Molly Cooke, MD: Medical students are assaulted with what is known about health and disease. I'd encourage all medical learners, from students and residents to fellows and practitioners, to pay more attention to what we don't know.
I would also encourage trainees to be curious about your patients, asking about their lives and their daily routines. I still like to start the social history with, "Where were you born? Where did you grow up? What did your parents do?" As a new intern at San Francisco General, I saw patients whose backgrounds were entirely different from mine and from the patients I had seen at Stanford. When a patient said that his sexual practices included "fisting" or that her drug of choice was "garbage can," they might as well have been speaking to me in Latvian. Just by being curious, without being judgmental, you can say, "I don't know what that is. Would you be willing to explain?" Your patients will (usually) fill you in.
I also found that, especially with potentially unlikeable patients , asking them to tell me how they spent a typical day often gave me something that I could hang on to. I can't always find something to like, but I can almost always find something to admire, even if it is, "I wouldn't survive 12 hours living on the street like this person. How does she do it?"
Molly Cooke, MD, MACP, FRCP, is a professor of medicine at the University of California, San Francisco, and coauthor of Educating Physicians: A Call for Reform of Medical School and Residency.
Sara Cohen, MD: One important tip I used during medical school was using old exams to focus my studying. Everyone used their old exams to practice right before a test, but my secret strategy was that I also used to take the exams when I first started studying. In medical school classes, it often felt like there was an encyclopedia's worth of information to learn. If you started out by taking the old exams, you got a much better sense of what the professors thought was important, and you could then use that to focus your studying. It rarely led me in the wrong direction!
My other tip is to study around other people, even if you're not studying together. In college, I always studied alone and felt like I couldn't focus around other people. However, when I got to medical school, I was studying so often that it became extremely isolating and depressing to study on my own. In med school, studying is one of the main social activities. Don't miss out!
Sara Cohen, MD, is a clinical assistant professor at Tufts Medical School in the Physical Medicine & Rehabilitation Department and a staff physician at Encompass New England Rehabilitation Hospital.
Daniel J. Egan, MD:I have a couple of key pieces of advice. The first is what I often tell students and residents when they are on rotations: "Early is on time, on time is late, and late is unacceptable." So much of what we do in medicine has to do with teamwork, sign-outs, and transitions of care. People rely on you to be present. It is important to make an impression with your reliability and accountability. Although it may not always seem like your team considers you an essential member, this is part of the process, and people will definitely notice if you are late.
The so-called hidden curriculum has to do with the culture in a hospital and the interpersonal relations and interactions between people. You will witness conversations that may at times seem unprofessional and shocking. A good rule of thumb is to always take the high road and treat unprofessional behavior with more professionalism. You will always win.
Also, be sure to take care of yourself. You will see things that many of your friends, peers, and family members will never see. Be sure to take time to reflect on these things and allow yourself to process them and to make meaning out of the work you are doing. The final goal is the awesome privilege of taking care of patients. It takes a bit of time to get there, but the prize is worth it in the end. Ask questions. Be inquisitive. Read about your cases. When it feels stressful or overwhelming, remember that this is about a patient who is trusting you with their health, their body, and oftentimes their secrets.
Daniel Egan, MD, is an associate professor of emergency medicine at Columbia University Vagelos College of Physicians and Surgeons and vice chair of education in the Department of Emergency Medicine. As a former residency director, he has focused much of his career on education. He has been contributing to Medscape since he was a medical student.
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Cite this: Advice Doctors Wish They Had Gotten During Med School - Medscape - Dec 06, 2019.