First of all, congratulations on making it this far in your journey towards becoming a physician. It truly is a privilege to be in the position of a third-year medical student because unlike the previous two years, we are now able to address the needs of actual patients, and in many cases, their family members and caregivers, whether they be emotional, mental, physical, or socioeconomic.

I admit that it sounds trite to be saying these platitudes, especially if you are halfway done with rotations like me. Perhaps, you are even rolling your eyes as you are reading this, thinking, “OK, that’s great and all, but am I actually learning anything?”

It’s a great question, and I’m sure you are not alone in positing that query. In fact, we are all too familiar with the oftentimes cynical and sometimes glowing sentiments about the third year. The variations in cynical stories typically fall into the following themes:

• Most of the tasks you are assigned are menial.
• You are just reporting information that the residents already know.
• Your moods oscillate between feeling bored, neglected, embarrassed, or anxious.
• You constantly ask yourself and your classmates what you are supposed or allowed to do.
• Rarely are you being taught “actual medicine.”

It would be dishonest of me if I said that I’ve never resonated with these statements myself. It is also worth noting that these sentiments may even be stronger now than in previous years due to our medical education’s interruptions. Pandemic notwithstanding, it still holds that these sentiments have been the default for many third-year medical students and we should recognize that harboring them is gratuitously problematic and, frankly, counterproductive to our learning.

In my humble opinion, I think that most of the learning opportunities that will make a third-year student a great physician need not come from scrubbing in on cases, quickly answering questions, and citing the most recent literature and treatment guidelines. These may have immediate value, insofar as you can demonstrate your clinical knowledge and guide your clinical team to a better assessment or plan. But the real challenge lies in the unspoken moments. And arguably, these unspoken moments will have more of a lasting and substantive impact on you, your future patients, and soon-to-be colleagues.

That being said, allow me to share the 15 pearls I’ve gathered so far during the third year that I think are worth mulling over:

• How to take better care of yourself and your relationships.
• Asking yourself what you truly value in life and your professional career and asking yourself why.
• Conditioning yourself to feel perfectly alright with not doing anything productive from time to time.
• Realizing that medicine does not define you.
• How to be more present and aware of your emotions, thoughts, and implicit biases.
• Being mindful of your interactions with your teammates and constantly reflecting on what you could have done differently.
• How to empower your teammates to make sure they thrive with you.
• When to say no and knowing your limits.
• Reading the room to develop situational awareness.
• Having no problem or shame with approaching nurses or other healthcare staff about your concerns.
• Not being afraid to create plans and solutions that are “outside of the box” and sharing them with your team.
• Being proactive about learning new skills from residents and other members of the medical team.
• Recognizing that answering correctly during “pimping” sessions is just as impressive as comfortably acknowledging that you don’t know the answer.
• Realizing that your words and actions always have an impact on those around you.
• Being comfortable with discomfort by embracing mistakes and seeking feedback instead of striving for perfectionism.

The third-year is indeed an overwhelming period that may seem, more often than not, unconducive to learning. However, I ask us to dig deep and allow our minds to see value in places, things, and people, that we’ve never seen as valuable before.

The truth is if we find ourselves saying, “I’m not really learning anything,” chances are there is actually much to learn.

King Pascual is a medical student.

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