The third year of medical school, also known as clerkships, is probably the most stressful and busiest year of medical school. We spend the daytime in clinical settings and hit the books as soon as we are dismissed. There is the constant pressure that everyone around you is evaluating you for a grade, and there is the pressure to achieve a certain grade on end-of-clerkship shelf exams. Our grades determine our class rank, as well as the specialties and programs we would be competitive for. This is on top of having to cook, exercise, and sleep, making for a challenging year mentally and physically. Now as I begin my fourth year of medical school, I want to share some pieces of advice with my younger self and with the students currently in the midst of, or about to start, their clerkships.
1) You will figure it out.
Without fail, I was anxious the first couple of days of every new rotation. The learning curve is indeed huge, as we start every rotation with knowledge gaps everywhere. It takes some time to figure out what the workflow is, what the expectations of your preceptors are, and even where the bathrooms are. But also, without fail, I noticed that toward the end of every rotation, I had gotten comfortable in the clinical setting. My knowledge grew as I worked through the question bank, and I started to understand what was going on. After a couple of rotations, I reminded myself at the start of every rotation that eventually, I was going to get the hang of it all, even if the first day felt like I was in a foreign country. It was just a matter of time, because I know I am able to adapt and learn as time goes on. This gave me confidence and eliminated the paralyzing fear that prevented me from even attempting to do anything, which brings me to my next point.
2) Do not be afraid to fail.
I do not mean we should actively try to make mistakes or hurt patients, but we should not be afraid to try new things and push our comfort zone, even if it means making mistakes. I was given this advice in my first ever rotation in plastic surgery, and I reaped its benefits for the whole year. A resident told me, “You might be in the ICU and have to present on an intubated patient in front of a whole crowd.” As she said that, the very idea of having to do that sent chills down my spine.
“Just do it,” she said emphatically.
Nine months later, that exact scenario happened on my own ICU rotation. Although I had a meticulous and detail-oriented attending physician who even residents were intimidated by, I didn’t retreat in fear because I remembered that advice. Although I received some critical feedback on my first presentation that could have left me afraid to try again, I focused on making the necessary changes day by day. This led to my last presentation, when the same attending said, “Very good presentation.” I feel that as medical students, we try to preserve our image of perfection, knowing we are constantly being evaluated, and harbor such a fear of failure that gets in our own way. But the fact of the matter is, we learn best from trying something, even if it means falling face down on the ground. But when we have a growth mindset of learning as much as possible, we become better clinicians by learning from both our successes and, what seems to be at the time, failures.
3) You are not alone.
As someone who spent the majority of the preclinical phase of medical school alone at home, I enjoyed being in the hospital with my classmates, sharing our experiences and tears with one another. This year helped me establish lifelong bonds: classmates in whom I confided, residents who took me under their wings, attendings who lent an open ear, and deans who I trusted. I realized we do have a lot of resources available, but it is up to us to reach out to those resources. Also, remember to check in with your classmates. It’s a tough time, and you never know what others might be going through. They might just need a friend to lean on.
4) Life is more than just medical school.
Medical school can feel like a bubble when your whole being is set on the goal of getting good grades, in order to get into a good residency, which would set you up for a good job, and so on and so forth. During clerkships, I experienced the loss of a close mentor, which gave me some perspective that life really is bigger than medical school. Life is too short to be burnt out and unhappy. But when I tried my best to maintain hobbies like playing basketball and traveling to see friends and family, I felt recharged to continue studying. Do not give up the things in life that bring you joy, even during this difficult season of medical school.
5) You do make a difference.
As medical students, sometimes we might feel like a fly on the wall. But we actually can and do make a difference. There were times when I spoke up during rounds to add a piece of critical information for my patient, acquired outside medical records, and even wiped the vomit and tears off a patient’s face as she was recovering from anesthesia. Though these may seem like little tasks, they are meaningful contributions to patient care. We usually have the privilege of spending more time with the patient than anyone else on the team. Take advantage of that time to get to know patients and their families deeply. It is totally worth it, and it is a reminder of why we chose this profession in the first place.
What advice would you give your younger self about surviving clerkships? Share in the comments.
David is a fourth-year medical student at the Renaissance School of Medicine at Stony Brook University, class of 2026. He graduated from Rice University in 2020 with a Bachelor of Arts in chemistry. He hopes to pursue a career in pediatrics. David enjoys playing basketball, working out, and spending time with his church community in his free time.
Illustration by Diana Connolly
