Clinical rotations are arguably the best time of medical school: You get to work directly with patients, be in the hospital, see what it’s like to really be a doctor, and put all that medical knowledge you learned into practice. But while our third and fourth years can be exciting, they can also be incredibly challenging. Throughout those two years, medical students are being evaluated at all times and the stress of having to be perfect, ask questions, and constantly look “interested” can be draining. In a sense, every day feels like a job interview. This is particularly true for introverts, like myself.
One of the hardest pieces of constructive feedback I received early on was that I “fade into the background” and that while I work hard, I am “too quiet.” I remember feeling incredibly disappointed, frustrated, and just confused as to how I could make myself stand out. I didn’t personally believe I was being quiet; I was actively trying to be social — but in comparison to my extroverted peers, it didn’t appear that way. I wasn’t alone in this issue and through my conversations with some of my more introverted peers, this was a challenge many of us were facing. There is an incredible pressure to have to constantly put on a social and energetic face to get a good evaluation.
The generic advice people usually give introverts is to be “be yourself” and while that’s great in theory, it’s not very useful. With that in mind, from one introverted medical student to another, here is how to survive clinical rotations and get good evaluations:
Form Connections with Your Patients
Ultimately, you are in the field of medicine to work with patients. Often, the best skill that introverts bring to the table is their ability to listen. In addition, while group situations may feel daunting, being an introvert does not mean you can’t form meaningful relationships with individuals. Learn to use your skills and strengths to your advantage. Take the time to really get to know your patients, spend as much time with them as you can, and know everything there is to know about them. If you take complete ownership of your own patients, it will show. By talking to your patients and forming connections with them, you are becoming their point person and the one they will look to when they have questions.
Use Your Presentations As Opportunities to Shine
Though having ownership of your patients will show, sometimes we still need to “tell.” Often, one of the biggest challenges is finding an opportunity to speak. Trying to come up with questions to seem interested never felt genuine to me and attempting to answer questions before my more extroverted peers was also a challenge. Presentations are the perfect time for you to shine; this is a set amount of time where you have the stage. For many of us introverts, we live by the motto of doing and not necessarily telling. The concept of verbalizing everything we are accomplishing can feel very awkward but is ultimately necessary. Specifically, make it a point to say what you plan to do for the patient that day and what tasks you have already completed. Your attending and senior resident won’t know how hard you have worked unless you show (and tell) them. In addition, if you are on a rotation with longer presentations and you feel that your attending is interested, use this time to tie in an article or a teaching point. Finally, maybe for you, the presentation is the scariest part of clinical rotations (public speaking can be intimidating for extroverts, too). If that is the case, practice and preparation are your best friends.
Be a Present Team Member
Speaking of friends, getting to know a completely new team of individuals every few weeks was possibly my biggest challenge during my third year. It takes me time to settle in and get to know individuals before I feel entirely comfortable in situations. Unfortunately, during your third and fourth years, time isn’t exactly on your side. However, you should use the time you do have to get to know your team. If your team is grabbing lunch from the cafeteria, taking a coffee break, or going someplace, make sure to go with them! I have seen multiple students state they “brought lunch with them” or just sit in a corner doing Anki cards instead of socializing with their team. Simply being present in the moment is important to being a good team player and will go a long way in helping you form those relationships with your team members.
Put On a Smile
In addition to being physically present, you should be emotionally present. Smiling should be obvious, but surprisingly isn’t. Sometimes when people are quiet, they may seem aloof. This is not great if you are trying to get a good evaluation. Use non-verbal cues to demonstrate your interest and excitement about medicine. This means smiling, making eye contact, laughing when appropriate, or even simply nodding your head to show that you are engaged in the conversation around you. Maybe speaking in certain situations is too daunting or you feel that you have nothing useful to say, but that doesn’t mean you need to fade into the background.
Take Time to Recharge
In general, introverts gain energy from spending time with themselves, and extroverts gain energy from more social situations. Being in the hospital all day, working with patients, and being in team settings that require multiple social interactions can be extremely mentally and physically exhausting. Taking the time to recharge is important to ensure that you have energy to be an engaged student the next day. Keep up with your hobbies, spend time with those you love, and give yourself time to decompress.
The key to surviving and thriving in clinical rotations — whether you are an introvert or an extrovert — is just working hard and being a good person. However, students with certain personalities are predisposed to greater success during clerkships and being seen as aloof or shy can negatively impact your clinical score. In addition, given that the clinical training environment favors extroverts, clinical rotations can be much more stressful for introverted students. Knowing how to navigate these inherent systemic biases by being a good team player, getting to know your patients well, and being present in the moment will hopefully allow you to be confident, shine, and enjoy some of the best years of medical school.
Are you an introvert? What tips have you found useful for navigating training and practice?
Ruchi Desai is a current fourth-year medical student at UC Irvine School of Medicine. She is planning to pursue a residency in internal medicine. During her free time she loves to read, listen to podcasts, and learn as much as she can about the world. She is a 2021–2022 Doximity Op-Med Fellow.
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