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Medical School Advice for 3rd & 4th Year Students
Advice for Every Rotation
- Read the section corresponding to your upcoming rotation in First Aid for the Wards prior to the start of the rotation (or at least within the first week). If you learn nothing else on your rotation, make sure you know this information.
- Practice questions are a great way to quiz yourself during each rotation. More students are leaning toward a year subscription to an online Step 2 question bank such as: Kaplan or USMLEWorld, but there are also decent Q&A review books divided by specialties such as: Lange Q&A: USMLE Step 2 CK
- No matter how tired you are, make sure you study at least one hour every day. Many students learn easiest when they study a chief complaint they encountered that day.
- Determine on DAY ONE how many pages of your basic text you need to read every day to achieve your reading goal. Then stick to your daily reading assignment. See our rotation-specific advice pages for DIT’s suggested study plans, complete with recommended review books and question books.
- Listen and take notes on rounds. Always be on time. Act interested. Be a person that others like to have around. These will help increase your chances of success and a good evaluation.
- Ask your resident and/or attending what is expected of you and how they like to hear you present. Do this within the first week of the rotation, at the latest.
- Learn the art of being concise and presenting pertinent information in your presentations. This will endear you to your attending, resident, and the rest of any team of which you are a part.
- Don't be too hard on yourself. Third year is all about doing something wrong every single day. So just relax, and continue to do stupid things because that means you're learning. It is ok to do things wrong now, because you are not the one making the final decisions. If you don't mess-up now, you're going to mess up later when it matters. So now is your chance.
- Try to get as many letters of recommendation during third year as you can. If you are not 100% certain what field you will go into, have the attending write a generic letter. More letters mean that you will have more to choose from when applying to residency programs next year, and having multiple choices means you can choose the best program to fit your needs. You should try to walk away from every rotation with a letter of recommendation. If it turns out to be a poor letter, then trash it. But in the majority of cases you will be surprised by how good of a letter an attending will write for you. Additionally, when your attending writes a letter for you, he or she will be forced to look at you in a more positive light, so you may end up getting a better evaluation because of it!
- For every rotation you will need Tarascon Pocket Pharmacopoeia, Maxwell Quick Medical Reference pocketbook, and a smartphone or PDA loaded with Epocrates Rx or another free drug reference. Here are some other iPhone applications that students have recommended: Monthly Prescribing Reference (aka MPR, free app), AHRQ ePSS (free preventative medicine screening guide), Mediquations ($4.99) or MedCalc (free), ABG (free), Hypermunes Pregnancy Wheel (free), iMurmur2 ($2.99; has great sample murmur recordings), ECG Guide ($0.99; great pocket reference for ECG interp), and Diagnosarus DDx ($.0.99; helps you come up with differential diagnoses for a given sign/symptom).
Studying for the USMLE Step 2 CK
The Doctors In Training USMLE Step 2 CK Online Review begins on any date you want. It gives you 45 days of access to 15 days worth of high-yield material that you won't find anywhere else. Most students take about a month to study more intensively for Step 2. If you did not do as well as you wanted on Step 1, this is your chance to show residency programs you have improved. If you need to cover your Step 1 blemish, then take Step 2 early (before October of 4th Year) so residency programs will have a chance to look at it. If you think you might do worse on Step 2 than you did on Step 1, then take the test later so residency programs only have your Step 1 score when making their decision. If you plan on this second option, make sure the residency programs in which you are interested in do not require a Step 2 score for ranking, because some do. Here are some of the best resources for Step 2 study:
- Doctors In Training USMLE Step 2 CK Review
- Step-Up to USMLE Step 2 (Yes, it's better than First Aid for Step 2)
- NMS Review for USMLE Step 2 and/or online question bank (e.g., USMLE World)
- USMLE Step 2 Secrets
Studying for the USMLE Step 2 CS
The last AAMC (American Association for Medical Colleges) meeting revealed that the CS exam will soon begin using new methods for testing students, causing the test to become more challenging. We will keep you posted as more information becomes available to help you better prepare for the new CS exam. For now, the tried-and-true techniques that currently apply will be very helpful to you.
We recommend studying from First Aid for Step 2 if you are taking the CS after taking the CK exam. Carefully view and prepare using all of the videos that are posted on the USMLE website for the Step 2 CS exam. This will help you familiarize yourself with the exam pattern and what is expected of you. Enlisting a study buddy/guinea pig (someone else who is preparing for the exam that you can practice with) is invaluable. A good website to help you prepare for the CS that we like is My USMLE Step 2 CS Study Notes-N-Tips-N-Tricks.
Scheduling Your Fourth Year Rotations
- Know that your first few rotations will appear on your transcript and Dean's Letter (now called the medical student performance evaluation, or MSPE). So you may want to either adjust your schedule to overshadow your 3rd year grades with better 4th year grades or take more P/F classes during this time to not mess up your current transcript, depending on how satisfied you are with your third year grades.
- Most residency interviews take place October through January. Schedule easy rotations and/or time off during these months to go on interviews.
- If you are undecided between 2 career choices, do rotations in these fields first so you can hurry-up and make up your mind. You don't have much time left to decide!
- If you still need letters of recommendation, rotations that will provide you with strong letters should be scheduled early in the year.
- If you are going into a competitive field and have not yet done research, you need to schedule a research rotation early in the year.
- You should make every attempt to do a rotation at your first choice residency program. This will help you decide if you really want to spend the next 3-5 years at that program. Also, this lets the program know that you are a very serious applicant, and they will place you higher on their rank list because of it (unless you make a fool of yourself while you are there). Some programs will not even rank an applicant unless that person rotated through their program.
On Writing Your Personal Statement and Applying to Residency
If you are a medical student and have additional information that you think third and fourth year medical students would find helpful or questions about success in medical school, please send your comments/questions to support@doctorsintraining.com.
