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Things I wish I knew before clerkship started


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Edit: Things I wish I knew before clerkship:

 

Just thought that this kind of thread might be useful to future clerks, so feel free to continue the list:)

 

How little time I would have to study during clerkship! I would have studied more before clerkship if I knew that.

 

The thick skin needed to be a clerk. Tip: always be nice to everyone even id they are not. But don't be a pushover nor too nice, people will se through it.

 

If you want to learn a procedure, you often have to ask to be given a chance to do it, very few attendings will offer it to you unless you ask.

 

Don't loose contact with friends outside of medicine, they will be your chance at sanity during clerkship.

 

Third year is hard, can't wait to see how fourth year is:)

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If you want to learn a procedure, you often have to ask to be given a chance to do it, very few attendings will offer it to you unless you ask.

 

+1

 

Don't assume, ask.

 

Don't let them hear you complain. Which is not to say you can't bring up legitimate issues, but do so in a constructive manner.

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Audition(away) rotations > Letters of reference > 3rd year evals > Research > Preclerkship grades (if applicable) >>>>>>>>>>>>> Everything else.

 

Even if you are a ****ing genius, if you're a jerk, you are going to have trouble matching.

 

Read the literature, not just your textbook/lecture notes. You will be shocked at how often your knowledge of the relevant literature will come up, if you're doing your clerkship in an academic hospital of course. And on that note, Uptodate =/= peer reviewed. It is a great resource, but not perfect- it is helpful to your understanding of the topic, and training as a physician to read the actual evidence.

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Audition(away) rotations > Letters of reference > 3rd year evals > Research > Preclerkship grades (if applicable) >>>>>>>>>>>>> Everything else.

 

Even if you are a ****ing genius, if you're a jerk, you are going to have trouble matching.

 

Read the literature, not just your textbook/lecture notes. You will be shocked at how often your knowledge of the relevant literature will come up, if you're doing your clerkship in an academic hospital of course. And on that note, Uptodate =/= peer reviewed. It is a great resource, but not perfect- it is helpful to your understanding of the topic, and training as a physician to read the actual evidence.

 

On the other hand, focus on a general source when you study. While knowing the ins and outs of the evidence for a single issue can be impressive, if you know nothing about the 10 other issues that come up that day you will look bad.

 

Use landmark studies as a nice supplement for things you know will come up in rounds the next day.

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2. Help them do some work. If they're making the bed, help them. Don't just stand there.

 

Their union won't be happy at all that their tasks are being done by someone else (same thing goes with every other unionized profession). Helping out is fine, but be VERY careful people.

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Their union won't be happy at all that their tasks are being done by someone else (same thing goes with every other unionized profession). Helping out is fine, but be VERY careful people.

 

obviously don't be stupid and go overboard.

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Here is a good tip I got at the start of clerkship.

 

When you don't have anything to do ask yourself, what can I do to make the teams life easier. At the end of the rotation you want people saying, wow, I miss that medical student who always helped out with X. Isn't that clerk going to be the guy people will want to work with in the future? That could be useful come CaRMS wink wink.

 

Common sense, but helpful when it is early in the morning or late at night and it's hard to be motivated.

 

Just don't over do it, be normal. You don't want to be that guy who has their nose glued to the staff's behind. Wow did I dislike working with fellow clerks who were all about impressing rather than being team focused and helpful, the later impresses without being painful to watch. The key is to be legitimately helpful, be organized, anticipate what things need to be done and do it without being asked if you can etc.

 

A good place to start is with morning blood work and labs prior to rounding. In the emerg stay on top of your patients check up on them and their tests. Offer to help out if someone is getting slammed with consults, prior to hand over know everything about what was done on that day and the outstanding issues and respective plans for said issues, volunteer to do presentations at teaching and prepare for these presentations to nail them etc.

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1. Never, EVER be late.

 

2. Learn how to do scut efficiently and effectively early. Everyone loves the medical student that started filling out the discharge papers the day before the patient leaves.

 

3. Learn to time manage your tasks for the day in order of importance. Never call for a consult at 4 pm on a Friday afternoon.

 

4. Keeping your residents happy is equally important as impressing your staff.

 

5. Clinical practice guidelines are a great resource, they're usually based on the highest level of evidence.

 

6. No one cares about your level of knowledge. They do care if you were pleasant and well liked by all members of the health care team.

 

7. You are at the bottom of the totem pole in a very hierarchal system. Suck it up. There are too many medical students for the system and unfortunately you'll find yourself fighting for learning opportunities more often than you'd like.

 

8. On that note, be a team player. If your colleague has never seen a laparotomy but you're a huge gen surg keener and you've seen a bunch, kindly offer to let them scrub instead. What goes around comes around.

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  • 3 weeks later...

Know people's expectations of you.

 

Clarify with staff, residents, previous med students coming off the rotation what the expectations are. Take some time to talk with your preceptors about what they are looking for.

 

Clerkship is such a varied experience for everyone, knowing what's expected of you will help you impress on your rotations.

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Never. Ever. Ever. Ever. Be late.

 

Be someone you would want to work with, don't complaint, don't talk ****, dont contribute to hospital gossip etc. Respect the hospital hierarchy, and at the same time don't participate in it when you later begin to climb it. When you start, every person in the hospital is higher on the totem pole than you. Nurses, NA's, janitors, attending staff, everyone. Med students have a reputation, particularly among nursing staff, for thinking they are the ****/gods gift to man. Identify any shred of this tendency in yourself and leave it at the door (preferably for the rest of your medical career)

 

Appreciate how little you know and stay humble in your knowledge. Read hard and smart. Focus on synthesized evidence sources. Know as much as possible. Identify and brush up on the things you don't know with every patient you see before presentation, always.

 

Wear sunscreen.

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