Advice for an upcoming 3rd year

[ANCAdoc]

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Hey SDNers,

I will be starting 3rd year next week! I would like your opinions on what I should carry in my white coat pockets? Alot of students seem to have these packed...I was just wondering what is essential to keep in them.

My first rotation is the surgery block. Any recommendations for small review books that are useful and will fit in my pockets?

Also, what do you recommend as far as PDA programs? IU requires us to have a PDA and thus I am interested in what the best medical software is (drugs, diff diag, etc).

THANKS!!

 

[Winged Scapula]

Hey SDNers,

I will be starting 3rd year next week! I would like your opinions on what I should carry in my white coat pockets? Alot of students seem to have these packed...I was just wondering what is essential to keep in them.

My first rotation is the surgery block. Any recommendations for small review books that are useful and will fit in my pockets?

Also, what do you recommend as far as PDA programs? IU requires us to have a PDA and thus I am interested in what the best medical software is (drugs, diff diag, etc).

THANKS!!

Essentials - Regardless of Rotation

Stethoscope
Maxwell's
Pharmacopeia or other drug handbook
Pens
Relevant handbook for downtime during day


Additional Stuff for Surgery

Trauma shears - most bookstores sell them or you can get them free from drug reps
Bandage supplies when on rotations like Vascular, Trauma, etc. where you might be doing am dressing changes. Looks good when students have these available.
Handbook: I liked Mont Reid or the Cleveland Clinic Handbook of Surgical Pt Mgt. Many students carry around Surgical Recall and you are pimped on questions which will appear in there, but its not sufficient detail for the shelf.

Check out the Technology forum for PDA program recommendations.

 

[kito]

I started with medicine, and I started with all of those goodies in the pockets of my white coat. And then I did surgery and I ditched it all except for the stethoscope and pen. Since then, I've stuck to the those bare essentials, and have left the rest (including the coat) behind.

As for you, go with Dr. Cox's advice.

 

[Winged Scapula]

Further tip for Surgery:

do not bring your reflex hammer, putting it in your top coat pocket. Heck, except when/if on Neuro, do not bring a reflex hammer. Use the side of your stethoscope. This is especially true if you have one of those foot long "Euro" hammers like I do/did.😀

carry a granola bar or some other quick to eat thing; do not eat on rounds while hungry residents are standing there. They are liable to grab the food from you for themselves.

do not purchase a diagnostic kit or it will languish in the trunk of your car for years as you kick yourself for spending the money on it when every clinic and every floor in the hospital has one.

buy comfortable shoes...clog, sneakers, who cares? If you do care, there are lengthy threads in this forum about the perennial foot wear debate.

 

[Arsenic]

Essentials - Regardless of Rotation

Stethoscope
Maxwell's
Pharmacopeia or other drug handbook
Pens
Relevant handbook for downtime during day


Additional Stuff for Surgery

Trauma shears - most bookstores sell them or you can get them free from drug reps
Bandage supplies when on rotations like Vascular, Trauma, etc. where you might be doing am dressing changes. Looks good when students have these available.
Handbook: I liked Mont Reid or the Cleveland Clinic Handbook of Surgical Pt Mgt. Many students carry around Surgical Recall and you are pimped on questions which will appear in there, but its not sufficient detail for the shelf.

Check out the Technology forum for PDA program recommendations.

you're an attending that knows all our secrets.... nooooooooooooooooooooooooooooooooooo


😉

 

[Bubb Rubb]

at the end of this year this is what's in my pockets (no white coat unless required for rotation):

tarascon pocket pharmacoepia, +/- spelling.
drug company pen with penlight on end for mouths 'n junk
regular pen for writing, not too thick, not too thin. plus attendings like to gank 'em
stethoscope in pants pocket
wallet/cell phone/beeper

that's it. no pda. no huge pocket medicine or other review books (leave them in your bag and grab them before retiring to your call room if you're that hardcore). no foot long reflex hammers . no piles of bandages and such while on surgery, although i did carry a bandage scissor: most of that stuff was right outside the room anyway.

 

[ericdamiansean]

If you have a PDA, then you probably don't need any books other than a small reference for downtime.

Medicine: Stet, tendon hammer, pens, pentorch, ruler, food (power bars, chocolates), phone, wallet, keys, bandage/dressing tape (I sewed an extra strip of cloth at the inner side of my labcoat, and slid my tendon hammer into it, some people slide it into one of their buttons..hate those guys who have those retractor-handle type tendon hammers)

Surgery: Same

Peds: Same + squeaky toy

Obgyn: Same + obstetric wheel + measuring tape

Ortho: Same

Psy: Your sanity

I've seen people carrying water bottles and books around I usually go without water from breakfast until lunch

 

[arthrodisiac]

the thing about not bringing a reflex hammer is bad advice, plenty of students got yelled at on surgery and medicine for not having it, and not doing reflexes on patients with, hyper/hypothyroid for example. its not that big of a deal to carry...the ones with a monofilament built in are good too.

 

[smq123]

I've seen people carrying water bottles and books around I usually go without water from breakfast until lunch

I've been wondering about this. One of the psych attendings told me that the best advice she got as an intern was to "stay hydrated." She says it's hard to think clearly (esp. when getting pimped) when you're not hydrated. But I didn't see how it's practical to carry around bottles of water everywhere.

I've been thinking about this some more lately. (I'll be starting 3rd year soon.) In our 2nd year physical diagnosis course a few months ago, we were standing around watching one of our professors demonstrating the PE on a standardized patient. Suddenly, one of the students lurched forward, said "Umm, I don't feel soooo...." and then his eyes rolled up in his head and he crumpled on the floor. It turns out that he was just really, really dehydrated.

So, yeah - that made me rethink the whole water bottle thing.

 

[ericdamiansean]

I've been wondering about this. One of the psych attendings told me that the best advice she got as an intern was to "stay hydrated." She says it's hard to think clearly (esp. when getting pimped) when you're not hydrated. But I didn't see how it's practical to carry around bottles of water everywhere.

I've been thinking about this some more lately. (I'll be starting 3rd year soon.) In our 2nd year physical diagnosis course a few months ago, we were standing around watching one of our professors demonstrating the PE on a standardized patient. Suddenly, one of the students lurched forward, said "Umm, I don't feel soooo...." and then his eyes rolled up in his head and he crumpled on the floor. It turns out that he was just really, really dehydrated.

So, yeah - that made me rethink the whole water bottle thing.

I have seen not one, but a few urologist carrying a bottle of water around which they refill from time to time at the water cooler, probably renal stone prophylaxis

But I think I should be drinking more, it is just that time and logistics do not allow me to do so.

I personally haven't seen anyone drop, but I have heard that it happens pretty often, usually females. I heard in one case, the professor stopped his teaching, opened up a bottle of dextrose and gave it to the student to drink when she started swaying.

 

[Winged Scapula]

you're an attending that knows all our secrets.... nooooooooooooooooooooooooooooooooooo


😉

It wasn't THAT long ago that I was one of you!

 

[Winged Scapula]

the thing about not bringing a reflex hammer is bad advice, plenty of students got yelled at on surgery and medicine for not having it, and not doing reflexes on patients with, hyper/hypothyroid for example. its not that big of a deal to carry...the ones with a monofilament built in are good too.

Your mileage may vary, but I have NEVER seen a surgery student carry a reflex hammer that wasn't teased about it and I have NEVER seen a student not carrying one that was yelled at.

Medicine is a different story, but you don't often come across a patient with thyroid problems on surgery for whom you cannot check reflexes with the edge of your stethoscope. Perhaps your hospital is riddled with thyroid storm patients, but mine wasn't...so take the advice from this attending with a grain of salt.🙄

 

[Winged Scapula]

I've been wondering about this. One of the psych attendings told me that the best advice she got as an intern was to "stay hydrated." She says it's hard to think clearly (esp. when getting pimped) when you're not hydrated. But I didn't see how it's practical to carry around bottles of water everywhere.

It might not be practical to carry around water bottles but every floor should have an ice and water machine (for the patients) and if you do some searching, you should be able to find it and fill up as needed.

 

[ChildNeuro]

I would also recommend, if you have a good white coat with alot of deep pockets, packing a good sandwhich wrapped in cellophane for medicine or other labor intensive rotations. Turkey and roast beef with lettuce and other veggies without mayo on a good bread like sourdough lasts well and outperforms the dried out fried chicken and sloggy fries that everybody else eats. When I eat less fried food and hospital cafeteria food I find that I perform/think better. Personally, the food at any hospital cafeteria grows tired, and any time you spend in the cafeteria is time you could use doing something else, that 15 minutes waiting in line each is 15 minutes you will never get back, and it really sucks when you are eating lunch and then miss out some procedure or something. Personally, before a long rotation, I woke-up at like 4-5 am, ate lunch then, and then went the whole day from 7:30 am until 6 pm only on liquids, then ate something at home. It worked really well, and I got to see alot more! Sometimes I would bring in food, because it cuts down lunch from 25-30 minutes to just 5 minutes. Over the course of a week it probably saved me 2.5 - 3 hours, but felt like alot more. This way I wouldn't be a vulture waiting to get some food after the attendings and residents got their digs from a pharmacology rep, and I was not dependent on the hospital cafeteria system. The whole point for me is to be more and more independent on a rotation, where you can call the lab etc . . . get things done for your patients, and for me it means being totally indepedent of the inhospital food system too.

 

[ericdamiansean]

I would also recommend, if you have a good white coat with alot of deep pockets, packing a good sandwhich wrapped in cellophane for medicine or other labor intensive rotations. Turkey and roast beef with lettuce and other veggies without mayo on a good bread like sourdough lasts well and outperforms the dried out fried chicken and sloggy fries that everybody else eats. When I eat less fried food and hospital cafeteria food I find that I perform/think better. Personally, the food at any hospital cafeteria grows tired, and any time you spend in the cafeteria is time you could use doing something else, that 15 minutes waiting in line each is 15 minutes you will never get back, and it really sucks when you are eating lunch and then miss out some procedure or something. Personally, before a long rotation, I woke-up at like 4-5 am, ate lunch then, and then went the whole day from 7:30 am until 6 pm only on liquids, then ate something at home. It worked really well, and I got to see alot more! Sometimes I would bring in food, because it cuts down lunch from 25-30 minutes to just 5 minutes. Over the course of a week it probably saved me 2.5 - 3 hours, but felt like alot more. This way I wouldn't be a vulture waiting to get some food after the attendings and residents got their digs from a pharmacology rep, and I was not dependent on the hospital cafeteria system. The whole point for me is to be more and more independent on a rotation, where you can call the lab etc . . . get things done for your patients, and for me it means being totally indepedent of the inhospital food system too.

I have a small and cute red car..we drive out for food
Anyway, I have McD, KFC, Pizza Hut delivery numbers..it does help..

 

[ANCAdoc]

On the surgery rotations, do they give you time to go and have lunch?

This might be a stupid question, but I am kinda worried about that. I need my energy!

 

[Winged Scapula]

On the surgery rotations, do they give you time to go and have lunch?

This might be a stupid question, but I am kinda worried about that. I need my energy!

Depends.

Depends on the day, what you are doing and how busy you are.

Depends on the sensitivity of the residents and attendings to the students.

Depends on what you call "time" and "having lunch".

IMHO, it would be rare to have a day when you can actually go to the cafeteria, sit down and enjoy a leisurely lunch. The days are just not scheduled in that fashion. While there is usually a break between am and pm clinic patients, since most clinics run behind that break rapidly disappears...along with your lunch hour. On OR days, the cases are not scheduled with attention to lunch breaks. Granted the OR turnover time in most academic hospitals is pitifully slow, you generally have a fair bit of things to do between cases.

That said, I tried to make sure the students went and got some food between cases or in clinic, but it does depend on how busy we were. I would recommend having a big breakfast before you hit the hospital and keeping some granola bars or other quick edibles available.

You may find your experience different, but in general, most surgery students and residents that I know eat very unpredictably...hence the old saying, "eat when you can, pee when you can, sleep when you can..."

 

[Dr. Dukes]

A sandwich recommendation from my hiking life.
Take a nice big bagel (not bread) and coat both surfaces with peanut butter. Then put a whole lot of jelly in the middle. The peanut butter on both sides prevents one half of the bagel from getting all soggy and gross. If you wrap it up in celophane or tin foil or something it shouldn't leak, and you can eat it pretty quickly as long as you have something to drink during/afterwards...

 

[ChildNeuro]

Depends.

Depends on the day, what you are doing and how busy you are.

Depends on the sensitivity of the residents and attendings to the students.

Depends on what you call "time" and "having lunch".

IMHO, it would be rare to have a day when you can actually go to the cafeteria, sit down and enjoy a leisurely lunch. The days are just not scheduled in that fashion. While there is usually a break between am and pm clinic patients, since most clinics run behind that break rapidly disappears...along with your lunch hour. On OR days, the cases are not scheduled with attention to lunch breaks. Granted the OR turnover time in most academic hospitals is pitifully slow, you generally have a fair bit of things to do between cases.

That said, I tried to make sure the students went and got some food between cases or in clinic, but it does depend on how busy we were. I would recommend having a big breakfast before you hit the hospital and keeping some granola bars or other quick edibles available.

You may find your experience different, but in general, most surgery students and residents that I know eat very unpredictably...hence the old saying, "eat when you can, pee when you can, sleep when you can..."

It is very rare to find an attending or resident who will make sure that you have time (i.e. 15-20 minutes) to actually purchase and scarf down a meal. On many rotations the attendings have their own meal schedule down, which may mean eating a big brunch/lunch around 10:00 am (always while you are in lecture), and then they may expect you to round with them from 10:30 am to 4:30 pm. I have been in many rotations where I would watch the clock go from 11:00 am to noon to 1 pm . . . to 5:30 pm until I could go eat. Residents also have their own schedules and meal plans, i.e. other residents bringing food or a drug rep/presentation for residents. Believe, they have the timing of their meals down to a fine art, and it does not include you. The worst is one rotation I was on a while ago and they had food brought in for the residents interviewing, the current residents, and attendings, and we had to wait to see if there was food left (often not!), I didn't mind, but they had to yell it out a couple of times to everybody ("Students wait until everybody else has eaten!").

The best bet is to bring your own food, and sneak it down when the attending or residents asks everybody to wait in a room for 10 minutes. Fourth year electives are the best because they actually treat you like a human being and you get excused for lunch. Third year can be painful because the comfort of the third year medical student is very low on everyone's list. Great rotations have residents that make sure students get food. I had a resident who was going out to grab a bite and he asked me if I wanted him to pick up anything for myself. I was really taken aback and shocked and politely refused. Needless to say, we students felt extra motivated to help out this resident however he needed it.

 

[Winged Scapula]

It is very rare to find an attending or resident who will make sure that you have time (i.e. 15-20 minutes) to actually purchase and scarf down a meal.

Sadly, that is often true. The focus of the house staff and attendings is not on the students and especially not on if they have eaten. You are expected either to "suck it up" (just like the rest of the team is doing) or manage to sneak something in. That said, it is bad form to eat on rounds when no one else is. 😉

The worst is one rotation I was on a while ago and they had food brought in for the residents interviewing, the current residents, and attendings, and we had to wait to see if there was food left (often not!), I didn't mind, but they had to yell it out a couple of times to everybody ("Students wait until everybody else has eaten!").

That's horrible! There is no excuse for rudeness - are there really that many students that it made a difference? If they were THAT short of food and worried abotu running out, they should have ordered more. Jeez...

At any rate, like others have posted...you have to fend for yourself most of the time. I wouldn't have been able to do Child Neuro's advice of putting a sandwich in my pocket - they just weren't big enough and even if I could get a sandwich in my pockets, it would have gotten squished (many stories of squished candybars at the bottom of my lab coat pockets). But if your lab coat is more forgiving, having something on hand is invaluable.

In addition, most wards have stashes of graham and saltine crackers. Not lunch, but they are mighty tasty when you are starving (just be sneaky, some of the nurses take offense to students eating "patient's food"). If in the ICU, many patients will not touch their lunch trays...fair game for students and residents. Our SICU nurses would save them for the residents on call, just in case we didn't make it to the cafeteria before they closed (between 2 and 6 am).

 

[ChildNeuro]

Sadly, that is often true. The focus of the house staff and attendings is not on the students and especially not on if they have eaten. You are expected either to "suck it up" (just like the rest of the team is doing) or manage to sneak something in. That said, it is bad form to eat on rounds when no one else is. 😉

That's horrible! There is no excuse for rudeness - are there really that many students that it made a difference? If they were THAT short of food and worried abotu running out, they should have ordered more. Jeez...

At any rate, like others have posted...you have to fend for yourself most of the time. I wouldn't have been able to do Child Neuro's advice of putting a sandwich in my pocket - they just weren't big enough and even if I could get a sandwich in my pockets, it would have gotten squished (many stories of squished candybars at the bottom of my lab coat pockets). But if your lab coat is more forgiving, having something on hand is invaluable.

In addition, most wards have stashes of graham and saltine crackers. Not lunch, but they are mighty tasty when you are starving (just be sneaky, some of the nurses take offense to students eating "patient's food"). If in the ICU, many patients will not touch their lunch trays...fair game for students and residents. Our SICU nurses would save them for the residents on call, just in case we didn't make it to the cafeteria before they closed (between 2 and 6 am).

Yes, I should have added that, it is bad form to eat when nobody else it, and NEVER eat in front of a patient, be a snack or other. I was thinking of adding that you could excuse yourself to go "freshen up" and on the way to the restroom, look at an interesting poster and scarf down covert sandwhich. Yes, it was rude that they made the students eat leftovers, and in front of the residents applicants it made us look bad because we were working there. There were about 20 students or so, maybe 20 residents, 15 people itnerviewing, and maybe 6-7 attendings, the worst part is that this happened every Wednesday (or whatever day it was)!!! for three months!!! They never ordered extra food, and always made the anouncement about students at the begining. Considering how much we were paying to run around the like heck I would have been happy with a one dollar ham & cheese so I could at least get some kcals. Oh well. They had attendings do sample cases to show the "excellent teaching", but it just made the attendings look bad as one applicant corrected the attending!

Some white lab coats have pockets on both sides, i.e. pockets *inside* the white coat, I use 'em to store contraband, heh heh, like sandwhiches, granola bars, and even a bottle of diet soda. Why drink H20 when you get some caffeine in you? These coats have a total of three outside, and two inside pockets, so no need to put anything else in your sandwhich pocket. Try aluminum foil, that decreases some of the squish. I have used tupper-ware to store a premade meal, at room temp for the morning, and then excuse myself to jam this down, but this only works if you get a student call room, or somewhere away from prying eyes.

Bottom-line, yes fend for yourself, there is always an attending or residents who has eaten who wants you to do something, so make you can eat on the run.

 

[smq123]

It might not be practical to carry around water bottles but every floor should have an ice and water machine (for the patients) and if you do some searching, you should be able to find it and fill up as needed.

Thanks for letting me know. That's a relief. It's much better than my sister's suggestion - buy a belt holster (like the one that Lara Croft wears), and use it to carry water bottles around. Hardy-har-har.

 

[kito]

Our SICU nurses would save them for the residents on call, just in case we didn't make it to the cafeteria before they closed (between 2 and 6 am).

They stayed open that late? Are you serious?

 

[Winged Scapula]

They stayed open that late? Are you serious?

Heck many hospitals have cafeterias that stay open 24 hrs a day. As a matter of fact, any hospital with an ACGME residency is required to have food available for the residents 24 hrs a day. Ours got around that by having a refrigerator for the residents which they stocked with drinks, sandwiches, left over food from the dinner meal, etc. Sometimes there was actually still food in there in the middle of the night.

But yes, it is not uncommon for larger hospitals to have cafeteria services around the clock. Its a real pain at this small hospital I moonlight at - they close for dinner at 6:30, don't reopen until 7:30 and close between 10a and 1045 a and 1:30 and 4:30.

 

[Winged Scapula]

Thanks for letting me know. That's a relief. It's much better than my sister's suggestion - buy a belt holster (like the one that Lara Croft wears), and use it to carry water bottles around. Hardy-har-har.

I like that idea! Really, there is little danger of getting dehydrated under most conditions, even a surgical rotation, and you can usually find some ice, juice or water on the floors. I am frequently amused when seeing people afraid to go 30 minutes without drinking something from their water bottle. You aren't hiking in the Gobi for days on end!

 

[ANCAdoc]

You are expected either to "suck it up" (just like the rest of the team is doing) or manage to sneak something in.

Wow, that seems grossly unhealthy (though a true statement for us!). No doc would ever tell their patient that no matter what the patients line of work (even if they were a med student)! And, I thought we were in the medical field...

I guess I'll be stuffing my pockets with granola bars. I've also noticed that some surgical wards have rooms that are stocked with snacks (cereals etc) and drinks (colas, juices). I'll try to hit that up when necessary.

 

[Winged Scapula]

Wow, that seems grossly unhealthy. No doc would ever tell their patient that no matter what the patients line of work (even if they were a med student)! And, I thought we were in the medical field...

Welcome! We have a long and well-established history of not taking care of our own. Some of it is self-induced (doctors and nurses are often the worst patients) and some of it is historical ("why in my day, we went days without peeing"...). But you are right...it isn't healthy and no one would advocate it, but it does seem to be expected.

I guess I'll be stuffing my pockets with granola bars. I've also noticed that some surgical wards have rooms that are stocked with snacks (cereals etc) and drinks (colas, juices). I'll try to hit that up when necessary.

Good idea. Bring some things in, stash some in the call room or if you have a locker in the OR, and keep an eagle eye out for those ward stashes (and the nurses who might catch you).

 

[koma]

Hey SDNers,

I will be starting 3rd year next week! I would like your opinions on what I should carry in my white coat pockets? Alot of students seem to have these packed...I was just wondering what is essential to keep in them.

My first rotation is the surgery block. Any recommendations for small review books that are useful and will fit in my pockets?

Also, what do you recommend as far as PDA programs? IU requires us to have a PDA and thus I am interested in what the best medical software is (drugs, diff diag, etc).

THANKS!!

You should carry a nice (secret) pen for yourself, and then a bunch of boring ordinary pens. people will be borrowing your pens all the time, and probably not returning them. it might seem like a minor point, but nothing is more annoying than seeing your attending/chief walk around with your favorite pen for days while you're biting your nails since you can't ask for it back or risk looking like an ass.

also, i always carry around a name badge wallet thingie in which I carry a credit card (to buy food from cafeteria) and a bit of cash in my coat pockets (to buy food from snack bar). this is one of the essentials.

 

[MadameLULU]

You should carry a nice (secret) pen for yourself, and then a bunch of boring ordinary pens. people will be borrowing your pens all the time, and probably not returning them. it might seem like a minor point, but nothing is more annoying than seeing your attending/chief walk around with your favorite pen for days while you're biting your nails since you can't ask for it back or risk looking like an ass.

also, i always carry around a name badge wallet thingie in which I carry a credit card (to buy food from cafeteria) and a bit of cash in my coat pockets (to buy food from snack bar). this is one of the essentials.

So true! I hate when that happens!! Now I carry at least 4 pens on my white coat.

 

[ericdamiansean]

I know it's rude to eat when no one else eats, but my metabolic needs are different. I can have a full breakfast and in 3-4 hours I'll be hungry, and this equates to unsteady hands. So, I'll hide in a corner and eat.

I had a very senior professor who does not allow students to drink. He said that there is no need unless he notes that you have signs of moderate to severe dehydration😕

I've had patients and their families offering me food as well especially when I'm on call and they see my puttering around for hours and they know that I haven't had my dinner🙂

 

[fab4fan]

But yes, it is not uncommon for larger hospitals to have cafeteria services around the clock. Its a real pain at this small hospital I moonlight at - they close for dinner at 6:30, don't reopen until 7:30 and close between 10a and 1045 a and 1:30 and 4:30.

I could swear you were posting about the hospital where I work except I haven't seen any female surgeons wandering around in blood-spattered scrubs. Wait! <smacks forehead> I forgot! We don't have any female surgeons where I work!

 

[Winged Scapula]

I could swear you were posting about the hospital where I work except I haven't seen any female surgeons wandering around in blood-spattered scrubs. Wait! <smacks forehead> I forgot! We don't have any female surgeons where I work!

Tell 'em to get with the program! There are lots of us out there (and my scrubs aren't usually blood-splattered, although I will admit to a Betadine splattered lab coat). 😀

 

[Bubb Rubb]

my secret to eating (and seeming cheerful) on the surgery rotation would be to make the time for myself, whether after a case, before/after a lecture, or in any other sort of nebulously-defined time of the day (ie, not around rounds or the first case of the day 😀). go grab your food, dodge the residents, and then reappear rife with energy and motivation... DON'T wait around for the residents to take pity on you -- if you have to eat/go to the restroom/whatever, then do it.

i'm not advocating slacking, per se -- pay attention on rounds, lectures, in the OR, etc. -- but am rather advocating not being a lapdog and fending for yourself a bit.

 

[AmoryBlaine]

1. I would really like to forcefully echo the wisdom of carrying a granola bar. If you feel the least bit tired/hungry/woozy before going to the OR eat the thing and slug some water. Even though alot of people end up needed to sit down in the OR it is not optimal. If you have a bad resident you might take heat about it. Plus it is just really hard to think when you are hungry. This whole game of starving yourself and then griping about it is unnecesarry.

2. Resist the temptation to fill every pocket on your white coat until the seams burst. Alot of M3s choose to adopt this look. In my experience it is usually b/c they carry the daily census from every day they've been on service and a copy of every H/P they've done. It makes you look like a newbie. Part of being a good M3 is learning to streamline your information processing. You can take 2 min every day and "diurese" your pockets.

3. After my first rotation I stopped carrying around a study book. They are just too heavy and too low-yield for day to day activity.

 

[njbmd]

Hey SDNers,

I will be starting 3rd year next week! I would like your opinions on what I should carry in my white coat pockets? Alot of students seem to have these packed...I was just wondering what is essential to keep in them.

My first rotation is the surgery block. Any recommendations for small review books that are useful and will fit in my pockets?

Also, what do you recommend as far as PDA programs? IU requires us to have a PDA and thus I am interested in what the best medical software is (drugs, diff diag, etc).

THANKS!!

Essentials - Regardless of Rotation

Stethoscope
Maxwell's
Pharmacopeia or other drug handbook
Pens
Relevant handbook for downtime during day


Additional Stuff for Surgery

Trauma shears - most bookstores sell them or you can get them free from drug reps
Bandage supplies when on rotations like Vascular, Trauma, etc. where you might be doing am dressing changes. Looks good when students have these available.
Handbook: I liked Mont Reid or the Cleveland Clinic Handbook of Surgical Pt Mgt. Many students carry around Surgical Recall and you are pimped on questions which will appear in there, but its not sufficient detail for the shelf.

Check out the Technology forum for PDA program recommendations.

In addition to the above excellent advice, I recommend purchasing a very small book called "How to be a Truly EXCELLENT Junior Medical Student" by Robert J Lederman, MD. This little book costs under $10 and gives a total overview of everything that you need to keep in mind to do well on every rotation during third year. It's also easy and quick to read (you can get through it in one evening).

On my Surgery Rotation, I liked Mont Reid and Surgical Recall for pocket books. I also carried Maxwell's in my pocket until a couple of months into my PGY-1 year. On my PDA, I kept Epocrates and Patient Keeper in addition to my patient's lab work that I downloaded daily.

Good luck!

 

[ESPNdeportes]

Best advice I can give?

Have a good attitude, show up early, appear happy (smile) even if you absolutely detest the rotation and/or team, don't talk about other team members or patients behind their backs (that burned another 3rd year on a rotation with me and I learned my lesson), READ about your patients, be willing to take an extra patient to help your team, try to come up with A&P's, LEARN from your mistakes, and perhaps most importantly take time for exercise, hobbies, keeping up with friends and family, etc.

That's what I did, and I got great evals all year. You won't believe how many of your classmates will have a terrible attitude all throughout third year, aka "I'm going into rads/ortho/peds/whatever and this means I'm going to b*tch all day long about how its such a waste of time for me to do psych/medicine/whatever rotation because I'll never use it again." There are people that literally complained about EVERY rotation of third year, drove me nuts.

 

[MadameLULU]

my secret to eating (and seeming cheerful) on the surgery rotation would be to make the time for myself, whether after a case, before/after a lecture, or in any other sort of nebulously

My secret to eating on my surgery rotation: go to the physicians lounge. Fortunately, I was at the more cush private hospital, where food was more abundant and the residents were fine with us getting food from the physicians lounge

 

[Winged Scapula]

My secret to eating on my surgery rotation: go to the physicians lounge. Fortunately, I was at the more cush private hospital, where food was more abundant and the residents were fine with us getting food from the physicians lounge

That's nice that the students have access at your hospital. Even as a fellow at mine I wasn't given access.

 

[Midwest Medic]

It will also change from day to day, rotation to rotation, and on what you acquire. I started out with EVERYTHING I could think of, and by the end of the first week, I had my PDA, stethoscope, a few pens, and my patient cards. I slowly built it back up to include the pharmacopia and a few others, then purged a few things again. It keeps changing all the time.

 

[46&2]

I had a lot of 'hurry up and wait' during 3rd year, so I always liked having a light book in my pocket.

Internal Med/Family: Pocket Medicine. Everyone had that book.
Ob/Gyn: 'The Little Red Book' Obstetrics, Gynecology and Infertility: Handbook for Clinicians-Resident Survival Guide by John D. Gordon
Psych: 'Little Green Book' Psychiatry Current Clinical Strategies
Peds: Many residents had Harriet Lane by I wasn't that motivated...
Surgery: Surgery Recall
If you do ICU a lot: Tarascon's IM and Critical Care Handbook

Other than that, I learned to ditch the white coat and just have notecards (or patient printouts), pen, and stethoscope. It can get ridiculously cold in the hospital, so I brought a hooded sweatshirt if scrubs were allowed. Preferred Pop Tarts to granola, even though they crumbled. Gum makes friends.

A PDA can be handy for ePocrates, basic calculator, and the rare MedCalc occasion. But it's the Freecell that's key.

 

[MadameLULU]

It will also change from day to day, rotation to rotation, and on what you acquire. I started out with EVERYTHING I could think of, and by the end of the first week, I had my PDA, stethoscope, a few pens, and my patient cards. I slowly built it back up to include the pharmacopia and a few others, then purged a few things again. It keeps changing all the time.

OOO, patient cards are a must (at least they are for me). It helped me so much on my surgery rotation when I began using them. I would write down the daily labs for all my patients and keep them in my coat pocket. Another thing that I like to do is keep blank notecards (more convenient) or a small clipboard handy so I can jot notes or things that i need to do.

 

[musm2008]

Bite the bullet and buy uptodate. it's a reference you can use on any computer with intenet access and it's reliable and all the residents do it.

 

[fab4fan]

Tell 'em to get with the program! There are lots of us out there (and my scrubs aren't usually blood-splattered, although I will admit to a Betadine splattered lab coat). 😀

OMG, that avatar...

 

[ANCAdoc]

When people mention "patient cards" are these actually cards where you simply fill in info onto a card template? If so, where do you purchase these?

Or, are they just plain index cards made into "patient cards"?

 

[AmoryBlaine]

When people mention "patient cards" are these actually cards where you simply fill in info onto a card template? If so, where do you purchase these?

Or, are they just plain index cards made into "patient cards"?

medfools.com

downloads

 

[Winged Scapula]

OMG, that avatar...

group_theory made that for me.

Don't I look pretty?! 😉

 

[raidermedic]

Yeah I've never been down with the med student hazing. As far as eating goes I usually did what the residents did. I don't think thats unreasonable, if they are going to preach about everyone being a team you're gonna treat me like a team mate no? If the residents had time to take a nice long lunch I did the same, most of the time I would actually go with them. If the service was busy and the residents snuck away to grab lunch then I did the same. If you are on a service where you are in class while attendings and residents eat then have to round the rest of the day then bring something in your pockets and eat it discretely on rounds. Heck when it's not your pt the attending barely knows you're there. Now I'm not advocating carrying around a bag of Taco Bell but chips, dried pieces of fruit, or a protein bar are all very discrete. As for eating in front of others, one like I said be discrete about it, two most students don't do this because they are afraid of making the wrong impression. Well IMO if you're willing to take the risk go for it. It's not your problem that your classmates are too scared of losing their high honors to do the unthinkable of actually carrying food with them.

 

[Winged Scapula]

As for eating in front of others, one like I said be discrete about it, two most students don't do this because they are afraid of making the wrong impression. Well IMO if you're willing to take the risk go for it. It's not your problem that your classmates are too scared of losing their high honors to do the unthinkable of actually carrying food with them.

While I can understand the perception that the reason its wrong to eat in front of others on rounds, etc. is because it will affect your grade, the real reason is that it is impolite in all situations.

For example, when dining, no one should begin to eat until everyone has been served. If you are being hosted (ie, someone else is paying the bill or you are eating at someone's house), no one eats until the host or hostess has been seated and has taken his/her first bite. These are commonly accepted, but frequently ignored, rules of social interaction.

I wasn't even thinking of the effect on one's grade when I mentioned not eating in front of others, but rather the above. Besides, if others are hungry as well and you're eating, its a bit rude unless you offer everyone a bite. Granola bars are generally not big enough to share with the entire team. Remember what they told you in grade school/scouts, etc. - if you don't have enough for everyone, don't bring it out.

 

[raidermedic]

I've found that a lot of the rules of social interaction are ignored in medical training

I can understand not eating because no one else has food. If a fellow med student doesn't have food because he forgot I will not break out the granola or I will offer him half. But if students on your team just flat out refuse to eat even a piece of hard candy in fear of "getting caught" then thats their problem. Heck I'll go to Sam's Club and load up on the snacks for everyone if need be. But if a member of the med student team refuses to eat that isn't going to stop me from discretely throwing back a Starburst or two.

 

[AmoryBlaine]

I've found that a lot of the rules of social interaction are ignored in medical training

I can understand not eating because no one else has food. If a fellow med student doesn't have food because he forgot I will not break out the granola or I will offer him half. But if students on your team just flat out refuse to eat even a piece of hard candy in fear of "getting caught" then thats their problem. Heck I'll go to Sam's Club and load up on the snacks for everyone if need be. But if a member of the med student team refuses to eat that isn't going to stop me from discretely throwing back a Starburst or two.

Agreed. There's alot of self-flagellation that goes on among med students on a busy service.

Not eating is unacceptable. If you don't have time to go to the store and buy a few boxes of granola bars and bananas to stick in your bag then you are in trouble. If you can't find 2 minutes in the day to wolf said granolas/bananas down then your time management skills need work.