Gold Humanism Honor Society

Presented at the Ohio State University College of Medicine

Student Clinicians Ceremony April 9, 2012


HowtoMentallyandEmotionallySurviveMed3.3

WardBehavior.17

BookSuggestionsandStudyTips25


BethanyBrisbin
Med3isanexcitingtransitiontotheclinicalworld!Youwillhavetheopportunitytoreallylearnhow
tomakeclinicaldecisionsandtakeresponsibilityforyourpatient'scare.You'llstartfeelingmoreand
more like a "real" doctor. With this increased responsibility and expectations, at times you may
become overwhelmed or mentally/emotionally exhausted. The best way to curb this is taking
advantage of your down time. Whatever you like to do before the start of Med 3, continue to do
that!ThereisNOreasonyouneedtogiveuphobbies,justlearnhowtoadjustthesetoyourMed3
schedule.AlthoughMed3isknownasbeingthetoughestyearandgreatesttimecommitment,there
isstillplentyoftimetohavefunmorethanyouthink!Spendtimewithyourfriendsandfamilyas
muchaspossible.LoadyourDVRwithyourfavoriteshows,readyournonschoolbooks,exercise,etc.

InadditiontoadjustingyoureverydaylifetoyourMed3schedule,it'salsoimportanttolearnhowto
getthroughemotionallytaxingsituationswithyourpatients.Youwillcomeacrossdisappointments,
failedtreatments,andevendeath.Beopentolearninghowtoexperiencethesedifficultsituations.
Takethetimetogettoknowyourpatients,theirhistory,andtheirfamilies,andyoucanplayavital
role in their ups and downs. It's also important to know yourself and know your limitations to
maintainyouremotionalhealthinthesesituations.

Med3isanAMAZINGopportunityyouwilllearnSOmuchbothaboutmedicineandyourself.Know
that you're not alone; many people have walked in your shoes before and many will soon follow.
Don'tbeafraidtoaskforhelpordedicatesomepersonaltimewhenneeded.Enjoy!

LisaCaronia
Congratulations!Youfinallymadeit!Belowyouwillfindafewofmysuggestionsonhowtosurvive
asaMed3.

GeneralRotationSurvivalTips

1. Try to read something every night. There will undoubtedly be those long days on rotations
whenyoujustdon'thavethebrainpowertositinfrontofabook,andtheideaofmeltinginto
yourcouchtomindlesslywatchTVhasneversoundedsogood.But,youwillfeelmuchmore
preparedwhencrunchtimecomesfortheshelfexam.Onehouradaywillgoaverylongway!

2. Doasmanypracticequestionsaspossible.CarryingaroundPreTestinyourwhitecoatisone
good way to help accomplish this because I have found that you may have 10 minutes of
down time on a rotation, and it is often difficult to get meaningful reading done in such a
shortamountoftime.Ihavefoundthatmypreparednessfortheshelfisdirectlycorrelated
tothenumberofquestionsIhavedone.


3. Looksomethingupabouteachofyourpatientseachmorning.UpToDatewasmyresourceof
choiceforthis.Inthemorningbeforerounds,Iwouldquicklylooksomethingupaboutmy
patient's diagnosis/clinical course/treatment. Time and again, having done this made me
especiallyknowledgeableonrounds.

MentalandEmotionalSurvivalTips
1. Leisure read each night. It's easy to get caught up with the sprint that can be 3rd year and
begineliminatingthefunthingsinyourlife.Don'tdothis!Itissoimportanttotaketimefor
yourselfwhenyou'reputtingin12hourdays.Itrytoreadfor10minutesinbedeachnight.I
greatly look forward to it after a long day and it provides some normalcy to days that are
anythingbutnormal.Figureoutwhatisimportanttoyouandmakesureyoucontinuetodoit.

2. Exercise,goonawalk,playasport!(Especiallyearlyintherotation,whenyourtimemaynot
beasstretched.)Nowforme,thiswasnotpracticalduringsurgeryandIM,anditlikelywon't
be very possible during Ob/Gyn. But for those other rotations, it is an important aspect of
maintainingabalancedlifeandpracticingwhatwepreachashealthcareproviders.

3. Maximizeyourtime.Whenmysparetimewasatapremium,ItriedtomaximizethetimeI
didhave.Thiscouldinclude:studyinginthehospitallibrarytomissrushhourtraffic,doinga
fewpracticequestionsbeforeworkinthemorning,orpackinglunchthenightbefore.Catch
upwithafriendoverastudydateatacoffeeshop.Getcreativeandmultitask.

4. Trynottobetoohardonyourself.It'sveryeasytogetfrustratedwhenyoudon'tgiveyour
best patient presentation or miss a couple of pimp questions during rounds. But just
rememberthatyouAREa3rdyearstudent.Everydayisalearningexperience,andnoone
expectsyoutoknoweverything,otherwiseyouprobablywouldn'tbea3rdyear.Itrytotake
advantageofmyfumblingasanopportunityimprovemyskillsorcommittomemoryafact
thatIwillneveragainforget.Ialwaystriedtolookateachdayasanopportunitytoshowmy
teamhowgreatIwas.Keepthisinmindandcommendyourselfwhenyoudothingswell.

5. Reflecteachday.Ihavefoundthatevenonmyworstdays,Ihaveatleastoneencounterwith
apatientthatremindedmewhyIchosetogointothisfield.Youwillfindthatyourpatients
willcometoappreciateandrespectyouifyoutakeaninterestintheirlivesandhealth.Check
on them in the afternoon if your schedule permits and see if you can do anything to make
theirstayalittleeasierthesethingshaveanimpactthatismagnitudesbeyondthefewextra
minutesittooktocheckbackin.

Again,congratulations,goodluck,andenjoy3rdyear...itisanincrediblejourney!


AmandaDelong
Welcome to Med 3! Congratulations on putting Med 12 and Prior Library behind you and finally
steppingfootonthelongawaitedwards.I'msureyou'reexcitedandanxiousasIwas.Med3isat
timesthemostexcitingandattimesthemoststressfulpartofmedicalschool.Thatbeingsaid,itis
notdifficulttobesuccessfulortostaysanethroughthischallenging(yetamazing)year.

ThefirstadviceIwouldgiveyouistoallowyourselffreetime,anddon'tfeelguiltyaboutit.Iknow
thisissaidoverandover,andduringStep1studyyoulikelyfeltlikeitwasanabsolutelyridiculous
statement.However,itisimperativetosurvivingthisupcomingyear.Ifyouhaveafamilyevent,want
to go to a concert, or have a standing Wednesday phone conversation with your childhood best
friend,byallmeansstilldoit.Ifyoulovetoworkout,keepgoing(andifyoudon't,I'dadvisestarting).
Tothatend,eatwellI'mabigadvocateofpackingalunch,partlybecauseWendy'sisakiller(and
expensive if you go daily), but also because there are many services where you won't know when
you'llbeabletoeat,sohavingfoodtoeatthroughoutthedayishelpful.

Academically, people advised me to study an hour a day. This isn't always feasible, and know your
ownlimits.Ifyou'vehadalongday,andanhourmoreofsleepisgoingtobemorebeneficialthanan
hourofstudying,doit.Justfigureoutastudyplanandsticktoit.Youlikelyknowwhatworksforyou
by now. More importantly, Med 3 is different than 1 and 2 becauseyou have patients that will be
yourbestteachers.Theywilleducateyoumorethananyreviewbookorlecturewill.Formanyofthe
rotations I'd fill in gaps in my knowledge with Blueprints or Case Files, but ultimately did QBank
questionstolearnandcheckmyknowledge.Theshelfexamsarereasonable,andifyouuseyourtime
onthewardswisely(andputinafewextrahoursontheweekends),you'lldofine.

Asfarasdaytodayonthewards,someoneoncetoldmetothinkofeverydayasajobinterview.I
thinkthisistrue,butmostimportantlyinhowyouinteractwithyourpatients,residents,attendings,
andfellowstudents.Nomatterhowmuchyouwanttobea[psychiatrist,rocketsurgeon,pediatric
cardiologist, etc] DO NOT throw other students under the bus. Residents notice, and they will
evaluateyouassuch.Behelpfultoyourresidents,bekindtoyourpatients,andbetheallyofyour
fellowstudent.Nomatterwhatspecialtyyougointo,youwillworkwithpeoplefortherestofyour
life,andthoseskillsarewhatwillhelpyouexcelonthewards.Additionally,stronginterpersonalskills
can turn a mediocre shelf score into a letters or honorsso be a good person as well as a good
student.

Lastly,thecookiesinthemaincafeteriaatNationwideareamazing.Ihopeyouhaveafantasticyear
andlearnasmuchasIdidaboutmedicineandaboutyourself.Aclassmateofminerecentlyreminded
methatifyouultimatelystruggletofigureoutwhatyouwanttodo(whichisalotofwhatMed3is
about),remindyourselfofwhyyoucamehereinthefirstplace.Findingthatfeelingagainreaffirmed

to me that I was in the right place, and it helped me to feel excited every day (even on services I
didn'tlike)becauseIwasworkingtowardthatultimategoal.
MichaelDiBartola
Med3willbestressfulandtaxinginadifferentwaythanMed1andMed2.Ittakestimetogetused
toworking8,10,12hour,sometimeslonger,daysandthenfindingtimetostudy.Ihavefoundthat
there are two big things that have helped me do this and stay sane. First, I have continued to do
thingsthatarefunandimportanttome,likeexercise.IranafewmarathonsduringMed1andMed
2.WhileIhavenotbeenabletotrainforanyfullmarathonsthisyear,Ihavecontinuedtorunand
competeinhalfmarathonsand5Ks.Secondly,Ihavemadeaconcertedefforttospendqualitytime
withmywife,family,andfriends.Theyaremysupportsystemandwithoutthem,Iwouldntmakeit.
It is important to remember that in order to be a great Med 3, you need to continue to do things
outsideofschooltostayhealthy.Pleasecontinuetodofunthingsandtaketimetoenjoylife.

Mybiggestadviceistorememberthatyouareaprofessionalandthatyourpatientslookuptoyou
withrespect.Nomatterhowtiredyouareorhowroughofadayitsbeen,itoftenhasnotbeenas
badadayasyourpatientmaybehaving.AsaMed3youwillhavetheuniqueopportunitytospend
extratimewithpatientswhentheinternsandattendingaresimplytoobusy.Takeadvantageofthe
extratimetogettoknoweachpatientasawholepersonandnotjustacase.Thisalwaysreminded
mehowmuchofaprivilegeitistohaveindividualsbecompletelyvulnerablewithyoudayinandday
out.Goodluck!

JordonDespain
YouwillhavealotofverydifferentexperiencesasaMed3.Someofthemwon'tbepleasant.My
advicetoyouistobeopenminded.Ifyouareinarotationthatyoujustdon'tlike,trytofindthings
you do like and see how they may enhance your future as a physician. Be open to feedback and
criticism.Ifpeoplesaythingsthatseemharsh,itisbecausetheycare.Theycareaboutyouandthe
patients,andtheywanteveryonetoavoidmistakes.Doyourbesttoimplementtheirfeedbackand
justdoyourbest.Aslongasyoudoyourbest,youcansleepwellatnight.Beopenminded,and
everythinggoesbetter.Goodluck.You'llloveit.

JessicaKatzEdison
1. Sleep.Thisiskey.Gettingmoreandmoreexhaustedeachdaysothatbytheendoftheweek
youareneardeliriouswillgetoldquickly.Findouthowmuchsleepyouneedtobeinagood
moodeachday(formeits7hours),andtrytogetitasoftenaspossible.
2. Taketimeforyourself.Besurethatyouhavesomefuntimemostdays.Formethisisgoing
outtodinnerandwatchingsometelevision.Whatevernonproductivethingsyoulovetodo,
keepdoingthem.
3. Startstudyingearly.Feelingbehindonstudyingisalwaysoneofmybigemotionalstressors.
Avoidthisfeelingasmuchaspossible.


4. Rememberwhyyou'rehere.Ifyou,likeme,wenttomedschoolat leastpartiallybecause
youwantedtohelppeople;dontforgetthat.Youfinallygettointeractwithpatients!Enjoy
this. No matter how busy or stressed you feel, remember that your patients are probably
feeling worse and thatyou can possibly make their day better. Feeling like I had a positive
interactionwithapatientoreventhatIhelpedstressedoutpeoplefindtheirwayaroundthe
hospitalalwaysmakesmydaybetter.

MargaretGermain
It may be a little obvious, but my best advice for Med 3 is to maintain a positive attitude in every
rotation and to be a team player. Not everyone wants to be a surgeon, or an OB/GYN, or a
pediatrician,buttheteamyouareworkingwithhaschosentodedicatetheirlivestothatspecialty,so
be respectful of that and really take advantage of the time you get to spend learning from those
physicians.Forexample,ifyoudontwanttobeasurgeon,thisisyouroneopportunitytobeinthe
ORandmakeanincisionorpracticesutures,somakethebestofit.Itisnotonlyaboutrespecting
thephysicians,butalsoyourpatients.Eachpatienthasgivenyoutheprivilegetobeapartofhisor
hercareandwecanttakethatforgranted!Gettoknowyourpatientsandreallygetinvolvedinthe
teamandthemanagementofyourpatientsandyouwilllookgood,learnalot,andbeveryhelpfulto
theresidents!Beingateamplayeralsomeansbeinghelpfulonthefloorwhetherthatmeanshelping
residents,scrubtechs,orothernursingstaffwithwhateverneedstobedone.Notaskisoutofthe
realmofmedicalstudentresponsibilityandyouwilllearnatonaboutpatientcarebybeinghelpfulto
thenursesaswell.Ifyouhavetime,offertohelptransferpatients,placeafoley,changedressings,or
evenbringyourpatientsthatPopsicletheyhavebeenaskingforallafternoon.Bepersonable,use
commonsense,askquestions,andbeinvestedinwhateverisgoingonatthatmomentandyouwill
dogreat!

I also think it is important to mention the fact that although Med 3 is awesome and exciting, it is
exhaustingattimes.Thereisnodoubtthatitisdifficulttowakeupat5AMandthengethomeand
havetostudyafterafulldayofwork.Ifyouneedtotakeanightofftogotobedattheridiculous
hourof6:00pmjustdoit!Youwillknowwhenyourbody/mindneedsabreakanditisimportantto
takethosebreaks.Makeitaprioritytodothingsthatyouenjoyduringtheweekandyouwillbeable
tomaintainthatenthusiasmformedicinethatyouhadcomingintomedicalschool!Itisanamazing
feelingtofinallystartbeingapartofpatientcare,anditdefinitelybeatssittingwithyournoseina
bookallday!

JosephLopez
Congratulationsonenteringthemostexcitingyearofmedicalschoolyet!Bynow,youknowallabout
professionalismandbeingateamplayer.Thisisyourchancetolearnabundleofusefulinformation
as well as really get involved in patient care. When on your clinical services, keep in mind that
9

everyone has the same goal of helping the patients. Be respectful to everyone and stay humble.
Remember how fortunate you are to be in this position. Try to make your fellow medical students
and everyone on yourteam succeed andlook good; if you do this, your education and evaluations
willbeverypositiveintheend.Also,besuretomaketimetoenjoyyourlifeoutsideofyourclinical
work.Youwillappreciatethistimeyouinvestinyourself.Goodluckandhaveablast!

LaurenMadigan
Firstofall,Iwouldliketocongratulateeachofyouonsuccessfullycompletingthefirsttwoyearsof
medical school and encourage you by saying that it only gets better from here! Med 3 is the year
whenyoudustoffyourwhitecoatandbeginlearningtheartofmedicine.Itisawhirlwindexperience
thatcan,unfortunately,takeitstollifyouarentcareful.Hoursarelong,thereisagreateramountof
responsibility and there will be days when you feel like you dont know ANYTHING. Everyone
developstheirownuniquewayofhandlingthestressandanxietyofthethirdyear,butherearea
fewofmyownthoughtsinthehopethattheymighthelpyousucceed:
Remaincalm.Youarentexpectedtoknowtherightanswereverytimeandnooneassumes
that you are perfect. Just keep a smile on your face and stay dedicated. There will be long
hours,therewillbebaddays,andtherewillbethefirstdayofeachrotationwhenyouwill
feel utterly lost. Luckily, these days pass and youll find that if you can just keep a positive
outlookthatthingsreallydogetbetter.
Takecareofyourself.YoullhearthisathousandtimesbeforestartingMed3,butitreallyis
important.Eatbreakfast,exercise,watchrealityTV,andGETSOMESLEEP!Partofbecominga
goodphysicianisfindingbalanceinlife,sotakethisopportunitytopractice.
Takeadvantageofyourroleontheteam.Youwillfindthatthegreatestcommodityinthe
hospitalistime,andasamedicalstudentyouwilloftenhavemoreofitthanothers.Useit
wisely.Gettoknowtheuniquestoriesandperspectivesofyourpatientandstrivetobetheir
advocateduringrounds.Youarentlikelytobethemedicalexpertonyourteambutyoucan
betheexpertonyourpatient.
Be independent. Although most residents are very willing to help, it is best not to plague
themwithtoomanysillyquestions.Ifyoucantfiguresomethingoutonthecomputer,tryto
work it out for yourself before running to the intern. Always look for the answers to your
medical questions before asking. Being independent is one of the best ways to earn the
respectofyourteam.
Beprofessional.Dontbelate,lookthepart,andrememberyourPsandQs!
Embracehumility.Ifyouwanttosucceedinthirdyear,youmustbehumbleandrespectful.I
guarantee that you will find residents, nurses, and scrub techs more willing to help if you
leaveyouregoathome.
Support each other. There is nothing that makes a rotation more enjoyable than a fellow
studentwhoisencouragingandsupportive.Ihavebeenblessedtoworkwithseveralamazing
peopleandIcannotthankthemenoughfortheirfriendship.

10

 Beatortoise,notahare.Studyingalittleeachdaywillnotonlybetterprepareyouforthe
shelf examinations, but it will also help you succeed on the wards and preserveyour sanity
cometestweek.

CassondraMajestic
The most important thing to remember throughout Med 3 is that you are considered part of the
team and should never view yourself as just the med student. Your actions are important even
whenyoufeelliketheyarenot.Itistoughtogetthroughalloftheserotations,especiallyifyouonly
like one specific aspect of medicine. Remember to view every day as a learning experience that is
important for your further training as a doctor. If you allow yourself to get frustrated because you
feellikeyourenotpartoftheteam,orresidents/attendingstreatyouasifyouareincompetent,it
canbringalotofnegativityintoyourlife.

Keepascheduleoutsideofwork,andletthatincludegymtime,happyhours,andtimetovisityour
family.Ifyouneeddaysofftakethem!Youareallowed3daysofabsenceifneeded.

Keep your friends close and vent to them when needed it helps. However, dont carry negativity
with you when you wake up in the morning if you dislike the rotation you are on. Try to keep a
positiveattitudeatworkandyouwillbemuchhappier.

ChristinaMartin
Classof2014...WelcometoMed3!!!

You'vemadeittothe"clinicalyears,"theyearsyouweresolookingforwardtoasaMed1andMed
2.Finallyyouarehelpingtakecareofrealpatients,whichiswhyyouwantedtobeadoctorinthe
firstplace,right?Well,letmetellyou,theyaregreat!Andalsochallenging.Butthenagain,nothing
thatisworthdoingiseasy.I'dliketosharesomeadvicewithyouthatI'velearnedsofar.Hopefullyit
canbeofsomevalue.

ThemostdifficultthingaboutMed3islimitedtime.Youwillbeapartofateamthatishelpingto
take care of patients. The experience will be awesome! You will learn a great deal about different
conditions, medications,procedures,surgeries,etc.Butyouwillstillneedtolearnmorethan what
youseeonthewardsorinclinic.

1. Maketimetostudyeveryevening.Itcanbereallydifficultsomenights(trustme...)However,
reading about something your patient has or a procedure you observed that day will help
solidify the information in your brain. If you don't have much time, just pick one topic and
readfor2030minutes.Atleastyou'llhavelearnedorreviewedonethingthatcanhelpyou

11

 take care of your patients. Shoot for at least one hour each evening and several on the
weekend(whichismymaincatchuptime).
2. Maketimetotakecareofyourself.
Get enough sleep, which is 6 1/2 hours per night. A great physician gave me this
advice,andI'vefoundithelpful.Ifyouaretootiredtoconcentratethenextday,you
won'tbeabletoeffectivelyhelptakecareofpatientsorhelpyourteam.
Eat healthy meals. Start your day off with some healthy energy for breakfast. Your
brainwillthankyouforit.Andbesuretobringahealthysnackthatyoucankeepin
yourwhitecoatpocket.ItWILLcomeinhandy(especiallyonlongmorningrounds!).
Getsomephysicalactivity!Evenifit'sassimpleastakingthestairsorwalkinginstead
oftakingtheshuttleatChildren's.Thiswillhelpkeepyourbodyinbettershapeand
you'll feel better. Also, try to get some workouts in. And if not, its better to modify
anddosomethingthannothingatall.Ifyoucan'trun,goforawalk.
Doctor's appointmentsgo if you need to! A healthy med student is a happy med
student
3. Maketimeforthingsthatareimportant.Lifedoesn'tstopwhenMed3starts.Schedulesome
time for family and friends. Some rotations have more free time than others. Keep up with
yourreligious,spiritual,andpleasureactivitiestoo(reading,movies,TVshows,cooking,etc.,
becauseeveryoneneedsalittlebreak).
4. Have fun! And stay positive! If you take a positive outlook, it will really make this great
experienceevenbetter.

LindsayMooney
ThehardestpartofM3isfindingtime.Youwillfindyourselfconstantlymakingmentallistsofallthe
thingsyouneedtodo,tryingtosqueezeinawholeweekoftasksintojustafewhours.Youwontget
it all done, and thats okay. The key to balancing everything is retaining the things that make you
happy.Whateveryourblissis,makesureyoustillmaketimeforit.Theoddsandendswedoinour
lifemakeuscompleteandallowustokeepperspective.Youwillbeinthemedicalsettingforenough
hours during our rotations, make sure you are spending your free time doing nonmedical things.
Considertryingsomethingnewmaybeitiscooking,workingout,painting,orsomethingelse.Itwill
helpyoumentallyrejuvenate.Taketimetostayconnectedwithfamilyandfriends.Thesepeoplewill
helpkeepyougroundedandmakeyouseethatmedicalschoolisnttheonlythingthatexists.Make
sureyouaretalkingtothosearoundyouaboutyourexperiences.Rotationscanbeisolatingandyou
needtomakesureyouarekeepingpeopleintheloopastohowyouaredoing.Nomatterhowtired
youmayfeel,manypeoplehavelivedthroughmedicalschoolandaresucceedingjustlookatallthe
longwhitecoatsaroundyou.

Along with making time for the important things in life, you also want to keep perspective. Dont
complaintoomuch;youareluckytobewhereyouare.Perspectivewillallowyoutoseehowlucky

12

youaretogettotakecareofandshareinthelivesofyourpatients.Asamedicalstudent,patients
give us theprivilege ofallowing us to make mistakes, practice,and learn from their ailments. Your
conversations,smiles,andsupportwillmeantheworldtopatients.

JacquelineRoth
Halfwaythroughthirdyear,IstartedkeepingajournalofthepatientsIhadworkedwithwhosestory
madeanimpressiononmeorwhotaughtmeanimportantlesson.Ithinkitwillbehelpfultorevisit
theseexperiences,toreflectontheimportantlessonstheytaughtmeandalsotoobservehowthese
experiencesinfluencemeasIgrowintotheroleofaphysician.IwishIwouldhavestartedthisfrom
thebeginningoftheyear.

PanktiShah
Ifyouareonarotationyoudonotlike,gointoeverydaythinkingthatthatwillbethelasttimein
yourlifethatyouwillhavetheopportunitytoworkinthatfield(i.e.aRouxenYwillnotbeonyour
shelfandyoumayhatedrivingthelaparoscope,butthesurgeryitselfisneat!Andyouwillonlyhave
~1 month to take advantage of being able to learn about it!). It will make the days slightly more
exciting.

Haveatemplateforyourmornings.Onemedicalstudenttoldmethatsheseeseverymorningasa
routine.Shehasamethodofwhatshedoesbeforerounds.Followingthistemplatedayafterday,she
has now mastered it and has no trouble with thorough presentations every morning. Find your
routineforthemorning;itwillmakeyourmorningslessstressful.

In general, morning rounds can be very stressful; however, you should see these rounds as
opportunitiesinsteadofastudentroastsessions.Attendingswillsometimespimpyou,butmost
ofthemmeanwell.(Youwillrememberafactmuchmoreifyouaretestedonit.)Andthemorning
roundsarethefewhoursthatyouwillhavetocompletelyWOW!yourattending.Ifyoudobadlyone
day,donotgetdismayed.Rememberthatyoucantakethenextdaytobetteryourpresentationsand
impressthemthen.

Ifyouseethataresidentiskeenonaskingstudentswhattheywouldliketolearnaboutandthen
endsupquizzingyouonthatsametopicduringtheirteachingsessionforyou(thisisverycommon),
useittoyouradvantage.Forexample,learnaboutatopic(letssaybreastcancer)onMondaynight
and then if, on Tuesday, a resident asks you what you want to discuss, you can say breast cancer.
Chancesare,duringhis/herteaching,theresidentwillendupaskingyouagoodamountofquestions.
Thisseemsdeceptive,butactually,theresidentteachingwillbeareviewforwhatyoulearnedthe
nightbeforeandyouwillhaveachancetoimpressyourresidentwithwhatyourememberonthe
topic.

13


Beexcitedaboutlittlethings.Focusonthepositivesandusethisfocustodownplaytheincorrigible
negatives(i.e.toughattendings,unsympatheticresidents,difficultpatients).

Dontstress!Med3isatough,butveryexcitingyear!
Youwillcertainlynotneedthisbut,justincase,goodluck!!!

RobinSnyder
Firstofall,letmebeginwithsayingthirdyearisfun!Likeeverythinginlife,itreallyiswhatyoumake
ofitandwhatattitudeyoucommittohavethroughoutallofitsupsanddowns.ThirdyearisaVERY
differentlifeyoulllearnthatgettingupat5amisnotalwayseasy,butitsdoable,thatdressingup
likeagrownupeverydayisntTHATbad,andthatthewarmfuzziesofmakingapositiveimpacton
peoples lives makes it all worth it. Here are a few things to keep in mind that helped me in my
personallifethroughoutthirdyear
1. PlanningtimeforfunisSTILLjustasimportanttherewillbelesstime(somerotationsless
thanothers)butmaximizingweekendtimefordoingthethingsyouhaveenjoyedfirstand
secondyearisamust.Weekendsarethetimetoreenergizeandrelax(withsomestudying
mixedinofcourse),somakesureyouhavesomefun.

2. Continue to invest in your friendships you have built the last 2 years; in third year it can
becomesupereasytodriftawayfromthosegreatfriendsthatyouhavemade,somakethem
a priority! My group of close friends started doing Sunday dinners; it was a permanent
commitmenttotradeoffmakingdinnerforallofusandcatchinguponlife,nomatterhow
busywebecameorwhatdifferentrotationswewereon.

3. Dont let the cynicism of residents and some attendings seep into your fresh/positive third
year enthusiasm. Residents and attendings are not always wiser than medical students, so
make it a point from day 1 to maintain a positive attitude towards patients, fellow medical
students,residents,attendings,andallothermedicalstaffyouwillworkwith.Itssupereasy
togetcaughtupintalkingaboutaparticularlyannoyingpatientoraresidentthatmightnot
besonicetoothers,butstayingneutralandnotlettingthesethingsgetunderyourskinisso
important.KeepinmindWHYpeoplemayactthiswayperhapsyourresidentisjusthavinga
badday(ormonth),perhapsapatienthasalotofissuesgoingonat home.Keepingthisin
mindwillmakeyoumuchhappierintheend.

4. Therewillberotationsthatwillnotbeyourfavorite.MakeitapointtofindSOMETHINGyou
likeaboutthem,andremindyourselfthatyoucanalwaysfindsomethingtolearnandapplyto
yourfuturecareerevenifitsnotalwayseasytodothis.

14

ClaireTolbert
PavlovsDogsAgreatmodeltosurvivingMed3

Pavlovsdogsandthirdyearmedicalstudentsatfirst,youmightthinkthatImcompletelycrazyand
thatthesetwothingsareinnowaysimilar.Well,spendamonthonthewardsandyouwillbeginto
notice a trend. Reward yourself for good behavior = continue good behavior. Seems like a simple
concept,buthowyouchoosetoimplementitcanbetricky.

Being on the wards can sometimes feel like you are going against your very nature similar to
Pavlovsdogs.WhyintheworldamIwakingupat3:45amtogettothehospitalinordertofinish
preroundsbefore5am?mightrunthroughyourheadduringsurgery.Whyisthisidiotringingabell
andwhyamIsalivating?probablyranthroughthosedogsheads(exceptindogspeak,itwouldbe
woofwoofwoof,woofwoof?).Forme,Ifoundlittletrickstorewardmyselfforsimplethingsthat
madesurvivingthemoredifficultrotationsaloteasier.Wakingupat3:45amsucksnomatterhow
you look at it. However, it sucked a little less for me when I treated myself to a dozen Brueggers
bagelsandhadayummybreakfasttolookforwardto.

FiveRouxenYbariatricsurgeriesinarowisnofun,nomatterhowmuchyoulovesurgery.Makinga
Cherylscookiedatewiththeothermedstudentonmyteambeforeroundsintheafternoongaveme
something to look forward to and got me through some of those cases. Rounding for hours and
gettingmercilesslypimpedbyyourneurologyattendingisneveranenjoyableexperience,soIwould
setagymdatewithafriendforimmediatelyafterworktorewardmyselfwithsomeendorphins.For
me,settingupthiskindofrewardsystemworksverywellifImtenminutesearlyeverydaythis
weekandremembertolookupimagingresultsonallmypatients,IcanbuyanewshirtatTargetor
ifIgetallofmypimpquestionsrightonroundstoday,Icantreatmyselftoafroufrouexpensive
latteatCafOasis.

Idontreallybuyintothepunishingmyselffordoingsomethingwrong,butIdosetupasimilar
mentalsystemifIgetthemajorityofmypimpquestionswrongtoday,Illstayup20minuteslater
todomorereadingtonightorifIforgettogetlabsonmypatient,Illgettothehospital10minutes
earlytomorrow.

Althoughitseemsreallysilly,formesettingupthiskindofmentalrewardsystemhasworkedreally
wellthroughthirdyear.Itencouragesmetostudymore(ifIdo20QBankquestionstonight,Ican
watchanepisodeofDancingwiththeStars),preparebetterforrounds(ifIgetallofmyprogress
notesdonebeforerounds,Icanbuyacoffeeafterrounds),and,allinall,looklikeIknowwhatIm
doingmorethanIactuallydo.So,inshort,doasPavlovdidandtrainyourselftosucceedinandlove
thirdyear.

15

KristineUrban
Med3issomuchbetterthanMed1and2!Itssucharelieftobeoutofthelecturehallsandintothe
hospitalactuallyseeingpatients.Thatbeingsaid,Med3isanexerciseinbeingoverwhelmed.Imnot
sure a single day has passed this year without at least one moment of being completely lost or
lookinglikeafool.Justacceptthatitsgoingtohappen,learnfromit,andmoveon.Weveallbeen
there.Mostattendingsandresidentsreallydowantyoutosucceedandareexcitedtoteach.Utilize
timetostudyduringtheday;residentsdontseemtomind.Thentakethefirstcoupleweekendsof
the rotation and give yourself a study break. Give yourself time off to have fun because youll be
workingmorehoursthanyouknowwhattodowith.

DuaneWang
Thethirdyearofmedicalschoolisextremelyexhausting.Yourelearninganewenvironment,howto
beapartofthewardteam,howtointeractwithpatients,andtonsofnewmaterial;youalsoneedto
study for a bunch of national board exams. On top of that you have a bunch of residents and
attendingphysicianswhoareevaluatingyouandcanmakeorbreakyou.Thereisalotofpressureto
performatthetopofyourgameeverydayandthisisoneofthehardestpartsofmedicalschool.Its
onethingtolearnloadsofmaterialandbetestedonceamonthorweek.Itsentirelydifferenttofeel
thatyouhavetoperformyourbesteverydayandthateverypresentation,topic,orpimpingsession
candetermineyourfuture.Whenstartingyourthirdyear,realizethatitsgoingtobealongslog,not
a sprint. Try to do your best, but know when you need rest. Its impossible to give 100% effort
throughallsixrotations.Asmedicalstudents,weareallhighachieversandwanttodothebestthat
we possibly can. Dont let false expectations push you to exhaustion. Make an extra effort on the
rotationsclosesttoyouranticipatedfuturecareeranddontbeatyourselfupifyouslackabitonthat
onerotationthatmakesyoumiserable.

Inrotationsyoumightnotbeinterestedin,ithelpstobefamiliarwiththegradingcriteriasothatyou
canconcentrateonthingsthatcountmoretowardsyourgrade.Forexample,inyourpsychrotation,
yourgradeisalmostcompletelydeterminedbyyourshelfscore,soconcentrateonthattodowell.In
surgery, there is a very specific breakdown of points awarded for various things like clinical grades
andshelfscores.Makesureyouknowthese.Obviouslythereismoretomedicineandbeingagood
physicianthangradesbutbeingefficientwithyourtimesothatyoucandevoteittotakingcareof
yourselfisalsoimportant.

16

17

18


ElizaBeal
IstartedMed3givingmyselfapeptalkeverymorning:

1. Alwayssmileateveryone,introduceyourselftoeveryone,andsayhellotoanyoneyoueven
faintlyrecognize,everytimeyousomuchaspasstheminthehallway.
Itturnsoutthatifyouarenice,peoplelikeyoumore.Incaseyoudidntrealizethat.

2. Alwayssay,Thankyouforthefeedback!
Whetherthefeedbackgivenwastrulyinsightfulordownrightoutrageous.
Whetheritwasgiventoyoubyanattendingphysicianorapatientcareassistant.

3. Alwaysaskifthereisanythingelseyoucandoandvolunteertodotasksthatattendingshave
assignedtoresidentssuchascallingoutsidehospitalsforrecords,tryingtoconvinceapatient
toeatordrink,orwalkingimagingCDsfromanoutsidehospitaltotheplacewherethosego.
Theresidentswillappreciatethis.
Your relationship with your residents can make a notsofun rotation awesome or a
totallyawesomerotationnotsofun.
Theywillhavemoretimetoteachyouthings.

4. Spendtimewithyourpatients.
Thiswillkeepyousane.Thiswillmakeyourpatientslikeyou.Theyarebored.Youwill
beboredtoosometimes.Thiswillenableyoutohavemoreinformationaboutthem
thananyoneelse.Thiswillmakeyourpresentationsbetteronrounds.Thiswillmake
youfeellikeyouareactuallyparticipatinginpatientcare.

MichaelDiBartola
TemplateforaProgressNote(SOAPNote):

Subjective:
Anyacutechangesfromovernightgohere.Iusuallyalsoprovidesomesortofupdatehere.
Ex:PtLUEweaknessmildlyimprovedthisam.

Objective:
Vitals:neverforgettomentionthevitalsinapresentation.Everyattendingisdifferentabout
whether you can simply say vitals within normal limits or present the last 24h ranges.
IncludeT,HR,RR,Sp02,andBP
Ins/Outs: A lot of times these may not seem accurate in EPICit is always good to ask the
patientiftheyhavebeeneatingandgoingtothebathroom.
PhysicalExam:Detailhereisdependentuponwhatrotationandserviceyouareon.WithEPIC
youcanchooseoptionsfromadropdownmenu.Onlychoosethingsthatyouactuallydo,and

19

 understandwhattheymean.IusuallywouldnotusethedropdownmenusforPE,butthat
wasjustmepersonally.Generallyaddressthefollowing:
o General,HEENT,Cardio,Pulm,Abdomen,Extremities,Skin,MSK,MentalStatus,Neuro
Labs:Listanynewlabs
Imaging:Listanynewimagingstudies

Assessment/Plan:
Alwayshaveaoneortwolinerdescribingthepatientandwhatislikelygoingon.
Then from here, it is service dependent. Some people really like a problems based A/P,
where each problem is listed with a working differential followed by the plan. Others like a
systemsbasedA/P,whereeachproblemislistedunderasystem(i.e.Cardio),andthenthe
planislisted.
IthenliketohaveaDisposectionwhereIbrieflydescribethedischargeplan.Whatiskeeping
thepatientinthehospital?
Finally,alwayssignyournote.

I would definitely also recommend that you get Pocket Medicine. It is a great resource to look
thingsupwhenyoucan'tgettoUpToDate.Itisalsoagreatstudytoolwhenyouhavethoseawkward
10minofdowntimehereandthere.

MatthewFlanigan
Beauthentic!Youareconstantlybeingevaluated,anditsworththeefforttobefriendlyand
enthusiastic even when youre not having the best day. However, be honest about what
interestsyouandwhatdoesnt.Berealandletpeoplelikeyouforwhoyoureallyare.
Dont be competitive with other med students. Youre on the same team! When you help
eachotheroutandlookoutforeachother,everybodywins.Whenyoupickupsomeones
weekendcallwhentheyhaveaconflict,youcanbesurethattheywillhelpyououtwhenyou
needit.
Avoidminimalism.Watchingtheclockalldayturnsyourdayintoawasteoftime.Enjoyyour
rotations for what they are, and take advantage of seeing things that you might never
experienceagain.Also,ifyouputsomerealeffortintoityoujustmightlearnsomething!
Be nice to nurses, scrub techs, social workers, and other team members. Not only is it the
right thing to do, but it will benefit you as well. Nurses especially can fill you in on whats
beengoingonandusuallyhaveinfothatsnotinthechart.Thisalsoimprovescommunication
andleadstomoreeffectivepatientcare.
Whenyouaredoingsomethingforthefirsttime(writingyourfirstH&P,presentingpatients
onrounds,etc),justdiverightintoit.Itwillnotbeperfectthefirsttime,andthatsfine.The
onlywaytoreallylearnhowtodosomeofthesethingsistodothemagainandagain!
Have fun! Med 3 is what you make of it, and the attitude you bring to team makes all the
difference.

20

CassondraMajestic
Alwayslookprofessional.Thismeansyoushouldbesmartaboutyouractionsaswell.Dont
pullyourphoneoutinfrontofanyone,dontsitdownwheneveryoneelseisstanding,andtry
nottoleaveforabathroombreakwhileothersarediscussingpatients.
I have found that one of the most important things on rotation is a positive attitude and a
smile. No one wants to work with a Debbie downer. There will be down time on some
rotations and none on others. Try to bring some type of reading material with you,
everywhereyougo.Youneverknowwhenyoullbestuckwithnothingtodobutwait.
IquicklyrealizedthatitwasbettertonotspeakfactualinformationaboutapatientunlessI
wassureIknewtheanswer,becausemystatementwasusuallyfollowedbymorequestions
thatIdidntknowtheanswerto.
Most importantly, be a team player. Volunteer to do things, and dont sit in the shadows.
Speakyouropinionanddontbeafraidtobewrong.

LindsayMooney
Onrotations,alwaysbehelpful.Watchwhatyourresidentsaredoingandtrytomirrortheirbehavior
from notes to rounds. You will work with many different personalities on your medical teams and
mustbeadaptableandunderstandingofdifferenttypesoflearningandteachingstyles.Alwayshave
abooktoreadstoredawaysomeplace.Therearemanyminutesineverydaythatwehaveavailable
tostudyifwetakeadvantageofthem.Alwaysbesupportiveofthemedicalstudentsyouareworking
with.Youareahugeassettooneanotherandcanbeamajorsourceofsupportthroughoutthedays.
Make sure you all communicate about what your plans are for the day and include your fellow
studentsonimportantlearningdiscussionswithresidentsandattendings.Informationsharinghelps
everybody.Beconfident!Knowthatitisokaytobewrong,andyourresidentsandattendingsreally
dontmindifyouarewrongattimes.Theywantyoutolearnandwanttoteach.Theywantyouto
thinkthroughthingsthoroughlyandhavegoodreasoningbehindwhatyousay.

ChristopherNau
RELAX,RELAX,RELAX.ThisisthemostimportantadviceIcangivetobeingaMed3.Youjusttook
Step1whichisthebestwaytogetreadyforbeingonthewards,andbythispoint,youknowyour
studyhabitswellenoughtodofineontheshelfexams.Realizethateachrotationmaybetheonly
timeyouareonaserviceofagivenspecialtyinyourentirecareer.Evenifitsnotwhatyouwantto
gointo,askquestions,beengaged,andlearnasmuchasyoucanyoullhavemorefunthatway.

Probablythemostanticipatedbutdreadedexperienceisgettinggrilledbyanattending.Youwillget
pimped during the year and, at times, youll look like a rockstar. Other times, youll stand there
awkwardly,mindblank,embarrassedbecauseyouareunabletorememberwhatyoureadthenight
before.Bothscenarioshappentoeveryone.Dontbeatyourselfuptoomuchwhenyoudontknow
ananswer;itsimpossibletoanticipateandcramforeveryquestionyoucouldbeasked.If,aftera

21

minuteortwo,youstilldontknowjustsayso.SomeofthebestteachingIgotduringMed3was
whenIdidnotknowananswer,andtheattendinguseditasanopportunitytoteachnotjustme,but
the entire team, important concepts. If youre worried about how it will affect your evaluation,
rememberthatyourgradeisnotdeterminedbyknowingtheanswertooneortwoquestions.From
mypersonal,anecdotalexperience,clinicalevaluationsarenotalwayseasytopredict;Ivehadless
thangreatevaluationsfromclerkshipsIthoughtIhaddonereallywellonandfantasticreviewsfrom
rotationsIthoughtIbombed(whilethisisntalwaysthecase,itssomethingtokeepinmind).

As to surviving on the wards, just try to be helpful and enthusiastic. Being a medical student with
littleexpertiseoftenmeansthatthereisnotalotyoucancontribute.Dontfeelguiltythatyoudont
alwayshavealottooffer;youremostlytheretolearn.Onthefirstdayofanewrotationitsalways
usefultoasktheresidentswhattheirexpectationsofyouare/whatyoucandotohelpout.Knowing
yourpatientschartreallywellcanbeahugehelptotheteam.Besidesmakingyourselflookgood,
knowingthatcrucialpartofthehistoryorlabresultwhentheinternorattendingforgetsitcanhelp
rounds move faster and smoother. That being said, making phone calls, obtaining outside medical
records,followingupontestresultsetc.areallwaysyoucanhelp.Somepeopleseethisasscutwork,
butifitsajobthathastobedonebysomeoneandyoureabletodoit(andfreeuparesidenttodo
somethingthatyoucantdo),thenyourejusthelpingtheteambeefficient,whichistothebenefitof
everypatientontheservice.

KatherineNotter
Figuringoutwhatsexpectedofyouonthewardswillprobablybethetrickiestpartofyourthirdyear.
Youmighthearthatyourexperienceisveryresidentandteamdependent,andthisistrue,butyou
canmakeanyexperienceagoodonebybeingpreparedandcontributingtotheteam.Therestofthe
teamwillreallyappreciateit,anditshowsinevaluations.

Therearereallygoodappsoutthere(alotofthemfree,too)thatcanhelpyougetquickinformation,
but attendings really appreciate the old school method of reading journal articles about patients
diseasesandtreatmentsandcitingthemduringrounds.Alsorememberthatyourtimeonthewards
isntjusttimetoshowwhatyouknow,butalsohowmuchyoucare.Gotheextramileforpatientsif
you can, like looking up diabeticfriendly cookbooks or glutenfree recipes for patients with new
diagnoses.Anylittlesmallthingyoucandowillreallymeanalottothepatientsandtheirfamilies.

RobinSnyder
1. Thermostatsinthecallroomsareadjustablefreezinginthecallroomsisnotarequirement.
2. Packingalunchissoworthityousaveawholelotofmoney,itshealthier,anditgivesyou
moretimetorelaxinsteadofstandinline.
3. Beefupyourprofessionalwardrobeaheadoftimethose2gotooutfitsforOSCEsduring
Med2dontquitecutitwhenyouhavetodressupeveryday.

22

 4. Having2whitecoatstorotatethroughwasSOhelpfultheygetreallynastyevenjustaftera
weekIfthemedschoolisnthavingasaleonthem,youcanorderanextraoneonlineand
takeitintogetembroideredon5thfloorscrubroomwhereyougotyouroriginalone.
5. Comfortableshoesareinvaluabletherewillbetimesyouwillbestandingforhoursonend.
Supportiveshoes,asGrandmalikeadviceasitsounds,werereallynicetohave.
6. Alwayshavingabookinyourpockettostudywhenyouhaveafewminutesreallymakesyou
moreefficientandgivesyoulesstodowhenyougohome.
7. InvestinalotofreallycheapblackpensIseemtogothroughlike3pensaweek
8. Itsokaytobewrongwhenyouarepimpedandyouwillbewrongmanytimessojustbe
confidentinyourbestinformedguess,andactenthusiastictolearntheanswerwhenyoure
wrong.Youprobablywontevergetitwrongagain.
9. Overestimatingthetimeittakesyoutogettoyourrotationisalwaysagoodideabeinglate
isabignono.
10. Dont get too caught up in grades (honors, letters, etc)you will find that grading is very
subjective, some attendings/residents will like you a lot, and some people will just give you
average no matter how hard you workso just stay focused on studying for the shelf and
learningfromyourpatients,andeverythingelsewilltakecareofitself.

PanktiShah
Take ownership of your patients. Get really involved in each patient as if he/she was your
own. Pretend that you are personally responsible for that patient throughout his/her care.
You will be that much more engaged in the patient and you will feel that much more
motivatedtodoyourbestinthepatientcare.
Beenthusiastic.Residentsandattendingsappreciatestudentsthatarezealousaboutlearning
abouttheirspecialties.Theywill,inreturn,bethatmuchmoreenthusiastictoteachyou.
Donottalkoveranotherstudent.Donotstealanotherstudentspatients.Generally,respect
yourclassmatesandhelponeanother.
UseUpToDateoften.

MalorieSpunger
Congratulationsoncompletingsecondyearandgettingreadyforstep1androtations!Iknowthese
nextfewmonthscanbeoverwhelming,anditsnormaltobenervous.Thebestthingyoucandoisbe
positiveandgetexcitedforthirdyearlikeeveryonesays,itreallyisMUCHbetter.Youvelearned
somuchinthelasttwoyears,anditssatisfyingtoapplyyourknowledgeandseehowwhatyouve
spenthourslearningactuallymatters.Herearesomewardtips!

1. Beateamplayer.Helpoutyourfellowmedstudentsandnevermakeanotherstudentlook
bad. Residents and attendings notice this. Answering questions directed to another student
does not make you look better. If you hear an update about another students patient, let
themknow.Determinewhattimeyouwillallarrivetopreround(surgery),anddontshowup
earlytodomoreworkthantheotherstudents.DivideORtimeevenly,andtakeoneforthe
teamoccasionally.Taketurnspickingupthecomplicatedpatientorgoingtothelongsurgery
case.

23


2. Payattentionduringroundsevenwhenitsnotyourpatient.Evenifyourenotinterested,
forceyourselftopayattentionbecauseitshowsthatyouarerespectfulofyourteammates
and that you care. You also may be asked a question related to a patient thats not yours.
Makesureyourphoneisonsilent!

3. Beenthusiastic.Simplysmilingonceinawhile,evenifallyouwanttodoisgohome,willgoa
long way. Show interest, even if youre not. You can do this by helping the resident make
phone calls (to the lab, outside hospitals for transfers, etc.), asking questions about a
case/patient if the resident isnt too busy, and offering to pick up another patient. Ask to
follow your patient down for proceduresthis shows interest and helps you be more
empatheticandunderstandingofwhatpatientsgothrough.

4. Asktheresidentstoexplaintheirexpectationsforyouthefirstday.Atthebeginningofeach
rotation,youwilllikelyfeelalittlelostandunsureofwhatyoushouldbedoing.Justaskat
the very beginning so its clear what is expected and that you can be helpful to the team.
Youllalsoprobablyfindtimeswhenyourefollowingaresidentaroundandfeellikeyourein
theway,buttheywillletyouknowifyouare.Justbecarefulnottofollowaresidentintothe
bathroomyes,itseasytodoandcanbeawkwardbutfunny.

5. Lastly, have FUN! This is a time when youre not expected to know everything youre
expectedtolearn,sohavesomefunexploringthedifferentfieldsofmedicine.Itsalsogreat
togettoknowclassmateswhomyouhaventinteractedwithmuchbefore.

KristineUrban
Work hard! Yes, youre paying to be there and learn, but nothing looks worse than a lazy med
student. Even if you think that this is a rotation you have no interest in, you might be surprised. I
endedupwantingtodotheonespecialtythatpriortoMed3,IwassureIwasntgoingtodo.Evenif
youdontendupchangingyourmind,therewillbethingsineveryrotationthatyoutakeintoyour
career.

Also,ittookmeawhiletobelievethatpeoplewantedreallyformalpresentations.Takethetimeto
reallyknowtheorderofanH+PpresentationandaSOAPnotepresentation.Itsnotjustformaltobe
formal, but people are used to hearing information in a certain order so that they can process it
quickly. That being said, each attending and resident is going to want something slightly different.
Knowthelargerstructure,andyoullquicklylearntotailorittowhattypesoflabvalues/historythey
wanttoknow.

24

25

26

ElizaBeal
IfoundthatthebestapproachtostudyinginMed3wastostudyalittlebiteveryday.Fiveorten
pagesadayaddsupquicklyoverthecourseofarotationandcanmakeabigdifferencewhenshelf
time comes around. In addition to the USMLE World QBank for Step 2 CK, which I used all year, I
foundthefollowingresourcestobehelpful:

Surgery
o NMSCaseFilesisthemostimportant.
o PreTestSurgery
o NMSSurgeryisausefulreferencepriortogoingtotheORforrelevantanatomy,howa
procedureisperformed,whatalternativeoptionsmayhavebeen,etc.
o SurgeryRecallisgoodtocarryaroundonthefloorforreferencepriortogoingintoa
specificcase.
o AccessSurgerywasveryhelpfulforgeneralsurgeryandgeneralsurgerysubspecialties
ifyouwanttoreadaboutrelevantanatomyandspecificallyabouthowaprocedureis
actuallyperformed.
ObGyn
o BlueprintsObGyncontainsalloftheinformationyouneedtosucceedontheshelf.
o CaseFilesObGyn
o Payattentioninlectureandonthewards!!!Therearealotoflectures.Youwilllikely
seealmosteverythingthatyouwillbetestedon.
InternalMedicine
o StepUptoMedicine
o PreTestMedicine
o CaseFilesMedicine
o They will give you a textbook book and a question book at the beginning of the
rotation.
Psych
o FirstAidPsychiatrywassufficientbyitself.
o PreTest Psychiatry has a lot of irrelevant stuff about human behavior and
developmentbutisotherwisehelpful.
o CaseFilesPsychiatryisavailableinPDFformforfreeonline.
Neuro
o BlueprintsNeurology
o PreTestNeurology
o CaseFilesNeurology
o Thehandoutstheygiveyouaneuroreview,questions,localizationhandout

27


Pediatrics
o BlueprintsPediatricsisacommonlyusedandcommonlycomplainedaboutresource.
o PretestPediatrics
o CaseFilesPediatrics
o Payattentioninlecture!Payattentionontherotation!

Many, if not most, of these books are available in their most recent addition, Used, but actually
new,onAmazon.comformuchlessthantheirbookstoreprice.Mostofthemcanalsobepurchased
atanyBarnesandNoble.

JohnBernot
Theonethemethatyouwillhearrepeatedlyisthatyouneedtostudyfor1hourpernight.Thisisa
greatruletoliveby.Itmaynotbepossibleeverysingleday,butmakeasolidefforttoadheretoit.
This will help you to be ready when the ShelfExam rolls around. Beyond that advice, you may be
wonderingwhattodowiththehour.Inmyexperience,theansweristhat"itdepends.Pleaseallow
metoelaborate.

Bythetimeyougettothirdyear,youwillhavesuccessfullycompletedyourStep1examination.I
would recommend that you reflect back to those days and determine what worked best for you
duringthatprocess.TheShelfExamquestionsareverysimilarinstyletotheStep1questions.Did
youlearnmorefromreadingatextbook?DidyoulearnmorefromtheUSMLEquestionbanks?Do
yourequireacombination?Itisworthtakingsometimetothinkaboutthisasyourstudytimeisvery
limited. You need to do what works best for YOU. You will receivegreat advice about which text
booksworkbestforeachrotation.Itisworthwhiletousethosebooks,butmakesureyouusethem
inawaythatfitsyourstudystyle.

With my learning style, I do better with cases or questions. I still find great value in "textbook
reading"aslongasitisrelevanttosomethingthatIamactivelyseeking.Iampersonallynotgoodat
pickingupatextbookandreadingchapterafterchapter.Manypeopleare,butIamnot.Hereiswhat
workedbestforme.Duringtheearlypartsoftherotation(normallythefirst34weeksofa2month
rotation),IwouldtrytospendanhouratnightreadingupontheconditionsthatIsawinmypatients
thatday.ThisreadingmaybefromBlueprints,FirstAid,UpToDate,etc.Dependingonwhatservice
youareon,thismaybeawidevarietyofconditionsoronlyoneortwo.Iwouldthenroundoutmy
hourbyreadingadditionalcasesfromCaseFilesordoingquestionsfromeitherPreTestorUSMLE
World. As the rotation progressed, I would normally see less variety, and my hour would become
evenmorequestionheavy.IwouldalsousethistimetomuddlethroughchaptersonconditionsthatI
havenotyetseen(buthopefullyhavereadacaseonorheardaboutinlecture).Forthelast2weeks,
Iworkedexclusivelyonquestions.IalsomadenoteofallquestionsthatIgotwrong.Duringthelast

28

few days, I would go back and review the questions that I missed. I made sure that I knew the
teachingpointandthatInowunderstoodtheanswer.Alsoofnote,donotbediscouragedifyouare
onlygetting6070%onsomequestionsets.Thisisallpartofthelearningprocess.

In closing, be confident that you know your style best. Do not be concerned if the other students
havereadseveraltextbookchaptersandyouhaveonlydonequestions.Ifyouareputtinginasolid
houreachnight,youwilldowellontheexam.Trustinyourcapabilitiesandrememberthatyouhave
theappropriateeducationtosucceedoneachandeveryrotation.Goodluck!!!

BethanyBrisbin
IM:Youaregivenatextbookandaquestionbook,althoughmostpeopleuseStepUpto
MedicineandaQbank.
FamilyMedicine:GivenPreTest,doAAFPquestions
ENTselective:Givenbook
OB/GYN:Blueprintsforreference,CaseFiles
Peds:Blueprintsforreference,CaseFiles
Psych:FirstAidPsychiatry,PreTest
Neuro:Blueprints,PreTest

Ofallthereviewbooks,IlikedCaseFilesthebestandfoundthistobegoodprep.It'salsogreattouse
Qbank questions to help prepare for each rotation and Step 2 CK throughout the year. Of course
peoplewillsaystudyalittlebiteverydaysoyoudon'tcramforshelfexams,butforsomethismay
notberealistic.Thefirstweekofanewrotationmaybeeventwo,mymotivationforstudyingwas
pretty low. Do the best you can to keep up with readings/questions, but most importantly know
yourselfandhowyoustudy/learnbestandmaintainthatinMed3.Bestofluck!

MichaelDiBartola
JustlikeStep1,findwhatworksforyouandstickwithit.Therearemanywaystostudyfortheshelf
exams. I usually used something for foundational knowledge like Blueprints and/or Case Files and
then hammered questions. For questions, I used PreTest or questions provided by the clerkship.
OthersusedUSMLEworldandfoundthistobehelpful.Itypicallytriedtostudy12hoursadayas
well as take advantage of free time during the day. Good luck! Never hesitate to contact me with
questions.

29

LaurenGraham
Congratulations on surviving boards and making it to Med 3 (finally!). Here are a few pearls and
studytipstohelpkeepyouintheknowduringyourthirdyearrotations.

SuggestedStudy
Rotation TipsforSuccess
Materials
Surgery Dontbeafraidtolooklostandtellthescrubtechs(who NMSSurgerydidnt
willbegowningandglovingyou)abouthowyoudontquite readitcovertocover,
knowtheropesyet.Theycanbeagoodresourcefortips justuseditfor
onORetiquette.Alwaysletyourresidentsandattendings reference
getgownedfirst.Ingeneral,donttouchANYTHINGexcept NMS
thepatient(afterhe/sheisgownedanddraped)andyou PreTestSurgery
willbelesslikelytocontaminateyourself. UWorldSurgery
Questions
SurgeryRecallNOTas
testpreparation.Carry
inyourpockettobrush
uponpimpquestions
thatyouwillbeasked
duringyourORcases.
Pediatrics Thisisafunrotation!Trytobeplayfulwiththekids.Keep BlueprintsPeds
stickersinyourpocketstogivethemwhenyouseethemin PreTestPeds
themorning.Stopbyintheafternoontoplaywiththemif CaseFilesPeds
youdlike.Makesurethatyouretheonekeepingthe UWorldPeds
parentsintheloopontheplanfortheirchildren. Questions
Family Experiencescanbeveryvariableonthisrotation.Doalittle ThisexamisVERYbroad
Medicine bitofresearchintowhatyourpreceptorspecializesin(if andhitormissasfaras
anything)sothatyoucanbesureyougetagoodbread coveringallofthe
andbutterfamilymedexperiencewhenitcomestimeto materialthatcouldbe
preferencesites.Offertodoanythingandeverythingyou asked
cansoyoucanhoneyourphysicalexamandprocedural CaseFilesFamilyMed
skills. PreTestFamilyMed
AAFPonlinequestions
becomeamemberfor
freeandusetheboard
reviewquestionsonline
Internal Ifyouhaveachanceinthemorningsbeforerounds,tryto StepUptoMedicine
Medicine gooveryourpresentation,assessmentandplanwithoneof UWorldMedicine
yourresidents,soyoucanlookstellarpresentingduring questions
rounds.Trytolookupalittleaboutthediseasesor MKSAPquestionsto
conditionsyourpatientshave.Dontbeafraidtovolunteer brushuponanytopic
togivealittletalkonsomethingyouvedonesome youfeelyouneedto
researchon.

30

 Psychiatry/ UsethisrotationaspracticeforreadingheadCTsandMRIs. PreTestNeuro

Neurology Trytohoneyourfullneurologicexamandlearnhowtotake CaseFilesNeuro
athoroughpsychiatrichistory.Studying/shiningonpsych BlueprintsNeuro
becomesALOTeasierifyoumakeitapointtomasterthe UWorldNeuro
names/uses/sideeffectsofthepsychiatricdrugsearlyonin questions
therotation.
FirstAidPsychvery
good!
PreTestPsych
CaseFilesPsych
UWorldPsych
questions
OBGYN Haventdonethisyet

LaurenMadigan

ROTATION STUDYMATERIALS TIPS

InternalMedicine StepUp to Medicine The amountofknowledge required
CaseFiles forthisshelfisextensive.Start
MKSAPquestions(provided) studyingearlyandbediligent.This
isonerotationwhereitisdifficult
tocatchupifyougetbehind.
Surgery NMSText Book The NMS textiswonderful but it
FirstAid:Surgery takesalotoftimetoreadthroughit
SurgeryRecall fully.SurgeryRecallisaMUST
CaseFiles whenpreparingforacaseintheOR
PestanaReview andIfoundithelpfultoprintoff
CaseFilescasesandcarrythemin
mypocketforuseduring
unexpecteddowntime.
Pediatrics Blueprints Pediatrics I like the combinationof Blueprints
FirstAidPediatrics (whichprovidesdetailandcontext)
CLIPPCases(provided) andFirstAid(whichisaquick
reviewwithbulletpoints).Also,
dontsimplyhurrythroughthe
CLIPPcases.Ifoundthemtobe
fairlyhighyieldforthewards.
OB/GYN Blueprints OB/GYN Blueprintsisagreattext for this
FirstAidOB/GYN clerkshipandisveryhelpfulwhen
CaseFiles preparingfortheoralexamination.
ACOGQuestions(provided) TakeadvantageofACOGquestions
astheycovertopicsthatarent
addressedinmanyofthereview
texts.

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ChristinaMartin
Studyeverynight.That'swhatIwishIhaddonedifferentlyforsomepastrotations.Shootforatleast
anhourifnotmore.AlsouseUpToDatewhileonthefloorsorinclinic.Itisagreatresourceandwill
fillyouinondetailsthatcanbehelpfulwhentakingcareofyourpatients.Iusuallywouldgetareview
book and a question book. I also bought the year subscription to USMLE World Qbank which is
extremelyhelpful.ThereisnowaniPodappsoyoucantakequestionsandreviewthemonthego,
whichI'vealsofoundusefulwhenIdon'thavemycomputer.Also,Iwouldn'trecommendbringing
yourcomputertothehospitalunlessitwillbeinasecuredplace.BringstudybooksandyouriPod
instead.

FamilyPracticeIusedthePreTestquestionbookandCaseFiles.Thistestspansagreatdeal
ofmaterialandwaschallengingbecauseIhaditfirst.

NeurologyandPsychiatryIusedBlueprintsandPreTestforNeurologywhichweregood.For
PsychIusedFirstAidforPsychiatryandsomeQbankquestions.

InternalMedicineIusedStepUptoMedicineandLangeQ&A(whichwasokay,butIwishI
had used my Qbank instead. I feel the Lange Q & A are not quite set up like USMLE style
questions). I would definitely recommend using the MKSAP or Qbank questions to prepare
forthisonesinceit'schallengingaswell.

Pediatrics I used Blueprints Pediatrics in combination with BRS Pediatrics (which I loved!)
BRSisalittlelongerbutitssemioutline/paragraphstylewaseasierformetoreadandithas
great tables, as does Blueprints. I just didn't like the prose writing style of Blueprints. The
CLIPPcasesarealsoadifferentwaytolearnsomeofthematerial.Theyhavesomepictures
whichareuseful(especiallythedermatologyandrashcase).

Surgery and OBGYN no advice yet for review books. Crank out your anatomy atlas and
textbookforpreppingforsurgeries.You'llneedtoreviewtoknowwhat'sgoingonduringthat
day'scases.YouWILLbeaskedquestions.

Goodluck!

JacquelineRoth
StepUpTo MedicinewasthebestresourceIusedallyear.Iwouldbuyacopyatthebeginningof
thirdyear,evenifInternalMedicineisnotyourfirstrotation.Itprovidesinformationaboutvarious
diseaseprocessesinabulletedformatthatallowsyoutoquicklyreviewthefinerpointsthatyoumay
have forgotten along the way. Throughout the year, I would use it to review details of a patients
comorbiditiesbeforerounds,ortostudywhenIhaddowntime.IamsofamiliarwithitnowthatI
thinkitwillbeagreatwaytoreviewmaterialforStep2.

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JavedSayed
Ithinkthekeytosuccessinthirdyearisfiguringouthowtostudy.Havingtherightstudymaterialto
prepare for shelves definitely makes exams a lot more manageable. To that end, I hope you find
thesetipshelpfulasyougointoyourthirdyear.

1. Most students will use one or two resources for a rotation: one prep book to teach the
material and another to go over cases and/or questions. That way you learn how to apply
informationyoulearnedtoclinicalsituations.IusuallyusedacombinationofBlueprintsbooks
and Case Files books. The exceptions were psychiatry (First Aid for Psych read twice) and
InternalMedicine(Stepuptomedicine+Qbank).
2. StudyTips:Readaboutyourpatients.Beingabletorelateinformationtoapatientmakesit
mucheasiertoremember.Also,you'llhearthisoverandoveragain,butstartstudyingearly.
Shelvesareprettytoughexams,andthesooneryougetstartedthebetteroffyou'llbe.Tryto
makeapointtostudyatleastoneortwohoursadayandyou'llbewellaheadofthegame.

AnneSiegel
Congrats!! You made it to the fun part! However, now that you will be starting the next phase of
medicalschoolyouwillhavetoadjusttoanewwayoflearningandchangeyourstudyinghabitstofit
aroundafullworkday.SometipsthatIcanpassalonginclude:
USEanydowntimeduringthedaytogetsomestudyingdone.Atabusynursesstationorin
a noisy conference room, I found it easier to use a question or case study book because I
foundIcouldlearnafewfactsinbetweengettingdistractedwithanewtask,aquestionfrom
someoneontheteam,oraconversationaboutwhateverTVshowwasonthenightbefore.
Also, if you dont have anything to study with you, you always have UpToDate available at
yourfingertipsoneverycomputer.
Tryyourbesttostudyfromthebeginningofarotation.Evenifitsjustfamiliarizingyourself
withthenewlingo/abbrevsthatseemtocreepupwitheachnewservice,itwillgoalongway
ifyoustayontopofthingsfromthebeginning.
If/whenyouhavearoughday,youreveningmaybebetterspenttryingtoshakeitoffor
refreshingyourselfsoyoucanbeanallstarthenextday.
Sharebooks/resourceswithyourfriends.Iboughtbooksformyfirstrotationandhavebeen
abletoswaporborrowmostoftheotherbooksIhaveneededthisyear.
Donotputoffclerkshiprequirements.IfyouarerequiredtoturninacertainnumberofH&Ps
orcompleteonlinequizzes/casesgetthemdoneearlyintherotationsoyoucandevoteyour
timeduringtestweektostudying.

Resources:
Neuro:BlueprintsandPreTest
Psych:FirstAidforPsychiatryandPreTest
Peds:BlueprintsandCaseFiles

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 Surgery:NMSCasebook,Pestanareview,Surgeryrecall(forquickreferencenotSHELF
studying),andwww.accesssurgery.com(availablethroughPriorswebsite)toreadabout
specificsurgeriesinordertoprepareforORpimping
OB/Gyn:BlueprintsandCaseFiles
Internalmed:StepUptoMedicine,MSKAPquestions,CaseFiles

GoodLuck!Feelfreetocontactmeatanne.siegel@osumc.eduwithquestionsandIlldomybestto
help!

PanktiShah
Overall,makesuretogothroughthesourcesyouwantto,butmostimportantly,savetimefor
review!Lookingatmaterialonetimewillhelpyoulearn,butlookingatitagainandreviewingwill
solidifyitandhelpyourememberwhatyoulearned.
Surgery:
o UsePestanasreviewtoskimatthebeginningoftherotationandtoreviewintheweekbefore
thetest.
o NMSCasebookisveryuseful.
o UsePreTesttopracticequestions.
o Makesureyouunderstandindicationsforsurgery(mosttimes,surgeryisnotnecessary).
FamilyMedicine/Ambulatory:
o CaseFilesarehelpful.
o Generally,studymaterialsforthistestarenotamazing.
o Thetestisverybroadand,personally,IfeltlikeIwastakingStep1again.
o Topicsthatarecommononthisshelf:Ob/Gyn,ENT,andDerm
Pediatrics:
o Blueprintswasagreattextbookifyoulearnwellfromtextbooks.
o PreTestquestionswereveryhelpfulandparalleledalotofquestionsfortheshelf.
o TheonlinePedsCLIPPCasesareveryhelpful.Trytodothemearly(firstmonthofrotation)if
youcan,soyoucanlearnfromthem.Theycanbeanuisanceifyouwaituntilthelastminute
todothem.
InternalMedicine:
o Knowntobeaverydifficulttest.
o Youwillbegivenasupplementalbook,MKSAP,fromtheIMcoursewithquestionstrytodo
allofthosequestions.
o IMquestionsonUWorldQBankarealsoincrediblyhelpful.
Ob/Gyn:
o Ihaveheardthatyouwillbegivenasupplementalcoursebookinthisrotationwithquestions,
andthatitishelpfultodoallofthesequestions.
o IhavealsoheardthatCaseFilesisamazing.
o IheardthatUWorldQBankisalsoincrediblyhelpfulfortheshelf.

34


RobinSnyder
ThebiggestthingIfoundhelpfulwasmakingastudyscheduleatthebeginningofarotationtokeep
myself on track; I would figure out which books I wanted to get through, divide up the number of
pages/week,andthenmakeacheckofflisteachweek.Youcanalsosavealotofmoneyonbooksby
buying one set of books for your first rotation then trading with your friends for the rest of the
rotations.

Rotation Book/ResourceIused MISCtips

Surgery NMScases Forthoseofyouwhoarent
NMStextbook interestedinsurgeryandare
o notveryhelpfulcanuseasareferenceif dreadingthisrotation(asI
youneedit was)ITSNOTTHATBAD
PreTest
o questionsareharderthantheactualshelf
questions,butIlikedtheformatofthe
questions
SurgicalRecall
o justusedforlookingupcasesthenight
beforetoprepareforpimping
USMLEQBankallofsurgeryquestions
o Someofthequestionsfromtheshelfcame
rightfromtheQbank(espthequestions
ontrauma)
Neuro Blueprints IdidmyrotationatChildrens,
o Densebutwasaniceoverviewtodo andallIbasicallysawwas
nearthebeginningoftherotationbefore epilepsy(whichisaverysmall
doingquestions partoftheshelf).Ifyouhave
PreTest theoptiontodotherotation
CaseFiles elsewhereevenifyouare
USMLEQBankallofneuroquestions interestedinPedsitwillmake
theshelfmucheasier.
Psychiatry FirstaidforPsychiatry Becausetheneuro/psych
o Iwentthroughthisbooktwiceonce rotationhastwoshelves,I
graduallythroughtherotation,thenonce plannedmyschedulesoIgot
allthewaythroughtheweekoftheshelf throughalltheneurobooks
PreTest duringneuroandpsychin
CaseFiles psych.ThenIreviewedthe
o CaseFileswaskindofredundantafterPre materialIdidfromthefirst
test,probablycouldhavedonewithout monthduringtheweekbefore
oneofthem thetest.Ihadtoplanmytime
USMLEQBankallofpsychquestions efficientlytomakesureI
coveredbothsubjectsandnot
getbehind.

35

 Internal StepUptoMedicine
Medicine o Boringtogetthroughbuteverythingyou
needtoknow
MKSAPQuestions(theygiveyouthisbook)
o Didafewofthesequestionsnoneedto
readthetextbook,IlikedQbankquestions
better
USMLEQbankallmedicinequestions
o ThereareALOTofquestions,butIdivided
theseequallythroughoutthe2months.
Itsalottogetthrough,butIfounditvery
helpful.
Family PreTest(theygivethistoyou) Thiswasoneofthehardest
Medicine CaseFiles shelvesforme,anditwashard
AAFPquestionsonline(allofthem) toprepareforbecausethe
StepUpAmbulatory subjectissobroad
o NOTthathelpfulformeyouprobably
couldskipthisifyouareusingadiff
resource
Peds PreTest
CaseFiles
USMLEQbankallpedsquestions
OB Haventhadthisrotationyet

KristineUrban
Unfortunately you really do have to study for most shelf exams. You wont be able to absorb
everythingfromjusttherotations.Idbuyacompletesetofbooksfor1or2rotationsandthentrade
withfriends.Thelikelihoodthatyoullallbeonthesamerotationatthesametimeisprettylow.I
usedUSMLEWorldquestionsfor mostrotations.Blueprints,CaseFilesandPreTestarehelpfulfor
mostrotations.ForSurgeryeveryonewilltalkaboutthe2NMSbooks.DONTusethethickerone!Itll
justboreyouandyoullnevergetthroughanything.TheNMSCasebookisgoodenough.Trackdown
a copy of the Pestana review and use Case Files on accesssurgery.com. Accesssurgery.com is really
helpful for looking up the specific procedures that youre going to be seeing each day.
Accessmedicine.comisagoodresourceforIMrotationquestions.

36