<p>Depends on your school, depends on what clerkship you're on, (ie Surgery) depends on the service (ie Blue Team vs Green team), depends on your resident, depends on the time of year you're going through (they'll expect more of you in April than they do in July). </p>
<p>For example, at my school, we have 6 clerkships in the third year:
Internal Med - 12 Weeks - 6 weeks on in-patient, 3 weeks on outpatient, and 3 weeks on a medicine sub-specialty selective.
OB/GYN - 6 weeks - 2 weeks Labor and Delivery, 2 weeks GYN Surg, 2 weeks outpatient
Psych - 6 weeks - 2 weeks out patient, 1 week substance abuse clinic, 3 weeks either on Adult Crisis Unit (patients admitted to the hospital for their psych problems) or Inpatient Consult Service (people admitted to the hospital for some medical reason who also have or develop psych problems)
Peds - 8 weeks - 2 wks inpatient, 2 wks outpatient, 1 wk Newborn Nursery, 1 wk Genetic disorders clinic, 1 wk private clinic, 1 wk selective
Surgery - 8 weeks - 4 weeks general surgery, two 2 wk selectives
Family Medicine - 8 weeks - required to be in a small town. School sets up all preceptorships based on student preference sheets (you get to rank top 3 locations, they try to match you up as best they can).</p>
<p>This is very different than how my girlfriend's med school runs their clerkships, everything is 8 weeks, they don't go to rural locations in the state and they seem to have a lot less variety/selection to their rotations...</p>
<p>The one constant is that just when you start getting comfortable somewhere with something, it's time to change. That's what happens when you only have 6 or 8 weeks for any one clerkship...</p>
<p>For tests:
The NBME administers the so-called "shelf exams" in a number of different areas - surgery, family med, psych, IM, peds, etc.
How different schools and different services use these exams varies greatly. Even within my own institution grades on these exams vary as to how much of the grade they make up.</p>
<p>Lectures - Yes, there are still are lectures, but again dependent on school and clerkship. Thus far, at least at my school on my surgery clerkship these have been aimed at getting key basic info across that is relevant to the shelf.</p>
<p>Reading - the best generalization is that you read up on the conditions your patients have. Knowing the differential diagnosis, general pathophysiology, and possible treatment options is a good start. From there different things will be important depending on the clerkship- in surgery, it's more important to know relevant anatomy, while on medicine knowing the drugs to use is more important.</p>
<p>As for what you do while on a service - again variable, even within the same clerkship.</p>
<p>For example, I'm on surgery at the moment. I spent all of July on a general surg service at a community hospital (rather than my University Medical Center). This specific group/hospital is usually the place where people not interested in pursuing a surgery residency are placed. You see more surgery stuff but are less involved in patient management and care sort of things. Typically I got to the hospital in the morning between 5:45 to 6:30 depending on the day, rounded on my patients - basically checking to make sure their post-op course was going as it should - wrote my SOAP notes in their chart, told my resident that they were doing okay, she'd check the patient herself, usually agree with what I found, I'd then follow her to finish rounding on all our patients, she'd change orders as necessary and then we'd go to our first case of the day in the OR.</p>
<p>The main things she wanted me to accomplish/recognize were when things needed changing, though not necessarily what the exact changes were. My notes were filled with a lot of "anticipate <strong><em>" and "suggest _</em></strong><strong>" and "consider possible _</strong><strong><em>" and "await _</em></strong>_".</p>
<p>But I had one resident, who was a 4th year resident, and 4 attendings. This is different than at the University services that some of my friends are on. They have a junior resident (1st or 2nd year) they report to, then maybe a senior resident (3rd or 4th), then a Chief resident (5th year house officers) then an attending to report to depending on how the service is set up and the way residents are assigned. There might even be a 4th year medical student doing a sub-internship on their service too representing another step in the chain of command. For them, they were more focused on patient management and were less likely to assist in a surgery. They certainly spent more time in clinic than I did.</p>
<p>Third year med students are generally required to do the full History and Physical for new patients...how often is again service dependent, and while on inpatient services a much bigger part of the process. I'll be doing far more while on inpatient medicine than I did on general surg.</p>
<p>Of course, now I'm on pediatric orthopedics as a two week selective, and I do nothing (mainly because medical schools are deficient in teaching anything ortho related during the first two years and I have no idea what's really going on - that of course means I'm learning a lot by watching and reading). The surgeries are awesome, but definitely different and are impossible for me to really read up on beforehand. I'm very wide-eyed. Next week I move on to ENT surg, which will be different as well.</p>