Disclaimer: the publication is a compilation of informal advice written by students for students. Those who use the document should be warned to exercise their own judgement depending on circumstances. Dpousjcvupst Xfmdpnf!up!Uijse!Zfbs! Uif!Cbtjdt Epdvnfoubujpo Ipx!up!Pqfsbuf!jo!Tvshfsz Xfmmoftt Tjuft;!WGNQ-!TNQ-!JNQ-!ONQ Spubujpot Zfbs!Gpvs;!Fmfdujwft!boe!DbSNT CLERKSHIP GUIDE Contributors Nancy Lum, Class of 2021 Annette Ye, Class of 2021 Gurjeet Bhangu, Class of 2021 Samantha Lui, Class of 2021 Manny Birk, Class of 2021 Nancy Lum, Class of 2021 Jennifer Brazeau, Class of 2021 Karthik Gopalakrishnan, Class of 2021 James Cairns, Class of 2020 Khashayar Hanjani, Class of 2021 Justin Chan, Class of 2021 Eric Jeong, Class of 2021 Kimberley Chang, Class of 2020 Mitchell Mammel, Class of 2021 Bavenjit Cheema, Class of 2021 Kirsten Roche, Class of 2020 Raymond Cho, Class of 2020 Sorush Rokui, Class of 2021 Charles Choi, Class of 2021 Emilie Russell, Class of 2020 Rakesh Dewan, Class of 2021 Alvin Qiu, MD/PhD Program Sarah Donnelly, Class of 2020 Michael Shao, Class of 2020 Eric Esslinger, Class of 2021 Ge Shi, Class of 2020 Tony Fang, Class of 2021 Jacky Tang, Class of 2021 Prineet Ghuman, Class of 2020 Maichael Thejoe, Class of 2020 Jennifer Ham, Class of 2021 Allyshia Van Tol, Class of 2021 Catherine Landells, Class of 2020 Jeffrey Wang, Class of 2020 Sabine Lague, Class of 2020 Jovi Wong, Class of 2020 Gabby Levesque, Class of 2021 Ryan Yan, Class of 2021 Chloe Lim, Class of 2021 Annette Ye, Class of 2021 Cody Lo, Class of 2021 Leo Yefet, Class of 2021 Annette Ye, Class of 2021 CLERKSHIP GUIDE This is it - the beginning of clerkship! This is an exciting yet intimidating part of our training: our transition from being pre- clinical students in lectures and CBL, to becoming young medical student interns (MSIs) assisting and learning from various services in the hospital. This is the first time that we are fully immersed in clinical environments. Most importantly, these months will likely determine the path you choose for your career in medicine. While this is an incredibly exciting time, it can be a transition with a steep learning welcomecurve. The goal of this guide is to help orient you to the often disorienting journey that is clerkship, to help you shine on your rotations and make the transition from pre-clinical to clinical learning as smooth as possible. While our first two years of medical school teach us the to medical knowledge that well need for our rotations, there are some gaps to be filled. For example, how does a hospital really function? What is expected of us as clerks? How can we maximize our learning while remaining helpful to the teams that we are learning from? This third guide will help answer some of those questions. Clerkship is an exciting time where we start to become the doctors we want to be, and hopefully this guide will help you achieve that! year As youve probably heard, third year is going to be a challenge. The hours are long and you need to find time to study for exams, while balancing the important things in your own personal life as well. Some mornings will start really early, while others can end quite late. Be prepared to spend up to 28 hours straight working on a call shift. You may also come up against difficult moments with patients or colleagues, or make mistakes that make you feel stupid. Youll probably have days where you come home, burst into tears, and wonder why you ever thought going into medicine was a good idea. But, thats okay! Weve all been there. Its tough. But its also rewarding and amazing. This year is your chance to jump in and try it all while having ample support to back you up, to become the best doctor you can possibly be. So when it seems like all the odds are stacked against you and the walls are caving in, focus on all the great things youve seen plus the awesome work youve accomplished and plow right on through! This guide was created by the Class of 2013 and has since been updated by the Classes of 2020 and 2021, in hopes of making Third Year a little less intimidating. Nancy Lum and Annette Ye Executive Editors, Class of 2021 CLERKSHIP GUIDE The Basics HOW TO CHOOSE AND RANK YOUR TRACK APPS VALUABLE PEARLS STUDYING WHAT 3RD YEARS ADVICE WISHED THEY KNEW HOW TO PREPARE FIVE THINGS LIFE IN CLERKSHIP CLERKSHIP MOMENTS How to choose and rank your track Track selection feels like a huge choice to make in second year, especially when you might not be sure about what specialty you want to pursue yet. However, do know that people are generally very happy with the track they end up with, since each track has its own set of benefits. Here are the rotations, divided up into four main blocks. Clerkship Rotations Ambulatory Care Block Surgery & Perioperative Care Block o Rural Family (4 weeks) o General Surgery (4 weeks) o Emergency (4 weeks) o Anesthesiology (2 weeks) o Ambulatory Care o Orthopedics (2 weeks) · Ophthalmology (1 week) o 2 of the Surgical Subspecialties (2 · Dermatology (1 week) weeks each) · Ambulatory Internal ● Cardiovascular Medicine (2 weeks) ● Neurosurgery ● Otolaryngology Women & Child Health Block ● Plastic Surgery o Pediatrics (6 weeks; 3 inpatient, 3 ● Pediatric General Surgery outpatient) ● Radiation Oncology o Obstetrics and Gynecology (6 ● Thoracic Surgery weeks) ● Urology ● Vascular Surgery Brain & Body Block · Psychiatry (6 weeks) · Internal Medicine (CTU) (6 weeks) The tracks, as of the time of this guide’s creation, are as follows (based on VFMP), also available on Entrada under Preparing for Year 3: https://entrada.med.ubc.ca/community/policiesandforms:program_information Clerkship Handbook 2020 6 Here are the rotations based on how busy they generally are, relative to the others. Note that this is highly dependent on your site, staff, and team. Lighter Heavier Rotations without call · Ambulatory Care · OBGYN · Ambulatory Care Block Block (all · Pediatrics (all rotations within; rotations within) · General however, some rural · Psychiatry Surgery family practice sites will · Anesthesiology · CTU put you “on call” in the · Some surgical · Orthopedics emergency room) subspecialties · Specific subspecialties (especially (ex. radiation oncology, Radiation Oncology) vascular surgery, etc.) · Psychiatry call ends at 2300h Clerkship Handbook 2020 7 Considerations for Track Selection Here are some things to consider when thinking about how you want to rank the tracks. ● Your learning style. Some people learn best by getting thrown into the water in a “sink or swim” style; some people prefer a more gradual, crescendo approach where you progressively build on your skills. ○ If you’re the former, A or D track might be good options for you, since Surgery & Perioperative and Brain & Body blocks tend to give you more experiences in a short period of time, which can be great if you are a quick, adaptable learner. ○ If you’re the latter, C track is an excellent option since you start with Ambulatory, where you can learn how to do your history and physical exams, practise your dictation skills, and warm up to clinical learning environments. It’s also nice to be able to learn all of this without needing to do call to start. Then, you go into your Women & Child Health Block where you graduate to more responsibilities in an inpatient setting, and then tackle the heavier blocks afterwards. ● How differentiated you are. A few weeks into your second block of clerkship, UBC’s elective selection process will open, which puts students into their local fourth-year electives in BC. This is important! ○ Because of this, you may want to put your specialties of interest into the first 1.5 blocks of your clerkship, so that you can ensure that the specialty is a good fit before committing to electives in that specialty. ■ This way, you also have time to start a research project, should you be interested in a specialty earlier on in the year. ○ On the other hand, if you know for certain that you want a given specialty, some people will tell you to put that rotation at the very end of your third year, so that you’ll basically be at the functional level of a fourth-year MSI and impress your staff with your clinical prowess, increasing the chances of getting a strong reference letter. ● Your fatiguability. If you’re the type of person to get tired quickly from a rotation with heavier hours, consider a track that allows you to space out the busy rotations. C and D track might be good options for this. Clerkship Handbook 2020 8 Perks of Each Track Here are the tracks and some benefits specific to each. Tra Block Order Benefits ck 1 Surgery & Perioperative Care A Block - You’ll get surgery out of the way first, when you’ll 2 Brain & Body Block have the most energy after a refreshing summer 3 Ambulatory Care Block vacation. 4 Women & Child Health Block - Learn how to do consults, admit patients, and manage the ward on surgery and CTU in the first half of clerkship, which will provide you with the core skills you need for the rest of clerkship. (Note that you’re expected to learn this on the go, so if you like more time to learn these skills, you may want to consider a different track, since you might not always have explicit teaching on these things due to time- constraints, especially on surgery). 1 Women & Child Health Block - Great for people who are interested in surgery, since B 2 Surgery & Perioperative Care you get exposed to the OR in OBGYN and get Block suturing practice before going into surgery, so that 3 Brain & Body Block you can impress your preceptors with your skills.