“Rookie” Mistakes to Avoid

• Don’t arrive late

• Not presenting in SNAPPS format or presenting in an overly abbreviated/disorganized manner. You will see house staff sometimes present in a less formal fashion, but as a medical student you have not yet earned your “literary license” to break from the standard presentation format. Once you have proven yourself clinically, presentations tend to become less formalized.

• Arriving at an MCT session without appropriate equipment for the clinical clerkship (i.e. not having a stethoscope for an emergency medicine observation)

• Please avoid examining from the left side of the patient

• Don’t come dressed unprofessionally

• Remember to introduce yourself to the patient: “I’m firstname lastname and I’m a second-year medical student here to . . . . . .”

• Remember to ask the patient how he/she would like to be addressed. If the patient has a doctoral degree they should be addressed as “Dr.” until/unless they say otherwise. We care for many professionals at Vanderbilt.

• Always come to the observations prepared to do a full history and physical exam. Have a stethoscope and any other equipment that may be necessary for the clinical rotation in which you are participating—reflex hammer, monofilament, penlight, ophthalmoscope, etc. Remember to not use your cell phone as a light source as it could be construed as a risk to confidentiality (The patient wonders if they are being photographed or videoed.)

• During your observation(s), a very common rookie mistake is prematurely jumping to one single “clean” diagnosis and immediately excluding everything else. This approach worked OK in clinical scenarios in CELA during your first year.  MCTs want you to come up with a differential diagnosis and to realize there may be many different factors contributing to a chief complaint. Keep an open mind about multi-factorial contributions to illnesses.

• Remember that these are “show me what you are able to do on your own” sessions. MCTs measure how far down the road toward competence and expertise you have traveled. Unless you have been in medical practice for several years prior to starting medical school, you are not going to get high marks at the start. MCTs expect this—and so should you. Pay close attention to areas in which you can improve for the next MCT observation. Your results are available online as soon as they are submitted by your MCT.

• Finally, remember to try not to be overly anxious.  These are “coaching” sessions and not meant to be “high stakes.”

• The session is not about arriving at the right diagnosis as much as having the right process to arrive at a list of potential diagnoses