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How to Honor Your Clerkships

Now that you’re in your clinical years of medical school, you finally get to transition from the classroom to the clinical setting and learn how to take care of patients during rotations. While it’s an exciting and invigorating experience, this phase can also become challenging and stressful. Not only are you trying to learn how to keep up in a clinical environment, you’re also focused on standing out and doing your best to succeed during every rotation.

According to a 2021 survey by the National Resident Matching Program (NRMP), residency program directors ranked clerkship performance among the top 10 criteria to look for when selecting applicants to interview. Receiving an “honors” evaluation on your clerkships is a great way to stand out in your residency application, especially now that Step 1 is pass/fail.

Over the years of my training as a medical student, overseeing resident, and a fellow, here are a few tips on how to honor your clerkships.

1. Know how you will be evaluated

Whenever you start clerkships, it’s important to determine how you will be evaluated for the month you are there and discuss expectations with your chief/senior resident on the first day of each rotation. Even though most medical schools now use a pass/fail curriculum, third-year clerkships still receive grades for their performance: honors, high pass, pass, and fail. 

There are usually two main components to your clerkship grade: your shelf exam score and your evaluations from the preceptors. You will most likely be graded on qualities such as professionalism, communication, work ethic, knowledge, and competency amongst others.

Every rotation has a different setup and therefore will have different expectations. It’s very important to learn about the expectations of a particular rotation so that you can adjust your day-to-day tactics appropriately. I think it’s important to know what the team expects of the students when they come to rotate on the service. In addition, knowing the expectations of a rotation will help you perform better, and therefore, you’ll attain a better evaluation from the preceptors. 

2. Focus on being and learning while on rotation

Throughout my past years of being a medical student, a resident, and then a fellow, I realized the importance of “being” rather than “doing” while on a rotation. Often when we’re trying to succeed at something, we focus too heavily on tactics and forget to learn or enjoy the task. We occupy our minds with “what can I do?” or “what can I say?” to look good before the preceptors and the team, but it’s not worth spending so much time obsessing over how to come across as a good medical student that you miss out on the opportunity to be a good medical student.

Learn to be curious, ask questions, and most of all, have fun learning about every specialty you get to experience even if you may not have an interest in that particular field. Keeping an enthusiastic and eager attitude to learn can contribute to a better evaluation and the possibility of honoring the rotation. In addition, keeping an open mind with a focus on being rather than doing can provide you with a special experience that you will remember.

If you adopt this mindset, not only will you be a better and more engaged medical student, but you’ll also learn more from the experience and become a better, more knowledgeable physician in the future. Remember, you never know when the obscure facts you learned during your clerkships will come up again and how that might help you years or even decades down the road. Experience is everything and will help you become a better physician. 

3. Always take advantage of the downtime 

During your rotations, it’s very important to take the most advantage of downtime. Every rotation will have downtime and it is up to you to maximize that time. Step 2 CK is at the end of your third-year clerkship and since Step 1 is now a pass/fail examination, Step 2 CK will be heavily weighted on your residency applications. You’ll want to be actively studying for your shelf exams during rotations to make sure you’re solidifying your knowledge in each specialty as you experience it.

Don’t get me wrong, it’s hard to find time during rotations to study. You have to be creative and efficient. What worked for me was doing flashcards between cases, especially with a shorter time period. Another option was for me to do questions from an available question bank while waiting for the next patient to go back to the operating room or while waiting for the operating room to be turned over. I would recommend against hauling textbooks and attempting to read them, as you will have to take breaks due to rotation responsibilities and it’s likely to not be effective or a good use of your time.

If you’re looking for an efficient way to start your shelf exam studying, check out the Rosh Review Shelf Qbanks for all seven rotations (plus, you can study on the go with a free mobile app)!

free shelf exam qbank

Put your shelf exam knowledge to the test with this FREE shelf exam practice quiz of the most commonly missed shelf questions from the Rosh Review Shelf Exam Qbanks (one for each specialty)! Each question includes a detailed explanation and visuals to help you retain anything you may have missed. How many questions can you get?

4. Ask for feedback

Halfway through a rotation, make it a habit to talk to your chief residents or the residents directly in charge of you regarding your performance and what you can do to improve. Asking for feedback gives your team an idea that you truly care about your performance and aim at being a better physician and clinician.

Once you have the feedback, make a conscious effort to improve and incorporate those suggestions for the remaining half of your rotation. These changes are reflected in your performance and can play a very important role in affecting your final grade.

5. Be prepared for the next day

As a student on your clerkship, be it an internal medicine rotation or a surgical rotation, it’s very important to be prepared for the next day. At the end of the day, ask your team what they want you to prepare and be ready for tomorrow. Read about topics that you struggled with or look up more details to help you manage a patient for the rounds the next day. For surgery rotation, read about the surgeries that you will be scrubbing in for the next day. Most importantly, look up the patient and know them well. 

6. Be kind to everyone

During your clerkship, you will interact with a lot of people including residents, fellows, attendings, nurses, techs, other students, patients, and their families. It’s very important to build a good rapport with those around you and to be kind to everyone.

As soon as you start your rotations, you become part of a team, so it’s important to be a team player who is kind to everyone. Ask the team what they need help with and always volunteer to help with tasks. You can watch how your resident and attending staff interact with the ancillary staff and the patients. Clinical rotations are the best time to learn and practice, so take up all the opportunities to learn new skills. These experiences will teach you about your preferred approach and patient interaction in the future.

Another thing to consider is that medicine is a very tight-knit community. You never know who is watching you or who knows who. Your disrespectful behavior toward one staff member such as the janitor or clerk can easily make it into your evaluation and greatly impact your rotation grade. Remember the quote, “Treat others the way you want to be treated yourself.”

These are just some suggestions that helped me succeed in my clinical rotations. Even if you take nothing else from this reading, remember to be polite and kind towards your coworkers and the staff while on rotation. Kindness will get you far!

About the Author

Sheel is an alumna of Old Dominion University at Norfolk, Virginia, where she tutored students in chemistry, math and physics. Finishing her school education in India, Sheel has always had a strong suit for tutoring and teaching others. She continued this passion throughout medical school where she tutored her colleagues in various subjects such as pharmacology and physiology while helping them prepare for Step 1 examination. She is a proud graduate of Lake Erie College of Osteopathic Medicine, Bradenton Campus and she completed her General Surgery Residency from Wayne State University. She is a current senior Cardiothoracic Surgery fellow at the University of Kentucky, Lexington. She is now a board-certified General surgeon and is working towards dual board certification once done with her fellowship. She has a strong interest in the field of surgery including general surgery and Cardiothoracic Surgery and that's where her passion lies. She likes to encourage similar passion and interest for the field of surgery and patient care. You can find Sheel on LinkedIn or Twitter.