Many medical students just starting their fourth years are coping with specialty-specific electives and sub-internship rotations. What are the tricks to making a good impression during these clerkships? Here’s a piece I wrote on how to succeed in your emergency medicine rotation; many of the tips translate to other specialty rotations as well.
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I had a thoughtful advisee years back who told me about an interesting plan she had made for herself: As she rotated through different specialties during medical school, she read a book appropriate to each field. For internal medicine, she read “Being Mortal,” by Atul Gawande. For neurology, she read the classic “The Man who Mistook his Wife for a Hat,” by Oliver Sacks. For surgery, she read “When Breath Becomes Air,” a beautiful book by Paul Kalanithi. The list goes on.
I was impressed by this contemplative approach to third and fourth year. So many of us are understandably focused on Shelf Exams and letters of recommendation that we don’t give ourselves a chance to comprehensively reflect on our subject matter and patients’ experiences.
If you have a moment, please check out a few book recommendations I have for those in the medical field. Perhaps my advisee’s stellar plan can be one that other medical students adopt. (You’ll see that I strongly recommend Cutting for Stone. Dr. Abraham Verghese has a new book out that I’m reading right now called The Covenant of Water.)
Just a reminder for residency applicants: ERAS tokens are now available for IMGs, and all residency candidates can start registering and submitting supporting documents on the myERAS website. Even if you aren’t ready to start working on your application, I’d recommend registering and taking a look at what will be required of you.
Additionally, I suggest you begin researching programs now, if you haven’t already. Residency Explorer allows you to compare your candidacy to those of applicants who have successfully matched to specific residency training programs in the past. You can also search the American Medical Association’s FREIDA database.
Getting started early will help you develop confidence and a strong plan of attack for the upcoming application season.
For many third-year med students, this is a challenging time of year. Preparing an ERAS can be daunting, but it’s even worse if you don’t know what specialty you want to practice. Here’s a short piece I wrote with my colleague David Presser MD MPH called “Choosing a Specialty: The Generalist vs. The Early Committer.” And here’s a complementary, but non-medical, New York Times article called “You Don’t Want a Child Prodigy” that’s a great follow up to our piece.
It’s troubling, but make sure to read this recent piece in the New York Times called “The Moral Crisis of America’s Doctors” about physicians’ “moral injury.” The phrase refers to emotional damage caused to workers – when in the course of fulfilling their duties – they commit an act or acts that conflict with their core values. The piece argues that, in part, our profit-driven system causes doctors moral injury and, in turn, they become depressed and/or burned out.
I remember many times when I had only bad alternatives in directing my emergency patients for follow-up: If they had no insurance, our knowledgeable social workers advised us that our sole option was to send those patients to the public hospital nearby for follow-up care. This meant I would splint someone with a non-operative, non-emergency fracture and advise him/her to then be seen at another hospital’s emergency department with a multiple-hour wait because that was the only way to get into the system for the affordable orthopedic clinic. I found this very upsetting and contrary to what seemed right to me: It was so hard on the patients, and it also burdened the already overwhelmed medical system.
If you’re interested in recent physician burnout statistics, please see this February 2023 blog on the topic.
Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more
