How to Conquer the Clinical Years of Medical School

You have spent countless hours in the books the last 2 years, and you are now getting ready to venture out into the clinical world to learn how to diagnose and treat patients. This can be nerve-wracking. All the patients I had seen in the first two years of medical school were mock patients, so it was far from a real experience and hard for me to grasp that I would be treating ACTUAL patients with ACTUAL disease processes. There are a few things that make the clinical years a little easier and I will talk about them below. 

A little side note before the list of tips: you will not know everything your preceptor asks you and that is OKAY! You are there to be wrong, to learn, and to grow. There will never be a better time to be wrong than as a student. It is a blow to the ego at times, but you have to let go of your pride. This will be the best way to gain confidence.

Tips to Conquer the Clinical Years of Medical School

1. BE EARLY- Being early shows you are prepared for the work day. It will make you appear more interested in learning. I shoot for at least 10-15 minutes early.
2. ASK QUESTIONS- This is a no brainer, but asking questions keeps you engaged. The preceptor will be more willing to teach you if you seem interested. I had a routine to keep me accountable with this. I would go home and review the cases of the day. I would then come back the next day with a couple questions on those cases.
3. READ- This is something I could have done a lot better at, so I want to stress the importance. Read up on the cases you see each day. If it is something you are not familiar with, do a thorough review that night. If it is something you have knowledge of and are fairly confident in understanding the management, do a quick review to solidify the knowledge.
4. RELY ON SKILLS LEARNED- History and physical exam skills were taught heavily in the first two years. Going back to these basics helped when I was placed in the room with a real patient. Bates’ Guide to Physical Examination and History Taking is a great book to reference if you want to increase your skills. There is also a pocket guide if you want something to carry with you on rotations.

Resources to Conquer Shelf/COMAT Exams

Shelf/COMAT exams are standardized exams taken in third year that are subject-based and typically taken at the end of each rotation. They are to test your knowledge of the management of conditions/diseases in that field. There are a few resources I found useful for studying:

1. OnlineMedEd– It is an online learning platform created for the clinical years of medical school. It follows a specific learning sequence to provide information most relevant to students in their clinical years. Click the link to learn more about their PACE learning method. I found the notes and videos extremely useful for the exams.
2. Uworld– Uworld is a question bank that has a plan for STEP 2 and Shelf Exams with a supplement for Level 2 if you are a D.O. student. I think it is the best question bank out there. I go more in depth in a previous post discussing resources focused on the first two years of medical school. Check it out to learn more about why I recommend Uworld.
3. Case Files Books– These are the only books I feel are necessary for studying for Shelf/COMAT exams. I have linked the one for internal medicine, but there is one for anesthesiology, cardiology, critical care, emergency medicine, family medicine, geriatrics, medical ethics, neurology, OBGYN, pediatrics, psychiatry, and surgery as well. Essentially, they have several cases in each book they present and then you answer questions on the case. Each case is board relevant and I saw several on my COMAT exams.

Final Thoughts

I know the tips are rather simple, but excelling during clinical years is simple; you just have to WANT IT. Be eager to learn. You do not need very many resources for exams either. Let me know in the comments if you found these tips and resources to conquer the clinical years of medical school helpful and feel free to leave some advice as well (: