Short Coat, Tall Tasks: Bits to Be a Better 'Student-Doctor'
The learning environment in medical school can be difficult to navigate. You may think to yourself that you’re a competent individual that would be able to balance contributing to your medical team, not looking like a moron, and not drowning in the firehose of new knowledge, but it’s difficult. While molding details learned in the classroom into the "art of medicine," you’re experiencing the real interactions and nuances of a medical system for the first time.
The advice presented below is meant to help make the best of the preclinical years, set yourself up for the wards, and then succeed in the intense atmosphere of a teaching hospital.
Show commitment in whatever it is you do.
This point applies to both research and extracurricular activities. You may think it’s important to pick a research project related to the specialty you’re going into…but who is 100% sure about right away? Statistically speaking, you’re most likely going to change your mind, and that’s why it’s important that you pick a project that’s legitimately interesting to you. If you find the project interesting, you’ll be more excited to continue working through struggles, and be able to freely engage in discussions if someone asks you about it (say in a residency interview). Once you hone in on a specialty, one can even make the argument to stick with the original project (at least in some capacity) rather than switch to a new one.
The extra time put into a long-term project will set you up for more conferences and publications, as well as potential spin-offs. It’s also a plus if the project/mentor could adapt with you as you have less time during clinical years, or perhaps more time during a research year. Similarly, with activities such as interest groups or community service initiatives, stick with a couple you enjoy and can devote yourself to. Also, remember that learning medicine will consume many hours. If you stretch yourself thin, it can be harder to obtain leadership positions (let alone run them well), and that may be noticeable on your residency application.
Study for Step 1 as the courses go along.
Step 1 is one of the most important exams of your life. Score too low and certain specialties become near impossible to get into (programs do have cut-offs). Knock it out the park and you leave yourself a cushion in case you want to do something more selective or change your mind last minute. The basic thing to do is read your study companion (book or online study aid) as you learn each system. Every once in a while, review ones you have already done. The repetition of concepts helps cement the material. Additionally, go through a Qbank (i.e. Kaplan or UWorld) simultaneously or immediately after a system is learned. The sample questions provide context for which to store and utilize the material just learned. This also helps to improve processing speed and familiarity with the exam.
Nail down patient interactions.
All schools spend some portion of the preclinical years teaching how to effectively talk to a patient and obtain a history/do a physical exam. Take time working on this part of your craft. At first, it’ll be very structured and take a while, but you’re supposed to be detailed early on. As you become more seasoned, you will be able to have a smooth conversation and mentally parse out what the patient is saying into a thorough yet directed history and physical. It’ll pay off when your time is limited.
Learn to work expeditiously.
Welcome to the wards, where for everyone else, it’s a job where people have a set time and schedule they need to check their boxes. When you’re a member of a team, you don’t want the one that slows everyone down. Time yourself when taking a history and physical. Keep a mental log of duties you have been tasked with and think what order you should triage them to maximize the patient’s care.
The learning never stops. Unfortunately, the amount of available organized time to learn drastically decreases. You’re primarily on your own to expand your knowledge. When you don’t know something, endeavor before asking, and instead ask for confirmation of concepts and practice. Continue to organize new notes and thoughts (I use Evernote as a scrapbook or charts and common pimping points). Stay up to date on evidence-based medicine. There are services out there that organize the latest studies and send them to you once a week. Even if you read 1 or 2 articles from the newest JAMA or NEJM, said articles typically take a few months to be digested by pertinent professional organizations passed around the physician community. You have a head start.
Be aware of social cues.
It’s all about the patient at the end of the day. As a learner, it’s easy to think about each scenario as a learning opportunity, and you should. It’s also vital to not forget that a patient’s health can be very personal. As an Ob/Gyn, many of my interactions involve sensitive topic, like birth of a first child or a routine well-woman complicated by PTSD from sexual abuse. I always tell medical students to take awareness of the vibe in the room and be respectful to your approach to a patient. This also applies to team dynamics. There is a hierarchy in medicine because ultimately each person on the medical team has a responsibility to uphold, and some have more than others. We love teaching and want you to be able to hang around to learn some things, but remember to stay professional.
Practice, Practice, Practice.
When we go over each medical student and discuss his/her strengths and weaknesses, something as simple as confidently tying a knot and holding an instrument goes a long way. If you have some down time, ask for some instruments or work on a skill. Get some at home and you can tie knots watching Netflix or sitting in a car (as a passenger, please). And if you can run a suture without fumbling the suture instruments, trust, you’ve wowed us. You’ll never get more time to grasp such a broad base of information than in medical school. Not to mention that it’s kinda expensive. You don’t want to waste the opportunity.
About the Author
Michael Simoni is an Ob/Gyn Resident at Yale-New Haven Hospital. Originally from South Florida, he spent his college years in the woods at Dartmouth College, before migrating south to Boston to attend Harvard Medical School. He spends most his free time watching sports and binge watching his next Netflix series, while reading up on his academic interests such as women's mental health in infertility and obstetrics.