What to Expect during Rotations and Clerkships in 3rd Year of Medical School

The third year of medical school has a rather unpleasant reputation at each and every single school in the United States because:

1. The third year of medical school is the most important year in terms of securing the future residency position of one’s choice, and

2. Unfortunately, the third year is also the hardest of the four years of medical school.

Now, what every reader should understand is that the complaint that “school is hard” reaches new, almost unimaginable, levels in the third year of medical school. Sure, massive amounts of information are shoveled in to the brains of 1st and 2nd year medical students. But, the third year of medical school is a whole other story. Let me explain…

The third year of medical school is a year filled to the brim with clinical clerkships. This means that med students graduate from the classroom to the hospital and clinician’s offices. Med students essentially get to play doctor, albeit a heavily supervised version, in the 3rd year of medical school.

Third year medical students talk to patients, do physical exams, write H&Ps and SOAP notes, present patient cases to residents and attending physicians, come up with treatment plans, and manage patient care to the best of their ability and allowed responsibility. Keep in mind that all of this is done with residents repeating just about everything behind the student and the attending physician, i.e., “the boss”, guiding the residents on patient management.

However, third year medical students get the added bonus and stress of required lectures, conferences, and studying for specific departmental exams. There is even a national shelf exam (also called national board exam) at the end of every single clinical rotation. A med student can’t pass a rotation and complete medical school until they pass the shelf exam for each and every clinical clerkship.

As if that weren’t enough, these 3rd year medical students are also expected to perform at their very best every single day for an entire year. A med student on a clinical clerkship knows that he or she must attempt to do the very best job they can all the time. Everything a third year student does and says is noted and stored away for that end of rotation evaluation.

So why would a med student try so hard just to please a resident and attending and ensure a good end of clerkship evaluation? Well, most clerkships are graded by combining the board exam score and the clerkship evaluation score, and the final clerkship grades that a student receives have a huge impact when a med student starts applying for residency positions.

Most residency programs heavily consider whether a student received honors, pass or fail in the clerkship representing the specific specialty of that chosen residency. They also strongly consider whether a student received mostly, some or (god forbid) no honors throughout the third year. When you are a third year med student, everything you do during a clerkship matters! Find out how to deal with it all in the article “How to succeed in the third year of medical school”.