Posts tagged advice

A Word with Fourth Year

For the students who have survived their foray into clerkship, congratulations for making it this far. You are only a year away from finishing your medical schooling. Here are some words of wisdom as you draw closer to the end as an undifferentiated stem cell and down the new path as a resident.

  1. Stay healthy. Surely by now you will have managed to find a daily routine that allows you to work hard but also enjoy time away from medicine. However, third year is also a time when one can pick up bad habits. Plan ahead, and take this opportunity before residency begins to really iron out the sore spots in your life.
  2. Explore your interests. Fourth year is really about finding your career interest and honing in on that goal. This is where you can start to expand on your career choice and take electives that give you inspiration, skills, or both. 
  3. Prepare early. Residency applications are meaty things and the deadlines come sooner than you think. Research the programs early, write cover letters early, and think about planning your electives early and in line with the residency matching schedule. 
  4. Have a backer. In third year, I mentioned that making a good impression was important. That trend continues on in the fourth year electives as well. The good will and social capital you accumulate with your attendings are what will fuel good reference letters. For a competitive program, these letters, particularly if they are from respected members of the faculty, can make or break an application.
  5. Study and keep studying. Elective choices can change the entire atmosphere of fourth year. While flexibility is welcome, it is never a license to take the easy road. Still take some time to read and study. At the end of it all, regardless of what program you match to, the licensing exam tests you on all facets of medicine.
  6. Big brother, big sister. When you began third year, you were the fresh face on the ward. There was some stuff you knew back then but a tonne more you had no idea about. Remember how stressful and terrifying it was once.
    Now that you are a fourth year, do not forget how that felt. When you meet a third year student on your team, help them along, guide them, impart your experience to them. Remember the kindness of your senior students and residents and pay it forward.
  7. Have fun. Medical school goes by very quickly. As a student, there is a flexibility and freedom that you will simply never come across again. Enjoy your rotations with your peers. Make the most of your electives. Take the residency interview tour as a nation-trotting adventure. Never forget to have fun on this job.

Related posts: A Word with First Year. A Word with Second Year. A Word with Third Year.

It’s in the act of making things that we figure out who we are.
Austin Kleon.
We treat patients, not diseases.
All healthcare flows through the relationships between the healthcare provider and patient.
The spoken language is the most important tool in medicine.
Eric Cassell, Talking with Patients, 1985.
I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.
Nelson Mandela, 1918-2013.
It is the duty of a doctor to prolong life. It is not his duty to prolong the act of dying.
Lord Thomas Horder, 1936.
First off, I love your blog and how you are passing your knowledge to others in this way, it really helps someone like me who is completely nervous & confused on the process of becoming a doctor. My question is: If you could go back and give your freshman self any advice as to how to better prepare yourself for applying to medical schools & building your resume what would it be? Would you do anything differently so that you might have had more confidence in your application? — Asked by Anonymous

Firstly, to you and everyone else who have been submitting questions, I am sorry for the late reply. 

The circumstances surrounding my plans to pursue medicine are complicated. However, if I could go back and give myself advice in a different life, I would advise taking my time. One of my biggest regrets has always been coming into medicine young. I feel that I could have benefitted from a year or two of life experience: working, volunteering, exploring, travelling etc.

The secret to being a great candidate is not how much time you invested in research, how many doctors you shadowed, or how stellar your grades were. The secret to being a great candidate doctor is being a well-rounded, honest, dependable, and kind person. Where medical knowledge can always be taught in school, these qualities that ultimately define you as a candidate are developed through the experiences you have gained in your life.

Without Mistakes How Would You Lern?
Even now, I have to always remind myself that it is alright if I make a mistake, it is alright if I cannot answer my attending’s question, it is alright if I missed something. In the end, what matters is that I learned something to make sure those mistakes do not happen again.

Without Mistakes How Would You Lern?

Even now, I have to always remind myself that it is alright if I make a mistake, it is alright if I cannot answer my attending’s question, it is alright if I missed something. In the end, what matters is that I learned something to make sure those mistakes do not happen again.

Trust no one.
Internist on verifying any information given to us rather than elicited ourselves.
Knowing yourself is the beginning of all wisdom.
Aristotle.

Neil deGrasse Tyson speaks about learning mathematics from the Great Debate: the Storytelling of Science.

I watched this last night and I think it is advice that applies to many of the readers who have asked through the years what to do about their struggles with math, chemistry, physics etc. Certainly, I feel that it applies to those who question if medicine is too hard for their passion to stay alive.

With practice, you can become better at your craft, no matter what discipline you pursue. It takes time, it takes work, and it takes practice. But you do eventually get there.

Watch the full Q & A session linked above for other responses by Dr. Lawrence Krauss and Bill Nye to this question.