Jarrod Shapiro, DPM
Advice To Our Upcoming Clerks

In a confluence of events, this year's residency match process is wrapping up a very short time before the current third year podiatry students begin their clerkships. A large number of us currently in practice remember – hopefully, but not always fondly – our own clerkship experiences. When I was a student they were called "externships," and they were usually filled with uncertainty and nervousness. You'd arrive at a new location unsure of your role or what to expect. You were excited to see a different program and learn something new. Mostly, though, there was the nervous anticipation of the unknown. Would this be my future residency? Or would I completely blow the month? High drama in the making.

In an attempt to make this scary process just a tiny bit more bearable (and hopefully more successful) here are my own personal top six pieces of advice – take ‘em or leave ‘em. Please remember that this is just one person's thoughts. Since each clerkship location is unique, so must be the approach to your month. The one consistency through all of the clerkships is that you should consider it a month long interview. The residents and attendings will examine your attitude and behaviors in light of whether you will be a good fit for their program.

Tonight's Premier Lecture is
Venous Leg Ulcers
Charles A. Andersen, MD, FACS

Prepare for the clerkship beforehand. Find out who the attendings are, and if they have published research, then read all of it. Speak to one of the residents at the program to get a feel for the program's culture and general structure. Practice suturing. Study your podiatry. There is a base level of knowledge all clerks are expected to have. Prepare by considering what you're most likely to see. Diabetic complications, trauma, infections, flatfoot issues, and common podiatric problems like bunions and hammertoes, among others, are topics you're likely to see on rotations. If you're asked questions and don't know your common podiatry very well you won't look good. A strong fund of knowledge is highly important.
Be friendly and outgoing (even if you're not). No one likes a sour puss. If you're rude to anyone, including office staff, nurses, janitors, or patients, you can guarantee that you won't get the program. Friendliness and openness makes allies. Also, don't be a wallflower. This is your month to show that you will be an aggressive resident physician who will eventually be an aggressive advocate for your patients. Think of it this way: if you're quiet and shy now will you change after becoming a physician? Will you be able to tell patients and other physicians what they need to hear? Ask appropriate questions. Strike up conversations. Listen to others. If you're not like this normally then fake it until it becomes normal for you. The quiet person in the back will be overshadowed by louder more aggressive students, and if the residency can't get to know you in the month then you won't be remembered, and you won't get the program.
Be appropriate. Don't be overly friendly. No one likes obsequious students. Don't be unfriendly. Be aggressive but not overly so. Over aggression can come across as rudeness. Don't be the first person to answer all questions all the time, but don't avoid answering questions. It's a matter of balance.
Be the best version of yourself. It's still important to be yourself. However, if who you are doesn't fit that particular residency that's OK. One of the purposes of doing multiple clerkships is finding a program that will fit your personal style and desires. If you've searched enough you'll find those programs that will match well with who you are.
Learn to be comfortable being uncomfortable. There are so many unknowns with this process that you can't and won't know what is going to happen from one minute to the next. You'll meet many new people, and you'll experience new things. You will be moved far outside of your comfort zone. Being uncomfortable will be your normal state of affairs, so get used to living there. Just relax the best you can and let it all wash over you.
Work your butt off. Show up early each day and stay late. Be first in and last out. Ask to help around on the weekends, early morning, and evenings. Ask office staff if they need help. Ask nurses in the OR if they need help. If you're observing a surgery help adjust the lights before the case, get the tourniquets and cast padding, tie up the surgeons' gowns. Offer to take pictures of cases. When in clinic be comprehensive with your patients but don't take too long. See extra patients. Take that extra work. Demonstrate that you are a hard worker and will be a tireless resident. You don't need sleep. You don't want sleep. Sleep is for the weak.

One last bonus piece of advice. While on your clerkship don't do anything stupid. Keep your hands off others – this is not a time to start a romantic relationship. Don't talk back to your attendings or the residents. Want to complain? Yell at the mirror at night. Has someone been rude to you? Don't give it back to them. Swallow your frustrations and keep smiling. Don't ask questions during a surgical case if they're having trouble. Read the social situation and wait until later. If you don't know an answer then say so. Don't BS your way to an answer. Thinking out loud is great; randomly coming to the answer is not. The attendings and residents not only know more than you but can tell when someone just doesn't know an answer. Say you don't know and that you'll read up on it tonight and get back to them later, making sure you do follow-up later.

Finally, enjoy your clerkships as much as you can and learn everything these excellent opportunities have to offer. Most of the people you will deal with will be genuinely nice and caring and will want your experience to be a positive one. And remember you'll only have this short intense time in your career once. Make the most of it.

Best wishes,

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]