By Maggie Axelrod, Rachel Brown, Patrick Wu, Bridget Collins, Brad Reinfeld, Abin Abraham, and Lizzie Hale (G1 class)
October 30, 2017

Transitioning to Clerkship Year:
Advice from the G1 Class

The transition from classroom to the bedside can be overwhelming, but it truly affords you with one of the greatest privileges as a medical student: the opportunity to simultaneously care for and learn from your patients. Each day you wake up not knowing how you'll feel at the end - will you share relief with your patient whose incidentally-found coin lesion turned out to be benign on biopsy? Or will you share a mixture of emotions with your patient whose biopsy didn't? The clinical clerkship year of medical school is widely acknowledged as a unique and important year in the life of a physician. We hope the following reflections from the G1 class will prove useful to you as you learn to navigate the clinical world.

  1. Try to approach each clerkship with an open mind, even if you think you know what you want to do. Don’t believe the reputations that precede each specialty. Knowledge from every clerkship will help in your future career no matter what you go into.

  2. Be proactive. Ask to see new patients/consults or ask someone to show you abnormal physical exam findings. Ask questions you cannot google the answer to.

  3. Spend as much time as you can with your patients - their stories are those you will remember years on, and they will help you best care for the person in front of you, not just the disease.

  4. Even at your most tired, take every opportunity that comes your way. Go on the overnight organ procurement. Walk down to the path lab to look at your patient's slides. Run down to the ED to catch that Stroke Alert. This may be your only chance to explore areas outside of your interests, and having that broader understanding will help you better provide for your patients in the future.

  5. The key to being a good medical student in the clinic is being able to get along with a wide range of personalities. You need to be prepared and have a basic amount of medical knowledge but that is not the limiting reagent to your success.

  6. Going through clerkships is like starting a new job every two weeks. This pace of change can be dizzying while you are in the midst of it. Once you get the hang of how a service works, you are thrust onto a new environment with different faces and personalities. Learn to embrace it as much as you can. There are a lot of things that were scary at first but become routine. The first day on a new service is going to be hard, but it gets easier from then on.

  7. Even though you will be studying more "clinical" material using your review books and UWorld, it is also a good idea to review First Aid for Step 1 for basic science material. Residents and attendings can "pimp" you on the facts that they memorized from First Aid while studying for Step 1 before their clerkships!  Plus, it is a good way to let some facts percolate in your mind for Step 1.

  8. The Assessment and Plan were the hardest parts of the patient presentation to formulate as a second-year medical student. Often, if you look up guidelines for how certain things should be assessed or treated, you will find that the team isn't really following them. There's usually a good reason why the team has chosen to do something slightly different, and it is very valuable to ask why.

  9. This is going to be a hard year. You will have patients who die. You will be in a very stressful environment. You are going to be expected to work overnight, early in the morning and work very long hours. Take care of yourself, and know that you have a big support system within the medical school, the MSTP, your college and your classmates.

  10. Eat breakfast. Bring snacks. Accept that attendings will steal your pens. Spending time with patients is more important than writing notes or memorizing every UWorld question. Nothing that helps the team or the patient is beneath you. Make friends with nurses. Take care of yourself and those around you. Be kind. Be human.

There is a method to the madness of medical training. During clerkships you will memorize countless facts and forget countless facts. However, on balance, you will remember fundamental concepts, learn to triage the information deluge, and, most importantly, develop as a clinician to apply your knowledge to better a patient's life. In middle of this whirlwind, the patients you see will receive life changing diagnoses, achieve cures, and sometimes be left with more questions than answers. The humanity of medicine happens everyday and with each of your interactions. Therein lies the awesome privilege of medical training.