Anesthesia Reading Plan

[pushthesux]

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Anyone have a good reading plan out there?

I'm a CA-1 who needs to plug through Baby Miller or M/M, but I just can't get motivated to read on a consistent basis.

What about audio books...or mp3? Maybe I could listen while in the car or on the treadmill?

Any ideas are much appreciated.

 

[huktonfonix]

No easy way around it. Set aside an 30 min - 1 hour each day to read. At this point in the year you should be far past Baby miller and starting into M&M at a bare minimum and even thinking about starting on Barash or Miller. You should have at least gone through one of the major texts before the end of residency. In addition I found Jaffe (Surgical procedures for anesthesiologists or something like that) and Yao and Artusio to be helpful also. CA1 cases usually lend themselves pretty well to getting some reading done in the OR. For boards, theres an audio version of Big Blue. Its a good review but should NOT be your primary source of information. This website also kicks ass in providing a variety of different perspectives. Ive found that in residency a lot of technique and information tends to be inbred and it helps to see how others do things even if you dont neccesarily agree with it.

 

[numbmd]

Advice? Study your ass off. This is best, if not the only time to read the big one. Big Miller. It's the biggest because it's the best. You can always repair your rotator cuff after residency is over.

Seriously, I've been intimately involved with our residency for over 15 years, and have been running it for the last 3 years. You need to spend at LEAST 10 hours a week studying for the boards.

The other thing you want to ask yourself is "What kind of anesthesiologist do I want to be?" Passing the boards is the bare minimum needed to practice today. To be really good you need to do more. Without a doubt. You can always study more.

I'll share what I used as a resident, but realize it was 12 years ago when I graduated.

Read Big miller 3 times through.
Subspecialties, I used different texts.
Cardiac: Thomas
OB: Schneider
Peds: Cote
Neuro: Cottrell

Throw in a little West for pulmonary physiology
A little Dubin as a guilty pleasure.

You can't go wrong.

You also can't go it alone, you need a study group. Present your readings to each other. Otherwise you don't have the urgency to read or to read it well. There is nothing like reading well enough to be able to present it.

You can't look at it all at once, it's too overwhelming. Just look at it one day at a time. Just 20 pages a night. It will be amazing how much you have gone through after a few months.

Most residents at my program who take this approach do well enough to pass the boards after the CA-2 year. No secrets, just work.

 

[VentdependenT]

If you aren't motivated enough to make it through M/M or lil' miller there ain't noooo way you'll wanna crack the big miller. Its an interesting read but its painful man. No doubt. Its extremely easy to lose the big picture in that book during your CA-1 year.

My advice? Read while you take a poop. If you're me thats like 30 minutes a day! What else are you gonna do on the toilet? Uhh....don't answer that.

Other sources which you may find useful:

1) Clinical Anesthesia Procedures of the Massachusetts General Hospital: Read this thing. Its great. Plus it'll answer lots of basic questions.

2) Faust review of anesthesiology: You'll have to put together the facts yourself into a cohesive picture but if you wanna nail the boards AND get good general info this book cannot be beat.

3)Clinical Cases in Anesthesia (Hardcover) by Allan Reed (Author), Francince Yudkowitz (Author). 5-6 pages per subject. This thing rocks and it will paint the picture for you. One of the best texts for a newb to anesthesiology!

Throw another 20-30 minutes of studying in bed before you pass out and bam you're up to 45-60 minutes a day of reading.

I'm not the brightest bulb and I passed the boards last year and this year (with some other books but not by reading Miller). If I can do it...

Vent

 

[CremeSickle]

If i had to pick ONE book to read it would be M&M. Get through that and you have the basics.

Otherwise, these are the books i have made it through:

Reed clinical cases in Anesthesia
Faust review
Duke Anesthesia Secrets

I have yao but not 1/3 through it yet. Also like Co-Existing Ds but Reed covers it all basically.

I use big miller as a reference, baby miller is crap and barash is a nice mid-range book which i currently use as reference when M&M dosent give me enough info.

 

[swpm]

Seriously, I've been intimately involved with our residency for over 15 years, and have been running it for the last 3 years. You need to spend at LEAST 10 hours a week studying for the boards.

[...]

Read Big miller 3 times through.
Subspecialties, I used different texts.
Cardiac: Thomas
OB: Schneider
Peds: Cote
Neuro: Cottrell

Always interesting to get a PD's perspective. Still, it seems quite heavy to lay that down as necessary to pass. My heaviest weeks were probably about 10 hours of reading, with most weeks quite a bit less than that.

I'm at a small program, and it's expected that the written exam be passed as a CA-2 at the latest. In fact, the atmosphere is such that most of us feel like we should be passing after the CA-1 year ... and most years, several of us do. I'm now a CA-2, and joined the CA-1 pass club a couple months ago with an upper 90s %ile (after a 99 on the AKT-6).

As a CA-1, I had hot and cold months - and this appears to have been typical of the other residents I know. By this I mean that I'd go for 5 or 6 weeks reading 1-2 hours per day (4+ on weekends), and then get lazy for a month or so and the only reading I'd do was 15-30 minutes specific to the next day's cases or conference (often nothing at all if I felt I had a good grip on what I'd be doing), with weekends spent goofing off.

I'm definitely in a lazy streak now, as evidenced by this long SDN post. 🙂

I have a decent personal library - I own copies of big Miller, baby Miller, Barash, Jaffe, Benumof, Stoelting, Reed, Yao, Morgan & Mikhail ... Q&A books (Hall, Connelly) ... review books (Bowman-Howard, Faust, Secrets, Board Stiff Too) ... plus a handful of pocket books like the Mass Gen procedure book. I lack subspecialty texts, but my program loans them out during those rotations. I also have copies of Big Blue and Audio Blue.

As a CA-1, I read

• the relevant section of Jaffe the night before every case, until I was comfortable with what a given surgery entailed
• the relevant section of Stoelting/Dierdorf or Benumof only if a patient had some funky disease or syndrome
• all of Marino's ICU book during my ICU month
• all of Baby Miller during the first two months of residency
• perhaps 1/4 of Morgan & Mikhail ... I must be the only person on Earth who doesn't really like this book
• perhaps 1/2 of Yao & Artusio, mostly as prep for a similar case the next day
• all of Reed (kind of a Yao-lite, shorter, less detailed, but easier to just sit down and read)
• 1.5x through Hall (non-specialty sections in Dec before the AKT, all of it in June before the ITE)
• 2.5x through Big Blue
• 2-3x through Audio Blue, on the drive to work
• skimmed Board Stiff Too before each of our mock orals

I virtually never cracked Big Miller or Barash, except on rare occasions to look up a specific topic. I have just this year (as a CA-2) started to really read through Barash, using Connelly's Q&A book after each chapter.

Some people swear by Faust, but I don't like it. I never study with other people; in fact, I absolutely loathe our problem-based learning discussions. I don't feel I benefit much from our journal club, grand rounds, or formal lectures. I think the key for why I've done so well on the written exams is that my reading time is high yield. I don't bother with 5 minutes of reading here or there. Except for an occasional journal article, I don't read in the OR. For me it's important that general reading (ie, not reading specifically for the next day's cases) be active. To force myself to really pay attention to what I'm reading, I take every single fact on the page and write a multiple choice question based on it. This means I get through 2 or 3 pages in an hour, but I know it when I'm done. This is also why I'm reading Barash and will probably never read Big Miller through. It would literally take me thousands of hours to get through Big Miller, but Barash already has a Q&A book associated with it. 🙂

To be honest though, I'm not sure if I'll finish my cover-to-cover read of Barash. I think now that I've got a decent grasp of the fundamentals, my time might be better spent with specialty books and practicing oral exam skills.

Big Blue is extremely high yield for the written exam. I think it'd be hard to fail the exam if you've thoroughly read that a few times.

 

[cchoukal]

I have a hard time reading for the sake of reading. My retention is very low. I need to make it active and involve synthesis of information. What I've done is put all my ITE keywords (they give you a list of the keywords for questions you got wrong) into a spreadsheet. Then I'll go one by one down the list, referencing whatever I can find (usu. big Miller) and putting the relavent facts into the spread sheet. As I go, I find that some keywords relate to each other and I can combine and synthesis the info to make it more compact. I'll then make lists, tables, etc. For me, this helps focus my learning, AND when it comes time to study for ITE/AKT, I've got a ready-made study guide of the things I got wrong the last time.

 

[VentdependenT]

I have big blue, It looks pretty damn solid, but I haven't read through more than 20 pages of it since residency started.

I think I'll do it this year though. Why? Because everyone else is and they swear by it.

Chattigan and Hall is the bomb. Its a must have for boards.

I hate that Barash question book. Its too minutia based. The MGH question book is also worthless in my opinion. Stay far away from it.

 

[DrDre']

Nice to hear a PD's view. THat said, having taken the ITE twice, I think it is pretty easy to pass, certainly by your CA-3 year.

I think the NEW baby miller is the single highest yield book. If you know everything in that book, plus another layer or two below it, you are golden.

I hate barash. OUr prog uses it. Some day, I will try Big Miller to see if I like it.

I bought nearly everything that Venty recommended a few months back. All good stuff.

MGH is the best Intraop or at home, it has a surprising depth of info.

I think faust is way too basic, not even like First aid for anesthesia.

I like Jaffee, as I know nothing about the surgeries. I used to read it every night, now I have a better idea what to expect without reading it.

Consistency always trumps cramming. YOu have to make studying part of your life, unfortunately or fortunately. It hopefully shouldnt stop after residency either.

Ask yourself- who do you respect that you have worked with? Why?

 

[swpm]

I hate that Barash question book. Its too minutia based.

What's the point of reading Barash or Big Miller, if not for the minutia? 😀 Everything else is in the little books. But you're right, knowing that the nodes of Ranvier are covered by negatively charged glycoproteins isn't high yield for the written ... or the orals, or anything else for that matter.

Which brings me back to wondering if Barash and Big Miller should be relegated to reference only material. Thing is, people keep telling me I should "read" one of them, and I have a hard time blowing off the advice of others who've been there and done that. Still ...

Read Big miller 3 times through.

😱 I ... how ... 😕 ... that's just mindboggling to me. I don't think I could do that.

Some drug rep gave everyone at my program a copy of the Barash question book. Most people think it's too detailed, and I'm the only one who uses it, so I know I'm in the minority in using that one.

 

[VentdependenT]

Don't get me wrong. I think you are sort of forced to read either one of the big fattie texts by the time residency is over by sheer right of passage.

I can appreciate Miller much more now than I could at the start of CA-2 year. I know what to try and absorb and what to just skip right over (there is lots of that). Barash gets to the nitty gritty faster, so its my main reference. We have Miller online now so its becoming more useful.

 

[bubalus]

Don't let yourself get overwhelmed. I in no way want to diminish the accomplishments of others, which are impressive and commendable, but may not be practical for you. I'd suggest starting with a modest goal--30 min/day. Have some sort of a plan that includes reading about your case for the next day, and pick a basic text like M&M or BM (what an interesting abbreviation for Baby Miller) and go through it. If you're going to do a TURP under spinal, read about spinal anesthesia and TURP syndrome. If you've got time left, or you've read about those topics, go through M&M or BM systematically.

I'm a big fan of keywords. Granted they may not be the most clear at times (Regional anesthesia: Anatomy--very specific, especially if you use ultrasound and not nerve stimulators or landmarks). But they tell you what is on the test and what you didn't know. I approached them like I did the topics you had to give little presentations on in med school--a 2-4 paragraph written summary. I did my keywords for the ITE I took at the start of my CA-1 and CA-2 years. I had passing scores at the beginning of CA-2 and CA-3. Most of my scores most recently were within a point or two of the average of those taking the exam for certification.

As for texts, there are a ton that have already been mentioned.

Find what works for you and do it. Good luck.

 

[leaverus]

CA1 cases usually lend themselves pretty well to getting some reading done in the OR.

I'm not sure I'd encourage this. Most of the faculty at my program frown upon it; even if they are *YAWN* cases.

 

[CremeSickle]

Well

Reading some of the choices people have made Id like to hear what they think are the best books for these subjects. I will list mine.

Cardiac: Kaplan
OB: Chestnut
Peds: Gregory
Neuro: I dont have a specific book for this

What do others use or think rocks?

 

[VentdependenT]

Well

Reading some of the choices people have made Id like to hear what they think are the best books for these subjects. I will list mine.

Cardiac: Kaplan
OB: Chestnut
Peds: Gregory
Neuro: I dont have a specific book for this

What do others use or think rocks?

Cardiac: Hensley (Kaplan is too much info for now)

OB: I've read parts of Chestnut. Its the tops for Neuraxial anesthesia. You wanna learn what to give and why, its there. Otherwise I read "Obstetric and Gynecologic Anesthesia The Requisites." Thats more than enough, and its doable.

Peds: Haven't done my 3 months at Childrens Memorial yet. They give us some big fattie text. For my first month I read M/M and "Manual of Pediatric Anesthesia." Rock solid.

Neuro: M/M, Miller, Barash. Be sure to read up on head trauma too in the last two books. Drug reps often have the handbook of neuroanesthesia for free. If you think you'll get through that then great. I never bothered....Or take 2 minutes and read this: http://www.cja-jca.org/cgi/reprint/52/suppl_1/R8.pdf

 

[numbmd]

There are lots of different recipes to make a good sauce, just like there are a lot of good recipes on how to study to be a good anesthesiologist. Just about any text is good, but you want to do two things 1- pass your boards, and 2 - be a well read anesthesiologist. Faust and Jensen ARE good sources. Absolutely. All the above texts are very good. But you want that next step.

I remember I got into a discussion with an attending when I was a CA-2 rotating at a different hospital. I thought sux worked prejunctionally and she didn't. She said "well what is your source?" I said "big miller." She was quiet. I copied it for her the next day and felt like superman. Don't dis the big boy. You look like a superstud if you know it. Who doesn't want to be a superstud?

Plus, you are going to be a consultant in anesthesia, don't you want to have read the definitive text on the topic? If you don't do it now as a resident, when will you? Yes, it's always wordy, and sometimes tougher than chinese arithmetic, but it's the gold standard.

Part of being a doctor is inquisitiveness and having a thirst to learn. Why wouldn't you want to read the most in depth book there is?

The other thing I want to caution you about is don't keep reading review books. You'll finish with a superficial level of knowledge.

Damn, I should get some kind of kickback from Ronnie, figuring as how much I push his book. Actually, Barash is an acceptable substitute.

Always bust your a$$ and do your best. The source is way secondary. It's the work that counts! Someday your patients may depend on it.

 

[gasnewby]

UCSD interview:
- What books do your resident use?
- Long pause...I see some of them with Anesthesia Secrets.

 

[VentdependenT]

Found a useful and comepletely doable echo book for residency:

Clinical Manueal and Review of Transesophageal Echocardiography by Joseph P Mathew