 So, how do you do well on your internal medicine rotation? How do you get honors? How do you do well on the shelf exam? Those are all questions that I had, I'm sure you have, and I'm going to answer them for you in this video by giving you my top seven tips that helped me, and many of my students just crushed their internal medicine rotation as well as shelf exam. I'm going to give you those tips after this intro. All right, guys. What is going on? Luxury for the MD journey, helping you succeed on your medical journey with less stress. If you're new to this channel, first of all, welcome. I am a fourth year medical student who is going into internal medicine, so it makes sense that this is my very first video on tips for a specific rotation. There's more to come. So, if you enjoyed this video, make sure, first of all, to give it a like and subscribe to this channel and join the community to get more advice like this one. In this video, as I mentioned, I'm going to give you my top seven tips on how to do well on your internal medicine rotation as well as a shelf exam. At the very end of the video, stay tuned because I'm going to show you where to go to. If you want just one resource that is going to tell you how to just crush your third year rotations and just make the whole process a little bit less stressful. But without further ado, let's get into the tips. So the first tip, and this is really what helped me separate myself from my classmates and get honors from all my evaluators, which just seems simple, but it's to be your patient's advocate. Sometimes we get so caught up in the grades and the honors and the high passes or whatever the valuations are that we lose track of what's important. That's becoming the best clinician. And one part of that, a huge part of that is becoming the best advocate for our patients as possible. Sometimes especially the third year med students, we don't think that we can offer much as a care provider. And so we try to do the things that's going to give us the grades and sometimes stay away from our patients. But if you work on being a patient's advocate and you try to do as much as you're possibly able to do for your patient, you are going to get the highest grade you could possibly get. Here's what I mean. The first step, and this goes into a multi-step thing, is when you see your patient for the first time, make sure that you know who you are and what you're going to be providing for them. So in a lot of my other videos, I give you this one statement that I love to use with my new patients. And I hope that maybe you can try to give it a chance and use it with your new ones as well. And it basically goes like this. When you see your new patient for the first time, introduce yourself at the start and then very in before you leave the room, remind them who you are. So I always say something along the lines of my name is Laksh once again, and I am the med student on your team. I will probably have the most time with you. So if you need anything at all, don't hesitate to ask me. I can make your stay a little bit more pleasant. I'll be happy to help. That statement guys does just so much because that patient probably doesn't have that many people that gives them a nice little soliloquy monologue of who they are and what their role is. Often we just go into their room, do something. And the patient really has no idea what happened. But if they know your name, they know that you're there for them and they know your role, then out of all the people in your team, they're probably going to look at you as one of the care providers as very essential and they're going to trust you. So if you're there, if you just start with that, everything becomes a little bit easier. The second level is to just stay on top of your patients, which means that it's not about just seeing them in the morning with your rounding team. And then after that, you know, you're working on your notes. No, have a structure of seeing them in the morning, maybe an afternoon, after lunch, and then once more before you go, you know, home for the day. If you've seen them multiple times throughout the day, they're going to recognize your face. They're going to just be able to tell you things that maybe the other residents and attendees just don't know. So if you were able to stay on top of your patient by having multiple visits throughout the day, you're going to be there and you're going to understand how to help them the best way. And finally is just understanding everything that goes into their care. If you know your patient is going through a specific disease process, make sure you read as much as possible about it. Because if you have something that you've read about that maybe the patient is not currently getting treatment, some type of management decision, you can ask about that. And even if that's not the right course of action, everyone knows that you're involved in your patient's care and you're looking out for them. Even though your decision-making may not be in the right direction, they know you're at least attempting it. So make sure the patient knows who you are and make sure you stay on top of it. And actively start making decisions for your patient. You may not be the one putting in orders that are actually finalizing, putting the final stamp of approval. But if you're at least trying to make management decisions, people know that you're actually caring for that patient. That's really what the big thing is in internal medicine. You're trying, you're showing effort, and you're showing ownership of the patients that you care for. So tip number two is to use a Scotchie. And I'm going to go ahead and just put a screenshot of one above here. Internal medicine has a lot of things that go on. And most of the patients that you have, you see for quite an extensive amount of time, versus maybe a rotation like surgery where your patients are there for maybe a day. Internal medicine, you can easily have a patient for a week, sometimes even more. And you're going to have to be able to stay on top of not only the history that they came in with and the complaint, but the things that happen to them while they're at the hospital. Patients can get diseases and conditions while they're under your care that probably were different than the ones that they had when they got admitted. You're going to be able to stay, you're going to have to be able to stay on top of, you know, what things changed, what meds you started and, you know, discontinued. What lab values they had when they came in and how they compared to the ones they have now. That's a lot of information to just stay on top of. And if you just have a blank piece of paper that you kind of throw on your white coat, it's really hard. And so you need a way to stay organized. Scotchies are amazing for this. And I'm going to link down the description. Scotchie, you guys can use a template that basically can give you and one page, keep all the track of all the labs and kind of temperatures, daily events that happen for a patient for like a week. Once you started getting to get used to what a Scotchie looks like and you get a little bit more practice, start creating your own. And I created an entire different video, which I'll link down below on how to stay organized and create your own personal Scotchies, which keep you more organized on your internal medicine rotation. The whole main goal is you should be able to at least be able to manage anywhere from three to four patients by yourself as a third-year med student. If you feel like you're just only comfortable at two, then you really need to get a little bit more organized. So check out the video in the link in the description below. You'll kind of get an idea of how they will use a single piece of paper throughout the entire patient stay without having any excess unnecessary information. So use a Scotchie if you're new to it and then transition into your personal kind of system. So check out that link in the description. I think you guys will enjoy it. So tip number three, and this refers to doing a shelf exam, is to begin your world early. I think that there was almost at least 1,000 questions on your world, and that was at least five to six times more questions than any other rotation. To be able to do that many questions while going through one of the most time-rigorous rotations, you have to have a very strict schedule. If you can, start doing those internal monosin questions in another lighter rotation, or just at least start maybe a week or two before the rotation begins, because then you can easily and realistically finish all those questions by the time that you have to take a shelf exam. You also give yourself some time to review. If you don't have a luxury of starting early, then I think the breakdown comes out to about 40 questions a day that you have to do from your world to be able to stay on track before your shelf exam. I'm going to make an entirely different video on what resources to use to just crush your shelf exam, but you really do have to stay on top of your questions. I'm going to give you those tips on the next video, but make sure you start early, ideally before the rotation, if not, just start from day one, and you're going to thank yourself compared to your classmates who are going to wait till a couple of weeks and realize that they have no chance of finishing. So tip number four, and this kind of goes with the Scotchy, which is have a plan of attack. Internal medicine, if you are a decent student, you're going to start balancing a few patients, and each of those patients, depending on the service that you're on, are going to have a lot of things going on with them. You may realize that there's something for them to have done when you're first pre-rounding, then your attending is going to add something else to the list, and then after lunch, you're going to realize the patient also needs X, Y, and Z. You're going to have to stay on top of the people you have to contact, the labs you have to order, questions you need to ask the patient, and to stay on top of it, maybe use your Scotchy, the one that I linked down below has a little checkbox where you can add all your to-do list items, but after you have your to-do list and you have multiple patients, make a priority list of kind of the order you're going to go through. You need to make sure that you get through all those before you go home for the day. So it may be something as simple as write note for patient X, write note for patient B, call pharmacy for patient X's, listen to a pro, whatever it may be, have each of those items and start scratching them off as you do them, because by the end of the day, there's no fear of, is there something left to do? Am I going home and then realizing, oh crap, I forgot to do that important thing. I'm going to look like a total fool the next day when I have to admit that I didn't do it, have a plan of attack. So when you round in the morning, I'm patient for the first time, to when you go home, everything needs to be accomplished, and then maybe create the plan of attack for the next day. So that way you're kind of already on top of the ball, you're going to do well on your rotation if you seem like the student who just owns their patients and owns the service. So the next two tips are really going to help you do well on the rotation as well as a shelf exam. So tip number one is using the pocket medicine method. Now this is going to be a resource on the touch on the resource video on internal medicine, but the pocket medicine is a small book that you guys probably seen. I'll link it up here in a screenshot, but it's a video or it's a book that you nicely fits in your white coat pocket. And it basically goes over everything that you probably need in your internal medicine rotation, but it's very intense. Obviously no one reads that as their main resource, but it's great when you have to just refer to something or a disease when a patient comes in with it. So a resident of mine gave me a great tip, which is if you have a patient with a specific disease, regardless of how comfortable you feel about it, go to that section in pocket medicine and read the whole section on it and then quiz yourself. Most sections are probably a couple of pages, maybe two to three. So when you go home and you have a patient with pancreatitis, read through the pancreatitis section and kind of just review and you'll realize there's a lot of stuff probably didn't know, some things you forgot, and it's going to make you kind of stay in front of the eight ball when you're taking care of that patient for the first time. So regardless of its condition that you know or condition that you're uncomfortable with, try to use the pocket medicine method and just go through each section and just read it again. Even if you have dirty patients with heart attacks or heart failure, read through that section again every time you're able to pick up something new and become a better and more student student. And tip number six, and this kind of goes along with the pocket medicine method is to use review articles. As I mentioned, internal medicine just has a lot of stuff and it's hard to, you know, learn all the information but sometimes you have to also get very deep into a specific category. So going back to our description about a patient with pancreatitis, you know, obviously pocket medicine may not have everything you need to know. So review articles are amazing. You know, if you have a patient with pancreatitis, you want to look like the student that knows how to take care of pancreatitis, not just beyond the high yield points that some of the resources give you or what you will may provide or tell you, but you want to be able to take care of that patient like, you know, a future doctor. So I love using the review articles. I would use the free printing that the hospitals would provide and I would print out an article or two about the disease, even if I was comfortable, even if it was pancreatitis, even though it was heart failure, I would print them out and I would just read them that night. Along with doing the pocket medicine, I would just try to pick up new things because again, if, you know, you have a resident that doesn't do something that is in that article, you can ask, you know, I realized that we didn't do this, you know, is this something that's an option for this patient and you're going to be able to learn the options of care that are available for that patient in that condition. You become a better student and you're going to do better on your shelf exam. So use review articles regardless of how common or uncommon the disease is. And finally guys, this is a very big tip but you need to be inquisitive. So it's very common for us to kind of shrub our shoulders, nod our heads when our attendings are talking but we realize that we don't actually understand what's going on or it may make perfect sense when they're teaching it on the board during the ward service. When we go home and we try to think about that topic, we realize that, you know, like we didn't retain as much as we should have. Maybe we actually don't understand that at all. So if you have a question versus just saying, I think I understand how that works, ask why, you know, it's not good enough to just ask the question but to know the answer. So if there's a question that you have, you know, ask your resident, if they can't answer, look it up, ask your attending or maybe look it up before you ask your attending, but make sure you're inquisitive about both the small and the big things. One thing that I would do is along with my sketch sheet of paper on the bottom, I would just simply have a list of the things that an attending would mention or I would read about on a patient's chart that I had no idea about what it was. For example, when I was on my CCU service for cardiology, I would see patients with TAVR, which stands for TAVR, which is a procedure for your aortic dialysis, but I did not know that at the time. And so I had to look it up and finally it made sense why all of these patients on the heart service kept having those acronyms written. So have a list of all the things that you want to kind of learn and go home and just review them because then you have less and less that is unfamiliar to you and you become a better student. But those guys were my top seven tips on how to do well on your internal medicine rotation. Hopefully you guys enjoyed them. If you guys have any more questions, obviously put your comment down below and I'd be happy to help answer the questions. But I'm also interested. Internal medicine is obviously the field I'm going into, but what's your favorite specialty or what's the specialty that you're considering going to and you think is really cool? I'd love to hear from you guys and make sure you comment down below. And before I end the video, I've mentioned that I would include where you go to next to try to get kind of an upper hand on how to do well on all your rotations. So a new project that I'm working on and it's kind of the next sequel, next obvious sequel to the books that I read last year is called My Clinical Guide. This is going to be my book or my newest book on how to do well on all your rotations through a device, resources, study schedules, as well as things such as how to do well on your step two exams, how to prepare for residency applications which are right around the corner. Just help me crush the process with a lot less stress. So if you're interested in kind of understanding when that project goes out, add your name to the link in the description because not only is it going to be a book, but I have a newer version and more kind of advanced ways to share all these tips with you. So if you want to stay updated and want to be a part of the creation process as well as get the bonuses before anyone else does and kind of be able to give me feedback, add your name to the list and I'll update you when the time is right. So link will be in the description for the Clinical Guide which ideally I'm planning on having ready by the end of February. So hopefully you guys are excited and hopefully you enjoyed this video. As always, if you did enjoy it, make sure you give it a like, subscribe to the channel and join the community. And as always, I'll stop babbling like I always do and I will see you guys in the next one. Take care guys.