How to prepare for the 3rd year of medical school

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The third year of medical school has a reputation at each and every single school in the United States because:

1. The third year of medical school is the most important year in terms of securing the future residency position of your choice, and

2. Unfortunately, the third year is also the hardest of the four years of medical school.

Now, what every reader should understand is that the term “school is hard” reaches new, almost unimaginable, levels in the third year of medical school.  Sure, massive amounts of information are shoveled in to the brains of 1st and 2nd year medical students.  But, the third year of medical school is a whole other story.  Let me explain…

The third year of medical school is a year filled to the brim with clinical clerkships.  This means that med students graduate from the classroom to the hospital and clinician’s offices.  Med students essentially get to play doctor, albeit a heavily supervised version, in the 3rd year of medical school.

Third year medical students talk to patients, do physical exams, write notes, present patient cases to residents and attendings, come up with treatment plans, and manage patient care to the best of their ability and allowed responsibility.  Keep in mind that all of this is done with residents repeating just about everything behind the student and attending physicians, ie “the boss”, approving everything that the residents do.

However, third year medical students get the added bonus and stress of required lectures, conferences, and studying for specific departmental exams.  There is even a national shelf exam (also called national board exam) at the end of every single clinical rotation.  A med student can’t pass a rotation and complete medical school until they pass the shelf exam for each and every clinical clerkship.

As if that weren’t enough, these 3rd year medical students are also expected to perform at their very best every single day for an entire year.  A med student on a clinical clerkship knows that he or she must attempt to do the very best job they can all the time.  Everything a third year student does and says is noted and stored away for that end of rotation evaluation.

So why would a med student try so hard just to please a resident and attending and assure a good end evaluation?  Well, most clerkships are graded by combining the board exam score and the clerkship evaluation score, and the final clerkship grades that a student receives have a huge impact when a med student starts applying for residency positions.

Most residency programs heavily consider whether a student received honors, pass or fail in the clerkship representing the specific specialty of that chosen residency.  They also strongly consider whether a student received mostly, some or (god forbid) no honors through out the third year.  When you are a third year med student, everything you do during a clerkship matters!

Honestly, that last sentence is the hardest part of the third year of medical school.  It’s one thing for a med student to have to learn loads of material and be tested once a month or week.  It’s an entirely different thing to feel that you have to perform your best every single day, to feel that your future is being determined with every presentation you give, every esoteric topic you get pimped on, whether you can manage an enthusiastic response to learning something on a rotation you have absolutely no interest in.

Being “on” all the time can make the third year of medical school exhausting.  The medical students that best retain their health, and their sanity, in the third year of medical school are the ones that have a strong sense of self.  If you don’t know what drives you, what keeps you healthy and what you care most about, then start figuring it out.  Take that summer before third year to do some soul searching!

When you finally start your third year of medical school try to do your best, but know when you need a rest.  Make the extra effort on the rotations closest to your anticipated future career, and don’t beat yourself up when you slack a bit on that one rotation that just makes you miserable.

Medical students are brilliant, motivated, and intensely competitive individuals.  By the third year you should have figured out your best test taking strategy.  Don’t veer from it!  Be aggressive on improving your weaknesses as early as possible in your third year because it makes the rest of your year that much easier.  If you are uncomfortable examining patients, take advantage of the opportunity to do it as often as possible.  If you can’t give a power point presentation to save your life, volunteer (really, atleast once!) to do a presentation on a topic pertinent to your clerkship’s specialty.

The third year of medical school can be a great experience if a medical student gets off to the right start and remembers what their priorities are through out the year.  Don’t let false ideas of expectations push you to exhaustion.  Sift through the med student gossip (which will more often mislead than assist subsequent students simply because every single student is different from the one before) and the actual clerkship requirements to make sure you do what you need to do to get the grade that you desire.

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