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Welcome to Your 3rd Year of Medical School

Session 37

Welcome to Your 3rd Year of Medical School

In today’s episode, we talk about life as a medical student on the wards. We talk about what it’s like to be a new 3rd-year medical student. There is no summer between 2nd and 3rd year. This is to match you up with the calendar of the residents coming in.

As a 3rd-year medical student, you move into a different type of learning: you learn on your feet as opposed to being in a classroom. It’s a transition into the clinical environment full time. It’s a big change, but remember that you’re not alone. You’re going to have a team of resident physicians backing you.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

Things to expect when you start on the wards:

  • Days start early with rounding, which refers to a conversation about the admitted patients (sick rounds, walk rounds, pre-rounds). Be ready to wake up at 5 am or earlier.
  • Built-in, dedicated lectures and didactics
  • Morning reports
  • Academic conferences
  • Chief’s rounds
  • Pimping: PIMPing is an acronym that stands for “Put In My Place.” Medical students will be asked by residents and attending physicians—but don’t be scared if you don’t know the answers.
Eat when you can eat. Sleep when you can sleep. And don't f&*k with the pancreas.Click To Tweet

Doing pre-rounds as a third-year:

  • Collecting vitals and seeing patients for the first time: You need to gather the information to present to your residents and attending.
  • Talking to the patient and doing a patient exam by yourself
  • Checking with the nurse and checking the chart for earlier notes
  • Checking in with the people who were on-call overnight

What your clinical grade is made up of:

  • Presentation with your attending physician
  • Empathy and bedside manner
  • Formulation of your assessment
  • Your treatment plans

Various exams you will be taking:

  • Step 2 CK exams based off your Shelf Exams or Levels
  • Shelf exams: For each required rotation, you will have an exam given at the end of the rotation covering the entire topic like internal medicine or surgery
  • Associated oral examination

Tips to do well on your third-year Shelf Exams:

  1. Don’t save studying for the end of the rotation.
  2. Read every night when you go home.
  3. Show the people you’re working with that you’re actively learning and picking up knowledge.
  4. Read as you go. When you admit a patient with a particular disease, read about that condition, so it will stick with you and you’re able to integrate everything together.
When you admit a patient with a particular disease, read about that condition, so it will stick with you.Click To Tweet

Third-year surgical rotations:

  • Being able to go to the OR and getting experience in the OR
  • Look ahead to find out the surgeries for the next day.
  • Learn about the operations in advance.
  • Scrub in (and respect the scrub nurse)

Possible questions the attending might ask you:

  • What do you need to look out for?
  • Which nerves and arteries are in the way?
  • What things may cause a problem during the surgery?

Some more pieces of advice for new 3rd-year medical students:

  • Don’t be a gunner.
  • Remember medicine is a team sport. Be a helpful member of the team. Take on any task to help out your team.
  • That said, say “no” to scut work (when people ask you to bring them coffee, or anything that has no educational value).
  • Polish your presentations. Practice at home.
  • Don’t fall asleep during rounds.
  • Be careful how often you use your devices. Pay attention.
  • If they send you home, leave together with other medical students as a team. You don’t have to stay.
  • Have something to read with you on the wards (pocket guides for different specialties)
  • Always bring a snack with you.
  • Get as much sleep as you can.
Remember medicine is a team sport. Be a helpful member of the team. Take on any task to help out your team.Click To Tweet

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