Transitioning from M2 to M3

My transition between second and third year of medical school, when my school shifts from classroom to clinical, has been a huge change in many ways. My grading system, study methods, social life, everyday wardrobe, and so much more is just so different. But as much as it is different, it’s very exciting! I’m finally applying all the knowledge I received in the classroom in the real world, and feeling like a member of the profession. It’s time to trade in my cute flats with no support for some extra comfy loafers and pack away my ripped jeans and crop tops. I’m definitely no master of rotations, but I’ve got two under my belt (Pediatrics and OBGYN,) so I think it’d be good to share my generally fresh perspective.

The biggest adjustment for me was the loss of autonomy in my day. During first and second year I could decide when I was going to study, plan meetings and volunteer opportunities around my schedule, and go to class only when I wanted or needed to. I was a morning person and could wake up at 5:30am to study. Now I’m at the mercy of my attendings and residents and I have to report at a specific time every day. If I’m allowed to come in later or get off earlier, only then can I get some extra work done. If I planned to study from 6-11pm but I’m still at the hospital at 6, there’s nothing I can do about it, so then I have to amend my plans. Lately, I’ve had to do the bulk of my studying in the evenings because that’s the only “free” time I have. That’s been hard because after a day in the hospital, I start getting tired at 9pm; I’m not a night person. I have to be stricter about staying on my study schedule because now there’s limited time to play catch up, especially if I actually want some downtime during the weekend.

The way I study has changed quite a bit because there are no lectures and PowerPoints to take notes on and study. Every rotation has its own set of resources and each time I have to pick the combination that I think is best for me–textbooks, online lectures, question banks, etc. Knowing how you best study is key to determine what resources you will use. It’s rather overwhelming especially because when I ask others what worked for them, everyone did something different. In my case, I know I need some type of reference text to read and refer to. I don’t do well just learning solely from questions. I also know that having my own personal notes is very reinforcing and helps me solidify concepts.

The last thing that really threw me for a loop is the change in our grading system. At our school, much of your grade is based on the Shelf exam for that rotation. To qualify for an A, you need to meet an eligibility cut off score on the Shelf for that rotation. That means you could be stellar in the clinical setting, but if you miss the eligibility cut off, there is a chance you may end that rotation with a B (there are some exceptions, but rare). Thankfully, the comments and evaluations you receive from your rotations stay on your record and are used later for your Dean’s letter for your residency application. So it’s important to do my best for the people I work with on the clinical side of things: step up to the plate, take on an extra patient, present as flawlessly as possible, etc. But at the same time, I NEED TO STUDY! Finding that balance is tough. What I’ve found is that during the first half of a rotation, I can be more able to stay for the extra procedure, see more patients, and offer to look things up. When the Shelf exam moves closer, I find it’s best to focus my time and attention to the books. While I am at work, I am a team member 100%, but when I hear those magic words “I don’t think there’s much else for you to do today” I feel relieved to know I have additional time to study.

Third year has been a blast so far, as I’ve completed Pediatrics and OBGYN and have palliative care and Family Medicine next. My career interests lie in primary care, so each of these specialties are great learning opportunities as I decide where my passions are for various specialties. Getting to know patients and their families, educating and treating both the young and the old has been so rewarding. In the spring, I expect I’ll have different sentiments and challenges as I rotate through Psychiatry, Neurology, Surgery, and Internal medicine. I’m definitely up for the challenge! Every day is a new learning opportunity and chance for me to make a difference in a person’s life.