Clinical rotations mark a pivotal transition for medical students from the classroom to hands-on patient care. Beyond mastering medical knowledge and honing clinical skills, developing strong relationships with your supervising physicians, residents, peers, and other healthcare staff is key to succeeding in this demanding environment.
These relationships not only contribute to your learning but also play a crucial role in shaping your professional identity, guiding your career path, and building your reputation. They also form the foundation for future recommendation letters and networking opportunities and influence your overall satisfaction and mental well-being during this time.
We will provide actionable advice for fostering these relationships, touching on practical strategies inspired by classics like Dale Carnegie’s How to Win Friends and Influence People and Harvard Business Review’s emotional intelligence series, including Dealing with Difficult People. Whether you’re interacting with a challenging supervisor or trying to build rapport with your team, we hope to help you approach clinical rotations with the interpersonal skills needed to excel.
The Importance of Relationships in Clinical Rotations
Clinical rotations are a gateway to developing professional relationships that could impact your career for years to come. Positive relationships with your supervisors and colleagues contribute to your learning experience, provide networking opportunities, and offer emotional support in the challenging environment of clinical practice.
Having a mentor who understands your strengths and areas of improvement can lead to more personalized teaching and invaluable career guidance. Similarly, residents who know you well are more likely to advocate for you when attending physicians request input for evaluations. Strong connections with peers foster a sense of community, which helps reduce feelings of isolation or burnout during stressful times.
On the other hand, poor interpersonal skills can lead to misunderstandings, reduced learning opportunities, and less favorable evaluations. Gaining medical knowledge alone is simply not enough. Strong interpersonal relationships are what often differentiate good physicians from great ones.
Strong interpersonal relationships often make the feedback loop between students and supervisors more effective. A supervisor who feels respected and appreciated is more likely to take the time to offer constructive feedback, helping the student to improve. For example, a student who proactively seeks feedback and shows gratitude may receive additional learning opportunities, such as more involvement in patient management or procedural skills. These personal connections not only contribute to evaluations but also foster a supportive learning environment where both the student and mentor benefit.
Starting Your Rotation on the Right Foot
Your first day in a clinical rotation is an opportunity to set a positive tone for the entire experience. In a high-stakes environment like medicine, where teams often rotate every few weeks, first impressions can leave a lasting mark. Here are some tips on how to start on the right foot.
Be Early and Prepared
Arriving early on your first day sets a professional tone and demonstrates your commitment. Make sure you know your responsibilities, the layout of the hospital, and any team members you’ll be working with. Familiarize yourself with the clinic’s or ward’s procedures and protocols. Being prepared reflects diligence, and it shows that you respect the team’s time and effort.
Introduce Yourself and Take Initiative
Introduce yourself to everyone on the team—from the attending physician to the janitorial staff—with a friendly and open demeanor. Demonstrating respect and humility when meeting people for the first time is key. Taking the initiative to introduce yourself shows that you are proactive and open to collaboration.
When appropriate, don’t hesitate to offer help with tasks, ask how you can contribute, or volunteer to take responsibility for aspects of patient care. However, be careful not to overextend yourself or appear overconfident. A good balance is to ask questions that show interest without becoming a burden on your seniors’ time.
Active Listening and Observing
The ability to listen attentively and observe how others work is a valuable asset during rotations. By actively listening to your seniors, you demonstrate respect for their expertise and a willingness to learn. Avoid interrupting unless absolutely necessary and take note of their communication styles and decision-making processes. Observing the interpersonal dynamics within the team can help you navigate complex professional relationships later.
Express Genuine Gratitude
A sincere “thank you” goes a long way in healthcare settings. Make it a habit to show appreciation for any teaching moments, guidance, or support provided by your colleagues and supervisors. People tend to remember those who make them feel valued and respected.
Fully Prepared for What Awaits
Arriving prepared goes beyond knowing your responsibilities—it also involves emotional preparation. Each clinical team has its unique culture, so you should aim to assess the communication styles of your supervisors early on. For example, some attendings prefer a direct, no-nonsense style of communication, while others may appreciate a more informal, inquisitive approach. Observing these subtleties will help you adapt and integrate more smoothly, avoiding potential misunderstandings.
Building Rapport with Residents and Attendings
Developing a strong rapport with residents and attendings is key to learning and earning positive evaluations. These relationships are not just about doing well but about growing as a clinician and gaining mentors who can guide you throughout your career.
Know the Role of Residents
Residents are typically closer to your stage in training and can provide invaluable insight into how to navigate rotations. They are your direct supervisors in many cases and play a major role in your evaluations. They also serve as role models, showing you the ropes of clinical care, time management, and how to interact with senior doctors and patients.
Respect their time. Residents often work long hours and juggle many responsibilities. Be mindful of their time when asking questions or seeking guidance. If possible, save non-urgent questions for quieter moments.
Offer to help. Whenever you see a resident juggling tasks, offer to assist. It can be as simple as asking, “Is there anything I can do to help with this case?”
Building Credibility
To build credibility, students should focus on demonstrating clinical competence and reliability. Small actions, such as diligent note-taking, following through on patient tasks, or volunteering for more complex cases, will gradually build trust with their supervisors.
Moreover, establishing credibility means understanding when and how to express your medical reasoning. For instance, if you notice something in a patient’s case that differs from your resident’s perspective, frame your observation as a question to show curiosity rather than overconfidence. This approach fosters collaborative learning while maintaining respect for your resident’s expertise.
Communicating with Attendings
Attendings often have limited time to interact with students, so it’s essential to maximize your learning opportunities without overwhelming them.
Ask thoughtful questions. Instead of bombarding attendings with basic questions, aim for thoughtful, reflective inquiries. Demonstrating that you have done some initial thinking or research on your own before asking questions reflects intellectual curiosity and diligence.
Show respect for their expertise. Always show respect for the attending’s expertise, but don’t be afraid to express your perspective or ask for clarification when you don’t understand something.
Be mindful of nonverbal cues. Pay attention to the attending’s body language. If they seem rushed or distracted, it might be a better time to step back and save your questions for later.
Challenging Supervisors
No rotation is without its challenges, and sometimes you will encounter difficult supervisors. Whether it’s a resident with a short temper or an attending who is highly critical, these situations can be unpleasant. However, learning how to manage such relationships is crucial for your professional development.
Stay Calm and Professional
If faced with an overly critical or difficult supervisor, it’s essential to remain calm and composed. Responding emotionally to criticism can escalate tension and reflect poorly on your professionalism. Instead, focus on receiving feedback with grace. Acknowledge the feedback and use it as a learning opportunity.
Understand Their Perspective
Often, difficult behavior stems from stress, overwork, or frustrations unrelated to you. Understanding this can help you not take it personally. Instead of feeling discouraged, approach the situation with empathy, understanding that medicine is a high-pressure field.
Seek Feedback Regularly
Sometimes difficult relationships stem from misunderstandings or a lack of clarity around expectations. Regularly asking for feedback can help ensure that you’re meeting your supervisor’s expectations and give you the opportunity to address any potential concerns early.
Document Your Experiences
In rare cases where a supervisor’s behavior becomes abusive or harmful, documenting specific incidents may be necessary. This allows you to address concerns with administration or course directors in an objective manner if needed. Always aim to resolve conflicts professionally, but know when to seek help if a situation becomes intolerable.
Different Personalities
In some cases, you may encounter supervisors who are dismissive or unreasonably critical. One approach is to use open-ended questions to de-escalate the situation: ‘Could you explain what I could do differently next time?’ This encourages constructive dialogue and can help turn a potentially negative interaction into a learning experience.
Reflecting on how attending physicians or residents handle stress can provide insights into coping mechanisms within the profession and demonstrate emotional maturity. Remember, navigating difficult relationships with grace could lead to future mentors advocating for you during residency applications.
Types of Difficult Supervisors and How to Diffuse Tension
No clinical rotation is without its challenges, and some of the most difficult situations can arise from working with supervisors who are hard to please or communicate with. Understanding different types of difficult supervisors and how to manage each type can help you with challenging relationships effectively. Here are some common types of difficult supervisors and strategies to handle each.
No matter how tempting, it is not advised to send this article to your supervisor to let them know which type of difficult supervisor they are!
The Perfectionist
The Perfectionist is a supervisor who has exceedingly high standards and expects nothing short of excellence. While this can push you to improve, it can also lead to stress if their expectations are unrealistic or if they become hypercritical.
How to Handle:
- Stay proactive: Show that you are eager to improve by seeking feedback frequently. Ask questions like, “What can I do to meet your expectations better?” or “Is there an area I could focus on to improve?”
- Reframe criticism: View their feedback as a challenge to refine your skills rather than a personal attack. If they’re overly critical, acknowledge their points without getting defensive, saying something like, “I appreciate your feedback and will work on that.”
- Take ownership: When you make mistakes, own them immediately and show that you’re taking steps to improve. This builds trust and demonstrates that you’re serious about learning.
The Silent Observer
This type of supervisor gives little to no feedback. They may seem disengaged or aloof, and it can be hard to tell where you stand with them. This can lead to uncertainty about your performance, which can be stressful.
How to Handle:
- Initiate communication: Take the lead in asking for feedback. Frame it in a non-confrontational way: “I would really appreciate any input on how I could improve. Is there something you think I should focus on more?”
- Ask for specific guidance: Silent supervisors may not offer much unless directly asked. Try saying, “Could you show me how you approach this procedure? I’d like to learn from your experience.”
- Stay confident: If feedback is sparse, don’t assume the worst. Continue to work hard and remain professional, understanding that this supervisor’s communication style may just be more reserved.
The Micro-Manager
The Micro-Manager closely oversees every task and provides constant corrections, making it difficult for you to demonstrate independence or initiative. This can feel stifling, and it’s easy to become frustrated.
How to Handle:
- Acknowledge their concerns: They may feel responsible for every aspect of patient care, so express understanding of their meticulous approach: “I appreciate how closely you monitor things. Could you help me understand what’s most important to focus on?”
- Seek small opportunities for autonomy: Show that you’re capable by asking for responsibility in low-risk areas: “Would it be alright if I handled this part of the patient workup on my own and report back to you?”
- Provide regular updates: Keeping them in the loop can preempt their need to check in constantly. Provide updates before they ask for them, demonstrating that you are conscientious and on top of things.
The Short-Tempered
Some supervisors have a very low tolerance for mistakes or delays and may express frustration quickly. Their impatience can create a high-pressure environment where it’s difficult to think clearly or learn effectively.
How to Handle:
- Stay calm under pressure: Don’t mirror their frustration. Keep your tone calm and steady, saying something like, “I understand this is a stressful situation. I’ll do my best to work quickly and accurately.”
- Prepare thoroughly: Anticipate their expectations by preparing extra thoroughly. If you know they’re impatient with delays, arrive early and ensure all necessary tasks are completed ahead of time.
- Acknowledge their concerns: Validate their feelings to diffuse tension. “I see that time is critical in this situation. I’ll move quickly to get this done.”
The Passive-Aggressive Supervisor
The Passive-Aggressive supervisor may not directly criticize you but instead makes subtle comments or withholds opportunities as a way of expressing dissatisfaction. This can create confusion and unease.
How to Handle:
- Confront respectfully: Approach the situation with tact. Say something like, “I’ve noticed some tension and want to ensure I’m meeting your expectations. Is there something I could improve on?”
- Set clear boundaries: Politely but assertively set boundaries if passive-aggressive behavior becomes disruptive: “I’d like to focus on how I can do better in the future. Could we talk about concrete steps I could take to improve?”
- Focus on solutions: If they criticize indirectly, steer the conversation towards actionable solutions. “Thank you for bringing that up. What would you suggest I do differently next time?”
The Dismissive
The Dismissive supervisor may seem uninterested in your development, brushing off your questions or giving minimal instruction. This can make it difficult to learn or feel valued in your role.
How to Handle:
- Ask for their advice directly: Try engaging them by asking for their specific input. “You’ve worked with many students—what do you think is the best way for someone at my level to improve quickly?”
- Seek learning from other sources: If a supervisor is unengaged, look to residents, nurses, or other colleagues for teaching moments. Ask them questions and observe how they handle patient care.
- Don’t take it personally: Understand that their behavior may reflect their own stresses or disengagement, not a reflection of your worth or potential as a student. Stay proactive in your learning.
By recognizing these common types of difficult supervisors, you can develop tailored strategies to manage each one, maintain professionalism, and continue to grow during your clinical rotations. The ability to navigate complex interpersonal dynamics will not only make your rotations smoother but will also build resilience and flexibility—key traits for any future physician.
Leveraging Emotional Intelligence
Emotional intelligence (EQ) is the ability to perceive, manage, and regulate emotions in yourself and others. Cultivating EQ during rotations is crucial for navigating high-stress environments and complex interpersonal dynamics.
Self-awareness
Understanding your emotions and how they affect your behavior is essential in managing interactions with others. If you’re feeling overwhelmed or frustrated, take a moment to reflect on these feelings before reacting. For example, if an attending provides harsh feedback, pause and assess your emotional response before replying. Taking a step back allows you to respond in a way that is constructive and professional.
Empathy
Empathy is at the heart of emotional intelligence. When dealing with colleagues, residents, or attendings, try to understand their perspectives and emotional states. If a resident is short with you, it could be due to exhaustion from a long shift rather than a reflection of your abilities. Understanding their feelings helps you respond with patience and professionalism.
Conflict Resolution
Conflict is inevitable in stressful environments, but how you handle it can define your professional reputation. Approach conflicts with a solution-oriented mindset, seeking to understand the other person’s perspective and finding common ground. Avoid taking conflicts personally and instead aim to address the root cause of the disagreement in a calm, respectful manner.
For Your Consideration
Emotional intelligence becomes particularly important when in high-stress situations during clinical rotations, especially when interacting with peers, residents, or attending physicians. Recognizing the emotional tone of your interactions and adjusting your approach accordingly demonstrates professionalism and maturity.
For example, if a resident appears frustrated or overwhelmed, offering understanding by saying something like, “I know this is a challenging day, is there anything I can do to help lighten the load?” can help build rapport and diffuse tension. These interactions often reflect your ability to balance empathy with clinical teamwork, which is crucial in fostering strong professional relationships and ensuring smooth collaboration within the healthcare team.
Sustaining Relationships Post-Rotation
The relationships you form during your clinical rotations can be invaluable as you progress through medical school and into your residency. Here are some ways that you can maintain these connections even after the rotation ends.
Express Gratitude
After the rotation ends, send a thoughtful thank-you note or email acknowledging the teaching and support you received. Make it specific by referencing a key moment or lesson that had a significant impact on your learning. This not only demonstrates your appreciation but also keeps the relationship alive.
Stay in Touch
Maintain occasional contact with residents and attendings through email or professional networks like LinkedIn. Keeping in touch, even with brief updates on your progress, can help maintain these valuable professional relationships. Avoid overdoing it, but checking in a few times a year can keep you on their radar for future opportunities.
Recommendation Letters
When the time comes to request a letter of recommendation, approach the process with humility and gratitude. Make sure to ask well in advance and provide them with all the necessary information to make the process easier for them. Express why you value their recommendation and remind them of specific interactions or achievements during your rotation.
Keep in Mind
Staying connected can take many forms. Beyond thank-you notes, consider reconnecting during medical conferences or specialty meetings. Joining professional organizations related to your field of interest can create opportunities for you to network with former mentors.
Long-term, these relationships may evolve into research collaborations, co-authoring papers, or even opening doors for residency or fellowship placements. Keeping your mentors updated on your career milestones shows them that their investment in your education has paid off, and they may be more inclined to support your career advancement.
Fostering Peer Relationships
While much of the focus in clinical rotations is on developing relationships with supervisors, your relationships with fellow students are just as crucial. These are the people who will understand the unique challenges of your journey and provide support when times get tough.
Collaboration, Not Competition
It’s easy to fall into a competitive mindset during rotations, especially when everyone is vying for the attention and approval of the same attendings and residents. However, clinical rotations should be viewed as a collaborative effort rather than a competition. By helping each other, sharing knowledge, and providing emotional support, you create a more positive and productive learning environment for everyone.
Study Groups and Debriefing Sessions
Forming study groups or debriefing sessions with your peers after a rotation can reinforce learning and provide an opportunity to discuss difficult cases or challenging dynamics in a supportive setting. These sessions not only help cement knowledge but also foster stronger peer relationships through shared experiences.
Many attendings will observe how well you collaborate within a team, and part of building strong relationships with your peers includes understanding their strengths and supporting them.
In competitive environments, it can be easy to view your peers as competitors. However, by fostering a spirit of collaboration—such as sharing study resources or discussing difficult cases—you create a more cohesive team. Many rotations include 360-degree evaluations, where peers assess your contributions, so nurturing these relationships is crucial.
Dealing with Mistakes Gracefully
Mistakes are an inevitable part of clinical rotations, and how you handle them can significantly affect your relationships with supervisors and peers.
Own Your Mistakes
If you make a mistake, take responsibility for it immediately. Trying to hide or shift the blame will only damage your reputation. Owning your mistakes shows maturity and a commitment to learning from them.
Learn from Criticism
After owning up to a mistake, ask for constructive feedback. Criticism is often difficult to hear, but it’s also an opportunity to grow. Ask for advice on how to avoid similar errors in the future and demonstrate your willingness to improve.
Apologizing after a mistake is an essential skill for any healthcare professional. A genuine apology should acknowledge the error, explain what was learned, and outline how you plan to avoid repeating the mistake.
For example, if you overlooked a step in a procedure, acknowledge it by saying, ‘I realize I missed this step, and I’m working on a strategy to ensure this doesn’t happen again.’ Additionally, reflecting on mistakes with a focus on improvement, rather than dwelling on failure, helps in emotional recovery. Mistakes can be stressful and may impact your confidence, so it’s important to find healthy coping mechanisms—such as debriefing with a trusted peer or seeking support from a mentor.
Balancing Personal and Professional Boundaries
During clinical rotations, it can be tricky to balance professionalism and forming meaningful relationships. It’s important to build rapport without crossing professional boundaries.
Keep Interactions Professional
Even when you form close relationships with residents or attending physicians, remember to maintain a professional demeanor. Avoid oversharing personal details or engaging in conversations that could blur the lines of professionalism. Keep discussions focused on medicine, patient care, and learning.
Social Media Awareness
Be mindful of your social media presence. Many professionals, including supervisors and future employers, may view your online profiles. Ensure that your social media presence reflects your professional persona and avoid interacting with supervisors or peers inappropriately through these platforms.
One example of the impact of social media awareness in healthcare comes from the case of nurses at Emory University Hospital Midtown in Atlanta. Several labor and delivery nurses posted a viral TikTok video mocking their patients’ behaviors during labor, sharing their “icks” or dislikes. Comments included complaints about patients asking for simple things like taking a shower during induction or asking about their baby’s weight immediately after birth.
This video, which garnered significant attention before being deleted, was viewed over 100,000 times and received widespread backlash for being unprofessional and disrespectful. As a result, the nurses involved were fired by Emory Healthcare. The hospital issued a statement reaffirming its commitment to patient care and noting that such behavior did not align with their values. This case highlights how a poor social media presence can have serious professional repercussions, especially in healthcare.
In Closing
Building and maintaining strong relationships during clinical rotations is essential for success in medical school and beyond. By approaching each rotation with respect, emotional intelligence, and a willingness to learn from those around you, you’ll cultivate connections that enrich your clinical education and help you thrive professionally. These relationships can support you through the challenges of medical training, guide your career decisions, and open doors to future opportunities.
In the fast-paced, high-stakes world of clinical rotations, mastering interpersonal skills is just as important as mastering clinical knowledge. By integrating the strategies that we have outlined, you’ll be well-equipped to thrive in a clinical environment, form lasting professional relationships, and excel in your journey to becoming a skilled and compassionate physician.
