 So if you want to get into your dream residency, there are a lot of things that you have to get right. And one of them is to do amazing on your sub-buy. In this video, we're going to talk about exactly how to do that step by step. Let's get into it. All right guys, welcome back to channel. In case you're new here, my name is Lakshman, I'm an internal medicine physician here at the MD journey. I make videos to help people just like you succeed on their medical journey but doing it with less stress. Now today's video, I'm going to break down exactly what you should be doing on your sub-buy, what you should be doing on your sub-buy. And these are taken for my own experiences when I was in medical school, as well as what I see from the good and bad students from this medical students that work with me on my own rotations nowadays. And I'm going to be sharing a bunch of golden nuggets. So feel free to jump around this video, feel free to check out some of the chapters down below and the links in description, as well as some of the other resources that'll be able to help you on your own medical journey as well as residency. Now before starting this video, I think it's also important to talk about exactly what a sub-buy is, especially if you're not familiar with the term. Now a sub-buy is a sub-internship rotation. Now this is something you typically will do the end of your third year or fourth year of medical school at your home institution. And think of these rotations as almost like an audition for the career that you ultimately go into. So if you're going to become a surgeon, you're going to do a sub-buy and surgery. If you're going to become an emergency medicine physician, if you're going to go into emergency medicine, you may do an ER sub-buy. Or if you're going to be somebody like me and you chose to go into internal medicine, you may do a sub-buy and a rotation related to internal medicine. So I personally did a CCU or cardiology rotation for four weeks. Now in addition, you can do a sub-buy at your own institution. And also if you have desires of going to residency elsewhere in the country, you can also apply to do an away rotation, which is essentially a sub-buy for an audition at another institution that you may be interested in going to residency for. So again, if you think of these as an audition, both for yourself to understand what your life will be like as an upcoming intern or first year resident, as well as for that institution to look at you as a possible resident at their program, it's going to kind of just make the whole process much more simpler. And because there's a lot of pressure on you to do well on your sub-buy, especially if you want to go to that institution that you are either doing a way of rotation or your home institution, you want to make sure that you know the nitty gritties of what to do and what not to do. That's exactly what we'll break down. So tip number one is to really focus on your patient management over the HPI. Now typically the medical school mindset that we're trained or second and third year medical school is to really get good at some of the nitty gritty of how to obtain a history, social history, family history, surgical history, medical history, physical exam. But as a future physician, none of that really matters if you can't take care of the patient. And sometimes we don't have enough practice to really get to the bottom of it, which is assessing the patient and managing the patient. Often there are times where I take care of patients that I have no idea how old they are, what problems they have. I just know what the main problem I'm taking care of now and how to do so. And so my number one tip that I always give to my sub-buys is whenever you take care of a patient, whether it's a new one and you walk into their room for the first time or an old one, come out of the room and be able to tell me three to four things that are their main problems. What's the first thing that you're taking care of in the hospital to use the reason that came in, but sometimes not necessarily, but it's the biggest thing that they're in a hospital for, as well as the other two to four items that you want to focus on and ask yourself, what are you going to do to work something up in case you still don't know why somebody has chest pain, why somebody has a fever. Those are things that require additional work up and management, but also how you're going to continue to take care of them. If you can walk out of a room and saying these are the three or four things I want to do for this person today, you're already on the right path of taking care of the patient, instead of doing what most medical students do. And this is where I can tell a good sub-buy from a bad sub-buy, which is the bad sub-buy starts to focus on the HPI in the story, especially in their progress notes and their presentations where the good sub-buy says, here's the quick kind of story synopsis of why the patient's in the hospital. Here are the main things that we found. And here's, let me really focus most of my time on telling you what I want to do for this patient. You can get to that latter half. I promise you're going to be much more successful and are also going to be able to practice some of those key skills you'll need as an upcoming first year intern and future physician. Tip number two is to understand that everyone is your patient. Now, when I was in a medical school and I was on my sub-buy, my team had 10 patients and my intern was taking care of all 10 and then I was assigned to five of them. So I was kind of offloading some of the patients for him, but I also realized that I was more useful to the team if I could not only know everything that needed to be done for my patients, of course, but also when I was on rounds, I would essentially just create a list of everything I needed to be done for everybody because one, I would focus on my patients, but if I realized some intern was busy or somebody was really sick, I could kind of offload him by taking care of the tasks that I felt comfortable with. There was a patient family member that I needed to call. If there was a lab test I needed to order. If there was somebody I needed to check on in the afternoon, I could just say, hey, so and so, I've already taken care of some of this stuff. Let me know if there's anything else I can help you with if you have any questions. I can also write this discharge note, this discharge summary for you. I can talk to these consultants for you. Again, as a sub-buy, you're almost auditioning as a future intern. As an intern, you don't really have to choose. I'm going to only take care of these patients. Everyone's your patient. And so as a sub-buy, although you may have your own assigned patients that your interns and residents and attendings give you, still knowing what's going on with other patients, so one, you can learn from them, but two, you can also offload and help your team will make your kind of position on the team much more kind of sought after. And people are going to look at you as a teammate versus a medical student who's on the rotation. Tip number three is probably going to be the most important from this video. So make sure you listen up, which is to focus on your growth versus impressing. And to really paint this picture, we're going to look at the two types of students that get a chance to work with. So student A is what we'll call the good sub-buy. And this is a student who's had three years of medical school underneath them, obviously very smart, very knowledgeable, but they're okay with focusing on tip number one, which is they focus on the management decisions. And they're also okay with making mistakes. So even if they suggest something on how to manage somebody's pain, I'm like, probably shouldn't do it that way. They're okay with that. Because as soon as they hear me say, oh, that's probably not the best approach, then the next time that they have to offer something on pain management, they kind of already know the better mental model of doing it. And now they've learned something both for their sub-buy as well as their future as a physician. But student B is so focused again, they're also smart, three years of medical school under their belt, but sometimes they're too focused on what their suggestions will look like to me in the 10ings that sometimes they don't make enough opportunities that may look bad. And so they only will suggest something if they feel comfortable. If they don't, they're sometimes too dependent on me or their intern to help them formulate a plan. They're not putting enough effort to make mistakes. And I find that those kinds of students don't do as well in residency because they're so focused on what they would look like in pressing their attendance and residence versus being okay, making mistakes and suggestions that will help them learn in the future. So bottom line, be okay making those mistakes to really focus on the growth versus impressing people, even if you're on an audition, like a way rotation where you really want to impress your attendings. It's okay to do so, but be okay making those mistakes so you can learn for your future. If you end up at that residency perfect, you rather end up at a residency as a smarter medical student than somebody who just kind of faked their way into it and then hope you figure it out. Tip number four is to focus on improving your management of one thing every single day. Now I try to tell this to my sub eye on every rotation, which is you're going to have a lot of patients with a variety of problems and you're not going to be able to be good at fixing all those problems. But every single day if you focus on fixing just one problem and learning how to improve on it. So for example, you may focus on pain one day, bowel regimen another day, diet, diabetes, hypertension, depression, anxiety, every single thing, focusing on one management every single day, even if it's 30 minutes on looking up stuff on up to day or Google and then having some way to just kind of store that information. And then again, if you take what you learn and give suggestions on rounds for new patients and old patients, your attendings may say that sounds great, or think about this as well, because this is going to change when you consider this versus this, that's going to help you in the next time to again improve on management of that pain and that bowel regimen, whatever it may be, both now as a sub eye, but most importantly, your future as a physician. And most sub eyes, if you think about it or anywhere from 21 to 28 days, it's 28 opportunities for you to learn one thing and truly improve on it and then refine and adjust over the course of the rotation. Now we're getting towards the last few tips, but a real quick reminder, if you are enjoying this video, then just hit that like button down below. It really helps me, it really helps the channel as well as gets the video on for more people that may need it. But getting into tip number five, which is to talk to your residents about the reality of residency. Now this is something I probably didn't do the best job of, but if you think of your sub eye as an audition for you, it should also be an addition of what life will be like as residents. So you want to ask the people that are currently in that position versus waiting to when you're applying to residency, asking brand new strangers, talk to your residents who are going to be much more open to you because they're comfortable with you working with them. Ask them what their hours are like, like how happy they are, how much time do they have for themselves? What tips do they have when you're starting residency? How happy are they with the program that they chose? That's going to be a huge question you want to ask. What type of things do they wish they had asked that they didn't? And that really starts to get them thinking. And if you have a whole month of them, then you will be able to really kind of understand what life as a residence like. So when you're starting on day one, you won't be completely in for a culture shock. And as a quick reminder, if you do want to talk to a friendly neighborhood resident as making this video of my 30-year residency, if you look on the link in the description, there's going to be a Q&A kind of survey. But in that survey, you can drop your questions as well as leave your name and email. So then I can send you my own individual response. So again, all the questions you have dropping in the comment section, as well as that survey, in case you're interested, a totally free service. Love to interact with you guys, love to help you guys. So that'll be linked down below in case you're interested. And then filing tip number six is to lead your patient conversations. As a sub, you really want to start thinking about yourself as a primary provider for that patient. Now you're an intern, now you're a resident, now you're attending, but it's you. So when you go into the room with your entire team, as well as when you go at various other courses of the day, really be that forefront person or try to make the effort of leading the conversation. How is the patient doing? You know, how are they feeling? And then leading the discussion of saying, the team and I have talked and this is the things that we wanted to do for you. What questions do you have? What suggestions do you have? And if there's something that you're not comfortable with during that process, obviously look to your residents and they can kind of jump in. But the more opportunities that you take on doing this, the more ownership you'll feel on that patient, but also when you're an intern and you're still kind of learning the ropes and don't feel completely comfortable with all the medicine just quite yet, you'll still be okay with talking to patients about medicine. Because again, you have so many more years of experience ahead of most of your patients are going to look at you as a source of resource. And so use that as a practice, go into your patient's rooms and lead the conversation. Don't wait for your attending, don't wait for your resident, don't wait for your intern to lead the conversation and then just leave you out of it. You don't want to be that person at the bottom of the hierarchy poll. You want to be the person who is going to be the first person to talk to them and really develop that patient report. Your attending is going to be able to see how well you can talk to your patients, how well you can communicate information with that jargon. At first, you may not be amazing at this, but that's where the practice comes in. And as a full disclaimer, obviously talk to your residents and your interns that they're okay with you leaving discussions. And if there's any pushback, obviously do what's best for your team. But if there is no personal preference, then try that out and see how it works. But those guys are some of my favorite tips on how to do amazingly well on your sub-internship rotation. If you guys have any questions, go ahead and drop in the comment section, as well as add it to that Q and A linked down below so that I can add it to future videos. But as always, guys, thank you so much for watching this video. If you did enjoy this video, then there's going to be two resources that you'll probably also enjoy. One is a crushing clinical program, which is a step-by-step on every single rotation on how to get honors, what resources you use, what study schedules you use, as well as how to prepare for tests like Step 2CK. I'll be linked down below, as well as you can see the results that our past students have gotten. And then also our intern survival guide. So if you're about to be a brand new physician and you really just want to get over the nervousness and anxiety that comes with being a brand new physician, our intern survival guide breaks down everything on how to present, how to be efficient, how to write your notes, how to take care of certain key problems, as well as resources for every type of residency and specialty. So that will also be linked down below and you can check out the reviews there too. But as always, guys, thank you so much for watching these videos all the way to the very end. I really appreciate your support. Now, just as a quick reminder, if you haven't done so, hit that like button as an additional form of support. Again, I guess these videos out in front of more people. Somebody who's on their sub-eye struggling may need to see this video and if you enjoyed it, maybe they will too. So hit that like button to truly support this video as well as your fellow med students. If you haven't done so already, if you're new here, or if you've been lurking around here on the channel, hit that subscribe button and notification bell to get notified when new videos go out on a weekly basis. With that being said, guys, thank you so much for watching this video. Thanks for being a part of my journey. Hopefully, I was a little helped to you guys on yours. If you did enjoy this video, then check out this video on how you can use onky like a pro step by step. Super recommended. So well as this video on how to study in medical school, step by step, everything I wish I would have known, that video's for you. But until then, my friends, I'll see you guys in the next one. Peace.