CME/Learning After Residency

[Backpack234]

In the last few years, I've learned all the tricks to getting CME done without putting forth much effort. Click through up to date, skip ahead to the q/a part, buy this or that program, etc. etc.. But now I'm wondering what the best method for actually learning after residency is. Are there any particular resources or studying methods that you all use now that you're outside of the temple of academics?

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[WilcoWorld]

When your clinical experience shows you that there's something you're not up to speed in, drill deep down on that thing. Start with an NJEM clinical review article, and then follow some of your questions down rabbit holes of further reading. This makes it specific to you, and driven by your curiosity.

 

[HLxDrummer]

I love EBmedicine (peds and general), EMRAP, EMA, PEDSRAP.

 

[deleted547339]

When your clinical experience shows you that there's something you're not up to speed in, drill deep down on that thing. Start with an NJEM clinical review article, and then follow some of your questions down rabbit holes of further reading. This makes it specific to you, and driven by your curiosity.

This doesn’t pass the sniff test. You don’t know what you don’t know. I’d hate for the first time I realized I didn’t know about a changing practice was when a lawyer informed me.

 

[WilcoWorld]

This doesn’t pass the sniff test. You don’t know what you don’t know. I’d hate for the first time I realized I didn’t know about a changing practice was when a lawyer informed me.

I'm giving a single approach which should be incorporated among several others. I did not intend to say this is the only thing you should do.

 

[Backpack234]

This doesn’t pass the sniff test. You don’t know what you don’t know. I’d hate for the first time I realized I didn’t know about a changing practice was when a lawyer informed me.

Thankfully I think most of us see things we don't know on a daily basis and fill in the gaps with consultants, quick wikem searches, or luck that it doesn't come back and bite us. I appreciate the suggested strategy here and might go ahead with the NEJM subscription.

 

[Angry Birds]

Watch Scrubs, House, and if you still need a bit more you can try Greys

 

[clibby]

I love EM:Rap and with it EMA. My employers also sponsor relevant CME which is helpful too. UpToDate is helpful on or immediately after my shift, but I just can’t blindly use it at home. I’m still fresh out, but I loved EM:Rap and EMA in residency and I continue to love it now that I don’t have didactics to keep me up to date on the latest guidelines and practices I need to learn more about.

 

[WilcoWorld]

Watch Scrubs, House, and if you still need a bit more you can try Greys

Agree with the order here, Scrubs is definitely the gold standard in TVCME.

 

[WilcoWorld]

I love EM:Rap and with it EMA. My employers also sponsor relevant CME which is helpful too. UpToDate is helpful on or immediately after my shift, but I just can’t blindly use it at home. I’m still fresh out, but I loved EM:Rap and EMA in residency and I continue to love it now that I don’t have didactics to keep me up to date on the latest guidelines and practices I need to learn more about.

Any comments from long-time users on the latest content of EMRAP?

I started listening in 2007 or so, loved it. Continued to listen for another 10 years and started to find that content was being repeated & I was getting less out of it. For those listening for over 10 years - do you feel the show is at a place where it would be fresh again?

 

[Groove]

The only thing I really study these days is Uptodate. I'm frequently referencing it trying to dig into something related to a case or something I want to refresh my memory about. It has the most recent journal articles already linked. Plus, I tend to think you retain information better when it's relevant to what you're actually doing. Sometimes it might be me brushing up on management of something I haven't treated in awhile. Other times, it might be just referencing a component of PMHx. Moyamoya would be a great example. All I could remember was puff of smoke. Other day I also had a protein c deficiency and couldn't remember all the details of those coagulopathies so I decided to look them up again. Uptodate keeps track of all my searches and I can print out CME anytime I want.

Other than that, I get Annals in the mail and CDEM. Both are occasionally interesting. I'll thumb through them once a month. I alternate between EMRAP subscriptions over the years. I didn't have it for the last 2 years or so and recently activated it again. I find it much lower yield than I used to in the past. Too much fluff IMO.

I can't remember the last time I touched a textbook like Rosens or Tintinalli. I doubt I ever will again.

 

[EKGdoc]

EMEDHOME is pretty good- lots of great lectures, Amal Mattu frequent contributor. ~3 question CME quiz after the lectures.
AAEM conference talks are on the site, as well as a lot of other good CME conferences to access. Pretty timely topics, speakers are really good. <$100/yr. Tracks all the CME for you, you can get Peds or trauma separate printouts also.

 

[deuist]

EMRap can be boring and repetitive, but EMA stays fresh.

 

[Mushdoc]

EM Cases has great clinical content if you can get over the canadian accent

 

[clibby]

Any comments from long-time users on the latest content of EMRAP?

I started listening in 2007 or so, loved it. Continued to listen for another 10 years and started to find that content was being repeated & I was getting less out of it. For those listening for over 10 years - do you feel the show is at a place where it would be fresh again?

I don’t think I can comment on a 10 year view, but I can say that even over 4 years I have noticed the main podcast has incorporated more fluff than when I first started listening. For instance, I really don’t think the rural medicine stories teach me much at all and I usually skip them. The fluff is why I like EMA more which is just articles. I also like the mini updates with new guidelines or techniques on things that I wouldn’t have heard of otherwise now that I’m not in training. I also like that I can listen on the way to work and any relevant papers to look up are easily documented in the podcast notes for later. Maybe my mind will change in 10 years or EM:Rap will, but I like it enough for now combined with UpToDate for in depth details.

 

[DrDrummer]

Emergency Medicine has the richest ecosystem of free continuing education available of any specialty, which is what I use mostly. There are literally dozens of blogs and podcasts that put out pretty good content on a regular basis -- while a lot of them will cover the exact same journal articles or topics (essentially EM Memes), some are really, really good and put lots of effort into deep dives into a specific area. Emergency Medicine Cases was mentioned above and I think is probably putting out the best content now. EMDocs does a lot of curation and aggregation of other sites' content, which is nice if you don't want to go looking on your own. In terms of individuals, everyone knows about the EMCrit ecosystem (check out the IBCC if you haven't -- the podcast that Farkas and Thomas put out is really, really good). Another individual who publishes things less frequently but who is a very good teacher is Ruben Strayer.

Many residencies such as Northwestern, Hennepin, SUNY Downstate and I'm sure a lot others that I'm missing put their content online. You can find a lot of lectures from EM Board Review series on YouTube. Conferences like CODA put their lectures online for free and you can find a lot of good EM Content from EM Conferences like Essentials online for free or pay for the CME and full access.

For keeping up with blogs I use Feedly, which is an RSS Aggregator, to keep track of a bunch and I'm sure I'm missing some good ones that I have started putting out content. I also follow some internal medicine podcasts (Curbsiders is pretty good, but only occasionally EM relevant depending on how IM-ish you are and how much workup you want to get started in the ED for outpatient f/u or for your hospitalists) and surgical / critical care podcasts.

You have to be cautious about taking everything from the FOAMed world at face value, and most sites do not grant CME for licensure purposes (though some do and it's worth supporting the individuals who make all this if you can) but it's a great jumping off point for keeping up with the literature and refreshing your memory on things you don't see very frequently.

 

[Fox800]

EMRAP was okay, but I got sick of the little ditties and songs and sound effects. It costs too much to be full of that crap and it seems kinda juvenile. I ditched it for ER Cast, which is Hippo’s answer to EMRAP. I like it a lot more. Less fluff, more focused, more pertinent for me.

EMedHome is choice for the questions of the day, weekly clinical pearl is good. Plenty of video lectures from some good conferences.

Love EBMedicine review articles. Probably the highest quality CME for emergency medicine. It’s like an updated textbook for EM topics.

I’ll never spend my own money to go to the ACEP conference again. Last one (Denver) had lectures dumbed down for midlevels and medical students. I’m interested in going to Essentials, I hear it’s good.

 

[gamerEMdoc]

Big fan of EMRAP just because the subsciption has so much content. Whether its the main program, or getting a review of the monthly literature (EM abstracts), you can definitely stay up to date.

Can't speak highly enough of EB Medicine. In particular, that October issue this year.... DVT... whew... one of those authors is a GENIUS...

 

[thegenius]

The only thing I really study these days is Uptodate. I'm frequently referencing it trying to dig into something related to a case or something I want to refresh my memory about. It has the most recent journal articles already linked. Plus, I tend to think you retain information better when it's relevant to what you're actually doing. Sometimes it might be me brushing up on management of something I haven't treated in awhile. Other times, it might be just referencing a component of PMHx. Moyamoya would be a great example. All I could remember was puff of smoke. Other day I also had a protein c deficiency and couldn't remember all the details of those coagulopathies so I decided to look them up again. Uptodate keeps track of all my searches and I can print out CME anytime I want.

Other than that, I get Annals in the mail and CDEM. Both are occasionally interesting. I'll thumb through them once a month. I alternate between EMRAP subscriptions over the years. I didn't have it for the last 2 years or so and recently activated it again. I find it much lower yield than I used to in the past. Too much fluff IMO.

I can't remember the last time I touched a textbook like Rosens or Tintinalli. I doubt I ever will again.

This is what I do too. UTD is 95% of my material, the other 5% are actual journal articles or magazines I get in the mail.

Actually the more I think about it, I listen to ER podcasts all the time too.

 

[Angry Birds]

On a somewhat related note, it must suck to be an EM resident nowadays. The whole point of a good residency program is to see a large variety of patient presentations. How relevant is COVID-19 going to be five or ten years from now?

 

[WilcoWorld]

Big fan of EMRAP just because the subsciption has so much content. Whether its the main program, or getting a review of the monthly literature (EM abstracts), you can definitely stay up to date.

Can't speak highly enough of EB Medicine. In particular, that October issue this year.... DVT... whew... one of those authors is a GENIUS...

Did you just out yourself?

 

[gamerEMdoc]

On a somewhat related note, it must suck to be an EM resident nowadays. The whole point of a good residency program is to see a large variety of patient presentations. How relevant is COVID-19 going to be five or ten years from now?

It is definitely not ideal to be in training in any field at the moment. Imagine being an IM resident and all you admit is COVID. Or any surgical subspecialty and having your case load drastically reduced. There is no doubt that the longer this goes on, the more affected GME will be in this country.