Medical School Life

7 clinical rotation tips from experienced physicians

Imagine your first day of clinical rotations. After hours of studying, you’ll finally transition from learning in classrooms to exploring the floors of real care environments. What should you focus on to ensure your success in patient care? Follow these tips from experienced physicians as you begin clinical rotations and start planning for your specialty.

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Nearly 150 students attended a clinical skills workshop hosted last month at the 2015 AMA Interim Meeting. Students in the workshop received hands-on training in airway management, blood pressure checks, ultrasound administration, casting and suturing (photos at right and below show students gettings hands-on experience).  

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AMA Wire® checked in with physicians who facilitated the workshop to discuss key insights students can use during their early days of clinical rotations. As you begin working with patients, be sure to: 

Practice skills you’ll use across clinical settings

For instance, during the workshop, students participated in a mini-training session with Jessica Millsap, MD, a musculoskeletal imaging diagnostic radiology fellow at the University of Alabama School of Medicine, who taught them how to operate ultrasound equipment. “Ultrasound is ubiquitous … now,” she said. “It’s used in the emergency room, ICUs, on the floors … and perhaps the most prolific use is to put in central lines, so it’s important people know what they’re looking at, and when things look [abnormal], they know what to do and who to talk to.” Dr. Millsap also encouraged students to take advantage of future clinical skills workshops and opportunities to master the technical aspects of ultrasound.

Check in with your fourth-year peers

Medicine is a field with complex technologies and health systems that are rapidly changing. That’s why Michael Rakotz, MD, a primary care physician and director of chronic disease prevention with the AMA’s Improving Health Outcomes initiative, recommends students ask senior classmates questions about their experiences working with clinicians.

“I always tell students to find somebody who is a fourth year when you’re going to be a third year because that’s invaluable,” he said. “These students would have been through exactly what future students will experience and will know what clinical rotations will be like in their school or hospital environment. They can always give the most precise advice on what to expect.”

Talking with your peers can keep you informed about important new health technologies, clinical skills, work hour requirements and procedures students should practice in training, Dr. Rakotz said.

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Speak with an attending in that specialty 

Clinical rotations can give you the rare opportunity to interact with attending physicians, ask questions and observe how they care for patients in a real care setting. This can be especially helpful for students who already know they’d like to pursue a very specific specialty.

“If you want to be something specific—like a cardiologist, nephrologist or surgeon—it’s great to talk to older students on those rotations, but also find an attending who has actually [practiced that specialty] in real life for years,” Dr. Rakotz said.

For instance, the life of a general surgeon teaching students on rotation or in an academic setting may differ greatly from that of a general surgeon who is actually practicing the specialty full time, Dr. Rakotz said. While immersed in a clinical setting, try to gain insights from a physician who practices in your field full time to make sure you understand the everyday expectations and culture of that specialty.  

Don’t forget to have fun—enjoy discovering medicine

From acing the United States Medical Licensing Exam to prepping for shelf exams, as a medical student, it’s natural to often have a goal or deadline in mind. But try not to let these responsibilities eclipse the excitement of donning your white coat or experiencing clinical rotations for the first time. “I still remember what seems like every second on my first clinical rotations,” Dr. Rakotz said. “I remember how much fun they all were and how great it was to get out of the classroom because I did not enjoy sitting in a classroom eight hours a day. But I loved every second of learning how to practice medicine from real doctors in a real hospital with real patients. I loved every second of it, and I know most students to do too. It’s really where you learn how to become a doctor.”

Choose your rotations wisely

Clinical rotations give students the experience they need to make informed decisions about what to practice, so “choose your medical school rotations wisely … get broad exposure to specialties, and look at them first hand,” said Chris Dangles, MD, an orthopedic surgeon at Gibson City Area Hospital in Gibson City, Ill. “I have a wife who knew she wanted to be a plastic surgeon from the time she was five years old and fortunately she was able to do that. Myself, as an orthopedic surgeon, I didn’t pick the specialty until my last year of medical school,” he said, noting that he gave himself the time he needed in training to gain exposure to orthopedic surgery before choosing the specialty. Dr. Dangles also encourages students to “come to the AMA meeting and ask questions of the specialists at workshops like this” to get more exposure to clinical skills and learn more about different specialties.

Read more about Dr. Dangle’s experiences in orthopedic surgery as part of AMA Wire’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. 

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Hone your ability to listen

Listening is one of most critical clinical skills you’ll need.  I tell my students all the time, ‘Just listen to your patients, and they’re going to tell you what’s wrong,’” Dr. Dangles said.  

If you’d like to start practicing now, check out this expert advice and acronym to help students master patient communication.  

Think about coordination of care during rotations

“[Students] have to think about how their rotations fit into an integrated care unit, [focusing on] the coordination of care,” said Howard B. Fleishon, MD, of the Department of Radiology and Imaging Sciences at Emory University. “I think that’s really important in today’s medical paradigms that we’re going to see. There’s going to be much more demand … not only for individual care within the medical homes but also integrated care, where everybody is working together with the patient at the focus of the care.” Dr. Fleishon recommends students focus on clinical rotations across a variety of specialties and strengthen their abilities to effectively practice team-based care. For instance, he said that as students progress in training and practice, they need to know how to comfortably refer to and work with radiologists on care teams.

“You need to concentrate on how everyone can work together and where you fit into the continuum of health care,” he said. 

For more student-friendly tips