Reflections on the Start of My Third Year as a Medical Student


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.”

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3 thoughts on “Reflections on the Start of My Third Year as a Medical Student

  1. 2 cents from an MS4:

    In a word- smile. Seriously, if you adopt a perpetually slightly upturned mouth posture, you will endear yourself to all- patients, residents, nursing staff, attendings, classmates.

    In another word(s)- ask questions. This is diabolical. If you have questions, you’re interested, and if you’re interested, then you care, and everything else is cake. The kicker is that it’s hard to ask good questions. Reading helps. Engaging with what’s going on helps. If you want to be truly diabolical, write down good questions when they come to you so that you can pop them out later. Inevitably, someone will turn to the group and ask “Are there any questions?” If you’ve got one stashed away, everyone wins.

    Everyone wins- that’s important too. It reminds me of the best characterization I’ve heard about third year….

    Third year is like being a dinner guest. Arrive on time (or maybe 5 min early- it seems like a lot, but those 5 minutes can be everything, and it’s only 5 minutes), be polite and cheerful, have interesting things to say or ask regarding the topic, but don’t be overbearing, and acknowledge everyone. In the ultimate dinner party, everyone wins, and that’s your goal.

  2. You will do well. When considering your future field look at your attending’s happiness not the relative unhappiness of the housestaff. Residency is over in a blink of an eye. Ask yourself, would I enjoy doing his/her job?
    Oh, and don’t make the same mistake twice. And remember to study for your Shelf exam if your school uses them for clinical rotation grades. Those clinical rotation grades will make it easier for you to end up where you want to be as a resident.

    KBC

  3. Hello there :)
    First, i truly enjoyed reading your thoughts about what it feels like starting rotations. I’ll start my first rotation in almost 3 weeks from now and i can’t wait!
    I totally agree about specialties, everyone keeps asking as if you’ve had enough time to decide while in fact rotations take a huge part in deciding which specialty you want to be in and for that this question needs to wait till you do most of them if not all. As you said, one way to answer is to list the specialties you’ve excluded and that’s how i answer it.
    thank you for your advice about people skills and communication I’ll definitely keep it in mind.

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