Be The Driver (or Balancer)- Getting The Most Of Your Clinical Rotations

What are you balancing?

When completing a rotation, the competing interests are:

• Humility and Confidence
• Passion and Curiosity
• Work Ethic and Wellness

Humility

As a student, it is expected you are there to learn. Within this, there is an implicit understanding that there are things you simply do not yet know. Being able to recognize these things, and say aloud or to yourself “I don’t know” is really the first step in recognizing a knowledge gap. Only after it’s recognized can that knowledge gap be filled. This reality is well encapsulated in the Maimonides quote “teach thy tongue to say ‘I do not know’ and thou shalt progress.”

Confidence

On the other side of the same coin, a learner ought to have confidence. This includes confidence to speak your mind about what you do indeed know. And that is often a lot. It is also recognized here that what you may know as a learner may not be in the medical knowledge realm, but come simply from another place. You may have been able to spend more time with the patient or family than the overseeing provider. You may have a unique perspective as a learner that gives you a vantage point others do not have. Listen to the podcast for a poignant example of when a learner, if he had the confidence to speak up, could have changed the trajectory of a patient’s life simply because of his different perspective.

Passion

Depending on where you are in your current medical education journey, you may have developed a strong passion or an understanding of your future career goals. During your learning years, lean into that. Find and pursue the things that excite you about medicine, that you want more experience and exposure to. Go after the electives, selectives, shadowing, or rotations that light a fire under you to learn more, grow more, and develop as a future provider. Your preceptors understand that excitement and want to support it.

Curiosity

As much as you have known you are going to be a left pinky surgeon or a dermatologist since you were 8, there are many other experiences and rotations you will need to do before you get there. Some of these will seem obligatory and rotations you “just have to get through.” Fight that feeling with all you have. Remember the phrase every provider has something to teach you. We say provider here because medicine is a team sport, you may well learn as much or more from the respiratory therapist, nurse or pharmacist on a rotation as you do your preceptor. And what you may learn may not be medical knowledge. You may pick up a bedside manner you want to emulate- how to get a history, talk to a patient, console someone with a bad diagnosis. On the other end of the spectrum, you may learn how not to act, talk to patients or staff, or conduct yourself. The amount of learning that can be accomplished in a “throw away” rotation is boundless and if you enter it with the mindset that every provider has something to teach you, you will do well.

Work Ethic

To get to where you are in your educational journey has taken hard work. If you are a third or fourth year medical student or an intern, it is only going to get harder. These years in medical education are amazing growth opportunities. It is a time to see just how hard you can work and how much you can develop. If you have not done so already, read the book Grit: The Power of Passion and Perseverance. We have already talked about the passion side of things. Now we are talking about the perseverance. These clinical rotations will push your body and mind to work longer hours, study harder, and engage yourself in your own growth like you may have never experienced before. Take on that challenge. Grow as a person and a provider. There is a great quote from Steve Prefontaine, a world class long distance runner that states “to give anything less than your best is to sacrifice the gift.” For Steve the gift was distance running, for us it is our mental capacity, our intellect, and our capacity to learn. This intelligence ought not be sacrificed and so see these rotations as a challenge to be met. You will be amazed at the growth you experience.

Wellness

While we push our bodies and minds to learn more and do more, we have to be conscious of wellness. Remember this is a time to love yourself and care for yourself. As we mentioned above, you will be working as hard as you have ever worked during many of these clinical rotations. That can be exhausting. So it is crucial to take time out for yourself. After your day in the OR or on the floors is done, make sure to reserve some time for some self care. If you are a runner, go out for a run. If you have a family, spend time with your significant other or children. These self care breaks are not only good for your mental and physical health, but can also “refill the tank” so to speak for the next clinical day. And don’t forget, multitasking is largely a myth. We task switch. So when you are off, be off. The analogy of a light switch comes to mind. While on shift that light is shining brightly as you care for patients and learn. When you get home and it is time for wellness, switch the light off. Care for yourself and the people who make your life whole. Then, when it is time to read up on the cases of the day or prepare for the next, turn the switch back on. Most importantly here, remember to love yourself.