By Joe Savarese
For the rest of you who have survived Step 1, welcome to the clinical years. This is the point in your life that you have been waiting for. Remember that time you turned to your study partner and said, “I just cannot wait until I am actually seeing patients”? Well the moment has finally come. As I finish my last week of third year, I took some time to reflect on lessons I wish I would have known before the year started.
1. Straighten up your personal life.
I cannot over stress this. For the past few months, you likely buried yourself in a hole in the library studying for Step 1 and making frequent Chipotle runs. Your family and your friends are probably wondering if your cell phone still receives calls or texts. Reach out to them and ask them about their life. Do not sit there and complain about how many hours you poured into some test, just enjoy your time with them. They will appreciate the effort and will be there to support you in the future.
2. Remember medical school is actually four years long, not two.
This is actually more difficult than it sounds. My first thought after Step 1 was “well the hardest part is over.” In reality, you are about to enter a different breed of difficulty. Do not just stop studying or reading because Step 1 is over. Shelf exams and Step 2 are on the horizon. I encourage you to keep working hard throughout medical school. Cruising through third year is possible, but you are not doing yourself any favors.
3. Seek out advice NOW in regard to textbooks, question banks, review books, and other resources to use from current third or graduating fourth years that were successful in that rotation.
Be sure to ask details about the rotation and the attending physician (if you were assigned the same one). Questions such as: What are the expectations? The hours? What can I do to impress them on the first day? Is the nursing staff friendly?
4. Learn new question stems and study in such a way to answer those questions appropriately.
The key word for third year is management. Learning how to manage and diagnose diseases is everything. Here is an example of a few popular question stems.
What is the most likely diagnosis?
What is initial step in management of this disease?
What is the appropriate test to provide a definitive diagnosis?
The patient is at the greatest risk for which of the following?
What is the most likely cause of this patient’s symptoms?
5. Learn how to read your preceptor/attending physician in order to balance time appropriately between clinic and ward hours versus study time.
Too much time spent studying and too much time spent in the clinic or hospital can be a bad thing. Clinical time is important because that is the backbone of third year. Use the time to expand your knowledge and practice your skills, but don’t neglect your study time. Be prepared to study hard after a long day. Too much study time can also be detrimental because learning tidbits of information is not as impactful as experiencing and learning from patient cases.
6. When you’re wrong, you’re wrong. When you’re right, you’re wrong. Just go with it.
Grin and bear it is the best advice I can provide. There are times in your heart that you know you are right about something, but sometimes the best thing to do, is to confirm you were right in the textbook later on that night. The best advice I ever received on this was from a general surgeon who said, “Never outshine the master.” You are a third year medical student, not Michael DeBakey. And if you are wrong, then admit your mistake, apologize (if necessary), smile, and move on. If you get “pimped” on a question, follow-up with an additional question. Show interest always.
Finally, I will leave you with a quote saved on the desktop of my computer. It is a popular Henry Ford quote, but I feel that it is one that captures the hardships of the upcoming year. Do not be discouraged; you have made it very, very far. My advice is only intended to keep you motivated and prevent complacency. Good luck!
“When everything seems to be going against you, remember that the airplane takes off against the wind, not with it.” – Henry Ford