Remember that you learn from people who suffer from illnesses. It is important to treat them as you would like to be treated or as you would treat a family member.
My advice would be to learn how to draw boundaries. How much time are you willing to spend on medicine? The most important thing for me as a resident was getting past the urge to help suffering people and realize that they would be okay after I left.
Also, looking ahead, these students need to continuously evaluate everything they are doing from the perspective of exactly what they want to do in their future career. They have to pay attention to the demands and lifestyles of the attending physicians. The need to be alert to the complaints that the various clinicians have about their practices and the stresses that they endure.
They will ultimately have to choose a type of practice (university, large clinic, small group, solo) as well as a field of medicine or surgery. I have seen many students/residents go through training and end up in a field with a lifestyle that doesn't work for them.
I have interviewed many physicians looking for a position. I always ask them the open ended question: "What are you looking for in a practice?"
The new general surgeon graduate always answers with something like, "I want to see a lot of cancer work, but some trauma also, and I also would like to do some vascular."
The general surgeon changing jobs will answer, "I want $400,00 salary, 6 weeks of vacation, and call no more than one in three." When I further query "What about the case mix?" I usually get, "Oh, that doesn't matter".
And that handy book of mnemonics for residents a mentor sent me at the beginning of the rotation... Seriously, as a student, "what do you want to teach" is a useful tip, and in an environment and profession which seems to have little respect for fellow human beings when they're patients, the reminder that there are clinicians out there who do value their patients is invaluable
This is such good advice. All of it. I had a once in a lifetime opportunity, I’m afraid I did not use it as well as I might have. Residency was different, good instructors, more motivation.
I will pass this on to any student I see. We have one life, make it worthwhile.
I enthusiastically endorse suggestions #6 - get to know your patients better than anyone else. Someone once said "every person you ever meet knows something you do not". This is especially true of our patients, who are our best teachers, and who almost always are trying to tell us what is wrong with them. In 30+ years of practice I have been shocked how often I read a patients obituary and think to myself "I didn't know that about them", and then wish I would have had not missed the opportunity to visit with them about a unique or interesting part of their life. I now think of patients as gold nuggets lying there in plain sight. All we need to do is be attentive, slow down, and observe and inquire carefully; when we do this, we will stumble by fewer, and pick up and treasure more of them, and that is the great joy in medicine.
Number 1 is so important. As a practicing veterinarian of 28 years, I can still remember a golden retriever from a medicine rotation my last year of vet school, and I think of him every time I encounter hypercalcemia.
One of my most important early lessons occurred when I was working as an intern in the ER in 1968. A lady brought her son in for what clinically was c/w Strep throat. After examining the patient and speaking with the Mom, I wrote an order for a penicillin injection. Immediately after it was given I panicked because I had not asked her about penicillin allergy. I then asked the mother what reaction had occurred and what was done. She didn't remember all of the details so I explained to her what my mistake was and told her we were going to watch her son in the ER for several hours where we could treat him if any allergic reaction symptoms occurred. We kept close tabs on her son near the nurses desk (I went in to see him often). He did very well with no new issues and was discharged home several hours later. She thanked me for being honest and ultimately sought me ought over the next year to ask for advice about some of her son's additional medical concerns. It was certainly not the only mistake I made during my career, but it did teach me that patients are much more likely to be forgiving and tolerant when you are honest about your own errors.
My first choice of specialties was Neuro. Studying the brain and neurotransmitters and synapses was amazing to me. But I was scared to enter that type of intensity because I thought I wasn't good enough and because I figured that the doctors would yell at me or chastise me in public for not knowing the answer or doing something incorrectly. (This was back in the day where nurses stood for doctors to sit at the nurse's station. When you could hear a surgeon bellowing at someone through closed surgical doors). So I chose geriatrics. It was something I was good at, I ended up loving, and I've been in this specialty for my entire career. I'm still learning as I'm eager to know more so I can help my patients and their families more.
Which brings me to another point. Many of the patient population are now Baby Boomers. Having lived through the beginning of a new century. Going from paper and pen to computers with keyboards. Living during a war nobody was happy about. Going to the moon. Living through a time where there were few laws and regulations to new restrictions that don't make sense to us. Listen to your patients keeping in mind when their formative years were which led to the shaping of that person today. It IS important.
Remember that you learn from people who suffer from illnesses. It is important to treat them as you would like to be treated or as you would treat a family member.
My advice would be to learn how to draw boundaries. How much time are you willing to spend on medicine? The most important thing for me as a resident was getting past the urge to help suffering people and realize that they would be okay after I left.
Also, looking ahead, these students need to continuously evaluate everything they are doing from the perspective of exactly what they want to do in their future career. They have to pay attention to the demands and lifestyles of the attending physicians. The need to be alert to the complaints that the various clinicians have about their practices and the stresses that they endure.
They will ultimately have to choose a type of practice (university, large clinic, small group, solo) as well as a field of medicine or surgery. I have seen many students/residents go through training and end up in a field with a lifestyle that doesn't work for them.
I have interviewed many physicians looking for a position. I always ask them the open ended question: "What are you looking for in a practice?"
The new general surgeon graduate always answers with something like, "I want to see a lot of cancer work, but some trauma also, and I also would like to do some vascular."
The general surgeon changing jobs will answer, "I want $400,00 salary, 6 weeks of vacation, and call no more than one in three." When I further query "What about the case mix?" I usually get, "Oh, that doesn't matter".
I especially love number 3! A student can't help but be open minded and engaged having this phrase on quick draw!
And that handy book of mnemonics for residents a mentor sent me at the beginning of the rotation... Seriously, as a student, "what do you want to teach" is a useful tip, and in an environment and profession which seems to have little respect for fellow human beings when they're patients, the reminder that there are clinicians out there who do value their patients is invaluable
If only we all believed and complied with this advice, the medical community would be a better place.
This is such good advice. All of it. I had a once in a lifetime opportunity, I’m afraid I did not use it as well as I might have. Residency was different, good instructors, more motivation.
I will pass this on to any student I see. We have one life, make it worthwhile.
Thank you.
great timing! just sent this to a student who will be starting her clinical rotations next month!
This is great!
I enthusiastically endorse suggestions #6 - get to know your patients better than anyone else. Someone once said "every person you ever meet knows something you do not". This is especially true of our patients, who are our best teachers, and who almost always are trying to tell us what is wrong with them. In 30+ years of practice I have been shocked how often I read a patients obituary and think to myself "I didn't know that about them", and then wish I would have had not missed the opportunity to visit with them about a unique or interesting part of their life. I now think of patients as gold nuggets lying there in plain sight. All we need to do is be attentive, slow down, and observe and inquire carefully; when we do this, we will stumble by fewer, and pick up and treasure more of them, and that is the great joy in medicine.
Number 1 is so important. As a practicing veterinarian of 28 years, I can still remember a golden retriever from a medicine rotation my last year of vet school, and I think of him every time I encounter hypercalcemia.
One of my most important early lessons occurred when I was working as an intern in the ER in 1968. A lady brought her son in for what clinically was c/w Strep throat. After examining the patient and speaking with the Mom, I wrote an order for a penicillin injection. Immediately after it was given I panicked because I had not asked her about penicillin allergy. I then asked the mother what reaction had occurred and what was done. She didn't remember all of the details so I explained to her what my mistake was and told her we were going to watch her son in the ER for several hours where we could treat him if any allergic reaction symptoms occurred. We kept close tabs on her son near the nurses desk (I went in to see him often). He did very well with no new issues and was discharged home several hours later. She thanked me for being honest and ultimately sought me ought over the next year to ask for advice about some of her son's additional medical concerns. It was certainly not the only mistake I made during my career, but it did teach me that patients are much more likely to be forgiving and tolerant when you are honest about your own errors.
Many truths here 👆🏼
I would add: plan a 4th year rotation abroad in order to get a better perspective on the U.S. system.
As a nurse, I would add, "Learn from the nurses. Treat them well, and they will have your back."
My first choice of specialties was Neuro. Studying the brain and neurotransmitters and synapses was amazing to me. But I was scared to enter that type of intensity because I thought I wasn't good enough and because I figured that the doctors would yell at me or chastise me in public for not knowing the answer or doing something incorrectly. (This was back in the day where nurses stood for doctors to sit at the nurse's station. When you could hear a surgeon bellowing at someone through closed surgical doors). So I chose geriatrics. It was something I was good at, I ended up loving, and I've been in this specialty for my entire career. I'm still learning as I'm eager to know more so I can help my patients and their families more.
Which brings me to another point. Many of the patient population are now Baby Boomers. Having lived through the beginning of a new century. Going from paper and pen to computers with keyboards. Living during a war nobody was happy about. Going to the moon. Living through a time where there were few laws and regulations to new restrictions that don't make sense to us. Listen to your patients keeping in mind when their formative years were which led to the shaping of that person today. It IS important.