Confused about how much to study....

[Bonesaw45]

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Hey All,

So I'm in my third week of M3 on psyche, and I still have no idea wtf I am doing for studying when I get home from the days work. My understanding is that a lot of the learning is done by following your patients and researching them when you get home. My issue with that is that I was on the consult/crisis response service for the first two weeks which is really just the psyche admission service. I really have no follow-up whatsoever with my patients because they are shipped off to other teams so I find it hard to get to textbooks on every patient because I have different patients every day. I have read through blueprints and FA for psyche (btw FA is definitely way better than blueprints) and I feel like it is mostly just a rehash of year 1 and 2 psych and pharm, there is really nothing new.

Is this what all of the year is going to be like? Are the review books are largely things I need to re memorize from the first two years + developing treatment plans? I'm just confused because I feel like I am missing something in terms of psychopathologies I need to know, and the depth I need to know them in.

 

[metallo]

Hey All,

So I'm in my third week of M3 on psyche, and I still have no idea wtf I am doing for studying when I get home from the days work. My understanding is that a lot of the learning is done by following your patients and researching them when you get home. My issue with that is that I was on the consult/crisis response service for the first two weeks which is really just the psyche admission service. I really have no follow-up whatsoever with my patients because they are shipped off to other teams so I find it hard to get to textbooks on every patient because I have different patients every day. I have read through blueprints and FA for psyche (btw FA is definitely way better than blueprints) and I feel like it is mostly just a rehash of year 1 and 2 psych and pharm, there is really nothing new.

Is this what all of the year is going to be like? Are the review books are largely things I need to re memorize from the first two years + developing treatment plans? I'm just confused because I feel like I am missing something in terms of psychopathologies I need to know, and the depth I need to know them in.

You'll find that you learn more new things on some 3rd year rotations than others. Psych and Internal Medicine are probably the ones with the least new material. As you said, a lot of the psych/pharm material is tested on Step 1, and a big part of Internal Medicine is knowing all the pathology you learned for Step 1. You'll learn a lot of new material on rotations like Peds, Surgery, and especially OB/GYN.

 

[BigRedBeta]

If you're looking only at new material as a measure of "learning" you're missing the point of clerkships (and essentially graduate medical education as a whole). Now is the time to learn how to apply everything that came from the last two years.

If you're on an admission service, then unless you can walk out of the patient's room, give a complete and coherent presentation with accurate diagnosis (since you're on psych, based off of DSM-IV criteria) as well as a complete plan for the hospitalization, then you still have many things to learn and to work on.

If you absolutely feel like you know the psych conditions backwards and forwards, then use the time to work on other skills - being efficient with your H&P, improving your presentation, learning about important aspects of follow up care, developing plans for if your patient doesn't improve, or finding out the types of resources that are available in your community.

Lastly, unless you're going into psych, try to find out the ways in which this is going to affect your future career. You will deal with patients who have mental health issues no matter what field you go into (except for path or radiology I guess), so figure out what it is you have to be aware of when you treat them for their heart failure, or their fractured arm, or their melanoma, or if they're having surgery, etc...

 

[Bonesaw45]

I appreciate the input, but here comes the next question, how do I go about doing that when the attending really doesn't seem interested in letting me work with the patients? Any advice on how to work on those skills if I'm really just shadowing the attending? It's really not an ideal situation but I have approached the staff and asked if my experience is consistent with past med students and I have gotten a resounding yes. So what advice do people have for making the best out of a ****ty situation.

PS: I'm already planning on approaching the attending and asking for time to interview and such, but I'm planning for the worst.

 

[mglavin]

FA is great for psych that book is all you really need to rock the shelf maybe some question too like pretest but I don't remember what exactly I used. As far as interviewing and such you will get plenty of that this year so I wouldn't worry to much about it. Plus psych patients are really annoying to interview (except bipolar ones) because they will never really tell you why there in the hospital to begin with. Enjoy the light work load and read FA and do questions.

I'm already planning on approaching the attending and asking for time to interview and such

if you really want to interview just go talk to the patient yourself later in the day and don't be afraid to call out to the nurses for some PRNs