After 2 full days of orientation, one “easy” day of shadowing, and a significant amount of apprehension, I am now a bona fide MS3. To be completely honest, I’m not entirely sure what I expected. I was terrified of caring for real patients while impressing my residents and attendings, and simultaneously ecstatic to put the knowledge I’ve accumulated in lectures and in the library these past two years to use in a real, live hospital. The best portmanteau I could come up with for this combination of emotions is “electrified”.
My first 4-week rotation is on the neurology service, which is part of the larger, 12-week internal medicine block in my institution’s curriculum. I chose this rotation intentionally – I scheduled those clerkships I consider potential career possibilities early-on, so that I would have a better idea of my ultimate specialty goal when scheduling fourth-year rotations later this year (By the way, if you already dread explaining all your thoughts regarding specialty choice at holidays and family gatherings, I suggest learning how to answer the question “So, do you have any idea what you want to do?,” before beginning 3rd year. I found out on Day 1 that most residents and attendings see through the answer “I want to go into your specialty.” Instead, try offering the specialty you know you’re NOT interested in.).
I can offer little in terms of “how to succeed in third year,” at least at this point, but I have found that the pressure we put on ourselves as MS3′s is quite possibly much greater than any of the pressure placed on us by attending physicians or residents. The residents I’ve worked with have not expected me to jump through hoops, but instead are quick to share personal experiences and advice. My current attending physician is firm and likes to keep rounds concise, but knows me by name. He is patient with both myself and fellow students, and has a sense of humor that is great for easing anxiety about that first patient presentation. That’s not to say medical students can take their place on the team lightly; but after only a few days one can truly appreciate the hierarchy of medical education.
With this said, the largest challenge is, perhaps, figuring out one’s place on the team. As a third year student, you are unsure of your clinical skills, knowledge, and judgment, which complicates interpersonal and professional relationships with your team members. Where do you fit in, and what could you possibly contribute to help your patient? Further compounding the situation are factors such as personal affinity to the specialty at hand, and the fact that your superiors will later help compile your grade for the course. How do you integrate the wealth of new, clinical information you are learning, while at the same time honing your “people skills” to enhance interactions with colleagues, peers, and your patients? In a sense, I’d like to think of third year as an exquisite exercise in professionalism and communication, in addition to the more widely emphasized and expected pursuit of academics.
I hope to explore these issues as I delve more deeply into my third year. For now, I’ll settle for whatever advice or hints those have to share about “survival.”