Thursday, March 24, 2016

what to wear on clinical rotations


Although my school had a professional dress code for our first two years of medical school, the transition from classroom to working in a hospital/clinic was not as smooth as I originally thought. Shoes that were fine for walking in and out of the building did not hold up for eight hours on my feet, skirts that were fine for sitting behind a desk aren't always appropriate for patient encounters, and even my hair and make-up routines have changed since starting my clinical rotations. Now that current second years are getting closer to wrapping up their pre-clinical years (you're so close!), I've had a bunch of questions asking about clothes during clinical rotations, so I figured one post discussing all parts would be easiest! Personally I think that third year has been the best year of medical school so far, so get excited!

As a disclaimer, these are just my personal opinions and experiences. What works for me at my hospital may not work for you at yours, what my opinions on appropriateness may not be equal to yours, but I think that overall, these are easily generalized to anyone going into clinical rotations!


General

The first few days of each rotation are the days I dress the most conservative - dress pants, a conservative shirt, simple make-up and jewelry. Your residents/attendings don't know you yet, so don't have them make their decision up about your based on what you are wearing. After you get a feel for the people you are working with, you can kind of gauge how to dress from there. For example, on my ENT rotation, my attending wore a shirt, tie, and his white coat any time he had patient contact. On that rotation, I also dressed "dressier" to match him. Then recently, on my GI rotation, my attending had a great sense of fashion and always had on the cutest outfits, so I got to have a little bit more fun (while of course staying within the professional dress code) too.

I have found it easiest to have a "uniform", especially on rotations where you start earlier in the morning - nothing is more frustrating than feeling like you have nothing to wear at 5 AM! For me, it has been my Limited ankle pants, a simple blouse, and flats. I can mix and match the various items in my closet, but don't really have to think about it.

You can still have fun with your clothes while learning how to dress professionally! It's all about following the basic rules, and then finding little ways to make it a bit more special.



Tops

This is a pretty easy one to cover. All you have to ask yourself is: does this cover my boobs? If the answer is yes, chances are you are good to go! For me this has always been something I'm very aware of as I have a larger chest and seemingly high cleavage (if that makes sense). So for me, I've always veered on the side of caution. My go-to top this year has been the pocket blouse from Loft - it covers everything, it comes in a bunch of cute patterns, it often comes in the tall sizes (which is great to add a little length), and it never wrinkles.

If you are on a rotation where you wear a white coat, this gives you the opportunity to probably wear a few more of the items in your closet as only a sliver of the top is showing in the front. This is when I wear my sleeveless tops or short sleeved items, especially in the summer.

Below are several other great options that would be appropriately covered up but still fun. My personal favorite is that shorter sleeved blouse - so pretty!

one | two | three (perfect for summer) | four

Bottoms

What style of pant you want is something you'll have to figure out yourself - and we all know how annoying it is to buy dress pants! For me, I've really found my go-to pair with the exact stretch skinnies from The Limited. The biggest thing for me is to find pants that are washable - dry cleaning is expensive, time consuming, and frankly just annoying, so machine washable pants are a must! My advice would be to go to the mall, try on as many dress pants as you can, and then buy three of the ones you like the most. Remember that tailoring is always an option if there is one thing you want to change about the pants - for me, pants are always too baggy in the knees, so I have my tailor take them in. It cost me $10, but was so worth it.

As far as skirts and dresses go, do the sit test at home - ie, just sit down and see how high the skirt rides. If it goes half way up your thigh, it may not be the most appropriate skirt to wear. Even on rotations where you aren't having a ton of patient contact, you will still be bending over and sitting down, so you want to make sure you can comfortably move and still be appropriately covered up.

Shoes
This has been the biggest issue for me so far. It's hard to go from sitting 14 hours a day studying to standing 14 hours a day!

For shoes on days I don't wear scrubs, I am still trying to figure out the best solution. I have been using insoles in all my flats, and that has helped somewhat, but I still have to use a friction block to stop the top of my toes from hurting when I wear my Tory Burch Revas (even though I've been wearing them for years now!). I have been debating buying a pair of Tieks just because everyone seems to love them, but at $175, I'm hesitating. I have an old pair of flats from Banana Republic that I loooove, so I think I'm going to try this black pair (as soon as they restock my size) as they are also padded, the elastic top would make them more comfortable, and all the reviews are raving about them.

As far as what to wear with scrubs, this depends a lot on what you will be doing on the rotation. If you'll be in a drier environment (no babies or bloody surgeries), comfortable tennis shoes are definitely an option. Danskos are obviously a hospital staple - they are comfortable, easy to wipe off, come in a ton of different patterns, and last forever. While I have two pairs of them, I haven't really worn them this year. They add about two inches of height, and as a taller girl, I don't really need any more height! Mine are also a half a size too big, so I feel like I'm constantly slipping out of them. If only they made a shorter pair, I'd be alllll about them. Instead, I have been wearing these clogs from Birkenstock all year, and they are the best. My feet barely hurt at the end of the day, and I basically look for excuses to wear scrubs just so I can wear my Birks instead of flats. While they aren't the cutest shoes, you're basically wearing pajamas anyway, so it doesn't make a difference.

In the end, I don't think any single pair of shoes is going to make standing for 10+ hours a day the best feeling ever. The best you can do is minimize the injury to your feet and give your feet time to adjust to going from sitting all day to standing and walking all day.


Accessories

As a general rule, the less flashy, the better. This is one of those situations where it will really differ greatly from rotation to rotation though. On any surgical rotations, the only pieces of jewelry I have worn are my pearl earrings and my everyday necklace. If you have a rotation with minimal patient contact, that's the time that you can really have a bit more fun. On my pathology rotation, where I had 0 patient contact, I wore my longer dangling necklaces and larger rings. On my IM rotations, where I was constantly moving patients around and leaning over them, I stuck with short necklaces. On pediatrics,  I wouldn't recommend dangling earrings. One of my biggest go-to items this year has been my multi-stranded pearl necklace - it's cute, doesn't get in the way, and goes with a ton of different outfits (bonus: it's currently super on sale!)

I would also recommend a watch with a second hand, or a digital watch. I've been eyeing up this white watch from Adidas that I think would be fun...although an Apple watch would be good too ;)

Hair & Makeup

As far as hair goes, this is really dependent on what rotation you are on. On any surgical rotation, I always put my hair into either a braid or top knot, and usually a headband. Dry shampoo is my best friend on those months - I really only wash my hair like twice a week! On rotations with less physical contact, I still pin the front of my hair back, but may leave it half down. Try not to go overboard with hairspray, as it can be irritating to patients (same goes for perfume).

For makeup, I haven't changed too much. On rotations where I wear scrubs, I generally wear a little less make up just because I feel dressed down as a whole. I personally don't wear really bright lipsticks while at work, but choose to go with tinted lip balms instead - they give you a bit of color, protect your lips from the dry hospital air, and make you look a little more alive in that horrid hospital lighting.

For nails, this depends on the type of rotation. For surgical rotations, short unpolished nails is the safest bet. While some of our female surgical residents wear nail polish, I think as a student it's best to 100% follow those types of rules (although the rules themselves may vary from hospital to hospital). On other rotations, I still keep my nails short (I hate long nails!) and almost always wear a light pink color on them.

In Your White Coat

I remember being SO excited to receive my white coat during first year, and then every time I got to wear it for OSCEs. Now that it's bogged down with overstuffed pockets, I'm thankful when I don't have to wear it! Don't get me wrong, I still love the "magic" of the white coat, but once you have a bunch of stuff in them, they get uncomfortable. Here's a general idea of what I carry around with me when I wear my white coat - my most important items are my foldable clipboard and Maxwell's quick reference book. On certain rotations, like OB currently, I also use a pocket guide book because I think it looks better to just use a book to look up simple information rather than pulling out your cell phone all the time.

I like to keep a little pouch in my purse with backups - a mini deodorant, that friction stick, hair ties, and bobby pins. Not only will you be thankful for those items, but you never know when a fellow student's hair tie snaps and they don't have any more (how do I know this? because my hair tie snapped during my surgery rotation and one of the other students luckily had an extra).

General Advice

There will be rotations that you love, and there will be rotations that you don't. Luckily they don't last forever - you just have to work hard, and get through it. For me, the good rotations have greatly outnumbered the not so great, so I'm really thankful that I've had such a good experience. Just remind yourself that it's only 4 weeks (or 6 weeks, or whatever - there is an endpoint!).

Always be willing to help. As a medical student, you're kind of useless for a lot of things. You probably can't put in orders, your notes probably won't be used by anyone, and you don't really have the skill set to fix someone yet. BUT! You can help move patients out of the ORs after surgery, find a nurse when a doctor needs help, carry around the various tools needed, and be as knowledgeable about your patients as possible.

Be enthusiastic! If a resident or attending asks you if you want to suture or cut or put in the speculum or see a patient first, the answer is always yes! I have found it helpful in situations where I don't know exactly what I'm doing to say "Yes! I have never done it before, but I'd love to try". That way they know that you can't exactly be trusted, but this is your chance to learn.

Be nice to everyone. The nurses and support staff have been working in that hospital/clinic a lot longer than you have. They know more, have more experience, and know all the tips and tricks. Besides the obvious statement of just being nice to people (kind of a "duh" statement, right?), people are just going to be a lot more willing to help you out if you are on good terms. I have relied on our nurses hundreds of times, and I think they are almost always nice to me because I'm nice to them too. Also, treats at the ends of rotations wins you a ton of points too ;)

Be comfortable with being uncomfortable. You will be in the way. You will not know all the answers. You will say the wrong thing or cut the wrong string or not know how to use a laparoscopic camera. You will puppy dog behind an attending and then be told to stop following them around. People may make fun of you. The best you can do is ask people how you can help them, and be kind to everyone.

Keep snacks nearby. Don't let the hanger get in the way of a great experience. My favorites include packets of peanut butter or granola bars in my white coat pockets, or hard boiled eggs or turkey jerky in my purse.

Have fun. Clinical rotations are the thing we've worked for this whole time. While books are still very much in the picture (don't neglect those shelf exams!), you finally get to see all that medicine you've been learning for two years in real life. You will get to participate in the best moments of people's lives, and the absolute worst. It truly is a privilege to be a part of that.


I hope that helps preparing for clinical rotations. If you are in the medical field, and especially at levels above me, I'd love for you to share our experiences, tips, and "can you believe that medical student did that" stories! Or if you are coming up to starting your clinical rotations, please let us know if you have any questions.