Before the start of any clerkship (rotation), and throughout its duration, I spend some time thinking about how best to prepare. But for what? How does one best get ready for a month of neurology? Or medicine? Or pediatrics? What are you supposed to know and do?!
Here are the five general categories of preparation for any clerkship:
1. Etiquette
This category involves understanding your role as a member of the team and what is expected of you. This is also the hardest to actually prepare for ahead of time, but you will learn quickly within the first day or two what the expectations are. Oftentimes students who have already rotated through a clerkship can offer their advice on this too. To whom on the team do you report directly? When is it appropriate to ask questions and when is it not? Are you in fact expected to be studying during downtime or is that actually unacceptable? What are everyone’s communication styles, and how can you best build rapport with your team and patients?
2. Routine
When and where are you supposed to report daily? Where can you put your belongings? What’s the workflow like? Should you pack a lunch, keep a credit card, or a few granola bars in your pocket? Should you drive, walk, or take a shuttle to your assignment location? What time are clerkship lectures? These are the ins-and-outs of the day-to-day, and as mundane as they may seem, they’re important to optimize so that you get the most out of your time during the rotation.
3. Skills
Perfect the level-appropriate skills for the specialty you’re in. On neurology, practice the really long neurological exam as many times as possible. On psychiatry, remember the parts and order of the detailed patient history. On surgery, practice suturing and knot-tying. Figure out what the most productive “action items” are for the specialty, and get good at them.
4. Ward knowledge
Learn the most commonly used drugs for that specialty, both generic and brand names. Learn about the patients on your clinic roster/inpatient unit (ward) and read about their diseases the night before. Learn the most commonly ordered diagnostic tests for specific differential diagnoses. For this category, you want to learn the information that will help you be an effective member of the patient care team.
5. Shelf knowledge
Many rotations have an exam at the end, called a “shelf.” The knowledge needed for the shelf is sometimes not exactly the same as the knowledge needed on a daily basis. The brand names you learned for the wards? Not needed here. The rare diseases you may not have encountered with a real patient? You do need to know those. Ask upperclassmen what resources they used to learn this information, and also answer lots of questions from established question banks. This is the hardest category to prioritize–because the shelf is at the end and the knowledge on the exam is not necessarily what you need to be an effective team player in patient care, it’s easy to put off this type of preparation. But it’s important to read a little every day, answer a few practice questions every day, and by the end, the shelf won’t be too bad!
And there you have it. If you pay attention to all five categories, you’ll be well on your way to learning as much as you can, being a great team player, and helping your patients to the best of your ability.
