How to succeed as a medical student on clerkships and electives

From one student to others who may be starting out, I decided to jot down the things that I thought were key to having a successful clerkship/elective rotation. While in medical school you'll hear a lot of different things about what you should and shouldn't do, and legends and tales of students who didn't and what happened to them. I can assure you all of the tips that follow come directly from my own experience and are not exaggeration or legend. This list is by no means authoritative, but I wanted to write down the things that would have been nice for me to read when I was first starting out (and didn't have to pay for in one of those overpriced and overrated "what you should do" books that you can find everywhere). Those of you who have also gone through the drill, please feel free to add your own thoughts and advice in the comments.

1. Act like you know what you're doing, even if you have no clue what is going on. In other words, if someone asks you to do something, say yes...even if you don't know how to do it. As long as you tell them you have never done it before, they will lead you through it and chances are you'll do just fine. Confidence is KEY. Being wishy-washy and fearful will not leave a good impression on your preceptor.

2. If someone asks you a question and you don't know the answer, give your best guess without hesitating. If you are wrong you nod your head when you are corrected and say something like "oh yeah, that's right."

3. If the answer you gave to the question was so far off that the preceptor said something to the effect of "you should look into that," take out a small notebook or piece of paper and write down the topic...even if know you probably wont have time to read up on it in the forseeable future.

4. Always have paper and pen handy to write things down.

5. Be the "secretary." This means you should have ALL labs, even the ones from yesterday. When someone has a question about medication you better have it written down somewhere to tell them. If the patient isn't in the room, you better know where they are at. The less your preceptor has to flip through the chart or ask around, the more efficient rounds will be and the better you will look.

6. Be around. Your preceptor should know where you are at or how he can reach you. The last thing you want to hear is "where have you been?" or "I've been trying to find you."

7. Answer your pages. This sounds like a no-brainer, but you'd be shocked at how often this is overlooked. If you're paged, the person on the other end shouldn't have to wait for 10-15 minutes, it's your responsibility to call back as soon as humanly possible.

8. Be professional. I can't believe how many times I've seen students chewing gum on rounds or joking around while the attending is speaking. Know when you're supposed to speak and when you have to shut up and listen. BE ON TIME. You should be the first one to arrive at a patient's room for rounds. Don't look like a slob. If you've been assigned a topic to present, make sure you do the leg-work and have something to say, don't just blow it off and then wing it. You'll embarrass yourself if you're not prepared and show you're not reliable.

9. Be honest. If you're asked to follow-up on something and you forget, don't lie the next day and say you did. Own up to your mistakes, apologize for them, and then do your best to correct them. Assure the attendings/residents that it wont happen again and move on. You'll be surprised at how understanding they will be if you just come clean and admit the truth. You DO NOT want to be caught in a lie.

10. Be enthusiastic. Even if you're on the most boring rotation on the planet...don't let the attending know that. Be attentive and ask APPROPRIATE questions. A word of caution, however, there's a difference between being enthusiastic and being an artificial ass-kisser.

Comments

[Alwin]

Re: #4 - my strong recommendation is a Moleskine notebook. It has a little pocket inside the back cover where you can stick receipts, passes, etc.; it has a "trapper strap" to keep it closed when not in use, and a bookmark all in a professional-looking "little black book." full of acid-free paper.

Eastgate Systems has 'em for $10,

http://www.eastgate.com/Tinderbox/Moleskine.html

but one of them in your pocket filled with the "notes of the day" is worth it's weight in gold. Mine has the usual formulas, meds, pearls - and the double-secret phone numbers of where to reach attendings when they can't be found by normal means (which makes it priceless).

[writing up dissertation]

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