Clinical Guide The Nerd's Guide to Pre-Rounding Table of Contents Introduction I expected the third year of med school to be a tortuous test of will. And it has been, at times. Overall, though, I leave third year excited about my future medical career, and amazed at the true privilege it is to take care of patients. If you're like me, you will have many moments in third year when you will draw on knowledge earned with the sweat of the first two years. In terms of pathophysiology, biochemistry, pharmacology, clinical reasoning, etc., UCSF prepares us well. I have had several moments when I blessed the names of teachers like Warren Levinson, Dan Lowenstein, Sexton Sutherland, Susan Masters & Bernard Katzung, Henry Sanchez, Diane Colby, and Ellen Hughes. Overall, UCSF does a great job of preparing us for third year. We have the knowledge. HOWEVER, we do not necessarily have the know-how. Knowing the branches of the internal carotid will not help you make an organized presentation in pre-rounds during the first week of clerkships. Knowing the up-regulators of glycolysis, or the sequence of drugs used to treat status epilepticus, will not help you get along with your team, or get the evaluations you need to meet your career goals. During the first day of each of my rotations, it was customary for the secretary of the clerkship program director to dispense a phonebook-thick stack of hand-outs intended to help "orient" us. I was often amazed at the gap between what they THOUGHT we needed to know, and what we actually NEEDED to know in order to function as medical students. Our academic supervisors often tell us what they want us to learn, but not how we're supposed to do our jobs-let alone how to do them well. That is the reason for the following guidelines. These tips and suggestions are intended to help you "survive and thrive" during the intense early weeks of clerkship year. They are the kind of specific instructions I wished I'd had when I started third year. By half-way through the upcoming year, you will have learned on your own much of what's in this guide. But why stumble and learn things the hard way, when, with a little forewarning, you can look thoughtful and well-prepared? Some caveats: First of all, this is obviously a limited, and self-indulgent, first-person view of what will help you on the wards. It's only my personal opinion, but I offer it for what it's worth. Second, this guide is only one section of the Clinical Guide, published by the Office of Curricular Affairs. The other sections of the Clinical Guide have great overall information on the "big picture" of third year, but doesn't go into some details I think would be helpful. Third, I strongly urge you to study the section by Dr. Jeff Wiese on making presentations included in your orientation binder[1] - it's excellent. [1] I have just heard that Dr. Wiese is leaving UCSF for Tulane. We are losing a truly gifted teacher; he will be missed. [Back]