The Weill Cornell Clerkship Guide

Table of contents:
2 - Intro
3 - Medicine
6 - Surgery
10 - Pediatrics
13 - Primary Care
15 - Psychiatry
17 - Obstetrics and Gynecology
19 – Neurology (not completed)
20 - Anesthesiology
F.A.Q.’s
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Congratulations on beginning your clerkship year. The clerkship year is an extremely

challenging, albeit rewarding, time period. This is your chance to learn and explore all of the
different fields within medicine. If there is one piece of advice to take from this text it is to keep
an open mind. After this year most of you will commit to one specialty in medicine. You might
never again step foot in the O.R., see or help deliver a baby, or even prescribe a medication.
Although you may already have an idea of which field interests you, take time during each
clerkship to envision yourself as an attending in that field. Reflect on what you like and don’t
like, but also take into account lifestyle – an often overlooked aspect.

Q. What is this guide for?

A. This is meant to supply preclinical students with a guide for each and every clerkship, as well
as provide answers to common questions. What do students do each day? What should their
goals be? How do I excel? How do I study for the shelf? What does rounding mean and why is it
so early? How do pre-rounds, morning rounds, afternoon rounds, and Grand Rounds differ?
What do I carry in my pocket? Read on and all, some (hopefully most), of your questions will be
answered. Caveat: This guide was prepared based on the 2017 clerkship year and some things
may change. It is the hope of this editor that each year, a new editor or team will take over the
project and prepare it for the class below them.

General resources:
1. UWorld (all clerkships)
2. Online MedEd (Medicine, Peds, OB/Gyn)
3. Pre-test – a book series with ~400-500 extra questions for each clerkship
4. Case Files (Primary Care, Ob/Gyn, Surgery)

In each of the chapters of this guide, you’ll find:

1. Clerkship overview
2. What a student’s day looks like and what student responsibilities are
3. What to keep in your pockets
4. Grading
5. Shelf study guide/resources
6. Pro-tips

Sincerely,
Drexel Neumann, Class of 2019

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Medicine

Medicine is arguably the most challenging clerkship in clinical year. This is due to having
a demanding schedule (6:30 am – 5/6 pm; 6 days/week), numerous extra-clinical
obligations (lecture and assignments), and the most comprehensive shelf. Taking it early
in the year will make every single clerkship after it easier by comparison; you’ll also be
more prepared/capable for other clerkships. Taking it later in the year will give you an
opportunity to have a challenging clerkship that combines all you have learned on other
clerkships.

Clerkship overview -The Medicine clerkship is designed to give students an overview of

internal medicine. Internal medicine encompasses the generalists of the hospital. If
you’re sick and you get admitted to a hospital these people take care of you almost all
of the time. Occasionally patients have a unique issue (cardiac, GI, etc.) and they are
placed on subspecialty service, but usually it’s handled by general medicine. If things get
complicated, rather than put them on a subspecialty service, general medicine will
consult another service.

Structure:
• Work/class schedule: Students work M-F and one weekend day. Usually two students
are assigned to the same team and work together so one of them is present on a
weekend day with one intern, one resident, and the attending. In addition to clinical
duties, there are often clerkship lectures during lunch, after work (5-8pm), or on
weekends. Additionally, you will be expected to attend lectures that are part of the
graduate medical education (your residents), but they’ll help you get a schedule for
those.
• Team assignment: The student will be assigned to two teams, each for one month
(team members may change throughout the month). One team will be general
medicine, another will be a subspecialty (some students will have their subspecialty be
general medicine at NYP-Queens).
• Team structure: Teams are composed of an attending, two senior (2nd and 3rd year)
residents, and two interns (1st year). These teams take care of a number of admitted
patients (~15-20). Each admitted patient is taken care of by an intern and senior
resident pair, who are overseen by the attending.

STUDENT DUTIES:
• Follow patients: This means you will learn about a patient on the team (or assist in
their admission) and treat them like they are your patient. Visit them every morning
for a physical exam and update of how they’re doing in their words (subjective
component of a SOAP). You should know everything about the patient: Why were they
admitted? What are their health issues? What is your plan for their care? How are
they doing (each day/morning/afternoon)? You should present your patients at
rounds to the rest of team – prepare to be pimped. You should also write a daily

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progress note on each patient you are following. Help your team with the discharge
note to show how involved you are.
• Teach rounds: Afternoon rounds are often ‘teach rounds’ in academic medicine.
Rounding on the patients will be much quicker/shorter than morning rounds, then
someone on the team will present an academic topic. You should volunteer to present
at teach rounds at least once a week (or maybe your resident will volunteer you). Pick
a topic relevant to your patient.

Daily schedule:
• 6:30-8:00 a.m. – Pre-Rounds: Visit your patients, see how they are doing, find out how
they did overnight from the night team or nurses.
• 8:00 a.m.-10:00 a.m. – Rounds: Your team will meet and go through every patient on
your list. The intern caring for them will present them, unless you are following the
patient – then you should! Some teams visit every patient, some visit a few, some visit
none.
• 10:00 a.m. – Afternoon rounds (team dependent) – Work!: This is the nebulous time
period of clinical medicine. During this time, you knock out the plan that was
discussed in rounds e.g. call consults, order labs/tests, write notes, admit new
patients, etc. Depending how many patients you are following and how sick they are,
your work can be busy or light.
• Afternoon rounds (usually 2-4pm): Quickly run through the list of patients and share
any updates. Often involves teaching a concept/topic afterwards.
• Dismissal (5-6pm): Following afternoon rounds you care for the patient more and
hangout until you are dismissed home.

Note: There are often things that disrupt the daily schedule like noon conference, grand rounds,
etc. Adapt!

What to keep in your pockets:

• Pocket Medicine – Mass Gen Internal Medicine Handbook
• Stethoscope
• Clipboard
• Pens – lots of pens
• Pager – make sure it works
• Pulse oximeter – you’ll use this maybe once a week but look awesome when someone
asks for one
• Optional: Penlight and reflex hammer

Grading:
• 50% Clinical
• 25% Shelf – must score ≥79 for honors; ≥65? For high pass; ≥57 to pass the Shelf
• 5% each for: (2) patient write ups; (1) transition of care; (1) critical appraisal
• 2.5% EKG quiz

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• 2.5% Physical Exam quiz

Shelf Study guide:

• UWorld is the single greatest resource. There are >1000 questions for medicine. Start
early and stick to a schedule. I recommend taking notes on questions you miss with a
running document, and using that in the last two weeks to review for the shelf.
• Online MedEd: FREE videos produced by the residency program director of Internal
Medicine at Tulane. These are incredibly useful for explaining work-ups for common
admission complaints (jaundice, heart failure, chest pain, SOB, giving IV fluids). Try to
watch 20-30 minutes of videos each evening and you’ll crush clinical duties and the
shelf.
• Symptoms to Diagnosis: for patient write ups only
• Optional: Step-Up to Medicine (very individual dependent on utility).

Pro-tip: Use the guides online for your patient case write-ups.
Pro-tip: Each time you have a free minute or hear something confusing on rounds, read the
section in Pocket Medicine. These little time periods add up.
Pro-tip: Nurses are great resources! They are great sources of how patients are doing, where
supplies are, etc. Use them!
Pro-tip: Write your patient notes (or at least start them) before rounds and print them off to use
when presenting your patients.
Pro-tip: Interns will present your patients if you don’t speak up. They’re not trying to be mean,
they just forget. Quickly interrupt and let them know you are following them and want to
present. The team will be happy/impressed at your initiative.
Pro-tip: If you have time before rounds, ask you intern or resident to help you practice.

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Surgery

Surgery is the anti-medicine. Not that it’s a suddenly easy clerkship with work one day a week,
but rather completely opposite priorities. Surgery rounds are fast and rushed. Complex patients
are turfed to consults or other departments so that the surgeons can maximize O.R. time. While
Medicine will exhaust a student with duties and formalities, Surgery wears you out physically.

Clerkship overview – Surgery is designed to teach students medical management of surgical

patients, and surgical solutions to medical problems. Patients can be ambulatory i.e. come in
for surgery and leave the same day, or be admitted depending on the complexity of the issue.
Note: A lot of people come in thinking they want to do surgery and quickly realize they do not,
but the opposite is also true. Keep an open mind.

Structure:
• Work/class schedule: Students work M-F and usually are assigned 2-3 call periods the
month they are at NYP-Cornell, whether staying late or on the weekend. Twice a week
there is afternoon lecture, often 4-7pm. Additionally you’ll often be asked to help out
in clinic with your team 1-2x a week. This is seeing pre-op consultations or post-op
patients. There are less teaching periods for surgery residents compared to what you’ll
see for residents on other rotations.
• Team assignment: The student will be assigned to two services, each for one month
(team members may change throughout the month). One service will be a surgical
team at NYP-Cornell, another will be at either NYP-Queens or MSK. Some service
assignments at NYP-Cornell are only eligible for students if their other assignment is
Queens.
• Team structure:
• NYP-Cornell: Teams are composed of two interns (spend most of their time
managing the floor and not in the O.R.) and two senior residents (2nd or 3rd year
+ 4th or 5th year). Students will work with a variety of attendings in the O.R.
within their service specialty. They will also work in these attendings’ clinics.
• MSK: Teams are composed of an attending and a fellow, some teams also have a
resident.
• Queens: Students are assigned to two teams for two weeks each. They will round
with these teams in the morning and work closely with the interns. However, for
actual surgical cases, students are not restricted to their own service. They
receive a schedule each evening with their assigned cases for the following
morning. Aside from those assignments, it’s often a free-for-all and you can go to
whichever (including none) cases you want.

STUDENT DUTIES:
• The List: NYP-Cornell uses an archaic method to round on patients. ‘The List’ is a multi-
collaborator word document with a table listing patients, room number, vitals, and
any other info your team might want. Think of it as an EMR before EMRs. The students

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on each team must arrive before rounds and prepare the list with updated info and
print it off for their teams.
• Follow patients: This is often optional on surgery. The most you’ll do is present a
patient (on surgery this should last no more than 1 minute), state their vitals, surgery
mile stones (wa2lking, farting, eating, etc.) and discharge date. You should however,
know patients before they are operated on in case you are pimped in the O.R.
• Within the O.R.: You should try to scrub for every case. Practice suture tying with
instruments and without. If you want to do well or go into surgery, learn how to tie
with two-handed, one-handed with both left and right hands, and instrument tying
and ask to close as often as possible. Often the student is pimped during the case
(read Surgical Recall in advance). Students are also often handed scissors by the scrub
nurse, your job is to cut the sutures after they are tied.

Daily schedule at NYP-Cornell:

• 5:30 a.m. – 7 a.m. – The List + Rounds: Prepare the list and round on patients with the
team. Learn to walk quickly.
• 7 a.m. – Afternoon – The O.R.: Hop into cases on your service. Always introduce
yourself to everyone in the room. Some scrub nurses and circulating nurses are
awesome at helping students, some don’t seem to understand a medical college is
attached to the building.
Floor work: Some teams have a ton of floor work (Red surgery)
so you may find yourself in the O.R. less and changing wounds
or going to trauma more often.
• P.M. rounds – Teams round on patients in the evening. Ingrained into surgery culture.
• Dismissal: Really hit or miss. You could leave at 3 p.m. or 9 p.m.

Daily schedule at MSK:

• 6:30-7:00: Rounds
• 7:00 – whenever: The O.R.
• ~5:00 p.m.: PM rounds

Note: MSK teams often operate only 1-2x per week. They also have clinic 1-2x week which is
unfortunately a lot of shadowing. There is a lot of down time during the week because they
have NP’s take care of patients on the floor. MSK has a formal culture and you’ll be expected to
wear business casual (Medicine-style) clothes when not in the O.R.; men are expected to wear
ties.

Daily schedule at Queens:

• 5:30 a.m. shuttle to Queens
• 6:00-7:30: Rounds
--Cases all day-- (or go get Dim-Sum J)
• 5:00 p.m. shuttle home

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What to keep in your pockets:

• Stethoscope
• 4x4 gauze packs
• 3-4 saline flushes
• Surgical tape (2 widths)
• Band-aids
• Alcohol swabs
• Sterile q-tips
• Abdominal pads
• Betadine swabs
• Cliff bars or Kind bars (high protein to stave off hunger)

Grading:
• 50% Clinical
• 25% Shelf
• 15% Oral exam
• 5% Case presentation
• 5% Case write-up

Editor’s note: Do well on your case write-up and presentation. These are graded Honors (100%);
High-Pass (67%); Pass (33%). You can see how getting a Pass on both earns you 3.3 pts out of 10
for your final grade. When in doubt, be succinct and follow their guidelines (e.g. if they say don’t
go over 7 minutes on a presentation – DON’T GO OVER 7 MINUTES).

Shelf and Course study guide:

• Pestana Surgery Handbook: Quick read – bare essentials. This alone can probably get
you a 75% on the Shelf.
• Surgical Recall: Read the first 100 pages (very quick read) of this book before you start
or within your first week – it’s a how-to guide for a student on Surgery. The rest of the
book is a great resource for clinical duties. It’s written as a Q&A of Pimp-style
questions. Read the section on a specific procedure before going in the O.R. to be
prepared for any questions you’ll get from an attending/resident.
• DeVirgilio
• UWorld – not a lot of questions but you should do them all.
• Case files – hit or miss
• Pre-test – extra questions if you have the time.

Pro-tip: Read the first 100 pages of Surgical Recall the weekend before you start, it will help
immensely.
Pro-tip: Introduce yourself to the scrub nurse before every case.

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Pro-tip: Offer to help transport your patients

Pro-tip: As soon as you get to the O.R. start helping: Get your resident’s gloves for them; offer to
put in the foley; immediately put on venodynes when the patient arrives.

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Pediatrics

Pediatrics is like the Land of the Lotus Eaters. Everyone is nice, happy, and relaxed. You’ll find
yourself suddenly sleeping more, eating healthier, and working out after clinic duties because
you have time. You’ll start telling people you want to be a pediatrician and you may even start
thinking you want to have kids. Peds is structurally similar to Medicine, but less chaotic and
more relaxed.

Clerkship overview: You’ll spend 6 weeks learning how to care for pediatric patients in different
settings: in-patient, emergency room, well-baby, and out-patient. Unfortunately, this guide is
currently limited to NYP-Cornell assignments, although you may still find it helpful if assigned to
Queens or Brooklyn.

Structure:
• Work/class schedule: Students work Monday-Thursday. Fridays are lecture days (note:
these may switch to bi-weekly and on Mondays for 2018). Throughout the clerkship
you will have 2-3 weekend day assignments. At least one will be in the E.R. during your
E.R. week and one will be in-patient. The third will be random in-patient/E.R.
• Settings:
• In-patient – Students will spend three weeks working in-patient. They may
switch teams throughout the period as in-patient. Peds is only one ward of the
hospital and it’s all jumbled together. All teams get sign out together in one
room in the morning, but will round separately with different attendings.
• Out-patient – Students will spend each afternoon/morning in a different clinical
setting. The most frequently visited/assigned setting at NYP-Cornell is resident
group practice (RGP), a practice run entirely by the residents. A lot of shadowing
unfortunately, so speak up if you want to see patients on your own in clinics.
• E.R. – A fun week in the E.R. triaging and working up patients.
• Well-baby nursery – You will spend a few mornings on well-baby nursery. This is
the unit moms and babies are admitted to after delivery on Ob/Gyn. Each
morning, each baby must be examined. This is a great setting to practice physical
exam skills and learn how to change a diaper.
• Team assignments/structure on in-patient: Students will be pre-assigned to different
interns/residents on either general Peds, Peds-Neuro, or Peds-Heme/Onc. Each team
has an intern and senior (2nd or 3rd year) resident, as well as an attending. The specialty
teams have a fellow.

STUDENT DUTIES:
• Follow patients: This means you will learn about a patient on the team (or assist in
their admission) and treat them like they are your patient. You should know everything
about the patient: Why were they admitted? What are their health issues? What is
your plan for their care? How are they doing (each day/morning/afternoon)? You
should present your patients at rounds to the rest of team – prepare to be pimped. You

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should also write a daily progress note on each patient you are following. Help your
team with the discharge note to show how involved you are.
• Teaching points: Similar to teach rounds in medicine, an attending may ask someone to
present on a topic at rounds later in the week. Less formal than medicine, but be
prepared to present something interesting for a few minutes.

Daily schedule for in-patient:

• 6:30-7:30 a.m. – Sign Out: Teams get sign-out from the night team. Get a seat at the
table for when your team is receiving sign out so you can learn about your patient’s
progress.
• 7:30-8:30 a.m. – Pre-rounds: Visit your patients and do your daily exams. Start a note
so you can present on them later. Maybe grab breakfast.
• 8:30-9:30 a.m. – Morning report: A teaching session for Peds residents that occurs in
the Ped’s library. Go to this.
• 9:30-11/12? – Rounds: Go through every patient assigned to your team with the
attending. Usually involves visiting every patient.
• 12:00-1:00– Noon conference: Grab some lunch and go to the Ped’s library for
another teaching session. You’ll skip this 2x week for tutor group.
• 1:00-5:00 p.m. – Care for your patients. Call consults, order labs/tests, etc. Leave
when you can or hangout to admit a patient or participate in evening sign out.

Daily schedule for E.R.

• 10:00-6:00 p.m. – See patients when they come in. Present to the attending or your
resident. Sometimes you have to fight to get to see the patient as there are two
residents, a fellow, and a few NP’s. If there aren’t a lot of patients, then it can be a
fight to see one. Feel free to ask to change your schedule to come in/leave
earlier/later.

Daily schedule for clinic:

• 9:30-12:00 – Morning clinic, see patients.
• 1:00-4/5 pm – Afternoon clinic, see patients.

Note: There are often things that disrupt the daily schedule like noon conference, grand rounds,
etc. Adapt!

What to keep in your pockets:

• Stethoscope
• Clipboard
• Pens – lots of pens
• Pager – make sure it works
• Optional: Penlight and reflex hammer; stickers

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Grading:
• 30% Clinical
• 25% Shelf – must score ≥77 for honors; ≥65? For high pass; ≥57 to pass the Shelf
• 10% each for: (1) formal patient write up; (1) EBM/case presentation; (1) patient note
• 15% Tutor group
• Editor’s note: Peds requires >90% for Honors. A very enjoyable clerkship, but you must
do well on each aspect of the course to earn Honors.

Shelf Study guide:

• UWorld (>400 questions)
• Pre-test – lots of questions. Can be esoteric, but covers a lot of things UWorld doesn’t.
• BRS Pediatrics – Incredible resource that covers everything on the Shelf. Read this
through 2x if you’re trying to get Honors.

Pro-tip: Peds is a relaxed rotation. It can be easy to start showing up late or taking a back seat
to clinical care. If you are interested in it or want to do well, you’ll have to be a bit more active
than the culture naturally dictates. If that’s not super important to you have fun and enjoy
yourself for 6 weeks!!!
Pro-tip: At time of writing this guide, the case write-up examples online for Peds are not
exceptional like Medicine. If you use them as a guide, you’ll probably get an 80%. Instead use
the grading rubric to make sure you put everything in.

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Primary Care

Primary Care is a strange clerkship in that each student has a different experience. Students in
Ithaca will get a very real experience in primary care of patients, genuinely seeing bread and
butter care. Students in NYC may still have this opportunity, but often are in sub-specialized
clinics e.g. you won’t see bread and butter dermatology, you’ll see super specific eczema clinic.
The clerkship is working to rectify this. If you’re interested in genuine primary care and building
physical exam skills, try to go to Ithaca and at both sites ask for a PMR, sports medicine, or
student health (not at Cornell) assignment.

Clerkship overview: An exposure to primary care (read: outpatient) medicine. You’ll work in
different outpatient clinics within specialties of your choice. Your exposure to what an 8-5 job
looks like.

Structure:
• Work/class structure: Monday through Thursday students will be work in different
outpatient clinical settings. Each day of the week is assigned to a different clinic; Fridays
are lecture/tutor group days. Ithaca students will all spend one day a week at Gannett
Student Health (Cornell Undergrad’s student health clinic) and NYC students will spend
one day a week in the E.R.
• Team assignments: 4 different clinical assignments (one is pre-assigned depending on
clerkship site)
• Fridays are lecture and tutor group days. Ithaca students skype in.

STUDENT DUTIES:
• Dependent on preceptor. Set expectations and understandings early on.
• Try at the very least to see patients and present them to your preceptor. Practice
physical exam skills under supervision (or not).

What to keep in your pockets:

• Stethoscope
• Clipboard
• Snacks
• Tools dependent on each clinical assignment.

Shelf Study Guide:

• Case Files – a lot of primary care is preventative medicine and this is an invaluable
resource. Read it through 2x.
• UVA primary care questions – google ‘UVA primary care questions’, they have about
125 available for free
• AAFP board questions – apply for free student membership of the AAFP and get access
to >1000 board prep questions (takes 48-72 hours for membership to go through). Some
are outdated, but this is a helpful resource as no UWorld exists for Primary Care. Most

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of the help will come from Medicine style questions you don’t know and preventative
medicine.

Grading:
• 50% Clinical evals
• 25% Shelf
• 10% Tutor group
• 5% Case write-up for your patient
• 5% each (2) A&P write-ups
For primary care you will have a week in tutor group where you do a case write-up
of everything except the assessment and plan. You are responsible for emailing this
to your tutor group a few days in advance. Members of the group will then be
responsible for writing A&P’s. During tutor group you’ll present your patient and
classmates will present their A&P’s

Pro-tip: Include odds-ratios, relative risk, real research in your A&P’s to go the extra-mile.

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Psychiatry

Psychiatry is a unique rotation in which you’ll learn a lot about the way the mind thinks. An
interesting characteristic of psychiatry is that the practice you learn at Cornell will not be
the same as people learn elsewhere in the country. Each institution and region have their
own psychiatric approach to treating patients. It’s a field that is on the cusp of a renaissance
due to advances made in understanding cerebral physiology and more specific drugs.

Clerkship overview: Most students will care for inpatient psychiatry patients entirely. This is
unusual, as it lacks the entire spectrum of outpatient psychiatry which is a huge component
of the field. Students at NYP-Cornell may rotate in the E.R., consult liaison service, or adult
or child partial hospitalization programs. Students at Westchester may rotate through
specific inpatient services including mood disorders, personality disorders, geriatrics,
substance abuse, child and adolescent, acute psychosis, second chance, VIP, eating
disorders, and women’s unit.

Structure:
• Work/class schedule: Students work M-F. There are occasional lecture days assigned,
but not weekly.
• Team assignment: The student will be assigned to two teams, each for three weeks
(team members may change throughout the month). At NYP-Westchester, you’ll be on
two different specific teams (e.g. geriatric, adolescent, psychoses) while at NYP-
Cornell, you’ll be on one in-patient team of general psych and one specialty team
(adult or adolescent partial, C&L, or E.R.). All students who aren’t assigned to the E.R.
(including Westchester students) are required to do (3) 6:00 p.m. -10:00 p.m. shifts
and (1) 8 hour weekend shifts within the psych E.R.
• Team structure: Teams are composed of an attending, a senior resident and an intern.
Some teams have double the house staff. Pair up with one resident and see their
patients.

STUDENT DUTIES:
• Follow patients: This means you will learn about a patient on the team (or assist in
their admission) and treat them like they are your patient. Visit them and speak with
them each day. Discuss goals of care and present on them at rounds.
• Specialty: Each specialty team has different student obligations.

Daily schedule at NYP-Cornell:

• 8:00 a.m.-8:30 a.m. – Prep: Not really enough time to see your patients and speak
with them. Get an update from night team of how they did, and review their plans.
• 8:30 a.m. – Morning Huddle: Everyone on 11N meets in the conference room to
discuss census and daily activities.
• 8:30 a.m – Rounds: Your team will meet and go through every patient on your list.
Psych rounds are often very quick as mostly updates.

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• 9:00 a.m. – Afternoon – Work!: See each patient you are following, write notes, and
call any consults. You may also need to schedule family meetings. Maybe participate in
some of the group therapies.
• Dismissal (5-6pm): Your resident will let you know when to take off.

Daily schedule at NYP-Westchester

• 7:30 a.m. – Shuttle
• Same as NYP-Cornell (see above)
• 5:00 p.m. – Shuttle home.

What to keep in your pockets:

• You don’t even need a white coat on Psych. Throw on your cardigan and bring a
clipboard for notes.

Grading:
• 50% Clinical
• 25% Shelf
• 10% Tutor group
• 10% Case write-up
• 5% Professionalism
• Editor’s note: Psych has a very high cutoff for Honors. Few students achieve this
grade.

Shelf Study guide:

• Psych is a lot of memorization of time frames and definitions of psychiatric conditions,
as well as drug mechanism and side effects. It is very straightforward and many
students remark this is the highest score of their clerkship shelves.
• UWorld is probably the best place to start.
• Lange Psychiatry is a good reference to read through the clerkship
• Lange Q&A’s for extra questions
• First Aid for Psychiatry
• First Aid for USMLE Step 1: Underrated resource. Basically reads like a dictionary. If
you know this chapter of FA you’re golden.

Pro-tip: Read the UpToDate section on the condition each patient you’re following is
predominately affected by.
Pro-tip: SketchyPharm is the best resource for learning psych meds.

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Obstetrics and Gynecology

Ob/Gyn is a unique clerkship that exposes you to the complexities of making and delivering
babies, as well as the distinct aspects of womens’ health that 50% of doctors grow up knowing
nothing about.

Clerkship overview – A diverse clerkship that sees you rotating on a surgical team, ambulatory
clinic, a subspecialty, and labor and delivery. Note: this guide is for students at NYP-Cornell.

Structure:
• Work/class schedule: Students work M-F and usually have a few weekend calls. Once a
week is lecture, but the specific day changes each week due to the unique schedule of
some ob/gyn clinics.
• Team assignment: The student will be assigned to the Gyn Surgery team for two
weeks, which has two interns, a second year, a third year, and a Chief (fourth year);
one week in ambulatory, which has a different team every half-day and different
attending covering every day; one week in a specialty clinic: either REI (hard to get
pregnant), MFM (high-risk pregnancies), or Gyn-Onc; and two weeks on L&D, which has
the same team structure as Gyn Surgery.

Note: Gyn-Onc is designed to actually have students do one week of gyn surgery and two weeks
of Gyn-Onc surgery.
Note: Historically L&D has been one week days and one week nights. There has been
consideration to make nights optional. It is this editor’s opinion that nights are invaluable no
matter which field you are going into and students are highly encouraged to take advantage of
this opportunity.

STUDENT DUTIES ON GYN SURG:

• Follow patients: Pre-round on inpatients assigned to you by your team. Present them
on rounds.
• Within the O.R.: You will receive a list of cases for the day from the interns, discuss
amongst other students who will go to which cases. You should try to scrub as much
as possible. Practice suture tying with instruments and without. If you want to do well
or go into Ob/Gyn or a surgical subspecialty, learn how to tie with two-handed, one-
handed with both left and right hands, and instrument tying and ask to close as often
as possible. Students are also often handed scissors by the scrub nurse, your job is to
cut the sutures after they are tied.

STUDENT DUTIES IN AMBULATORY CLINIC:

• See patients: Pair up with an intern/resident for each half-day and see their patients,
then present them to the attending.

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STUDENT DUTIES ON L&D:

• Triage: Pregnant women with health issues (from a cold to no longer feeling the baby
move) come to L&D triage. You’ll usually see someone has arrived on the triage list
before they are brought back. You should see the patient, figure out why they came in,
get the basics (Water break? Contractions? Baby still moving?) then present and write a
note that you assign to your resident to sign.
• Delivery: Introduce yourself to patients upon arriving and help out throughout the day
until they are ready to push (get them water, blankets, check on them). Help deliver
their baby.
• C-sections: Go to c-sections. Self-explanatory. Introduce yourself to the attending
beforehand and ask if it’s ok to scrub. Make sure you know your anatomy, it’s always
going to be the same so its unforgiveable not to know.

Daily schedule at NYP-Cornell Gyn-Surg:

• Rounds: You’ll start rounding with your team at a predetermined location and time,
usually between 6-7. Pre-round if assigned a patient beforehand.
• 7:30 a.m. – Afternoon – The O.R.: Figure out which cases you’re going to go to all day
at the beginning of the day.
Floor work: In between cases help out with things on the floor.
• Dismissal: Really hit or miss. You could leave at 3 p.m. or 7 p.m.

Daily schedule at Ambulatory:

• 9:00-12:00: Morning clinic
• 1:00-5:00: Afternoon clinic

Daily schedule on L&D:

• Day starts depending what morning obligation you have (see below), followed by sign-
out. Stay until evening sign-out (changes throughout the week)

Note: Ob/Gyn has several morning obligations that usually start at 7 a.m. Students on all
teams are expected to attend:
• Monday: M&M
• Tuesday: Fetal Trace Rounds
• Wednesday: Off
• Thursday: Journal Club or Questions
• Friday: Off

What to keep in your pockets:

• Stethoscope
• Cliff bars
• Pens
• Clipboard and list

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Grading:
• 50% Clinical
• 25% Shelf
• 15% Tutor group
• 10% Case presentation

Shelf and Course study guide:

• UWorld
• UWise/Apgo: A subscription service to questions that Cornell buys for you. Very
helpful. It’s ~500 questions but it’s separated into 10 question quizzes on different
topics. Because of this it’s very helpful if you have difficulties with specific topics
(delayed puberty, abnormal uterine bleeding, etc.)
• Case Files

Pro-tip: OB/Gyn is a field that allows, and expects, students to do a lot more than other
clerkships. Use this as an opportunity to get better at blood draws and suturing.
Pro-tip: The MPR room is the common OB/Gyn work room for the residents. It’s the only place
that is truly their’s in the hospital so although you may be in there a lot for sign out or dropping
things off – don’t kill time in there, instead go find somewhere on 7S to hang out.
Pro-tip: When you see a triage patient pop up on the list while on L&D, immediately start
reviewing their Epic chart to get their pregnancy history prepared (3rd trimester labs; blood type;
etc.)

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Neurology

Neurology is the shortest graded clerkship. It’s pretty chill and easy to do well in.

Clerkship overview: 4 weeks of inpatient neurology, typically divided into two 2-week rotations.

Structure:
• Work/class schedule: Students work M-F and usually have one or two weekend calls.
One day a week is dedicated to didactics, although you will usually round with your
team in the morning.
• Team assignment: The student will be part of a neuro team and round with them and
follow patients. When picking up a new patient on the team students should see the
patient first and present to a resident. Students may be on general neuro, pediatric
neuro (only NYP), consult neuro, or stroke neuro (only Queens).

STUDENT DUTIES: Round on your patients before your team rounds. Present them at rounds.
Pretty chill.

DIFFERENCE BETWEEN SITES:

NYP: If you are interest in Neuro complete your rotation here. This will give you the greatest
exposure and experience ina neuro residency and bread and butter cases. You have the option
for Peds or doing 2 weeks of neurosurgery, although that comes with surgery
hours/responsibilities.

MSK: Very unique neuro exposure and great for students interested in Heme/Onc although can
be a very depressing service. Often considered the most demanding schedule because of the
length of rounding hours here. Students will divide their time between general and consult
services.

Queens: Chillest rotation location set up ever. There are no residents at Queens and all the
attendings are very relaxed and great teachers. You alternate between general consult and
stroke consult. Can be a very busy rotation depending on the number of consults (Queens can
have a lot of strokes). The site director is also head of the mobile stroke unit group so you can
often spend one day riding in the mobile stroke unit ambulance seeing a novel form of stroke
response not present in many parts of the country.

What to keep in your pockets:

• Stethoscope
• Pen light
• Reflex hammer
• Long q-tips (for neuro exam)
• Snellen eye chart

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• Pens
• Clipboard and list

Grading:
• 50% Clinical
• 25% Shelf

…honestly can’t recall completey

Shelf and Course study guide:

• UWorld
• Case Files

Pro-tip: Neuro has a finite amount of material. Know the bread and butter stuff (approach to a
stroke patient) and practice your neuro exam – no excuse for not being able to do a complete
one on demand with someone watching.

Pro-tip: Because of the finite info obtaining a high score (>90) on this shelf is very achievable
without exhaustive studying. That doesn’t mean don’t study, but study smart.

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Anesthesia/Critical Care

Pass/fail two weeks of pure bliss.

Clerkship overview – Students will spend one week rotating through different anesthesia
services. The second week will be spent in an ICU. You’ll have lecture every afternoon for the
full two weeks, but it’s pass fail, so it all feels great.

Structure:
• Work/class schedule: Students work M-F in an OR or on an ICU floor.
• Team assignment: On anesthesia, the student will receive an email each night with
their OR assignment for the following day. You will likely be put in a different specialty
each day and can request a day in the pain clinic if you’d like. On critical care, students
will request a specific ICU (pediatric, neonatal, surgical, medical, burn, neuro,
cardiothoracic) and spend the week there as if they were back on their medicine
rotation (think pre-rounds, rounds, helping on the floor, etc. but far less intense).

STUDENT DUTIES ON ANESTHESIA:

• Be excited and practice your skills: You will be in a different OR with a different
resident and attending every day. Request cases you’re interested in and the clerkship
directors are happy to oblige (neurosurg, CT surg, peds surg, things most people don’t

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see on their surgery rotation). Ask questions, offer to help, intubate patients, put in IVs,
and then go to breakfast when they tell you to go to breakfast.
• Assignments: You will write up one case each day—essentially a summary of a cool
case you saw that day.

STUDENT DUTIES ON CRITICAL CARE:

• Follow patients: You will probably have one patient you follow and present for the
week. Pre-round, round, present, repeat.
• Assignments: There is one group assignment due the first day of critical care.

Daily schedule on Anesthesia:

• 7:00 a.m. – Cases: go to your assigned OR and offer to help. Once the patient is
intubated and IV’d and under, they’ll probably tell you to go get breakfast or coffee;
enjoy it!
• 3:00/4:00 p.m. ish – Lecture: go to lecture and then go home for the day, woohoo!

Daily schedule on Critical Care:

• Totally dependent on your service

What to keep in your pockets:

• Tape tape tape
• Stethoscope
• Cliff bars

Grading:
• Pass/fail!!!!!!

Shelf and Course study guide:

• See “Grading” !!!!!!!

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Frequently Asked Questions:

Q. What are Grand Rounds?

A. Grand Rounds are weekly lectures that each department puts on at the same pre-
determined time each week. Most often these lectures are given by visiting scholars.
Departments vary in their expectancy for attendance and how well dressed you should be, but
students are generally encouraged to attend.

Q. What should I do on elective?

A. Elective can be a break if you need it, alternatively you should use it to explore a field to
which students aren’t usually exposed (e.g. radiology, surgical subspecialty) or as an
opportunity to do something fun for school credit (medical education or research elective).
Students are required to complete a certain number of electives to graduate, this is an easy way
to get a head start on knocking these out.

Q. How do I register for an elective?

A. Search for electives via the catalog on Learn – then get help from the registrar to register.

To be expanded.

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