Bottom line: Resident physicians may be the most important part of a medical student’s experience on any given rotation. This post series is about characteristics of my favorite residents that I’d like to embody when it’s my turn. This first post is about having prepared mini-lectures for student teaching.
For a while now, I’ve been meaning to make a post (or a series of posts, rather) as a sort of tribute to the most impressive residents that I’ve been privileged to work with as a medical student. During your clinical rotations as a medical student, your residents make or break your experience. Even though the attending physicians are the “bosses” of the team, it’s often your residents that will
- do 90% of your clinical teaching
- give you opportunities for procedures
- determine when you get to go home
- determine if you get to eat
- determine how heavy or light your workload is
- stand up for you when you’re getting grilled
- push you to get better
… or not.
Hopefully this series of short posts (tagged #KindOfResident) will be something I can look back on next year to remind me what it was like while I was a student. Please keep in mind that I’m going to try to pick out things that made particular residents stand out to me in positive ways. That doesn’t mean that I think these are necessarily the most important things for a residents to do or be. In fact, I think that most of my residents performed their jobs well, so by definition these rarities are not necessary attributes or practices of a good resident.
#1: I want to be a resident that has a handful of prepared mini-lectures.
Many of my residents were eager to do clinical teaching, and most of them were at least willing. Only rarely, however, did a resident have a prepared topic. The dilemma I’d encounter most frequently was when a pleasant, knowledgeable, well-intentioned resident would ask, “So, do you have anything you’d like to learn about?” I’d often run into problems here. For starters, residents often don’t have all of the answers, and it was awkward to get a dubious response. For this reason, obscure or controversial questions aren’t the best to ask. On the other hand, many of the simpler questions were topics that I could easily read about at home, and I learned early on not to ask questions that I could look up myself. On top of that, you don’t want to look disinterested by responding that you have no questions… but by the time the residents are caught up on clinical work and have time to do teaching, it’s often late, and you’re hoping to be sent home… So there you are, trying to think of a question that’s not too hard, not too easy, and not too broad in scope or likely to require a lengthy response. Not ideal. I had a few residents that made teaching simpler and more effective by giving us a short overview of a fundamental and relevant topic that they had selected for us.
One resident in particular sat down with my fellow students and me early in the rotation and let us know, “You should not leave this portion of the rotation without at least being familiar with a few topics. They are…” and listed off around 3 common clinical problems relevant to that portion of the rotation. I hadn’t gotten any resident teaching whatsoever on my prior rotation, so I didn’t expect anything to come of this. Just in case, I went through the first of the topics that night. Boy, was I grateful – the very next day, immediately after rounds, he sat down with all 3 or 4 of us and took 15 minutes or so to go over that topic, from risk factors to diagnostic clues to management to prognosis. He went one by one through the students, letting us take turns answering questions until we we ran out of ideas, then he’d fill in the gaps. It was painfully obvious which of us had squeezed in a few minutes to read the night before.
I took a hint from this experience and read on the next topic that night. Sure enough, the next day the same experience repeated itself. This motivated me to read on the next topic. When this resident told me that we’d soon talk about a core clinical topic or concept, I knew that I needed to read up on it that same night. I worked with him again a few weeks later, and the same pattern continued (but with different topics, relevant to that part of the rotation). This was the most powerful motivator to study that I ran into during all of third year. Subsequently, this rotation ended up giving me the highest score of all clinical areas on my board exam (Step 2), despite being so long before the exam compared to other rotations.
My goal: when I’m a resident, I’d like to build up three or four 15 minute lectures on core concepts for each rotation. I can even accompany them with visual aids in the form of Keynote presentations on my iPad. I’ll notify students of the topics early on, so they can prepare if they’d like. Of course, I’ll additionally welcome any questions they have. I can improve these little talks each time I give them, and by the 3rd or 4th time each, I’ll have a fairly rehearsed mini-lecture that may even have a bit of flow to it.