Starting Clinical Rotations

Saturday, March 10, 2018




I remember being so excited yet nervous about clinical rotations! So far these are the rotations I've completed: Two Family Medicine rotations, Internal Medicine, and General Surgery. I'm currently on Psychiatry and next up I have Emergency Medicine, Dermatology (as my elective) and Pediatrics in that order!

Today, I wanted to share some of my tips for what to expect or things to keep in mind as you start clinicals.

A little flexibility goes a long way

Every day on rotation can be different. The schedule can vary a from day to day and you may or may not even work with the same preceptor. You may not always have a lunch break (or a short one if that) and you may not get off exactly at 5pm if that's when the clinic is supposed to close. The best way to make your life easier is to learn how to roll with the punches. These are just some of the experiences you may have in real life and its best to be mentally prepared for them.

Learn to love the word YES

Say yes to (almost) everything. If your preceptor asks you if you want to assist in a procedure, say yes! If they ask if you want to go see a complex patient on your own, say yes! I'm a strong believer of see one, do one, teach one. I will say that clinical rotations taught me a great deal about stepping out of my comfort zone and facing my fears. Of course, if you are terribly uncomfortable about doing/saying something, you should let your preceptor know and ask them to guide you through it. Just don't let your fears hold you back because 9/10 times, you'll be grateful you said yes and tackled something that is personally challenging for you!

Read up 

I would suggest reading up on the most common diagnosis and treatments for each speciality before starting a rotation. For example, you'll see a lot of hypertension (high blood pressure), diabetes mellitus (DM), and GYN conditions in Family Medicine. You see a lot of heart and renal (kidney) failure in Internal Medicine in addition to HTN and DM and may read a lot of EKGs of your ER rotation, etc. For surgery, I would look up YouTube videos and try to see if I could watch the surgeries the night before.

It's also a good idea to read up on something after you see it at clinic/hospital. This helps solidify the information now that you've seen it in real life!

Wear comfy shoes

You might stand a lot on your rotation depending on how the clinic is set up. On my surgery rotation not only did I stand a lot, we also walked back and forth between the hospital and the clinic since they were a parking lot away from each other.

Load up on snacks

I always kept a small snack in my white coat to stuff my face with in between patients. There were times those snacks were a lifesaver.

Jot down notes

I still keep a small moleskin notebook in my white pocked to take notes. I jot down pearls that my preceptors would either share with me or anything said to the patients in terms of treatment, side effects, etc. A lot of times what's done in practice is different then what's taught in the books and you will not get those pointers from school (your professors know this too), which is one of the reasons why we go on rotations. I remember so many of those small pearls that have accumulated over time and it's been very helpful so far!

Discuss expectations with your preceptor 

I always made it a good habit to ask my preceptors what was expected of me at that rotation on the very first day (if we get the chance). Some rotations are very hands on and you get a lot of autonomy. Others are very different and they like you to shadow a lot more than see patients on your own. I also always ask my preceptors if its okay to use my phone throughout the rotation to look something up on UpToDate or Epocrates on my first day. This way, I avoid any incidences where they think I'm spending all my time on social media instead of learning medicine. Most of the time, preceptors and I looked things up together so usually its not a problem.

Ask for feedback

My program requires our preceptors to do a mid-rotation and a final evaluation. This allows us to figure out how things are going on early on and gives us the opportunity to make changes as needed. However, if your school does not require your preceptors to do a mid-rotation evaluation, I would ask them if they have a few minutes at the end of a day to discuss your progress and if they have any suggestions that you can benefit from/there are things you should do differently. This way you can have the best experience possible.

Don't be too hard on yourself

We've all been there. We all have felt incompetent or think we are incapable of practicing medicine. We're all afraid of looking stupid in front of our preceptors or getting yelled at. Thankfully, I haven't had any terrible experiences but I have been pimped a lot and you know what? Those rotations are actually the ones I learned the most from. Being wrong allows you to learn in a way that you'll never forget it again. Feeling insecure is okay, because we're students! We're not supposed to know it all. Heck, even our preceptors don't know it all, which is why it's called practicing medicine. So don't be afraid to be wrong and if you are wrong, learn from it!

Clinical rotations are the most fun part of PA school. The experiences you'll have, the patients you'll help, and the different people you'll meet will shape you into the provider you're going to become. Enjoy this exciting journey and let nothing hold you back! And as always, remember: do no harm.

If you have any experiences you want to share with the rest of us or have any advice of your own, please leave a comment below. Thank you for reading and good luck! :)

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