 So the beauty of being up for level resident is now I get to give you a grade on your rotation. Let me tell you of what things you should not do. Hey guys, welcome to another episode on the TMJ show and the empty journey channel completely dedicated to helping you succeed on your medical journey and doing it with less stress. If it's your first time here, my name is Lakshman, internal medicine resident, been making videos, blog posts, you name it for the last two, three, four years now, crazy. But here on the channel I make content on how to study better, how to get better grades, how to be more productive as well as how to crush it on your clinical rotations. So if any of that sounds interesting to you, then definitely consider hitting that subscribe button and hitting that like button to support the channel as well as getting more videos just like this one in the future. But today I want to talk about a few things you should not be doing on your clinical rotations and this is from personal experience because now as an upper level resident, I get to give that grade of an honor, high pass, you know, near honors, whatever grade your institution uses. I want to give you a few things that I've noticed even in my short time of being an upper level resident that really have cost some med students their grades and hopefully you can use them to actually increase your chances of getting that honors and a high grade on your shelf exam. And at the very end of the video, we'll also talk about a resource to help you crush every phase of your clinical rotations and ideally get both the honors as well as into your number one residency spot. So stay tuned. And one of the worst things that you can do to cost yourself a high grade on your clinical rotations is having terrible presentations. Now I'll give a few examples of where med students struggle. One of them is that they forget that the presentation is their opportunity to shine and they don't give the right proportion of attention of where they can really show off their knowledge to where they can kind of speed up on things. So a few common characteristics of a typical med student presentation is that they're long, they're not informative, and most importantly, they don't highlight what that med student knows and how they want to use it to manage the care of the patient. And that just ends up wasting time and not really leading you to a higher grade. And a few things that I've noticed that really make bad presentations is that some med students will just quickly go through everything. I had an experience where we had a med student on one of our rotations who clearly knew what we were going to be doing for that patient. They knew the plan, they knew the history, but they just rushed through everything. They were almost talking as like a very fast robotic tempo and they weren't slowing down on where they wanted to show off their knowledge. So it didn't matter if they were giving a piece of information that was irrelevant or important, they set it at the same speed. And one of the most important things you can do to yourself and for yourself on your presentations is when there's a piece of information that you really want to share and show that one, you know what's going on, two, you know what that means for the care of your patient, slow down. So for example, if your patient's first primary problem was shortness of breath, then when you present that problem in your assessment plan, make sure you take your time of explaining your thought process, what you think the patient has, why you think it, what you think the patient also doesn't have, and then why you made certain decisions in their management. A lot of times in my experience, I find that the med students will go just quickly list out everything that they've seen their residents tell them that they'll be doing or have seen in the note that the resident has already written, but they aren't able to highlight this is what's important and this is what's not. So for example, if you have a patient with a low blood count, they have anemia and you're not really sure why. The most important part of that presentation is explaining what your differential is for why they're anemic and to what you're going to do to work it up. But sometimes I find that the med students will quickly go through their differential and their workup and then also spend excess time talking about things like, well, if they're hemoglobin is less than seven, then I'll transfuse them and XYZ will trend them with CBCs. But honestly, those are things that you probably read in somebody's note or you written in yours and they are not important for your presentation. So next time that you give a presentation to your attendings and your residents look through your presentation and focus on where the money spots are, what are the pieces of information in the HPI that are going to contribute to your final diagnosis, they're going to contribute to the final management suggestion that you have when you present the patient. Those are parts that you should slow down on and other parts that don't necessarily fit in those money regions are going to be things that you should be able to quickly go through or not even have to say at all. And my final personal gripe about patient presentations, try saying that eight times in a row is really that med students start to find themselves in a reporting phase. I mentioned this in previous videos, but the most important thing you should do when you get a new patient or even if it's an old patient that you've been taking care of for some time is ask what do I want to do for them before you start working on your HPI or subjective and your objective data. If you can really master your management, you don't have to rely on the notes and the things that your upper level residents will tell you instead, you'll say, well, for this problem, I see that this is happening and this is what I want to do and then focus on the things that don't require a lot of mental energy, including working on their HPI and their objective data. So definitely keep working on your patient presentations. If you're struggling, I promise you, if you can suddenly increase the quality, how quick you are, how concise you are, but also make sure you're highlighting where you know what's going on, you're going to be able to increase your chances of being in honors. I can really dictate the students who get honors from the students who don't base off just their presentations alone. And number two is not offering to help. Sometimes they feel like the med student is waiting for me to tell them what to do. And in some regards, that is the proper thing to do, but always look for an opportunity to help your team out, especially if it's your patient. One thing that I often recommend you do is keep a list of all the different things that are on the to do list of your intern and your upper level resident. You obviously may not be able to take care of all of them, like putting in an order or calling a consult or calling a family member if it's kind of outside your wheelhouse. But if there's something special like checking on the patient at later in the day or calling social work or working with the PTs or calling a family member for your residence, then you can definitely add that to your list. And then you can tell your interns like, hey, I can take care of A, B, and C. And sometimes to define that the students who are the most enthusiastic about helping the team without being a suck up, don't do that, can definitely increase their chances of getting honors. Because sometimes I can look past your lack of clinical knowledge for your ability of enthusiasm and ability to help both team as well as the patient. So if you're sitting in a corner doing your UL questions, studying for yourself exam, make sure before you do it, you always ask if there's another opportunity that you can help your team before you take some appropriate time to work on your own. And number three on a similar note is not being your patient's advocate. As a med student, you have the most opportunity, the most time of building both relationships for poorer, as well as the ability to see your patients multiple times a day. Your interns can be busy taking care of all the patients, your residents can be busy supervising the team. And you're going to honestly have the most amount of time to see the patients specifically in the morning, during rounds, as well as in the afternoon. So use those opportunities to ask yourself, does the management that we did for this patient earlier, is it working? If they're in pain and we started them on a new medication, is it actually having a difference? So always check in on your patients that way, they can one, know who you are to know your name and three, sometimes they'll just brag about you in front of your residents, in front of your attendings. But it doesn't happen if you only see them when you have to, which is before rounds and then during rounds. So be your patient's advocate, always see them throughout the day. I like to say that if you're coming back from lunch, quickly just lay eyes on all your patients, make sure everything is good, and then come back and report if there's anything worth reporting to your interns and residents. I know personally, if I have med students who'll just kind of independently check in on their patients, it really helps when they tell me, Hey patient, so and so is feeling a little bit nauseous, maybe we can schedule their Zofran instead of just making a PRN because I don't think the nurses are getting it. Those are very small instances that I'll remember that this medical student really cares for the care of their own patient. And again, it just elevates their chances of getting honors. Obviously, they have to have the clinical acumen, all those skills that they're required to build. But those kind of things just kind of raise your chances of doing so. Number four is being inefficient. Do not be an efficient med student. When you're first starting, obviously, you're going to be learning the small skills of how to write better notes, how to present quicker, how to see your patients quicker. But always ask your interns, your residents of like, Hey, how can I do this faster? How can I look at this problem, the situation and being able to do it efficiently, but effectively, I've been through numerous experiences already where med students have been staying till very end of the day, still working on their notes. And if they only have two patients, sometimes it shouldn't take you till five or seven PM to work on your progress notes. Always ask how can you make this faster? How can you make every experience a little bit more efficient? That way, then you have more free time to one study for yourself exam, which you should and two, being able to help both the patients as well as your team kind of further the care of that patient. If you're noticing that you're slow on a certain task, always ask for advice on how you can potentially get better and more effective doing it. And on that note, if you want more tips for your clinical rotations on being more efficient, being more effective, I'll link down below a full playlist that we have on YouTube. And finally guys, the most important thing that will cost you a high grade and a mistake that you can make on your rotation is a lack of professionalism. Now professionalism includes a lot of things. Number one is showing up on time. So don't show up late. If you show up once, make sure that you text your upper level resident, your intern to let them know what happened and that you're going to be a little bit behind, but don't make it a repeat process. Two is making sure that you are having proper conversations with your interns and residents. Sometimes med students get a little bit too comfortable and sometimes they're on the opposite end. And so understand that your interns and your residents are really what they should be their upper levels or your supervisors. And they're your mentors and they're people who you can look forward to advice, but don't try to make them your friend. You can be friendly, but sometimes looking at your upper levels as a friend can lead you to say some things that maybe you probably wouldn't have said otherwise. And I'll just leave it at that. I've had some med students say some inappropriate things, whether it's about their grading, whether it's about patient care. You just don't want to have a chance of that being on your final evaluation. So always be professional with your patients, your attendings, your team members and make sure you show up on time. Get a watch. And finally, guys, if you want more resources to help you on your clinical rotations and if you are nervous, if you haven't started or if you're on your rotations and you're struggling, then definitely check out the crushing clinical program that we have on remedy journey.com. I've had a lot of students go through the program already and they found that one, they've increased their chances of doing well on their shelf exam, which is super important. But two, they've also increased their chances of getting honors on their rotations. I haven't definitely had some students who've been able to crush all of their rotations, get a 4.0, but most importantly, set themselves up for getting a number one residency spot. So I'll link down below the crushing clinical program if you guys are interested, but that's going to be on this video on what mistakes you should make on your clinical rotations. I'll keep making more videos like this as I go through my upper level training and realize other common things that I find in my experiences, but also make sure you comment down below with any questions you have about your clinical rotations, any tips that you would like. I'd love to make more videos or just specifically answer your questions down below. And before you click off this video, because I know you're ready to do so, hit that like button and really supports both the channel as well as tells me that you enjoy this piece of content. So I'm waiting. Cool. And also consider if you're watching this, you made it to the very end, hit that subscribe button to get two videos at least like this one every week. But thank you guys so much as always. Again, all the resources that I mentioned this video are linked down below. Hopefully you guys will check them out. I appreciate you making it to the end of the video and the support. Thank you for always being a part of my journey. Hopefully I've been a little help to you on yours. I'll see you guys in the next one. Peace.