Transitioning to Clerkships: Class of 2021 Takes on Next Level of Training

April 12, 2019 by Michelle Bookless

After 18 months of active-learning in the classroom, primary care offices around Vermont, and clinical skills sessions in the Clinical Simulation Laboratory at the University of Vermont, the UVM Larner College of Medicine Class of 2021 was excited, if not a bit nervous, to start working more regularly and directly with patients and physicians in clinical settings. This week, as many students in the class started to round out their first clinical rotation, we touched base with them to hear about their expectations, challenges, successes, and takeaways from this next step in their medical education.

Naira Goukasian '21 (in yellow) poses with her classmates and the team of residents with whom she worked during her pediatrics clinical clerkship at UVM Medical Center.

"Clerkship year will be one of the most humbling, challenging, and inspiring years of your life! Lean into the moment when you feel lost and totally out of your league, because those are the moments when you will grow the most." - Words of advice from members of the UVM Larner College of Medicine Class of 2020 to the Class of 2021

On March 11, the Larner College of Medicine Class of 2021 officially entered the second level of the Vermont Integrated Curriculum (VIC) and began their clinical clerkship training.

While the Foundations level of the VIC focuses on the integration of basic and clinical sciences, the Clerkship level teaches students the basic principles of clinical medicine. They gain expertise in primary care, preventative care, surgery, inpatient internal medicine, neurology/outpatient internal medicine, psychiatry, family medicine, pediatrics, and obstetrics & gynecology at sites in Vermont, Connecticut, and Florida.

After 18 months of active learning in the classroom, primary care offices around Vermont, and clinical skills sessions in the Clinical Simulation Laboratory, the students were excited, if not a bit nervous, to start working directly with patients and physicians in clinical settings. As many students in the class started to finish up their first clinical rotation, they shared details about their expectations, challenges, successes, and takeaways from this new phase in their medical education.

Before starting his family medicine clinical rotation at Milton Family Practice in Vermont, Pirapon Leo Chaidarun was uncertain of how to behave and what to expect. With the experience now completed, he is more comfortable and says that his favorite part of the rotation was interacting with patients, physicians, and nurses on a daily basis. For Chaidarun, his biggest challenge was "beginning to implement medical knowledge in a real clinical setting outside of the classroom," but, he says, working with a variety of different physicians at the practice allowed him to observe different and approaches to caring for patients.

"Before this rotation I was pretty nervous that this would be the moment the curtain fell and my imposter complex would come to fruition," says Reed Hausser. "Fortunately, that didn't happen." Hausser just completed his first rotation in neurology at Danbury Hospital in Connecticut and says that his favorite part of the clerkship was working with such a diverse community of patients. "Many of the patients we saw spoke little to no English, and it was a great opportunity to practice a little medical Spanish and learn how to work with interpreters for other languages," he says. Hausser was also grateful to work with Robert Bonwetsch, M.D., who took extra time to quiz Hausser and his classmates about everything they saw to help them solidify important concepts and patient experiences. "Even in our downtime, he recommended things for us to review to discuss with him later, so we felt as though our time without patients still had purpose," says Hausser. As he moves into his next rotation, Hausser says that he's feeling more confident in himself and realizes that "even the residents and attending physicians are still learning every single day." "At some point they were in the same position we are," says Hausser. "And most aren't nearly as scary as the world has made them out to be."

Having some research experience in the field of psychiatry, Sidney Hilker was excited for her first rotation at the University of Vermont Medical Center (UVMMC). She says that although navigating her new role as a medical student and member of a care team was challenging at first, she's thankful for the opportunity to take care of patients and learn from skilled physicians. In particular, her favorite parts of the rotation were "exploring the many dimensions of child psychiatry from the Autism Clinic to Perinatal Psychiatry," and the opportunity to be "immersed in clinical medicine and take on greater responsibility."

Michael Chmielewski
says that he was at once terrified and thrilled before his rotation in surgery at UVMMC. "Terrified," he says, "because I had no idea what to expect, and excited to transition into patient care instead of studying for Step 1." For Chmielewski, the most challenging part of the rotation was "balancing clinical responsibilities, clerkship requirements, sleep, and wellness, while spending lots of time at the hospital." Although he is not interested in pursuing a career in surgery, Chmeielewski says that the rotation gave him a greater appreciation for what surgeons do and he was grateful for the chance to get to know the patients and their stories.

"Learning from books and videos is great and all, but there's nothing like actually seeing these things that I have read about in books in the hospital," says Naira Goukasian. "It's amazing how much more you can remember when there is a patient/face/experience to associate it with." Goukasian is finishing up her pediatrics rotation at UVMMC and says that she was excited for her first clerkship because she "wanted to be thrown into the midst of patient care." Throughout the experience Goukasian says that she was thrilled to see clinical scenarios come to life and amazed by the amount of coordination and teamwork involved in patient care.  

Joy Benner says that before she started her first clinical rotation in obstetrics and gynecology at UVMMC she was "really nervous about transitioning from primarily being a reporter to making different diagnoses, assessments, and plans for patients." However, she ended up being amazed by the residents, attendings, and nurses she worked with and how patient and eager they were to help her make the transition. "They have all been intelligent, compassionate, and amazing teachers," she says. "Working with the residents has been especially helpful as a student because they were just in our shoes and are really eager to help us learn." As for her favorite part of the rotation? Benner says that being a part of a family's birthing process was a privilege. "Of what I've seen so far there are few things in medicine as magical as childbirth."