The leap from classroom coursework to clinical rotations is one of the most exciting (and terrifying) transitions of a medical student’s career. While medical schools do their best to prepare their students for the start of real work with patients through extensive objective structured clinical examinations (OSCEs), these practice clinical experiences don’t quite prepare you for joining the medical team as a “student doctor.”
With that in mind, getting the most out of your rotations means going in with the right attitude. Here’s your guide to good clinical rotation etiquette.
Regardless of your personality, being proactive is imperative for a successful MS3 year. Find out in advance what resident or team you’ll be rotating with and contact them a few days before starting your rotation. Let them know who you are, what day you’ll be starting and what time you’ll be ready. (Some rotations start with a required orientation lecture for MS3s, meaning you won’t be available to meet with the medical team until after it’s over.)
Before you start, ask how to access the patient list for the rotation and how many patients you’ll be expected to follow so you can be prepared on your first day. Many residents won’t make you take ownership of patients on your first day, but taking initiative can help you put your best foot forward.
Although surgery is notorious for “pimping” students — that is, grilling them on their knowledge of a topic — the other rotations will also expect you to be well-prepared for each day. If you’re scrubbing in to a surgery for the afternoon, do yourself a favor by reviewing the anatomy involved as well as common indications and complications for and from the procedure. When on internal medicine, you’ll likely be busy all the time, but making yourself look up at least one topic relevant to the care of your patients when you go home each night will make you a better doctor and a more prepared student.
At the same time, know that no matter how hard you try, there will still be times when you’ll be pimped on questions you don’t know how to answer. In these situations, saying something along the lines of, “I don’t know the answer to that question right now, but I’ll research it tonight” can help demonstrate your desire to learn even if you’re not fully prepared at the moment.
Pocket Notebook is a must-have resource for fast answers to diagnostic questions you’ll face on clinical rotations. Download the Pocket Medicine from the Apple App Store or Google Play.
While it might seem like this should go without saying, some students struggle with basic professionalism. As a resident, I’ve been shocked at how many students don’t seem to prioritize punctuality or professional appearances. It’s never a good thing for a patient to call a student out for having his shirt untucked!
Simply put: Be on time. Dress for the rotation. The easiest way to do this is to take note of what the residents are wearing and plan your own wardrobe accordingly. Scrubs may be acceptable on some rotations, but professional attire may be preferred in others. If you have other obligations during a rotation, such as required attendance at a lecture, make sure you’ve notified your team in advance so that your sudden absence isn’t a mystery.
There’s an unspoken rule that medical students are expected to be a help and not a hindrance, but often it’s hard to figure out exactly how to do that. Clinical rotation etiquette says that you shouldn’t get in the way, but at the same time that you should be helpful in any way possible.
Ask how you can best help the team in general if you have downtime. Take notes during rounds about what needs to be done for the patients you yourself are following and offer to make the calls needed for those patients — appointments, consults, medicine reconciliations with a patient’s pharmacy. Know your school or hospital’s policy on medical student notes; some actually allow student notes to be considered billable documentation when they’re attested by an attending, while others prefer that student notes not be left within the actual EHR.
When working with patients yourself, remember to follow exam room etiquette by introducing yourself as “student doctor _____” so that they’re less likely to mistake you for a licensed physician. At the end of the day, always ask, “Is there anything else I can help with?” Residents may universally understand this question to mean “I’m done with my work — can I go now?” But asking it makes a difference.
Finally, remember that your clinical rotations are designed to be a learning experience for you. You won’t be perfect: You’ll get the wrong diagnosis, you might have to rescrub in after contaminating the surgical field and you’ll more than likely get lost in the winding hallways of your hospital. Be willing to learn from your mistakes; be quick to acknowledge and apologize for your errors. The student who works hard but isn’t perfect is more favorably remembered than the know-it-all, and you’ll need letters of recommendation for your residency applications. Leaving a positive, lasting impression on the attendings and residents you work with may be essential for your professional success.