Many medical schools are now enhancing their preclinical curriculum (which is typically taught in the first two years of the program) with mandatory and optional clinical opportunities. Though intensive clinical exposure is typically reserved for third- and fourth-year rotations and sub-internships, students whose early curriculum provides clinical experiences should reflect on the impact of these opportunities.
If you are in a medical school with early clinical exposure, consider evaluating these experiences for the following reasons:
1. You can use your early experiences to inform the structure of your third and fourth years
Whether through mandatory or optional opportunities, many medical schools expose their students to several areas of practice within the first two years of their programs. Take time in each of these clinical settings to define what you like and do not like about that particular type of medicine. Did you experience primary care in an internist’s office? If so, did you enjoy the pace of the work and the breadth of cases that were involved? Did you spend time in an emergency department thereafter? Did you find the intensity of that work more engaging? Write brief notes after every clinical experience you complete, and be sure to record the components that you found most intriguing, as well as the components that did not align with your personality. While many third- and fourth-year rotations are mandatory, there is still room for elective rotations that are aimed at giving students an opportunity to explore those areas of medicine into which they might consider matching for residency. Using the perspective gained from early clinical experiences may help mold your personal and professional outlook on medicine, and may thus allow you to make choices that are better aligned with your goals.
2. You can develop the skills and boundaries necessary to effectively work with patients by reflecting on your strengths and weaknesses in your initial clinical encounters
Negotiating the medical care of your patients extends well beyond addressing their physical complaints. In addition to developing your diagnostic and treatment skills, you must also develop the professional interpersonal skills that allow people to feel they were treated appropriately. As you meet your first patients, take note of how you handle any emotional difficulties. Do you respond empathetically to tears? Are you calm in the face of anger? After patient encounters, reflect upon how your response to their concerns either improved or worsened their care, and be prepared to make adjustments as necessary in your future clinical experiences.
3. You can begin to define—in broad strokes—what aspects of medicine you would like to see included in your future specialty
You may not be able to precisely identify what you wish to do for the rest of your career in the first two years of medical school. However, you can pay attention to what aspects of medicine you consider necessary to your career trajectory. Do you find that you enjoy long-term patient care? Inpatient care? Outpatient care? Do you like doing procedures? In addition to noting your interest in specific specialties, pay careful attention to what kinds of care you one day hope to provide.
4. You can start to learn how to personally cope with the rewarding, yet strenuous, task of taking care of sick patients
Providing medical care is an incredible privilege, but it can also be emotionally taxing for providers. It is crucial to your patient care that you maintain your own physical and mental wellness, and reflecting upon your initial clinical experiences can help you build the foundation you will need to cope with the longer hours of your clinical years and residency. Be sure to consider how you feel after your clinical encounters. Are you frustrated? Are you tired or burned out? Think about ways to cope with any negative emotions that may be cropping up as you care for patients, and look to mentors to help you learn to balance your own wellness with the demands of patient care.
Cassie Kosarek, MD is a professional tutor with Varsity Tutors, a live learning platform that connects students with personalized instruction to accelerate academic achievement. She earned her Bachelor of Arts from Bryn Mawr College and was a member of the Class of 2021 at the Geisel School of Medicine at Dartmouth College.