Dr. Cranquis' Mumbled Gripes

TheNotQuiteDoctor Presents: What to expect when you’re expecting (to start med school)

Hi! First of all, I really enjoy reading your blog! Second, I’m a senior in undergrad who has been accepted to med school (YAY!!!), but is looking at the next year of my life with a healthy combination of fear and excitement. Not sure if you have done a post like this already, but could you offer some wisdom on surviving and thriving as an M1?

First off, congrats on getting into medical school. That is an amazing accomplishment. My first bit of advice is to really reflect on that and let it sink in. You got in!

Now I have a disclaimer. I am still in my first year of med school (three weeks from being done) so I may not be an authority. But I feel like I have enough experience to offer some advice. So take this for what ever you think it is worth. Here are some tips (in no particular order) for the coming year:

Read More

TheNotQuiteDoctor asked me to “chime in” on this excellent reply. I agree with all of his tips! Here’s my own list of Med School Survival Tips (broken down by year). Good luck to all of you upcoming MS1 students! :)

hart, MD: Thoughts for MS1's →

aspiringdoctors:

hartmd:

Congrats! You made it! Now you’re on your way. Hold on to that excitement as long as you can. You’re going to need it! Because…

Burnout is going to GET YOU! You may be excited now, but there will be a time when you lose interest. Maybe it’s because the drudgery of the study/exam cycle starts to take it’s toll. You’ve been doing this school thing for about 20 years already after all. Maybe it’s because there are other more pressing things in life: personal relationships, searching for personal meaning and fulfillment, or just college football season. Regardless, burnout will come.

Study fatigue will too! And almost on a daily basis. Especially during test weeks. This is different from burnout. Burnout implies a lack of interest. Study fatigue is a simple inability to continue studying, but not because you lack motivation or interest. The mind is only able to handle so much studying in a day or week. This is why cramming doesn’t work. This is why you should do your best to stay on schedule or even get ahead. Study fatigue is why I’m writing this post!

So here’s some advice for a good year:

This is your life. You can let med school own you, or you can define your own life. Set study limits. Keep relationships and hobbies that are important to you. There’s a lot of time in med school; there’s a lot of time in LIFE. Use it wisely.

Studying is overrated. Never study on a Friday night. Or a Saturday night. In fact, take most of your weekends off. Still, study a LOT. Medicine is your full-time job. Study on your own, and with friends. Then obey your limits.

Be healthy! Exercise, play sports, and sleep a lot. Don’t study if you need to sleep. I slept more this year than ever in my life. Don’t neglect your mental health either. Make sure you have friends you connect with and get the emotional reprieves that you need.

Get involved with some volunteer clinics that remind you of what you will actually be doing once Step 1 is over. This helps a lot with that burnout. I will not be a full-time student for the rest of my life; I’m going to be a full-time doctor. A people-person.

Don’t join clubs or do research for your resume. If you want to do it, then go for it. But don’t do anything you don’t want to do. You’ll regret it later.

Enjoy yourself outside of medicine. Volunteer, join some clubs, start a new hobby. Maybe you can even forget you’re in med school for a moment or two!

Maintain perspective. You’ve made it into med school; the school is invested in your success. Everyone is trying to slowly mold and train you into the expert physician you want to be. Today’s test hardly matters in the long run. A momentary failure will not deter you from that ultimate goal. Stay calm and study on.

Best of luck to all my MS1 friends, now and in the future.

Wise words, thank you very much.

This makes me feel better about taking this evening off to go to a concert with a friend from art school and a new friend from med school. When worlds collide!

Another excellent collection of MS1 (First Year Med Student) survival tips!

Medical State of Mind: A Word with Second Year →

medicalstate:

For the students who have made it through the first year, congratulations to you. You have earned a quarter of the way to earning your stripes. But brace yourself now, because school is about to get tougher. They will expect more of you, and you will need to rise up and meet the challenge.

Much like my last list of advice for first year, I have here a list of a dozen pieces of advice. On top of everything I have already mentioned before -which still apply - here is a quick guide to second year:…

Yet another terrific collection of tips and tidbits for med students from Medical State — specifically the 2nd years this time around!

Medical State of Mind: A Word With First Year →

medicalstate:

For the students out there who will soon begin their first year in medical school, let me say congratulations and welcome. There is a long road ahead of you. After reflecting on the experiences I have had and the observations I have made, I have here a list of 16 words of advice to set the course. Here is a quick guide to first year:

Succinct and very accurate suggestions for first-year med students. (Plus links to a few other valuable lists by current/prior med students, including one by yours truly — Thanks for the shout-out, Medical State!)

Advice to Medical Students, First Year Edition

wayfaringmd:

A new academic year is beginning, which means there is a whole new crop of thousands of first years who are, at any given moment, this close to peeing themselves out of excitement or utter fear. So to calm your worries, I’ve compiled a little advice column. Here goes:

1. Don’t look at the cadaver’s face on the first day of dissection. Save that emotional challenge for a week or two in.

2. Take the amount of time you think you’ll need to study and double it. Seriously.
3. Yes, you really do have to know that minute detail about the alpha subunit of the cholera toxin molecule (there’s a reason why I still remember it. Hello first day of medical school… ah the memories).

4. Don’t pull all-nighters. If you don’t know it by 10pm, you won’t know it at 3am.

Read More

These are all golden. And #13 made me almost snort Cheerios through my nose. :)

El Gala Grande: The Audio Treasure: “Cranquis reads the Intern Year Survival Guide, and more”

So for those of you keeping score at home, Chief Cranquistador(k) ohheytherehi is one of only two readers to find a treasure hunt prize. Here is her personal account of finding the treasure, if you’re interested in vicariously experiencing the thrill of finding a prize for yourself.

The treasure itself is a CD with 6 audio tracks of Your Friendly Neighborhood Cranquis, primarily of me reading/retelling the Intern Year Survival Guide, plus A Stupid Poem. And ohheytherehi has been large-hearted enough to post all the tracks on Tumblr for all of you to enjoy…

Even though the rest of you are all slackers who couldn’t work up the energy to travel to New York and find the prize yourselves.

Anyways… here are the links to those audio posts. Enjoy! :)

Intro
Intern Year Survival Guide pt.1
Intern Year Survival Guide pt.2
Intern Year Survival Guide pt.3
A Stupid Poem
Outro (now with 100% more “Creepy Ta-ta”)

Advice for Mini-MDs

Any advice for the med students out there that you wished you had known during your time in medical school?

Much admiration and appreciation,
md-admissions

Yo! I know I gave you a hard time about this question already, but actually: thanks for giving me to opportunity to reblog one of my most popular post-series: Dr. Cranquis’ Med School Survival Guide. That series summarizes all of my “I wish I’d known this before med school, instead of only learning it during med school” knowledge.

Also, some of my Lasix for the Soul posts contain good advice for facing the emotional challenges of medical education.

And last of all: I wish that med-student blogs had been popular and easy-to-find, back when I was a med student, for those blogs can provide excellent support, advice, and encouragement! So for those of you who are just starting down the Medical Pathway, I strongly recommend reading/following the med student blogs listed in this post. (Oh look, md-admissions, you’re on the list!) :)

Keep on keepin’ on!

***Pending Cranquis-Mails: 1; Inbox: Closed***

Inadvertent Pre-Med: Tips for Surviving Medical School →

ziyadmd:

Remember when you were a premedical student in college? It seems like a century ago for many of us who have just completed the first year of medical school. It feels that way because our lives have changed dramatically. Normal life seems to have vanished, and suddenly, 24 hours in a…

Excellent advice article! And a lot of these tips apply to general study habits/attitude for ANY scholastic field.

(via inadvertentpa)

Anonymous Asks:

Hey, Dr. Cranquis!

First, awesome blog!

Second, I have something that I need to get out of my system.

I’m on my first year in med-school. And I feel kind of...alone, I guess. No one in my family is a doctor, so I can’t really talk to anyone about what I’m going through. None of my old friends understand either, and while I’ve met really great people this year, I don’t feel quite comfortable talking to them about „my inner thoughts and feelings“ just yet (which is odd, considering I’m now writing this to you, a total stranger who I’ve never met :D but I guess the whole Anonymous-and-online thing makes it slightly easier).

ANYWAY, to get to the point...I feel that since school started again after new year, I’ve been kind of losing the handle on things. I feel like I’m wasting too much time. Over the years I've found that I learn best by taking notes and then going over them again later. Only problem is that it takes an awful lot of time. Even if I butcher my handwriting. So that technique isn't really working out anymore.

I’ve always tried to get the best results in everything. I don’t know how to do things „half way“. And it just becomes frustrating when I have so much to do and little time to do it. I get stressed out, start panicking and end up not being able to do anything. I’m not a brain of gold either, I have had to work hard to get to where I am now, and while I am very proud of that, it makes me even more frustrated to see that some people in my class seem to be able to just wheeze through everything on natural-born intelligence...Why do I have to do SO much work and they don’t?

Okay, rant over. I get that I need to make the best of what I’ve been given. On that note...I’d like to know if there is maybe a way to for me to train my memory? I have a hard time memorizing stuff on the spot. While reading, for example...I may read something, but 5 minutes later I would have forgotten most of the details. It’s like I run into a white haze. I know that there was „something“...but that’s about everything I can recall. For it to actually stick into the memory, I’ll have to go over it a few times, which, as I said, takes time.

So I guess this looooong „question“ is now over, sorry for spamming your already full inbox :D Thanks for reading!

cranquis Said:

Hello there, Loan Wolf —

Well, my friend, I feel your pain — or to be more accurate, I HAVE FELT your pain. Your MS1 experience sounds very much like mine.

I too was the first person in my immediate family to go to medical school.
I had a couple college classmates who also went to my med school, but I didn’t know them very well, so my first couple years were very lonely times.
To make it worse (not to “one-up” you or anything), I spent the first 2 years of med school in a long-distance (>2,000 miles) relationship with the future Mrs. Cranquis, so I had that whole “pining for ~~the fjords~~ my woman” thing going on.
I also am/was a bit of a perfectionist who was accustomed to succeeding rather easily in undergrad, and then found myself being handily out-performed by 90% of my classmates in first year of medical school — very hard on the old self-esteem. :(

Ok, comparison-of-war-wounds over. Good question about “training your memory.” Whenever people ask me for advice on handling all that material in med school, I tell them about the “preview-view-review” method. That was my life-saver. I didn’t take it seriously enough during the first half of MS1 year, but after my dismal performances on Christmas exams that winter, that study method became my mantra. It took WAY more time than I had expected to ever spend studying (since again, I was used to breezing through my undergraduate classes with just a few late-night cram sessions before exams), but it really paid off.

Aside from that, I found it very helpful to start incorporating “review books” into my studies early — EARLIER than just “2 days before a final exam or board exam.” After slogging through the day’s lecture notes, I would whip out a slim and trim review book for each particular class, and find the sections reviewing that lecture’s topics. Since review books, by nature, are not as complete as a textbook or lecture note, I would write-in important-but-omitted facts in the margin of the review book. What I was intending to do was create an enhanced review book for each class (which would then save me time during exam-prep sessions, because all the important data would be sitting in just one place for each class, rather than be scattered through lecture notes + review books + old quizzes + textbooks + computer programs) — BUT this “sifting through and re-writing what I had just learned in a summarized fashion” also helped the knowledge stick to my old brain-cells better!

I hope these tips can help you a bit. As for your loneliness, your social life may benefit from occasionally joining up with study groups of your classmates for review sessions. You’re not going to feel comfortable sharing your inner emotional struggles and stresses with your med-school peers until you’ve developed some closer bonds with a select few of them. You’ll be surprised — most of them will have the same fears that you do, and the ones that claim not to are just very good at suppressing and denying their feelings. (After all, med school SHOULD be a scary and stressful time — you think it’s any less scary and stressful to be actually responsible for people’s health and lives in “real life”?) :)

Good luck, Loan Wolf. :)

***Pending Cranquis-Mails: 18***

EDIT: Also, see the Disqus section under this post’s permalink for another great tip from a reader about using question-banks to help exercise your memory!

Anonymous Asks:

Hello, Dr. Cranquis, I will be a junior intern in the coming days. I am nervous, scared, excited and a bunch of other feelings. Are there any words of advice, tips you could give me? Thanks!

cranquis Said:

Greetings, Slave Labor!

Oh man, I feel your pain — or at least, I can vaguely recall it (it HAS been almost 7 years, after all). Yes, you have a nerve-wracking and exciting year ahead of you. In the words of many many movie trailers: Expect the Unexpected. You will learn things about medicine, people, society, and yourself that you could not have imagined and will find hard to believe.

I suppose it’s only right that I put together a Internship Survival Guide to accompany the Med School Survival Guide that I wrote a couple months ago. So thanks for prompting me/giving me that opportunity. Here goes!

Do your prep-work early — You’ve made it through the 3rd and 4th years of medical school, so you may assume that you’ve got the rhythm of hospital-based life figured out. You don’t. Your life as an intern is going to be busier and more stressful than anything else you’ve experienced so far. So, do as much as you can to “prepare” your life for intern year now. Get your finances figured out (pull your tax papers together, consolidate your med school loans, consolidate your credit cards, setup an auto-bill-pay function for as many of your monthly bills as possible.) Get your relationships/family life stabilized (Intern year is not the best time to be planning a wedding or getting pregnant/having a baby; try to avoid scheduling any major events during this year, since you will be almost powerless over your schedule). Get your licensing paperwork/classwork rolling asap (do as much as you can towards getting your BLS/ACLS/PALS/ALSO certifications, if applicable; get the paperwork for your DEA and medical licenses now so that you can send them in as soon as you qualify.)
Approach intern year with the right attitude — Listen, let’s get this straight right now: If you are lucky, you will run into 3 or 4 residents and attendings who will treat you with respect, motivate you to higher levels of performance and skill, and model a well-balanced “doctor lifestyle” for you. The rest of the residents and attendings you meet will be just going through the motions, and a few of them will be downright toxic to be around. But if you go into this intern year with a big “everybody owes me everything and I’m the smartest intern since William Harvey” chip on your shoulder, you will ruin your interactions with even the few “good” potential mentors you may encounter! For these 12 months, you certainly may believe that you are a smart person, a good person, a bundle of unrecognized potential genius, even — but don’t go into those 12 months expecting everyone else to automatically agree with your analysis. You’ll be disappointed by their lack of applause and adoration, and you’ll just make life (more) miserable for everyone on your team… including yourself. Humility and persistence are the two non-scholastic keys to a successful intern experience.
Devise and revise a system of keeping track of your patients and your to-do list — As a MS3 or MS4 student, you might have occasionally been on a really busy medical service, where you were expected to “manage” 3 or 4 patients with the assistance/oversight of an intern or resident. Now, as an intern, you can expect that number to double… or more! And for each of those patients, you will be responsible for keeping track of lab and test results, upcoming procedures and studies, changes in status, medication adjustments, discharge planning, family meetings… and more! So you need to adjust (or revamp) your “patient-tracking” system ASAP to handle this increased load. It doesn’t matter if you use index cards, a 3-ring binder with daily/weekly progress pages for each patient, a crumpled handful of printed-out labs and prior progress notes, a patient-tracking app on your phone, permanent marker on the back of your hand — whatever system you use, you’ve got to make it work for you! If you are spending most of your time digging through all your data, trying to figure out what’s old and what’s new and what’s irrelevant among the piles of information you’re carrying around: your system isn’t working. If you can’t quickly and obviously demarcate the Top 3 Things I Need to Do Next for each patient in your list: your system isn’t working. If you have to spend more than 5 minutes/patient transferring important data from today’s list to tomorrow’s list: your system isn’t working. You will likely need to revamp, redesign, or even completely-reinvent your system a few times during your residency, as your responsibilities change from team to team and hospital to clinic — so be open to constantly fixing what isn’t working. Share patient/list-management ideas with your colleagues — they’re in the same boat as you are.
Don’t be a hermit or a cut-throat — Unless you got into the most exclusive residency ever, you’re gonna have at least a few fellow interns traveling along The Trail of On-Call Tears with you. Despite their outward confidence, they are all nervous, anxious, and/or downright scared too. So don’t make their lives even more miserable than they’re already gonna be: be a team player. Offer to help. Don’t make them look bad in front of the residents/attendings. Take the time to get to know (at least some of) them on a “friend” level. Trade around tips on who the “good” and “bad” attendings are. Don’t be a conniving weasel when it comes time to schedule your (meager) vacation times. Be a good example of professionalism and ethical conduct.
Keep your head down while you’re under fire — As I’ve hinted, you will run into some truly Machiavellian characters during your internship/residency. You will spend at least a few weeks or months under the thumbs of snotty residents, passive-aggressive secretaries, puffed-shirt attendings, inept and incompetent department chiefs, selfish and slothful chief residents. Simultaneously, you will often here phrases like, “If you feel you are not being treated properly, let someone know,” or “If you don’t provide feedback, things will never change.” These phrases are true — and deadly if obeyed at the wrong moment. My rule of thumb regarding “providing feedback on toxic people” is: Don’t do it until you are out of their reach. If you play your cards too soon (i.e, at a half-way rotation evaluation meeting with the attending of the service), you may find yourself getting maligned, slandered, and abused by the very jerks about whom you naively complained during that “confidential” evaluation. (Yes, I speak from experience). Don’t NEVER speak up — just be wise about your timing. Wait until that rotation is over and your evaluation paperwork is safely filed into your record — then provide a factual, rational, as-emotion-free-as-possible evaluation of what the sniveling jerk-tard (resident, attending, whoever) did and didn’t do right. If you NEVER speak up, you just consign all your colleagues to suffer the same idiocy.
Be aware of the Holiday Blues — The hardest time-period within intern year, emotionally/psychologically speaking, is the 2 months around the Christmas season, approximately from Thanksgiving to Valentine’s Day. At this point, you’ve survived 5-6 months of brutality — and you’re just starting to realize that you have 6-7 months of More Of the Same to come. Plus, you probably got scheduled to be on-call for at least one (if not all) of the major winter holidays, so you feel a little more put-upon than normal. This is the crucial survival time of your intern year — if you can make it through January, you can make it through the rest of the year (well, from a psychological standpoint, if not a scholastic one). :)
Make time for the important things — You will need to devote 98% of your awake time to your internship duties. But use that other 2% wisely. Make time for physical exercise, emotional/psychological recreation, and spiritual renewal (if you are so inclined). Try to eat healthy at least once a day. Drink enough water every day (carry a water bottle around, like I mentioned for 3rd year med students). Make your bed, clean up your room, brush your teeth, how many times do I have to remind you that money doesn’t grow on trees? (Oops, sorry, got a bit carried away there.) :)

Those are some of the things I learned along the journey myself, Slave Labor. As you learn valuable survival tips for yourself, go the extra mile and pass those tips along to those who travel behind you. It’s called “contributing to the grand art of medicine,” and it’s important.

Good luck!

EDIT: Want to hear this Survival Guide read aloud by Cranquis? Check out these audio posts!

Dr Cranquis' Guide to Surviving (and maybe even thriving) at Med School →

iwannabetheverybest-medic:

Advice for American Med Schools (but includes piles of stuff that would be great for anyone about to plunge into the rather demanding world of Medicine).

Intro

1st Year

2nd Year

3rd Year (Part A)

3rd Year (Part B)

3rd Year (Part C)

3rd Year (Part D)

4th Year

Special Features:
1st Year Deleted Scene
Qualities of an Ideal Doctor
Prevention of Procrastination

Oh, and if you’re not already following this guy: why not?!

What a nice link-collection of some of my posts! Thank you for putting that together.

(My guilt-ridden soul admits that I need to get around to creating a “Best Of” and “FAQ” links-page on my Tumblr… someday, Cranquis, someday…)

EDIT: And here’s the Intern Year of Residency survival-tips post!

Reply: Med School Survivor: 4th Year

thisismehidingfromtheworld asked:

and here’s a real question : how did you survive med school? i’m in my second year and i just want to know how did you survive this thing ;)

Part 4 (finally!) of a 4-year 4-part reply on “Tips for Surviving 4 Years of (American) Med School” — see disclaimer from Part 1, please!
————

Do you remember, WAYYYY back in the day, when you were a senior in high school? You remember the mixture of status and stress that came with that coveted title, “Senior”? Well, 4th year of med school is just that, times 1,000.

STATUS:
Ain’t nothing quite like being the “top of the heap”, right? As a 4th-year med student, you are envied by all the other med students “below” you. You know your way around most of the hospitals by now, some residents and attendings recognize you in the hallways (this is USUALLY, but not ALWAYS a good thing), you’ve already narrowed down your choices for residency specialties and started taking electives accordingly.

If you’ve played your cards right, you’ve knocked out your USMLE Step 2 exams early in your 4th year, gone through the whirlwind of Interview Season, and still saved up some of that precious “exam prep/interview” time to be spent on a nice vacation instead! (May I recommend doing some overseas travel, possibly a medical missions experience? Go see what other countries’ medical systems are like, and start to appreciate the aspects of American health care that still rock. But regardless of where you go, GO — this will be the last chance you’ll have to do a real vacation for a while).

And on the rare occasions when your world intersects with the lecture-hall/lab-bench world of the 1st-year med students, you can just feel their envy and admiration oozing out through every pore, like some horrible Oedipal cologne. Try to remember what it was like to live in a study cubicle all the time — then be a real champ, and offer to take a 1st or 2nd year student along with you for a day of hospital or clinical experiences during your rotations. Also, start visibly “coaching” the 3rd year students who are on your rotations with you: not only is this good practice for residency, and will help you remember your medical data better, but it looks really good to the attendings who may sit on local residency application committees!

STRESS:
So, as much as you’re enjoying 4th year, you still have some dark spots coming up on your calendar — Interview Season, Match Day, and INTERN YEAR.

Interview Season, the period of time when most residency programs start offering interviews to applicants for next year’s residency slots, usually begins in the fall and ends in February of your 4th year, so plan your rotations accordingly: Try to line up rotations during Interview Season which won’t be too picky about letting you take a couple days for traveling to and interviewing at your residency choices. Don’t over-load yourself with applications and interviews (unless you’re competing for a really tough residency); when you reach a “breaking point” where you’re just showing up to interviews “because I already had scheduled them,” start canceling them.
Match Day is gonna be nerve-wracking, regardless of how well your Interview Season went, but hopefully you won’t be stuck “scrambling” for open slots in random residencies.
With Intern Year looming, 4th year is a good time (similar to 2nd year) to get your ducks in a row: get your relationships with SO’s/spouse/kids stabilized, organize your finances, sit down with a financially-savvy person to discuss upcoming issues like “renting vs. buying a house”, “consolidating your school loans”, and “deciding on supplementary life and disability insurance policies.”

RANDOM TIPS:

In preparing for the USMLE Step 2 CK exam, I found Boards and Wards and Swanson’s Family Medicine Review to be the 2 most useful books. (I finished med school before the USMLE Step 2 CS became mandatory, so I don’t have specific tips for that — but practice practice practice!)
At graduation season, ask your dean’s office to give you a copy of the application essays that you wrote when applying to med school: it’s like taking a trip back in time, to a more innocent age when you had idealistic goals and no uncertainties about the “truth of Science” and the “desire to help others”. Let this “trip” show you how you’ve changed, but also remind you why you got into this in the first place: you’ll need that perspective to help you endure through the rigors of Intern Year.

——————-

And that, thisismehidingfromtheworld, finally concludes that!

For those of you who started following me after I started writing this mini-series (which is probably MOST of you!), here are links to all the previous Med School Survivor posts:

Intro

1st Year

2nd Year

3rd Year: Part A, Part B, Part C, Part D

Or you can see them all at once on the “Survival”-tagged page (as long as Tumblr’s search function is working… no promises.)

Reply: Med School Survivor: 3rd Year (Part D)

thisismehidingfromtheworld asked:

and here’s a real question : how did you survive med school? i’m in my second year and i just want to know how did you survive this thing ;)

Part 3 of a 4-year 4-part reply on “Tips for Surviving 4 Years of (American) Med School” — see disclaimer from Part 1, please!

[Part D of an ever-expanding set of posts about 3rd year…]

————

Rotations: Sounds like something I always forget to have done to my car tires. For most American med schools, 3rd-year is when the concept of Rotations enters the med student’s life. The layout of a student’s year-long rotations schedule (or “track”) can vary widely from school to school. In general, however, most 3rd-year rotations will include the BIG BOYS of: Internal Medicine, General Surgery, Pediatrics, and OB-GYN. (Other possible 3rd-year rotations may include: Family Medicine, Neurology, Psychiatry, Orthopedics — again, it varies!). Some schools don’t give you any choice on the particulars of your rotation schedule, but if you DO get any choice on the order of your 3rd-year rotations, here are my tips on exercising your (limited) control over 3rd year:

Try to “stagger” the order of inpatient and outpatient rotations. In general, inpatient (hospital-based) rotations will require you to take call, while outpatient ones won’t. Avoid having call-heavy rotations back-to-back — you’re gonna get enough of that in your residency!
If you are going to try to do any “external” rotations (rotations performed at another facility away from your school’s physical or institutional location), start this process early! Even if you’re doing an “externship” with a program that has provided this opportunity for hundreds of students from your school before, every secretary and dean involved will act as if this is the first time anyone has ever done this crazy thing before, and delay your planning accordingly!
If you’re thinking of entering an internal-medicine-style residency (Internal Medicine, Family Medicine, Pediatrics, Nephrology, Neurology, Endocrinology, etc), push your Internal Medicine rotation later into 3rd year — This way, you can bumble around in “less-important” rotations early on, (improving useful skills such as note-writing, presentation of patients, performing History and Physicals), so you can really shine in the Internal Medicine rotation. In this way, the Internal Medicine attendings will be happy with you and more likely to write shining letters of reference for your residency applications.
On the other hand, if you’re planning to do any other residency (anything Surgical, Psychiatry, Dermatology, OB-GYN, ER), do Internal Medicine as early as possible — Despite being a masochistic way to start your 3rd year, this rotation will help “set the stage” for the knowledge and skills that you will use on most other rotations, and allows you to benefit from a later (and therefore “better-performed” = “better reference letters”) rotation in General Surgery.

And that, I believe, concludes my 3rd-year survival tips! Coming up next: The Last Nice Year of your Professional Life (OR: “Appreciating 4th year before it’s gone!”)

Any other pre-med/med-school/residency questions I could shed light upon for y’all?

Reply: Med School Survivor: 3rd Year (Part C)

thisismehidingfromtheworld asked:

and here’s a real question : how did you survive med school? i’m in my second year and i just want to know how did you survive this thing ;)

Part 3 of a 4-year 4-part reply on “Tips for Surviving 4 Years of (American) Med School” — see disclaimer from Part 1, please!

[Part C of an ever-expanding set of posts about 3rd year…]

————

Politics: It’s everywhere, whether you like it or not. And as a 3rd-year med student, you will quickly discover that you need to learn to play (if not enjoy) the hospital-politics game. Your efforts at learning who has The Power(tm) in your clinical rotations will pay off in increased learning, slightly less stress, and better evaluations. Here’s some tips on navigating these icy waters:

Be nice to the nurses
-I don’t care how you see doctors treating nurses on TV, but in real life, a doctor (and especially a med student) who is rude to the nurses or treats them like unpaid slaves will soon discover just how miserable their day (and more importantly, their night) can get! Nurses may look all innocent in their optimistically-white outfits, but they have gobs of The Power(tm)!
-Ways to “suck up” politely: Always refer to a nurse by name if you know it; if you DON’T know it, ask! Never act surprised when they display their medical knowledge — they may not have suffered through Biochemistry with you, but they have lots of practical experience! Introduce yourself to them early on, explain that you’re a med student and that you’d love to learn anything they might want to contribute to your education. Offer to help with patient-care issues, especially wound care and dressing changes — the nurses have a lot of wound care knowledge that is not specifically “taught” to us medical students, and this info is priceless in the real world! Bring in treats once or twice (pastries, fruit plates, and gallons of juice or coffee are always big hits).
-BIG NO-NO: Never blame a nurse for a patient-related issue that YOU could have dealt with (i.e. confirming that the lab tests were drawn, repeating a blood pressure when the last BP is suddenly abnormal). They are not your servants or your slaves. Take some responsibility!
(NOTE: These tips also apply to all the other health-care and hospital services that you will encounter: respiratory therapists, physical therapists, chaplains, social workers, food service, janitors, secretaries, unit clerks, the list goes on — we’re all just a bunch of humans walking around taking care of other humans, and no amount of initials on your name-badge gives you the right to disrespect anyone else.)

Be nice to doctors on other services (consultants, specialists, etc.)
-The Lord of the Flies mind-set is an easy one to fall into: It’s US (the attendings, residents and students on your particular rotation) versus THEM (any doctors on the other services in your hospital, the other surgical teams in the OR, the ER doctors or primary-care doctors trying to admit patients to your team, the specialists that you have to consult from time to time). AVOID THIS TRAP: not only can it set the stage for poor patient care (I can recall many times when a patient’s admission, consultation, procedure, or discharge was delayed because the doctors involved were mad at each other and intentionally delaying things just to piss off the other doc), but it can also come back to bite YOU later. You are on 3rd year ROTATIONS — pay close attention to the circular nature of this word. The very resident that you are back-stabbing today may be the same doctor who gets to write an evaluation of you in a future rotation. That 4th year medical student may be a resident on the interview panel in your chosen residency 2 short years from now… with new-found The Power(tm) to repay any slacking or insults you may have provided years before.

Uh-oh: I discovered that a resident or attending with The Power(tm) is a JERK! What do I do?