Thank you for the thoughtful question! The transition from the pre-clinical to clinical years in medical school is certainly challenging, and I want to empathize with what you are feeling.

To give some context to my perspective, my clerkship year was a bit different from the typical experience of M3s. I was lucky enough to attend a school that did not have any clerkship grades and where shelf exams were optional, which removed significant stress from the typical clerkship experience. Even without grades, I consistently received strong feedback on my rotations. That being said, the year was still extremely challenging, and I think I have some unique perspectives to share due to my clerkship experience and now being a resident.

First, I want to validate that being an M3 is tough! I was often the least knowledgeable and least experienced person in the room, and I often felt like I didn’t have an essential role on the team and was simply in the way of actual healthcare being done. What helped me most was clear communication—at the start of each rotation, talk with your resident about their expectations and how you can function best within the team. This will cause you to second-guess yourself less, which was a big source of my stress.

Second, the most valuable thing you can offer as an M3 is your time, which you have in excess compared to your residents (although it might not feel like it). You will probably be assigned one or two patients to start. Know these patients inside and out. Read their charts closely, study their conditions, and truly understand their care plan.

Finally, find a healthy balance between caring and not caring. Be invested in learning, take excellent care of your patients, and show that you’re growing both on and off the wards. But don’t hound the residents with constant questions, and absolutely leave when you are dismissed. I think by not having grades, I felt less pressure to be a people pleaser and insert myself unnecessarily, and ironically, my evaluations were better because of that.

The rest of my advice is fairly standard but still important: protect time for the things you love outside of medicine, find a study schedule that fits your learning style, and strike a balance between shelf exam preparation and preventing burnout. Lean on your support system whenever you need to.

As a last bit of advice—and this may vary based on your school—but the last half of M4 year for me was the calmest time I’ve had in my academic career, so you really only need to lock in for about 1.5 years. It’s cliché, but the days are long and the months are short; it will be over before you know it!

Philip Wang, MD