Letter to a Third Year

I stumbled across this in my Google Docs. My school used to put together a book of letters every year from third years at the end of their year to give to students about to start clinical clerkships. This was written in 2011 (I still largely agree with myself).

Long before the end of third year, people will start talking about boring or interesting patients or about scut work or about the grind of clinic. Most of us probably wondered at some point during second year how long it would take us to be comfortable enough to feel bored. The beauty (or the bane) of third year is that each time you are comfortable enough to feel bored, your residents switch, or you change clinic or team or hospital or clerkship. You have just enough time to say, “hey, I’ve got this,” and then you’re on to the next adventure. It’s at least mildly frustrating, but then at some point you’ll come to this realization: If I’m bored today, that means I’m comfortable today. And that means I can do this.

And at first it might take six weeks, but then it’ll be three weeks, and then a week, and then maybe just a few days. You’ll be a little less impressed (or scared) of attendings and residents and maybe even disease, because when you show up to work and see your patients and write your notes you’ll realize that at this stage of the game you don’t need to be scared anymore. That looking back that some of those fresh interns on July 1st didn’t know much more than you did and were probably twice as scared. That you’ll always have backup. That the majority of patients you see will have the same common problems and that common problems can be diagnosed and treated once you’ve done it a few times. Then there are the “interesting” cases, the tough ones, the demanding attendings, and the fascinatingly rare zebras–and all of that is great, especially when you can help–because they keep things fresh. Hopefully at that point, the individual wrinkles that each patient has can stand out, and that’s what makes practicing medicine worthwhile. The people.

But when you first start and you’re scared and you know full well that you can’t do a history or a physical (let alone both at the same time), don’t worry. You’ll be fine. We all were.

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