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  • Everyone talks about studying, clinical rotations, and the more typical things you would expect

  • in medical school. But until you live it, those don't quite give you the full experience.

  • These are the unwritten and unspoken rules of medical school.

  • Dr. Jubbal, MedSchoolInsiders.com. This is inspired by a video I did on my personal

  • channel, Kevin Jubbal, M.D., linked in the description. That video is a bit more raw

  • and raunchy and is largely a compilation of your responses to my post on Instagram. If

  • you want something more unfiltered, be sure to check out that video after this one. Here,

  • we'll discuss more extensively the unwritten rules that no one else will tell you.

  • The first rule is a broad general rule, as your medical education and training is going

  • to be lengthy with plenty of reason to complain. You'll have professors whose competence you

  • question, attendings during your clinical rotations that seem impossible to please,

  • schedule changes that seem to always work against you, and other forms of bad luck.

  • But no one likes a Debbie Downer, so although there will always be reasons to get irritated

  • or whine about how things are inefficient, unfair, or a waste of time and resources,

  • don't become the person that's seemingly always pessimistic. Doing so just brings other people

  • down and makes the already irritating situation become worse than it already is.

  • Rather, if you're able to be the person that always finds the silver lining, that can turn

  • negative into positive, you'll not only win many friends and favors, but find yourself

  • much more at peace with the roller coaster ride of medical school.

  • In line with this, avoid getting defensive or egotistical when your knowledge gaps are

  • pointed out. If you're wrong or don't know something, don't try to explain why. Just

  • appreciate the person who is teaching you something and move on.

  • The second rule is to know clinical rotation etiquette before you get to your clinical

  • rotations. And this expands beyond simply knowing that a small towel on the handle of

  • the call room means it's occupied. Actually, that's a good one to know to make sure you

  • don't barge in and wake someone from their few minutes of precious slumber on a busy

  • call night. First, understand that a big part of your

  • overall grade in any rotation comes down to a subjective evaluation from your residents

  • and attendings. There are pros and cons to this, one of which is that being on your phone

  • is often interpreted as you being distracted and texting, going on social media, or finding

  • dank memes. It is for this reason that I bought an iPad Mini. By using my iPad to look up

  • information, I was more likely to be perceived as being studious and hard working when using

  • my devices, as opposed to distracted on a phone. The irony here is that just about anything

  • you can do on your phone you can do on your tablet, and vice versa. You could be studious

  • on your phone and be distracted on your tablet, but again the optics of your behavior are

  • important for your clinical evaluation. Second, don't be a gunner. When you rotate

  • at clinic or in the hospital, you'll usually be rotating with one or more other students.

  • You should never, under any circumstance, throw them under the bus. Making others look

  • bad is not only a terrible thing to do that will weigh on your conscience, but your residents

  • and attendings can usually see right through it, and that's not a good look.

  • Similarly, consider how your behavior makes others look. If you're in the operating room

  • or on rounds and the attending asks the resident a question, don't pipe in with the answer.

  • Sure, it may be impressive that you know something the resident doesn't, but what's more salient

  • is that you couldn't contain yourself to blurt out the answer, thus making the resident look

  • bad. No one wants to work with someone like that. If you are directly asked the question

  • next, it's of course fine to answer. When you put energy into looking good, you

  • come across as conceited and you paradoxically look bad. If instead you value others and

  • try to make them look good, you become a likable personality who appreciates others, and that's

  • the kind of teammate we all want. Another under appreciated skill is knowing

  • when to ask a question. If it's something that's easy to look up, look it up yourself

  • and don't waste other peoples' time or energy answering a simple question. If it's not easy

  • to look up and it's a genuine question, don't be afraid to ask it. However, know when to

  • ask questions. This comes down to social calibration. If things are hitting the fan in the operating

  • room, try to be helpful and let the team handle the situation, and refrain from asking unnecessary

  • questions in moments of acuity or stress. And finally, it's deeply frowned upon by everyone

  • in the hospital and clinic when you fail to like this video and subscribe to Med School

  • Insiders. The third rule is to appreciate and value

  • the little time you have. It's normal to feel like there aren't enough hours in a day, and

  • it's normal to feel like you're expected to do an impossible amount of work or studying

  • in too short of a time period. The value of facing this reality will serve

  • you well for the rest of your life. If you allow it to, it will teach you lifelong lessons

  • in productivity, efficiency, and effectiveness that will make you better rounded and able

  • to handle more than you thought possible. I have entire videos and playlists on efficiency

  • and productivity, so I won't rehash them here, but they are linked below. What I will emphasize

  • is that while you're in the hospital or clinic, maximize any down time you have. There will

  • be moments when you are waiting on the patient to be rolled into the OR, or when you're waiting

  • on seniors to begin rounding. Never let a moment in the hospital or clinic go wasted.

  • After all, you will not be able to relax and unwind while you're there, so seize the moment

  • in one of two ways: if you're feeling mentally sharp, power through some flashcards, practice

  • problems, or quick bursts of studying. If you're feeling mentally fried, then focus

  • on procedural memory, like practicing your suturing or knot tying.

  • The fourth rule is actually two rules about finances.

  • First, be mindful that everyone's financial position is different, and it's best practice

  • to avoid talking specifics. Some of your medical school classmates will be taking out more

  • loans, others will be taking out less. A surprising number won't take out any loans at all because

  • their parents are footing the bill. Those who have parental help may feel guilt or receive

  • some resentment from those who have to take out loans. It doesn't matter what other medical

  • students' financial situations are. Simply concern yourself with your own finances. And

  • if you're footing the bill, trust me when I say it's an incredibly empowering feeling

  • to know you paid your own way through medical school and the feeling you get when you finally

  • pay off your loans is priceless. Second, physicians are notorious at being

  • terrible with money. Don't contribute to the stereotype. Educate yourself on some simple

  • financial basics. I recommend the White Coat Investor book, linked below, for a quick and

  • easy read that will teach you 80% of what you need to know. Countless medical students

  • make poor financial decisions under the premise that since they're already in six figures

  • of debt, spending another few hundred dollars here or there is just a drop in the bucket.

  • The truth is that it's not just a drop in the bucket. In fact, it's a snowball that

  • rolls faster and grows larger the more you contribute to it due to interest and the compounding

  • effect working against you. It's a common trap medical students fall into

  • they want to crush their boards, ace their pre-clinical blocks, dominate their clinical

  • rotations, and match into the best residency they can. I get it. I've been there.

  • At one point or another, the students that take this approach become miserable, burn

  • out, and find medical school far more painful than it needs to be. Tying in rule three,

  • it's not about brute forcing work at the expense of everything else. Success in medical school

  • comes down to optimizing your time and energy, and that includes high density fun and relaxation,

  • like spending time with friends or your partner, and of course the three pillars of exercise,

  • nutrition, and sleep. Some say not to enter a relationship while

  • in medical school, but the reality is that some relationships can immensely help with

  • your resilience and perspective of medical school, and others will be an energy drain

  • and hold you back. I was fortunate in medical school that I dated a fellow medical student

  • who definitely made my life better. But I know others who found that their relationships

  • caused their class performance and mental state to suffer.

  • Speaking of relationships, there's a common saying to not have a bowel movement where

  • you eat. This is said to indicate you shouldn't date someone where you work or in a small

  • class. The counterpoint to this is that you'll meet some amazing people you may want to enter

  • a relationship with. The key is to act with integrity so that if you part ways, you can

  • do so on good terms. Medical school classes are also much smaller

  • than any typical college, and for that reason you'll hear about everyone's business. Gossip

  • is a plenty, and it feels more like high school in this way. Don't give into the temptation.

  • Stay out of the gossip and drama and stay in your lane. You'll thank me later when things

  • implode and become a distraction from the little time you already have.

  • If you view your fellow classmates through a long term lens, meaning that you want to

  • be on good terms with everyone, and for a long period of time, you'll find yourself

  • avoiding many faux pas, like asking others what score they got on a quiz or test. Doing

  • so has very little upside for you but substantial downsideafter all, you already know the

  • class average and max scores, but there is a high probability to make someone else uncomfortable.

  • When you view medical school and your classmates through this perspective, it's natural to

  • look out for one another and want the best for each other. After all, you're all in it

  • together, and challenging times can be great sources of strength and bringing us closer,

  • but only if you let it. If you enjoyed this video, check out the other

  • unspoken rules on my Kevin Jubbal, M.D. channel or this other video. Much love, and I'll see

  • you guys there.

Everyone talks about studying, clinical rotations, and the more typical things you would expect

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