At many medical schools, clinical training begins in earnest in the third year. This is an exciting time as it represents the next phase of your medical training. However, it is often an incredibly stressful and high pressure time as it represents a huge change from your preclinical work with different roles, responsibilities, and expectations. Here are some things to think about as you prepare to embark on your clinical clerkships:
- Always keep in mind the two primary goals of clinical training: To learn to actually take care of patients, and to help you develop your professional identity as a physician. It is easy to be distracted by worries about how well you are doing and what your supervisors and teachers think about your performance. However, maintaining a clear focus on these objectives will help you maintain perspective during challenging times during your clinical rotations.
- Be prepared for your clinical rotations. If your school has a traditional clerkship structure, you will rotate through the major disciplines of medicine, usually a month at a time (although some clerkships will span several months). It is important that you prepare both academically and mentally for each rotation.
- From an educational perspective, look ahead to each rotation by finding out the specific requirements for each and make sure you have the appropriate resources available around the start of the experience. Students who have already rotated through the clerkships are a great source of advice, but be careful not to let multiple individuals’ opinions of what materials to use and how to succeed in the rotation intimidate you!
- You will find that each discipline of medicine has its own way of doing things and its own ‘personality’. Although this may feel a bit strange when you experience it (you will certainly find some rotations more comfortable than others) and may take some getting used to, don’t be surprised, and try to take advantage of seeing how different fields view the world of medicine.
- Don’t underestimate your abilities. Clinical training is intended to help you apply the basic science knowledge you have acquired over the past several years to real patients. This is an extremely difficult, frustrating, and often painful exercise. At times you will feel as though you don’t know anything, and it is not uncommon for students to say that the more they experience, the more they realize how little they actually know. But don’t forget that in reality you do know a lot, and that over time things will become easier and eventually fun. Also remember that those who are supervising and teaching you were at one point in exactly the same position as you will be, and possibly not that long ago. Learning medicine is a process that extends far beyond a single clerkship rotation and involves much repetition, trial, and error. If you understand this, it should make dealing with the day-to-day challenges easier. Also remember that students are integral parts of the medical education process. Although it may not always feel like it, students make major contributions to patient care and patient care teams, so always remember that your presence and engagement really are valued.
- Don’t overestimate your abilities. It is also important that you understand your own strengths and limitations to optimize your clinical learning. Many medical students feel as though they always need to have the correct answer or never need to ask for help in order to be successful. This approach can be a great hindrance when learning clinical medicine. It is perfectly acceptable to indicate what you don’t understand, to ask questions, and request help with things you don’t know. Your supervisors and teachers understand that you are early in training and that different students progress at different rates when transitioning from the classroom to the clinics. Therefore, it’s OK to tell people what you need help with in order to fill in your knowledge and skill gaps.
- Don’t be scared. It is difficult to do significant damage as a medical student early in your clinical training. The system is structured with many layers of supervision above you specifically because it is recognized that you can’t be expected to know everything, and that you are in the process of learning what needs to be done. So even though you need to work hard at not making mistakes, be assured that there are checks in place to make sure that you don’t effectively harm patients.
- Take advantage of this incredibly unique period in your professional training. This will be the only time you will be able to be intensively involved with the different disciplines of medicine, and many of the clinical and professional experiences you will have during this part of your training will stay with you forever. So despite the expected stress and anxiety you will undoubtedly experience at times, try to relax and enjoy the process!