Here is my list of HONEST tips to help you become an outstanding medical student during your nephrology rotation!
1. Be on time: This might sound simple, but this is an easy way to get ahead in medical school. You don’t want your team searching for you at 9am!
2. Ask questions: You are on a specialty team and you’re not expected to know everything. If you don’t understand something—ask! Remember that this is your chance to learn nephrology before you enter residency.
3. Stay interested: Even if you are going to dermatology, you are still in medical school and this is your time to learn as much as you can. It’s too early to be specialty oriented.
4. Learn to spin urine: We are going to spin almost every patient’s urine on this rotation; try to learn this skill on your first day. NephSIM has a nice step by step guide.
5. Look up urine sediments pictures: Once you spin the urine, you will need to look at it under the microscope. Seeing these images before starting your rotation will help you identify sediment in real samples. Be sure to check out the RFN Urine Sediment of the Month.
6. Learn the lingo: This will make your life way easier. This way, when you hear a patient needs a work up for AKI or hyponatremia, you know what that means and what tests are needed.
7. Go through all of your patient’s medications: Although this might be time consuming, it’s important to recognize if your patient is on a nephrotoxic medication.
8. Make a list of common nephrotoxic medications: Keep this as a note in your phone so you can reference it on the fly.
9. Know the exact intake/output and daily weights: Sometimes these are not charted correctly. To really shine on rounds, try to find the nurse in the morning and confirm them. Know how the weight was obtained- standing versus inaccurate bed scale.
10. Perform a detailed physical exam: In addition to your usual exam, make sure that you carefully assess their volume status. Crackles in the lungs? Lower extremity edema? Think about going the next level and learn about how to utilize the portable ultrasound in nephrology.
11. Get social: This one is optional. The nephrology community is very active on Twitter and it’s a great way to learn passively. Try to take advantage of this while you are on this rotation. Check out this list of nephrology programs on Twitter.
12. Finally, try to present at least one paper during your rotation. Best to tie this paper to one of your patients. This way you won’t ever forget it. Your fellow will be so proud of you!
Good luck! Nephrology is an amazing field. You will encounter a lot of electrolyte abnormalities and, like a detective, you will have to find the underlying reason. Here is the secret: the more information you get from the patient and chart, the more likely you’ll be to solve the mystery!
Sayna Norouzi, MD
Baylor College of Medicine, Houston, TX