staring IM residency in July, concerned! - havent seen a patient in a year

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I took a year off after medschool to pursue a research fellowship
my step scores were 240s/260s.
I haven't seen a patient or studied any medicine for a year, since i took step 2.
is there anything i can do to prep ?
heck, i realized i can't even read an EKG normally anymore like i used to.

Originally Posted by jesseruva

I took a year off after medschool to pursue a research fellowship
my step scores were 240s/260s.
I haven't seen a patient or studied any medicine for a year, since i took step 2.
is there anything i can do to prep ?
heck, i realized i can't even read an EKG normally anymore like i used to.

I'm in the same boat kind of. graduated offcycle in october and the last patient I saw was cutting off someone's leg in my Vascular Surgery elective.

if you know your stuff, which you seem to, I'm told it will all come back to you. you aren't expected as an Intern to run the place right out of the gate (of course it depends on where you go, but where I'm headed they really are patient and train you hard the first year so you know the whole system and can run a team by the end of first year).

I'm also told to look through the latest Wash Manual - lots of good stuff in there. I'm also planning on reading mtb step 3.

I'm also planning on going through H+Ps to make sure I don't look stupid day one forgetting to ask family history and allergies to meds...

Haha, if it makes you feel any better I'm coming off 4th year and feel worthless as well. Regardless, I will be doing no studying (I can't count the times I've heard people tell me not to do anything). I guess you are in a somewhat different situation, but to be honest it just doesn't seem like there are very many sources to go to for "intern knowledge." Maybe just relax and wait for things to hit the fan? That's mostly what I'm going to do. On a related note, please don't go to my academic institution in July

Originally Posted by jesseruva

I took a year off after medschool to pursue a research fellowship
my step scores were 240s/260s.
I haven't seen a patient or studied any medicine for a year, since i took step 2.
is there anything i can do to prep ?
heck, i realized i can't even read an EKG normally anymore like i used to.

You will be fine. Review ACLS. As far as EKGs, make sure you can recognize asystole, VT, and VF in a hurry.

My intern year, the IM dept had a "boot camp" where they went over common floor emergencies and how to dx/treat them. This was very helpful - maybe your program has something like that.

Originally Posted by PMPMD

You will be fine. Review ACLS. As far as EKGs, make sure you can recognize asystole, VT, and VF in a hurry.

My intern year, the IM dept had a "boot camp" where they went over common floor emergencies and how to dx/treat them. This was very helpful - maybe your program has something like that.

I say know what to do with the acute things that you might experience overnight:
Acute chest pain
Hypoxia
Severe Hypotension
Severe Hypertension
Codes

The rest you can learn on the job. Don't spend too much time "preparing." Nothing can prep you for intern year. I'm not saying this to scare you but when you get there, you'll realize you just have to learn it on the job (and hopefully you didn't waste some of your 4th year trying to prep).

Originally Posted by Instatewaiter

I say know what to do with the acute things that you might experience overnight:
Acute chest pain
Hypoxia
Severe Hypotension
Severe Hypertension
Codes

The rest you can learn on the job. Don't spend too much time "preparing." Nothing can prep you for intern year. I'm not saying this to scare you but when you get there, you'll realize you just have to learn it on the job (and hopefully you didn't waste some of your 4th year trying to prep).

OOC, does MKSAP/Medstudy serve well to read during intern besides a study-aid? I feel like most people I talk to are just reading Uptodate for their patient and the rest comes later.

Also your list of acute events overnight are help, any other things to brush on? Also, how is: On Call Principles and Protocols?

http://www.amazon.com/On-Call-Princi...4158233&sr=8-2

Thanks again for the replies!

Originally Posted by DrVanNostran

OOC, does MKSAP/Medstudy serve well to read during intern besides a study-aid? I feel like most people I talk to are just reading Uptodate for their patient and the rest comes later.

I personally don't think so although others might disagree. I think as an intern you should be reading about your patients, period. Come 2nd year, you can start to do board review stuff and more in-depth reading, especially on topics you don't "get" just yet.

Also your list of acute events overnight are help, any other things to brush on? Also, how is: On Call Principles and Protocols?

I don't know anything about that book. Frankly, I never really found any of the pocket books that helpful but YMMV of course.

There a pretty decent "Things I wish I knew as a PGY1" thread in the Internship forum with more good stuff (and a lot of whining).

Originally Posted by DrVanNostran

OOC, does MKSAP/Medstudy serve well to read during intern besides a study-aid? I feel like most people I talk to are just reading Uptodate for their patient and the rest comes later.

Also your list of acute events overnight are help, any other things to brush on? Also, how is: On Call Principles and Protocols?

http://www.amazon.com/On-Call-Princi...4158233&sr=8-2

Thanks again for the replies!

I actually had this book and perused it during some free time. I didn't open it a single time on call.
Save yourself some money and use the wayback machine to get the UCSF hospitalist handbook.

http://web.archive.org/web/200905211...ook/index.html

Originally Posted by gutonc

I don't know anything about that book. Frankly, I never really found any of the pocket books that helpful but YMMV of course.

There a pretty decent "Things I wish I knew as a PGY1" thread in the Internship forum with more good stuff (and a lot of whining).

The only book I thought was usefull was the MGH pocket medicine book.

Originally Posted by Instatewaiter

I actually had this book and perused it during some free time. I didn't open it a single time on call.
Save yourself some money and use the wayback machine to get the UCSF hospitalist handbook.

http://web.archive.org/web/200905211...ook/index.html



The only book I thought was usefull was the MGH pocket medicine book.

Did you actually carry the UCSF hospitalist handbook with you or was it just something you had at home to read every now and then?

Originally Posted by gutonc

I personally don't think so although others might disagree. I think as an intern you should be reading about your patients, period. Come 2nd year, you can start to do board review stuff and more in-depth reading, especially on topics you don't "get" just yet.



I don't know anything about that book. Frankly, I never really found any of the pocket books that helpful but YMMV of course.

There a pretty decent "Things I wish I knew as a PGY1" thread in the Internship forum with more good stuff (and a lot of whining).

thanks for the tip

Originally Posted by Instatewaiter

The only book I thought was usefull was the MGH pocket medicine book.

That was definitely the most useful one. But I still didn't use it more than a dozen or so times during residency.

Originally Posted by Instatewaiter

I say know what to do with the acute things that you might experience overnight:
Acute chest pain
Hypoxia
Severe Hypotension
Severe Hypertension
Codes

The rest you can learn on the job. Don't spend too much time "preparing." Nothing can prep you for intern year. I'm not saying this to scare you but when you get there, you'll realize you just have to learn it on the job (and hopefully you didn't waste some of your 4th year trying to prep).

Agree w/above. Also, get Pocket Medicine.
Also, develop some kind of organizational scheme, like a clipboard with a blank H and P template with spaces for vitals, labs, etc. I didn't do this but wish I had - this will keep you from forgetting important chunks of presentation (like skipping Meds list, etc.) like you were mentioning. Important things to know on rounds are the patient's chief complaint, vitals, brief exam, labs, and the ECG and chest radiograph if it's shortness of breath or chest pain. Mostly, just come ready to work hard and things tend to work themselves out.