Post by Betsy on Sept 17, 2005 22:53:40 GMT -5
Here is the stuff that the class of 2006 sent to us on how to survive the 3rd year. Its a bit hard to read, so you can also download it here:
Unofficial Advice from the Class of 2006 On Surviving 3rd Year
Making the Transition to Third Year
o Yes, you can do anything for 8 weeks! Chant it as your personal mantra if you must.
o The beginning is difficult because the hospital is awash in people just getting oriented, so be patient, and expect to have to do some menial labor.
o Eat when you can. Sleep when you can. Pee when you can. You laugh now…
o Find a balance between doing your work, learning, and helping the team.
o Ask your attendings and residents to teach! It is part of their job, but not all will volunteer. It’s often helpful if you can give them a topic that’s of interest.
o Take everything in stride and nothing personally. If you are getting ridden hard by a resident or attending, don't let it bother you. This is easier said than done, but it will pay off in the end.
o If you're sick, stay home. You're no good to the team, and you could easily get your patients sick.
o Take the stairs. It will be your most consistent exercise regimen for the next 11 months.
o You can (and should) bleach your coat. Just be sure to dilute the bleach in the wash water first.
o Pace yourself. It’s a long year, a lot of learning, and you need to avoid burnout early. Continue to see friends, talk to family, and do things that are fun.
o Wednesday is taco salad and banana pudding day at the MCG cafeteria.
o Third year is a lot of fun - It's hard work and really daunting at times, but at the end of the day you're doing what you've been working to be doing for years. So enjoy it!
o Try to relax and enjoy yourself. Don't get too stressed out. If you screw up or have a bad pimping session, don't linger on it. Read up and move on.
Advice for the Wards
• It is easy to do well on the wards if you:
o Act like a professional at all times. After all, you’re training to be one.
o Show up on time or early, and always be ready for rounds. Attendings may be late, not the team.
o Always be pleasant and have a good attitude. If you can't manage that, at least be polite. Everyone is annoyed by a complainer, it drags the team down, and it tends to trickle up to the attending. Besides, a good attitude can go a long way to making up for a lack of knowledge!
o Get your work done and volunteer to assist others. The sooner the team gets done, the sooner everyone goes home or has time to study.
o Be a team player! Be someone others want to work with, help others out.
o Be curious and enthusiastic, even if you know for certain you don’t want to go into the specialty. Find aspects of the rotation that interest you, and treat it as if it were your first choice. Attendings and residents are quick to pick up on lack of interest, and it will hurt your grade if you make it apparent.
o Know your patients and listen to what they tell you – they are your best teachers. Your attending will quickly learn to trust you if you present personal details about the patient.
o Start thinking of yourself as your patients’ doctor - they certainly do. Don't expect someone to come behind you and make sure you did it right. 2 years from now you won't have that luxury, so don't learn to rely on it.
o Always be nice to the nurses, physicians’ assistants, staff etc. They can be extremely helpful and good teachers, too. If they’re rude or short, as they sometimes are, kill them with kindness.
o If something goes wrong, and it's your fault, say it's your fault and offer to fix it. Problems will be resolved faster that way, and you'll feel better about it.
o Read and study when you have time, especially about topics the attending mentions or about your patients. If you find pertinent info regarding a topic they have brought up you will score big points.
o Work actively on your fund of knowledge. Expect to study an hour or two each night at home after a long day on the wards.
o Always ask for feedback before the rotation ends. Don’t be satisfied with “you’re doing fine” – that is not an answer. Ask specifically where you could improve – notes, history taking, etc.
o Give your attendings and residents something concrete to remember come grading time – handouts, good presentations, and case presentations are all good ways to have the higher-ups remember you in a positive light.
• Some Don’ts:
o Do not ever show up another student by answering a question or doing a presentation that was not intended for you. ’Nuff said.
o Do not pimp other students – only attendings and residents should engage in this behavior. And for heaven’s sake, don’t pimp attendings or residents!
o Do not become the team’s scut monkey. It is fine to help out, but if you notice that you are the only student routinely assigned menial, scut-work tasks, make some adjustments. You are here to learn, not to do others’ work for them.
o Avoid arguing with team members/residents, especially during rounds. This looks bad and shows a lack of cooperation. Residents and fellow students will never forgive you if you embarrass them in front of an attending.
o We hate to state the obvious, but, having seen it done…don’t argue or debate with attendings! Even if you think it’s a safe, “off-the-record” topic, you’re gambling with your grade. Smile and nod, even if you’re itching to say something.
o Do not expect people to come find you or to do things for you. You need to be proactive, seek learning opportunities, and be a self-starter. Not surprisingly, people will then start to seek you out!
o Don’t be afraid to say what you’re interested in. If you know for sure what you would like to do, don’t be ashamed. If you’re not sure or are uncomfortable telling an attending for fear of discrimination (it can happen, sorry), you can be vague and say that you’re keeping an open mind.
o Do not write notes longer than two pages - it's not worth it, plus it gives the impression that you're rambling and failing to summarize and prioritize important medical details.
o Don't freak out! Everything is new and you may not be sure of yourself, but the purpose of your 3rd year is to learn and mature.
• Thoughts on “This is so unfair!”
o 3rd Year, and life in general, are inherently unfair. Adjust.
o When you feel something unfair or wrong has happened, and you feel that you really need to report it or confront an individual, sleep on it for a night, talk to a few good friends about it and get their view, and then come back the next day with a clear mind (and not seeing red) to address the problem in a calm, professional manner.
o You will do grunt work - but don't whine about it. We promise, you'll have far MORE grunt work 2 years from now as an intern - so get used to it. A good rule of thumb is: make your intern's life as easy as possible. At the end of the day, your intern will ALWAYS work harder than you. So...enjoy this year and be amazed at how much you learn!
• On Gunners and the practice of gunning
o It's okay to be a gunner sometimes - enthusiasm is greatly appreciated - but not at the expense of your colleagues. It will end up hurting you and the rest of the team in the end.
o If you know you will be gunning on a particular rotation (because it’s what you want to do with the rest of your life), let your classmates know. Tell them up front you’ll be working extra hard, and ask them to let you know if it gets out of hand. Most people are okay with that.
o If someone is exhibiting gunner behavior, try first to simply talk to that person. He or she may not realize how it’s affecting others.
o If all else fails, step up your own efforts. Learn from the gunner in your midst.
o To impress the attending during rounds, try to memorize as much of the presentation as possible. Review your data quickly before your patient is presented, and try to give succinct presentation. Memorizing numbers isn't necessary, but showing that you can talk about your patients without notes shows that you truly do know the patient.
• Off Campus rotations
o When you're going off campus, it'll take you about 2 days to get used to the new system. There will be similarities to MCG's system, but there will be definite differences. Ask these questions as early as possible so that you're not spending more time learning the system rather than seeing patients and learning from them.
o Read the orientation packet if you’re given one.
o Always try to find out who is evaluating you. In some rotations, the interns have a great amount of input, in other rotations, your grade may be dependent solely on the resident's evaluation of your performance, while in other rotations your attending has complete control of your evaluations.
o Remember that you are a guest representing MCG - act accordingly.
o Never forget your role = STUDENT. Your team does not/should not depend on you and will not collapse without you. You are here to learn, not run the hospital. Don't laugh - some will try.
o Away rotations may or may not mean easier grading and/or workload. It all depends, so ask those who’ve gone before you.
General Resources/Publishers for study:
• Pretest – many students used and liked these books. Recommended for almost all rotations.
• First Aid for Step 2 – most students purchased this book and used the rotation-relevant sections as either prep for general topics or a quick cram.
• Appleton and Lange – lots of questions over a wide variety of topics. Some students found that the questions did not reflect the format of the exam well.
• Medical Knowledge Self-Assessment Program (a.k.a MKSAP) – most true to the question format of the shelf exams, thorough explanations of answers. Especially suited to Medicine and Surgery rotations, good Step 2 review.
• Blueprints – good review of major topics, but some students were put off by the outline format and felt it lacked detail; probably not a stand-alone resource.
• Recall series – Quick, short-answer questions, good for review in a few minutes of downtime. Some liked it, some didn’t care for the format; read through before you buy.
Preparing for Shelf Exams
• Shelf exams are hard. You will have to study, and it may take you a few before you get used to them and figure out what works for you.
• Questions, questions, questions! Repetition and practice are key. Do them until you can’t stand it anymore.
o Work through Pretest, Appleton & Lange, or your question book of choice thoroughly at least once.
o Read through explanations and understand the concepts behind the questions.
o Be sure that you are pacing yourself well. The shelf exams are long and tiring, and most of us found we had just enough time to finish, especially on the first few tests.
o If you know yourself to be a slow test-taker, you may want to practice timing yourself – there is nothing worse than not finishing the exam, especially since there’s no penalty for guessing.
o Learn to be able to pick out the relevant data and not linger on minutiae during the exam – you can waste a lot of time on distractors.
• A good rule of thumb: read your resource book of choice and about patients for the first half, then start doing questions during the second half.
• Read on patients and topics as they come up, especially for inpatient experiences. Being able to connect a concept with a patient makes it much more memorable.
• Start studying on the first day so that you're not caught doing too much at the last minute.
• Always have book on you while on the wards for downtime study - PreTest, Surg Recall, or the Washington Manual are good choices.
• Actually read a book, any book, every day and finish it before the test.
• In terms of study books and resources, the best books are the ones you will use. We know this seems obvious, but many of us bought expensive books, only to have them in pristine condition on our desks at the end of the rotation.
• Overall:
o Think about how you study best.
o Do lots of questions.
o Develop a study plan to cover all the essential topics and stick to it.
Rotation-Specific Books/Study Advice
• Family Medicine
o The Family Medicine department gives you a whole bunch of books (free!) to use during the rotation. These include resources and question books, so take a look at these before you buy any books.
o The Family Medicine exam is more difficult than the clerkship itself - consider the exam more of a medicine or surgery exam than a pure primary care/family medicine exam. If you’re taking it early in the year, study harder – you’ll be at a disadvantage having not had other core to boost your fund of knowledge.
o Familypractice.com has a bunch of questions that are good practice.
o Swanson’s is the main question book given by the department. It got mixed reviews from students. Some really liked it, others found the question formats and topic emphasis inappropriate. It’s long, but if you can get through it, it will probably help you.
o Know your preventive medicine, evidence-based medicine, and screening tests.
• Medicine
o The Medicine exam is one of the broadest and most daunting you’ll take all year. Start studying early, but don’t be overly concerned about details, at least initially; you have a lot of ground to cover and you need exposure more than minutiae. Questions generally run to management, what’s the next step, which medication should you prescribe, etc.
o MKSAP is the run-away favorite. Get through it all (it’s long) and know it well.
o Other recommendations included First Aid and PreTest.
o Current Medical Diagnosis and Treatment (CMDT) is a good (if heavy) resource. Leave it at home for reading about your patients. The Washington Manual is a more portable, pocket-friendly resource with less detail.
o Learn to do a quick, effective OVID search and actually present your findings on rounds the next day (or your time has been wasted). Present pertinent findings, from randomized controlled studies only - not off the wall case presentations unless they are truly applicable to your patient.
• Neurology
o This is a short rotation for the huge amount of material that’s covered, and the exam has a reputation for being one of the hardest all year. You will need to study from day one, sorry! A lot of people are not very comfortable with neurology to begin with, so it’s worthwhile to put in some additional time here.
o Most students liked the recommended text, Lange’s Clinical Neurology. It’s short enough that you can easily read through it during the clerkship, and it provides sufficient detail without being horribly dry.
o Pretest was the favorite for questions.
o Some students also used First Aid, Appleton & Lange, and Blueprints. A few used Oklahoma Notes.
o Learn to do a complete neuro exam on this rotation, even if your attending never quizzes you on it. You will need it for the rest of 3rd year and throughout your clinical career. Residents and 4th years are helpful with this if your attending is less inclined.
• OB/GYN
o You will likely be tired on this rotation, and it’s difficult to find time to study. Be sure to make time – the concepts are pretty straightforward, but distinctions matter (e.g. you must be able to distinguish primary vs. secondary amenorrhea and know their respective causes).
o The book recommended by the department, Obstetrics and Gynecology, 4th Ed. (Lippincott Williams & Wilkins), offers good basic coverage of main topics, but some information is outdated and it doesn’t cover some subjects in sufficient detail. You may want to consider a supplemental resource.
o Lots of people liked PreTest and First Aid. You may be pressed to get through PreTest, so make sure to start early.
• Pediatrics
o Yep, kids are not little adults. Not much you will have learned on prior rotations will help you here, so expect to start over and have a steep learning curve. The good thing about this rotation is that they provide you with study materials, on-line cases, and a mid-term exam to keep you honest, and there is a genuine interest in teaching from most attendings.
o On the wards, Harriet Lane is a great reference, and pocket-sized. A number of students also found a few chapters to be good, condensed study references.
o Resource books – check them out from the department. Rudolph’s Fundamentals of Pediatrics and the Lange Clinical Pediatrics were good.
o For questions, Appleton & Lange, PreTest, Blueprints.
o Spend some time with the on-line CLIPP cases if you can – they actually are good teaching tools.
o If on campus, pay attention to the lectures. If off campus, try to watch the CD-ROM lectures. They will be on the mid-term exam, which is a chunk of your grade.
• Psychiatry
o This is a rotation where you can really excel on the Shelf Exam, and you may need it to bring up your clinical grade. You should have plenty of time to study. Know the subtleties that distinguish disorders - schizophrenia from schizophreniform from schizoid, for example.
o There is no need for the DSM-IV to be your reference; pick something more accessible. Your text from 1st year is adequate.
o Hit PreTest, First Aid, and Blueprints hard. It will pay off on the exam.
• Surgery
o Another rotation where you will be tired and study time will be rare and precious. It’s good to carry a pocket study book with you to maximize your time. Do not waste your time learning the detailed mechanics of surgical procedures – they will not be tested. The exam is difficult, and there is a surprising amount of management and Medicine. If you have not had Medicine beforehand, be warned.
o A lot of students liked PreTest and Surgical Recall.
o Appleton & Lange is another good source for questions, but start early – it’s long. MKSAP is also good, but again, beware its length.
o The Lange text on Surgery is good for looking up patients.
• Helpful Websites
o emedicine.com – gives complete, short articles about certain conditions. Free. Good for presentations.
o familypractice.com for a few practice questions. Free.
o uptodate.com – an excellent, thorough, EBM resource. Great for presentations. Not a great idea to share with others; they WILL catch you and suspend your account. It is available at the, MCG library, VA and some other sites for free.
o MD consult – available through the MCG library system. Good reference, especially if looking up drugs. Good for access to online texts, articles.
o AAFP.org -- good source for articles that are at the 3rd year level
o PubMed -- used it for every presentation!
o Info Poems easy way to look up relevant articles and association guidelines on dealing with certain conditions like CHF. Very good for medicine.
o OVID - more difficult to use, but when you are looking for something obscure it is probably the best.
o NEJM Online - you have to pay, which is not much, but it has a good seach engine and good articles. Free through MCG library.
o www.medfools.com - has great patient tracking sheets. Go to “Wards” then “Downloads” for PDF files. Used by med students everywhere for Medicine and Surgery.
• Phone numbers and Codes
o The little laminated Yellow Card is gold – don’t lose it! Keep it with you at all times.
o MCG
Operator - 0211
Med Supply Closets: (4C-8837*, 4S-2345*, 3ICU-0607*, 5S-5605*/1308*, 6S-2648*, 6N-6622*)
Posting for Surgery: 3330
Surgery Clinic: 3672
Walton Rehab: 231-2260
IT - 7500
ER - 4951
Radiology dictation - 1-7198 Go to the radiology file room (1st floor main hallway) to fill out the form to get a password/code to access the system. You can use your resident’s in the meantime.
Lab results: 2876
Chemistries: 2931
CT scanner: 4586
EEG monitoring: 4503
EEG results: 3325
EEG techs: 3608
MRI reading room: 3681
MRI scheduling: 8671
Neuroradiology: 3681
Hematology Lab: 2120, 2660
Dietician/Nutrition: 2586
o AMC:
Radiology 5-6910 enter #1-55-pt DOB
Surgery Conference Room 5-6285
Medicine Conference Room 5-3661
OB Conference Room 5-3796
Interpreter 5-3796 (Priority to L&D)
Fresh, decent coffee in AMC ICU 24/7. Enter ICU through OR to avoid lack of badge. Take back steps from another floor to get to OR without badge.
Computers in AMC library - door code after hours is 2&4 together, then 3.
Call rooms door code 51231.
o Medical Record requests:
Egleston Fax-404-785-6437, Phone-404-785-6432
Scottish Rite:Fax-404-785-2225,Phone-404-785-2431
Doctor's Hospital: 651-3232
Unofficial Advice from the Class of 2006 On Surviving 3rd Year
Making the Transition to Third Year
o Yes, you can do anything for 8 weeks! Chant it as your personal mantra if you must.
o The beginning is difficult because the hospital is awash in people just getting oriented, so be patient, and expect to have to do some menial labor.
o Eat when you can. Sleep when you can. Pee when you can. You laugh now…
o Find a balance between doing your work, learning, and helping the team.
o Ask your attendings and residents to teach! It is part of their job, but not all will volunteer. It’s often helpful if you can give them a topic that’s of interest.
o Take everything in stride and nothing personally. If you are getting ridden hard by a resident or attending, don't let it bother you. This is easier said than done, but it will pay off in the end.
o If you're sick, stay home. You're no good to the team, and you could easily get your patients sick.
o Take the stairs. It will be your most consistent exercise regimen for the next 11 months.
o You can (and should) bleach your coat. Just be sure to dilute the bleach in the wash water first.
o Pace yourself. It’s a long year, a lot of learning, and you need to avoid burnout early. Continue to see friends, talk to family, and do things that are fun.
o Wednesday is taco salad and banana pudding day at the MCG cafeteria.
o Third year is a lot of fun - It's hard work and really daunting at times, but at the end of the day you're doing what you've been working to be doing for years. So enjoy it!
o Try to relax and enjoy yourself. Don't get too stressed out. If you screw up or have a bad pimping session, don't linger on it. Read up and move on.
Advice for the Wards
• It is easy to do well on the wards if you:
o Act like a professional at all times. After all, you’re training to be one.
o Show up on time or early, and always be ready for rounds. Attendings may be late, not the team.
o Always be pleasant and have a good attitude. If you can't manage that, at least be polite. Everyone is annoyed by a complainer, it drags the team down, and it tends to trickle up to the attending. Besides, a good attitude can go a long way to making up for a lack of knowledge!
o Get your work done and volunteer to assist others. The sooner the team gets done, the sooner everyone goes home or has time to study.
o Be a team player! Be someone others want to work with, help others out.
o Be curious and enthusiastic, even if you know for certain you don’t want to go into the specialty. Find aspects of the rotation that interest you, and treat it as if it were your first choice. Attendings and residents are quick to pick up on lack of interest, and it will hurt your grade if you make it apparent.
o Know your patients and listen to what they tell you – they are your best teachers. Your attending will quickly learn to trust you if you present personal details about the patient.
o Start thinking of yourself as your patients’ doctor - they certainly do. Don't expect someone to come behind you and make sure you did it right. 2 years from now you won't have that luxury, so don't learn to rely on it.
o Always be nice to the nurses, physicians’ assistants, staff etc. They can be extremely helpful and good teachers, too. If they’re rude or short, as they sometimes are, kill them with kindness.
o If something goes wrong, and it's your fault, say it's your fault and offer to fix it. Problems will be resolved faster that way, and you'll feel better about it.
o Read and study when you have time, especially about topics the attending mentions or about your patients. If you find pertinent info regarding a topic they have brought up you will score big points.
o Work actively on your fund of knowledge. Expect to study an hour or two each night at home after a long day on the wards.
o Always ask for feedback before the rotation ends. Don’t be satisfied with “you’re doing fine” – that is not an answer. Ask specifically where you could improve – notes, history taking, etc.
o Give your attendings and residents something concrete to remember come grading time – handouts, good presentations, and case presentations are all good ways to have the higher-ups remember you in a positive light.
• Some Don’ts:
o Do not ever show up another student by answering a question or doing a presentation that was not intended for you. ’Nuff said.
o Do not pimp other students – only attendings and residents should engage in this behavior. And for heaven’s sake, don’t pimp attendings or residents!
o Do not become the team’s scut monkey. It is fine to help out, but if you notice that you are the only student routinely assigned menial, scut-work tasks, make some adjustments. You are here to learn, not to do others’ work for them.
o Avoid arguing with team members/residents, especially during rounds. This looks bad and shows a lack of cooperation. Residents and fellow students will never forgive you if you embarrass them in front of an attending.
o We hate to state the obvious, but, having seen it done…don’t argue or debate with attendings! Even if you think it’s a safe, “off-the-record” topic, you’re gambling with your grade. Smile and nod, even if you’re itching to say something.
o Do not expect people to come find you or to do things for you. You need to be proactive, seek learning opportunities, and be a self-starter. Not surprisingly, people will then start to seek you out!
o Don’t be afraid to say what you’re interested in. If you know for sure what you would like to do, don’t be ashamed. If you’re not sure or are uncomfortable telling an attending for fear of discrimination (it can happen, sorry), you can be vague and say that you’re keeping an open mind.
o Do not write notes longer than two pages - it's not worth it, plus it gives the impression that you're rambling and failing to summarize and prioritize important medical details.
o Don't freak out! Everything is new and you may not be sure of yourself, but the purpose of your 3rd year is to learn and mature.
• Thoughts on “This is so unfair!”
o 3rd Year, and life in general, are inherently unfair. Adjust.
o When you feel something unfair or wrong has happened, and you feel that you really need to report it or confront an individual, sleep on it for a night, talk to a few good friends about it and get their view, and then come back the next day with a clear mind (and not seeing red) to address the problem in a calm, professional manner.
o You will do grunt work - but don't whine about it. We promise, you'll have far MORE grunt work 2 years from now as an intern - so get used to it. A good rule of thumb is: make your intern's life as easy as possible. At the end of the day, your intern will ALWAYS work harder than you. So...enjoy this year and be amazed at how much you learn!
• On Gunners and the practice of gunning
o It's okay to be a gunner sometimes - enthusiasm is greatly appreciated - but not at the expense of your colleagues. It will end up hurting you and the rest of the team in the end.
o If you know you will be gunning on a particular rotation (because it’s what you want to do with the rest of your life), let your classmates know. Tell them up front you’ll be working extra hard, and ask them to let you know if it gets out of hand. Most people are okay with that.
o If someone is exhibiting gunner behavior, try first to simply talk to that person. He or she may not realize how it’s affecting others.
o If all else fails, step up your own efforts. Learn from the gunner in your midst.
o To impress the attending during rounds, try to memorize as much of the presentation as possible. Review your data quickly before your patient is presented, and try to give succinct presentation. Memorizing numbers isn't necessary, but showing that you can talk about your patients without notes shows that you truly do know the patient.
• Off Campus rotations
o When you're going off campus, it'll take you about 2 days to get used to the new system. There will be similarities to MCG's system, but there will be definite differences. Ask these questions as early as possible so that you're not spending more time learning the system rather than seeing patients and learning from them.
o Read the orientation packet if you’re given one.
o Always try to find out who is evaluating you. In some rotations, the interns have a great amount of input, in other rotations, your grade may be dependent solely on the resident's evaluation of your performance, while in other rotations your attending has complete control of your evaluations.
o Remember that you are a guest representing MCG - act accordingly.
o Never forget your role = STUDENT. Your team does not/should not depend on you and will not collapse without you. You are here to learn, not run the hospital. Don't laugh - some will try.
o Away rotations may or may not mean easier grading and/or workload. It all depends, so ask those who’ve gone before you.
General Resources/Publishers for study:
• Pretest – many students used and liked these books. Recommended for almost all rotations.
• First Aid for Step 2 – most students purchased this book and used the rotation-relevant sections as either prep for general topics or a quick cram.
• Appleton and Lange – lots of questions over a wide variety of topics. Some students found that the questions did not reflect the format of the exam well.
• Medical Knowledge Self-Assessment Program (a.k.a MKSAP) – most true to the question format of the shelf exams, thorough explanations of answers. Especially suited to Medicine and Surgery rotations, good Step 2 review.
• Blueprints – good review of major topics, but some students were put off by the outline format and felt it lacked detail; probably not a stand-alone resource.
• Recall series – Quick, short-answer questions, good for review in a few minutes of downtime. Some liked it, some didn’t care for the format; read through before you buy.
Preparing for Shelf Exams
• Shelf exams are hard. You will have to study, and it may take you a few before you get used to them and figure out what works for you.
• Questions, questions, questions! Repetition and practice are key. Do them until you can’t stand it anymore.
o Work through Pretest, Appleton & Lange, or your question book of choice thoroughly at least once.
o Read through explanations and understand the concepts behind the questions.
o Be sure that you are pacing yourself well. The shelf exams are long and tiring, and most of us found we had just enough time to finish, especially on the first few tests.
o If you know yourself to be a slow test-taker, you may want to practice timing yourself – there is nothing worse than not finishing the exam, especially since there’s no penalty for guessing.
o Learn to be able to pick out the relevant data and not linger on minutiae during the exam – you can waste a lot of time on distractors.
• A good rule of thumb: read your resource book of choice and about patients for the first half, then start doing questions during the second half.
• Read on patients and topics as they come up, especially for inpatient experiences. Being able to connect a concept with a patient makes it much more memorable.
• Start studying on the first day so that you're not caught doing too much at the last minute.
• Always have book on you while on the wards for downtime study - PreTest, Surg Recall, or the Washington Manual are good choices.
• Actually read a book, any book, every day and finish it before the test.
• In terms of study books and resources, the best books are the ones you will use. We know this seems obvious, but many of us bought expensive books, only to have them in pristine condition on our desks at the end of the rotation.
• Overall:
o Think about how you study best.
o Do lots of questions.
o Develop a study plan to cover all the essential topics and stick to it.
Rotation-Specific Books/Study Advice
• Family Medicine
o The Family Medicine department gives you a whole bunch of books (free!) to use during the rotation. These include resources and question books, so take a look at these before you buy any books.
o The Family Medicine exam is more difficult than the clerkship itself - consider the exam more of a medicine or surgery exam than a pure primary care/family medicine exam. If you’re taking it early in the year, study harder – you’ll be at a disadvantage having not had other core to boost your fund of knowledge.
o Familypractice.com has a bunch of questions that are good practice.
o Swanson’s is the main question book given by the department. It got mixed reviews from students. Some really liked it, others found the question formats and topic emphasis inappropriate. It’s long, but if you can get through it, it will probably help you.
o Know your preventive medicine, evidence-based medicine, and screening tests.
• Medicine
o The Medicine exam is one of the broadest and most daunting you’ll take all year. Start studying early, but don’t be overly concerned about details, at least initially; you have a lot of ground to cover and you need exposure more than minutiae. Questions generally run to management, what’s the next step, which medication should you prescribe, etc.
o MKSAP is the run-away favorite. Get through it all (it’s long) and know it well.
o Other recommendations included First Aid and PreTest.
o Current Medical Diagnosis and Treatment (CMDT) is a good (if heavy) resource. Leave it at home for reading about your patients. The Washington Manual is a more portable, pocket-friendly resource with less detail.
o Learn to do a quick, effective OVID search and actually present your findings on rounds the next day (or your time has been wasted). Present pertinent findings, from randomized controlled studies only - not off the wall case presentations unless they are truly applicable to your patient.
• Neurology
o This is a short rotation for the huge amount of material that’s covered, and the exam has a reputation for being one of the hardest all year. You will need to study from day one, sorry! A lot of people are not very comfortable with neurology to begin with, so it’s worthwhile to put in some additional time here.
o Most students liked the recommended text, Lange’s Clinical Neurology. It’s short enough that you can easily read through it during the clerkship, and it provides sufficient detail without being horribly dry.
o Pretest was the favorite for questions.
o Some students also used First Aid, Appleton & Lange, and Blueprints. A few used Oklahoma Notes.
o Learn to do a complete neuro exam on this rotation, even if your attending never quizzes you on it. You will need it for the rest of 3rd year and throughout your clinical career. Residents and 4th years are helpful with this if your attending is less inclined.
• OB/GYN
o You will likely be tired on this rotation, and it’s difficult to find time to study. Be sure to make time – the concepts are pretty straightforward, but distinctions matter (e.g. you must be able to distinguish primary vs. secondary amenorrhea and know their respective causes).
o The book recommended by the department, Obstetrics and Gynecology, 4th Ed. (Lippincott Williams & Wilkins), offers good basic coverage of main topics, but some information is outdated and it doesn’t cover some subjects in sufficient detail. You may want to consider a supplemental resource.
o Lots of people liked PreTest and First Aid. You may be pressed to get through PreTest, so make sure to start early.
• Pediatrics
o Yep, kids are not little adults. Not much you will have learned on prior rotations will help you here, so expect to start over and have a steep learning curve. The good thing about this rotation is that they provide you with study materials, on-line cases, and a mid-term exam to keep you honest, and there is a genuine interest in teaching from most attendings.
o On the wards, Harriet Lane is a great reference, and pocket-sized. A number of students also found a few chapters to be good, condensed study references.
o Resource books – check them out from the department. Rudolph’s Fundamentals of Pediatrics and the Lange Clinical Pediatrics were good.
o For questions, Appleton & Lange, PreTest, Blueprints.
o Spend some time with the on-line CLIPP cases if you can – they actually are good teaching tools.
o If on campus, pay attention to the lectures. If off campus, try to watch the CD-ROM lectures. They will be on the mid-term exam, which is a chunk of your grade.
• Psychiatry
o This is a rotation where you can really excel on the Shelf Exam, and you may need it to bring up your clinical grade. You should have plenty of time to study. Know the subtleties that distinguish disorders - schizophrenia from schizophreniform from schizoid, for example.
o There is no need for the DSM-IV to be your reference; pick something more accessible. Your text from 1st year is adequate.
o Hit PreTest, First Aid, and Blueprints hard. It will pay off on the exam.
• Surgery
o Another rotation where you will be tired and study time will be rare and precious. It’s good to carry a pocket study book with you to maximize your time. Do not waste your time learning the detailed mechanics of surgical procedures – they will not be tested. The exam is difficult, and there is a surprising amount of management and Medicine. If you have not had Medicine beforehand, be warned.
o A lot of students liked PreTest and Surgical Recall.
o Appleton & Lange is another good source for questions, but start early – it’s long. MKSAP is also good, but again, beware its length.
o The Lange text on Surgery is good for looking up patients.
• Helpful Websites
o emedicine.com – gives complete, short articles about certain conditions. Free. Good for presentations.
o familypractice.com for a few practice questions. Free.
o uptodate.com – an excellent, thorough, EBM resource. Great for presentations. Not a great idea to share with others; they WILL catch you and suspend your account. It is available at the, MCG library, VA and some other sites for free.
o MD consult – available through the MCG library system. Good reference, especially if looking up drugs. Good for access to online texts, articles.
o AAFP.org -- good source for articles that are at the 3rd year level
o PubMed -- used it for every presentation!
o Info Poems easy way to look up relevant articles and association guidelines on dealing with certain conditions like CHF. Very good for medicine.
o OVID - more difficult to use, but when you are looking for something obscure it is probably the best.
o NEJM Online - you have to pay, which is not much, but it has a good seach engine and good articles. Free through MCG library.
o www.medfools.com - has great patient tracking sheets. Go to “Wards” then “Downloads” for PDF files. Used by med students everywhere for Medicine and Surgery.
• Phone numbers and Codes
o The little laminated Yellow Card is gold – don’t lose it! Keep it with you at all times.
o MCG
Operator - 0211
Med Supply Closets: (4C-8837*, 4S-2345*, 3ICU-0607*, 5S-5605*/1308*, 6S-2648*, 6N-6622*)
Posting for Surgery: 3330
Surgery Clinic: 3672
Walton Rehab: 231-2260
IT - 7500
ER - 4951
Radiology dictation - 1-7198 Go to the radiology file room (1st floor main hallway) to fill out the form to get a password/code to access the system. You can use your resident’s in the meantime.
Lab results: 2876
Chemistries: 2931
CT scanner: 4586
EEG monitoring: 4503
EEG results: 3325
EEG techs: 3608
MRI reading room: 3681
MRI scheduling: 8671
Neuroradiology: 3681
Hematology Lab: 2120, 2660
Dietician/Nutrition: 2586
o AMC:
Radiology 5-6910 enter #1-55-pt DOB
Surgery Conference Room 5-6285
Medicine Conference Room 5-3661
OB Conference Room 5-3796
Interpreter 5-3796 (Priority to L&D)
Fresh, decent coffee in AMC ICU 24/7. Enter ICU through OR to avoid lack of badge. Take back steps from another floor to get to OR without badge.
Computers in AMC library - door code after hours is 2&4 together, then 3.
Call rooms door code 51231.
o Medical Record requests:
Egleston Fax-404-785-6437, Phone-404-785-6432
Scottish Rite:Fax-404-785-2225,Phone-404-785-2431
Doctor's Hospital: 651-3232
