Whether your next student clerkship is in your university hospital or an away rotation in a new city, there are obvious planning procedures that are overlooked. If this is your first clinical rotation – or U. S. clinical experience for foreign or international medical schools – these tips will get you off to a great start.
What Should I Bring on My Medical Rotations?
Put some time in and see what materials may be useful, both for patient care and studying on the wards. There are many forums that recommend different resources students should carry. But the most reliable is often advice from a former student.
Many preceptors will also have a Learning Objectives sheet with their personal recommendations. Do remember that, while useful for physician expectations, the physician may not be aware of more recent study materials or technology. Gather advice from several resources when possible prior to your first rotation.
Can you study on your cell phone or is that considered rude or unprofessional? How about a tablet? Does it fit in your lab coat? What written material would you like to carry around for studying or notes? What medical tools and devices are recommended per rotation (i.e.: ENT vs radiology)? Your school and other students can greatly help guide you through these questions when preparing for your clerkships. It’s important to realize that medicine is constantly changing. Always keep an eye out for the latest information.
For most sites, you will want your lab coat, writing utensils, a notepad, and assorted medical devices. A stethoscope is universally needed for physical exams. However, you may also wish to bring a penlight, Snellen eye chart, and a pocket-sized guide for quick lab reference ranges. Don’t forget to ask if there are specialty-specific items you should bring prior to your first day. These will all be necessary for proper patient care.
Medical students should also consider how they will make it through the day. Will cafeteria services be provided or should you pack a lunch? You will expel a lot of energy during rounds. Be sure to eat a nutritious meal and stay hydrated!
Commuting to the Hospital or Clinic
Plan your commute! Visit the physical location prior to your first day of the clinical rotation. Many medical students assume Google Maps will get them to where they need to be on time, but this isn’t always the case. Make sure you know where to park, what building to enter, and account for daily variations in traffic. See if there are areas of construction to be aware of and have an alternate path planned in case of emergency.
If you are taking public transportation, download the local app (if applicable) but also bookmark important websites on your phone. Have an alternative prepared in case the public transport is down. Generally, preceptors are understanding of these types of limitations. But don’t forget that first impressions matter!
If you have your own mode of transportation, it can be easy to forget when the last tune-up was. Do you have a spare tire and a jack? What about tools or roadside assistance in case our vehicle breaks down? It’s a good idea to have your vehicle serviced before starting your first externship. A little forethought can prevent massive stress when accidents inevitably occur.
Lastly, what emergency contacts might you be able to reach? Have at least two classmates’ numbers so they can inform the physician if you are running late. The hospital or clinic’s operator or manager number is also good to have ready. Also, have someone’s number that is not going to be in the clinic today in case you need a ride.
Setting Expectations During Your First Day
Plan questions for your preceptor ahead of time if you wish to clarify details. This may be regarding the rotation itself, requirements for a strong letter of recommendation, or even residency questions. Preparing these ahead and storing them may prevent you from forgetting to ask in the busy clinical setting.
Determine the preceptor’s expectations on day one. This is the most common recommendation from physicians and often overlooked by medical students. The clinical instructor may assume a certain level of responsibility, knowledge, or experience of a student. The student may assume a quality of education, patient or procedural diversity, or level of training from their preceptor. However, without clarifying each person’s expectations initially both parties increase their chances of disappointment.
Do they need you at the clinic at a strict time each day? What happens if you are late? Are there presentations, assignments, or case reports to prepare? What is the correct or incorrect way to present this material? Is there a unique dress-code for this clerkship? How can a medical learner “stand above the pack?” What is requested for a letter of recommendation? What is expected of patient interactions? Will there be procedures available to explore? There are many questions that can shed light on how to best perform during that clerkship.
Be Professional and Respectful
Although university and hospital staff may constantly say to “be professional” while on clinical rotation, it is not always clear what this means in each situation. Here are just a few general guidelines that may also be accidentally overlooked during a busy externship.
- Show up early! Yes, on-time is fine. But if you want to show your interest in a specialty or preceptor it is best to be early. Plus, this decreases some of the concerns discussed with transportation issues above!
- Remember that ALL STAFF is there for the same reason you are. Everyone from the health engineer to the hospital administration should be treated with respect and understanding. Train your emotional intelligence early on and it will go a long way in your life and career.
- You are treating the Patient. Not the Disease! It can be easy to get stuck in a pattern of thinking we used during earlier coursework. The patient is not a textbook or a qbank. Interactions with patients and their families are much more complicated with real patients. They may react negatively to your presence or recent news they have received. Be attentive to their needs and understand that much of their aggression or sadness is likely due to fear of the unknown. How would you console a close family member or friend in that situation?
- Don’t be an Askhole! Nobody likes someone that asks too many questions. As a general rule, if you can easily Google it, then consider not burdening your attending with it during rounds. Think of high-order questions and notate them. Ask when the time is appropriate. When on the medical wards, be careful not to violate HIPAA. Avoid discussing sensitive material when in public. Discuss in private staff areas or see if the physician offers after-hours meetings.
- Leave the place cleaner than you found it. This works as a general life rule as well! There’s no telling when a mess will be cleaned or by whom. Don’t expect cleanliness to be someone else's responsibility, especially in the cafeteria! If there’s something left behind by other staff or patients, consider throwing it away. If there’s water on the floor, block off the area and alert someone immediately. We don’t want anyone getting hurt! Just make sure to wear gloves or properly sanitize your hands after handling soiled materials.
Your first clinical rotation is likely to be a new environment with many unknowns. However, if you follow these simple guidelines you will gain respect from your colleagues and appreciation from your preceptor. With a little bit of research and some common sense, you can rock your first clinical rotation!
