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Be Naturally Impressive: Tips for Medical Students (Part 1)

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As of this writing, I’m currently working in the busy cardiology ICU.

Since this is my second time through the service as a cardiology fellow – I’ve begun to hear comparisons made between myself and other fellows, residents, and doctors in general.

The repeated theme over these past few weeks have been – “You’re just a first year??!”

Without boosting my ego too much – I’ve been made aware that I’m doing things & taking steps that have made me look more experienced & put together than my years in training.

So here are some tips for medical students on how to do simple things to be naturally impressive in the classroom and rotations.

I’m hoping this series is helpful for all of you about to start a new phase – whether it’s starting residency, medical school, or a new rotation/course. I’m sure these simple approaches will help you also be naturally impressive.

Today I’ll start with one of my favorite.

Pretend Like You’re The Only Decision Maker

In training, you will get spoiled and used to the idea that there is always someone who can oversee your decision-making.

In med school, you have your residents & attendings. In residency, you have fellows & your attendings.

Even as a fellow – I can over-rely on my attending.

But – the growth doesn’t happen until you’re forced to make calls.

Being an independent hospitalist really helped me get used to this and it’s served me well as a cardiology fellow.

For example – in the cardiology ICU, the patients are quite sick. It can be easy as a first-year fellow to be nervous to make decisions without the green light from your supervising attending.

But to be naturally impressive – you have to make it natural to make decisions and learn from them.

And since we don’t want any of our decisions to harm a patient – here’s how you do it safely…

… ask what you would do if you were the only decision-maker for the patient.

What would be all the big and small stuff that you would do to make them better?

I’ll give you an example of a recent patient I took care of in the ICU.

I received a consult on a patient with very difficult to control high blood pressure which began to affect her other organs.

I saw the patient and then wrote an entire consultation note of what I would do before even discussing the patient with my attending.

I just didn’t sign the note.

I then staffed (ie. discussed) the patient with my attending and ended with – “here’s what I would like to do for the patient”.

That last sentence is a great way to tell your supervisor – “hear me out and tell me what you would do differently”.

Now after I share my entire plan – one of two things happens.

  1. The attending completely agrees with every step I want to do (happens but not always)
  2. They adjust parts of my plan and tell me why

The second option is where you naturally learn the most. It’s a quick feedback loop of what to consider based on the patient in front of you.

And the next time you see a similar patient – you can ideally take the same things in consideration.

Now by itself this may not seem like much. But imagine doing this process over hundreds/thousands of patients.

Each day as a fellow I see 10-20 patients. I make decisions for all of them and tell me attending “here’s what I would like to do”.

Each time I do this – the plan is likely adjusted and I get feedback.

Each patient is another repetition to sharpen my clinical decision-making, confidence to make decisions, and naturally…

… the confidence of my attending in me increases.

Now fast forward years of doing this. Yes a long time but in the grand scheme of things – you’ll be putting the years in anyways.

I’ve been doing this process since med school. So with nearly a decade of experience – I’m likely better/more confident at making hard decisions than my peers just because I’ve made myself do it.

So if you want to be naturally impressive in medicine – while in training… pretend like you’re the only decision-maker in the room. Get feedback on your plans, realize what you missed or didn’t consider, and repeat.

Hope this helps!

More to come in the upcoming days on other ways to be naturally impressive on your medical journey! Get excited :D

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Hopefully we were a little help to you on your journey today. Thanks for being part of ours.

Until next time my friend…

Lakshya Trivedi, M.D.
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