Medical Training Hierarchy: Your Role as a 3rd or 4th Year Student

surgical specialties

I’ve just started my fourth year, and while it’s a relief to be done with all of my medical school exams, I’m finding that there are plenty of new responsibilities to take on! I’m no longer the lowest member of the medical food chain, which also means that I partially have the responsibility of taking care of my M3 classmates. I am currently rotating on a surgical service where this dynamic is especially prevalent. It comes into play when scrubbing in to surgeries or doing other “higher level” tasks. I think this hierarchy is important to discuss for those M3s just beginning their first clinical year.

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Making Clerkships Work

Are clerkships a grind, or a boon?  It’s up to you.

The second-year students are moving from the pre-clinical curriculum to the clerkships this week. This transition is exciting—after all, seeing patients is what they’ve come to medical school to do, and now it’s finally happening.

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Internal Medicine: The "Classic" Physician

By Brent Schnipke

If the average reader is asked to imagine a typical medical student, he or she might picture the following scene: a group of frazzled young people in short white coats, scurrying around the wards of a large academic medical center. They travel in hordes, flocking to the nearest attending, who calmly asks them asinine questions and then chides them for their lack of knowledge. This scene is stereotypical of an often-stereotyped field, and might be something one would see in a caricature of the hospital – on a show such as Grey’s Anatomy or Scrubs. Although this is only one example of what medical education can look like, it is helpful for giving a simplified look at the life of a third-year medical student in the throes of clinical rotations.

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Dear Me, MD | Love Me, M3

July 21, 2015
Dear Me, MD:
Now that you have opened this letter, you may have graduated or maybe you just matched into residency— somewhere, anywhere, hopefully?! As you read this, it should be some time during spring 2017. But, you never know, sometimes the train derails and it takes a little longer than expected, so forgive yourself if that is the case. You learned a while back that the fast lane is overrated so never mind months or years. You now have the degree that you worked so tirelessly for; the one they told you that you would never get; the degree that bears the title I know you will probably never feel is real.

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The Year of Privilege: A New Perspective on Third Year

During my pediatrics clerkship, one of our core faculty gave a lecture during orientation. This orientation lecture was particularly good, as the professor giving it was one of our most-loved faculty members who is deeply in tune with medical students at all stages. This was back in the summer when we were just getting started with our clinical experiences, but what he said stuck with me all year. He noted with a bit of humor that third-year medical students are the lowest of the low—barely even acknowledged by many team members, ignored by some patients who refuse to talk to anyone but a “real doctor,” disregarded by residents unless it is to point out something you are doing wrong. We chuckled, already able to relate with this view, but he turned the conventional description on its head by encouraging us to think of the third year of medical school as “the year of privilege.”

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The Undifferentiated Medical Student Podcast: Your Virtual Mentor for Choosing a Specialty

What is the Undifferentiated Medical Student podcast? Give us an intro.
TUMS is an interview-based podcast about choosing a medical specialty and planning a career in medicine. Many medical students feel lost when it comes to picking a medical specialty and planning their careers (myself included). There are many reasons for this (and some I personally faced):
-they are overwhelmed by the number of options
-they may feel they don’t understand enough medicine yet to start the discussion
-they don’t have a mentor

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Mental Health and More: A Look at Psychiatry

Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.

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How to ace your first patient encounter

As a medical student, you spend four years of college and the first two years of medical school studying non-stop for what feels like thousands of hours, cramming your brain with knowledge. But when the time comes to conduct your first face-to-face patient encounter, your confidence is rocked by the challenge of having to establish rapport, extract all the relevant medical history, and complete a physical exam, all while showing compassion, answering patient questions, and developing a differential diagnosis list and treatment plan in 30 minutes or less. Clinic is even worse with a meager 12 minutes scheduled for each patient encounter. 

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A Day in the Life: A Look at the Medical School Clerkship Year – Part II

Make sure to check out Part I here!

The remaining day

Following rounds, teams will typically “run the list,”or quickly review the to-do items discussed during rounds and delegate the work as necessary. Since medical students typically cannot input orders, which include things like prescribing medications, scheduling diagnostic imaging and tests, and requesting labs, this usually involves more administrative tasks: obtaining medical records from outside institutions, following up on tests, and other ancillary tasks. Most rotations also incorporate some form of formal teaching in the curriculum. As such, students may be expected to attend lunch lectures with residents or may have their own lecture schedules. Some attending physicians enjoy giving quick teaching sessions and will set aside 30-45 minutes to talk about a particular clinical topic (e.g., management of diabetes, working up an acid-base disturbance, and other common issues) each day in addition to the more formal teaching opportunities scheduled by the clerkship.

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A Day in the Life: A Look at the Medical School Clerkship Year – Part I

A caveat, an introduction

To try and describe the clerkship year of medical school – the year-long, in-depth experience for students to actively participate in patient care in a clinical setting, usually in the third year – to those who haven’t experienced it firsthand is a difficult task. I steadfastly believe that medicine is an experiential endeavor, one that cannot be truly understood by someone until he has undergone it himself. The fact that each trainee has his own unique set of “critical-incidents,” to use a term from the medical education literature (1), that profoundly shapes the physician he will become makes the task even more arduous. Nevertheless, I will do what I can to try and give a good look at a day in the life of a third year student and what the experience entails.

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