Studying at the beginning of EM residency

[Greymatter468]

Start of residency seems quite hard with all differentials and all together - medicine trauma surgery critical patients. It is obvious that we learn by doing but how much on average do you read home after work or on off work days (1, 2, 4 hours?) and how do you split all subjects when you study - acute medicine, acute trauma and surgery etc..

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[gamerEMdoc]

2 hrs a week IMO for base reading, then looking things up based on questions that come up on shift (which shouldn't take a ton of your time). If you read 25 pages a week ( which should take about 2 hrs a week), you can cover the text of Tintinalli in 2 years. The key is being disciplined. If you try to do too much, you'll burn out and just stop reading. Slow and steady...

 

[bearstanley]

i did not have the discipline to tackle primary texts my intern year. my studying revolved around rosh review questions, hippo EM, EMRAP, and other FOAMED resources. i honestly did not study very much as an intern. i used most of my free time to go to the gym and take care of myself in other ways in order to stay fresh and not burnt out.

as a second year, i find myself hungry to read resources that previously seemed too dense for me. i am opening up tints, roberts and hedges, and other primary texts on my own because i want to dive deeper. studying is much more engaging for me now and i actually genuinely enjoy it most of the time.

my advice for studying during residency is like the advice about picking a workout: it's critical to pick something you'll actually do, because doing something is 90% of the battle.

 

[swamprat]

I read tintinellis throughout my residency. Not like cover to cover but essentially if I saw a case I’d read a small section on it later on. Once I got some of intern year under my belt I started to listen to EMRAP. I felt that it was a little too advanced starting out especially because they spoke about a lot of niche things and alternative ways of doing things and I didn’t know the traditional way. The continuing cord content they have now would have been great as an intern.

 

[deuist]

We had a reading schedule when I was in residency where we had to get through Tintinalli twice in 3 years. As for what to do before residency, read an EKG book such as The Art of Interpretation.

 

[Tenk]

Just do questions. They are more entertaining than reading, have higher yield for boards and you can just do a few at a time. If you have to read something: “just the facts” and like 1/3 of the baby Miller anesthesia book since you don’t need to learn about gasses and surgery much, just sedation, drugs and airway.

 

[PianoMedic]

Start of residency seems quite hard with all differentials and all together - medicine trauma surgery critical patients. It is obvious that we learn by doing but how much on average do you read home after work or on off work days (1, 2, 4 hours?) and how do you split all subjects when you study - acute medicine, acute trauma and surgery etc..

I'm a current first year, not sure where you're at in the process. I can only tell you my experience, but it will not be the right answer for everyone.

I used all of fourth year med school to build an EM base. My school only gave us four weeks off in all of fourth year and no dedicated time that could be used for interviews, so my vacation was used for interviews. I studied hard on my aways then kept reading about rotation relevant EM topics on each other rotation I was on (ICU, nephro, cards, GI, ID, inpatient peds). I also had fantastic attendings that knew I was EM bound and would try to tailor our discussions during the day to relevant topics. During residency itself, studying has been mostly on days off. My program uses Emergency Medicine Foundations so I try to get through as much of the readings for each week as possible, but usually fail to finish more than a chapter or two. We then get Rosh review questions after each foundations session which is where the majority of my studying actually happens.

Would I recommend doing what I did in fourth year? Probably not. It's a surefire recipe for burnout. Once I got into the thick of residency, I quickly realized there is no possible way I can learn everything in EM in three years. Even in four it'd be nearly impossible. Maybe if you have an eidetic memory. Part of EM is practicing in uncertainty, in my opinion. The diagnosis is often unknown. The sickest patients don't give much time to think, just to act to support the ABCs then try to slow think after the fact.

I heard over and over from attendings on aways to pick out a patient each shift and read up on some aspect of their disease processes. I thought it was silly at the time and wouldn't give me a broad enough base. Now that I've done it for the past month or so, I see how much better things stick. Approach each patient as if they could be a case conference presentation or case report and try to take away a key learning point from them. Add in some Rosh review questions and you should get a pretty solid base of EM knowledge in residency. Lifelong learning seems to be key in EM, so a current base of knowledge is about all we can ask for. That's my plan anyway, but I'm really just starting out in this and could be very far off.

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