xxxxxThese are some important examples of clinical procedures that should be done prior to entering a Fifth Pathway or Internado. Students should always try to do more than the minimum.

1. Labs: The sophistication and variety of these tests are constantly growing along with physician’s dependence on them. Knowing your lab test and normal ranges is a foundation for fourth-year medical students. You may not know the diagnosis, but you can be familiar with what labs should be given and how to interpret them out of the normal range. Knowing these may make you a valuable asset on the wards, try the book “Interpretation of a Diagnostic Test” by Jacques Wallach or any other similar type text.

2. Digital Rectal: This is a physically simple procedure that can give good clinical information regarding your patient’s prostate. You should not avoid this procedure and become familiar with value in a clinical setting.

3. I.V/ Blood Draw: These skills must be mastered. If you are to be the work horse of the wards and be comfortable with patient contact, you should be able to place lines and draw blood like it is your first language.

4. Foley Catheter: Female and Male patients many time require the placement of these catheters. Have experience in placements, sizes used and types, Also be aware of the most common risks.

5. ACLS: If you haven’t taken ACLS its okay, but you will eventually. These are good skills to start reviewing ahead of time as basis for your emergency knowledge. Also it will make taking the course that much easier.

6. ABGs: Be able to take them proficiently. Understand their clinical value and interpret those results as well.

7. NSGs: Naso-gastric tubes are very important tools in medicine whether administering activated charcoal or some other meds. Be proficient and understand proper placement and auscultation of the abdomen always to verify.

8. Delivery: Be able to speak about the procedure in an interview.

9. Femoral Stick: If you can create the opportunity to master this experience, it can be a great site for blood draw on those tricky ER patients.

10. Central Line: Get experience in assisting and doing this life saving procedure.

11. Procedural Notes: Good writing skills are essential, become proficient in writing history and physical notes, off service notes, post-partum notes, and pre-operational notes to mention a few.

You should have confidence in being able to discuss these procedures during an interview or with your Attending and Chief Resident. This is just a list of some of the basics; other clinical exams and test should be known as well (i.e. palpation techniques). It is important to remember to be honest with yourself and others. Never lie or try to skirt an issue about a procedure you don’t know either at a Fifth Pathway/Internship interview or on the wards. Be straightforward and you will earn the respect of your peers.