GENERAL THOUGHTS/ADVICE
“I guess my biggest piece of advice would be that patients generally don’t see a difference between long
and short white coats. They come to the hospital or clinic for medical care, not to teach, and they
look at you as part of the team that is caring for them. It’s important to realize that while learning is
still important, it now has to come second to caring for the patients. While as a student you’re
generally protected from seriously hurting anyone, and the responsibility does ultimately fall on the people
with “MD” or “DO” after their names, you should still take a personal responsibility for your patients
and try to take an active role in the team. You’ll look better, and the learning curve is still much steeper
than it has been in year 1 or year 2. You can learn infinitely more from interacting with a patient and
seeing them through the course of their disease than from reading CaseFiles. All that being said, you
should also have fun this year. Yes, it will be time-consuming and can be difficult, but it’s also what most
of us will be doing the rest of our lives. You won’t love every rotation, but it should almost always be
better than sitting in class (or video-streaming). Most of the time though, it should be enjoyable, and if
you enter it with confidence and a good attitude, it will go by really fast.”
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“Arrive early everyday and have all the notes written before the intern does---although this might
seem intuitive, not everyone does this and I think it is part of your job as a medical student and it does go a
long way. Plus, if you do this, you will have time to review everything going on with your patients while
everyone else is making their rounds and it will give you an advantage during your presentation to the
attending. Also, try to know most of your presentation without reading (not all the lab values or
specific numbers) when you can look an attending in the eyes during your presentation, it comes across
well and is better that reading from a piece of paper the whole time. Make sure you know all the new
labs, the past few days labs and test results/pending tests so you can be ready if any of this information
is requested. Ask your interns if they need help with anything and be willing to help if they need it.
READ, READ, READ, if you can answer questions and showcase your knowledge, this will go very far
with everyone (but always answer it when YOU are asked or if nobody else knows the answer, not when
someone else is asked first). Volunteer to give presentations and, even if they say don't worry about
making a handout, make something really simple for everyone to follow along with, it helps them
concentrate and to remember what your presentation was about when it comes time for evaluations.
Always have a smile on your face; it makes such a difference. And, try to anticipate what your team might
need during rounds, especially on surgery, if you come prepared, it will really help the team. Finally,
remember you can make what you want of each clerkship and, even if you aren't interested in the specialty,
they ALL have something to teach you and will help you solidify the information you learned during years
1 and 2. Yes, some days are horrible and sometimes you will feel like everything is out of your control, but
EVERYONE has felt this way and, in the end, you will be one step (a HUGE step) closer to being a
doctor!”
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General 3rd year advice:
Scut work can be annoying and boring, but (in my opinion), it is only scut work if you already know
how to do it. If you aren't good at bandage changing or suture removal, it's not scut. If you don't know
how to draw blood, start IV's, etc., it's not scut, it's part of your education. I had very little true "scut" 3rd
year, almost everythingI was asked to do helped me learn something and helped my residents
get their work done faster (teamwork)! One last bit of advice: make a few of presentations on small
topics that you come across on rotations. There was time to present something on every rotation.
Don't wait for someone to ask you. Just make a PowerPoint, some handouts for everyone else, and have
a 5-8 min talk ready. Pick something you don't know a lot about, so that you actually learn something
from it too. There were many times where we had unexpected free time (finished rounds early, or had to
wait or something to happen), and the attending asked if anyone had a talk to give. Take advantage of the
opportunity and show your initiative. Hope this helps Dr. Levine. The pep talk you gave us last year was
helpful, I'm sure it will be this year as well! Keep encouraging people to READ every day. I can still
hear your voice from last year telling us to read. And it's true!
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“One thing I came to realize is that the best thing to do is ask intelligent questions. It is the best way to be
interested, confident (but not arrogant) and to actually learn.
Also, I didn't realize how formative the third year is for a clinician. I think students need to remember that
part of their goal should be to develop their own habits, attitudes, and techniques. It is easy to feel
powerless, abused, low on the totem pole. One way to combat feeling downtrodden is to look inward and
realize that in ten years you will be who you are partially because of what you've experienced. Every
experience that makes you uncomfortable has the potential to teach you a great deal more than you realize.
It is incredibly empowering to realize that you are thinking critically and are establishing your way of
looking at clinical and ethical problems. It's a pretty amazing feeling when at the end of 3rd year that all
seems to come together.
Lastly, the one thing I wish I knew a year ago was the following: Don't ever be afraid to think for yourself
and ignore advice that doesn't compute. If people keep telling you that your study habits won't work or that
you need to act in a particular artificial way to succeed, don't listen. You have to be true to yourself. At the
end of the day you have to be happy with how you lived your life.
Oh and tell them to buy the book "How to Choose a Medical Specialty." It helped me think through my
career choice and solidify it.
I hope that helps. Third year was a lot of fun. It was a lot of work, but I have some really great memories.
It was all worth it in the end.”
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“1) At the beginning of a rotation, if you're unsure what to do, just find an intern and stick with
them.
2) Expect to make plenty of mistakes. You will likely be made known of your shortcomings at least once a
day for the first semester. This is not to be taken as a detriment to your eval, but as feedback to help you
grow.
3) Interest and helpfulness are more important than competing. Strive to be a good member of the
team, not a self-promoter, as they're usually not appreciated.
4) In general, staff does not like feeling like they're being pimped by students. "Safe" questions to ask
involve things not easily found in texts- the practitioner's preferences, experiences, etc. "Do you see much
of this?" "What suture do you prefer for this?" "Could you explain this portion of the surgery?"
5) Given the opportunity, display your knowledge, but humbly. If you have a question, offer what you
think the answer might be. After becoming comfortable with presentations, include your impression and
plan for the patient.
I'm just getting warmed up, but I'll leave off here :-)”
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“Here are some facts I thought were important:
1) Find an organized way of keeping track of the pearls of wisdom. You may never hear things
explained in such a way that makes quite that much sense to you (i.e. a great EKG lecture), and
you may want to pull it out as a reference in other rotations/residency.
2) Make sure you are always managing the most interesting patient on the floor (even if not your
intern's patient). Nobody will ever fault you for wanting to learn more.
3) Learn early on what is appropriate for you to look up vs ask your resident vs ask your attending;
don't ask your attending a question until you have read about the topic.
4) Even if you are shy, make sure you are an active participant in the team (even if you are
answering the questions incorrectly...at least show your line of thinking). Otherwise, you will be
ignored. Most docs assume med students don't care unless you prove otherwise. I heard this advice
at the beginning of my 3rd yr, and thought it was really useful and true.
5) Lectures are a really great way to integrate info. Keep useful lectures and bring coffee if you
need to :)
6) Always be helpful to your team. They are tired and stressed, and you need to be a team player.
And always be nice. They will usually reward you w/teaching :) Always ask for feedback. Again, I
heard this advice at the beginning of my 3rd yr, and thought it was really useful.
7) When starting any new rotation, look at other notes/discharge summaries in the chart and
model your notes accordingly. Ask questions if you need to, but also try to be an independent
learner.
8) When looking t/notes before a patient is admitted, always look at all ER notes, notes from
ppl w/in the field you are rotating t/, radiology, most recent labs, and discharge summaries.
9) You should read about every patient on your team's service and be prepared to talk
intelligibly. It's the best way to learn!!
10) Find an organized way to keep track of day to day changes w/your patient (index cards,
running list, medfools)
11) Do NOT take things personally from residents, docs, other members of the team. They don't go
home thinking about you. If you get yelled at, learn from it and never make that mistake again, but
move on.
12) Always do more than what is asked of you...if they tell you to manage 2 patients, you should
have 4 patients (even if it means you are getting there earlier). Offer to do morning admissions.
Offer to take care of all aspects of care involved w/your patient (even if it is asking the nurse if
you can put a Foley in..it's a great way to learn!), including notes. You learn a ton by challenging
yourself this way.
13) What was hardest for me at the beginning of third year was how to come up w/differentials: info
from 2nd yr may be a mish mosh at the beginning of third year. Come up w/your differential on
your own w/INVICTOE for each organ system. Then Up to Date CCs/sxs and see what you may
have missed. 3rd yr is the beginning of more independent learning, and I consolidated a lot of info
this way.
14) You will inevitably see people on your team interact with patients in a way that will make you
flinch. Everyone feels a little jaded after a while, especially when you have patients who may be
drug-seeking, etc. We all went into med school to help people on some level, and it helps a lot to
really try and picture how the patient ended up that way...sure he/she may be drug-seeking, but
what awful things did they go t/to make him/her that way? Even if other people on your team
are making jokes about the patients, you can still be respectful to your team w/o joining
in/laughing. 3rd yr is a really great time to be introspective. A really great attending told me
that everyone has their biases (i.e. maybe patients who are drug seeking really bother you), but it's
important to try and figure out why and acknowledge that you bring these biases to your
interactions.
15) I did the clinical campus model this past yr, and thought that it was great. There are definitely
pros/cons, just like rotating through multiple hospitals. A really big thing that I noticed though is
that since you work with the same 10 students all yr, sometimes personalities can rub each other
the wrong way. This seems like silly advice, but do NOT talk about your fellow med students
w/other med students. You are just asking for needless drama that will make you and all your
classmates feel like you are in high school again. Vent to your mom if you need to.
16) People (even if it is only the other med students) know when you come in late or skip
lectures. Don't give yourself the reputation of being lazy or unprofessional, not worth it for
an extra 10 minutes of sleep.”
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Know your patients, research their disease process inside and out (i.e. etiology, diagnosis, treatment,
complications), be helpful to the team, ask questions, and learn as much as you can.
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1) If a resident or attending tells you it is okay to go home/go study/go eat - DO IT!!! You may not have
opportunities to have a break or an afternoon off to study as often as you expect, so any time someone with
authority tells you to stop working, listen to them. It is NOT a secret test of your interest in the field or
stamina. I wish that I had been more willing to go home in my first few months of third year. (Dr. Levine
advises against this. Residents often tell you to go home. They are trying to be nice. Remember thirds
year is a clinical year. Your patients are your teachers. Do not go home if you are expected to be at the
hospital; it looks unprofessional. Find a place to study and study; go to the coffee shop, the library, a
conference room, the lounge; find a place to study and study there. Your residents may give you
permission to leave but they do not have the authority to tell you to go home.)
2) Have something to do during downtime. It doesn't really matter if it is studying with a pocket sized
book, printed chapter of a text or UpToDate article in your pocket, a full sized book you've stashed on the
floor, even solitaire on your PDA or phone or a granola bar is okay. Just have something to do on those
occasions when you're sitting around waiting without a computer in front of you or you will be bored out
of your mind. This happens more than you would expect.
3) How to politely ask if you can go home once your work is done is an important skill everyone should
learn. Sometimes hanging out on the floor can be very fruitful (procedures might need to be done, the
resident may give impromptu teaching), and specific hours may be required (i.e. on labor and delivery
service), but at other times it is a complete waste of your time to be on the floor if nothing is going on and
you are being totally ignored by all the residents. First, learn who is allowed to send you home (sometimes
interns have the authority, other times you will need to clear it with the senior resident). Then, establish
that your work is done and ask them if there is anything else you can do to help them or anything
interesting going on. If they have no tasks, scut, or interesting procedures for you to participate in, this
will often trigger them to tell you to go study and/or go home for the day. Sometimes a more direct
approach is needed, and you may have to come out and ask. Again emphasize that your work is done, no
one on the team wants your help, and nothing noteworthy is occurring on the
floor, then ask if you could go home. Often having a specific reason, i.e. I would like to look up disease X
that my patient has for tomorrow, or I need to work on this presentation for next week, or I am behind on
my shelf studying, or it is so-and-so's birthday and we're going out to dinner, etc. is helpful. Certainly
don't lie, but it is pretty easy to come up with a specific reason. (Levine: Again, this advice sounds close
to unprofessional. You don’t want to be identified as the student who is always trying to leave early.)
4) Most hospitals now have premade forms your team will want you to use for doing H&Ps and sign outs
and you won't need to make your own unless you really want to be a superstar (exception - specific Wayne
assignments in which your H&Ps are being evaluated, and these usually have to be typed or on blank lined
paper so they can see you have learned what needs to be in it). I found that making copies of my new
patient H&Ps (or the first SOAP note I wrote) before they went into the chart worked as a great
reference for my pocket and saved me from having to spend time re-writing on a premade form or trying
to remember things on the fly.
5) Also, if it is possible, I would recommend watching an intern (or better yet the senior resident) do at
least one H&P/work-up of a new patient and one quick morning exam and SOAP note at the
beginning of the clerkship to get a general idea of how detailed you need to be, which labs and other
info from the EMR needs to be looked up and/or ordered, and what physical exam maneuvers they
do on most patients on that service. Otherwise it takes a few days of wasting time doing too much or
getting called out for not having the specific information that is desired before you figure out exactly what
that service or team is looking for. Each attending will have their own little quirks and specific items they
find important as well which you'll have to learn.
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WHAT TO CARRY IN YOUR POCKETS
“Stuff to carry in lab coat all the time (takes up less room than you would think, and it decreased
throughout the year)- in/on small top pocket - pens, penlight, Maxwell, hospital ID badge, SINGLE
sheet of paper neatly folded with that month's schedule and important numbers (phone/pagers of
team members, secret door code of supply rooms on the floor, checklist of what cases need to be logged on
campus mobility, etc.). One inside pocket - chapstick, breathmints, tiny bottle of hand
lotion (for after all those repeated washings), something to pay for lunches and snacks if you don't bring
them from home. I would usually leave one outside pocket free for all the paperwork I'd accumulate over
the month (H&Ps, articles from uptodate, notes, etc.) and my pager. PDA/smart phone or pocket drug
book was really helpful for looking up meds, especially at the beginning of the year, but I eventually quit
carrying it. I added on sentence to each clerkship's description to specify what else I carried while on that
service.”
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“Always have some food in your pocket, try to pack a sandwich to have in your bag (PB&J will last all
day) for the crazy days and the cafeteria may be closed. Plan on long hours for surgery and OB/GYN.”
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EVALUATIONS
It’s important to know that in many clerkships EVERYONE on your team will be evaluating you.
Even some attendings will say to students, what did you think of so and so as a team member? On my
obgyn rotation, we were asked by the clerkship director to discuss all her residents and who was helpful
and who was not helpful over the 2 month rotation. The clerkship director was then going to do the same
kind of discussion with the residents about the students and its scary to think of what some of the residents
would say about one of the students on my team. Also, never pimp back to an attending. I saw this happen
once and it was ugly. And also, it is okay to request a change of team. If you get a bad feeling about an
attending that you think is really rude or disrespectful, this is not right. it is okay to report this and it will
not get you in trouble.
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You will likely get strange, unfair evals from time to time (either worse or better than expected, or even
with contradictory comments). Try not to worry too much as only the positive comments end up on your
MSPE/Dean's Letter. There isn't too much you can do about it, but I have a few tips.
1) Attendings in most fields don't really care if you are interested in their specialty or not, so be honest, but
try to emphasize that you understand why rotating through their department is important or useful
for all physicians. EXCEPTIONS to the rule include Internal Medicine (Levine: of course I disagree),
they really do want everyone to lie and pretend that they are interested, and Surgery - I would NOT
recommend pretending interest to the surgeons (they often expect you to stay in the OR later, will pimp
you more, etc.) unless you are also willing to work your butt off.
2) Take advantage of opportunities to select who fills out your evals. Interns are notorious for giving evals
based more on whether they liked you than your actual skills, so on the few clerkships in which you get to
choose an intern or junior resident to evaluate you (possibly neuro, peds inpatient), pick the one that you
seem to get along best with. Senior residents and attendings are likely to be at least a bit more objective,
but I've noticed that the higher status the attending is, the busier they are and the less likely any evaluation
forms you give them will actually get filled out. So you may need to give forms to practically any
attending you meet in the hopes that at least a few will fill them out. You may need to give them multiple
copies and politely pester them as well if there is someone in particular you'd like to evaluate you. In other
rotations, these evals are all done "behind the scenes" and you will have no idea who received them.
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SHELF ADVICE
1) Many practice question books have epidemiology-type questions. Skip over these and don't worry
about them, I don't think I had ANY epidemiologic/ "what percentage of people get X" questions on my
exams.
2) The time limit is often the main factor on the shelf exams and the question stems are often much
longer than in practice question books (pretest especially has very short stems). You will need to find a
method for skimming these huge stems and picking out the relevant info.
Some people like to read the last sentence with the question and the answer choices first.
3) Do the last few questions of the exam first. Usually the last 5 to 10 questions are the really short, almost
matching style questions that have a bazillion answer choices that can be done quickly and you don't want
to miss. (Levine: Be careful if you do this to not bubble in the answer on the wrong question
number.)
I hope this can help future classes
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The best way that I prepared for peds and medicine was by doing many questions. Pretest, USMLE
World, etc., it doesn't matter. The shelf is so diverse and will ask various details that you will end up
skimming over reading through a general text or even case files.
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STUDY AIDS and RESOURCES
Overview
USMLE WORLD online question bank questions are really good throughout the year, for studying
and preparing for shelfs. I dont think any of the other practice question books have questions that are as
challenging or explanations that are as thorough as usmleworld qbank. Also, uptodate summaries are
great for learning about your patients throughout each clerkship. also, the Mass General Pocket
Reference is an excellent reference to keep on you at all times. I bought it midway through 3rd year and
used it often on rounds for a quick reference.
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I used case files for every rotation and loved them! I would skim it again the day before the exam by
reading over the bold print, notes in margins, charts, and clinical pearls. I also used pre-test for questions.
They were okay. Some chapters were ridiculously hard and none of those hard ones ever showed up on the
shelf.
Also, believe it or not, I still used my FIRST AID FOR STEP 1 during every rotation when I needed to
refresh my memory. It was so very helpful. I was very nervous about neuro anatomy for the neuro shelf,
but I just reviewed the neuro section from FIRST AID FOR STEP 1 and it was quite sufficient.
After going through the process, I learned along the way that I performed better (and faster) on the shelf
exams when I had some confidence in my knowledge. That is why I would do a rapid review of case files
the day before the test. It sort of put everything I had learned in the front of my memory. It just made me
feel confident and I was able to trust my answers and get through the shelf faster.
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I would always read case files twice and then made sure to review the question book (after I went
through it earlier in the rotation) the day before the exam.
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Get a Step 2 reveiw book (either First Aid, USMLE step 2 secrets, Crush step 2) that you like and use it to
review during each clerkship--ideally read it at the beginning and then use clerkship specific materials the
rest of the way. By using these sources, you will have 2 advantages: You will already be well on your way
to preparing for Step 2 and you will have a high yield source to use for your shelf (the shelf questions are
retired board questions).
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Case Files has been a solid series for me during each clerkship. I liked the Kaplan lecture notes for
surgery, peds, ob/gyn. Step Up to Medicine was also good. For surgery I'd also recommend the NMS
Casebook. Casefiles was always a good baseline. I thought Pretest was hit or miss for most clerkships.
 NMS questions for the shelf exams
 PreTest was hit or miss for most clerkships
 I'd recommend getting the USMLE World subscription.
 Towards the end of the year when I had more knowledge I thought the Step 2 Secrets book was a
really good quick review of multiple subjects before the shelf exams
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With few exceptions I used the same books for each clerkship. At the start of the clerkship I would
purchase case files, pretest, and blueprints. Purchasing them meant that I could mark them up all
I wanted. It also was a way to motivate me to get through them. I liked having a reliable
system, it was comforting and it worked - it forced me to read regularly and do a ton of
practice questions. My shelf scores were almost always higher than expected.
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I found Case Files and USMLEworld Qbank to be the most helpful. I used both in all of my rotations.
Please remind then to look up anything a question bank mentions that they don't remember or don't
understand. Wikipedia is usually enough to jog your memory.
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SPECIFIC CLERKHIP ADVICE
SURGERY:
General Advice:
 Be honest with surgeons about whether you are interested in surgery or not. In my
experience they were less likely to penalize you for telling the truth than other specialties.
Warn family/friends/significant other ahead of time that you will be working 70-100 hour
work weeks and will vanish off the face of the earth for the stint of your rotation and any
time off will likely be spent sleeping or recovering from illness brought on by sleep
deprivation. You shouldn't need any physical exam paraphernalia except your stethoscope.

Depending on the service, you will likely need to carry a stash of gauze, tape, scissors, and
other wound dressing supplies during morning rounds.
One student wanted you to know, “The amount of blood loss is a sensitive number for
surgeons.”
Reading Source:
 Case Files for Surgery, Kaplan Notes for Surgery, (some student recommended NMS
casebook), One student recommended BRS General Surgery (nice bullet-point style)
o Note: the required textbook for Surgery is available in the Library so DO NOT
purchase - plus it isn't THAT helpful and some hospital site clerkship directors
recommend other books that are MORE helpful for general reading
o The surgery text books can get you bogged down in details. The
casefiles are good, but won't teach you all you should know about
electrolyte disturbances. I used the text books, but only read a few
of the basic chapters instead of trying to do it all.
For the floors:
 Surgical Recall*
o *The Schiffman library has a couple copies of Surgical Recall and some hospital
libraries have them available to check-out
o Many other students liked Surgical Recall for quick response to pimping in the OR,
but I found it of limited value for vascular, which I was assigned to for my first three
weeks. Probably good for other specialties or general surgery though. Also, some
surgeons are strongly opposed to Recall if they see it.
Questions:
 PreTest for Surgery, Appleton & Lange Surgery Q&A book, USMLE World Surgery Qs ,
mount sinai handbook, First Aid
Oral Exam:
 Try to review the list of potential oral exam topics at least a bit, as this will help prepare you
for the shelf as well.
OB/GYN:
General:
 The Wayne-provided lectures are also pretty good and it is wonderful getting out of morning
rounds once a weekFavorite pimping/shelf question (asked by multiple attendings): What
enzyme is measured to diagnose 21 alpha hydroxylase deficiency, the most common
congenital adrenal hyperplasia? 17 alpha-hydroxyprogesterone (17-OHP). OSCE was not a
problem. You will need your stethoscope, a wheel to calculate dates, and it is handy to carry
around extra lube and paper rulers in your pocket.
Reading Source:
 The assigned reading material is excellent
 Case Files for OB/GYN, Kaplan Notes for OB/GYN, Blueprints was fantastic. Read the
whole thing and you'll pretty much be set for the shelf.
o Note: the required textbook for OB/GYN is available through Schiffman Online
Questions:
PreTest for OB/GYN, USMLE World OB/GYN Qs, First Aid
NEUROLOGY:
General:
 One of the more difficult exams.
 Definitely know the difference in presentation and CT appearance of different kinds of stroke
and hemorrhage (subdural vs. subarachnoid).
 You will get a sore neck from carrying around all the tuning forks, reflex hammers,
oto/opthalmoscopes, cotton swabs (break in half for soft and pointy sensory testers), plus
your stethoscope.
 This is the only rotation where you might want to carry a small lunch sized or messenger
bag to put all your crap in.
Reading Source:
 Case Files for Neurology, Weiner & Levitt's Neurology (House Officer Series), In a Page
Neurology, Blueprints (one student thought Blue Prints was a very poor resource)
Questions: PreTest for Neurology & USMLE World Neurology Qs, First Aid
PSYCHIATRY:
General:
 Focus on knowing the specific number of symptoms and time qualifiers for various DSM IV
diagnoses and you'll ace the test.
 Lectures with Dr. Morreale were well done.
 OSCE was easy.
 Make yourself some nice forms for psych history and mental status exams so you don't forget
to ask anything and your notes are organized.
Reading Source:
 And for psych, there are review slides that one of the residents put together. They are
incredible and should be used from the beginning - everything you need to know is
summarized
 Case Files for Psychiatry, First Aid for Psychiatry Clerkship, DSM-IV Pocket Book , PreTest.
Appleton and Lange
Wards:
*DSM-IV Pocket Book is helpful on the wards, but some sites have books that students can borrow
for the rotation but all the criteria are available in the First Aid for Psychiatry Clerkship
Questions:
 PreTest for Psychiatry, Appleton & Lange Psychiatry Q&A book, USMLE World
Psychiatry Qs, First Aid
PEDIATRICS:
General:
 Shelf exam was quite difficult. OSCE does not prepare you for the shelf exam.
 OSCE: Be warned that practically none of the information that Dr. Friday emphasizes on her
OSCE was on the shelf (i.e. memorizing nutritional requirements, entire immunization
record, lots of safety screening questions and other primary care issues). You might get one
very basic and/or out of date immunization question or one interpretation of a growth curve
on the actual shelf. Also, don't feel bad if you have to remediate part of the OSCE, it seemed
like the vast majority of the group I worked with had to do this for at least a few sections. Dr.
Friday is very enthusiastic, but she overloads you with what many people feel is an excess of
"busywork" type paperwork. It takes an extra hour or two of orientation just to go over all of
these additional assignments. The "rash review" was the only assignment that I thought was
truly helpful for the shelf, go to as many sessions as you can. You should only need your
stethoscope, maybe an otoscope if there isn't one available on the floor.
Reading Source:
 Case Files for Pediatrics, Blueprints
Questions:
 PreTest for Pediatrics, USMLE World Pediatric Qs, First Aid, Appleton and Lange
INTERNAL MEDICINE:
General:
Dr. Levine's assignments are much fewer than peds and all are easy to turn in (can be emailed
directly to her). In addition to Case Files, you will want to learn EKGs and acid/base disorder
interpretation. EKGs - the classic Dubin book is great and quick to read if you haven't bought one
yet. Also, the doctor who taught EKGs at the ACLS class was very good and covers pretty much all of
the obvious/serious findings you're likely see on the shelf. Acid/Base - Find an organized, step-bystep method of interpreting acid/base disorders that you like (you can use Dr. Rossi's old notes, a
textbook, an online resource, whatever) and stick to it. You DO need to MEMORIZE the appropriate
compensation for various disorders and how to calculate anion gap and delta gap. If you learn this at
the beginning and practice at least once a week, you'll be a pro for the shelf. Clinical Tip: Internal
Medicine doctors seemed more concerned than most that you at least pretend to be interested in
their field, even if you really aren't. Dr. Levine is serious when she tells you to do this. I did not
take this advice, and my "lack of interest" in IM definitely hurt my clinical evaluations. You should
only need your stethoscope.
Reading Source:
 Case files has been a solid series for me during each clerkship. Internal medicine was
particular favorites. Step Up to Medicine
 I strongly recommend Step-Up to Medicine (By Agabagi). I found it very useful for my
medicine clerkship. It pretty much covers all the bases. It helped me do well on the floor,
and in making recommendations etc. to the team.
Questions:
 MKSAP for Student Q book, USMLE World Qs
FAMILY MEDICINE:
Reading Source:
 Case Files for Family Medicine, Step Up to Medicine (Ambulatory Medicine Section),
Blueprints
Questions:
 NMS Family Medicine Qs, (one student said, “NMS is okay but there are bad questions in
there and know to skip the bad questions immediately. There are lots of these questions that
require you to know lab values that you would never know!...just skip these and move on to
better questions. Also, the Aesculapians site has a family in service exam which is a great
source of questions for review before the exam. I hear the family case files is the worst of the
bunch, First Aid
CONTINTUITY CLEKSHIP:
General:
The exam is ridiculously easy, just go over the old practice exam that gets emailed out by various
students and flip through your packet of assignments the night before. DO know the difference
between CPT and ICD-9 codes. Scheduling your day - Mornings early in the week (Mon-Wed) are a
good way of regularly getting out of morning rounds if you prefer outpatient
clinic to inpatient rounds. The catch is that you may have to reschedule occasionally for orientation
or miss your first day on a service when everyone usually meets each other and establishes the
routine. Avoid Thursday or Friday morning if possible because you'll have to reschedule constantly
for exams and/or study days. If you have an afternoon time, you won't miss any morning inpatient
rounds ever, but may end up working later those days if your CCC doc gets overbooked or
you would otherwise be excused earlier from a less busy inpatient service.
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After reading all this, one student simply said, "I wish that somone would have told me to purchase usmle
world question bank at the begining of 3rd year. Invest or obtain all of the case files and use the Kaplan
step 2 ck board review books and thats it, no more books required. If you need more info Harrisions is
always a good investment but you can get it off the net. And more questions dont hurt.”
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FINAL THOUGHTS
I hope that helps. Third year was a lot of fun. It was a lot of work, but I have some
really great memories. It was all worth it in the end.