7 ways to thrive during clinical rotations

One of the milestones medical students look forward to is getting out of the classroom and interacting with patients during clinical rotations. Clinical rotations, also known as clerkships, give students the chance to make a memorable impression on program directors, attendings and hospital staff—which can lead to a successful residency placement.

A 2015 study found that about 43% of students enrolled in a residency program where they had done an audition clerkship. Published in The Journal of the American Osteopathic Association (JAOA), the study examined the relationship between residency placement and clerkship site enrollment at New York Institute of Technology College of Osteopathic Medicine, and also found that 5% of students enrolled in a residency program at a hospital where they had rotated. 

Ready to rise up during clinical rotations? Three DO preceptors offer their words of wisdom:

1. Ask questions

Students are sometimes afraid to ask their attending why they chose a particular treatment or medicine for a patient, but it’s important to do so, notes Mark Rogers, DO.

Dr. Rogers is an associate professor of family medicine and sports medicine at Edward Via College of Osteopathic Medicine, where he trains students, residents and fellows.

Asking questions in a professional and respectful way without trying to challenge your preceptor’s expertise is a way to show that you’re engaged and paying attention.

“While students may be engaged mentally, if they’re not speaking up and asking questions, it might appear as if they’re uninterested on the rotation,” Dr. Rogers says.

2. Hit the ground running

Many students don’t truly understand what a clinical rotation entails, says Nancy Bono, DO, chair of family medicine at NYITCOM. Dr. Bono serves as a preceptor to students who rotate with her at the college’s clinic.

“They think it’s going to be like medical school, and they’ll just show up and have didactics and sit for a lecture, but you have to start that rotation full-speed ahead,” she says.

In addition to reviewing the clerkship guide students receive from their school and First Aid for the particular specialty they’ll be rotating in, Dr. Bono also suggests students practice the portfolio of skills they’ve learned, such as:

• Tying surgical knots
• Taking history
• Presenting patients
• Writing notes
• Giving physical exams
• Oral case presentations

Doing this will make students feel more confident helping out when the opportunity presents itself.

“Students have to take a lot of initiative themselves to get the most out of their clerkships,” Dr. Bono says.

3. Adopt the attitude that no job is too small

By taking on tasks that might seem mundane, such as drawing blood, you’ll demonstrate that you’re someone to rely on, which can open doors to more exciting tasks, Dr. Rogers says.

“Your preceptor will be more likely to ask you to participate in more opportunities if they know you’re willing to help out,” Dr. Rogers says.

4. Familiarize yourself with the community you’re serving

Before the start of the rotation, get to know the area the institution or clinic serves.

“You have to know where your patients are coming from both ethically and culturally,” says Dr. Bono.

Students can show initiative and get a sense of the environment where they’ll be training by asking to visit the hospital to talk with interns, residents and attendings prior to their clinical rotation, Dr. Bono notes.

5. Stay off your phone

Students should use a notebook or patient flowbook during rotations rather than a smartphone, recommends Józia McGowan, DO, who servers as a preceptor for students as an assistant professor of internal medicine at Kansas City University College of Osteopathic Medicine.

“Too much utilization of smart devices could lead your preceptor to misinterpret whether you’re engaged or texting or tweeting,” she says.

6. Ask for feedback

Drs. Rogers and McGowan suggest asking your preceptor to identify areas for improvement during your clerkship. Doing so also gives you the chance to talk about receiving a letter of recommendation.

“You don’t want to get to the end of the rotation and find out that you were doing something that could have been corrected or improved, and now you don’t get the grades or the opportunity for a letter of recommendation,” Dr. McGowan says.

7. Tap into your medical knowledge 

Students should anticipate an assessment and plan for their patients, Dr. McGowan says.

“If you have a plan that you feel would benefit your patient, bring it up, but always defer to your attending,” she says.

Depending on the rotation, Dr. Rogers encourages students to look for occasions to use osteopathic manipulative medicine.

“If you learned an OMM treatment in med school that you think would help the patient, ask your attending if you can try it out,” he says.

For further reading

Audition rotations: 7 tips for success

The ABCs of clinical rotations: Always be curious

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