Quick disclaimer: This will be a lot more informal than my usual writing; it felt like the right way to tackle this. Enjoy the read!
If I had to sum up the MS3 experience in a single sentence, it would probably be “Please dear God let me actually get 8 hours of sleep tonight.”
I’m only half joking.
My questionable sleep schedule aside, I quickly learned that people aren’t kidding when they tell you that the third year of medical school is when medicine starts to feel real. It’s a big step up from classrooms and block exams, but despite the increased demands, it’s a truly rewarding and engaging experience. It certainly has its ups and downs – the ups are, after all, what many of us use to decide what residency we wish to pursue – but even the lowest lows generally offer valuable learning and real-world experience.
When myself and my fellow MS3 (now MS4, and wow does that feel odd to say) editors decided we all wanted to write about third year, we weren’t entirely sure how to format our articles (joint vs individual) or what to tackle. We knew we wanted to talk about third year, but ultimately decided we would each write what came to mind and what we thought might be interesting or helpful for rising third years in particular to read. I value mentorship and firmly believe that a great deal of my success is due to the advice of students and preceptors who helped me out. As a result, I knew a pretty significant part of my article would be made up of extra bits and pieces of advice I wish I’d heard before tackling rotations and want to share with others. So, here’s some rapid fire information that might save those of you starting rotations some stress.
- Consider setting expectations with your preceptors early on. If I ever had extra downtime around my preceptors, I found that they were open to providing feedback and telling me what they wanted me to work on next. Preceptors will generally be delighted that you actually care enough about improving to ask how to get better. It’s a great way to identify areas you need to work on and set concrete short-term goals.
- Where you start matters very little compared to where you finish. At least as a 3rd year, the expectation is less that you know tons of things at the start of the rotation and more that you clearly work to improve as the rotation goes on. Make an active effort to take on more patients over the course of a rotation, and to write up more detailed plans if you ever find yourself tackling your twelfth diabetes management case in a row. Show that you are actually taking opportunities to improve.
- Consider keeping a mini-journal with some of your best work/patient cases. Other than the benefits of reflection and opportunities for improvement, some preceptors like to hear about specific experiences that were really meaningful to you if you ever decide to ask for letters of recommendation. Mind your HIPAA compliance, but keeping a log can help; rotations are a blur and generally chaotic, so you may not remember every detail of even the most meaningful experiences.
- This is the piece of advice I consider the most significant. If you have specific interests you want to pursue, ASK! Again, preceptors and directors love to see you show genuine interest and enthusiasm. I plan to apply PM&R for residency, and when I was on Pediatrics, I contacted the clerkship director and asked if there was any chance I could work on the rehab service for part of my rotation. He got me connected to the right people, and the end result was that I got a great look at Peds PM&R and made connections that I never would have if I hadn’t searched for the opportunity. Third year goes by fast, and if you don’t make an effort to ask for these things, they can slip by easily. Again, showing interest is never a bad thing! The worst thing that can happen is someone says no and you proceed with the usual rotation!
- Get the Anki phone app if you’re an Anki person, and consider the UWorld one as well. I get many more cards/questions done per day now since I can pull my phone out when I’m in line for a coffee or at the cafeteria.
- Last one: try to give every specialty a chance. It’s easy to walk in and decide you dislike a program or a specialty in the first few hours, but most rotations make an effort to assign you to a broad spectrum of teams and subspecialties. The simplest example is that I met lots of people in OB/GYN who didn’t feel particularly attached to one side of the specialty, but absolutely adored the other and still felt interested in pursuing the field as a result. Keep an open mind!
My hope is that I’ve left something useful here for those starting their rotations around this time. Ultimately, third year is a wild ride with a unique blend of chaos and learning. The simplest piece of overall advice I can give is to put in the effort and focus on learning so that you feel more competent when someone’s life is actually placed in your hands. Beyond that, you may never get a chance to see some of the third year specialties again, so treasure the time you get and make the most of it. And if any of the rising MS3s ever feel overwhelmed, hopefully it helps to know that myself and my MS4 classmates believe in you all and are rooting for you to get through it!
Cheers!
(Side note: any rising students with an interest in PM&R, feel free to reach out if you want to chat or have questions! My email is in my bio on the website!)
Salman Azfar is a fourth year student at the University of Arizona, College of Medicine Phoenix. He graduated from UCLA in 2020 with a degree in Physiological Science. He loves dodgeball, swimming, playing games, and spending time with his friends and family. He can be reached at smazfar@arizona.edu.