
- Bedside manner
- I didn’t realize that this is something most med students struggle with until multiple attendings commented on it. It’s not something that is taught or emphasized in med school. But people notice, especially attendings, if you demonstrate good bedside manner!
- Find physicians who make good role models and emulate them. This is how I developed mine! Listen to how your residents talk to patients. Take notes. I would literally write down phrases I liked that I heard physicians use. It’s truly an art!
- Respond to emotions! If it’s sadness/frustration, “You have every right to feel the way you do”, “It’s understandable that you feel that way”. If it’s pain/symptoms, “We’ll take a look at your medications and see what we can do”. You can also say “I’m sorry you’ve been feeling so X/Y/Z” although some argue that this is more sympathy than empathy.
- Always ask the patient if there’s anything else that the team could do to make them feel better!
- Be your patient’s number 1 advocate!
- Ask if they’re comfortable or if there’s anything you can get them – do they want an extra pillow or blanket? Is the TV working?
- Is there anyone they want us to call?
- Take ownership of your patient’s care.
- Check in on them often throughout the day, not just before rounds or during.
- Report back to your residents if it’s a good time.
- Track labs and be the first to report them. Track consults.
- Basically be the first one to report everything about your patient!
- Know everything about your patients!
- Meds, social history, where they live/facility they came from, what happened in last hospitalization, etc., or at least have a scut sheet you can refer quickly to!
- This helps facilitate rounds! You can find the scutsheets I used here.
- Medfools.com has some great ones!
- Do your reading!
- Read up on your patient’s conditions.
- Read up on the evidence for management. Bringing it up during rounds shows you’re interested and you’re being proactive. “I read that…should we consider doing XYZ?”
- Write all the notes on your patients and be thorough in your Assessment & Plan to make your resident/attending’s life easier!
- What’s the working ddx?
- What’s less likely?
- Why are we ordering this workup?
- Why are we going with this plan?
- What’s the threshold for changing the plan?
- Many residents would tell me this is how they knew I was paying attention on rounds and how they would evaluate my knowledge & clinical skills!
- They also appreciated when they didn’t have to change much and just had to sign it!
- For writing your plan, try to include your rationale for it. It will be impressive if you can cite evidence from your reading!
- UptoDate helps, but may not always be what’s followed in actual practice. You can always ask!
- When presenting patients, be detailed in your Assessment and Plan and include your rationale as you would in your note!
- I struggled with this, but attendings often grade you based on how good your A&P is.
- Pay attention during rounds even if they’re not your patients. All patients are learning opportunities and you can still ask questions even if they’re not yours, but don’t be a gunner and overdo it!
- Answer the phones, this helps out your interns and residents at on!
- Listening to what’s happening to other patients during rounds helps with this.
- Offer to write patient discharge summaries. This is when you write the hospital course in layman’s term for the patient so they know what was done for them.
- Offer to call family to update them or obtain collateral – this reflects well on the team and prevents future calls from frustrated family members wondering why the team hasn’t updated them yet
- Ask questions often, but not if it can be easily looked up.
- Ask why often – why this medication/management over the other?
- Ask your interns/residents how you can help throughout the day. Don’t sit around! There’s always something to do!
- Never ask if you can go home.
- Your interns/residents will usually let you know when you can go home.
- You are not allowed to exceed a certain number of hours and they are aware of that.
- If they’re not and you’re staying later than usual, simply ask if there’s anything you can help with before you leave for the day.
- Study only if there’s nothing left to do.
- Never ever try to make your partner look bad! This can be hard because sometimes if one person is interested in the specialty and the other isn’t, but most of the time both students will try to work at same pace!
- Communicate with the other student and check in with them to see if they have any concerns.
- Working together reflects better on you.
- People notice when if you are actively trying to put the other student down.
- This one is obvious, but work as a team! No one likes a gunner, not even the attending. People notice. It will work against you, while working as a team will put you in a much more favorable light!
- Don’t sleep on the shelf! It’s hard, but if you do well this will bring you closer to honors.
- UWORLD, UWORLD, UWORLD. Start from Day 1! There are 1400 questions.
- Anki if you have time. I decided to do UWorld once with taking notes on my incorrects and then used Anki to review, but in hindsight I would have tried UWorld 2x.
Because this is my specialty of interest, I always tried to find ways I could help even if it was extra! You don’t necessarily have to follow this exactly of course, as I’m sure other students were able to honor the rotation without doing what I did. I hope this helps!
With lobe,
Kelly