Advice for a 3rd year

Note: I wrote this note a few weeks ago (back before I went on vacation and deep fried my brain) after reflecting on the past year and all the experiences I've had. It may not be the most well-written piece of information ever, and maybe the advice isn't even that good, but I figured it was worth posting anyway. You don't have to take my advice - you don't even have to read it if you don't want to! :)

This past year has probably been the most fun I've ever had. I've worked hard, played hard, and been successful (so far...match day will be here before we know it!). I hoped to attend "scut monkey day" which is more formerly known as the now-4th years unofficial orientation to 3rd years to give advice, tours, and general guidance and assurance to the class below us. I've been thinking about what advice I have--what I would do over this year if I could. I've made a semi-dorky little list of things I would recommend to anyone starting 3rd year, as well as advice I hope to keep in mind next year and for years to come. It's a little hokey and I feel sort of like I wrote the same thing over and over, but hopefully you get the point.

On studying

• At least for me, getting enough sleep is about equal to a few good hours studying, so don't cram. It's not worth it.
• That being said, coffee is your friend too.
• Know your patients. You will hear that over and over again and it's hard to do at first but read about their conditions and take a thorough H&P if you can even if you don't have to. It's so much better to learn by talking with real people instead of reading it in a book or in a chart. I will never forget my patient who had a thyroidectomy and had post-op hypocalcemia because I got to tap on her face and see Chovstek's sign.
• Talk to other students about books, study materials, tests, and just about everything. It helps to find some people with whom you can share books, notes, and learn about which attendings to avoid. For example, I was recommended this website in the beginning of the year by a study buddy and it’s helped me breeze through most of the surgery quizzes.

On learning in general

• First, and most importantly - learn and do everything possible. This is the only time in your life where you're the VERY BOTTOM of the totem pole. Use that to your advantage and ask the dumb questions, get people to show you the basics as well as the details.
• Help with as many foleys, paracentesis, IV lines, etc as possible. Write prescriptions for your residents to sign. Ask to do these things, because they often forget to ask you if you want to do them. And trust me, it will help you in the future! One little tip for those at the VA: they have some awesome software with "how to" for many procedures and "patient info" packets on almost every subject imaginable. Try to find those because they're aweome.
• Similar to the first two: Practice. Do a physical exam on everybody so you get a sense of what normal is. You may not think you need to, but why not? You may even find a clue that no one else has.
• There will be patients that you don't like. Learn something about yourself from them.
• There will be patients that need you. You, unlike the doctors, can spend time talking to them (or their family) that no one else has time to do. On psych I spoke with one girl's mom almost every day about her fears for her daughter, and I really felt like I made a difference. It's a great feeling - it's the reason we all wanted to become doctors, right?
• As hokey as it sounds, try to make everything a learning opportunity.

On personalities

• You're probably going to be ignored quite often. Try not to take it personally. Everyone is under pressure, especially the interns. If you're irritated because you've been watching them enter orders for an hour, remember that you're not their top priority (they're trying to keep from killing their patients, not trying to make sure you go home early)
• "Is there anything else I can help you with?" is always a valid question and equivalent to "Can I go home?" but in a nice way. Hopefully they will take the hint.
• There are definitely career options you will realize quickly that you are not interested in. Still, learn what you can from them, because even if you would never in a million years do neurology, you may have a patient with MS, or with a history of stroke, and you need to know what they're dealing with.
• Don’t be shy. This is really hard for me but you must go out of your comfort zone and show enthusiasm and interest.
• Spend time with your loved ones, no matter how busy you are. Having a social support group is important for patients but is just as important for you. Without Chris and my parents I don't know where I would be today!

Finally, one of the biggest keys to success is to be on time, act interested, and smile. Smiling not only puts patients at ease, but interns, residents, attendings, and everyone else too. and enjoy it. This is your opportunity to learn - with real people, but no real responsibility. Use it to your advantage. Oh, and HAVE FUN!