After a few months “off” away from clinical rotations (while I was on a teaching rotation, interviewing, and taking my fourth year vacation), I’m back on an elective month in the allergy and immunology clinic. Returning to the clinical environment required a bit of time to re-acclimate, but soon I was off and running. While I was getting back up to speed, I thought of some helpful tips for clinical rotations to share!
- Stalk the electronic health record.
When you call up your preceptor’s schedule for the day, read ahead a bit and familiarize yourself with as many of the patients as possible. Skim through their referral form, or their last progress note and get an idea about what conditions you’ll be dealing with that day. Then, continue to check and recheck the system to see when patients are roomed and ready to be seen. You can help make sure the clinic runs efficiently if you are ready to see patients as soon as they are roomed, weighed, and measured! Most patients appreciate speaking with someone right away, and you can help the attending by faithfully delivering their story, highlighting the relevant facts and emphasizing the patient’s priorities for the visit.
- Make priority lists.
Fairly early on in my clinical rotations I developed a habit of asking patients for a priority list when I finished taking their history. After asking if they have any other questions or concerns, I ask them to make a priority list for the attending. This allows the patient to guide the encounter and make sure their most pressing concerns are addressed and helps focus my presentation to the attending, giving me a solid summary statement to close my recital of the history. Sometimes, it even allows me to remember an important thing that the patient wanted addressed that the attending has forgotten about during the encounter and call attention to it before the encounter ends. In this way, I feel like I am, in a small way, helping patients get the complete care they hope for and deserve.
- Write things down in a little book.
Often, your attending will suggest journal articles to read or topics to look up. These can quickly become overwhelming. To show your interest and enthusiasm, jot down the names or authors of articles and important topics in a little notebook. The secret is that most attendings don’t follow up on whether or not you’ve read the articles. Of course, it would be ideal if you could read them all. But if you can’t, at least you’ve made a fairly convincing show of diligence and you have a reading list of topics should you find more time later.
That’s all for now! Good luck out there in your clinical rotations!