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Pearls of wisdom for the pre-clinical years of medical school

The term “clinical pearls” is often heard during med school teaching sessions. If you haven’t heard it, I like the description given to me by one of my medical school advisors as we worked through a clinical case in which the patient was jaundiced: “They’re very helpful random tidbits of knowledge or ways to remember things that your professors and mentors will give you here and there that they’ve picked up from experience.”

These one-liners and mnemonics are meant to be short, sweet, and easy to remember. Learning in medical school can sometimes feel like trying to drink out of a fire hose: Every organ system is a complex process in and of itself, and uncovering the etiologies and pathophysiologies of diseases may be more difficult than finding a needle in a haystack. “Clinical pearls” are meant to be simple, common pieces of clinical knowledge or associations that med students learn to “keep in their back pockets,” to help them diagnose and treat patients well.

Some examples of pearls include the facts that jaundice -- a sign that one’s liver may not be functioning optimally -- can first be seen on the bottom of a patient’s tongue and whites of a patient’s eyes; and that the three P’s of diabetes, helpful for recognizing a diabetic patient that initially presents in clinic with these symptoms, are: polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased appetite).

I’m certainly not qualified to give you readers my own bits of “wisdom” given the limited experiences I’ve had with patients and medicine in general; however, in the same vein as “clinical pearls,” as my first quarter of my second pre-clinical year ends soon, I’ve come up with a few “pearls” I’ve picked up from my first two years of medical school so far:

  • Caffeine works magic to increase your study stamina. For caffeine to be most effective when you need it, drink less caffeine during normal school weeks and save larger amounts for days that really require an extra boost.
  • Keep your white coat and a set of professional dress clothes in a locker or storage room near the med school/hospital. Your schedule can get hectic, and you may not have time to run home and get these things should you forget that you’re seeing patients on certain days.
  • Use these early years of medical school to ask “stupid” questions, get lost in the hospital, and fumble your way through procedures under the guidance of instructors. As a first- or second-year medical student, it is understood and expected that you will be a bit lost and confused.
  • Always be professional towards both patients and fellow colleagues. There is no reason that you should not afford every person you meet a certain level of respect.
  • There are always important things and not-quite-as-important things on your to do list, and in life in general. Learn how to prioritize, and don’t sweat the small stuff!
  • Everyone has their own ways of studying that are most effective for them. Everyone has their own talents, skills, and interests. Don't compare yourself to others.
  • Finally, especially since Thanksgiving is approaching soon, always show gratitude to the people who help you through the exciting, rewarding, confusing, sometimes overwhelming whirlwind that is medical school. Don’t take the advisers who have written you letters of recommendation, colleagues who have shared their study guides, and friends who have supported you through anxiety-filled, pre-exam moments and days, for granted. In the end, the relationships we create and foster during these pre-clinical years of medical school will be our lifelines throughout the long journey left for us ahead.

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category

Natasha Abadilla was born and raised in Hawaii, graduated from Stanford undergrad in 2014, and spent two years doing public health work in Kenya before returning to the Farm for med school. She just started her second year of medical school, and she enjoys writing, cooking, eating desserts, running, and scrubbing into the OR. 

Photo by TheAnnAnn

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