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GUIDE TO THE CORE CLERKSHIPS A Collaborative Project between Medical Students a

GUIDE TO THE CORE CLERKSHIPS A Collaborative Project between Medical Students and Faculty F I F T H E D I T I O N 2009-2010 E D I T O R S Grant Chu, M.D.‘06 Steven Chan, M.D.‘04 Julie Chee, M.D.‘01 Melisa Lai, M.D.‘99 2 Our Special Thanks To Alex Morang, the Director of the Office of Student Affairs – for providing this opportunity, answering endless questions, and being a source of guidance through this process. To Janice Viticonte, Donna Arruda, and Linda Bozzario – for answering oddball queries, providing guidance for this handbook, and being the best support group a medical student could ever wish for. To Dr. Mark Fagan, Dr. Julie Taylor, Dr. William Metheny, Dr. Randy Rockney, Dr. Robert Boland, Dr. Michael Mello, Dr. Edward Feller, Dr. Patricia Nolan, Pat Gemma, Pam Richardson, Helen DaSilva, Helene Felici, Jane Shaw and Joann Barao – for your timely feedback, great suggestions, and kind corrections to gratuitous errors. To Steven Chan, Julie Chee, and Melisa Lai – for your work on previous editions and invaluable guidance through the third and fourth years of medical school. F O R E W A R D After nearly eight years at Brown, it still continues to amaze me what Brown students can do and how much they have invested in not only their own future, but the future of others as well. The creation and perpetual update of the Guide to the Core Clerkships is a testament to that spirit. This handbook is a tremendous resource for the novice medical student, but as with all things, the details need updating and additions made to address changes that have arisen since the previous edition. Nonetheless, I did not want to take away from the voices of Melisa, Julie, and Steven from previous editions and have done my best to be true to the original voice, but also remain focused on progress that will help future medical students. Be prepared, but relax. The latter two years of your medical school career will be challenging, but it will also be among the best years you will ever have. This handbook is meant to ease you into the perpetual motion machine of the medical world in spite of new residents, new interns, and of course, new medical students every year. The faster you learn where you need to be, where you need to go, what you need to do, and whom you should be with, the sooner you can start learning the art of medicine, help out your team, and begin making a difference in the lives of patients since you decided way back when: ―I want to be a doctor.‖ Also, JMS returns with even more helpful hints on getting by on the wards, so be on the lookout for him again. Finally, don‘t worry. This is your time to shine and show people how bright and brilliant you are. Just be yourself, and you‘ll do great. Cheers, Grant Chu, M.D.‘06 (April 2006) 3 JMS says: I will give you tips you need to know… and probably stuff you would rather not know. F O R E W A R D F R O M T H E F O U R T H E D I T I O N Third year is a big transition from second year. But what you‘ve heard is correct: third year is better than second year, and fourth year is better than third year….in fact, fourth year is the best!!! But to enjoy your clinical years, you should be prepared. First of all – don‘t panic! Everything contained in this handbook will be old hat to you within a week of starting each clerkship. Things are always new (and maybe confusing) during the first couple of days of any new clerkship or at any new site. However, the learning curve is steep – by the end of the first week, you will be in the swing of things. The purpose of this handbook is to minimize the amount of time you do spend at the beginning of each clerkship wondering what the heck is going on. Hopefully, you‘ll be prepared for what the clerkship is like and learn the ropes sooner – and you‘ll have more time to shine and show your residents and attendings how amazing the Brown Medical students really are! Also….be on the lookout for JMS, a.k.a. ―Joe Medical Student.‖ He has some sage tips to give to you that are scattered throughout this guide. These tips are ones that are often not told to medical students, but things that are figured out by all as the clerkship unfolds…..and then wished were known earlier on. Or he sometimes provides advice that people don‘t outright tell you, but expect you to know….that kind of subtle, implicit advice that you may have missed. Following are forwards from the first and third editions – Julie and Melisa sum things up so well, that I wanted their thoughts and sentiments printed for all to read. Julie would be disappointed that I didn‘t investigate why medical students are cut off of residency food budgets…but this is something that I pass on to someone else to investigate (those volunteer meal cards just don‘t cut it). Thanks to Julie and Melisa, too, for doing such great jobs with this guide that I found very little to change. And now my tidbits of advice: like with your first two years of medical school, the third and fourth years are about balance. That‘s the only way that you‘ll be happy enough to be your spry, bright self on the wards – and this enthusiasm is infectious (not in the Pseudomonas kind of way, but in the contagious- happy kind of way). If you are determined to learn, to help, and to enjoy, these next two years will be among some of the best in your life. Best of luck! Steven Chan, BMS-IV (M.D.‘04) (January 2004) F O R E W A R D F R O M T H E T H I R D E D I T I O N Two years ago, upon receiving the previous edition of the Clinical Clerkships Guide, I was so impressed by Melisa‘s effort that I knew immediately that I wanted to write the revision before I graduated. ―Don‘t drop the ball‖ she said in that second edition‘s forward, and I was so moved that I decided I was not going to drop the ball, and sure enough, Alex gave me the chance to update Melisa Lai‘s pet project. In re- reading these pages, so much of her insights and information have held true, even three years after she herself started the clinical portion of her medical education. As a result, there was really very little work left to be done. Some minor tweaking, some editorial and anecdotal comments, and some revisions of the community health and surgery rotations, but everything 4 else pretty much holds true. A lot of my time has been spent in researching and reconfirming technicalities of the clerkships, such as when the lectures are held, what the call schedule is like, and where to scrounge food now that we are cut off of residency food budgets (grrrr... someone should get on that one ASAP). As a result, most of this book is still Melisa‘s voice, in part because I agree with her, and in part because I couldn‘t have said it better. So to you, future classes of BMS-3s, I offer Melisa‘s challenge to continue to better our medical school through working hard and working together. I hope that someone will look to add their voice to mine and Melisa‘s by making it a tradition that this guide gets updated regularly. Sincerely, Julie Chee, M.D.‘01 (May 2001) F O R E W A R D F R O M T H E O R I G I N A L E D I T I O N To our newest clerks: Congratulations! You made it. The proverbial light at the end of the tunnel which leads out of the Purple Palace is upon you. It can be glaring at times but as you have no doubt been assured by tens of students who went before you, it‘s worth it – even if you don‘t own polarized sunglasses. What you‘re holding in your hands (or reading on your kitchen table or using to fan yourself during orientation…) is the pre-first edition of the soon-to-be official Brown University School of Medicine Clerkship Handbook. While a ―First Aid for the Wards‖-type handbook isn‘t my brainchild, this specifically Brown- oriented publication is my independent study (yep, Melisa‟s earning a little research credit here – isn‟t Brown wonderful?). It‘s pre-first edition because I‘m waiting for your feedback about what else should be put into it – so be sure to send your commentary and critiques my way so that the real first edition will be good to go for the class of 2001! (The plan is uploads/Management/ clerkship-guide.pdf