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Medical Education - Page 14


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7. Allow for several short periods of relaxation during the day. These can be taken
at mealtimes and for more extended periods on weekends. Periodic holiday
vacations can help you to recover from long spells of intense activity.
Looking Ahead
While at the outset of your medical school career it is natural to focus on the courses at
hand, it is also important to have a longer-term perspective on your education. One
needs to recognize that in its essence the first two years are the essential preparation for
the last two-year clerkship training years. It is thus important to master a number of
skills during the preclinical phase of your education to be able to satisfactorily cope
with the challenges you will face when undertaking clinical service on the wards.
In this regard, a recent report indicated that a significant number of medical students
may have an uphill battle during their clinical training. This is suggested from a study
that found that between 30 and 50% of clerkship directors reported that medical stu-
dents are unprepared in six competency areas.
A survey of a significant number of clerkship directors indicates that they believe
that improvement is necessary in communication, interviewing, and examination skills,
professionalism, and understandings of systems of care and life cycle stages. As a con-
sequence of this situation, some clerkship directors have been forced to provide remedi-
ation in one or more of these areas of professionalism, communication, interviewing,
and examination skills, because of a deficiency in preclinical preparation. It is thought
that preparation for the clinical skills component of the USMLE Step 2 may prove help-
ful in this area when working on the wards.
First-year Guidelines
Special emphasis deserves to be placed on the freshman year of medical school, where
attrition, if it will occur at all, is most likely. Like the first year of high school or college, it
marks a year of transition from the triumph of graduation to the lowest rung of the school's
hierarchical ladder. It frequently involves relocating and having a new group of peers.
The average freshman begins medical school with unresolved feelings about his or
her level of achievement attainable in a new and unproven milieu. The nature of the
academic environment, with its large volume of work and the presence of bright and
hard-working classmates, makes it difficult to prove oneself and attain one's inner
expectations. Students with a high degree of self-worth and those who can gain gratifi-
cation from intrinsic rewards, such as the satisfaction derived by keeping up with and
passing through the curriculum, will best respond emotionally to the existing stressful
situation. Providing self-praise rather than seeking external sources of encouragement
is helpful.
The special features of the freshman year that deserve to be brought to the attention
of prospective medical students are as follows:
1. Students frequently have a wide range of emotional experiences during the
course of the year, ranging from exhilaration to anxiety, frustration, and, at
times, depression.
2. The academic program offered is usually uneven, with some courses being
exciting and others dull. Taken as a whole, the program is exhausting.
3. A key to success is to organize one's time most effectively to meet your specific
needs. Allowance should be made in your schedule for a reasonably fulfilling
personal and social life.
4. Upperclass students may provide useful insights into the pressures to be faced
and methods of coping, as well as helpful study tips. The advice given should
not always be taken at face value, but must be adjusted to one's specific needs.
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