When medical students step from the classroom into the clinic, most often at the start of third-year clerkships, they are asked to make a fundamental change in how they think.
In the preclinical years, memorization is often at the center of study. When clerkships come along, students are asked to put those facts into action and display their clinical reasoning.
“You’re still reviewing content, but now it’s connected to actual patients and cases that don’t fit neatly into a set of bullet points,” said Myra Aquino, MD, MPH, senior content strategist at Sketchy Medical.
“And while all of this is happening, your brain is undergoing a full reorganization.”
“Instead of thinking in terms of conditions, you now must think in terms of chief complaints. That rewiring is tough, and it’s happening while you’re simultaneously adjusting to the nonstop reality of rotations.”
What makes a medical student ready for clerkship? Dr. Aquino offered insight into that question and how Sketchy Medical can help.
Getting proactive
In an ideal world, medical students start preparing for clerkships as early as possible. Realistically, students are likely to start after they take Step 1 of the United States Medical Licensing Examination (USMLE).
“Once you’ve taken the exam, give yourself a breather, then start slowly easing into the clinical mindset, it’s a different kind of learning, so the earlier you adjust, the better.”
In anticipation of each rotation, Dr. Aquino advised medical students to get familiar with its structure.
“If it’s surgery, what does a typical day look like?” she said. “What’s expected of you as a medical student on that rotation? Which apps or resources can help you succeed?”
Dr. Aquino also said medical students should review core clinical presentations of common conditions—and begin practicing how to build differential diagnoses around them. Students should also brush up on fundamental skills such as history-taking and physical exams. Any direction on how to write notes and gather information in the EHR is also helpful, Dr. Aquino said.
When you join the AMA as a medical student, you can choose to receive 25% off any Sketchy Medical plan. A Sketchy Medical subscription includes access to 1,000-plus video lessons, over 10,000 practice questions and more than 70 patient-case simulations—with new cases added weekly. Sketchy combines visual storytelling and AI-powered case simulations to help students learn faster, retain more and confidently prepare for real-world clinical challenges. Learn more about why Sketchy works.
Coming in with confidence
Aptitude alone isn’t the key for clinical success, Dr. Aquino opined.
“What separates students who thrive on rotations from those who struggle usually isn’t who’s ‘smarter,’ but who’s better prepared,” said Dr. Aquino. “The ones who review core topics ahead of time, ask questions, and follow up on their patients tend to do better.”
A new offering called Sketchy Cases gives medical students a tool that helps you get rotation ready. The simulation tool offers students the opportunity to practice patient encounters in a low-stress setting. Each case—focusing on high-yield presentations you’ll likely see on the wards—starts with a chief complaint, then walks you through history, exam, differential and management, with feedback offered along the way.
“What makes Sketchy Cases especially helpful is the feedback you get from the virtual preceptor,” Dr. Aquino said. “You don’t just get told that your answer or way of thinking is incorrect, you get shown why your reasoning didn’t hold up, and how to reason through it more effectively.”
For medical students who are gearing up for clinicals, the tool helps transition to a mindset that emphasizes critical thinking.
“The more cases you work through, the more those patterns start to click,” Dr. Aquino said. “You can do them on your own time, whether that’s on your laptop at night or on your phone between patients, and you can pause mid-case and go back to it later.”
Before each rotation begins, Sketchy Cases gives students a method to build up their knowledge of the fundamentals.
“By running through all the cases relevant to that specialty, you can get familiar with the common presentations, diagnostic reasoning and clinical language you’ll need to perform well,” she said.
Clerkship rotations, Dr. Aquino said, are about building a foundation of skills that will carry into residency and beyond. Sketchy cases can help in laying the groundwork.
“The students who treat rotations not as something to survive but as a real chance to learn usually get more out of it,” she said. “That’s not always easy, especially if you’re dealing with a lot of personalities in the hospital and you’re running on little sleep, but these are the moments that shape your clinical intuition. You’ll remember patients and experiences from the wards for years.”
