Any good intern guides?

[blight]

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What did you all do (if anything) to prepare for internship? I haven't had a rotation in months, have killed a considerable number of braincells since interview season ended, and thus remember nothing I've learned in med school (or, feel like i don't remember anything). 😱

I don't want to suck (or kill anyone) when I first start because of my unproductive 4th year. Any recommendations on what to review in the next few weeks?

And to make matters worse, my med school was not very good about letting med students pretend to put in orders, so it's definitely going to be a train wreck in patient care if I don't read something. Are there any good resources for the basics in deciding what orders to put in for common situations (or anything of the like)?

I would love ANY recommendations if you have any! Thanks!

 

[PMPMD]

Pocket Medicine is great for the basics. I would enjoy your free time the next few weeks, it will become a scarce commodity soon.

 

[gutonc]

And to make matters worse, my med school was not very good about letting med students pretend to put in orders, so it's definitely going to be a train wreck in patient care if I don't read something. Are there any good resources for the basics in deciding what orders to put in for common situations (or anything of the like)?

Your med school and residency likely have such different systems that any specifics you learned for admit orders in med school will be irrelevant for residency. Besides, you will need to start thinking critically about your orders, rather than by rote memorization alone.

The good news is that your residency program likely has electronic or paper order sets that you can use for admissions that will give you something to start with. Clinical judgement will be made on top of that.

Finally, you will kill people, get used to it. The vast majority of them will die of their presenting complaint regardless of the decisions you do or don't make. The rest will die simply because that's what happens to us all. The trick is to figure out when you can move people from that first group to the second group...for the first few months (at least) of residency, that's what your seniors and attendings are for.

 

[dragonfly99]

Pocket Medicine is the book you need for next year.
If you are feeling like you need a review, could get some USMLE Step 3 books and start reviewing those.
Harrison's is always good too.
COPD, NSTEMI, pneumonia, sepsis and uncontrolled diabetes and HTN are some good presenting complaints to start with.

 

[reslife]

I also haven't had a rotation in months (at least one that required any brain usage) and am wondering what to do before intern. I tried going through harrisons but i'm not a text learner. Are there any videos or interactive cases that people recommend. I was thinking about going through the onlinemeded intern content as I used the step 2 videos and found them useful.

 

[ChessMaster3000]

Looks like the latest pocket medicine is from 2013 (5th edition). while i'm sure this is more than up to date, anyone know if there is a regular cycle of updating these or any plans to make a 6th edition?

 

[Raryn]

Looks like the latest pocket medicine is from 2013 (5th edition). while i'm sure this is more than up to date, anyone know if there is a regular cycle of updating these or any plans to make a 6th edition?

5th edition: 2013
4th edition: 2010
3rd edition: 2007
2nd edition: 2004
1st edition: 2000

If I had to guess, the next one will come out in 2016. No big deal though, I still use the 4th edition and it's just fine. A few people in my program even still have the third edition. (Wonder what color the next one will be...)

 

[intmed2014]

Pocket Medicine is a good reference tool but not a great learning material in my opinion due to condensed format. No amount of preparation will make you feel ready by the time intern year comes around but maybe you can lay the groundwork for how to learn when you are on the wards. There are a few concepts which will be key when you are on the wards:

1. Management of CHF exac, COPD exac, DKA, sickle cell crisis, cellulitis, pneumonia, AKI, Management of CKD, Cirrhotic management and other common scenarios
2. Electrolyte replacements (usually expected to be done prior to rounds)- find a decent resource for this online and stick with it
3. Discharge planning (bulk of intern time will be spent doing this. become very familiar with social worker regarding disposition and funding. SNF vs. LTAC vs. shelter etc)
4. Chart Review- it is imperative that you go through patient's notes, labs, images, prior medications from previous hospitalizations at your hospital and outside hospital if available. You will thoroughly impress your attending and upper level by knowing your patient inside and out.
5. Utilize pharmacy- regarding questions over medications and documented allergies, inpatient pharmacy is a phone call away. They are massively helpful if unsure about certain medications.
6. Radiology reading room- also another phone call away, great resource especially on admit days

In the beginning, your attitude and work ethic will probably set you apart from your colleagues rather than your knowledge base.