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Countdown to clinics: 5 pleasant surprises of jumping into third year

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.  

this wayHere at SMS Unplugged, we’re counting down to July 1, when current second-year medical students will make the leap from pre-clinical to clinical trainees – arguably the most formative transition in medical training. We began with the most challenging aspects of the third-year transition, involving early mornings and the emotional demands of confronting morbidity and mortality on a daily basis.

But for every new challenge, there comes at least one welcome surprise. Above all else, third year is a time of professional and deeply personal discovery. Systematically rotating through every major medical specialty is a tour of the health-care system that we may never experience again. And it’s during third year that we decide which specialty to pursue – a choice that will have an impact on the rest of our lives.

With that in mind, we continue our countdown with the most pleasant surprises of third year.

5. Productive confusion
There are two types of students entering third year: those with a short list of specialties they’re interested in, and others who are open to exploring the wide world of medicine. But even the most focused students can end up somewhere vastly different than they'd originally planned – much to the relief of those of us who hadn’t decided on a career path. Every rotation is truly fascinating, to the point where even the best laid plans suddenly come into question. Discovering that you’re interested in (and maybe even good at) something completely new is a great feeling, even if it derails the career you mapped out at the start of medical school.

4. You know a lot more than you think
Third year is notorious for constantly pulling the rug out from under you: As soon as you start to feel competent on a rotation, it’s on to the next one, which reminds you just how little you know. But in spite of spending most days struggling to speak the language of a new field, students also have a wider knowledge base than they realize. A seasoned resident or faculty member will have command over the information specific to their field – but if a patient has an issue the expert doesn’t remember from their own medical school days, suddenly the student becomes the teacher.

3. Nurses are not doctors… or are they?
Although the role of mid-level providers has sparked significant controversy recently, one thing is clear: Nurse practitioners and physician assistants have a lot to teach us. One big lesson I learned during third year is that high-quality patient care takes a lot more than just a professional title or even a great medical or scientific knowledge base: diligence, leadership and a certain degree of savvy in navigating a complex health-care system are required. We don’t learn those qualities in medical school lectures; we’re expected to pick them up on the wards. And as any third-year can attest, nurses and physician assistants are often the best teachers in the clinical setting. It’s humbling to realize that MDs aren’t the only ones who can make decisions in patient care. But it’s also refreshing to realize that we’re not alone in that undertaking.

2. The prescience from standardized patients
Pre-clinical students work with ‘standardized’ patients – actors who simulate a variety of clinical encounters. It feels a bit odd to practice (and be graded on) seemingly obvious interaction skills like introducing oneself, listening carefully or letting the patient speak. I didn’t fully appreciate those lessons until I observed a senior physician bluster into a patient’s room without any introduction, deliver a 10-minute soliloquy on her prognosis and leave without asking if she had anything to say. As it turns out, she did: “You were talking to the wrong patient.”

1. The person waiting for you at the end of the year
You’ll meet hundreds of patients, physicians and nurses over the course of the year, but the person you’re looking for all along is the one in the mirror. The best surprise of third year is discovering not just your interests, but your talents, passions and even weaknesses. As one of my classmates said, “It’s like being in a movie, but you get to write the ending.” And no adviser, professor or countdown list can spoil it.

Stay tuned for the final installment in this series, when we’ll count down the most rewarding parts of third year. To all the second-year medical students out there: Good luck and keep your chin up!

Mihir Gupta is a third-year medical student at Stanford. He grew up in Minnesota and attended Harvard College. Prior to writing for Scope, Mihir served as co-editor in chief of H&P, Stanford medical school’s student journal.

Previously: Countdown to clinics: 7 challenges of jumping into third year
Photo by Dave Catchpole

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