How to make the best out of your rotation (Obsie/Elective)?

This is the time that most of you apply for the observerships and electives. But, the entire process doesn't end with getting a rotation. It is important that you all put forward your best version and gain a reasonable letter of recommendation and if possible, future contacts.

I have noted down the most common questions that I frequently receive from fellow applicants and drafted them here.
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Part A
Q. I have received my rotation confirmation and I start soon. What can I do in the meanwhile for a favorable impression? // THINGS THAT ONE MUST DO BEFORE THE START OF THE ROTATION

Be in touch with the person who you have received the rotation confirmation from and get contact of the attending who you will be rotating with. Get in touch with them.

Stuff you need to ask in advance or on your first day of rotation-
1. Inform the attending who you are and tell them you would be rotating with them with the specified dates. Ask them if there is anything required of you to do prior to your start date.

This will prepare the attendings to expect you on the first day. Will save a lot of confusion and creates a good impression, trust me.

2. Ask if there are any preparatory materials that you can go through before the start date of your rotation.

This will give them the impression that you are eager to learn. If they don't end up suggesting any specific study material, they will tell you what cases to expect out of your rotation.
Most times, they do have study materials they provide with but only if specifically asked.
[In my Hem/Onc rotation, after I requested for appropriate study materials, I was provided with important research articles in both hard copy and soft copy. Another student who was rotating with me hadn't requested for it and didn't know anything about that until I told him the other day.]

3. Find out when you are supposed to report for your first day. Mostly, it would be mentioned in the offer letter and some self-scheduled observerships don't have it.
Be ON time.

(***Some institutions allow email contact with your attending prior to your rotation start dates and some don't. If your institution where you have the rotation scheduled doesn't let you do that, you need to ask in person when you start on your first day.***)

Other than that:
Go through the topics of that specific sub-specialty in which you would be rotating.
--- revise your step 1 notes. Basics are tested a lot.
--- go over your CS patient case mnemonics.

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Part B
Q. This is my first day of the rotation, what do I do?// THINGS TO DO ON YOUR FIRST DAY OF ROTATION

If you haven't been in touch with your attending, go over the Part A stuff.

In addition to that -
1. Discuss what your duties and responsibilities are: Ask them what they expect out of you.
Only if you know what you are supposed to be doing, you can give your best.

2. Discuss the attending's approved Patient case presentation format:
Ask how they like the case to be presented; some prefer a long version, some like to have a short 2 min version, and some prefer more focus on management part
So, know who you are presenting the case to

3. Know when to arrive and when you leave.
Always be early. I can't stress this enough.
ALWAYS.
Not just early than your attending, but also the other staff members.
[In one of my rotation, the head staff nurse is well known to be early, and I used to be early than her. She talked about this to my attending and told him how I am always before time.]

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Part C
Q. What can I do during my rotation period to have the best results?// THINGS TO DO DURING YOUR ROTATION

1. Most importantly,
Tell the attending your career plans on how you are planning to apply for the residency match and that you are looking for a letter of recommendation at the end. (This is best done in the 1st week of your rotation. Plan it out.)

If you inform them earlier, they will pay attention to you and observe if you have what it takes for them to write a letter. At the very least, you will have their attention.

2. Talk to your residents. Talk to the other staff.
-- Let them know who you are and politely ask for guidance.
-- Ask for pointers from your residents. Be friendly.

3. Know the Names of all the people you get in contact with: especially the attendings, residents, any person.
It will be later on easy to get contacts.

4. Actively, ask if you can do a ppt or oral presentation at the end of your rotation or in between. Take all the chances.

5. Take the initiative to write 'patient notes'. And, get feedback. Don't use any templates. Make your own.

6. Present your own cases. Doesn't matter if you didn't personally do the physical examination (as an observer you can't). But, request to present your own cases.

7. FEEDBACK. Ask for feedback weekly or bi-weekly depending on how your attendings change shifts.

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***TIPS for a good Patient Case Presentation***

Most of the attendings expect this out of your case presentation:

S = subjectivity : What did the patient present with// chief complaints

O = objectivity : what did you find in the patient// pertinent findings and physical examination
(for physical examination follow CS exam terminology)

A = assessment : a short summary in 2-3 lines which includes S, O and your Dx

P = plan : what is your management plan// treatment

In the end, add
- specific concerns of the patient
- any social issues to be taken care of
- any follow-up issues to be kept in mind

[This is what I summed up after my rotation experiences, there can be variations]

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***TIPS for a good ppt/ oral presentation***

-- Choosing the topic:
Choose a topic that hasn't been presented recently.
Ask around what topics have already been presented in the last few months.
Discuss your chosen topic with your attending and ask if it has been presented.

-- Use research articles as references for your presentation, so that you have the latest information.

-- Include the 'basics'.
If you are having a talk on latest advances in CML, talk about the disease and the epidemiology before you go into your actual topic.

-- *Have printed copies of the 'references' you used for your presentation and give it to the people attneding your presentation.*

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Q. When is the best time and HOW to ask for Letter of Recommendation?

During the mid-end of the rotation (3rd week) would be an appropriate timeline. Never do it in the end when you are leaving in a day or two.

How -
Fix an appointment with the attending who you want to request an Lor from, other than during the usual clinic/hospital patient care timings. (It is better if it is the same attending who you have frequently asked for feedback during your rotation and talked about your career plans with as suggested in part B)

It is rude to ask upfront while you are among many others. Atleast, make sure yourself and your attending are the only people there when you raise this topic.

Have your CV polished, a printed copy and also a soft copy ready to send an email.

Politely ask. But, be confident. Don't hesitate with your words.

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That should be all. If there are any more doubts, you can ask in the comments.
Good luck to all the applicants