Tag: rotations

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How To Prepare for Intern Year of Residency

One of the most frequently asked questions that I receive from medical students is about how to prepare for their first year of resident. It parallels one of the most common fears among medical students in that they will not be adequately prepared for day one of residency. It’s a valid concern because you will never truly be ready for intern year but if you’ve made it this far in your training then you are likely ready enough. Almost everything you learn intern year isn’t taught in medical school because you have to do actively do it to learn it. At least that’s what I thought until I came across OnlineMedEd.. It’s the only resource I’ve found that actually prepares medical students reasonably well for intern year. Again, nothing is going to make you fully prepared but this is as close as you’re gonna get.

 

I started using OnlineMedEd during third year of medical school

OnlineMedEd is an amazing resource with videos that help explain complicated topics that overlap real world experience with the textbook. They do an amazing job of translating all of that USMLE step 1 material into actual practical knowledge so you can look sharp on all of your third year rotations. I would watch a few before each rotation started and it showed. Dustin and the OnlineMedEd team also drill home all of the important facts that are frequently tested on step 2 CK. Sure, nothing will ever replace UWorld but OnlineMedEd gives it a run for it’s money. Start using OME early and often.

 

A curriculum for fourth year medical students

Your fourth year of medical school is a magical time especially after interview season is over and your rank list is finalized. You’re basically just waiting to graduate and planning your vacation to South East Asia. It is all to easy to fall into a trap of laziness and forget that you are going to be a full fledged doctor in 6 short months (well technically you’ll be an intern but a doctor nonetheless). If you dedicate yourself to the structure of OnlineMedEd during your fourth year you will have a dedicated curriculum that keeps you fresh and sharp on the wards. Sure, you’re still gonna forget a lot before intern year starts but at least OnlineMedEd will get you into some good habits.

 

It prepares you for intern year

My advise to all of my fourth year medical student is always the same- go home because life is too short to be spent in the hospital watching me type notes and at least one of us should see the sun today. I also tell them that the best way to be a good intern is to develop good habits while you are still in medical school. The dirty truth about residency is that you don’t need to be all that intelligent to be a good intern. You simply need to be efficient, thorough, and work hard. The sooner you develop habits that enable you to work smarter, and not harder, the better off you will be. OnlineMedEd has developed a fantastic Intern Boot Camp that helps you do exactly that. If I could do my fourth year all over again I would use the Intern Boot Camp and test out what does and does not work for me while I was still on the wards in the hospital. That way when I show up day one of residency I at least had a system that I knew worked for me. It’s like when I had to learn how to actually study in medical school- I wish I didn’t have to go through the process of figuring out what works best for me. I wish I knew how to study more efficiently back in undergrad. Likewise, take the time to learn the ropes of what it takes to be an intern while you are still a medical student.

 

Start studying for step 3

Ugh I know. Sorry for bringing up the USMLE’s again but you have to get it over with eventually. I’ve written extensively about when you should take USMLE Step 3 as well as how to study for USMLE step 3. If you use OnlineMedEd during your fourth year of medical school you will get a head start on it. You don’t need to use OnlineMedEd as your primary study aid but it will certainly help cement concepts in your head and make it easier for you once you start your dedicated step 3 study period as you transition from medical student to resident.

 

They also have great study products

Last thing I’ll mention are their study aides. The Intern Guide Book and the Quick Tables Book are great study tools for medical students. They succinctly provide you with a ton of well organized material. You have to fill in the blanks and annotate it just like any guide book. But if you are going to use OnlineMedEd then these books are essential as they go hand in hand with some of the videos. Just like any resource, the more you use it the more results you get from it!

 

So if you are interested in using OnlineMedEd check them out here: OnlineMedEd.

 

*Full disclosure: sponsored content. That being said, I only support brands that I believe in.*

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The Day To Day Schedule of a Third Year

An incoming first year medical student asked me, “what is the day to day schedule like in medical school?” To begin with, I want to differentiate the two halves of your medical school education. The first half is spent in the classroom and the second half is spent in clinical rotations. In this post I will be discussing the day to day schedule during your clinical years, specifically your third year (because fourth year is basically like senior year of college).  Now before you scroll down to see the day to day hourly schedule of a third year medical student I have a few caveats about your third year clinical rotations to reveal.

Everyone’s experience is different. 

During the first two years of medical school, regardless of what school you attend, everyone basically learns the same stuff. The information that you are eventually are tested on during your United States Licensing Exams (USMLE) is standardized regardless if you went to an Ivy League school or a Caribbean one like me. So the first two years of didactic lectures are pretty similar in every medical school. This standardized experience of your first two years of medical school is grossly different compared the second half of your schooling. You can be from the same school and be in the same rotation and have completely different experiences during your rotations, and there’s a number of reasons why. You works with different residents, different fellows, and different attending physicians and each one of them will share with you something unique. Not to mention that you end up seeing entirely different pateints. There is simply no way for everyone to have the same experience. Ultimately, although you might have the same schedule as your colleagues, your experience can be considerably different.

Each respective rotation is different

My third year core rotations consisted of the following: 6 weeks of pediatrics, OB/GYN, psychiatry, and family medicine, and 12 weeks of internal medicine and surgery and each rotation’s schedule was completely unique. Just think about how different the day to day life of a surgeon is compared to a psychiatrist. The same is true when it comes to your schedule. More so, each hospital’s respective rotation experience can vary widely between the hours you work, number of patients you see, balance between autonomy and supervision, and how much the residents and attending physicians are willing to teach. So take the following daily schedule with a grain of salt because it is mainly applicable to my internal medicine rotation that I completed in Brooklyn, New York.

Here’s my daily internal medicine schedule

  • 7:00am. Handoff from the night team. Pick up a new patient.
  • 7:00-9:00. See patient(s). Write note. Talk to the cute nurse. Look up how to treat my patient. Talk to my patient’s actual nurse. Present and discuss my patient with my resident. Prepare presentation for rounds.
  • 9:00-10:30. Round with my team. Present my patient. Discuss assessment and plan with the attending. Make updates to my patient’s treatment plan.
  • 10:30-10:35. Find that piece of paper that you wrote everything down on and then subseqently lost.
  • 10:35-10:40. Find your team that you lost while you were trying to find the piece of paper that you just found.
  • 10:40-11:30. Play it cool. They wouldn’t have noticed if you left altogether. Update my patient’s note. Call consults and check if lab-work results are back and interpret them if you can.
  • 11:15-12:00. Lunch. Attempt to resist drinking second cup of coffee.
  • 12:00-1:00. Lecture of some sort.
  • 1:00-1:15. Go get that second cup of coffee. Remind myself to stop trying to stop drinking coffee.
  • 1:15-4:00. Go say hello to my patient. Make sure labwork, radiology, and procedures were ordered. Call people to make sure it gets done. Eventually ask my resident, ‘if there is anything else I can help with’ and hope that they don’t need something faxed. God I hate fax machines. Seriously, why do they still exist?? I think its punishment for all the years of attitude I gave my parents when I wouldn’t help them find the ‘TV/VIDEO button’. Side note, when are TV/VIDEO buttons going to be a thing of the past?
  • 3:00-3:05. Complain about my research project.
  • 3:05-3:30. Work on my research project.
  • 3:30-4:00. Find someone to procrastinate with. Find someone to annoy if they won’t procrastinate with you.
  • 4:00-6:00. UWorld.
  • 6:00-7:30. Home, relax, gym, shower, eat.
  • 7:30-8:30. Review UWorld or watch Kaplan videos (Thank you Conrad Fischer and Online MedEd)
  • 8:30–midnight. Beer, Netflix, Xbox, read something non-medical, and lament over how little I got done today. Repeat tomorrow.
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The Medical Student’s Guide to Clinical Rotations

With my third year of medical school coming to a close, here is what I wish I did differently, wish I knew beforehand, or figured out along the way during my core clinical rotations. Its nothing groundbreaking and you may have heard this before but it can’t hurt to hear it again.

Hold yourself accountable for the welfare of your patient
During your clinical rotations it is surprisingly easy to be lazy. But once you graduate medical school it will be your responsibility to care for the patients. Sure, as a resident you have a safety net to fall back on but at the end of the day the goal is to become self-sufficient. The more patients that you see in medical school the more prepared you will be for residency. So do a quick search on UpToDate for differentials on your patient’s chief complaint, think about which lab tests to order, and find the best treatment options. It’s also good practice for step 2 CS! So start holding yourself accountable for the welfare of your patients instead of waiting for that day to come.

Take onus of your medical education- be aggressive, take the initiative, and anticipate your next move
Don’t wait for someone to ask you if you would like to perform a physical exam task or a specific procedure. Be aggressive and take the initiative by asking your resident if you can do it. When you interview a patient and anticipate that they will need a urinalysis go get a clean catch cup for your patient- don’t wait for someone to tell you its okay for basic things like that. If the patient’s vitals aren’t hooked up to the monitor then attach the EKG leads, pulse ox, and blood pressure cuff and record the vitals. Do you need practice placing IV’s? Go speak with the nursing staff and find out if anyone needs blood drawn. They will be happy to oblige you with work. At the end of the day you are paying the hospital to be there so you might as well get your money’s worth. Be decisive and take your education into your own hands.

SCUT work- some clinically useful task
As a medical student nothing is above your pay grade. Especially since, again you are literally paying them to be there. So don’t feel neglected or insulted if your resident has you do what seems to be menial labor. Some SCUT work is fun- like drawing blood from a patient or performing a paracentesis. Other SCUT work is not- like transporting patients or copying, faxing, and delivering paperwork. But its all necessary. If you weren’t doing it then your resident would be.

Learn from your mistakes
I make a fool of myself on a daily basis. I’ve missed easy diagnoses, forgotten to ask rudimentary questions, and I’ve been sprayed by just about every bodily fluid imaginable. All of these mistakes can wear on your confidence but you are expected to make mistakes as a medical student- its how you learn. Simply never make that same mistake twice and move on. Better yet, learn from your colleagues’ and your residents’ mistakes. For instance, always wear a face shield and a mask when you drain an abscess. You’ll thank me later.

Again, at the end of the day you’re paying them to be there so you might as well get your money’s worth and make the best of your clinical experience. As always, I’d be happy to address any specific concerns you may have- just shoot me a message or leave a comment. Happy studying!