Advice for incoming third-year medical students

The co-presidents of the Class of 2011 (current fourth-year students) spoke to us about Phase III clinical rotations. I found their perspective very helpful. Blake actually prepared 13 specific pieces of advice, which he was kind enough to share, and which I want to pass on:

1. As many of you have heard, sometimes tempers can flare in the clinics. Remember that 95% of the time, it’s not about you. Is there something that this resident or attending needs to do, or a statement that they feel they need to make by acting this way? Does it really have to do with you, your knowledge, or your performance? Of course, honest self-appraisal of your own skills is an important part of learning to be a physician as well. But this may save you some undue heartache.

2. On services where there is a list, your intern should not beat you there in the morning. Make your intern’s life easy, and you win the game.

3. Write about your experiences. You have to log each patient anyway. Try taking the time to write a few sentences or a paragraph about what you learned from each patient outside of the realm of “medicine.” You may find it re-engages you with your daily duties as it refreshes why you went into medicine in the first place.

4. Everyone handles pressure/stress/failure/sorrow/death differently. Respect those differences.

5. Make your patient look to you as their primary physician. When you walk in to their room on rounds, lead the team in and make the initial introduction for the morning to the patient. When a patient asks a question about their care in the presence of your whole team, they should be looking at you. You are learning how to become a physician.

6. Make friends with the nurses – they can be your biggest ally or your worst enemy. The vast majority of them want to be your biggest ally, and those that don’t have never met a student like you.

7. Never suck up or throw a fellow student under the bus. Everyone on your team has been in your position: the student. In fact, many were there just a few years ago. They understand what’s going on and the pressures to perform and achieve certain grades. But make no mistake, they see right through your brown-nosing and colleague-under-bus-throwing – they know what you’re up to. Don’t do it.

8. “Try on” every specialty. They are going to make you do the rotations anyway, right? See what the life of a neurosurgeon is like or what the emotional stresses of a psychiatrist are. What is it like to be called by a patient in the middle of the night? And don’t forget to take note of what the attending physicians are doing. You won’t be a resident forever, and sometimes life as a resident and an attending in a certain specialty are vastly different.

9. “No,” and “I don’t know how” are never the right answer. “I don’t know how to do that, but if you show me how this time I can do it in the future” is much better received and helps you learn new things.

10. Have an academic (grade) as well as a personal goal for each rotation. I knew that I didn’t want to do OB/GYN, but my personal goal for the rotation was to not have to duck in a crowd of people if someone shouted, “Is there a doctor here?! This woman is going into labor!”

11. Not everyone will like the third year. It’s a hard transition, and for a lot of the clinical situations, despite your best efforts, it can end up being a shadowing experience. At times it can feel like “playing doctor.” There can be quite a bit of “meta-behavior” in the clinics when people know they are being evaluated at the end. This can be frustrating and disheartening, but try to look beyond that.

12. As #11 states, sometimes there is little role for a medical student on a certain service. Don’t just “get through it.” Your new goal when a rotation turns into more of a shadowing experience is to try to be of use to the team. You’re not above doing any work that needs to be done. Neither is your attending physician for that matter.

13. If you’re five minutes early, you’re ten minutes late.


Blake J. Hyde, MSIV
Class of 2011 Co-President, M.D. Candidate
University of Colorado School of Medicine