GENERAL THOUGHTS/ADVICE

I guess my biggest piece of advice would be that patients generally dont see a dieren!e "et#een long
and s$ort #$ite !oats% T$ey !o&e to t$e $ospital or !lini! or &edi!al !are' not to tea!$' and t$ey
loo( at yo) as part o t$e tea& t$at is !aring or t$e&% Its i&portant to reali*e t$at #$ile learning is
still i&portant' it no# $as to !o&e se!ond to !aring or t$e patients% While as a student youre
generally protected from seriously hurting anyone, and the responsibility does ultimately fall on the people
with MD or DO after their names, you should still ta(e a personal responsi"ility or yo)r patients
and try to ta(e an a!ti+e role in t$e tea& !oull loo" better, and the learning curve is still much steeper
than it has been in year # or year $ ,o) !an learn ininitely &ore ro& intera!ting #it$ a patient and
seeing t$e& t$ro)g$ t$e !o)rse o t$eir disease t$an ro& reading Case-iles %ll that being said, you
should also have fun this year !es, it will be time&consuming and can be difficult, but its also what most
of us will be doing the rest of our lives !ou wont love every rotation, but it should almost always be
better than sitting in class 'or video&streaming( Most of the time though, it should be en)oyable, and if
you enter it with confidence and a good attitude, it will go by really fast
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Arri+e early e+eryday and $a+e all t$e notes #ritten "eore t$e intern does&&&although this might
seem intuitive, not everyone does this and I thin" it is part of your )ob as a medical student and it does go a
long way +lus, if you do this, you will have time to review everything going on with your patients while
everyone else is ma"ing their rounds and it will give you an advantage during your presentation to the
attending %lso, try to (no# &ost o yo)r presentation #it$o)t reading 'not all the lab values or
specific numbers( when you can loo( an attending in t$e eyes d)ring yo)r presentation, it comes across
well and is better that reading from a piece of paper the whole time Ma"e sure you (no# all t$e ne#
la"s' t$e past e# days la"s and test res)lts/pending tests so you can be ready if any of this information
is re,uested %s" your interns if they need help with anything and be willing to help if they need it
READ' READ' READ' if you can answer ,uestions and showcase your "nowledge, this will go very far
with everyone 'but always answer it when !O- are as"ed or if nobody else "nows the answer, not when
someone else is as"ed first( Vol)nteer to gi+e presentations and, even if they say don.t worry about
ma"ing a handout, ma"e something really simple for everyone to follow along with, it helps them
concentrate and to remember what your presentation was about when it comes time for evaluations%
Al#ays $a+e a s&ile on your face/ it ma"es such a difference %nd, try to anticipate what your team might
need during rounds, especially on surgery, if you come prepared, it will really help the team 0inally,
remember you can ma"e what you want of each cler"ship and, even if you aren.t interested in the specialty,
they %11 have something to teach you and will help you solidify the information you learned during years
# and $ !es, some days are horrible and sometimes you will feel li"e everything is out of your control, but
2324!O52 has felt this way and, in the end, you will be one step 'a 6-72 step( closer to being a
doctor8
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7eneral 9rd year advice:
S!)t #or( !an "e annoying and "oring' ")t .in &y opinion/' it is only s!)t #or( i yo) already (no#
$o# to do it% If you aren.t good at bandage changing or suture removal, it.s not scut If you don.t "now
how to draw blood, start I3.s, etc, it.s not scut, it.s part of your education I had very little true ;scut; 9rd
year, almost everythingI was as"ed to do helped me learn something and helped my residents
get their wor" done faster 'teamwor"(8 One last bit of advice: &a(e a e# o presentations on s&all
topi!s that you come across on rotations T$ere #as ti&e to present so&et$ing on e+ery rotation
Don0t #ait or so&eone to as( yo)% <ust ma"e a +ower+oint, some handouts for everyone else, and have
a =&> min tal" ready +ic" something you don.t "now a lot about, so that you actually learn something
from it too ?here were many times where we had une@pected free time 'finished rounds early, or had to
wait or something to happen(, and the attending as"ed if anyone had a tal" to give ?a"e advantage of the
opportunity and show your initiative 6ope this helps Dr 1evine ?he pep tal" you gave us last year was
helpful, I.m sure it will be this year as well8 1eep en!o)raging people to READ e+ery day% I can still
hear your voice from last year telling us to read %nd it.s true8
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One thing I came to realiAe is that the best thing to do is as( intelligent 2)estions It is the best way to be
interested, confident 'but not arrogant( and to actually learn
%lso, I didn.t realiAe how formative the third year is for a clinician I thin" students need to remember that
part of their goal should be to de+elop t$eir o#n $a"its' attit)des' and te!$ni2)es% It is easy to feel
powerless, abused, low on the totem pole One way to combat feeling downtrodden is to loo" inward and
realiAe that in ten years you will be who you are partially because of what you.ve e@perienced 2very
e@perience that ma"es you uncomfortable has the potential to teach you a great deal more than you realiAe
It is incredibly empowering to realiAe that you are thin"ing critically and are establishing your way of
loo"ing at clinical and ethical problems It.s a pretty amaAing feeling when at the end of 9rd year that all
seems to come together
1astly, the one thing I wish I "new a year ago was the following: Don.t ever be afraid to thin" for yourself
and ignore advice that doesn.t compute If people "eep telling you that your study habits won.t wor" or that
you need to act in a particular artificial way to succeed, don.t listen !ou have to be true to yourself %t the
end of the day you have to be happy with how you lived your life
Oh and tell them to buy the boo" ;6ow to Bhoose a Medical Cpecialty; It helped me thin" through my
career choice and solidify it
I hope that helps ?hird year was a lot of fun It was a lot of wor", but I have some really great memories
It was all worth it in the end
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#( At t$e "eginning o a rotation' i yo)0re )ns)re #$at to do' 3)st ind an intern and sti!( #it$
t$e&%
$( 2@pect to ma"e plenty of mista"es !ou will li"ely be made "nown of your shortcomings at least once a
day for the first semester ?his is not to be ta"en as a detriment to your eval, but as feedbac" to help you
grow
9( Interest and $elp)lness are &ore i&portant t$an !o&peting Stri+e to "e a good &e&"er o t$e
tea&' not a sel4pro&oter' as they.re usually not appreciated
D( In general, staff does not li"e feeling li"e they.re being pimped by students ;Cafe; ,uestions to as"
involve things not easily found in te@ts& the practitioner.s preferences, e@periences, etc ;Do you see much
of thisE; ;What suture do you prefer for thisE; ;Bould you e@plain this portion of the surgeryE;
=( Gi+en t$e opport)nity' display yo)r (no#ledge' ")t $)&"ly If you have a ,uestion, offer what you
thin" the answer might be %fter becoming comfortable with presentations, include your impression and
plan for the patient
I.m )ust getting warmed up, but I.ll leave off here :&(
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6ere are some facts I thought were important:
#( -ind an organi*ed #ay o (eeping tra!( o t$e pearls o #isdo& !ou may never hear things
e@plained in such a way that ma"es ,uite that much sense to you 'ie a great 2F7 lecture(, and
you may want to pull it out as a reference in other rotationsGresidency
$( 5a(e s)re yo) are al#ays &anaging t$e &ost interesting patient on t$e loor 'even if not your
intern.s patient( 5obody will ever fault you for wanting to learn more
9( 1earn early on what is appropriate for you to loo" up vs as" your resident vs as" your attending/
don.t as" your attending a ,uestion until you have read about the topic
D( 2ven if you are shy, &a(e s)re yo) are an a!ti+e parti!ipant in t$e tea& 'even if you are
answering the ,uestions incorrectlyat least s$o# yo)r line o t$in(ing( Otherwise, you will be
ignored Most docs assume med students don.t care unless you prove otherwise I heard this advice
at the beginning of my 9rd yr, and thought it was really useful and true
=( Le!t)res are a really great #ay to integrate ino Feep useful lectures and bring coffee if you
need to :(
H( Al#ays "e $elp)l to yo)r tea& ?hey are tired and stressed, and you need to be a team player
%nd always be nice ?hey will usually reward you wGteaching :( %lways as" for feedbac" %gain, I
heard this advice at the beginning of my 9rd yr, and thought it was really useful
I( 6$en starting any ne# rotation' loo( at ot$er notes/dis!$arge s)&&aries in t$e !$art and
&odel yo)r notes a!!ordingly% %s" ,uestions if you need to, but also try to "e an independent
learner%
7/ 6$en loo(ing t/notes "eore a patient is ad&itted' al#ays loo( at all ER notes' notes ro&
ppl #/in t$e ield yo) are rotating t/' radiology' &ost re!ent la"s' and dis!$arge s)&&aries%
J( ,o) s$o)ld read a"o)t e+ery patient on yo)r tea&0s ser+i!e and "e prepared to tal(
intelligi"ly It.s the best way to learn88
#K( -ind an organi*ed #ay to (eep tra!( o day to day !$anges wGyour patient 'inde@ cards,
running list, medfools(
##( Do 5O? ta"e things personally from residents, docs, other members of the team ?hey don.t go
home thin"ing about you If you get yelled at, learn from it and never ma"e that mista"e again, but
move on
#$( Al#ays do &ore t$an #$at is as(ed o yo)if they tell you to manage $ patients, you should
have D patients 'even if it means you are getting there earlier( Offer to do morning admissions
Offer to ta"e care of all aspects of care involved wGyour patient 'even if it is as"ing the nurse if
you can put a 0oley init.s a great way to learn8(, including notes !ou learn a ton by challenging
yourself this way
#9( What was hardest for me at the beginning of third year was how to !o&e )p #/dierentials: info
from $nd yr may be a mish mosh at the beginning of third year Bome up wGyour differential on
your own wGI53IB?O2 for each organ system ?hen -p to Date BBsGs@s and see what you may
have missed 9rd yr is the beginning of more independent learning, and I consolidated a lot of info
this way
#D( !ou will inevitably see people on your team interact with patients in a way that will ma"e you
flinch 2veryone feels a little )aded after a while, especially when you have patients who may be
drug&see"ing, etc We all went into med school to help people on some level, and it helps a lot to
really try and picture how the patient ended up that waysure heGshe may be drug&see"ing, but
what awful things did they go tGto ma"e himGher that wayE E+en i ot$er people on yo)r tea&
are &a(ing 3o(es a"o)t t$e patients' yo) !an still "e respe!t)l to yo)r tea& #/o 3oining
in/la)g$ing% 8rd yr is a really great ti&e to "e introspe!ti+e% % really great attending told me
that everyone has their biases 'ie maybe patients who are drug see"ing really bother you(, but it.s
important to try and figure out why and ac"nowledge that you bring these biases to your
interactions
#=( I did the clinical campus model this past yr, and thought that it was great ?here are definitely
prosGcons, )ust li"e rotating through multiple hospitals % really big thing that I noticed though is
that since you wor" with the same #K students all yr, sometimes personalities can rub each other
the wrong way ?his seems li"e silly advice, but do 5O? tal" about your fellow med students
wGother med students !ou are )ust as"ing for needless drama that will ma"e you and all your
classmates feel li"e you are in high school again 3ent to your mom if you need to
9:/ ;eople .e+en i it is only t$e ot$er &ed st)dents/ (no# #$en yo) !o&e in late or s(ip
le!t)res% Don0t gi+e yo)rsel t$e rep)tation o "eing la*y or )nproessional' not #ort$ it or
an e<tra 9= &in)tes o sleep%>
????????????????????????????????????????????????????????????????????????????????????
Fnow your patients, research their disease process inside and out 'ie etiology, diagnosis, treatment,
complications(, be helpful to the team, as" ,uestions, and learn as much as you can
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#( If a resident or attending tells you it is o"ay to go homeGgo studyGgo eat & DO I?888 !ou may not have
opportunities to have a brea" or an afternoon off to study as often as you e@pect, so any time someone with
authority tells you to stop wor"ing, listen to them It is 5O? a secret test of your interest in the field or
stamina I wish that I had been more willing to go home in my first few months of third year .Dr. Levine
advises against this. Residents often tell you to go home. They are trying to be nice. Remember thirds
year is a clinical year. Your patients are your teachers. Do not go home if you are expected to be at the
hospital; it looks unprofessional. Find a place to study and study; go to the coffee shop the library a
conference room the lounge; find a place to study and study there. Your residents may give you
permission to leave but they do not have the authority to tell you to go home.!
$( Ha+e so&et$ing to do d)ring do#nti&e It doesn.t really matter if it is studying with a poc"et siAed
boo", printed chapter of a te@t or -p?oDate article in your poc"et, a full siAed boo" you.ve stashed on the
floor, even solitaire on your +D% or phone or a granola bar is o"ay <ust have something to do on those
occasions when you.re sitting around waiting without a computer in front of you or you will be bored out
of your mind ?his happens more than you would e@pect
9( 6ow to politely as" if you can go home once your wor" is done is an important s"ill everyone should
learn Cometimes hanging out on the floor can be very fruitful 'procedures might need to be done, the
resident may give impromptu teaching(, and specific hours may be re,uired 'ie on labor and delivery
service(, but at other times it is a complete waste of your time to be on the floor if nothing is going on and
you are being totally ignored by all the residents 0irst, learn who is allowed to send you home 'sometimes
interns have the authority, other times you will need to clear it with the senior resident( ?hen, establish
that your wor" is done and as" them if there is anything else you can do to help them or anything
interesting going on If they have no tas"s, scut, or interesting procedures for you to participate in, this
will often trigger them to tell you to go study andGor go home for the day Cometimes a more direct
approach is needed, and you may have to come out and as" %gain emphasiAe that your wor" is done, no
one on the team wants your help, and nothing noteworthy is occurring on the
floor, then as" if you could go home Often having a specific reason, ie I would li"e to loo" up disease L
that my patient has for tomorrow, or I need to wor" on this presentation for ne@t wee", or I am behind on
my shelf studying, or it is so&and&so.s birthday and we.re going out to dinner, etc is helpful Bertainly
don0t lie' but it is pretty easy to come up with a specific reason 'Levine" #gain this advice sounds close
to unprofessional. You don$t %ant to be identified as the student %ho is al%ays trying to leave early.!
D( Most hospitals now have premade forms your team will want you to use for doing 6M+s and sign outs
and you won.t need to ma"e your own unless you really want to be a superstar 'e@ception & specific Wayne
assignments in which your 6M+s are being evaluated, and these usually have to be typed or on blan" lined
paper so they can see you have learned what needs to be in it( I o)nd t$at &a(ing !opies o &y ne#
patient H@;s .or t$e irst SOA; note I #rote/ "eore t$ey #ent into t$e !$art #or(ed as a great
reeren!e or &y po!(et and saved me from having to spend time re&writing on a premade form or trying
to remember things on the fly
=( %lso, if it is possible, I would recommend #at!$ing an intern 'or better yet the senior resident( do at
least one H@;/#or(4)p o a ne# patient and one 2)i!( &orning e<a& and SOA; note at t$e
"eginning o t$e !ler(s$ip to get a general idea o $o# detailed yo) need to "e' #$i!$ la"s and ot$er
ino ro& t$e E5R needs to "e loo(ed )p and/or ordered' and #$at p$ysi!al e<a& &ane)+ers t$ey
do on &ost patients on t$at ser+i!e% Otherwise it ta"es a few days of wasting time doing too much or
getting called out for not having the specific information that is desired before you figure out e@actly what
that service or team is loo"ing for 2ach attending will have their own little ,uir"s and specific items they
find important as well which you.ll have to learn
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6HAT TO CARR, IN ,OUR ;OC1ETS
ASt) to !arry in la" !oat all t$e ti&e 'ta"es up less room than you would thin", and it decreased
throughout the year(& inGon small top poc"et & pens' penlig$t' 5a<#ell' $ospital ID "adge' SINGLE
s$eet o paper neatly olded #it$ t$at &ont$0s s!$ed)le and i&portant n)&"ers 'phoneGpagers of
team members, secret door code of supply rooms on the floor, chec"list of what cases need to be logged on
campus mobility, etc( One inside poc"et & !$apsti!(' "reat$&ints' tiny "ottle o $and
lotion 'for after all those repeated washings(, so&et$ing to pay or l)n!$es and sna!(s if you don.t bring
them from home I would usually leave one outside poc"et free for all the paperwor" I.d accumulate over
the month '6M+s, articles from uptodate, notes, etc( and my pager% ;DA/s&art p$one or po!(et dr)g
"oo( was really helpful for loo"ing up meds, especially at the beginning of the year, but I eventually ,uit
carrying it I added on sentence to each cler"ship.s description to specify what else I carried while on that
service
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Al#ays $a+e so&e ood in yo)r po!(et, try to pac" a sandwich to have in your bag '+NM< will last all
day( for the craAy days and the cafeteria may be closed +lan on long hours for surgery and ONG7!5
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EVALUATIONS
Its important to "now that in &any !ler(s$ips EVER,ONE on yo)r tea& #ill "e e+al)ating yo)% 2ven
some attendings will say to students, what did you thin" of so and so as a team memberE On my obgyn
rotation, we were as"ed by the cler"ship director to discuss all her residents and who was helpful and who
was not helpful over the $ month rotation ?he cler"ship director was then going to do the same "ind of
discussion with the residents about the students and its scary to thin" of what some of the residents would
say about one of the students on my team %lso, never pimp bac" to an attending I saw this happen once
and it was ugly %nd also, it is o"ay to re,uest a change of team If you get a bad feeling about an
attending that you thin" is really rude or disrespectful, this is not right it is o"ay to report this and it will
not get you in trouble
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!ou will li"ely get strange, unfair evals from time to time 'either worse or better than e@pected, or even
with contradictory comments( ?ry not to worry too much as only the positive comments end up on your
MC+2GDean.s 1etter ?here isn.t too much you can do about it, but I have a few tips
#( %ttendings in most fields don.t really care if you are interested in their specialty or not, so be honest, but
try to emphasiAe that you understand why rotating through their department is important or useful
for all physicians 2LB2+?IO5C to the rule include Internal Medicine 'Levine" of course & disagree!
they really do want everyone to lie and pretend that they are interested, and Curgery & I would 5O?
recommend pretending interest to the surgeons 'they often e@pect you to stay in the O4 later, will pimp
you more, etc( unless you are also willing to wor" your butt off
$( ?a"e advantage of opportunities to select who fills out your evals Interns are notorious for giving evals
based more on whether they li"ed you than your actual s"ills, so on the few cler"ships in which you get to
choose an intern or )unior resident to evaluate you 'possibly neuro, peds inpatient(, pic" the one that you
seem to get along best with Cenior residents and attendings are li"ely to be at least a bit more ob)ective,
but I.ve noticed that the higher status the attending is, the busier they are and the less li"ely any evaluation
forms you give them will actually get filled out Co you may need to give forms to practically any
attending you meet in the hopes that at least a few will fill them out !ou may need to give them multiple
copies and politely pester them as well if there is someone in particular you.d li"e to evaluate you In other
rotations, these evals are all done ;behind the scenes; and you will have no idea who received them
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SHEL- ADVICE
#( Many practice ,uestion boo"s have epidemiology&type ,uestions C"ip over these and don.t worry
about them, I don.t thin" I had %5! epidemiologicG ;what percentage of people get L; ,uestions on my
e@ams
$( T$e ti&e li&it is oten t$e &ain a!tor on t$e s$el e<a&s and t$e 2)estion ste&s are oten &)!$
longer t$an in pra!ti!e 2)estion "oo(s 'pretest especially has very short stems( ,o) #ill need to ind a
&et$od or s(i&&ing t$ese $)ge ste&s and pi!(ing o)t t$e rele+ant ino%
Come people li"e to read the last sentence with the ,uestion and the answer choices first
9( Do the last few ,uestions of the e@am first -sually the last = to #K ,uestions are the really short, almost
matching style ,uestions that have a baAillion answer choices that can be done ,uic"ly and you don.t want
to miss .Le+ineB Ce !are)l i yo) do t$is to not ")""le in t$e ans#er on t$e #rong 2)estion
n)&"er%/
I hope this can help future classes
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?he best way that I prepared for peds and medicine was by doing &any 2)estions +retest, -CM12
World, etc, it doesn.t matter ?he shelf is so diverse and will as" various details that you will end up
s"imming over reading through a general te@t or even case files
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STUD, AIDS and RESOURCES
O+er+ie#
US5LE 6ORLD online 2)estion "an( 2)estions are really good t$ro)g$o)t t$e year' or st)dying
and preparing or s$els% I dont thin" any of the other practice ,uestion boo"s have ,uestions that are as
challenging or e@planations that are as thorough as )s&le#orld 2"an( %lso, uptodate summaries are
great for learning about your patients throughout each cler"ship also, the 5ass General ;o!(et
Reeren!e is an e@cellent reference to "eep on you at all times I bought it midway through 9rd year and
used it often on rounds for a ,uic" reference
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I used !ase iles for every rotation and loved them8 I #o)ld s(i& it again t$e day "eore t$e e<a& by
reading over the bold print, notes in margins, charts, and clinical pearls I also used pre&test for ,uestions
?hey were o"ay Come chapters were ridiculously hard and none of those hard ones ever showed up on the
shelf
%lso, believe it or not, I still used my 0I4C? %ID 0O4 C?2+ # during every rotation when I needed to
refresh my memory It was so very helpful I was very nervous about neuro anatomy for the neuro shelf,
but I )ust reviewed the neuro section from 0I4C? %ID 0O4 C?2+ # and it was ,uite sufficient
%fter going through the process, I learned along the way that I performed better 'and faster( on the shelf
e@ams when I had some confidence in my "nowledge ?hat is why I would do a rapid review of case files
the day before the test It sort of put everything I had learned in the front of my memory It )ust made me
feel confident and I was able to trust my answers and get through the shelf faster
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I woud aways read case es twce and then made sure to revew the queston book
(after I went through t earer n the rotaton) the day before the exam.
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7et a Step D re+ei# boo" 'either 0irst %id, -CM12 step $ secrets, Brush step $( that you li"e and use it to
review during each cler"ship&&ideally read it at the beginning and then use cler"ship specific materials the
rest of the way Ny using these sources, you will have $ advantages: !ou will already be well on your way
to preparing for Ctep $ and you will have a high yield source to use for your shelf 'the shelf ,uestions are
retired board ,uestions(
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Case -iles has been a solid series for me during each cler"ship I li"ed the Faplan lecture notes for
surgery, peds, obGgyn Ctep -p to Medicine was also good 0or surgery I.d also recommend the 5MC
Baseboo" Basefiles was always a good baseline I thought +retest was hit or miss for most cler"ships
5MC ,uestions for the shelf e@ams
+re?est was hit or miss for most cler"ships
I.d recommend getting the US5LE 6orld subscription
?owards the end of the year when I had more "nowledge I thought the Step D Se!rets boo" was a
really good ,uic" review of multiple sub)ects before the shelf e@ams
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Wth few exceptons I used the same books for each cerkshp. At the start of the
cerkshp I woud purchase case es, pretest, and bueprnts. Purchasing them
meant that I could mark them up a I wanted. It also was a way to motivate
me to get through them. I liked having a reliable system, it was comforting
and it worked - it forced me to read regularly and do a ton of practice
questions. My shef scores were amost aways hgher than expected.
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I found Case Fes and USMLEword Obank to be the most hepfu. I used both n a of
my rotatons. Pease remnd then to ook up anythng a queston bank mentons that
they don't remember or don't understand. Wkpeda s usuay enough to |og your
memory.
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SPEI!I "E#$%IP &'(IE
S)#*E#+,
Genera Advce,
Be honest wth surgeons about whether you are nterested n surgery or not.
In my experence they were ess key to penaze you for teng the truth than
other specates. Warn famy/frends/sgncant other ahead of tme that you
w be workng 70-100 hour work weeks and w vansh oh the face of the
earth for the stnt of your rotaton and any tme oh w key be spent seepng
or recoverng from ness brought on by seep deprvaton. You shoudn't need
any physca exam paraphernaa except your stethoscope. Dependng on the
servce, you w key need to carry a stash of gauze, tape, scssors, and other
wound dressng suppes durng mornng rounds.
One student wanted you to know, -.he amount of blood loss is a
sensitive number for surgeons./
Readng Source:
ase !iles for Surgery, $aplan 0otes for Surgery, (some student
recommended NMS casebook), One student recommended BRS Genera
Surgery (nce buet-pont stye)
o Note: the requred textbook for Surgery s avaabe n the Lbrary so DO
NOT purchase - pus t sn't THAT hepfu and some hospta ste
cerkshp drectors recommend other books that are MORE hepfu for
genera readng
o The surgery text books can get you bogged down n detas. The
casees are good, but won't teach you a you shoud know about
eectroyte dsturbances. I used the text books, but ony read a few
of the basc chapters nstead of tryng to do t a.
For the oors,
Surgca Reca*
o *The Schhman brary has a coupe copes of Surgca Reca and some
hospta brares have them avaabe to check-out
o Many other students ked Surgca Reca for quck response to pmpng
n the OR, but I found t of mted vaue for vascuar, whch I was
assgned to for my rst three weeks. Probaby good for other
specates or genera surgery though. Aso, some surgeons are strongy
opposed to Reca f they see t.
Ouestons:
Pre.est for Surgery, &ppleton 1 "ange Surgery 21& book, )S3"E
4orld Surgery 2s , mount sna handbook, Frst Ad
Ora Exam:
Try to revew the st of potenta ora exam topcs at east a bt, as ths w
hep prepare you for the shef as we.
567*+0,
Genera:
The Wayne-provded ectures are aso pretty good and t s wonderfu gettng
out of mornng rounds once a weekFavorte pmpng/shef queston (asked by
mutpe attendngs): What enzyme s measured to dagnose 21 apha
hydroxyase decency, the most common congenta adrena hyperpasa? 17
apha-hydroxyprogesterone (17-OHP). OSCE was not a probem. You w need
your stethoscope, a whee to cacuate dates, and t s handy to carry around
extra ube and paper ruers n your pocket.
Readng Source:
.he assigned reading material is e8cellent
ase !iles for 567*+0, Kapan Notes for OB/GYN, 6lueprints was fantastc.
Read the whoe thng and you' pretty much be set for the shef.
o Note: the requred textbook for OB/GYN s avaabe through Schhman
Onne
Ouestons:
Pre.est for 567*+0, )S3"E 4orld 567*+0 2s, !irst &id
0E)#5"5*+,
Genera:
One of the more dmcut exams.
Dentey know the dherence n presentaton and CT appearance of dherent
knds of stroke and hemorrhage (subdura vs. subarachnod).
You w get a sore neck from carryng around a the tunng forks, reex
hammers, oto/opthamoscopes, cotton swabs (break n haf for soft and ponty
sensory testers), pus your stethoscope.
Ths s the ony rotaton where you mght want to carry a sma unch szed or
messenger
bag to put a your crap n.
Readng Source:
ase !iles for 0eurology, Wener & Levtt's Neuroogy (House Omcer
Seres), In a Page Neuroogy, Bueprnts (one student thought Bue Prnts was
a very poor resource)
Ouestons: Pre.est for Neuroogy & )S3"E 4orld 0eurology 2s, Frst Ad
PS+%I&.#+,
*eneral,
Focus on knowng the specc number of symptoms and tme quaers for
varous DSM IV dagnoses and you' ace the test.
Lectures wth Dr. Morreae were we done.
OSCE was easy.
Make yoursef some nce forms for psych hstory and menta status exams so
you don't forget to ask anythng and your notes are organzed.
Readng Source:
And for psych, there are review slides that one of the residents put
together. .hey are incredible and should be used from the beginning
- everything you need to know is summari9ed
ase !iles for Psychatry, !irst &id for Psychatry Cerkshp, DSM-IV Pocket
Book , PreTest. Appeton and Lange
Wards:
*DSM-IV Pocket Book s hepfu on the wards, but some stes have books that
students can borrow for the rotaton but a the crtera are avaabe n the Frst Ad
for Psychatry Cerkshp
Ouestons:
Pre.est for Psychatry, &ppleton 1 "ange Psychiatry 21& book, )S3"E
4orld Psychatry Os, Frst Ad
PE'I&.#IS,
Genera:
Shef exam was qute dmcut. OSCE does not prepare you for the shef exam.
OSCE: Be warned that practcay none of the nformaton that Dr. Frday
emphaszes on her OSCE was on the shef (.e. memorzng nutrtona
requrements, entre mmunzaton record, ots of safety screenng questons
and other prmary care ssues). You mght get one very basc and/or out of
date mmunzaton queston or one nterpretaton of a growth curve on the
actua shef. Aso, don't fee bad f you have to remedate part of the OSCE, t
seemed ke the vast ma|orty of the group I worked wth had to do ths for at
east a few sectons. Dr. Frday s very enthusastc, but she overoads you
wth what many peope fee s an excess of "busywork" type paperwork. It
takes an extra hour or two of orentaton |ust to go over a of these addtona
assgnments. The "rash revew" was the ony assgnment that I thought was
truy hepfu for the shef, go to as many sessons as you can. You shoud ony
need your stethoscope, maybe an otoscope f there sn't one avaabe on the
oor.
Readng Source:
ase !iles for Pedatrcs, 6lueprints
Ouestons:
Pre.est for Pedatrcs, )S3"E 4orld Pediatric 2s, Frst Ad, Appeton and
Lange
I0.E#0&" 3E'II0E:
Genera:
Dr. Levne's assgnments are much fewer than peds and a are easy to turn n (can
be emaed drecty to her). In addton to Case Fes, you w want to earn EKGs and
acd/base dsorder
nterpretaton. EKGs - the cassc Dubn book s great and quck to read f you
haven't bought one yet. Aso, the doctor who taught EKGs at the ACLS cass was
very good and covers pretty much a of the obvous/serous ndngs you're key see
on the shef. Acd/Base - Fnd an organzed, step-by-step method of nterpretng
acd/base dsorders that you ke (you can use Dr. Ross's od notes, a textbook, an
onne resource, whatever) and stck to t. You DO need to MEMORIZE the
approprate compensaton for varous dsorders and how to cacuate anon gap and
deta gap. If you earn ths at the begnnng and practce at east once a week, you'
be a pro for the shef. Cnca Tp: Interna Medcne doctors seemed more
concerned than most that you at east pretend to be nterested n ther ed, even f
you reay aren't. Dr. Levne s serous when she tes you to do ths. I dd not
take ths advce, and my "ack of nterest" n IM dentey hurt my cnca
evauatons. You shoud ony need your stethoscope.
Readng Source:
ase :les has been a sod seres for me durng each cerkshp. Interna
medcne was partcuar favortes. Step Up to Medcne
I strongy recommend Step-)p to 3edicine (By Agabag). I found t very
usefu for my medcne cerkshp. It pretty much covers a the bases. It
heped me do we on the oor, and n makng recommendatons etc. to the
team.
Ouestons:
3$S&P for Student 2 book, )S3"E 4orld 2s
!&3I"+ 3E'II0E,
Readng Source:
ase !iles for !amily 3edicine, Step Up to Medcne (Ambuatory Medcne
Secton), Bueprnts
Ouestons:
03S !amily 3edicine 2s, (one student sad, "NMS s okay but there are bad
questons n there and know to skp the bad questons mmedatey. There are
ots of these questons that requre you to know ab vaues that you woud
never know!...|ust skp these and move on to better questons. Aso, the
Aescuapans ste has a famy n servce exam whch s a great source of
questons for revew before the exam. I hear the famy case es s the worst
of the bunch, Frst Ad
50.I0.)I.+ "E$S%IP,
Genera:
The exam s rdcuousy easy, |ust go over the od practce exam that gets emaed
out by varous students and p through your packet of assgnments the nght
before. DO know the dherence between CPT and ICD-9 codes. Schedung your day
- Mornngs eary n the week (Mon-Wed) are a good way of reguary gettng out of
mornng rounds f you prefer outpatent
cnc to npatent rounds. The catch s that you may have to reschedue occasonay
for orentaton or mss your rst day on a servce when everyone usuay meets each
other and estabshes the
routne. Avod Thursday or Frday mornng f possbe because you' have to
reschedue constanty for exams and/or study days. If you have an afternoon tme,
you won't mss any mornng npatent rounds ever, but may end up workng ater
those days f your CCC doc gets overbooked or
you woud otherwse be excused earer from a ess busy npatent servce.
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%fter reading all this, one student simply said, ;I wish that somone would have told me to purchase usmle
world ,uestion ban" at the begining of 9rd year Invest or obtain all of the case files and use the Faplan
step $ c" board review boo"s and thats it, no more boo"s re,uired If you need more info 6arrisions is
always a good investment but you can get it off the net %nd more ,uestions dont hurt
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____________________________
!I0&" .%5)*%.S
I hope that helps. .hird year was a lot of fun. It was a lot of work, but
I have some really great memories. It was all worth it in the end.