Hi, folks. I head off tomorrow for the first day of my first clinical rotation (FP), and I’m feeling like I should have a “danger” sign hanging around my neck given how little I feel I know. I’ve more or less dumped all the info. I crammed in for Step One. I’m wondering, for those of you who have already trod this path, when does one stop feeling like a total pretender?
Wish my patients luck!
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Hi, folks. I head off tomorrow for the first day of my first clinical rotation (FP), and I’m feeling like I should have a “danger” sign hanging around my neck given how little I feel I know. I’ve more or less dumped all the info. I crammed in for Step One. I’m wondering, for those of you who have already trod this path, when does one stop feeling like a total pretender?
Wish my patients luck!
Hey Bill,
You are not going to feel like a physician tomorrow because everyone will keep reminding you that you are a medical student. Enjoy this protected time and use it to learn. Hone your interview skills and take a stab at patient managment. You will be either right or wrong but you will get the hang of clinical thinking much quicker if you keep trying.
No one is going to let you have any responsibility that will change any patient’s life. Your job is to observe and absorb things that you can use to treat your future patients.
You can do a “data dump” now. My strategy on each rotation was to read about the things that my patients had; do some questions every day for the shelf exam and get used to treating all of the common clinical entities such as CHF(acute and chronic), coronary artery disease, COPD(exacerbation and maintenence), RAD (exacerbation and maintenence) gastritis, influenza, preventive medicine, diabetes, hypertension, pediatric maintenence stuff and peripheral vascular disease.
My family practice preceptor was the only one in DC who delivered babies so I got to do lots of OB with her. I also got pretty good at office procedures too. You should be able to observe and learn some practical things that will help you on the wards.
Enjoy and study as you go along. That Family Practice shelf exam was one of the harder ones.
Natalie
Thanks, Natalie. What question source did you use to prepare for the FP shelf exam? Was it the Swanson book?
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Thanks, Natalie. What question source did you use to prepare for the FP shelf exam? Was it the Swanson book?
Hi there,
I used swanson’s for my Family Practice shelf. Still it was a very difficult exam.
Natalie
Bill,
You most pressing responsbility as a medical student is to learn as much as you can cram into your gourd! As Nat pointed out, you will not be given such resp as to affect significant impact on a patient. However, maximize this opportunity to learn the “why” behind the decisions you see made. It the why & your ability to apply various “why’s” to a multitude of unique situations that will eventually make you a physician & not just a very knowledgible technician w/ a massive student loan burden. It will take years of training & practice to reach that point, which is why it takes so long to become a physician.
Furthermore, no matter what you are told, there is more than 1 way to skin a cat…meaning, as physicians, we do not understand physiology & esp pathophysiology sufficiently deep to determine THE exact way to treat ailments. Therefore, there will be significant variations on ‘style’ of assessment, diagnosis & treatment. Some physicians may claim to know THE correct way. More precisely, that is the way they feel most comfortable. You, on the other hand, do not have sufficient experience to express a style. However, by critically assessing each physician’s approach to problems, you can evolve what will eventually become your style of operation. Essentially, sorting the wheat from the chaf.
I personally feel the best approach to your clerkship years, esp the 3rd year, is to invest yourself in each rotation as though it was the specialty for which you are destined. Only then can you begin to appraise how well you may/may not fit into that specialty. Many many classmates ended up selecting specialities they either never heard of or had actually expressed the desire to avoid prior to their 3rd year experience. So, to maximize your learning & potential for a successful & happy career, invest yourself in your 3rd year.
Thanks, Natalie and Dave, for your thoughtful replies. I didn’t mean to imply by my original message that I thought I ought to be feeling like a physician at this point. I recognize how far I have yet to go. Every patient that walks into the FP’s office reminds me of that…
I was just wondering, in a moment of idle panic, at what point the physicians here actually began to think of themselves that way. Did it start to happen near the end of med school? Midway through residency? Or “Stay tuned, I’ll let you know when it happens?” 
I appreciate your replies, and will follow your advice through the coming rotations. Surgery is next and it fills me with trepidation!