Does ability to recognize signs/symptoms vastly improve in residency?

[jacksweeds]

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Feeling a bit overwhelmed at the moment. Wondering how in the world I'll remember the signs/symptoms of every condition we've learned about in the first two years. From Christmas disease to microscopic polyangiitis to posterior scleritis....I just don't have any faith in my ability to retain signs/symptoms of everything.

Is it the case that once you're out there in residency you see the same handful of cases over and over (field dependent of course), so you get good at distinguishing those? My hope is this is how it works in the real world..because frankly, I don't see myself being a very good physician at the moment which really has me down..

 

[Psai]

You'll see a case and be like hm this doesn't fit. Then you call in the specialists to help you figure out what's going on. No one can remember everything.

 

[I'm No Superman]

Christmas disease apparently isn't as fun as it sounds.

What Is Christmas Disease?
Christmas disease, also called hemophilia B or factor IX hemophilia, is a rare genetic disorder in which your blood doesn’t clot properly. If you have Christmas disease, your body produces little or no factor IX. This leads to prolonged or spontaneous bleeding. The less factor IX your body produces, the worse your symptoms are. Without treatment, Christmas disease can be fatal.

A person is born with Christmas disease, but it may not be diagnosed until later in life. It’s estimated that two-thirds of cases are inherited. The other cases are caused by spontaneous gene mutations that occur for unknown reasons during fetal development. The disease almost exclusively in males.


The disease is named for Stephen Christmas, who was the first person diagnosed with the condition in 1952.

http://www.healthline.com/health/hemophilia-b

 

[Anicetus]

M3 here. I realized I'm one of those who doesn't get better at it. 100% committed to Gen Surg now. It's a calling. Join us.

 

[musicalfeet]

M1 and I can't even remember basic conditions in our beginning physical diagnosis course. I don't know how some people are super fast at it--we had some quiz questions in lecture and people were shouting it out like 5 seconds after the question came up on the presentation and I'm all like Wait I gotta marinate".

Like, they'll talk about x patient presenting with a large V wave on their JVP or whatever and soft S1 and somehow someone will immediately know the answer. I have to sit there and be like " wait...so what are the causes of a large V wave...okay...what can cause soft S1...okay what's in common between the two...oh that's it". Makes me feel like an idiot..

EDIT: Being that we haven't even started learning diseases or anything like that, I'm pretty sure I'm going to suck it up 2nd year and it's just going to get worse.

 

[dpmd]

It is a combo of doing more exams so getting better at it and common things being common so you remember those constellations (and when it is a weird pattern you at least recognize it is weird so you can look up potential reasons).

 

[Ismet]

You get familiar with what's in your specialty's wheelhouse, if you're not sure you look it up, and if you're really not sure or you want more input then you consult another specialty or subspecialty.

You also retain things better when you see patients present with diseases in different ways. Instead of remembering it from a book or UWorld question you remember it from that one patient who had this interesting presentation of X disease, or you've just seen enough patients with it.

 

[jacksweeds]

It is a combo of doing more exams so getting better at it and common things being common so you remember those constellations (and when it is a weird pattern you at least recognize it is weird so you can look up potential reasons).

So I'm guessing it's somewhat as I suspected; taking X histories and doing X physicals and seeing disease X number of times will help me retain what I need to retain. That's comforting to hear.

 

[cbrons]

presenting with a large V wave on their JVP or whatever and soft S1

oh those arent real world patients, just bad board exam questions.