Every rotation in the third year of medical school provides us with a concrete foundation of clinical knowledge for our medical degree and the opportunity to determine whether or not a particular specialty would be suitable for our future careers.
Pediatrics may teach us about developmental milestones; ob/gyn about the stages of labor; surgery about the 5 W's; family medicine about the USPSTF recommendations; and so on. However, each rotation taught me something unintentionally that could be applied broadly to my role as a resident physician and ultimately my future career.
Pediatrics was my very first rotation of medical school, so everything was new.
Why was the monitor making that beeping sound? Was the newborn crying because something was wrong or because he is a newborn? How was I supposed to explain things to parents when I barely understood them myself?
What was all uncertain and new at first began to become more apparent as the rotation went on. Conversations with parents became easier, and talking to patients became more about playing peek-a-boo or letting the 3-year-old play with my stethoscope before listening to lung sounds.
Pediatrics taught me the importance of verbal and nonverbal communication with both patients and their families. Allowing the 3-year-old to play with my stethoscope while I talked to the parents about their development milestones allowed for the patient to become comfortable with me before the physical exam, as I retrieved information from the parents.
Communication, both listening and conversing, is crucially important to provide the highest-quality medical care and to allow the patients/families to feel well cared for. For this reason, I was so glad that pediatrics was my first rotation so that I was able to establish a foundation and practice these communication skills for future rotations.
Ob/Gyn: Time Management
A wild balance of labor and delivery, gynecologic oncology, in-office procedures, emergent cesarean sections, and annual well-woman exams. So much would be packed into a day, which seemed to always fly by in the midst of whimsical, organized chaos.
Obstetrics and gynecology provided a breadth of clinic, perioperative care, and procedures with long work hours that allowed a medical student like myself to learn the importance of time management. Working in a busy community practice one-on-one with an attending, we were incredibly busy between call, clinic, and scheduled operations during the week. This allowed me to have the most fulfilling and intensive learning experience, however reduced the amount of time I had to study outside of the hospital.
This taught me how to study and become productive during in-house downtime. Waiting for labor stages to advance? Time to do some flashcards. In between cases? Might be able to do a handful of practice questions. Time management is difficult during third year, but this rotation allowed me to establish good habits to learn the most I could clinically and study for my shelf exam.
Cardiology: Lifelong Learning
The cardiologist I rotated with was able to recite the results for clinical trials almost verbatim, seamlessly relating the findings to applicability of his patients. He had medically complex patients both in the hospital and in his clinic. Despite the amount of reading and studying I did, this rotation made me realize that I will never know everything, even after years of schooling, training, and practicing decades of medicine.
With this daunting realization, I developed a goal and expectation for myself: Learn one new thing from every patient, every day. While there is much I know I don't know, there is likely that much more I do not know. That's what makes medicine so fascinating and intriguing to lifelong learners.
General Surgery: Relationship Building
Fundamentally, we have to establish trust with our patients in every field. Whether prescribing medication, taking history, or operating, the patient trusts our judgment and knowledge, with their health and life.
During my general surgery rotation, I noticed the calming manner in which my attendings were able to create a relationship, ease concern, and establish trust with their patients. It was in these scenarios I began to truly understand the weight and responsibility of relationships that we have with our patients. It was also in these situations I discovered my future career path.
Psychiatry: Value of a Thorough History
My psychiatry rotation was heavily focused on inpatient psychiatry at a community hospital and provided ample opportunity to acquire histories and collateral.
In the many conversations I had with patients, I realized the power of a thorough history and exam. While many other rotations may rely on ultrasound, EKG, or stethoscope for diagnosis, the care for patients on this rotation relied on history and exam — providing the opportunity to hone in on these skills.
Family Medicine/Internal Medicine: Acknowledging Medicine's Limitations
In both my outpatient-heavy family medicine and inpatient-focused internal medicine rotations, I faced the reality that medicine does not always fix a patient's disease or concern.
The inability of medicine to always resolve the problem at hand was something I always knew to be true, but I didn't understand its weight until these rotations.
Vascular Surgery: Significance of Teamwork
The incredible culture within a team can change the dynamic of the workday and cohesiveness of patient care. Palpable from the very first day on my vascular surgery rotation, the team of surgical techs, circulator nurses, and first assists not only made my learning experience wonderful but assisted in the fluidity of procedures in the operating room.
Working as a team in medicine is so important, and working with this seasoned team over the course of a month made it clear to me the type of environment I want to work in the rest of my career.
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Cite this: Abigail Schirmer. Unintentional Lessons of Third-Year Clinical Rotations - Medscape - May 20, 2022.