Havent been on is ages...

[G0dFather]

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Hey everyone hope all is well, finally back on ... if anyone has any questions about 4th year please feel free to ask them here ... I have gained some insight from all the nonsense this waste of a year has to offer ...

 

[Ferocity]

 

[Adam Smasher]

Hey everyone hope all is well, finally back on ... if anyone has any questions about 4th year please feel free to ask them here ... I have gained some insight from all the nonsense this waste of a year has to offer ...

"waste of a year" is pretty extreme, but I have similar feelings.

 

[dyk343]

Everyone always says 4th year is the worst. Why so?

(3rd year rocks)

 

[Adam Smasher]

Accounts of 4th year will vary, since we spend our year in different programs. Personally, I've had good months and bad months. During the bad months, the student's job consists entirely of manual labor, the attendings and residents are not remotely interested in what you learn that month, and you have to smile and thank them for the opportunity while wondering in the back of your mind why you still pay tuition.

During the good months, the residents challenge you to think about what you're doing instead of just telling you what to do, and while you still will be tackling all the scut work, they appreciate you for it.

In my opinion, nothing sucked harder than 2nd year.

 

[Royal Rooters]

I know this question gets asked every year, but for 4th year and the months leading up to 4th year what what materials do you most recommend students focus on using? With classics like Presby, Hershey, PI manual, Foot and ankle secrets, pocket podiatrics and prism there are plenty of options available. I imagine that it'd be very easy to spread yourself out too thin as a student tackling all these resources.

Thoughts/advice? Many thanks!

 

[air bud]

Right now as a 3rd year you should be reading McGlamrys. The new one is great. Very easy to read, better pictures, less history, less boring. Read the chapters you think you should be reading. 6 things to focus on: Anatomy (numero uno), antibiotics/bugs/doses, internal fixation, trauma and classifications, Osteo, Imaging. You don't need to be reading individual steps on how to do a triple (as a 3rd year).

You need to understand principles of fixation (Rockwood and Green is my favorite for this), types of plates, how to achieve compression, steps in screw fixation...

You need to know Ankle, Calc and Talar classifications, how to fix them, complications....

You need to know how to recognize OM, from physical signs and symptoms to x-ray/MRI/bone scan....

You need to know basic dosages and when to use Zosyn, Vanc, Ancef, Keflex, Cipro, Levo, Clinda, Bactrim, Zyvoxx, Linezolid, Invanz. Understand Staph, Strep, MRSA and psuedo ( and anaerobes)...

You need to know anatomy. Anatomy, Anatomy and Anatomy. If you understand anatomy, you can answer 75 percent of questions asked in the OR. Much of it you need to see in surgery to really grasp, but you can understand location and function from a book.

You need to understand principles of bone healing, wound healing and tendon healing...time frames, stages....

You need to understand flatfoot - how to evaluate plane of deformity based on X-rays, suggest procedure that will correct that plane

You need to know how to read an X-ray. I know every program is different, but I found the quickest, fastest way is too combine views and make one profound statement. Instead of going through your AP and saying you see lateral displacement of the MT fracture, then moving on to your oblique, say "I am looking at both an AP and MO. The 2nd MT has an extra-articular midshaft spiral fracture with plantar and lateral displacement." It takes time to get comfortable. Any chance you have, ask a resident if you can read it quickly (your best judgement on if there is time...). Say what you see, it is that simple. Don't get caught up saying "There doesnt appear to be any soft tissue emphysema." if there isnt any. Give the pertinent positives. Short and sweet. If they want more, they will ask. Explain what you see, thats all. I used to get caught up in trying to say all the fancy words and try and sound smart and the like.

You need to know how to look at an X-ray and know what procedure was done based on where the screws/plates/staples are.

This is the type of thinking you need to be doing as a 3rd year.
Edit - forget part of flatfoot and last sentence also.

 

[jehjr]

That's pretty much a summary of all of the advice i have received that seemed useful. Thank you, sir.

 

[pacpod]

Right now as a 3rd year you should be reading McGlamrys. The new one is great. Very easy to read, better pictures, less history, less boring. Read the chapters you think you should be reading. 6 things to focus on: Anatomy (numero uno), antibiotics/bugs/doses, internal fixation, trauma and classifications, Osteo, Imaging. You don't need to be reading individual steps on how to do a triple (as a 3rd year).

You need to understand principles of fixation (Rockwood and Green is my favorite for this), types of plates, how to achieve compression, steps in screw fixation...

You need to know Ankle, Calc and Talar classifications, how to fix them, complications....

You need to know how to recognize OM, from physical signs and symptoms to x-ray/MRI/bone scan....

You need to know basic dosages and when to use Zosyn, Vanc, Ancef, Keflex, Cipro, Levo, Clinda, Bactrim, Zyvoxx, Linezolid, Invanz. Understand Staph, Strep, MRSA and psuedo ( and anaerobes)...

You need to know anatomy. Anatomy, Anatomy and Anatomy. If you understand anatomy, you can answer 75 percent of questions asked in the OR. Much of it you need to see in surgery to really grasp, but you can understand location and function from a book.

You need to understand principles of bone healing, wound healing and tendon healing...time frames, stages....

You need to understand flatfoot - how to evaluate plane of deformity based on X-rays

You need to know how to read an X-ray. I know every program is different, but I found the quickest, fastest way is too combine views and make one profound statement. Instead of going through your AP and saying you see lateral displacement of the MT fracture, then moving on to your oblique, say "I am looking at both an AP and MO. The 2nd MT has an extra-articular midshaft spiral fracture with plantar and lateral displacement." It takes time to get comfortable. Any chance you have, ask a resident if you can read it quickly (your best judgement on if there is time...). Say what you see, it is that simple. Don't get caught up saying "There doesnt appear to be any soft tissue emphysema." if there isnt any. Give the pertinent positives. Short and sweet. If they want more, they will ask. Explain what you see, thats all. I used to get caught up in trying to say all the fancy words and try and sound smart and the like.

That is great advice, air bud. Thanks!

 

[dyk343]

Right now as a 3rd year you should be reading McGlamrys. The new one is great. Very easy to read, better pictures, less history, less boring. Read the chapters you think you should be reading. 6 things to focus on: Anatomy (numero uno), antibiotics/bugs/doses, internal fixation, trauma and classifications, Osteo, Imaging. You don't need to be reading individual steps on how to do a triple (as a 3rd year).

You need to understand principles of fixation (Rockwood and Green is my favorite for this), types of plates, how to achieve compression, steps in screw fixation...

You need to know Ankle, Calc and Talar classifications, how to fix them, complications....

You need to know how to recognize OM, from physical signs and symptoms to x-ray/MRI/bone scan....

You need to know basic dosages and when to use Zosyn, Vanc, Ancef, Keflex, Cipro, Levo, Clinda, Bactrim, Zyvoxx, Linezolid, Invanz. Understand Staph, Strep, MRSA and psuedo ( and anaerobes)...

You need to know anatomy. Anatomy, Anatomy and Anatomy. If you understand anatomy, you can answer 75 percent of questions asked in the OR. Much of it you need to see in surgery to really grasp, but you can understand location and function from a book.

You need to understand principles of bone healing, wound healing and tendon healing...time frames, stages....

You need to understand flatfoot - how to evaluate plane of deformity based on X-rays

You need to know how to read an X-ray. I know every program is different, but I found the quickest, fastest way is too combine views and make one profound statement. Instead of going through your AP and saying you see lateral displacement of the MT fracture, then moving on to your oblique, say "I am looking at both an AP and MO. The 2nd MT has an extra-articular midshaft spiral fracture with plantar and lateral displacement." It takes time to get comfortable. Any chance you have, ask a resident if you can read it quickly (your best judgement on if there is time...). Say what you see, it is that simple. Don't get caught up saying "There doesnt appear to be any soft tissue emphysema." if there isnt any. Give the pertinent positives. Short and sweet. If they want more, they will ask. Explain what you see, thats all. I used to get caught up in trying to say all the fancy words and try and sound smart and the like.

👍 Thanks for taking the time to type that up.

 

[air bud]

See my edit, added a few sentences to flatfoot and at end.

Also, in regards to anatomy, you will often get questions like "what am I worried about hitting if I do this _____"

You don't need to be getting caught up in things like types of growth factors involved in bone healing (IGF, VEGF etc....), Get the big picture, then it will be easier to fill in details later

You don't need to get caught up in historical procedures, you will see an Austin 90% of the time.

I am speaking in generalities, each program will have specific things they like. Residents, Attendings and other clerks jump in here.

 

[G0dFather]

Right now as a 3rd year you should be reading McGlamrys. The new one is great. Very easy to read, better pictures, less history, less boring. Read the chapters you think you should be reading. 6 things to focus on: Anatomy (numero uno), antibiotics/bugs/doses, internal fixation, trauma and classifications, Osteo, Imaging. You don't need to be reading individual steps on how to do a triple (as a 3rd year).

You need to understand principles of fixation (Rockwood and Green is my favorite for this), types of plates, how to achieve compression, steps in screw fixation...

You need to know Ankle, Calc and Talar classifications, how to fix them, complications....

You need to know how to recognize OM, from physical signs and symptoms to x-ray/MRI/bone scan....

You need to know basic dosages and when to use Zosyn, Vanc, Ancef, Keflex, Cipro, Levo, Clinda, Bactrim, Zyvoxx, Linezolid, Invanz. Understand Staph, Strep, MRSA and psuedo ( and anaerobes)...

You need to know anatomy. Anatomy, Anatomy and Anatomy. If you understand anatomy, you can answer 75 percent of questions asked in the OR. Much of it you need to see in surgery to really grasp, but you can understand location and function from a book.

You need to understand principles of bone healing, wound healing and tendon healing...time frames, stages....

You need to understand flatfoot - how to evaluate plane of deformity based on X-rays, suggest procedure that will correct that plane

You need to know how to read an X-ray. I know every program is different, but I found the quickest, fastest way is too combine views and make one profound statement. Instead of going through your AP and saying you see lateral displacement of the MT fracture, then moving on to your oblique, say "I am looking at both an AP and MO. The 2nd MT has an extra-articular midshaft spiral fracture with plantar and lateral displacement." It takes time to get comfortable. Any chance you have, ask a resident if you can read it quickly (your best judgement on if there is time...). Say what you see, it is that simple. Don't get caught up saying "There doesnt appear to be any soft tissue emphysema." if there isnt any. Give the pertinent positives. Short and sweet. If they want more, they will ask. Explain what you see, thats all. I used to get caught up in trying to say all the fancy words and try and sound smart and the like.

You need to know how to look at an X-ray and know what procedure was done based on where the screws/plates/staples are.

This is the type of thinking you need to be doing as a 3rd year.
Edit - forget part of flatfoot and last sentence also.

How about this guy huh?!.... Hate to be competeing with whoever wrote this... But This is it.... if you can do this as a 3rd yr you are boss.. sadly many fourth years cant even do this...You have an excellent grasp of whats going on man props... CAN SOMEONE STICKY THIS PLEASE!!?!

 

[G0dFather]

Waste of a year in what way? In that you felt you didn't learn as much as you thought or that you basically had no life for a year?

A mix of both Anklebreaker ... a mix of both...🙁

 

[Royal Rooters]

Wow, thanks for the detailed breakdown Airbud - solid gold stuff right here!

 

[PADPM]

Airbud has given excellent advice. Additionally, if you don't know an answer or don't know the details related to your answer, keep quiet. If not you will be questioned for more details and that will ultimately prove how much you DON'T know. If you answer, make sure you understand what you've said.

One more quick point. Not every pathology is esoteric, nor is every question a trick question.

I've asked students about their thoughts, and they give me a pathology that has been described twice in literature, and both cases were in the remote areas of Namibia. When in reality, the answer was "it's a corn". So don't always try to impress them with some esoteric minutiae. The answer is often very simple and straight forward.