Top 10 List of Advice for Clinical Rotations
As we are having our inaugural class of medical students enter their third-year clerkship/clinical rotations this fall, I thought it would be good to share my top 10 pieces of advice for medical students on clinical rotations.
I love just about everything in medical education and clinical rotations are among my favorite things. My clinical rotations were the most transformative of experiences in my life and I wish future medical students the same. Here is a list to my top 10 pieces of advice for our medical students:
1. Patients are King/Queen…and So is Everyone Else
Many medical students entering clinical rotations often have little to know previous customer service experience. I had the blessing of the experience to work at Publix Supermarkets for over 5 years while I was growing up and it was an incredibly valuable experience and I got a chance to use many of the skills that I learned about customer service in the hospitals and in the clinics. Of course, taking care of patients and satisfying attending physicians and other healthcare providers is different, but some of the principles are the same. One of the most valuable things that I can tell trainees is to treat everyone like gold. Think about the best customer experience that you ever had (e.g., at Disney or some other place that has great customer experiences) and then treat everyone you encounter with the same kindness, dignity, and service. This can change even the most mundane clinical rotations into magical experiences where attending physicians and other healthcare professionals become hungry to teach you joyfully and patients are happy to have you involved in their care as you learn to become a physician.
2. Relationships
I believe that the quality of our lives are dependent upon the relationships that we have and I also believe that the quality of a medical education can be dramatically improved through great relationships. The physician world is highly networked and there is high trust amongst physicians for respected colleagues — this makes it incredibly important to create authentic and meaningful relationships. There are many things that go into building trusted and meaningful relationships, but in general, kindness, trustworthiness, integrity, and hard work are the most important factors. For medical students, working hard, doing what you say you are going to do, treating folks with kindness, and finding and sharing knowledge widely are important keys. Small gestures such as writing thank you cards after the rotations, holiday wishes, and maintaining contact after rotations are all helpful. These relationships will help to improve your life, get into residency, provide ongoing mentorship, and develop the roots and foundation for a strong professional network.
3. Everything You Can Learn Will Save Someone’s Life
Medical students have been strongly reinforced with a carrot-and-stick type of motivation throughout their academic career. The best medical students and physicians are the ones that realize that everything they learn will have the potential opportunity to save or improve someone’s life. The other rewards (passing licensure exams, getting into residency, passing boards) will follow if done correctly. This is really the great leap from being a medical student to becoming a great physician. In my career, I was truly able to make that leap as I entered clinical rotations and my career has been incredibly rewarding as a result and I have had the opportunity to make an impact on so many through this mindset of lifelong learning.
4. Learn from Everyone
Everyone is important that you encounter in clinical rotations and you can learn from everyone. I truly learned how to be proficient with performing venipunctures and Foley catheter insertions from nurses. I learned about rehabilitation from physical therapists. I learned how hospitals worked from hospital administrators. Medical Assistants taught me about patient flow and managing expectations. Front office folks taught me about insurance. Residents taught me how to be a good resident. And patients taught me the meaning of life (that is a topic for a future blog).
5. Show Up 15 Minutes Early
In the military, it is often taught that if you are on time, you are late. I believe that in medicine, you should always be early — ideally at least 15 minutes early. By being early, you are subtly communicating so many positive things about yourself: punctuality, eagerness to work/learn, integrity, professionalism, organization, and a positive work ethic. That is a lot of positive things for people to think about you by doing one of the easiest things that you will do all day. I have also found that by being early, knowledge and experiences have come to me that I would not have gotten any other way. I think it is kind of the way that the world smiles on you for that little bit of extra effort each day.
6. Professional Appearance & Shiny Shoes
One of my favorite attending physicians in medical school was a stickler for dress code. He would tell me of the story of his father when he had returned from WWII and was able to land a difficult-to-find job in accounting in New York City after the war. Years later, he had asked his boss why he had put his faith in hiring him and the boss said that he had looked at his shoes that day and figured that anyone who would have put as much care into shining his shoes would put just as much attention into the details of his books. Whether fair or not, people do have the tendency to judge a book by its cover and people do treat professionals who are well groomed, smell clean, dress professionally in a much more positive way. While there may be plenty of ways for folks to find fault with me, they would have a hard time finding fault with my professional appearance or clean smell each day.
7. Make Everyone’s Life Better
I have interviewed thousands of people for medical school and residency. I have often asked folks why they want to be a physician and the most common response relates to wanting to improve the lives of other human beings. It is important that everyone remembers this throughout their medical education journey. Patients don’t care how much you know until they know how much you care. The question that we must always ask ourselves is how can we improve the life of the patient that we are caring for. We also should ask the same question for all of the people around us (e.g., attending physician, nurse, fellow students, etc.). As Zig Ziegler often discussed, you get everything you want out of life if you can just help enough other people get what they want out of life.
8. Teach as Much as You Can
To teach is to learn. Teaching is one of the best ways to apply information and garner better knowledge of a subject (e.g., Bloom’s taxonomy). Teaching is an integral part of being a physician. A great physician is teaching all day long — to their patients, staff, and trainees. I have talked with countless physician educators over the years. One the most frequent things that I have heard as to the motivation of why they teach future physicians (in addition to paying it forward) is that they learn so much and it “keeps them on their toes”. Medical students and residents do have a tendency to teach their attending physicians some of the newest research and thoughts in medicine while their attending physicians teach them the practical aspects of practicing medicine and the wise approaches to various clinical situations.
9. Learn from Every Patient
Every patient is another lesson for you as a medical student or resident. Whether it is a chance to practice your communication or interpersonal skills, learn from their physiology and disease, or learn about life through them, they are the best instructors that you will have in your training. While we get so accustomed to learning quickly and moving on, it is important to reflect on every patient encounter, conversation, and disease process.
10. You Get the Clinical Rotation that you Deserve
I strongly believe that you get out of each rotation exactly what you deserve. The medical students who put great effort into learning and serving on each rotation are rewarded with world-class experiences that will improve their lives as well as the lives of the future patients that they care for. Your medical education is a precious time in your life that you can never get back. Make sure that you treat it as the precious opportunity that it truly is.
