Tuesday, February 12, 2008

It's About That Time

You have probably been asking yourself: "Self, I wonder how long it will be until Dr. VonB decides she has been in 3rd year long enough to begin giving out often obvious advice in her know-it-all way?" Well, the answer is: right about now.

So, first off, a brief run-down of outpatient medicine. As with any rotation, the quality and overall suckitude (or, if you're lucky, the lack thereof) depends entirely on your preceptor. I am at our University's outpatient clinic and it is definitely higher pressure than most of my classmates seem to be experiencing. On the other hand, I think I have learned a ton, which brings me to my first official piece of advice about 3rd year medical school (or maybe I'm deluding myself, and I've already given out a bunch of advice, but as with most things these days I don't remember it):

OFFICIAL PIECE OF 3RD YEAR ADVICE #1: You get out what you put in.

I mean this in a few ways.

SUBADVICE 1A. Read every day. This may sound 1) oblivious and/or 2) like a pain in the ass, but either way, it is key to success in 3rd year. Most rotations have a lot more reading than you expect, and if you put it off it creeps up on you and kicks your everloving butt. I was told to pick your review book, divide the number of pages by the number of days in the rotation minus about 5 days, and read that number of pages every single day. Your residents and, if you are lucky, your attending, will notice, and importantly you will get more out of what you see in the clinic. Also, do not underestimate the shelf exams. Those who underestimate the shelf exams end up curled up in a small ball, crying, in a corner. And no one wants that.

SUBADVICE 1B. Be enthusiastic. Sometimes you may have to pretend, but if you came to medical school for the right reasons, that won't be too often. Most days you get to see at least one really cool thing. And the best thing about being enthusiastic is that most supervisors will give you more cool stuff to do if you follow pieces of subadvice 1A and 1B, which makes both easier to follow.

SUBADVICE 1C. Do a good job. I know how dumb that sounds, and yet I am consistently amazed at how many of my fellow classmates fail to do this every single day. And here's the thing: doing a good job is something within the grasp of just about every even semi-normal person, because all I mean by doing a good job is stuff like: show up when they tell you; if they tell you to look something up, look it up; try not to make the same mistake a bunch of times in a row; etc. It is NOT THAT HARD. Just try. Even a little.

Basically what I am getting at here is the fabled Cycle of Awesomeness. How this works is that the more you read, and try, and are enthusiastic, the more people trust you and teach you and let you do stuff, which makes you read more and try harder and be even more enthusiastic, etc etc, until you feel like you are actually getting close to be a realio, trulio doctor. And it. Is. AWESOME.

Also, before I forget, one thing you MUST have in your white coat pocket: Sabatine's Pocket Medicine. I cannot begin to describe the awesomeness of this book. If you are a student buy it IMMEDIATELY. No real need for it on surgical rotations or possibly stuff like psych, but it is stunningly useful on any vaguely medicine related rotation.

Okay, I need to follow my own SUBADVICE 1A and get to reading. I am about halfway through this rotation, and ahead lies neurology, psychology, and inpatient medicine. Then I will be an honest-to-God 4TH YEAR MEDICAL STUDENT! HURRAH!

In the meantime, keep an eye out for the crazy patient who came back to clinic with a knife today because we wouldn't give him percocet. Good times!


Old MD Girl said...

Re: Do a good job. I agree for the most part. The only thing is, it's occasionally a little more amorphous than that. Or you try to do something better but fall on your ass the first few times. But I think the key here is: try. It's ok to be wrong, just don't be a jackass.

Dr.VonB said...

Totally. I think a big part of it is getting up every time you fall on your face and feel like an idiot. But I think that doing a good job is just doing a good job at what they expect from you, which as a 3rd year, isn't much.