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How to succeed as a medical student on third year rotations

When you are in medical school, much of your application to residency will be based on your performance on the third year clinical rotations. The most helpful thing to keep in mind is simply to put yourself in those people’s shoes who are evaluating you. Thus, we provide a brief guide to who is evaluating you and what they would want in a medical student. 

1. Intern: The intern is trying to take care of the minutiae involved in the hospitalizations of up to 10 patients at the same time.  Anything that you can do to make his or her life easier will be much appreciated. This means really knowing the patients that you are assigned, allowing the intern to be less involved in that patient’s care and thus spread less thin. There are a lot of mundane tasks involved in taking care of patients, including getting outside records, figuring out how to send complex labs, etc. Help the intern out and he will love you. However, also appreciate that interns are very busy, so avoid the trap of being the “over-eager” medical student who pesters the intern with excessive numbers of complex questions purely to show interest or hovers behind them repeatedly asking “what can I do for you next.”

2. Resident: The resident is the de facto mind of the team and is there to make sure the patients are getting proper medical care. He is also demonstrating to the attending that he knows what he is doing. Before you present to the attending remember to review the plan with either your intern or your resident so that during your presentation you describe the plan that they want presented. Residents are often trying to sway the attending in a particular direction, they are providing an argument for their management plan, so make sure to understand why they are doing those things and don’t spontaneously deviate from their plan because you want to look smart. Additionally, the entire team is trying to keep rounds efficient, so leaving irrelevant details out is often a sign that the student has a strong grasp of the medical problem. Your presentations should be comprehensive, but keep your words efficient and avoid rambling simply to get every single thing the patient said during the admission.

3. Attending: Attendings are typically there to give the residents advice, to oversee the entire operation, and to educate. Make their jobs easy for them by bringing up relevant literature with new admissions. Run the paper by your resident first to make sure it’s appropriate, but the best medical students will quickly reference an item of primary literature when they present new patients. This could be a seminal paper published years ago, but if it is relevant it allows the attending to discuss an important clinical point. It also shows that you are interested in the rotation.  Attendings are also used to being an authority so if you do ask questions on rounds, ask questions that the attending can probably answer, not esoteric inquiries on molecular mechanisms (We are talking to you MD-PhDs).

 The desires of the interns, residents, and attendings all shift with each rotation. The advice above is most relevant to your internal medicine rotation which is likely the most important for residency applications. On surgical services, there is less emphasis on comprehensiveness and more emphasis on efficiency. Always be gauging what people actually want from you and deliver that.

However, the most important thing to remember is just be a normal human. This can be incredibly difficult during the third year of medical school where you play the role of totally superfluous person with no real knowledge to contribute whose education is largely slowing everybody down all while being judged continuously. The pressure can cause lots of otherwise normal people to act weird and there is nothing more unpleasant to be around than a stressed-out third year medical student. So avoid that and just try to be as normal as possible while also trying to learn something. Everybody knows you are there to learn and that you don’t know everything so ask genuine questions to learn, not just show-off what you already know.