Any residents still reading textbooks?

[propofabulous]

CA-1 here with a question for other residents (especially CA-2/3's with more experience) and young attendings.

Research on learning has shown that active recall/doing questions provides significantly better retention than passively reading. In my program (and talking to some friends from other programs), nobody seems to really be reading textbooks cover-to-cover anymore (at least as CA-1's). The new landscape of studying appears to focus more on the use of review books and question banks.

Personally, I read the first 25 chapters (of 50) of Baby Miller and found it laborious and time-consuming (which is fine) but also inefficient (which is not), and so immediately moved on to doing Truelearn questions.

However, if you go back through some of the posts on this forum debating the merits of baby miller vs. M&M vs. Barash (as recently as in the last few years), a lot of contributors seem to highly advocate reading.

Does anyone with more experience than me with both resources think I am missing out by utilizing this non-textbook approach to learning? I am trying to decide moving forward if I should read either M&M or Barash, or if I should simply continue to do other question banks (like M5, Hall, Truelearn advanced, OpenAnesthesia, ACE ?'s). For what it's worth, I've scored well on my AKT's thus far (ITE scores not yet available) but I do not know if that is a reflection of the strength of my clinical knowledge or simply the efficacy of these new resources at "gaming" these tests.

Thanks in advance for any opinions!

---

Members don't see this ad.

 

[DM27]

I found that doing question banks/ACE exams made me very good at taking my exams, and I loved doing questions, I generally over prepared in this regard. I do not think it made me significantly better at my job. The question banks added a lot of test-oriented pattern recognition, and gave me some superficial to moderate knowledge of many topics, but it did not fill in gaps well. I found that reading review articles and textbooks overall filled in my knowledge much better than question banks.

I would recommend reading Barash and using question banks as a method of reinforcement, but mainly as prep for upcoming exams. If you find reading a textbook to be too laborious or you find yourself falling asleep during it, I recommend review articles. If you end up going the question route as your main method of learning, which I would not recommend, I would focus on the ACE exams as their explanations may as well be small review articles.

I also personally hated baby miller. The big Miller textbook(s) have the least personality of the anesthesia textbooks and try to make up for it with excessively dry evidence-based detail. Baby miller gives you the personality-less experience of big Miller while arbitrarily cutting out information...double fail.

 

[jeesapeesa]

i think the most effective way to learn is to associate your patients in the OR with the chapters you read. most of them have HTN/DM/PVD/CABG hx/stents/renal failure/COPD who need GA/Regional/Neuraxial/IV anesthetics/opioids. that's like more than half the book right there. i think i read most if not all of barash the as a CA1.

CA-1 here with a question for other residents (especially CA-2/3's with more experience) and young attendings.

Research on learning has shown that active recall/doing questions provides significantly better retention than passively reading. In my program (and talking to some friends from other programs), nobody seems to really be reading textbooks cover-to-cover anymore (at least as CA-1's). The new landscape of studying appears to focus more on the use of review books and question banks.

Personally, I read the first 25 chapters (of 50) of Baby Miller and found it laborious and time-consuming (which is fine) but also inefficient (which is not), and so immediately moved on to doing Truelearn questions.

However, if you go back through some of the posts on this forum debating the merits of baby miller vs. M&M vs. Barash (as recently as in the last few years), a lot of contributors seem to highly advocate reading.

Does anyone with more experience than me with both resources think I am missing out by utilizing this non-textbook approach to learning? I am trying to decide moving forward if I should read either M&M or Barash, or if I should simply continue to do other question banks (like M5, Hall, Truelearn advanced, OpenAnesthesia, ACE ?'s). For what it's worth, I've scored well on my AKT's thus far (ITE scores not yet available) but I do not know if that is a reflection of the strength of my clinical knowledge or simply the efficacy of these new resources at "gaming" these tests.

Thanks in advance for any opinions!

 

[vector2]

I was both a textbook reader and heavy qbanker. Talking to my residents who almost all are entirely qbankers (except when they occasionally read a chapter for lecture), I think their ability to actually expound on a topic as opposed to regurgitate a multiple choice bullet point is significantly decreased. In the long run, I think pure qbanking will allow you to pass tests but it is a detriment compared to a mixture of textbooks, journals, and qbanks in as far as building a competent anesthesiologist who could fly through an oral board stem.

 

[Modanq]

Its an iterative cyclical process. Clinical exposure, Intellectual curiosity, Textbook resource, Online search, Forum inspirations, question bank, fill in gaps of knowledge, re-experience clinical scenario -> learn new piece of information. Until you become a veteran. And then you think back and wonder how you didn't know the most first concept since the beginning or how you actually even took care of patients.

My recent example is learning about indications for dialysis (question banks AEIOU) which typically most intern level people know ... but now i was encountering when do you stop CVVH which then lead me to articles and text which then led me to actually physically learning the CVVH machine spiking and priming, etc which then lead me to realize that the CVVH machine can fixate your body temperature - similar to a fluid warmer which then i realized its much harder to spike a temp on CVVH -> which then led me to a ICU board exam question. And this is the Scholastic Osler MD way of learning.

This approach is captured in Osler’s precept: “learning at the patient’s bedside, observation, cautious induction, confirmation of impressions from patients, library, and laboratory, expansion of knowledge by correlation of autopsy findings with clinical observations, and working with a love of every person equally without regard to rank”

 

[deleted875186]

I read baby miller cover to cover, didn’t think it was great, but helpful early in CA1 year. I then started reading big miller. Bigger is better...

I recommend reading some sort of exhaustive text occasionally, otherwise you will have holes in knowledge from just doing questions, even though I think you would still do well on written exams.

 

[abolt18]

Current CA-1. Working my way through big Barash (slowly but surely). I find that there are definitely pearls but also lots of random irrelevant info so far. Only like 300 pages in.

 

[MoMoGesiologist]

Reading a textbook will give you a more thorough and organized understanding of topics and build a strong foundation as you move forward that will be fleshed out by question banks and clinical experience. It's the in depth knowledge that makes a physician. Otherwise, what's the difference between us and CRNAs? Just my two cents...

 

[GlowInTheDark]

Baby Miller is for med students and the first month or two of CA-1.

I find myself reaching for Stoeltings Pathophys Basis of Disease and Barash most often for any deep learning. Faust is a great succinct review.

 

[anbuitachi]

How accurate are these textbooks?

 

[chocomorsel]

How accurate are these textbooks?

In comparison to what?
Journals? Real world practice? Anecdotal experience?

 

[AdmiralChz]

How accurate are these textbooks?

Nearly all of it is evidence-based, even if the evidence is pretty old. Barash frequently addresses old evidence pretty directly. The references are always listed at the end of the chapters, and each chapter can have hundreds of references.

 

[Urzuz]

Does anyone with more experience than me with both resources think I am missing out by utilizing this non-textbook approach to learning? I am trying to decide moving forward if I should read either M&M or Barash, or if I should simply continue to do other question banks (like M5, Hall, Truelearn advanced, OpenAnesthesia, ACE ?'s). For what it's worth, I've scored well on my AKT's thus far (ITE scores not yet available) but I do not know if that is a reflection of the strength of my clinical knowledge or simply the efficacy of these new resources at "gaming" these tests.

Thanks in advance for any opinions!

How good of a physician you are is determined by much more than how you do on standardized tests and question banks. Doing nothing but question banks will arm you with tons of useless, esoteric knowledge (e.g.: electrical safety questions anyone?) to crush these exams while leaving huge gaps in your fundamental understanding of basic anesthesiology concepts.

Do not forsake reading. It will be a huge, huge mistake that you will regret later on.

 

[anbuitachi]

In comparison to what?
Journals? Real world practice? Anecdotal experience?

Nearly all of it is evidence-based, even if the evidence is pretty old. Barash frequently addresses old evidence pretty directly. The references are always listed at the end of the chapters, and each chapter can have hundreds of references.

Just wondering since as i get older and more advanced in my training i wonder about these things. the more i read, the more i realize how many bad studies there are out there. and i'm in a major academic institution where there are big names in pretty much every department, with their own books and such. and it makes me realize that the books we read are just written by some guy or girl, probably not that different from us. they probably also got some residents who wanted something on their resume, write a couple chapters as well. its good that each chapter has hundreds of references, but.. whos reading these references? did the writer even go thru all these studies/references in detail? especially if a resident wrote it, did they just look at teh conclusion and put it down as a reference? do the book editors go thru each reference papers?

 

[zizzer]

I'm glad to see such an overwhelmingly positive response here regarding reading. I agree completely, but Truelearn isn't as bad as people here seem to say. Most of the explanations are *very* thorough, so it's a bit like reading a book if you really delve into each question. One disadvantage I of doing it this way is a lack of organization. When you learn something new, you don't have the framework to fit it into. For example, let's say I read a neuraxial chapter. When I read the chapter on spinal anesthesia, I'm able to make many associations to epidural anesthesia, which I just read about and have fresh on my mind.

One thing I think many people do wrong regarding reading is that they don't refer back to it, and therefore forget it. I've found it extremely helpful to litter the ebook with notes and comments (specific things like, "Dr. so-and-so says such-and-such technique also works well in this situation") and highlighting so that it's easy to refer back to immediately when I remember reading something but don't remember the specifics. If you read like this, you can still do all the Truelearn questions, but skim through or skip many explanations if you already know about them. Then you still get the active recall component, which I also agree is important.

 

[anbuitachi]

books are similar to questions, depending on the book a lot of the information aren't used that much and you'll just forget it.

 

[abolt18]

Baby Miller is for med students and the first month or two of CA-1.

I find myself reaching for Stoeltings Pathophys Basis of Disease and Barash most often for any deep learning. Faust is a great succinct review.

Stoelting's is a phenomenal resource IMO. Worth it in every way.

 

[dannyboy1]

Experience >>>> book knowledge. Especially in anesthesia.
Think about your challenging or memorable cases. How you handled them. How the attending a you think are “good” handled them. What works and what doesn’t. Examples. How did your last massive transfusion protocol go. How did you handle a challenging airway with an uncooperative patient. How when do hemodynamic shifts happen in big cases and how can you better anticipate them. Can you tell by “ feel “ if your epidural is in the right place. How do you handle the LMA that just won’t sit right. Think about the cases where you look back and said, that patient didn’t look right I probably should have cancelled. The list goes on. Honestly not that much knowledge is needed on a day to day basis to practice anesthesia. As for the tests, use whatever is the most efficient method. For most people that will be the qbanks.

 

[deleted162650]

Yao is also a great one, especially for oral board prep.

 

[Arch Guillotti]

Experience >>>> book knowledge. Especially in anesthesia.
Think about your challenging or memorable cases. How you handled them. How the attending a you think are “good” handled them. What works and what doesn’t. Examples. How did your last massive transfusion protocol go. How did you handle a challenging airway with an uncooperative patient. How when do hemodynamic shifts happen in big cases and how can you better anticipate them. Can you tell by “ feel “ if your epidural is in the right place. How do you handle the LMA that just won’t sit right. Think about the cases where you look back and said, that patient didn’t look right I probably should have cancelled. The list goes on. Honestly not that much knowledge is needed on a day to day basis to practice anesthesia. As for the tests, use whatever is the most efficient method. For most people that will be the qbanks.

Are you a nurse?

 

[dannyboy1]

Are you a nurse?

Nope. I figured I would get this response from someone. I am a board certified attending anesthesiologist and I work full time primarily in a large busy community hospital. I’m just relating my experience of what works for me in my daily practice. I am well liked within my department and by the surgeons I work with (for ). I have not heard any complaints about my clinical competency, nor have I had unexpected bad outcomes attributed to anesthesia. Again I’m just saying what works. I’m not saying that I’m a great doctor, more that in our field common sense and decent technical skills can go a long way.....

 

[anbuitachi]

its not just the training, but also the mentality and the mind that differentiates many CRNAs from MDs. there are smart excellent CRNAs, but lets be honest, theres a difference in avg IQ between MD and CRNAs and that can play a huge factor in how one perceives and receives the training and develop from it.

 

[MoMoGesiologist]

Are you a nurse?

Dam... savage

 

[propofabulous]

Current CA-1. Working my way through big Barash (slowly but surely). I find that there are definitely pearls but also lots of random irrelevant info so far. Only like 300 pages in.

Nice! Pearls but also lots of random irrelevant info sounds pretty similar to the question bank I did. Do you feel that it's been a good use of your time? How does it compare to simply doing questions?

 

[propofabulous]

Reading a textbook will give you a more thorough and organized understanding of topics and build a strong foundation as you move forward that will be fleshed out by question banks and clinical experience. It's the in depth knowledge that makes a physician. Otherwise, what's the difference between us and CRNAs? Just my two cents...

Great point! I am under the impression however that CRNA's do not use question banks like M5 or truelearn but rather use their own resources geared towards their own examinations.

While I do understand how reading a textbook could provide more organizational structure upon which to build a strong foundation, research has also shown that "interleaving" or studying related concepts in parallel (as you end up doing with a question bank) can be even more efficacious for retention. Regardless, I will definitely give reading a go.

 

[propofabulous]

How good of a physician you are is determined by much more than how you do on standardized tests and question banks. Doing nothing but question banks will arm you with tons of useless, esoteric knowledge (e.g.: electrical safety questions anyone?) to crush these exams while leaving huge gaps in your fundamental understanding of basic anesthesiology concepts.

Do not forsake reading. It will be a huge, huge mistake that you will regret later on.

To be fair, Baby Miller and Morgan and Mikhail and Baby Barash all have their own chapters on electrical safety!

I just find it a little hard to swallow that thoroughly doing one question bank (1000 ?'s) and actively learning from the explanations would leave huge gaps in my knowledge that I would not have if I instead spent that time thoroughly reading a textbook. Part of this is because I have scored 95-99% or >99% on my AKT's thus far by focusing on questions, and I do not think those scores would be likely if I actually did have huge gaps in my knowledge. But I have always struggled with reading textbooks and so maybe I'm just making excuses. The general consensus of all the replies has been very pro-reading, so I will definitely try to get through one of these introductory texts.

 

[DM27]

The AKT and ITE are worthless. I routinely scored a raw of 48-50 on the ITEs and you would be astonished at the practical things I didn't know and still don't know that would have frightened me if I was my attending then. The exams do their best to test a random distribution of questions felt to be of varying importance. I would not consider your test scores a good correlate to your skill or even competence, just an overall view of your test taking abilities and some random stabs at your knowledge base. What it does show though is you are likely able to process and learn information and assign relevance quicker than the average person.

I eventually realized during the middle of my residency that the perception of me being intelligent based on exams was totally off the mark and I revamped a lot of how I learned towards a more clinical angle and I am much better off now for it. Very little of that material was tested on.

But hey man, I can tell you Linezolid acts as an MAOI and central core disease can trigger MH.

 

[Urzuz]

To be fair, Baby Miller and Morgan and Mikhail and Baby Barash all have their own chapters on electrical safety!

I just find it a little hard to swallow that thoroughly doing one question bank (1000 ?'s) and actively learning from the explanations would leave huge gaps in my knowledge that I would not have if I instead spent that time thoroughly reading a textbook. Part of this is because I have scored 95-99% or >99% on my AKT's thus far by focusing on questions, and I do not think those scores would be likely if I actually did have huge gaps in my knowledge. But I have always struggled with reading textbooks and so maybe I'm just making excuses. The general consensus of all the replies has been very pro-reading, so I will definitely try to get through one of these introductory texts.

Standardized tests do not test foundational knowledge. They assume you know the foundations of anesthesia. They test trivia-like questions so they can distinguish the 99% percentile from the 90th, and the 90th from the 80th, etc. I’m not saying you shouldn’t do question banks, but I’m saying you should balance your use of question banks with reading.

When preparing the night before your first AAA, liver transplant, CABG, etc, do you see yourself opening up your question bank and reading the explanations, or finding the chapters you read and highlighted previously on those topics?

 

[abolt18]

The AKT and ITE are worthless. I routinely scored a raw of 48-50 on the ITEs and you would be astonished at the practical things I didn't know and still don't know that would have frightened me if I was my attending then. The exams do their best to test a random distribution of questions felt to be of varying importance. I would not consider your test scores a good correlate to your skill or even competence, just an overall view of your test taking abilities and some random stabs at your knowledge base. What it does show though is you are likely able to process and learn information and assign relevance quicker than the average person.

I eventually realized during the middle of my residency that the perception of me being intelligent based on exams was totally off the mark and I revamped a lot of how I learned towards a more clinical angle and I am much better off now for it. Very little of that material was tested on.

But hey man, I can tell you Linezolid acts as an MAOI and central core disease can trigger MH.

I feel like this accurately portrays my feelings on question Banks. Great for preparing for a test. Not as great for actually practicing anesthesia. Tons of important gaps not yet filled in for me. I learn things pertinent or even essential to my patient care nearly every day, things that I've not seen in a qbank.

 

[DM27]

My study method was to simply do an assload of questions, I usually just sat in the OR or wherever I was at work and did every QBank possible as well as all available ACE Exams in the 2 months leading up to the exam. My goal was to never have to study at home, because that is where I live.

 

[propofabulous]

The AKT and ITE are worthless. I routinely scored a raw of 48-50 on the ITEs and you would be astonished at the practical things I didn't know and still don't know that would have frightened me if I was my attending then. The exams do their best to test a random distribution of questions felt to be of varying importance. I would not consider your test scores a good correlate to your skill or even competence, just an overall view of your test taking abilities and some random stabs at your knowledge base. What it does show though is you are likely able to process and learn information and assign relevance quicker than the average person.

I eventually realized during the middle of my residency that the perception of me being intelligent based on exams was totally off the mark and I revamped a lot of how I learned towards a more clinical angle and I am much better off now for it. Very little of that material was tested on.

But hey man, I can tell you Linezolid acts as an MAOI and central core disease can trigger MH.

Awesome, thank you!! This is exactly the insight I was looking for. Do you mind expounding on how you revamped your learning towards a more clinical angle?

 

[DM27]

Mainly just review articles, targetted googling and youtubeing. A lot of asking the opinions of attendings I trusted or wanted to emulate.

Example would be:

Doing some thoracotomy for a lobectomy.

YouTube a lobectomy and just click through it to get the gist, can consult a book like Jaffe. Read the typical test-prep of troubleshooting a desat during one lung ventilation and the steps of typical management. Ask attending how they found the technique that worked for them for an epidural, try it if I liked the sound of it or had never done it before. See how the attending likes doing the case and try it out. Read a review article on epidural placement and troubleshooting (applies more to OB but crossover is nice). Ask attending what mixture of local/opiate mixture they've settled into giving for the case and if they do it during the case or purely post-op. See how this goes and reflect on if I would integrate it into my practice. Place a DLT, see how the attending likes to place is (drive it over a fiberoptic once past the cords or blindly advance until it "seats" and then check it), see if I like the method or not. Read the package insert that comes with the DLT on size, ports, material etc. Surgeon wants fluid restricted bc of concerns for pulmonary edema, peruse the pneumonectomy paper most of this was inappropriately extrapolated from. See what the attending likes to do for emergence and try this out. Reflect on how the case went as a whole and decide what I would toss out and what I would continue.

This is just a random example. The downside is lazier attendings may assume you don't know what the hell you are doing because you keep asking them things. My mentality as a resident was I didn't/shouldn't have "my way" of doing things, I wanted to experience the method of everyone I worked with and basically steal all the good tricks to create a better way of doing things (if possible). This results in a lot more of a practical and useful day to day education that may add a nice flourish or context/relevance to the stuff you've been reading. You also quickly realize how much is BS.

 

[2Fast2Des]

I tried to read books but I would quickly fall asleep or get very distracted. I did q banks and read relevant articles and find information from different sources. It allowed me to pick out what I felt was most valuable. Also doing q banks helped guide me as to what I should be picking up from reading, as memorizing every word just wasn't working out since I would forget it if it didn't have a clinical aspect to it for me. I loved up to date also, has great information and explanations with sub topics you can click and keep reading on and on about

 

[deleted162650]

Mainly just review articles, targetted googling and youtubeing. A lot of asking the opinions of attendings I trusted or wanted to emulate.

Example would be:

Doing some thoracotomy for a lobectomy.

YouTube a lobectomy and just click through it to get the gist, can consult a book like Jaffe. Read the typical test-prep of troubleshooting a desat during one lung ventilation and the steps of typical management. Ask attending how they found the technique that worked for them for an epidural, try it if I liked the sound of it or had never done it before. See how the attending likes doing the case and try it out. Read a review article on epidural placement and troubleshooting (applies more to OB but crossover is nice). Ask attending what mixture of local/opiate mixture they've settled into giving for the case and if they do it during the case or purely post-op. See how this goes and reflect on if I would integrate it into my practice. Place a DLT, see how the attending likes to place is (drive it over a fiberoptic once past the cords or blindly advance until it "seats" and then check it), see if I like the method or not. Read the package insert that comes with the DLT on size, ports, material etc. Surgeon wants fluid restricted bc of concerns for pulmonary edema, peruse the pneumonectomy paper most of this was inappropriately extrapolated from. See what the attending likes to do for emergence and try this out. Reflect on how the case went as a whole and decide what I would toss out and what I would continue.

This is just a random example. The downside is lazier attendings may assume you don't know what the hell you are doing because you keep asking them things. My mentality as a resident was I didn't/shouldn't have "my way" of doing things, I wanted to experience the method of everyone I worked with and basically steal all the good tricks to create a better way of doing things (if possible). This results in a lot more of a practical and useful day to day education that may add a nice flourish or context/relevance to the stuff you've been reading. You also quickly realize how much is BS.

So basically you just decided to actually be an anesthesia resident??

 

[DM27]

Yeah exactly, there is unfortunately no secret sauce or shortcut. Doing QBanks was an easy way to do great on exams and basically be left alone, but it wasn't useful for actually doing cases well.

 

[anbuitachi]

The AKT and ITE are worthless. I routinely scored a raw of 48-50 on the ITEs and you would be astonished at the practical things I didn't know and still don't know that would have frightened me if I was my attending then. The exams do their best to test a random distribution of questions felt to be of varying importance. I would not consider your test scores a good correlate to your skill or even competence, just an overall view of your test taking abilities and some random stabs at your knowledge base. What it does show though is you are likely able to process and learn information and assign relevance quicker than the average person.

I eventually realized during the middle of my residency that the perception of me being intelligent based on exams was totally off the mark and I revamped a lot of how I learned towards a more clinical angle and I am much better off now for it. Very little of that material was tested on.

But hey man, I can tell you Linezolid acts as an MAOI and central core disease can trigger MH.

To be fair that's actually relevant. Kind of reminds me of how many junior residents don't know methylene blue is a maoi even though it's not uncommon used in certain cases. If something goes wrong cause patient is on another MAOI, I'd imagine most of the blame would go on you

 

[rakotomazoto]

Made it through residency, first year attending now. Everything I needed to know, I learned on SDN. Shut those textbooks, sneak a thick and juicy sandwich into the OR, and get surfing. So many threads, so little time!

But seriously, you need to read selected textbook chapters (cover to cover is a less-effective study plan) that are relevant to your rotations, do qbank questions to prep for exams, and grill your attendings. They SHOULD be teaching you something other than how to tape the tube...

Although I joke about SDN, some of these threads did prompt some investigation on my part. There are some decent websites out there on specific topics. Everyone learns best in different ways, but undoubtedly, you will learn the most if you create a unique study plan that you will actually follow. There is no way that I would ever sit down and make flashcards or do some of the other things that other residents found quite useful.

 

[deleted875186]

Mainly just review articles, targetted googling and youtubeing. A lot of asking the opinions of attendings I trusted or wanted to emulate.

Example would be:

Doing some thoracotomy for a lobectomy.

YouTube a lobectomy and just click through it to get the gist, can consult a book like Jaffe. Read the typical test-prep of troubleshooting a desat during one lung ventilation and the steps of typical management. Ask attending how they found the technique that worked for them for an epidural, try it if I liked the sound of it or had never done it before. See how the attending likes doing the case and try it out. Read a review article on epidural placement and troubleshooting (applies more to OB but crossover is nice). Ask attending what mixture of local/opiate mixture they've settled into giving for the case and if they do it during the case or purely post-op. See how this goes and reflect on if I would integrate it into my practice. Place a DLT, see how the attending likes to place is (drive it over a fiberoptic once past the cords or blindly advance until it "seats" and then check it), see if I like the method or not. Read the package insert that comes with the DLT on size, ports, material etc. Surgeon wants fluid restricted bc of concerns for pulmonary edema, peruse the pneumonectomy paper most of this was inappropriately extrapolated from. See what the attending likes to do for emergence and try this out. Reflect on how the case went as a whole and decide what I would toss out and what I would continue.

This is just a random example. The downside is lazier attendings may assume you don't know what the hell you are doing because you keep asking them things. My mentality as a resident was I didn't/shouldn't have "my way" of doing things, I wanted to experience the method of everyone I worked with and basically steal all the good tricks to create a better way of doing things (if possible). This results in a lot more of a practical and useful day to day education that may add a nice flourish or context/relevance to the stuff you've been reading. You also quickly realize how much is BS.

My own opinion and my experience as a resident is that I can cover almost ever said above and much more by simply opening the thoracic surgery chapter in big Miller and reading it. It’s about 40 pages or something I think, and you’ll go in depth about preop evaluation, lung isolation, prediction and treating desaturation in one lung, pulmonary mechanics, more than you’ll ever want to know about HPV, etc.

I do agree that you have to supplement this still clinically. For instance, you’ll need to supplement your knowledge bronching and airway anatomy, and practical things like airway technique or plan for emergence only come with clinical experience. However, I think as a resident you should focus on these after you know all the basics from reading the chapter.

 

[pgg]

I think the large reference textbooks are best used as ... references.

For me the best way to study for boards was to do questions. Then, for each question and each answer, I went to Big Miller or Chestnut or Cote until I found the paragraph or section that specifically affirmed or refuted the answer. By the time I was done I'd probably read most of those books.

Passively reading those thick texts without a specific need or objective was wasted time for me.

Books I could just sit down and randomly read were case-based ones like Yao. Reed and Atley were Yao-light kind of books, very short chapters of just a couple pages each.


No one cares about the silly electrical safety questions until the LIM goes off and everyone else in the room is standing around wondering what that buzzing sound is ...

 

[DM27]

Yao is a very good book and a valuable source that I think is underutilized. My only real complaint about Yao is that if you don't have some background prior to reading it, the book can feel like a movie you're walking into halfway through.

 

[anbuitachi]

I think the large reference textbooks are best used as ... references.

For me the best way to study for boards was to do questions. Then, for each question and each answer, I went to Big Miller or Chestnut or Cote until I found the paragraph or section that specifically affirmed or refuted the answer. By the time I was done I'd probably read most of those books.

Passively reading those thick texts without a specific need or objective was wasted time for me.

Books I could just sit down and randomly read were case-based ones like Yao. Reed and Atley were Yao-light kind of books, very short chapters of just a couple pages each.


No one cares about the silly electrical safety questions until the LIM goes off and everyone else in the room is standing around wondering what that buzzing sound is ...

View attachment 252374

i dont even know how to troubleshoot that stuff despite doing several questions on LIM

 

[DM27]

All I know is unplug it in the reverse order it was plugged in and see if it stops, or close the OR and leave for the day.

 

[Shimmy8]

Read Morgan and Mikhail early to get base.

Questions as much as I could with Open Anesthesia, True Learn, phone apps, etc.

Read big texts and review articles for reference as prep for cases as much as I could. Stoetling, Yao, Miller, whatever.

True Learn for tests/ITE/boards.

 

[zizzer]

All I know is unplug it in the reverse order it was plugged in and see if it stops, or close the OR and leave for the day.

I think it's pretty important to understand the concepts of current density and microshock as well.

 

[abolt18]

I think it's pretty important to understand the concepts of current density and microshock as well.

You mean like when there are small wires traveling outside the body that are tied directly into the ventricle? Seems made up...

 

[deleted171991]

i think i read most if not all of barash the as a CA1.

And we are looking forward to you sharing all the interesting stuff you have learned from there. It's been more than 10 years since I first got that book, and I still haven't read more than 10% of it. It would put me to sleep pretty fast.

I think M&M is a fantastic textbook that finds the middle way between handbooks and reference books. So is Yao (after M&M and Jaffe, as a CA-2/3). In my daily work, my go-to reference is Essence of Anesthesia Practice.

I rarely find myself reading one of the big anesthesia textbooks. To be honest, I have to force myself to even read my favorite critical care one, unless I need to look something specific up. And I do enjoy reading critical care.

The problem is that most medical textbook authors write for resume padding reasons, not out of pleasure or talent. Also, most of these big textbooks are just edited collections of chapters of various quality, from many different authors. Hence few of them come close to the pleasure of reading a single-author book such as The ICU Book or Evidence-Based Critical Care. A good medical book is opinionated, and a good author has a voice, that you can almost hear in your head. My residency edition of M&M had an opinion piece about how muscle relaxants are overdosed; I still remember and apply it.

 

[spacegun]

And we are looking forward to you sharing all the interesting stuff you have learned from there. It's been more than 10 years since I first got that book, and I still haven't read more than 10% of it. It would put me to sleep pretty fast.

I think M&M is a fantastic textbook that finds the middle way between handbooks and reference books. So is Yao (after M&M and Jaffe, as a CA-2/3). In my daily work, my go-to reference is Essence of Anesthesia Practice.

I rarely find myself reading one of the big anesthesia textbooks. To be honest, I have to force myself to even read my favorite critical care one, unless I need to look something specific up. And I do enjoy reading critical care.

The problem is that most medical textbook authors write for resume padding reasons, not out of pleasure or talent. Also, most of these big textbooks are just edited collections of chapters of various quality, from many different authors. Hence few of them come close to the pleasure of reading a single-author book such as The ICU Book or Evidence-Based Critical Care. A good medical book is opinionated, and a good author has a voice, that you can almost hear in your head. My residency edition of M&M had an opinion piece about how muscle relaxants are overdosed; I still remember and apply it.

As a med student my translation is:

Don't try to read through every single word of Robbins Pathological Basis of Disease (big Robbins), but Pathoma or Goljan are much more high yield. Don't try to read through all of Harrison's, but OnlineMedEd is great. Sattar, Pappy, and Dustyn Williams are each so memorable they're in my head!

 

[blockstar]

And we are looking forward to you sharing all the interesting stuff you have learned from there. It's been more than 10 years since I first got that book, and I still haven't read more than 10% of it. It would put me to sleep pretty fast.

I think M&M is a fantastic textbook that finds the middle way between handbooks and reference books. So is Yao (after M&M and Jaffe, as a CA-2/3). In my daily work, my go-to reference is Essence of Anesthesia Practice.

I rarely find myself reading one of the big anesthesia textbooks. To be honest, I have to force myself to even read my favorite critical care one, unless I need to look something specific up. And I do enjoy reading critical care.

The problem is that most medical textbook authors write for resume padding reasons, not out of pleasure or talent. Also, most of these big textbooks are just edited collections of chapters of various quality, from many different authors. Hence few of them come close to the pleasure of reading a single-author book such as The ICU Book or Evidence-Based Critical Care. A good medical book is opinionated, and a good author has a voice, that you can almost hear in your head. My residency edition of M&M had an opinion piece about how muscle relaxants are overdosed; I still remember and apply it.

The real key here is a TEXTBOOK you actually READ versus a REFERENCE book where you read about a particular case. No one is reading Jaffe cover to cover (or Big Miller or Barash for that matter) and actually absorbing information. For example, if youre doing an Abdominal aortic aneurysm read Jaffe then read the AAA section of Barash. Dont read them cover to cover its a waste of time...unless youre much smarter than me which you probably are!

 

[Mman]

The real key here is a TEXTBOOK you actually READ versus a REFERENCE book where you read about a particular case. No one is reading Jaffe cover to cover (or Big Miller or Barash for that matter) and actually absorbing information. For example, if youre doing an Abdominal aortic aneurysm read Jaffe then read the AAA section of Barash. Dont read them cover to cover its a waste of time...unless youre much smarter than me which you probably are!

I found it most useful to read chapters in Miller related to whatever rotation I was on or if there was a particularly interesting/challenging case I had the next day. I probably read every paragraph in the book several times, but it was never straight cover to cover, only skipping around through the related and relevant parts to what I was actually doing in the OR.

 

[TechnoDonut]

And we are looking forward to you sharing all the interesting stuff you have learned from there. It's been more than 10 years since I first got that book, and I still haven't read more than 10% of it. It would put me to sleep pretty fast.

I think M&M is a fantastic textbook that finds the middle way between handbooks and reference books. So is Yao (after M&M and Jaffe, as a CA-2/3). In my daily work, my go-to reference is Essence of Anesthesia Practice.

I rarely find myself reading one of the big anesthesia textbooks. To be honest, I have to force myself to even read my favorite critical care one, unless I need to look something specific up. And I do enjoy reading critical care.

The problem is that most medical textbook authors write for resume padding reasons, not out of pleasure or talent. Also, most of these big textbooks are just edited collections of chapters of various quality, from many different authors. Hence few of them come close to the pleasure of reading a single-author book such as The ICU Book or Evidence-Based Critical Care. A good medical book is opinionated, and a good author has a voice, that you can almost hear in your head. My residency edition of M&M had an opinion piece about how muscle relaxants are overdosed; I still remember and apply it.

Marino is a fantastic book with a ton of personality that I think really helps with retention. I start a CCM fellowship in August. I'd not heard of Evidence Based Critical Care before today. Is it worth the buy? Any other suggestions for reading material? A buddy of mine is a medicine CCM fellow now, and he suggested the MGH Review of Critical Care and the Washington Manual of Critical Care.

I found it most useful to read chapters in Miller related to whatever rotation I was on or if there was a particularly interesting/challenging case I had the next day. I probably read every paragraph in the book several times, but it was never straight cover to cover, only skipping around through the related and relevant parts to what I was actually doing in the OR.

Agreed. My residency buys all the residents Big Miller at the beginning of CA1 year. I estimate that I've read about 20% of it over the past 2.5 years similarly to how you describe. For example, I would read the chapters on obstetrics, neuraxial, and local anesthetics during an OB rotation.