Remote Clerkships in 2020: How to Thrive in Clinical Rotations at Home
Published on Aug 27, 2020. Updated on Sep 15, 2020.
With tens of thousands of medical students studying at home during these uncertain times, it’s difficult to maintain the same work ethic you were finally able to achieve at school or in the hospital. This blog is meant for all students looking for success in the coming months as they try to find a plan that helps them learn medicine, find peace at home, and succeed in their remote clerkships in 2020.
You finally found a schedule that works for you, and you’re ecstatic to see your grades reflect your seamless workflow when it comes to studying and being productive. You have the support of your classmates, professors, attendings, residents, friends and family, making medical school that much more bearable.
But all of a sudden, the world came screeching to a halt. Classes were cancelled and coffee shops were closed, but the hospitals became flooded with patients. Physicians, residents, nurses, therapists, and all other workers on the front line had a definitive purpose: help their patients and keep them alive.
Medical students, in contrast, struggled with quite a different battle; while the rest of the healthcare sector fought a novel virus, we had to figure out how to stay calm and...study? No in-person lectures, no group studying, no patient encounters—medical students had truly never felt so alone in their pursuit of learning medicine.
Whether you are at home with your family or in an apartment on your own during these uncertain times, this guide will hopefully inspire you to strike a balance between studying medicine and being productive, staying active, and keeping calm, all within the comfort of your own home!
1. Creating the right study environment
The study spot
First and foremost comes the environment of your workspace. Find a spot in your place of residence where you can get “in the zone” with minimal distractions. This means from your parents, your siblings, and even your pets. Make this spot your “productivity sanctuary” where you can look forward to getting work done.
Ishan Dahal, the Osmosis Health Coach, recently wrote an article listing the top 7 methods to maintain productivity in the midst of uncertainty. A few other helpful tips from Ishan include making your study spot your own DIY-project; “pick the technology, appliances and color combinations that put you in the best frame of mind. Being in the office that YOU created, just the way you like it, will put you in a great frame of mind to take on the day.”
Now, more than ever, stress needs to be addressed and managed. Keep your study spot free of stress—if you are taking a stressful phone call, or are on the opposite spectrum and trying to relieve stress by watching Netflix, do it away from your study spot. Try to continuously reinforce the fact that your study spot is meant for one thing, and one thing only—being productive.
Maintain a schedule… but be flexible
When things have been far from normal this year, it’s comforting to have a sense of routine and normalcy while studying, which makes having an organized schedule incredibly important.
Planning out the day/week in advance can come in several different fashions, depending on your personality. Do you want to be micromanaged, and told exactly what to do at what time (i.e. UWorld questions from 9–11, review cardio chapter from 11–12), or do you want to have a task list, with just a basic list of things you need accomplished (i.e, 40 UWorld questions, read cardio chapter, etc).
Make sure to schedule time for yourself to work out and relax! Most importantly, be easy on yourself. It’s okay if you’re behind schedule, or some tasks are not accomplished—keep your weekend more open than the weekdays, leaving you time to catch up, or take off if needed.
Dress for success
Sweatpants are undefeated—it’s a fact of life. But when it comes to feeling productive and having a productive day, your mindset is often the product of your routine. Put on real pants with a real shirt and you’ll feel like you’re having a real, normal day.
On the other end of this, wearing sweat pants all day runs the risk of developing poor sleep hygiene. Osmosis Health Coach Ishan Dahal states that “your mind is great at learning by association; this is one of the reasons why non-sleep related activities are discouraged in bed. If your brain associates non-sleep related activities with being in bed, it can impair your ability to fall asleep and decrease your quality of sleep.”
Set up multiple study spots
You know what’s better than one study spot? TWO study spots. Where you study, once again, is SO important!
Research shows studying in various locations can boost long-term retention of material. Varying the study environment provides your brain with more memory cues it can later use to recall information. The more memory cues your brain has to retrieve the information, the more likely you'll be able to recall the information during the exam, and the better your score.
2. Virtual rotations
Not all students are in virtual rotations currently, so this applies to those who are currently in one, or are scheduled to be one in the near future. Stay tuned for more information on preparing for specific core rotations (e.g. surgery, internal medicine, pediatrics), including which resources to use.
Be in contact with your attending
First off, KNOW your attending(s)! Reach out to your clinical coordinator or the hospital secretary to figure out which attendings will be running your virtual rotation. Once you figure out who it is, reach out to them letting them know your name, your year, your school, and what you have done so far in the hospital. Introduce yourself to them and let them know you exist and are absolutely ready/prepared to learn.
Remember, they are likely busy during these tumultuous times, so be patient if they don’t respond immediately, but also be persistent. If you haven’t received a reply within two days, try again, or reach out to the department secretary.
As always in medical school, be prepared! Preparedness in a virtual rotation is not as concrete as being prepared in the hospital, so here are some helpful tips to make sure you show up to your virtual clerkship lectures ready to learn:
Reach out to classmates who have done the rotation already, or who already know the attendings you will be interacting with. Attendings have patterns, and they often consistently ask the same questions or the same pattern of questions; these are things you can ask your classmates about before you first meet them.
Additionally, ask your classmates what resources they used to prepare for the rotation, as well as the shelf examination. Knowing what was helpful and what was not helpful are both equally important and vital to know before diving into the rotation.
Do any/all assigned readings prior to your online lecture. Attendings send out these files to students from them to read, comprehend, and prepare questions for during the lecture. Doing the readings helps you look prepared AND engage in a meaningful conversation with your peers and your attending.
Additionally, have questions prepared about the topic! Not only does this show you did your reading, but it also demonstrates your enthusiasm for medicine, as well as your curiosity about the subject. This will go a long way, I promise.
Are you preparing with your own resources for the rotation? You should be! And it should include the relevant UWorld questions for the rotation, as well as other resources (i.e., Osmosis Clinical Reasoning Series) you or your classmates have found helpful (read the following section on General Studying tips).
In addition to looking prepared during your Zoom meetings, have questions prepared for your attending, either regarding specific UWorld questions, or a specific topic. Your attendings love to explain concepts, and with their years and years of experience, they can give you the clinical perspective necessary to excel as a future physician.
3. General study tips for remote clerkships in 2020
If you’re new to the clinical rotation aspect of your medical school career, it might be daunting to take on the task of learning clinical medicine, especially since the last two years of your career were based on the basic sciences. The good news is that everything you have learned so far is absolutely relevant to clinical medicine, and your attendings will hold you to it to make sure you know it. They will ask questions on basic pharmacology and pathophysiology, so if you’re coming fresh off of USMLE® Step 1 studying, you’re going to be extra prepared!
The “bad” news is there are a lot of resources, so it’s easy to feel overwhelmed.
The following is a list of helpful resources:
USMLE World (UWorld) Questions: This question bank is the absolute gold standard for practice board-style questions. By now, you have used it extensively for Step 1, and Step 2 is no different. Each and every question is packed with high-yield information, but don’t lose sight of the bigger picture. As you go through each question, instead of simply answering the questions, try to explain to yourself why other answers are wrong. More often than not, the wrong answer choices for one question (termed the “distractors”) are the right answers for other questions. Supplementing UWorld questions with self-made Anki cards (or any flashcard application) is maximally productive and efficient in retaining knowledge.
Anki (or any spaced repetition software): Spaced repetition is a cheat code to having information easily accessible in your head—when an attending asks you the adverse effects of metronidazole, you’ll be surprised how quickly you are able to come up with “nausea, metallic aftertaste, peripheral neuropathy, disulfiram-like reactions,” simply because of the magic that is spaced repetition. The main predictor of success with Anki is consistency. When students say they “sometimes use Anki” that means they are absolutely not using it properly. Although premade decks are extremely popular (e.g., Zanki, Dorian, etc), the best cards are the ones you make yourself. Your cards are based on your weaknesses, and the simple act of making a flashcard is immensely helpful in retaining information as well.
Osmosis Clinical Reasoning Series: These videos were prophetic, in some ways; they bring clinical cases straight to you in the comfort of your home and help you work through the most common presenting symptoms, the pathophysiology, the diagnostic workup, and the treatment for hundreds of different diseases you would see during a clerkship. This series helps you master the clinical reasoning concepts that you'll need to diagnose and treat various conditions you will eventually see on the wards (and impress your attendings with your clinical acumen).
Textbooks: This is where the water becomes muddier. Unlike for Step 1, where First Aid was the Holy Grail of information, Step 2 has a multitude of textbooks, with no one book being a definitive source of knowledge. This is where asking your peers for advice comes in handy—ask them which textbooks they used, and which they found not as helpful. Stay tuned for future blog posts providing more information on preparing for specific core rotations (e.g., surgery, internal medicine, pediatrics), including which specific textbooks to use:
Studying with a partner or group
A global pandemic means you need to study at home, alone, without a partner right? Absolutely not!
We are tremendously privileged to be able to video chat with whoever we want, whenever we want, wherever we want. Try to schedule study times with a partner or a group of people, where each of you discuss a certain topic, or work through a specific case.
Additionally, this is a great time to discuss UWorld questions you may have gotten wrong, and ask your colleagues for their thought process through a specific question.
Active Testing > Passive StudyingStudies have consistently shown that actively engaging in studying is far superior to passively reading and highlighting. So, what does this mean?
Passive study strategies may appear to take less time and feel easier. However, active strategies are more effective and efficient because they help you rapidly move information into your long term memory. Research shows that students with higher performance scores do not necessarily study longer than their counterparts; instead, they are likely to study differently by using active review (think “study smarter not harder”).
All right, as a quick recap...
Constantly remind yourself: you are brilliant, and you are not alone. Be kind to yourself—watch an episode of your favorite show on Netflix, or go for a walk, especially on the days you are feeling unmotivated and uninspired. Regardless of whether you are at home with your family or in an apartment on your own during these times, find your balance of studying, staying active, and most importantly, keeping calm.
This guide is neither the definitive guide of what you should do, nor is it comprehensive in everything you can do; it simply serves as a reminder that you have resources available to you!
Neil Mehta is a fourth-year medical student at St. George’s University who is currently doing rotations at a hospital in Northern NJ. Neil is a Question Writer and Question Editor at Osmosis, and is passionate about medical education. He is applying for a residency in Internal Medicine this year, and hopes to stay in the Northeast. In his free time, Neil enjoys reading, being outdoors, but also being indoors for long naps.
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