Starting clinical rotations can be both exciting and a little scary, but I got you covered !
1. Go Shopping for new clothes and shoes
You will need business casual attire as well as scrubs. Here’s a great Youtube video guide for business casual women’s attire for clinical rotations. For male medical students professional attire is advised and this guide may be helpful.
Each rotation is different. Most outpatient offices will require business casual/professional attire with your white coat. Rotations like Surgery, OBGYN and Emergency Medicine will require scrubs and sneakers/clogs. The best shoes for clinical rotations are the ones that are most comfortable for standing and walking around for hours. I personally prefer to wear Dansko or a running sneaker. Every preceptor is different, so make sure you check in with them prior to starting.
2. Know Your Patients
You will be responsible for gathering the patient history and physical exam. If you are rusty in your physical exam skills, I suggest you visit Geeky Medics on Youtube to brush up on your skills. Additionally, for every history you take, you should read more on UptoDate (using a PC or your phone in private or as permitted) for the most current evidence-based information. Your attending preceptor may ask you about disease presentation, treatment, pathophysiology, etc, so it is best to know more than just what the patient tells you.
My favorite history taking tools were the Perfect H&P Journal and the Maxwell pocket guide. They both fit conveniently in the white coat and will be helpful for writing soap notes. The H&P journal is great for taking patient histories and presenting to your attending like a pro. It has every section for a comprehensive history and physical, so you won’t miss anything when seeing patients.
The Up to Date app is usually provided by your medical school’s library. I also purchased the Massachusetts General Hospital Pocket Handbook for Internal Medicine and Primary Care so that I could access similar information without using my phone often.
3. Study Daily
I suggest to completing and reviewing atleast 10-20 questions daily no matter what.
Once a month you will have a shelf or COMAT exam which is a national standardized exam based on the specialty you are currently rotating in. The shelf has 110 questions while the COMAT has 125 questions.The best COMAT tips I have is to finish the first pass of questions at least 2 weeks before the test. Once you are finished with the 110 questions, you can make a document of all of the incorrect and redo them as well as additional questions, videos and readings with other resources to crystallize your weak areas.
All students should have USMLE World (U-world) which is an incredible question bank that is essentially a textbook. U-world should be your main resource regardless of attending MD or DO school. I would suggest doing at-least 20 U world questions daily. If it is the weekend, you can increase that amount to 40-60 if time permits.
If you are a DO medical student, you should do the Combank True Learn and or Comquest shelf specific questions. There’s been an endless discussion regarding combank vs comquest so I’ll discuss that further. There’s usually 100-125 (Combank) questions or up to 350+ (Comquest) questions that are high yield. Combank questions are more similar to the style of the COMAT exams while Comquest has better explanations although some questions go more in depth. Lastly, the following two FREE video resources will help hone in on your clinical knowledge. Online Med Ed is the perfect adjunct video resource for learning clinical and treatment algorithms for your exam. I will also mention Dr. High Yield on Youtube who has quick facts to get you last minute bonus points on your Shelf and COMAT exams. Lastly use the free online resource Online Med Ed for clear and concise clinical algorithms to help you tie everything together !
4. Learn Medications, Now!
We’ve spent so much time learning pharmacology but once we get into the hospital all of the drug names sound so foreign. It’s because many of the commonly used medications have trade or brand names. I’ve put together a list of the top 110 medications used with their generic and brand names so that you can be a pro at familiarizing yourself with medications in the hospital. This list will be helpful for your internal medicine or family medicine rotation. Check out the list here.
5. Be Prompt
Every student should arrive on time. On time is 15 minutes prior to scheduled start. It shows initiative and eagerness. I commuted from New York City to New Jersey by bus daily and it was a convenient 35 minute bus ride door to door. If it serves you better to move closer to the hospital, do whatever it takes. Remember, your final rotation grade is a reflection of your professionalism and not solely based on your exam grades like pre-clinical days.
6. Know Your Place
The hospital is a new and exciting environment. You will be heavily stimulated by new people, places, procedures, smells and feels, but you must exercise restraint. This means knowing the right times to speak, ask questions or intervene in procedures. You should ask your preceptor questions when prompted or as time permits. This shows your interest and respect for each preceptor’s specialty. I would often have atleast one question based on what I observed during the day.
Respect EVERY staff in the hospital. From the transporters, cafeteria employees, janitors, nurses, nursing assistants, they all contribute to your success in the hospital. Don’t be afraid to ask the nurses for advice in making the best out of the rotations and they may even help you insert an IV or foley catheter if you ask nicely. A smile and hello goes a long way. Dont be that person that fails a rotation due to disrespecting hospital staff. All eyes are on you and will report back to your preceptor.
7. Have an Open Mind
You should present to every specialty as if you are interested in pursuing because you never know how much it will influence your selection. Let’s say you want to be a plastic surgeon but rotate in OBGYN. This is not the time to tell everybody how much you “hate deliveries and pap smears “. This reflects unprofessional conduct and could also cost you your evaluation grade.
Enter every rotation with an open mind and absorb as much as you can. No specialty is beneath you. There is so much overlap within different fields of medicine. You’d be amazed how much you may change your mind after just one rotation.
It happened to me and it could happen to you too!
Goodluck starting clinical rotations !