up and allowed me to spend my time in M4 focusing on acquiring letters for the specialty I applied to.

 

[canada747]

I'm really not sure, but it seems to me that everyone gets similar or the same comments where I am. All of the people on a given rotation got the same copy and pasted comments for their Dean's Letter. So I'm not sure that the extra mile is ever measured sometimes. I think learning for what will be important for you probably comes first, and then also having a good work ethic.

[MedHopeful93]

What I would say is, the stress of being a Med3, for me at least, was more trying to make sure I knew things as it's a HUGE learning curve, and much less "trying to impress" people.  I'm a current Med4, and I would say that having this frame of mind of "how to I impress people," or "how do I do a good job for my eval" as a primary motivator is a draining and maladaptive way of thinking in general.  Obviously this will be on your mind, and you'll want to impress people, but try to approach things by asking yourself "how can I be the best clinician" or "what can I do to give this patient the best care."

Sounds cheesy, but honestly it's so much more rewarding, and my best clinical performances were when I did things that way.  Some of my strongest clinical moments that came up during interviews (e.g. "tell me about a time") came from times that I was honestly working hard for my patients and maybe my preceptor never knew that I did those things, or demonstrated that quality, etc.

As an aside, as a Med 4, I notice and appreciate Med 3s who are going above and beyond for patients in ways that are not necessarily trying to impress people.  In other words, try your best, but focus on your growth as a clinician and person and you will learn more and probably perform better!