Tips on how to succeed on your clinical rotations

I had a nice FaceTime call with a childhood friend of mine yesterday. She is about to complete her didactic year and enter her clinical year of PA school (way to go, you!). After chatting with her, she mentioned that it might be a good idea to write a post about some of the tips I offered her. So here it is — let’s get into it, shall we?

  1. Bring a notebook: My manager hilariously added this to her email out to our PA students that they should “bring a notebook to take notes especially if working with Darren.” So true! The worst thing you can do is be taught something and believe you can memorize it and then not be able to recall it when asked again. I don’t mind if you write it down and look at your notebook for the answer when asked later on. Most of us don’t expect you to memorize things — there’s too much to learn in medicine.
  2. It’s OK to say “I don’t know”: If you don’t know the answer to a question, just say you don’t know. If you kinda know, you can guess but don’t keep on guessing over and over again. I personally “pimp” my students but it’s not to penalize you or catch you off guard. It’s for me to gauge what you do know and what you don’t know so I can find a teaching opportunity. So if you don’t know, that’s OK, I’ll teach you or we’ll find out together — that’s why we’re both there.
  3. Communicate: Your preceptors are human beings. We’re not your teachers or professors. Think of us more as professional colleagues showing you the ropes. If you need to go to the bathroom, just go. You’re an adult. No need to hold it in or ask. If you want to eat lunch, tell me you’re hungry and you’re going to eat lunch. On a few occasions I forgot to tell my student to eat until it was 2p (because it was busy and I didn’t think about it). Communicate your needs — it’s OK. Most of us don’t bite. If you need to leave early for some reason, that’s OK too. We understand.
  4. Be enthusiastic and say yes to everything: If I ask you to perform something — a task or a procedure, say yes — even if you’re uncomfortable with it. Your preceptors will never ask you to do something dangerous or something we don’t think you can handle or something that will endanger a patient. We’re there if you need us. And if you’ve taken out a central line ten times already, keep on doing it — it’s not beneath you.
  5. Don’t follow me around: I need “me time” at work. I can’t have you following me everywhere (like to bathroom or if I need some time away to do something). When the rounds are over or you’re done with your notes, ask me what you can do. Most likely I’ll ask you to review the charts or look something up (a list of things I told you early on in your rotation). Note: For those on your ICU rotation, there are plenty of trials/bundles I will tell you to read about (surviving sepsis campaign, NICE sugar trial, etc).
  6. Look through patient charts all day! When I ask you to follow a patient or two, I expect you to follow that patient all day! When I tell you to chart review, it’s not a “one and done” in the morning. Labs, vitals, imaging test are dynamic and constant. There will be afternoon labs or evening labs. If it’s 3pm and you’re looking bored and I ask what the result of something is and you don’t know, that’s a no-no. You can’t say I don’t know to this one — that’s not appropriate.
  7. Introduce yourself to the nurses and ask them what you can help with: Very important. You’re not only trying to impress your preceptors, other APPs, and the doctors. You’re also trying to impress the nurses. They are the life source of the floor. The people that tie the floor together. There is a lot to learn from them. If I notice that you have a good rapport with them, that looks very favorably on you.

Good luck to you guys on rotations!

Dk

Darren is a physician assistant specializing in Cardiac Critical Care in New York City. Passionate about resus, shock, PE, cooking & coffee.

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