So much happens in a hospital on any given day. It’s easy to just go with the flow and hope that you passively absorb all the things you need to. With this approach you may have the occasional great clinical experience and will gradually pick up the required knowledge and skills with enough time. However, the more self-directed you are, the quicker you can learn and the better you can become.
This is achieved by deciding your objective in advance. For me, this involved making a weekly priority list as well as a daily objective list. For the latter, at the end of each evening, I would take a piece of A4 paper and fold it in half three times. On this, I would write six things that I would like to achieve the following day, as in the example below. I would carry this in my pocket at all times, and cross things off when I achieved them, providing a small sense of achievement each time. Sometimes I would add a priority order by numbering them 1-6.
An example of my priority six:
- Write in patient notes
- Take blood from ≥3 patients
- Recognise hepatomegaly
- Understand Liver Function Tests (LFTs)
- See 2 or 3 endoscopies
- Understand 2 patient’s cases from the ward in depth
This list can be tailored to the opportunities that you know you will have, for example if you know there is an endoscopy list tomorrow. When you write the objectives, you can think of ways you will achieve them. For example, for the list above you could plan to join the ward-round and ask to write in the patient notes (1) as well as choosing two interesting patients from the ward-round to study later (6). You could ask to leave the ward-round early to attend endoscopy (5), then after lunch come back to the ward and ask if there are any bloods to be taken (2), any patients to examine with signs (3) and if any of the doctors are free to explain LFTs (4). However, it’s important to be flexible as you can’t always predict how things will go. Maybe the doctors won’t let you write in the notes on the ward-round, or they are all too busy to teach you about LFTs. In these cases, you must be adaptable and seek alternative ways to achieve your aims, for example finding a guide on LFTs on the internet and then looking through the blood results of patients with deranged LFTs. Or maybe there are no patients in the hospital with hepatomegaly, in which case you can think of another sign you want to learn to recognise. It is on these days where having the objectives is so important, as otherwise you may spend a lot of time waiting around and achieve very little.
A great little book with suggestions for objectives is “101 things to do with spare moments on the ward” by Dason Evans and Nakul Patel. (The title is self-explanatory.)
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This article is an excerpt from my latest book, The Modern Medical Student Manual, which offers guidance for succeeding at medical school, while finding deeper fulfillment in work and setting yourself up for an impactful medical career. For more information, click here. It is available now on Amazon.