MD What can a preclinical student do right now to prepare for rotations?

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Just started M2, rotations starting next May. I am feeling a little nervous about rotations because I realize once I am an M3 I will actually be making a real impact on patients (very small impact at first, but still) and I want to make sure I do everything I can do now to be prepared.

For current clinical students (and those beyond this training stage), is there anything you wish you did more of during your pre-clinical years? Can be anything from professional (shadowing/practicing physical exams regularly/getting used to reading papers for making presentations/refining patient presentation skills) to personal (lifestyle habits/relationships/time management).

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Learn your preclinical material well.

It's very tempting to start looking ahead and thinking about clinical management. But you will spend the rest of your medical training, including residency, potentially fellowship, and throughout your career as an attending learning how to manage patients. You will never have another opportunity, in your entire life, to spend weeks on end solidifying your understanding basic pathophysiology. Take advantage of this time. This kind of fundamental, mechanisms based way of thinking is what separates us from APPs.
 
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Learn to walk, then you can run. Start with mastering the basics.
 
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Agree with the two posters above. I’m in year 3 on rotations and there’s nothing I could have done outside of learning pre-clinical material that would have made me better prepared.

A little side note though: part of your preclinical curriculum is some sort of “doctoring” course where you learn physical exam skills, how to write a note, present a patient, etc. a lot of students sleep on this class and cram the physical exam the day before, get a decent OSCE grade, then move on. Go ahead and take the time to learn your exam, note-writing and presentation skills now, so you won’t have to look up how to do a Neuro exam or write a progress note properly later when you’re expected to.
 
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Start thinking about what you want to do. Anyone can go and interview a patient and regurgitate an H&P. Try to think of what tests you would order or what you would do in a given situation. A lot of this you won’t know at first and that’s ok. You can cheat by looking at plans on other patients or talking it out with residents. Find residents who are chill (like I was) and who would gladly go over stuff before you present to an attending so you look smarter. Very few students take advantage of this.
 
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A little shadowing can help you “get the lay of the land” in the hospital.
 
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Thanks everyone for encouraging me to not worry too much about the future and focus on the pre-clinical curriculum at hand! It is comforting to hear that I do not need to do anything else at this moment!

Follow-up question...I am not a particularly strong student. Up to this point, I've always been around average to below average in my class. I am worried that I might not be retaining enough basic info for the clinical years. Is there anything you guys recommend to keep the knowledge in long-term memory? I'm guessing the quick answer is Anki, but I really, really do not like flashcards, so any other recommendations would be appreciated.

A little shadowing can help you “get the lay of the land” in the hospital.
Oh my gosh, I needed to go do something for med school in the hospital (large metro health center) today and I legit got lost for 20 minutes. Had to text a resident to rescue me.
 
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Thanks everyone for encouraging me to not worry too much about the future and focus on the pre-clinical curriculum at hand! It is comforting to hear that I do not need to do anything else at this moment!

Follow-up question...I am not a particularly strong student. Up to this point, I've always been around average to below average in my class. I am worried that I might not be retaining enough basic info for the clinical years. Is there anything you guys recommend to keep the knowledge in long-term memory? I'm guessing the quick answer is Anki, but I really, really do not like flashcards, so any other recommendations would be appreciated.

It's not so much the retention of particular pre-clinical material that is relevant. As GoSpursGo said, the application of pre-clinical knowledge is understanding the mechanisms underlying diseases and treatment and that's what separates us.

For example, you don't need to keep the knowledge of every antibiotic classes' mechanism of action in long-term memory (unless you become ID). You do need to understand that different bugs have different susceptibilities to antibiotics based on their mechanisms of action and this will drive/tailor the treatment plan. If you understand this, you may be able to manage an antibiotic regimen yourself instead of consulting ID.

The APP model for infection is often: hit 'em with the big broad spectrums. If it's atypical, consult ID. They're not taught the pathophysiologic basis of disease like you are.
 
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Thanks everyone for encouraging me to not worry too much about the future and focus on the pre-clinical curriculum at hand! It is comforting to hear that I do not need to do anything else at this moment!

Follow-up question...I am not a particularly strong student. Up to this point, I've always been around average to below average in my class. I am worried that I might not be retaining enough basic info for the clinical years. Is there anything you guys recommend to keep the knowledge in long-term memory? I'm guessing the quick answer is Anki, but I really, really do not like flashcards, so any other recommendations would be appreciated.


Oh my gosh, I needed to go do something for med school in the hospital (large metro health center) today and I legit got lost for 20 minutes. Had to text a resident to rescue me.
Hey, your situation sounds similar to mine! Did not do anki, did average for step 1 and preclinical scores.

For medical knowledge:
I agree with all the posters above that learning the preclinical material is the best thing you can do to prep for 3rd year, especially the pathophysiology. I loved Pathoma for that. But, I wish I had a little more time to actually re-explain concepts to really make sure I was understanding them. Whether in a group study setting, peer tutor setting, whatever. I got a lot of help from my school's (free) peer tutors and am now working as one. Teaching a concept really helps reinforce it. Also, if you are a visual learner, try Sketchy for recalling the nitty-gritty.

Try to think about your own differentials and treatment plans as much as you can, especially if y'all have case-based learning or a doctoring course where they are trying to teach you this.

For career choice:
Now that the pandemic is more stable, try to shadow and volunteer to expose yourself to the different specialties, and different settings like inpatient vs outpatient. Shadowing was closed in my school due to covid during most of my preclinical, and it made my specialty choice harder in M3. If you already know what specialty you want to go in, start networking with attendings and residents.

For clinical encounters:
Definitely practice as many physical exams as you can, especially on different genders and different sizes/shapes. Don't feel shy to say that you didn't understand how to do a maneuver, and to ask someone to show you again. If you can practice presenting to patients, that is great. It's fine if you don't get too much practice since most rotations have slightly different styles.

Misc:
Do whatever helps build your confidence. Improve your own mental and physical health, self-esteem, etc (or keep it stable if yours is god) so that inevitably when constructive criticism or bad days come they won't break you. If you have chronic health conditions or mental health needs, make sure you keep up with your own healthcare so you can start clinical year with all the resources (meds, therapy, etc) you need. If you are "type A", know you will have to become more flexible and spontaneous in third year because you will literally not know your schedule until the day before for some rotations. Try to keep up some sources of joy and connection outside medicine, whether through friends, family, hobbies, etc.
 
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Just started M2, rotations starting next May. I am feeling a little nervous about rotations because I realize once I am an M3 I will actually be making a real impact on patients (very small impact at first, but still) and I want to make sure I do everything I can do now to be prepared.

For current clinical students (and those beyond this training stage), is there anything you wish you did more of during your pre-clinical years? Can be anything from professional (shadowing/practicing physical exams regularly/getting used to reading papers for making presentations/refining patient presentation skills) to personal (lifestyle habits/relationships/time management).
It needs repeating...as previous replies have stated, it is not the memorization of pre-clinical material and regurgitating it on tests (yes, memorization and regurgitation assessments are prevalent even in medical school) that is important, it is a deep and thorough understanding of the basics AND THEN applying. You have to understand what is happening first to understand why a certain pathology is occurring, and then you will be able to implement it into patient presentation and physical exam skills. Always good to stay on top of Case-based learning opportunities but when you get to clinics you'll have a learning curve there as well. Try to build your foundation so you can learn from clinical years - they are a blast if you feel as though you can engage!
 
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My advice is to establish good self-care routines asap if you have not already. I find people that the same people who dont do this, tend to never really figure it out - and it bleeds into residency.

Being well rested and well taken care of go a long way for performing well in rotations - and really in life in general.
 
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