 So in this video, we're going to talk about how to be more efficient on your clinical rotations, whether you're a medical student or an intern or a resident. Let's get into it. All right guys, welcome to the MD journey and channel, completely dedicated to helping you succeed on your medical journey with less stress. My name is Lux, I'm an internal medicine physician and resident in training. And this whole channel is about videos on how to study better, be more productive, as well as just help you crush it on your medical journey, hope with a smile along the way. If you're new here, definitely consider hitting that subscribe button for videos just like this twice a week. And today we're going to talk about a topic that is truly dear to my heart and that's about being efficient and productive, but specifically in the clinical rotations kind of realm. One thing I realized for a lot of my students as well as the interns that I work with now as a medical resident in internal medicine is that there is just a lot of room for inefficiency and through experience, I've learned how to get faster at things like writing notes, seeing patients and just being able to get out of the hospital while making sure that my patients get amazing care, but still being able to do it efficiently. So this video I'm just going to kind of break down the most common kind of areas that we will fall in terms of being unproductive and how to be able to get past them. That way you're not spending excessive amount of time to the hospital or doing things like writing notes. Now the first place to start with efficiency is truly understanding what makes you efficient. Now that sounds like a very obvious thing to say, but really when you ask people, especially medical interns and residents, and saying, well, why are you saying so long in the hospital? Most people will tell you, I'm just not very good at managing my time, but then when you ask them to kind of dive into that deeper, they just don't really have good answer for you. They don't know what is really kind of causing them to be slow. They just think they're slow in general. And honestly, that's not true. So really focus in on what is taking you the most amount of time. Is it interacting with patients? Is it pre-routing in the morning and looking at vitals and labs and information? Is it writing everything down? Or is it actually doing your notes, which probably will be the answer for most people? Or is it getting your orders down in the afternoon? Or finally, is it just being comfortable leaving in the hospital and saying it's gonna be okay? Somebody else will be watching from my patient and I can now go home and be myself. Those are all different things to consider of rooms for inefficiency, and then you can finally start taking the steps to work on them better. Now, once you understand kind of your rope lock inefficiency on your rotations, whether it be notes for seeing patients, ideally I recommend that you try to do them as quickly as possible into your day. So a great example in residency for first year doctors and interns is usually writing notes. There's just takes so much time to understand what goes into a note, how to do it efficiently, and I'll find a lot of the interns that I'll work with will probably start doing their notes still into the late afternoons, where now I can probably go into work tomorrow and have my notes done before rounds. And it's not because I'm a faster typer or I suddenly just know what goes into a note, I just know how to approach it. If the note is gonna take you the most amount of time, it's the thing I recommend you try to do as quickly as possible into your day. So for example, when I'm writing my notes, I know that if that's gonna take me the longest time, I have to think about everything that goes before it. So I know to write my note, I have to see my patient, I have to look at their vitals, and I also have to get comfortable of creating an assessment and plan for that specific day. And then once you understand all the many tasks that are kind of in the way before you can even get to your time cruncher, you can start working on making those more efficient. So for example, before when I first started as a new doctor, when I was pre-rounding, I would write everything down, labs, vitals, overnight events, and I would have them on a piece of paper, I would have one paper for each patient, and then it just realized that it was just taking me forever to just go through the data that it then wasn't able to go actually see my patient. Then if that ever took long, I wasn't actually able to get to my notes. So I asked myself, how can I pre-round quicker? Well, the first thing is, if I see vitals and they're normal, why write them down? Obviously if my attending wants it, I can write them down. After doing my note, or I can write them while doing my note, but I don't need to do it now because I wanna see my patient so I could then write my note. And similar to things like labs, if the labs are normal, if I don't need to make any adjustments for electrolytes or I don't need to start thinking about an assessment because everything is normal, I just put a quick check into their name and I move on to the next patient. So for me, my approach is look at the vitals, if they're okay, I'm not gonna write anything down, if their labs are okay, I'm not gonna write anything down, and then I just look at overnight events, but quickly just counting through the notes, there's nothing there, then I move on and I just kind of already know that that patient is done for in terms of pre-rounding and I do that for every single one. And the bonus tip is I try to do it within a set amount of time. One common thing that we have here on the empty journey is I try to give myself time constraints for everything I do because one, it forces me to try to ideally hit them, but it also forces me to be efficient within that specific task. So this approach of going through the vitals and not writing anything down is really something I've created because I wanted to hit that time limit I gave myself. So in a similar fashion, once you're trying to parse through the tasks that you have to do to be efficient throughout the day, ask yourself what time limit do I wanna do? How quick do I wanna get through all my pre-rounding if you have 10 patients, ask yourself, can you pre-round in all of them within 30 minutes or 45 minutes? And then the next step, if you have to see your patients and seeing your patients is taking you very long, ask yourself how you can kind of speed up the interaction. Obviously you don't wanna be rushed when you're interacting with your patients, but ask, you know, what questions should you keep in mind before you walk into the room? That way you can have a very effective conversation. What physical exams do you wanna do to make sure that you can chop those in your notes and then quickly just either tell the patient that you'll come back to avoid any long conversations and then two, just giving them a quick brief update of what you think the plan would be, but again, telling them that you'll be back to give them more information. All of this works really well of helping me again going 30 minutes to pre-rounding my patients and then spending about 30 to 40 minutes to actually see all of them without spending excessive amount of time during each phase. Now in the past way, it may have taken me an hour to do the pre-rounding. I've now gone through the pre-rounding and seeing the patients by this time so now I can finally dive into the nips. And so far I've given you an approach of how to look at the tasks that kind of in your way before you get to your time cruncher. So ideally you can make those more efficient so then even if you spent the same amount of time on your notes or seeing patients, you'll still be able to be more efficient. Now staying on to the example of doing your notes more efficiently because that just happens to be the thing that keeps interns in the hospital longest, it's really hard to kind of focus on things when you're getting pages and we're not sure when to put orders in. Usually I like to create a very systematic thing. My first rule is if I get a page, if it's not urgent, I'm not gonna respond to it immediately. I'm gonna finish that thing that I'm doing that just keeps me focused, keeps me in a sense of flow. And the next thing is I kind of go from patient to patient instead of trying to go back and forth between the notes and orders and notes and orders. An example I would use is once I've rounded all my patients I would want to first do the note of the person who's gonna take the longest time. Usually it's very typical for us to do the quickest notes quicker just so we can feel like we're at a sense of accomplishment but then that's probably gonna kind of delay us later in the day is trying to work on those very busy dense notes later on. So instead I try to do those first and usually it happens to be my sickest patients anyways. So I pull up their notes, I pull up their orders and I pull it in the orders that I wanna do for the day and I try to work on that note as quickly as possible. Now you may be asking, well I'm not sure if my assessment and plan is correct. What should I be doing? Well, you can do one of two things. One, you can append your note with what you think the assessment and plan should be and you can update it later or you can do what I do which is I sign the note with the assessment and plan I think I'm gonna carry out and if anything changes you have the power to attend and assess and adjust your note later on. So one, you can have been completely right and everyone agrees with your plan or two, even if they don't you can make minor adjustments later on without having to work on the entire note from scratch. So so far I've given you a breakdown of finding your most inefficient task and trying to do it as quickly into the day as possible. A lot of my interns that I work with are still slow in their notes but they still don't try to prioritize doing their notes until much later. Now I honestly try to flip that approach if it's possible for you. Now for the rest of your day how can you be a more efficient and we've already talked about not responding to pages as quickly or not responding to a request immediately unless obviously it's an emergency but also having kind of very systematic ways and checklists that you can use for the rest of your day. So all of the things you wanna do for each patient as well as the things that you wanna do before you leave. That way if you have any downtime you can just kind of look at the remaining kind of to-do items that you have left and you can potentially work on those to make sure you don't have to do them later. Now I told you from the very start that could babble on and on about efficiency but to make sure that this episode doesn't go too long a few of the resources I do recommend if you want more step-by-step advice is the Crush on Clinical course for students on their clinical rotations as well as an intern survival guide for all new residents. I wanna learn not only how to be more efficient but also be more knowledgeable and confident as a new doctor. And I wanna know what you guys think about this approach, this strategy. Let me know down below in the comments section one what tends to take you the most amount of time in your day, on your rotations or your life as a doctor and let me know how I can help you drop all your comments down below make sure you hit that like and subscribe button on the side, one it supports the channel and two it tells me you love content like this please make more. So definitely hit that like button that truly do appreciate it. But with that being said guys thank you so much for watching this video hopefully you found it helpful to make yourself a little bit more efficient on your rotations but as always thank you so much for joining me on my journey hopefully I've been a little helped to you on yours I'll see you guys in the next one, peace.