title: The third year in the first person: medical students report on their principal clinical year.
abstract: OBJECTIVE
  To obtain an accurate and detailed portrait of medical students' principal clinical year using firsthand accounts of their experiences over the course of the year.
  
  
  METHODS
  All 45 Harvard Medical School students at four clinical sites who were training in 2005-2006 under three different pedagogical models provided open-ended responses to a monthly check-in asking them for brief descriptions of any interesting or memorable experiences associated with their clerkships. Associations with gender, time of year, rotation, and clerkship model were also studied.
  
  
  RESULTS
  A total of 770 incidents were collected, and these were coded for positivity-negativity and content. Five broad theme areas were identified: stories about physicians (e.g., physicians giving instruction, acting as role models), medical students and their behavior (feelings of uncertainty or being useful, of workload), patients and patient care (e.g., learning by doing or observing, forming bonds with patients, memorable patients, treating patients over time), groups and group climate (e.g., effectiveness of teams, informal groups, comparison of services), and content themes (e.g., birth, death, cancer, bad news). Two-thirds of all stories were coded as positive.
  
  
  CONCLUSIONS
  These third-year medical students often framed their experiences positively, finding learning lessons even in stressful or unpleasant events. Their stories also reflect relatively consistent orientations toward patients and patient care (e.g., biomedical versus patient-centered). The authors believe these incidents reflect the emerging professional identities of medical students; educators can use these to help students reflect on the kind of physician they aspire to become.
authors.affiliation: Center for Evaluation, Harvard Medical School, Boston, Massachusetts 02115, USA. ed_krupat@hms.harvard.edu
authors.forename: Edward
authors.initials: E
authors.lastname: Krupat
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Pelletier
authors.forename: Darren W
authors.initials: DW
authors.lastname: Chernicky
mesh_terms: D002982:Clinical Clerkship / Q000379:methods*; D003479:Curriculum; D006801:Humans; D012189:Retrospective Studies; D012577:Schools, Medical; D013337:Students, Medical; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*