Although it’s a bit esoteric, I figured between the 3rd semester students starting fall rideouts, and some groups finishing up their in-class training, it was worth doing another (and final) article about preceptorship. Having now finished my time on the road, there were a few more things I wanted to add to my original thoughts in Digest #1.

Never stop studying

This sounds daunting, but we memorize by repetition, and it’s incredible how quickly small details get lost if you don’t think about them for a month.  Near the end of my time on the road, I would find myself forgetting small (but important) points in protocols we hadn’t run into for a while.  The experience was both a bit embarrassing and discouraging as I felt like there was very little excuse for not knowing the basics at this point in the process.  That said, it was a good reminder that I had to stay on top of these things and not wait for a call to come in to reinforce them.  My advice for those of you starting into this phase of your education is to set aside at least a few hours each week and force yourself to review all of your ALS and important (but obscure BLS) protocols.  That way, regardless of what you’re doing call-wise, you’ll keep those important protocol details in your head.

You are not the gum on the bottom of someone’s shoe

Before going out on the road, we got the idea that “students were the absolute bottom of the pile” drilled rather deeply into our heads.  Unfortunately the important message of “work hard, be first to offer to help, always try to make the best impression etc.” got mostly imparted on us as “most medics out there will treat you like crap because you’re a student…paramedics eat their young”.  Having been on the road, I can tell you that my experience was very different.  As a student, you are definitely at the bottom of the pecking order.  Sleeping on a couch (when there’s a medic who wants it), watching someone else clean a truck, walking by full garbage cans etc. is a sure-fire way to get a bad reputation for both yourself and your school.  That said, every medic I met treated me with respect, and I was never made to do something just because I was the student.  I might have just been lucky, but in talking with the rest of my class, it seems their experience was similar.  Long story short…expect to be “on” all the time, (you’re trying to make a good impression to your preceptor and the service…in fact, your time on the road is kind of like a painfully long job interview), but don’t worry that every medic is going to behave like the drill sergeant from hell.

Focus on your preceptorship

A few students have asked me what other stuff I did during my time on the road.  Did I do a PALS course, get my ITLS out of the way (probably a good idea), was there lots of extra CME I could do?  Everyone’s energy level is different, but my advice would be to just focus on your preceptorship for these next few months.  There is MORE than enough to study and learn without adding extra stuff to your plate.  I found 12hr shifts difficult to get used to.  It got easier, but for the first few weeks, I was literally useless after a busy day.  Some of you might have more downtime then others, but between studying on shift, running every call (another joy of being a student) and doing most of the cleaning / organizing in the truck and station…the days are long.  One thing I started doing early on was writing notes / reminders after every call (and studying them later).  I also wrote down all the medications we came across that I didn’t know, and have been trying to memorize that list as well.  Little things like that will help you get more out of your hours on the road, and will keep you busy enough that a PALS course will be the last thing you want to do.  Partway through my preceptorship, my preceptor also had me start writing 3 positive and 3 “needs improvement” things for each call, something that might be worth considering for yourself.  90% of the time I wasn’t attending a call (or sleeping), I was reading or writing in my notebook, and I think that made a big difference overall to what I learned and retained over the last 3 months.  At the end of the day, you’ll find a rhythm that works for you, I just think there’s enough to do while on the road that most of you won’t need to look outside of your preceptorship for extra work.  Focus on the experience and made the most of it that you can, because you’ll never have another opportunity like it again (until you get to your ACP preceptorship…but we’ll write about that in a few years )