Experiences/methods/tricks used in getting great clinical ev

In terms of general clinical rotations (not necessarily Ortho), to get good clinical evals, one of the most important things is getting along with the resident. If they don't like you as a person, they are not going to evaluate you well. So, NEVER make them look bad, always seem interested in what they are talking about, volunteer to do things that will make their life easier, laugh at their jokes, etc. They may be impressed if you are knowledgeable on the topics at hand, but in most cases I don't think that they really mark down if you don't know every fact. They seem to grade more on effort and enthusiasm than knowledge. And yes, asking questions is always good. Well, maybe not ALWAYS. For instance, at 6pm on a Friday, don't keep asking questions, but in general I think that questions show that you are interested and that you are putting in the effort to understand and learn more about whatever topic.
Those are just my $.02 as I finish my 3rd year (only 23 more days left until 4th year!)....OrthoDreamer :smokin:

The biggest "tricks" are probably hard work, enthusiasm, and sincerity.

Read student post and agree with above (a little M3 humor). Hard work and enthusiasm are very essential, but try to do this without being a suck-up. Have notes done before rounds, be a team player, make your residents look good, don't try to make fellow classmates look bad, don't whine, and ALWAYS show interest no matter how bored you may be. When asking questions be genuine. What I mean is don't ask a question in an attempt to make yourself look intelligent. My experience is that you really have to try hard to do poorly. Best of luck, I'm sure you'll enjoy your time on the wards.

Agree with all above. The advice is not just for ortho but any rotation in general (even life in general). Make those you work for look good, be a team player, get along with the team (or at least do your best if you actually don't like them), arrive early or, at least, on time; if there are no ortho techs available, volunteer to make and carry a supply basket during rounds; if you have time before presenting a clinic patient, read-up on him/her in those few minutes after an evaluation and before presentation; read and read some more when you get home; ask if there are any case reports that need to be worked on for publication; etc. The subject of advice for MS4s was covered in the old forum. You can reach the messages here:

All the advice here is pretty solid. I think work hard, don't whine, and don't suck up could be repeated. Also, pay attention and learn the system quickly. By the end of the first week, you should be getting your stuff done without the residents asking you, or you having to ask them what they want.

Read and agree with MS3 note above (a little new Dr. humor)

1. Work hard. you make intern's life easier, intern makes junior's life better, junior makes chief's life better, who makes attendings life better. You get the idea.

2. Fit in. Be a "cool" person. Personality seemed to be the second most important variable in terms of me getting good evals, letters, and eventually doing well on rotations.

3. Not too many, but not too little questions. As a rule of thumb, I asked enough questions to seem interested, but not too many as to be annoying or come across as if I had not been reading or something. As a general rule, if I could easily look something up I wouldn't ask about it, everything else is fair game.

3. Fund of knowledge is key. read about the case that you're going to be in on and know the anatomy.

Agree with intern note above.

T - I think some o our classmates made it by pure butt kissin'
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Some of the little things you can do include writing post-op orders and notes after each case you scrub on. You can do this for the non-surgical rotations as well, but the orders you write obviously will not be post-op :tongue: When your residents/staff are discussing tests and consults needed for your patient grab an order sheet and begin filling it out. It will make your resident's life a little easier and at the same demonstrate your initiative. It also help to keep a script pad in your pocket to quickly write for meds for out patients or for the patients you're discharging. Again, these are just little things you can do to help out the team.

I agree and disagree with what's been posted above. For my ortho rotations, i thought the above were applicable and hard work and "fitting in" were crucial.

For medicine, ob/gyn, peds and family, i found that kissing rear end was the way to go. Pucker up and kiss as much rear end as you can stand without vomiting at the end of the day. But you still have to kill the end of rotation exam to get honors so study hard too. But remember that a large part of your grade is subjective (i.e. predicated on butt-smooching)

For surgery, i felt lost in the crowd. Too busy, not enough time to kiss rear end as efficiently as other rotations. But conferences are a great time to kiss deriere (i.e. ask questions when you could care less what the answer is).

In sum, be yourself on your ortho rotations cause orthopods in general are pretty cool and don't like it when you kiss rear end. I think it reminds them of med school years and the kids who wanted to do medicine and they get turned off. But for the others, an opportunity to kiss rear end is an opportunity to shine, and vice versa.

And one more piece of advice from someone who's "been there": There are 2 types of butt-kissers in medschool - the "nerdy" butt-kissers and the "cheesy" butt-kissers. I suggest you take the former approach because it p@#$es off your classmates a little less than the latter. Cheese is not good. Donuts and coffee for residents is not good. Yelling "Good morning everyone!!" with a big grin on your face at 6 a.m. to the nurses at the station in your short little white coat is NOT good. But bringing in articles on relevant topics and bringing it up in rounds or conferences is much better. Hold off on the cheese as much as you can. If you don't have a patient, don't say "I wish I had a patient to present!!" during rounds. During morning report in medicine, don't cross your legs and lean forward with your coffee and nod and smile at everything your resident utters. That's cheese.



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Agree with most of what was written above.
Overall, Show your strengths and hide your weaknesses.
Surgical/Ortho honors are highly dependent on 2 things: 1) Knowing your Anatomy and BASIC physiology and 2) Being easy to get along with. So if they aren't already, you better make them your strengths before the rotation.
Medicine, Psych and OB/Gyn honors...Who knows, I never saw honors in those.

One important exception: If you want Ortho honors in a "tough guy"/"jock" program, challenge each resident to a steel cage match, then schedule a title match with the attending

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Hulk,

That's funny as h$%&. Funny thing is, I got challeged to an arm wrestling match at a Xmas party after my MSU-Kalamazoo interview (big jock program). I politely declined because I didn't think it was a good career move - especially considering the resident was drunk off his behind, and that my biceps were bigger than the guys thighs
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I'll throw some ideas out there:

DO NOT under any circumstances forget that you are a student and the ortho boys are residents. As confident as they are, they are full of their share of insecurity. I can guarantee you if they ever feel threatened by your lack of humility, you will be crucified in evaluations. Now, there's an amazingly razor-thin line between humility and boldness/quiet confidence, but you have to find it. If the residents think, "that guy knows his stuff and works his arse off, but he knows his place in the hierarchy", you'll be golden. Good luck, guys.
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true true, John. There is definetly a fine line you gotta walk as 'the student' - whatdya think about "paling around" or being pretty casual with the residents - some people would say not to try and be their friends, that you should know your place and kinda lay low - that whole wanna fly with the birds dont mess with the eagles thing )

A few more golden nuggets to put in your pocket that should be obvious but I see many people fall into the abyss and never come out in their final evaluations. Don't ever, ever ask a question that is molded to show off what you know, subtext: "look at me, look at me" For example, yesterday I heard, "I know chloramphenicol causes grey baby syndrome so what ABX would you use instead?" I felt the pillars of heaven shake on that one. I've found the right mix to be reliable in whatever you do, speak well of attendings/residents/nurses that deserve it and bite your tongue on everyone else, do not answer a question correctly if it filters through an intern or resident who didn't know it, and come correct when asked a question about your patient or something you had to read a little extra for. What do you give the man that has everything???????????????penicillin

I think you have to play that by ear. Generally, when the time comes to be social, the residents will give you a chance if you've worked hard, present yourself well, etc. They'll initiate stuff most of the time. It's hard to know what they expect in a social context - I've only rarely heard it said, "man, that guy is too wild and crazy for ortho!". I definitely believe in letting loose and pal-ing around out of the hospital.

Believe me, residents know when you're crossing the line...

Don't agree with the point on not fielding questions if residents or interns have gotten them wrong (or not answered). If you know it, spit it out. It's your time to shine, and the resident/intern should understand. It shows that you're on the ball. You might want to save face though by putting it like, "I'm not sure, but I think I read last night that. . . .blah,blah,blah." Fact is, the residents have their spots, you're still trying to get yours. I'm not going to feel slighted if some 4th year student shows me up this year.

I don't agree with bone_jock. If an attending asks an MS4 a question that the resident/intern didn't know the answer to, proceed at your own risk. However, I would never recommend for anyone to volunteer an answer, without being asked, that the resident/intern was not able to provide. I saw a guy once get completely slaughtered by the attending in front of everyone at the weekely trauma conference for trying to answer a question that the 2nd year resident got wrong. Trying to answer a question that your resident didn't get does not make him or her look good, and the essence of teamwork in a surgical team is to make those above and below you look good.

i agree with Orthopedics on this one. If a question is directed at a resident, and he doesn't know the answer, but IS THEN DIRECTED AT YOU, then feel free to speak up humbly. But spitting out the answer when a resident doesn't know it WITHOUT being asked is totally inappropriate and is only appreciated in "medicine" circles (if that). Surgical culture dictates that you work hard, know your stuff, but keep your mouth shut UNTIL ASKED.

hey bonejock! which resident at kalamazoo challenged you to arm wrestle? I ask since maybe when i go there next month for internship i can whoop them for you!! Of course we already established in an earlier discussion that maybe squats are more my forte, while you can stick with arm wrestling!
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Clarification,

I wasn't implying that you step on a resident's toes and answer a question that they missed/didn't know. That's just plain common sense. And that goes for questions posed not just to residents, but to other medical students as well.. But my experience is that most questions trickle down through the ranks. Meaning that usually an upper level resident gets asked the question and if they don't know it's thrown out to the floor. THEN it's okay to field the question (even if the resident didn't know). Sorry about the confusion. I'm really not a gunner in sheep's clothing
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