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I'm curious about what resources you guys use/plan on using during your training, and whether you'll be buying them on your own/with book funds/or if your program pays for them.

I bought myself the full epocrates for my phone this year and absolutely love it, I've thought about getting an Up to Date subscription and maybe something psych specific (though I'm not sure what).

Thoughts? What have you guys found most useful?
 

The Long Way

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Hey Psychelle,
You may already know this...and perhaps it has changed. But the last time I checked (several months ago), UpToDate was quite limited in the Psychiatry department. Of course it would still be useful on the general medicine and neuro rotations, but less so for the Psychiatry rotations.
 

TexasPhysician

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Up to Date is usually provided by schools.....at least all the ones I interviewed at.

What does subscription epocrates have? Free medscape on my iphone worked well for me.
 

whopper

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My residency program used to provide up to date to the psychiatry residents, but it turned out none of them used it. That greatly bugged me because I wanted to use it, and would've.

Most programs have some things it provides to the residents. Some programs will reimburse residents for books-up to a certain amount per year. My program did that, but you had to purchase the items after the start of residency. My program also provided some books for free.

Best way to look into this is to call the program and ask what they can provide to the residents.

I hate saying it but drug-reps often provide books. While we should avoid the gifts of drug-reps, being over 100K in debt and making a very underpaid salary is enough justification to get a $50 book for free from a rep. Just don't allow that to influence your choice of meds.
 

TexasPhysician

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.

I hate saying it but drug-reps often provide books. While we should avoid the gifts of drug-reps, being over 100K in debt and making a very underpaid salary is enough justification to get a $50 book for free from a rep. Just don't allow that to influence your choice of meds.
Exactly. I don't understand why there is so much drama with drug reps. They can provide quality information about their drugs, provide educational resources, etc. If you allow drug reps to influence your prescribing, we should ban tv commercials and billboards too. Those catchy jingles probably influence prescribing just as much as drug reps, and jingles don't provide me with any education.
 
Sep 21, 2009
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Thanks for the input guys.

I used Up to Date constantly during my inpatient rotations, I agree that it's stronger on medicine, ob/gyn, etc topics but I wouldn't mind having it as a quick resource.

I definitely plan to keep my epocrates subscription for my phone, it's saved me saved me embarrassment before more than a few get pimped-on-random-junk sessions. :) The paid version even has pictures of pathology, typical imaging, histology, etc. It doesn't have every zebra in the jungle, but it's an excellent bread and butter resource with good info on ddx's to consider, standard workups and treatment options. It also has OTC drugs and herbal stuff added to the formulary (complete with known side effects and drug-drug interactions), which is really awesome.

At the very least the free version provides pricing information for Rx drugs, something I always check before writing a new script.

I decided early during medical school not to take free stuff from drug reps.
 

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Agree with the above posters re: find out if there is reimbursement or educational funds for residents to buy resources. Again, you may have to wait till your start date to purchase, in order to have your receipts be reimbursable. Call up your program and check.

My recommendations are the following--but note, I really like to read and have references:
- Kaplan & Sadock: my program gave us the "baby" K&S, which is okay. The "big" K&S (2 volumes) is about $200 and I haven't bought it--books go out of date, and many med school libraries have access to the electronic version of the textbook for free.
- Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (3rd ed). This is "big" Stahl, the textbook version. Great reference and for core reading. Great diagrams.
- Stahl's "The Prescriber's Guide" - indispensable clinical reference on every psychotropic you've ever heard of (and some you haven't), with practical points for dosing, how to start someone, key drug interactions, key lab testing/monitoring, most common side effects & how to address, clinical "pearls". I referred to this on a pretty regular basis during my intern year. I use it less now, mostly because I have a pretty standard arsenal of drugs that I use a LOT and therefore know a lot about them. But I still like having this around for reference for when I encounter a patient on a drug that I am less familiar with, or want to try something that's not part of my usual repertoire.
- Your program/hospital should have institutional access to UpToDate; I wouldn't pay the big bucks for your own subscription.
- Kaufman, "Clinical Neurology for Psychiatrists"
- "Core Competencies in Psychotherapy" series: my program gave us some of the books in this series, the two best ones are probably "Long Term Psychodynamic Psychotherapy" by Glen Gabbard, and "Learning Cognitive Behavioral Therapy" by Wright et al. You definitely don't need these for your intern year. When you start learning therapy, they are good basic texts to familiarize you with major concepts and approaches.
- Finally, I love my free resident membership to the APA, which comes with a monthly subscripton to the "green journal" (AJP) and unlimited online access to all the APA-affiliated publications (green journal, Psych Services, etc) that carry most of the major papers in our field. Also, they have access to e-books through the APA website.

I wouldn't go crazy and get all of these at once. But I'd definitely recommend the Stahl's Prescriber Guide to get started. Have fun!
 
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Exactly. I don't understand why there is so much drama with drug reps.
I think while everyone thinks that they're not influenced by drug reps, research shows that when doctors accept gifts from reps they're more likely to prescribe the drug the rep is promoting. While no one has the time to read all the literature and be perfectly evidence based, seeing drug reps can just add even more (unconscious) confusion to the prescribing process.
 

whopper

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I think while everyone thinks that they're not influenced by drug reps, research shows that when doctors accept gifts from reps they're more likely to prescribe the drug the rep is promoting.
True. We need to not allow ourselves to fall into the trap. I have argued in the past that I do think drug-reps can still be a beneficial part of the process, though the exact line between where their prescence becomes good to evil is hotly controversial.

As for anything you buy for your training, remember such purchases are tax-deductible. If you are not reimbursed, save the receipts and you can use them for a deduction.

One thing several medstudents do not know how to do, nor have the time to learn about, is organizing your financial future. While many of you medstudents are in easier electives, you might want to pick up a financing book. It's time to start looking into 401Ks, getting your debts paid off, and planning when you want to do Step 3 so you can start moonlighting.
 

TexasPhysician

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I think while everyone thinks that they're not influenced by drug reps, research shows that when doctors accept gifts from reps they're more likely to prescribe the drug the rep is promoting. While no one has the time to read all the literature and be perfectly evidence based, seeing drug reps can just add even more (unconscious) confusion to the prescribing process.
So do commercials, billboards, ads in medical journals, books called Prozac Nation, etc. etc.
 

whopper

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If this becomes a debate on the issue of drug-reps, I say another thread should be started since it is a different topic. So, everyone hold their peace, or please start another thread if you want to discuss the issue.
 

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If this becomes a debate on the issue of drug-reps, I say another thread should be started since it is a different topic. So, everyone hold their peace, or please start another thread if you want to discuss the issue.
Well, drug reps are a resource of sorts...it's just that they're trying to buy YOU, instead of the other way around.

(Happily practicing in a Rep-Free environment for 3 years now...)
 
Sep 21, 2009
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Thanks for all the advice guys!

I recently discovered that I can email myself articles from Up to Date to read at my leisure at home (for free!) and I've totally been taking advantage of this. Definitely motivated by the looming terror of being a "real" doctor in a few months. ;)

As far as financial stuff, don't I know it... My husband recently forced me to sit down and look at our loans and budget for the next few years, painful! I'm so excited about actually having a job, I find myself having a hard time not indulging on stuff we've been putting off for so long... I just want a couch... and some new work clothes... and a kitchen table... and and and... :D
 

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My most used item ever is the Tarascon Pocket Pharmacopedia. Never got much benefit from the electronics.
 

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I just put together my first iphone app "Psych Dx" for this purpose. I'd love feedback on how to make it more applicable for your particular clinical work (whoever you are). I'm going to be continuing to develop it over time.
 

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I just put together my first iphone app "Psych Dx" for this purpose. I'd love feedback on how to make it more applicable for your particular clinical work (whoever you are). I'm going to be continuing to develop it over time.
Speaking of which--has anyone put together a list of "Must have" iphone apps for a psychiatrist?
I'm making the jump as soon as ATT gets me my hardware!
 

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For iphone apps I use on a regular basis:

epocrates (free) -- not much more to say about it. Dosing help, mechanisms, some pharmacology info. The interactions search is woefully inadequate, though, missing a lot of interactions.

Skyscape (free) -- less so an app as much as an ebook reader of medical books. Of course the medical books are full priced. This is the current portal to such resources as Stahl's prescriber's guide.

Calengoo ($6.99) -- Syncs all your google calendars, including tasks. Useful for keeping track of the 200 things to do in a day. Only competitor seems to be smart time pro, which has a feature that you can list time of tasks to be done, and it will offer times to fit in those tasks in your day. ST Pro will probably be better than calengoo in a couple of updates, but right now still has some bugs.

E-readers (kindle/stanza/ibooks) -- haven't been using these for medical books yet, but may in the future.

Convert Units -- exactly what you think it is.

Keeper (Free) -- Password protected password keeper. Anyone else rotating at 3+ hospitals each with 3+ logins and passwords that have to be changed every 1-3 months. I have a great memory but I still need this as a backup with all the different sites I'm at. Some of my hospitals have 3 different EMR's and it's just too much.

Psych Dx ($5.99) -- Yes I designed it and I'm not trying to over-advertise, but thought this an appropriate venue. Basically I was sick of looking for software that didn't exist but was sorely needed. This current first edition includes 1. a MSE breakdown and thesaurus, great for teaching medical students, includes definitions of many terms often misused. Also includes some simple cognitive tests. 2. An ICD-9 lookup, broken down into diagnostic classes, searchable, and includes codes for billing (more specific than what DSM-IV uses of ICD-9 codes). 3. Medical testing -- utox breakdown, common false positive causes, periods of detectability; recommendations for workup of psychosis, including first episode. 4. References, clinical pearls built into the MSE/ICD-9 components. Many other additions on the way, including: a glossary of terms and common abbreviations (useful again for med students/interns). Utility of other medical testing for other psychiatric conditions. Neuropsych testing and how/when to get it and understand others reports. And a bunch more.

Evernote (Free) -- take notes in typed, voice recording, or camera. Not as useful on an ipod touch.

Dragon (free) - Dictation software. More useful for small samples of speech. More of a nice backup than a regular use.