Third Year Review

Third year definitely seemed like the longest year of my life. I felt like it was as hard as everyone says it is.  It never feels like there's enough time to study, and the study conditions at the hospital are not ideal with constant interruptions whether that's scut work, attending surgeries, walking or calming patients, making phone calls, or just going home to crash.  I remember multiple times, mainly during Ob-gyn, flopping on the bed with the lights on dreading waiting to wake up at 4 am the next morning.

My schedule of rotations were: Family medicine, Pediatrics, Psychiatry, Ob-Gyn, Surgery, and finally Internal medicine.  My favorite rotations in order were: Family medicine, Internal Medicine, Pediatrics, Psychiatry, and much lower on the list... Surgery, Ob-Gyn.  Luckily we had a week off in the middle of Pediatrics that previous groups of students didn't have, but the year still seemed like a marathon.  The first half of rotations were mostly low intensity, I still felt like I had time to do things outside of school. But that second half was a real struggle to maintain a balance (Ob-gyn, Surgery, IM), but I still made time to at least exercise in the mornings, even if it meant getting up at 3 am, because it helped me get up in the morning and relieve stress. In general the quality of the rotation was directly tied to the attitude and inclusiveness of the residents and the group of students you are paired with. You don't want to be the lazy student who makes the other students do more work, the residents will notice.  You will be working closest with the residents and they will usually make or break your experience. I've had some rotations with great attending physicians but rude and moody residents who make the experience miserable.  I'm not sure what changes in that span of one year between med school and residency that causes some people's ego's to spiral out of control and completely forget that they were just in our shoes.

Some of the things I would recommend doing in third-year rotations include:

-Jump in and embarrass yourself: This is the time to ask stupid questions, make mistakes because this is the time when we're supervised the most.  I wasn't as active in third year as I should've been and will make changes going into fourth.

-Pick one review book and master it: It matters more how you utilize whatever book you choose to study for clerkships more so than which book you use. 

-Spend time before rotations begin or early on during surgery rotation is spending a good amount of time learning to suture.  It will allows you to repair more lacerations in the ER and take less time helping to close after operations: You can find some kits on Amazon or use pig feet, banana skin, or whatever just get used to handling the instruments and tying knots. Like one resident said: If you're a doctor and your neighbor's kid scrapes their knee you will look like an ass if you don't know how to repair it.

-Read about at least one of your patient's pathophysiology in detail every night before going to bed: This will be the way you remember them the most.  I heard people say this before starting rotations however I didn't do it most nights because I felt like i had to do more U-world questions or we had too many patients.  In internal medicine, the nights I would look up Tuberculosis, Spontaneous Bacterial Peritonitis, etc,  I would remember the criteria better and be able to place a face with the disease. It will be difficult but it you at spend even 5-minutes per night doing this it will pay off exponentially.

-Ask questions: Looking back i didn't ask as many questions as i should have because we always seemed busy or i was afraid of sound stupid to my own detriment

-Respect yourself: You're also an important part of the medical team.  One of y classmates who was in the marines said the hierarchy is similar to the military and some people abuse their power. A little hazing will always be part of the culture but don't accept blatant disrespect from a resident. I've had to address a situation with a resident personally that led to a much smoother rotation down the road.  In the same manner treat your patients with respect. We have the benefit of not being jaded from being in medicine so long that we become insensitive. 

-Self-care:  It's important to take time for yourself, especially in harder rotations when there are longer hours. I've seen multiple students have public breakdowns after their emotions pile up.  Seek-help when you need it and make time to exercise and do activities that don't involve medicine.

-Have fun: We're lucky to be in this position of making a direct impart on patient's lives and learning a lot in the process. You will build relationships with classmates and residents and spending a lot of time with them so do your best to make it an enjoyable environment for everyone.

Best of luck. On the Fourth-year. Hopefully it's as chill as they say it is.