The following stressors often experienced by clerkship students were identified in research with 3rd and 4th year students at one medical school (Houpy et al., 2017). They are in order with the ones most often of concern at the top.
1
Poor team dynamics
82% of 3rd year students, 75% of 4th year students
2
Difficult encounters with other staff
58% of 3rd year students, 38% of 4th year students
3
Systems issues
45% of 3rd year students, 42% of 4th year students
4
Dealing with difficult patients
30% of 3rd year students, 38% of 4th year students
5
Unanticipated deaths
18% of 3rd year students, 31% of 4th year students
6
Difficult family discussions
10% of 3rd year students, 28% of 4th year students
7
Chronic narcotic patients
13% of 3rd year students, 15% of 4th year students
8
Medical errors
15% of 3rd year students, 13% of 4th year students
Tips for Transitioning to Clinical Training:
Develop skills and greater self-efficacy in:
- Applying clinical skills learned in pre-clinical classes in the real-world context.
- Developing relationships with the clinical team, understanding the hierarchy
- Adopting a self-directed learning strategy, including looking up and reading about or seeking experience with what you don’t know. You will need this skill throughout your medical career.
- Understanding your role and some clinic protocols, such as patient handovers. Learn your role in each setting as quickly as possible. Tip: Different specialties have different expectations.
- Dealing with the workload.
Learning clinic protocols and skills is like learning a new culture, language, and rules. It takes time. Take advantage of any programs offered that inform you of your future roles, rules/expectations, resources, and supports. Some clinics will provide you an introduction. If not, be proactive and ask a peer who has been through the clerkship for any tips they can share.
If, near the end of a rotation, you have missed an opportunity to learn something critical in a clerkship, be proactive and bring it to a supervisor’s attention, in case there is still a chance to get that experience.
