Preparing for Surgical Clinical Rotations
Review the Surgery and Relevant Anatomy
When preparing for surgical clinical rotations, reading up on the surgery or procedures and reviewing relevant anatomy the night before can be helpful. This preparation will enhance your understanding while observing the procedure and help you anticipate and answer potential pimping questions effectively.
Clinical Procedures: Maximizing Opportunities
Be Present and Proactive
Increase your chances of participating in procedures by being available and ready to assist. If there’s something you’d like to try, ask the preceptor ahead of time (not in front of the patient).
Often, opportunities will be offered spontaneously. React with enthusiasm and gratitude to encourage more opportunities in the future.
Follow Preceptor Cues
If your preceptor puts on gloves, do the same—even if it’s just to be prepared. Wear regular gloves before scrubbing in, as this might lead to opportunities to assist with anesthesia or other tasks.
Performing Osteopathic Manipulative Medicine (OMM)
Diagnosis and Recommendations
During rotations with osteopathic preceptors:
Diagnose somatic dysfunction and report your findings.
Include a recommendation for OMM in your plan.
Your preceptor will decide whether they’re comfortable supervising you. Many DO preceptors, especially residents, are open to letting students perform OMM under supervision.
Always Get Approval
Never perform OMM without explicit approval from your preceptor. Just as you wouldn’t prescribe medication or perform a procedure without supervision, OMM requires the same level of oversight.
Professionalism on Rotations
Etiquette
Avoid asking where someone went to medical school. If you’re curious, look it up discreetly. If it comes up naturally in conversation, fine—but otherwise, it’s best not to bring it up. Most preceptors will share this information voluntarily if they’re comfortable.
Always check before using a computer. Ask if the computer is available to ensure you’re not inconveniencing anyone.
End-of-Day Protocol
Ask if there’s anything else you can help with. If the answer is no, but you aren’t explicitly dismissed, frame your question differently the next day. Ask, “Is there anything else I can help with before I leave?” If the answer is still no, politely say you’ll see them tomorrow. Remember, your primary goal is to learn, not to take on unnecessary busy work or sit around for hours.
Tips for Pimping Questions
Embrace the Teaching Opportunity
Pimping is a teaching method designed to test your knowledge and encourage learning. To prepare:
Use Anki for instant recall and concise answers. I had countless times recalled an Anki card to answer a pimping question.
Regularly practice questions to improve your readiness.
Stay Consistent
Even during rotations, continue Anki reviews and practice questions. Learning during each specific rotation is more beneficial than revisiting unrelated topics.
Keep in mind that topics overlap—psych concepts may arise in any setting, and surgery patients often have medical histories tied to internal medicine.
Shelf Exams and COMATs
Adapting to Time Constraints
COMATs have tighter time constraints than second-year tests. You’ll have 1 minute and 12 seconds per question and longer question stems. I used to be able to go through the whole test in my second year of medical school twice or at least my flagged questions, but with COMATs, I didn't have that luxury of time. You have to hustle through, hoping for a few minutes to review a few more questions again. I got better at this throughout the year, but it is a big change that many students have noticed.
Adjusting Expectations
The third year does not have as much new information as I expected. Third-year exams emphasize decision-making over the detailed pathophysiology and mechanisms of action often emphasized in the second year. There is a greater focus on decision-making instead of the pathophysiology and mechanism of action type questions like 2nd year has. Think about lectures from DO/MD professors instead of from the PhD professors.
Final Thoughts
Third-year clinical rotations are about building decision-making skills and integrating knowledge across specialties. By staying prepared, professional, and proactive, you’ll maximize your learning opportunities and perform well clinically and academically.
Frequently Asked Questions
1. How should I prepare for my first day on a surgical rotation?
Start by reviewing the procedures and anatomy relevant to the surgeries you’ll observe. Arrive early, review patient charts, and familiarize yourself with the surgical team’s routine. Don’t hesitate to ask questions to clarify expectations.
2. What’s the best way to get involved in procedures?
Be proactive and present. Tell your preceptor you’re eager to assist by asking if they need help. Show enthusiasm and gratitude when opportunities are offered.
3. Can I perform OMM during rotations?
Yes, but only with explicit approval from your preceptor. Always discuss your findings with them first, and ensure they are comfortable supervising the procedure.
4. How can I prepare for pimping questions?
Use Anki or other flashcard tools to practice recall and review key concepts. Stay consistent with your study routine during rotations and focus on the material most relevant to the specialty.