How to get excellent evaluations for clinical rotations as a 3rd year clerk

[Keep Persevering]

Hello folks. Just started clerkship at Queens. How do I get excellent evaluations on rotations e.g Surgery and Medicine?  I feel inadequate. I am punctual and trying my best but seem to spend more time per patient. Please provide detailed examples and share your experiences on how I can be more efficient and stand out in a good way. I want to learn and do good clinically. 

Thanks

 

 

[MedicineLCS]

My somewhat cynical take is that the best way is to have an extroverted personality and a great deal of commonality with your preceptor. It also depends highly on your preceptor, some give out top whatever % like candy, others will write "best student in a long time" and then check all the middle boxes down the form... It doesn't get any better in residency by the way. 

Really it comes down to being easy to work with (things you mention + personality compatibility) and knowledge. The balance between the two will depend on the specialty, in some all you need is to be likable and that's good enough to score well. So long as you're actively improving I wouldn't care too much about evaluations, the reality is there are many many fickle personalities in medicine who probably shouldn't be interacting with trainees anyway. For knowledge trying to study ahead of the block always served me well, there's no feeling quite like studying for a block exam and realizing you could have learned so much more 2 weeks earlier if you'd had the proper framework for thinking about the presentation/workup/treatment. 

Efficiency will come with time, the junior/senior residents were once slow themselves, but they have way more experience than a clerk at this point. Probably the most useful is to ask a more advanced/home service junior resident their approach to rounding/consults because they've fine tuned it over the years and the exact nuances depend on the charting system and setup of rounds. The generic advice is to know your patients well which is good but often difficult when short on time.  Probably the most important thing you can do is make sure that tasks are actually getting done, consults called, labs completed. 

[attempt2]

3 hours ago, MedicineLCS said:

 

My somewhat cynical take is that the best way is to have an extroverted personality and a great deal of commonality with your preceptor. It also depends highly on your preceptor, some give out top whatever % like candy, others will write "best student in a long time" and then check all the middle boxes down the form... It doesn't get any better in residency by the way

 

Highly agree; as twisted as it sounds, clerkship (and doing well) very much does have a vibes check and politic component. A good handful of people will never give outstanding/excellent and just copy paste past MSPR write ups, or provide opportunities to display such traits (ie you mainly shadow or their pimping questions are ridiculously specific). Even knowledge expectations are highly variable. Some people care more about your practical knowledge (navigating EMR, logistics for workflow) more than medical. 

No need to expect excellent as most specialties regard MSPR as pass fail anyways.

[shikimate]

Out of 10 staff/resident, there will probably be 1 that you really like, 1 you really hate, and 8 that are somewhere in the middle.

The key is to not piss off the 1 that you really dislike. This way nobody gets in the way of you passing the rotation

the 8 in the middle, you can work on them, see if you can win over some of them. 

the 1 you really like, maybe it's worth your effort to dig deeper and see if you can get a LOR out of them.

Sometimes defense is the best offence. If you are new to something or weak in one area, the best offence is to not make mistakes or do stupid things to jeopardize you from passing the rotation. Opportunities to stand out doesn't come all the time. When you have spent enough time in clinical work and in an area, then you can get a "feel" as to when it's best to make a move.