Clinical Mistakes Med Students Make and How to Avoid Them

Year 3 of medical school is arguably the most challenging, especially with the pressures that come with clinical rotations. You’re truly putting your book knowledge to use for the first time, as you interact with patients and experience the day-to-day happenings of core specialties.

But while seeking to put their best foot forward — and grasping as much hands-on knowledge as possible — some medical students get sidetracked from what should be their top focus: Patients. Medscape Medical News spoke to physicians and student advisors about the most common mistakes medical students make during clinical rotations and how to avoid them.

Be More Personable

Many medical students treat their patients like a test, according to Anthony Giuffrida, MD, director of Interventional Spine and Pain Management at Cantor Spine Center at the Paley Orthopedic & Spine Institute in West Palm Beach, Florida. “I remember [in med school], you walk in and you’re trying to get information from the patient,” said Giuffrida. “You’re trying to figure out a diagnosis, deciding what to order and what to do.”

Instead, start off the conversation with something else, he suggested. Ask your patient where they’re from or what brought them to their area.

“Med students can be very robotic with their answers and [that will change] with time,” he said. “Treat them like a patient and you’ll get better answers from them. They’ll open up to you more and you’ll have a better chance of fixing their problem.” 

Studies have also shown that being more personable with patients can boost their health outcomes, Giuffrida added.

You should also steer clear of super complex medical jargon when communicating with patients, which can lower patient comprehension and rapport, said Michael Chichak, MD, medical director at MEDvidi, an online platform offering mental health care for conditions such as attention-deficit/hyperactivity disorder, anxiety, depression, and insomnia. “Instead, students should prioritize clear and compassionate communication by using layman’s terms whenever possible and making patients feel heard and respected.”

Being open and cordial should stretch far beyond your patients. If you find yourself glued to your computer, or only talking with your supervisor, try to get out and engage more, said Giuffrida.

“Medicine is a team game,” he said. “It’s not just the physician: It’s the nurses, medical assistants, the front desk, the authorization team, the billing people. Make an effort to be a part of the team, be a part of the conversations.”

Get Involved

Not being fully engrossed in the learning process is one of the most frequent mistakes medical students make during clinical rotations, said Chichak. For example, students may be afraid to ask questions to avoid seeming inept. This can ultimately deter their development, and they won’t get the most out of this valuable learning opportunity.

“Students should approach clinical learning with a curious mindset, asking thoughtful questions to deepen their knowledge and show genuine interest,” said Chichak.

Also, don’t be afraid to be wrong. In fact, getting the wrong answers is one of the best forms of learning, Giuffrida said.

“A lot of times med students will come out of patients’ rooms and ramble, but won’t give an answer,” he said. “I say, ‘what would you do if you were the physician?’ Have confidence to be wrong. The reason you’re still in medical school is to learn, not to know all the answers.”

Learning new skills takes time. Strive for continuous improvement vs expecting mastery right out of the gate, said John Ragsdale, MD, cross-continuum consultant for undergraduate medical education at the Association of American Medical Colleges.

“It’s natural to feel a little defensive when someone highlights an area in which you could perform better,” said Ragsdale, who is the associate dean of curriculum at the University of Kentucky College of Medicine, Lexington, Kentucky. “But, try to embrace that feedback as a tool to help you improve. And, when you are not offered any feedback, ask for it.”

False Reporting

Reporting findings that you haven’t observed firsthand is one of the major ways to find yourself in trouble.

“If a student is unsure or hasn’t conducted the exam, it’s better to admit it upfront rather than falsely reporting a finding,” said Marshall Kirsch, DO, a board-certified neurologist and admissions expert at Inspira Advantage, a medical school admissions consulting service. “Lying or misreporting can significantly damage a student’s reputation among colleagues and is difficult to recover from.” 

Instead, practice transparency with your reports. If you realize you’ve made an error, make the correction immediately.

“Overconfidence can be a double-edged sword,” Kirsch said. “A common mistake is assuming that you’re now an expert on the chapter you just read on acute symptomatic seizures and presenting it as such.”

Be Flexible 

There’s a lot of moving parts during clinical rotations as you experience changes in your schedule, supervisors, assignments, and different specialties, said Ragsdale. Being adaptable is imperative in order to handle the shifts in day-to-day activities and expectations.

“I can feel it challenging, like the ground is constantly moving,” he said. “Try to approach each day with curiosity and an acknowledgment that change is not the exception, but to be expected.”

Time management is another critical skill when adjusting to schedule shifts.

“Patients depend on medical students to spend enough time with them to accurately report any changes or new information,” Kirsch said. “Many students struggle with being on time, and for those who tend to be late risers, setting multiple alarms and placing them far from the bed can be a helpful solution.”

Stay Grounded 

Always stay rooted in the main objective of medical school, which is understanding how to care for patients, said Ragsdale. “On any given day, there will be a myriad of clinical tasks that will compete for your time and attention,” he said. “Throughout all of it, remember that your patients are the basis for everything you are doing. Take the time to connect with them as people, beyond their illnesses.”