One thing I have learned from my rotations is that running on too little calories is the quickest way to become miserable. Rounds will seem to last longer, and soon you will be thinking about how you wish you were anywhere else but here. If you are very unlucky, you might be in a surgery and start to feel lightheaded and have the strong need to sit down because there’s a chance you might fall forward and break the sterile field. Thereby angering the scrub tech, the resident, and the surgeon which is the last thing you want to do in your miserable state. Some rotations are more energy intensive than others simply because of all the walking you have to do. The best way to prevent this is to snack while you can. It doesn’t always have to be the healthiest snack, but some form of calories is bet- ter than no form of calories. During my surgery rotation, I accepted that I never knew when I would be able to get lunch so it was just easier to wolf down a granola bar and continue working. I also bought Ensure because sometimes it is a lot more convenient to drink your calories than eat your calories. This was especially true when I was on call. Hydration is also incredibly important even if it does lead to times when you really want to go to the bathroom, but there is no convenient time during rounds. So pee when you can. Drink when you can.

One of the first things Dr. Bernard taught me was that you will take out as much from your rotations as you put in, and it is very easy for medical students to fade into the background, so you need to show initiative. This advice has served me well not only in surgery, but also in other rotations. Assert yourself. Ask questions when it is a good time. There is a lot you can learn from residents if you just take the time to ask. You also look more impressive because you show that you are eager to learn and that you care. Also, you can learn from a resident’s experience because there are somethings that you just can’t learn from a textbook. Showing initiative can also ingratiate yourself with the surgery techs, and they can help you look more impressive to the team by telling you ways you can subtly help out during the operation.

As a medical student, you will have more time compared to residents so what you can do is show that you are a team player by helping the residents when you are free. There are many ways to do this. See patients in the afternoon and ask the residents if they want you to check on their patients as well. For some surgical services, have wound supplies ready. This will make rounds a little more efficient because you or the nurse will not have to search for supplies while the team is seeing the patient and their wound. Update patients’ hospital courses. In a separate article, I will describe ways to write a hospital course. When you take the time to do this, it makes the resident’s life easier because they can simply edit what you wrote, which saves them time as they don’t have to write it from scratch. Also, it will make your life easier because if you are caring for a patient who has been in a hospital for a while, by updating the hospital course almost every day, you will save yourself the headache of trying to figure out what happened to the patient from the first day they were admitted all the way to present day. If you are working with the orthopedic team, help prepare the patient before the surgery and help clean up the OR. In psych, you can volunteer to call collateral.

This is a very important thing to do, and it is also a very hard thing to do. You are working in a new environment so you are bound to make mistakes, and that is fine. Everyone wants to do what is best for the patient, and you are only human. All you have to do is work to the best of your ability, and if it is something you can improve on, then take the time to figure out how to improve. If it is not something you can fix, acknowledge it and move on. One example of this is during laparoscopic surgeries. As the medical student, you get the role of manipulating the camera, which is terrifying because you don’t get a lot of experience with this in M1 and M2. The surgeon might get upset that you aren’t doing a good job, and that judgment might hurt a lot, but sometimes you need to give yourself credit for trying. You did something to the best of your ability with the limited experience you had prior to this surgery. You will get better with manipulating the camera, and you can take some time later to figure out how to improve your skills. But you did the best you could with the experience and knowledge you had. Another example of this is when you present your plan on rounds. It can be very discouraging when you suggest a plan, and then the attending proceeds to eviscerate your plan. It feels even worse when they do this in front of the patient during bedside rounds. Forgive yourself for making mistakes. You did the best you could with the knowledge you had. Learn from the mistakes you made, and next time you can proudly present a better plan when you have a patient with a similar problem.

I can only speak to what I did to study for Shelf so take my advice with a grain of salt and change it to best help you. I tried my best to finish all the associated UWorld questions for a rotation. I was not always successful with this. Sometimes I was not even close to finishing all the questions. Initially, I tried to do a block of 40 questions each day. That did not always work out well because by question 15, I would lose steam and want to give up. So, I adjusted to doing blocks of about 20 questions. Even then, there were days when I couldn’t even finish a block. I would try to keep the blocks pertinent to an organ system or a specific topic within an organ system since I viewed Uworld as a learning tool, and then take notes on the mistakes I made. It can be discouraging to see scores < 50% on UWorld, but it’s fine since Uworld is meant to be a learning tool rather than a testing tool. I would learn new content from OnlineMedEd and Emma Holliday. OnlineMedEd has great videos that average around 20 minutes or less about important topics. They even provide a possible schedule to watch videos. You will have to adjust this schedule because the length of a rotation was often different from how long OnlineMedEd thought a rotation would be. I would also do OnlineMedEd cards from AnKing’s deck to help me retain information from the videos. For Emma Holliday, I would read her PowerPoints and quiz myself with a premade Anki deck . So go forth and enjoy your third year of medical school. You will make mistakes and sometimes things will feel awkward. You will have growing pains. But overall, you will learn so much. And hopefully, my advice makes your life a little bit easier.