Pearls and pitfalls for medical students entering their clinical years

Transitioning from the classroom to the wards is an uncertain and anxiety-provoking time for many medical students. Schedules are constantly changing, as are expectations and learning objectives. Mentorship and advice from upperclassmen, residents, and attendings was an essential tool in my MS3 toolbox. I would go so far as to say that these pieces of insight are the toolbox. The 2020-2021 academic year will provide its own degree of obstacles and uncertainty. As such, I would like to share my toolbox with hopes that it helps even one student as they make this transition.

Without further ado, I present to you the pearls and pitfalls for the rising clinical student:

1. Show up. This is more than just beating your resident to the team room. Show up with the attitude of a team member. Be present mentally and physically, even when you are on a service that you don’t love. There is always something to learn!

2. Take initiative. Don’t wait to be told what to do. You would be surprised at how often I received feedback regarding how rare that is. Look for ways to help the team and do it!

  • Pitfall: Keep this within your role as a student. Do not go around asking for scalpels or starting central lines.

3. Follow-through. If you tell your team that you are going to do something, then do it. You often read or hear of a medical student complaining to the effect of “my resident told me to read up on the indications for aortic valve replacement, but never asked me about it later.” Yeah, residents are busy! Wait for an appropriate and remind them.

  • Pitfall: An appropriate moment is not in the middle of the aforementioned valve replacement after someone says, “oops.”

4. Be honest. This is three-fold.

  • If you mess something up, fess up. Patient care is no joke, and you shouldn’t risk anything.
  • If you don’t know the answer to a question you are being asked, that is okay! Look it up and follow-through.
  • Finally, a big misnomer is that you should lie about the specialty that you are interested in to align with your current rotation. In my opinion, this is absurd. I was honest about my interests in orthopaedics since day 1 of my third year. However, I made it crystal clear that I was here to learn everything that I could and to be a physician first, surgeon second. What did I get? On my psychiatry clerkship, I got assigned to the patient with a fractured femur from a suicide attempt. On anesthesia, I was put with the attending who handled the orthopaedics cases. Not once did my interests reflect poorly on me in my evaluations or otherwise. Most residents and attendings in academia enjoy teaching and want you to get the most out of your education.

5. Embrace it. You will likely work harder than you ever have before, but you will also have a greater sense of purpose and reward. You are paying to be here, make the best of it!

6. Look out for yourself and others. You will feel overwhelmed at some point. You will get down on yourself. You will feel like an imposter at some point or another. If you are feeling down or losing control, ask for help. Your course directors are there for this reason. So are your peers, admin, staff, and even #MedTwitter. Your mental health and wellbeing need to be prioritized. You cannot heal others unless you yourself are in an appropriate mental place to do so. The number for the National Suicide Prevention Lifeline is (800) 273-8255. Save it in your phone now. Nobody plans on needing this number.

7. Say thanks. It takes a village to make a successful medical student. Thank your family and friends for supporting you. Thank the resident that takes the extra time to teach you. Thank your mentors and always remember: Mentorship is a two-way street.

Garrett K. Berger is a medical student and can be reached on Twitter @gkberger.

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