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Navigating the Wards AND the Boards as a third-year medical student.
Welcome to the Jungle
During medical school, one is constantly bombarded with information and statistics that are often irrelevant by the time graduation rolls around.
This phenomenon is very similar to social media literature in the sense that it seems to be outdated the moment it is published. Science pushes forward; the endless block of knowledge is constantly being chipped away at, and every resulting morsel is scrutinized. As this is happening, one must often wonder what the differences are between theory and practice.

As third-year medical students in rotations, we study the information we need to know in order to pass a shelf exam. However, we learn medicine from our attendings and our experiences. Quite often then, we might see discrepancies between those two lenses of academia. An obvious answer to a UWorld question might not line up with what a practicing physician of 40 years will teach you. This can hatch an internal dilemma for lots of medical students and a huge frustration about what to actually do when in practice.
The last thing ANY medical student wants is to appear to be questioning the judgment of their attending physician. So, if in a given situation the UWorld answer is a certain medicine and dosage while a seemingly identical situation in real life leads to an expert prescribing something else, what do you do?

So what does this all mean? What do I do?
It is at this juncture that we should look into the fabled Use and Gratification Theory as I believe it is essential to the survival of a medical student. The theory examines the various ways an individual seeks out, processes, and uses various forms of media for their benefit. A commonly taught practice in any marketing class, this theory boldly goes against the “one size fits all” belief of yesteryear.
Basically, we as students have a need to gain knowledge, and we are presented with a variety of different methods by which to achieve said knowledge. Our goal is not only to become a better future physician, but to also pass our exams. We must shine in the duality of our aim.
Residents and attendings will all tell you to learn what you need to for the exam. Afterward, they will say, you can begin to practice the way you see fit.
In my limited experience, I have found that there are numerous different ways to tackle the exact same problem. And usually, each expert is convinced that their way is superior regardless of what UWorld says.
A Moment of Reflection…
The major thing to take away from this brief discussion is that each of us should continue what we have been doing and continue to have faith in the process. Absorb each piece of information as it were. Use it where it is needed most. The puzzle will eventually begin to come together.

For those of us that are third-year students, there is a wealth of knowledge yet to come. Even for attendings, there is always another perspective that can be heard, another option to be considered. Real-life is not an NBME exam.
The brilliant Dr. Seuss aptly said:
“So be sure when you step, step with great care and tact. Remember that life is a great balancing act.”
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