How Can I Distinguish Myself on Clinical Rotations?

Graham Walker, MD


May 18, 2010


How Can I Distinguish Myself on Clinical Rotations?

Response from Graham Walker, MD
Resident, Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY

Here are 10 tips to help you earn recognition as an outstanding member of the clinical team:

1. Be enthusiastic. Energy is contagious, and we all need more of it in medicine. Bring it to your rotations! Even if you're not interested in, say, surgery, look for a particular aspect that you do find interesting. Help out where you can. Volunteer to do more. It goes a long way.

2. Avoid complaining. As hard as you're working (and I'm sure you are!), your residents are working even harder (or at least have more responsibilities and are balancing more spinning plates). It's fine to join in when people are venting about how big your team's census is getting, but you won't be winning any points by saying how rough your job is. (We all know scut sucks, but if you don't do it, your resident will be doing it for you.)

3. Anticipate tasks that need to be done. Once you've spent a week or two on a service, you can start to see some patterns: calling for a nutrition consult, getting social work involved, collecting a patient's list of home medications, and requesting the old chart. Surprise your resident by thinking ahead, and you'll be at the head of the pack.

4. Take ownership of your patients. The point of clerkships is to prepare you to be a good clinician and a good resident. Write a good history and physical ; get your notes ready for rounds; and be the first one to know about any changes, such as a consultant's recommendations or the medications added while your team was post-call.

5. Help your intern or resident stay informed. Write good patient notes and provide frequent updates. Your residents are ultimately responsible, so let them know when laboratory results are back or if the radiologist just called with CT results, for example.

6. Ask questions. This is huge! It's your responsibility to learn patient management, so if you're not sure why your team is ordering a test or giving a certain medicine, ask. It will show your interest and allow your residents to do some teaching (and for most of us, it's enjoyable to pass on knowledge to someone at a stage of training). Just make sure to raise your questions at the right time: Asking to see the ligament of Treitz while your resident is trying to get control of a bleeding surgical field will not win you any points.

7. Don't lie. If you don't know the answer to a question, go ahead and say, "I don't know, but I will find out." This is especially true if you're asked about patient-related information; if you forgot to listen to the lungs, just admit it. It's much better than saying they were normal and then finding out the patient has rales and has been fluid overloaded all night.

8. Be nice to nurses and other staff. This should be as obvious as the Golden Rule, but sometimes students can overlook it. Be the first to introduce yourself, say "please" and "thank you," and try not to leave a mess. Behind any excellent doctor is a bunch of excellent nurses, no doubt.

9. Show up early. Or at least be on time. (See "Avoid complaining," above.) Your interns and residents on the team are getting even less sleep than you, and they are still making it in!

10. Come up with your own patient assessment and treatment plan. There's no better way (besides maybe #6, above) to show your colleagues that you're thinking and learning. You'll sometimes be wrong, but you're supposed to be wrong, right? Otherwise there'd be no reason to go through medical school and residency.


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