4th Year - Clinical Essentials

[galixia17]

Hi all,

With my clinical year fast approaching, and family members requesting christmas gift ideas, I was wondering if there were any essentials recommended for your fourth year? I already have a Littmann Cardiology, but I am curious to see what else may be recommended.

Side note - anyone have comfortable but professional shoe recommendations?

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[allieh8607]

I'm sure I can think of more things when I have more time but off the top of my head I really liked having the book "Small Animal Medical Differential Diagnosis": Amazon product (just to give you an idea). It was small and fit in my pocket- was good for refreshing my memory quickly when I'd get bloodwork back or something and needed to jog my memory before talking to a house officer. Also very handy for writing SOAPs.

I'm following this for shoe recommendations because I've just been wearing plain flats since clinics last year and I feel like I can be nicer to my feet!

 

[DVMDream]

I'm sure I can think of more things when I have more time but off the top of my head I really liked having the book "Small Animal Medical Differential Diagnosis": Amazon product (just to give you an idea). It was small and fit in my pocket- was good for refreshing my memory quickly when I'd get bloodwork back or something and needed to jog my memory before talking to a house officer. Also very handy for writing SOAPs.

I'm following this for shoe recommendations because I've just been wearing plain flats since clinics last year and I feel like I can be nicer to my feet!

I still use that book.

 

[JaynaAli]

My parents got me an iPad the Christmas before senior year. It was helpful to have something besides my phone to do lit searches on and was useful to take notes, but accessing the medical records system (something they told us we could do with an ipad) was difficult. Still, it was a helpful gift.

I don't have recommendations for comfortable shoes, but I do think that is a good gift. Dress clothes might be helpful too if you're spending time on small animal clinics, especially if you have a regular student's wardrobe of jeans/sweats and tshirts.

 

[Dr. NWS]

A good pocket knife for when you're on large animal rotations.
A sturdy pair of bandage scissors.

 

[SocialStigma]

Bandage scissors, hammer, penlight (if you don't already have these). Dress clothes is also a good idea.

I love my Danskos but they are not good for running/walking around the clinic, only for standing for long periods of time. I didn't get these until I was a surgery resident but they were an awesome investment for me. For appointment days, I wear Lifestride black flats that have a memory foam insole. I'm on my 2nd pair and I wear them 3-4x weekly.

 

[LetItSnow]

Alcohol of your choice.

And regular old sneakers.

 

[pinkpuppy9]

Hi all,

With my clinical year fast approaching, and family members requesting christmas gift ideas, I was wondering if there were any essentials recommended for your fourth year? I already have a Littmann Cardiology, but I am curious to see what else may be recommended.

Side note - anyone have comfortable but professional shoe recommendations?

I've been told that the Small Animal Veterinary Nerdbook is a good resource. I'm not sure how similar it is to the ddx book listed above.

Maybe a few white coats, more scrubs, etc. to lessen the chance of waking up and realizing you have no clean clothes (or is that just me?). A nice/durable watch might be nice too.

 

[DVMDream]

I've been told that the Small Animal Veterinary Nerdbook is a good resource. I'm not sure how similar it is to the ddx book listed above.

.

I have both. They are quite different. The ddx book is literally a "book of lists" if you have say hyperkalemia in a patient... you can go to the potassium part in the book of lists and it will give you a decent list for most everything (I am sure some IM specialist would say it is missing things) that can cause hyperkalemia.

The nerdbook actually has guidelines for diagnosing things. Fluid therapy guidelines. There is a great calorie chart in there that I have copied and posted to the cork board at work so I can quickly reference it for patients that need to lose weight (basically every patient that walks through the door).

So, really, can't go wrong with getting both of those books.

 

[LetItSnow]

I've been told that the Small Animal Veterinary Nerdbook is a good resource. I'm not sure how similar it is to the ddx book listed above.

Maybe a few white coats, more scrubs, etc. to lessen the chance of waking up and realizing you have no clean clothes (or is that just me?). A nice/durable watch might be nice too.

For what it's worth, Nerdbook is one of those "some people love it, some don't." I had two (Sophia Yin's and ... um ... crud ... whatever the other common one is. Pasquini? The anatomy person?).

I used neither. Not once. All 4th year. I still have Yin's, and I gave away Pasquini randomly on a surgery teaching trip. I'll give away Yin's on the next trip. And I love reference books, so I was sure I would use them.

I wish I knew what to tell people to help them predict if the book would be useful to them or not so they knew if the $$ would be worth it. I know a lot of my classmates loved them. I really thought I would use it. And then just found it to be 120% unnecessary.

A durable watch is a pretty good suggestion. Nothing complex. Something that will withstand fluids and has a second-hand sweep.

More clothes are always nice ... but on the flip side, I still have my white coats and I don't use them (and wouldn't even in general practice). So they end up being useless after the year.

All the things I can think of that I wanted most 4th year were not related to school. A gift certificate to a nice restaurant because money was tight and I wanted to treat my wife. That sort of stuff. School was pretty much just a matter of showing up and remembering to wear decent clothes.

 

[LetItSnow]

Bandage scissors, hammer, penlight (if you don't already have these). Dress clothes is also a good idea.

I see people talk about bandage scissors, reflex hammers, penlights, and all that stuff ...

... I never carried, nor needed, any of those. There were always some laying around when needed.

I must have been that student that just bummed off of everyone else. ;-) Only thing I carry nowadays in practice is 3 pens, a super heavy duty metal penlight, my cheater glasses, and my little notebook with info I tend to forget (my own super-mini-nerdbook, I guess).

(Yes, I start every shift with 3 pens. Because as the shift goes on I lose them.)

 

[JaynaAli]

Oh, I get a nice watch from my mom every couple of years, I forgot that. Just make sure it can count seconds.

During my internship I always grabbed one pen and one highlighter from the bins. Then I’d lose them and try to borrow from the techs because everyone also grabbed one and none were left in the cups. By December no one would lend me ‘their’ highlighter because they said I kept them every time. I denied that one day, went to my desk, and found like seven highlighters I’d stolen. Even now, I walk into the lab to ask a Tech something and tend to unconsciously pick up whatever pen is around. I am getting better about leaving them there but they’ll chase me down now if they notice a pen is gone since we don’t have many extras.


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[Coquette22]

Snacks - something reasonably healthy and non-perishable to keep stashed at school.
Cheap pens by the bucket load - you will lose them, it's fine, that's why you get cheap ones.
Some form of coffee - instant, k-cups, whatever is easy for you.
Gift cards so you can splurge and do something fun/eat a bunch of good food/buy something cool once it's all over with.
And as taboo as it is, money. There's a crap ton of expenses that go with fourth year.
A few good textbooks - avoid Cote/Fossum/Ettinger/Blackwell, they're all good books, but you'll have easy access to them in fourth year and wherever you go afterward, pick something more tailored to what you think you might want to do. Really into ultrasound? Love nutrition? Think dentistry is awesome? Into exotics? Find a highly rated titled and go for that.

I had a penlight, I rarely used it. I had a thermometer, I rarely used it (like LIS said, there's usually one around).

 

[ukrainiandude]

What watch with second hand do you recommend?
Timex easy reader (laud they say) or Casio easy read or something else

 

[pinkpuppy9]

I have both. They are quite different. The ddx book is literally a "book of lists" if you have say hyperkalemia in a patient... you can go to the potassium part in the book of lists and it will give you a decent list for most everything (I am sure some IM specialist would say it is missing things) that can cause hyperkalemia.

The nerdbook actually has guidelines for diagnosing things. Fluid therapy guidelines. There is a great calorie chart in there that I have copied and posted to the cork board at work so I can quickly reference it for patients that need to lose weight (basically every patient that walks through the door).

So, really, can't go wrong with getting both of those books.

This actually makes me more interested in picking up a copy of the ddx book. I have the nerdbook which I like.

Idk if other people find them useful, but there are those pull and know things...they're so expensive though.

 

[pinkpuppy9]

Also, now would probably be a good time to get a new stethoscope if you're unhappy with yours for whatever reason. I wish I got mine longer than the standard length for example. A cute tag from Etsy or something for said stethoscope so if it goes missing, people know whose it is.

A donation towards the NAVLE/NAVLE prep? I was thinking about that for myself. Not a fun present.

 

[LetItSnow]

Also, now would probably be a good time to get a new stethoscope if you're unhappy with yours for whatever reason. I wish I got mine longer than the standard length for example. A cute tag from Etsy or something for said stethoscope so if it goes missing, people know whose it is.

A donation towards the NAVLE/NAVLE prep? I was thinking about that for myself. Not a fun present.

For an out of town student ... a plane ticket home for whenever vacation rotation is?

 

[dvmhopeful2018]

As far as shoes go, I bought a pair of new Merrell Moab Mid GoreTex hiking boots off eBay for my equine rotations, and wore them most days for small animal as well. I’ll probably buy another pair soon to be able to rotate in. I absolutely love them-great arch support, don’t stain, definitely worth the money!

 

[meningealworm]

For large animal rotations: a waterproof, easy to read watch with a second hand. a good pocketknife. bandage scissors. comfortable boots. warm clothing that you can wear on field rotations. snacks.
For small animal rotations: scrubs. snacks. notebooks that will fit in your pocket. a backup charger for your ipad/computer (or maybe I'm the only one who forgets theirs at home). comfortable shoes.

 

[galixia17]

Thanks for all the wonderful suggestions

 

[DVMDream]

What watch with second hand do you recommend?
Timex easy reader (laud they say) or Casio easy read or something else

A cheap watch from Walmart or target.

 

[DVMDream]

I see people talk about bandage scissors, reflex hammers, penlights, and all that stuff ...

... I never carried, nor needed, any of those. There were always some laying around when needed.

I must have been that student that just bummed off of everyone else. ;-) Only thing I carry nowadays in practice is 3 pens, a super heavy duty metal penlight, my cheater glasses, and my little notebook with info I tend to forget (my own super-mini-nerdbook, I guess).

(Yes, I start every shift with 3 pens. Because as the shift goes on I lose them.)

Yeah I had my pair on bandage scissors stolen. Never got a pen light, that's what a cell phone flashlight is for, or even the focused light on the ophthalmascope. And I did have a reflex hammer, I never used it but the neurologist would borrow it from me. I left it behind in neurology land.

 

[LetItSnow]

Yeah I had my pair on bandage scissors stolen. Never got a pen light, that's what a cell phone flashlight is for, or even the focused light on the ophthalmascope. And I did have a reflex hammer, I never used it but the neurologist would borrow it from me. I left it behind in neurology land.

My cell phone is my reflex hammer. Learned that from our neurologist.

 

[Trilt]

My cell phone is my reflex hammer. Learned that from our neurologist.

mine is too. learned that from you on another thread like 6 months ago.

 

[meningealworm]

I think a lot of those things are more useful when you're on large animal rotations. Like when we're working on livestock and biosecurity is an issue, I sure don't want to be grabbing my phone all the time. And when you're working on an animal in the field, or even in a stall, it's much easier to have things like bandage/suture scissors available than have to have someone run to the truck to find some. When you're in a small animal treatment room it's a lot easier to have things accessible.

 

[Lab Vet]

This text is book is also nice: Amazon product
I have it and the Book of Lists mentioned above (Thompson's book is coming out with a third edition soon), but think that the Gough/Murphy text edges it out just a bit.
Five minute consult is also nice.

 

[ukrainiandude]

A cheap watch from Walmart or target.

I ordered from Amazon prestige medical deluxe
Looks very nice on the picture, dark back, white numbers and red seconds hand.

 

[ukrainiandude]

This text is book is also nice: Amazon product
I have it and the Book of Lists mentioned above (Thompson's book is coming out with a third edition soon), but think that the Gough/Murphy text edges it out just a bit.
Five minute consult is also nice.

I have them all three.
Did not like Thomson's

 

[cbarne01]

This text is book is also nice: Amazon product
I have it and the Book of Lists mentioned above (Thompson's book is coming out with a third edition soon), but think that the Gough/Murphy text edges it out just a bit.
Five minute consult is also nice.

I can't see this, what's your book?

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[DVMDream]

I ordered from Amazon prestige medical deluxe
Looks very nice on the picture, dark back, white numbers and red seconds hand.

Expensive on a student budget. Hence my cheap watch recommendation. But, hey, if you have the money, go for it, just not necessary to spend more than $10 on a watch.

 

[ukrainiandude]

Expensive on a student budget. Hence my cheap watch recommendation. But, hey, if you have the money, go for it, just not necessary to spend more than $10 on a watch.

Not really that expensive, $20 on amazon
I couldn't find any watch with distinct seconds hand of my liking in Walmart.

 

[hygebeorht]

- A cheap watch with a second sweep that is easily visible (I had a $10 Target special that looked like a fancy expensive watch - did great all year!)
- The book of lists
- Uni-ball Jetstream pens - LABEL WITH YOUR NAME! - in extra fine point. Perfect for patient charting and anesthesia charting, but everyone will steal them off you. I got turned on to them by our anesthesia service.
- Croc flats are comfortable and waterproof. In the winter, they keep your feet insulated from the cold ground. I like the Katee (Kadee? Katy?) ones, but you can get the fancier versions too - just be warned, if there aren't big enough vents, your feet sweat.
- Small pocket-sized book for jotting things down. I like them gridded.
- A nurse pocket organizer to keep the pocket vomit under control (you can find them on amazon)
- If you wear white coats, I bought some that had tons of pockets, inside pockets too. Avoid 100% cotton. It wrinkles like hell and you always look like a snotty tissue.
- I like having my own bandage scissors. They can double as a reflex hammer (but I usually just use my stethoscope for that). You can use mod podge and glitter to spiff up the handles and slow down thieves.
- I also liked having my own thermometer - I almost never needed it, but it sucks to wait for a thermometer when you're in the middle of treatments.
- Having 7 pairs of scrubs helped my laundry situation a lot.
- Veterinary Board Game was my favorite way to study for NAVLE.

Also helps having things that streamline your morning routine. 2-in-1 shampoo/conditioner, a chubby stick for lips/blush (if makeup is your thing), 2-cup Gladwares so you can cook a big pot once a week and aliquot it out.

 

[VetMedSurvivalGuide]

From a textbook perspective, you should check which ones are available in the hospital. Every teaching hospital has (should have) books available for students in each service's area/rounds room. From year 1-3, you probably got books that are clinically relevant, such as Ettinger's textbook of veterinary internal medicine and others which will help when it's time to do paperwork/SOAPs at home.

A book of differential diagnoses is very helpful. Both books mentioned above are great, and it is usually a personal choice between them. Small Animal Medical Differential Diagnosis: A Book of Lists is smaller and fits in your labcoat's pocket. Check both of them out and decide. As mentioned above, there's a new edition coming out soon.
I'd also recommend a clin path book - you'll be looking at a lot of results and that's another helpful resource.

I have a blog post on useful textbooks for vet school (and afterwards) that you can check here: Which Textbooks should you buy? - VetMed Survival Guide

Finally, label everything with your name!!!! Especially your stethoscope!

 

[ukrainiandude]

A cheap watch with a second sweep that is easily visible (I had a $10 Target special that looked like a fancy expensive watch - did great all year!)

Could you please refer me to that watch ? because all watches with actual sweeping second hand I could find cost couple hundred bucks.
Thanks

 

[KCgophervet]

Putting in my 2 cents, a digital display watch works just as well so long as it displays time down to the seconds. Got mine for $12 at Target, waterproof, has lasted for all of 4th year and the first 6 months of my residency.

 

[ukrainiandude]

Putting in my 2 cents, a digital display watch works just as well so long as it displays time down to the seconds. Got mine for $12 at Target, waterproof, has lasted for all of 4th year and the first 6 months of my residency.

We're required to have wristwatch with second hand.

 

[Trilt]

I actually asked for a Pebble the christmas before clinics and loved having a smartwatch. Not cheap but they're honestly not that expensive for the entry level ones and it was really an efficient little device. Loved having text messages and emails at my wrist instead of fishing through the white coat constantly.

 

[pinkpuppy9]

We're required to have wristwatch with second hand.

...what's the difference? Guess I don't understand why someone would care whether your watch was digital or analog.

 

[hygebeorht]

We're required to have wristwatch with second hand.

So "sweep" was probably a strong word...it had a second hand that ticked. But I got a lot of compliments on it!

...what's the difference? Guess I don't understand why someone would care whether your watch was digital or analog.

For me, whatever I read overrides whatever is in my brain, so counting breaths or heartbeats becomes impossible when I'm looking at digital numbers flashing by. Much easier watching a second hand.

 

[DVMDream]

For me, whatever I read overrides whatever is in my brain, so counting breaths or heartbeats becomes impossible when I'm looking at digital numbers flashing by. Much easier watching a second hand.

I mean, that's personal preference. Why the heck would anyone else care if you have a digital watch or one with a second hand? As long as it counts seconds, who cares?

 

[ukrainiandude]

I mean, that's personal preference. Why the heck would anyone else care if you have a digital watch or one with a second hand? As long as it counts seconds, who cares?

Analog watch with second hand considered gold standard for taking vitals in nursing.

 

[DVMDream]

Analog watch with second hand considered gold standard for taking vitals in nursing.

Point to where there's a "gold standard" for the watch you wear. I really doubt such a thing exists. The only thing that matters is that you have one that can count seconds.

 

[LetItSnow]

Analog watch with second hand considered gold standard for taking vitals in nursing.

Really.

That's the first I've ever heard of a "gold standard" for taking a pulse. I call B.S. Do you have a reference for that "gold standard"?

Am I really the only person who listens to the heart for a while, then turns and stares at the wall clock and mentally counts off the approximate rate? Like, all I care about is whether the HR is 60, 100, 140, 180, or higher/lower than those. I couldn't give two toots whether it's precisely 144 or 140. That's just dumb.

 

[CalliopeDVM]

I wear a Timex kids watch:

It has an elastic adjustable band, so it always fits (it seems I'm always in between buckle holes), it's water resistant, and it's easily washable when something gets spilled on it. It lasts forever unless you lose it, and it's inexpensive.

FWIW, I also can't count while watching a digital display of numbers.

 

[CalliopeDVM]

Am I really the only person who listens to the heart for a while, then turns and stares at the wall clock and mentally counts off the approximate rate? Like, all I care about is whether the HR is 60, 100, 140, 180, or higher/lower than those. I couldn't give two toots whether it's precisely 144 or 140. That's just dumb.

Close, though I do actually count while I'm listening, but I round to the nearest 4 or 6 beats (i.e. I count in 10 or 15 second interval).

 

[ukrainiandude]

Really.

That's the first I've ever heard of a "gold standard" for taking a pulse. I call B.S. Do you have a reference for that "gold standard"?

Am I really the only person who listens to the heart for a while, then turns and stares at the wall clock and mentally counts off the approximate rate? Like, all I care about is whether the HR is 60, 100, 140, 180, or higher/lower than those. I couldn't give two toots whether it's precisely 144 or 140. That's just dumb.

I can't post links here, just search for "top nurse watches" none of are them digital. This is also the type of watch required at my alma mater. I won't have enough impudence to break moral set of standards of patients care.
Also it's easier to take vitals with analog watch.

 

[DVMDream]

Really.

That's the first I've ever heard of a "gold standard" for taking a pulse. I call B.S. Do you have a reference for that "gold standard"?

Am I really the only person who listens to the heart for a while, then turns and stares at the wall clock and mentally counts off the approximate rate? Like, all I care about is whether the HR is 60, 100, 140, 180, or higher/lower than those. I couldn't give two toots whether it's precisely 144 or 140. That's just dumb.

I am in this same boat. I basically listen for bradycardia, tachycardia, murmurs and arrhythmias. I will get an approximate rate but could really care less if the heart rate is 136 or 142... 140 is fine.

 

[DVMDream]

I can't post links here, just search for "top nurse watches" none of are them digital. This is also the type of watch required at my alma mater. I won't have enough impudence to break moral set of standards of patients care.
Also it's easier to take vitals with analog watch.

So you have zero proof of a "gold standard" watch. Got it.

Come on, you are in a medical field, provide actual research, not some "top 10" crap list that some Joe Blow off the street slapped together one night while bored. There is not a single bit of information out there that states "analog watches are standard for patient care". It is all BS based on your own preferences.

 

[CalliopeDVM]

So you have zero proof of a "gold standard" watch. Got it.

Come on, you are in a medical field, provide actual research, not some "top 10" crap list that some Joe Blow off the street slapped together one night while board. There is not a single bit of information out there that states "analog watches are standard for patient care". It is all BS based on your own preferences.

That made me look a few things up, wondering if there was actual research. I didn't find any.........but I did find the requirements of several nursing schools that specifically say "watch with second hand" among their dress code/equipment specifications.

 

[DVMDream]

That made me look a few things up, wondering if there was actual research. I didn't find any.........but I did find the requirements of several nursing schools that specifically say "watch with second hand" among their dress code/equipment specifications.

Oh I looked it up to when he first mentioned it. But "second hand" doesn't say you have to have an analog watch. I am sure a digital one that reads seconds satisfies that requirement just fine.