Clinical rotations

How to get the most out of clinical rotations during your third year

Looking back on my third year, these are the words of wisdom I want to share with students preparing or starting their clinical rotations.

Editor’s note: This story was originally published through ACOEP’s The Fast Track and has been edited for The DO. It has been reposted here with permission.

Before I started my fourth year of medical school, while I was preparing for the Level 2 exam and audition rotations, I spent a lot of time reflecting on what I learned from my third-year clinical rotations. As a student who wants to pursue emergency medicine, I liked that my core clerkships gave me greater insights into what happens before and after that ED visit.

Third-year students are in a unique position. Most of us probably started our first clinical rotation as confused, awkward students who felt more in the way than anything else. After spending two years knowing exactly what needed to be done to pass classes and crush boards, we were suddenly thrust into a world where there was no Pathoma and those long uWorld vignettes were now hourlong patient interviews, with differential diagnoses much narrower than A through N answer choices.

But once you get a little more comfortable in your new role, things aren’t so bad. You have got the basic anatomy and physiology down, and now you get to apply it to real patients.

As your preceptors start to give you more responsibility with charting and orders, you can learn to develop treatment plans for your patients with the safety net of having a physician behind you to catch your mistakes before you make them. You get to explore different specialties and hopefully begin to figure out where your best fit may be.

And if you already know what specialty you want to pursue, third year is the perfect opportunity to gain exposure to areas of medicine you may not see again once you begin residency. So what’s the best way to take advantage of this year?

Keep an open mind.

It can be tempting to want to blow off a rotation just because you think you will never end up in that specialty. Ultimately, you never know what you might end up loving, or hating, if you do not give every clerkship a fair shot. At the most, it will only be eight weeks of your life. Dedicate yourself to it, and you may end up surprising yourself.

Listen to every heart, and look in everyone’s ears.

Pathology will be easier to spot when you know what normal is supposed to look and sound like. After a month of screaming children in pediatrics, looking at the ears of a calm adult should be a piece of cake. Practice your physical exam skills as best as you can while your preceptors still don’t expect you to know very much. That way once they do start to expect more, you know what you are doing.

Take the time to get the full story.

Your third year is the time where you get to spend an hour with a patient trying to learn how to elicit a good history. Use this time to get to know the full story.

Remember why you chose medicine.

I asked each of my preceptors for one piece of advice, and I think part of me was hoping for some tangible piece of medicine that I could write in my notebook and never forget during a patient visit. Instead, everyone seemed to tell me variations of the same ideas: Never forget why you pursued medicine in the first place. If you find something you love, chase it. Never let the job keep you from remembering why you care about people. Remember, while it may be just another day of work for you, many of your patients will be people who are enduring a really rough day.

More articles about clinical/audition rotations

9 ways to succeed in your clinical rotations

The ABCs of clinical rotations: Always be curious

Audition rotations: 7 tips for success

1 comment

  1. When I attended KCUMB a few decades ago, we had classes third year. Usually 30-35 hours a week in class.
    We covered all the specialty areas including cancer. These classes increased the foundation knowledge of our classes. There was no hit or miss in the third year with rotations.
    With medicine becoming ever more complex, we need to go back to third year classes and give more uniform and extensive knowledge.
    Presently, after second year there is no uniformity of education because each student will see different sets of patients under different doctors; with that there is a lot of room to miss many less common diseases or variants.
    Everything after basic education is clinical so you will have the chance to do fourth year clinicals, internship, and residency, and maybe fellowship years to add to the academic basic education.

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