Tip for Rounds
Written by Adam Ephraim
As a medical student rotating through the core specialties, you will experience rounds in many different ways. For some rotations, rounds will be short and only the attending and the chief resident might speak. For others, rounding will take hours and you'll be expected to bring printed publications supporting your treatment plan. Here are tips to get the most out of rounds and add value to the team every day.
Ask your attending and fellow/chief resident "what are your expectations for rounds?"
On the first day on a new rotation or with a new team or attending, ask what the expectations are for rounds. This is an important question because it shows you are thinking proactively about doing things the way the attending prefers, and will help you to focus on what is important to them. Additionally, ask an intern on the team: "how do you structure your presentations?"
Don't be afraid to speak
Speak more by asking questions about something you legitimately want to learn more about. Don't speak to demonstrate your knowledge and don't ask questions to simply fill the silence. Ask genuine questions as much as possible.
Repeat after me: "I don't know, but I will look it up and can speak about it tomorrow"
It's okay to not know the answer to a question--it means you're learning, which is why you're there in the hospital in the first place. If an attending expects you to have all the answers at this stage in your training then they are not doing their job as a clinical instructor.
Ask for feedback
Ask for informal feedback. Oftentimes formal evaluations take weeks to receive and are then unhelpful. Feel free to ask over email.
"Hi Dr. X, it was a pleasure working with you today. If you could offer any informal feedback for me from rounding this morning that would be very helpful. What do you think I should work on for next time? What things did I do well that I should continue to emphasize? I'd be happy to read your thoughts in an email or speak in person. At this point in my training, it's helpful to get feedback in real-time so I can incorporate any changes now and practice them."
Ask for a Letter of Recommendation
If you receive positive feedback or connect with an attending, ask them in person to write you a letter of support for residency. It doesn't necessarily matter if they are in your field. You can decide whether or not to use that letter when the time comes, but it's much better to have more to choose from than be scrambling to get enough.
Seek out mentors
Anyone can be a mentor. They don't have to do everything well to offer something to learn. Your resident who might be underwhelming at the patient's bedside might have an incredible amount to teach about navigating the EMR. An attending who handles team dynamics poorly might be an excellent patient advocate. You can pick and choose traits from several mentors rather than resolving to emulate one person.
Written by Adam Ephraim, a 4th-year medical student at Albert Einstein College of Medicine. Incoming IM intern at Dartmouth.
Twitter: @adamjephraim
