It has been really exciting to use all the fundamental knowledge I learned in first and second year throughout my clinical year. During my first two years of medical school, I became pretty comfortable studying for exams and relying on tests for grades. I knew what to expect out of the exams and spent most of my time studying and watching lectures. Transitioning to third year was very daunting, with such a variety of patient complaints and attendings with different expectations and seemingly unpredictable questions.
It was a very different experience implementing knowledge on the wards versus on a test. For example, on a test they give you all the information you need to be able to answer the question, whereas in real life you have to gather this information yourself or figure out a way to get the information through labs or imaging. In addition, the treatments or diagnoses do not come from a list of options, but from research and thinking back on all the possibilities we have ever learned about. For me, I felt so lost and inadequate at the beginning of this year, because even with a lot of knowledge about many diseases, I did not feel capable of putting my knowledge into practice. My first ring of third year was definitely a difficult adjustment and I received feedback that I needed to be more confident and act as a true member of the team. I have learned to push myself to be more outspoken through becoming confident in my medical knowledge base. To do this, I spent a lot of time researching my patient cases to further my knowledge and prepare a wide differential and plan as if I were a resident.
Starting third year, I was also unaware of how to show I was engaged and an active team member. I felt bad waking sleeping patients to perform a physical exam and ask them how they were feeling, but after my first rotation I realized that it needed to be done to really get the full story of what is going on. After my first ring, to show that I was an active member of the team, I spent extra time with the patient to really get to know them and understand their needs. I also updated the team with new test results, helped place orders, and wrote progress notes, handoffs and hospital courses.
In the future as a resident, I plan to continue reading literature and practice bulletins to stay up-to-date on diagnostic and treatment plans, so I can be confident in sharing my plan with superiors. My goal is to read at least two practice bulletins per week in my first three months as an intern. Another goal for me is to do at least 20 questions per week of UWorld or board style questions in the first three months of residency.