Year3

=MS-3: Introduction to the clinical years= toc

Planning your third year
These are some principles that I think are useful in planning your MS-3 year.
 * __Start with a clerkship that you think you are unlikely to end up specializing in__. Understandably, you won't be as good on the wards on day 1 of your clinical experience as later in the year.
 * __If you "know" what you want to go into, don't wait until the end of the year to do that clerkship__. Med students change their mind about specialty an average of 3.2 times. You may dream of doing orthopaedic surgery but then find you hate it when you do it for the first time. If this first time is at the end of the year, you may find yourself scrambling to rearrange away rotations in your fourth year, etc.
 * __If you want to do surgery, take medicine first__. There is a ton of medicine on the surgery shelf. A more apt name would be "the medical management of surgical patients." Take medicine first so you will be prepared.
 * __Take surgery in the winter__. It is the most intensive in terms of hours (procedures, rounding, taking call), and it is painful to be inside this much during the late fall or spring.
 * __Do a surgery AHEC__ as one of your (3) sites on surgery -- even if you don't want to do surgery, and especially if you do. AHECs in surgery are generally more laid back and you are also allowed to be more involved in cases since there are no residents. Take this site last so you are well prepared to tie knots and throw suture. The AHEC in Lima with Dr. Oaks is especially awesome.
 * __If you want to do medicine, take surgery first__. There is some surgery on the medicine shelf, and taking surgery first will help you prepare.
 * __Take psych before neuro__. Up to 10% of the neuro shelf is on "mental disorders" as indicated by the subject exam content outlines released by the NBME (see below). Taking psych first will help you brush up on these before neuro. Alternatively, just review mental disorders during your neuro clerkship.
 * __Take psych in the spring__. It is one of the less intense clerkships and it is nice to have some free time in the spring. Then again, if you think you want to do psych or neuro, it may be useful to do these sooner.
 * __Take family medicine or internal medicine last__//unless you want to do these for a career.// They are the best at preparing you for Step 2 CK, so it is good to take one of them at the end of the year to have a built in review.


 * What I did:** Pediatrics/Obstetrics & Gynecology, Surgery, Internal Medicine, Neurology/Psychiatry, Family Medicine/Elective (which includes 1 week of vacation time)

NBME "Shelf" Exams

 * **NBME Publications - See the "[|Subject Exam Content Outlines]" for sample questions and exam info.**
 * [[file:Subject Exam Content Outlines and Sample Items.pdf]](Accessed 3/23/2011)
 * Contains content outlines for each subject exam (eg. what % of the OB/Gyn exam will be labor & delivery type questions and what % of the exam will be gynecology health maintenance type questions)
 * Contains 20 sample questions for each exam with answers. //Not representative of the real exams// (the real exams are 3x harder). However, they do give you a feel for the length of question stems etc. Good to do a day or two before the exam to make sure you have covered everything.
 * ** Question stems are very long. Time will be a factor, even if you finished other exams in med school with plenty of time to spare. **

Miscellaneous Resources

 * [|Auscultation Assistant] - Great link for learning about heart murmurs, rubs, gallups etc!
 * EKGs: LearnTheHeart.com - may not look like much, but has great tutorials and 100 practice EKGs with explanations.
 * Chest X-rays: Yale Cardiothoracic Imaging - great tutorials and guides for beginners and advanced learners.
 * [[file:How to Write a Prescription -Dr. Marco.ppt]]
 * [[file:Introduction to Laboratory Tests Handout Version.ppt]]
 * [[file:Lab values.xls]]
 * [[file:Acid-Base.ppt]]