BraveNewWorld:

ManagingtheCultureof
Medicine
UCR Clinical Foundation
June 30, 2015
Joyce M. Fried
Assistant Dean
David Geffen School of Medicine at UCLA

Thebestwaytoprepareistofigureout
theanswerstothefollowingquestions:
What is the culture of medicine?
How can you fit in?
What are common pitfalls for medical students?
How do you distinguish yourself?
What is student mistreatment?
What should you do when you encounter a difficult
situation?

Understandthelandscape
You are leaving the cocoon of UC Riverside to join the
real world of healthcare
Your role as a clerk is limited with unclear expectations
A grading system that is subjective
You are no longer the center of the universe

Howcanyouprepareforeachrotation?
Speak with students who have recently completed the
rotation
Read the clerkship orientation information that is sent to
you or is available online
Dont miss any of the critical information during the
clerkship orientation

Whenyoustartanewclerkship
Arrive with the necessary electronic resources
Arrive with the necessary books
Learn the medical chart
Learn the electronic chart
Know where to go and where to find things
Meet with the resident and intern
Meet with your attending physician

Questionstoaskyourresidentandinternat
yourinitialmeeting
Can you go over a typical day with me?
What

time should I arrive in the morning?

What time do work rounds begin?
Where

do we meet for work rounds?

What time are attending rounds? Where do they take place?
Do we have afternoon rounds? When and where do we meet?
How does this schedule differ on a weekend day?

What is our call schedule?

What are my responsibilities on call?
What procedures do you expect me to perform?

Questionstoaskyourresidentandinternat
yourinitialmeeting
Can you go over your preferences regarding the writing of
the daily progress note?
Is there a particular time of the day the progress note needs
to be written by?
Can you show me the paperwork I need to be familiar with?
Can you provide me with a list of important phone numbers?
Where can I safely keep my bag and other personal items?
Where do you recommend that I work?

Focusonalloftheimportantelementsofthe
job,notjusttheobviousones
You will be judged on your:
Ability to work effectively with other team members
Ability to learn new subject material
Communication skills with patients and the medical
team
Overall work ethic

Whatarecommonpitfalls
forstudents?

Frequentproblemsaccordingtoresidentsand
attendings
Bright with poor interpersonal skills
Excessively shy, non-assertive
Poor integration skills
Over-eager
Cannot focus on what is important
Disorganized
Disinterested
A poor fund of knowledge

Howthesearedescribedinevaluations
Very nervous, timid initially
Displayed little curiosity
Had difficulty applying knowledge clinically
He came across as confrontational
Maybe somewhat overconfident for his level of training
Lack of enthusiasm
Problems in organization
Needs to read more on her own
Lots of effort, uneven outcome

Howdoyoudistinguish
yourself?

Waystostandout
First impressions matter
Smile (but appropriately)
Your attire is a reflection of your professionalism
To provide the best patient care, you must be organized
Create a to-do list
Prioritize tasks
Get things done on time
Know everything about your patient
Make sure your data are accurate

Waystostandout
Ask questions
Move from observation to action mode as quickly as
possible
Anticipate rather than react
Maintain your credibility
Always maintain the highest level of integrity
Take initiative
Be confident, but not arrogant

Asastudent,youhavetheabilitytoaidyour
intern,resident,andattendinginmanyways
Understand their goals and priorities, and anticipate
their needs
Keep them informed of any new developments with
your patients
Pay attention to what makes their lives more difficult
and volunteer to help in these areas
When the opportunity arises, offer praise. If your intern
is going above and beyond in his teaching role, let the
attending know.

Whatshouldyoudowhen
youencounteradifficult
situation?

Verbalizeyourdisapprovalat
thetimeofthebehavior

Reportthebehavioranditwill
beactedupon.Youwillnotbe
retaliatedagainst.

Resources
Grievance Committee

Emma Simmons, Chair 951-827-7826 or grievance@medsch.ucr.edu

Student Affairs Office

Christopher Sweeten, Director 951-827-4751

Ombuds Office

Andrew Larratt-Smith 951-827-3213

Title IX
Debbie Artis, Director 310-206-8976
Title IX/ Sexual Harassment Office 951-827-7070

Campus Health Services

951- 827-3031

ITISYOUR
RESPONSIBILITYTOLET
ADMINISTRATIONKNOW
WHATISHAPPENINGIN
THETRENCHES