Having a hard time

[AllUpOnYoMama]

---

Members don't see this ad.

What's up everyone. A little background: Im a caribbean med student who just passed step 1 with a 210/87. I have about 4 weeks till I start my first rotation (family medicine) and thought I should start reading my internal medicine book (internal medicine essentials for clerkship 2) while everything from step 1 is still fresh... I read the first 30 pages of the IM book today. Anyways, I'm having a REALLY tough time learning the material... knowing when to order transesophageal echo (I dont know what the hell that is), use this med because studies say better prognosis if the pt is hemodynamic stable vs this med, interpreting ECGs. I would think that after taking step 1, Id be somewhat familiar with the readings, but I feel like I'm reading chinese... You know, when the books talks about say heart failure and crackles in the lungs and all that good basic science stuff, that makes sense and its easy reading, but as soon as the book dives into prognosis and which tests to order etc, I just feel lost! Is this normal? Should I be starting off with a different book? Sorry for the long post guys. Thanks for the responses.

 

[Jumpin JAK STAT]

My advice would be to look up things if you don't know what they are. There's a lot of stuff to learn--that's why they call you doctor at the end of it!

 

[harrypotter]

What you're feeling is definitely normal. Just keep reading and looking things up. When you see patients with the symptoms, disease, it'll click. Hang in there!

 

[AllUpOnYoMama]

thanks for the replies

 

[rahulb]

first aid step 2 ck

 

[McGillGrad]

You should really be reading something more accessible to our level of understanding such as this book. This intro to clinical medicine book has short, concise chapters that cover all major issues we'll see every day.

It is more applicable to us and builds a bridge between basic sciences and the wards. Plus it makes you look smart when you quickly look something up and know what to do next.

 

[AllUpOnYoMama]

You should really be reading something more accessible to our level of understanding such as this book. This intro to clinical medicine book has short, concise chapters that cover all major issues we'll see every day.

It is more applicable to us and builds a bridge between basic sciences and the wards. Plus it makes you look smart when you quickly look something up and know what to do next.

Thanks for the reply. I think Im going to take your advice and find an easier read.

FA step 2 CK... really rahulb? I compared step-up for CK and FA and thought Step up was superior. Thats the word on the street as well. I'll take another look if you say so. Thanks man

Thanks for the replies everyone. For a minute there, I thought I was going to get smashed for saying I can't follow the text. Gd luck

 

[sirscrubsalot]

@McGillGrad - that was a great recommendation, thank you! 👍
In regards to cores & electives, how applicable was the text outside the Family & IM realm?

I was definitely looking for a text that would facilitate that bridge to clinical medicine and possibly to other areas.

@AllUpOnYoMamma - I felt the same way when I picked up the internal medicine clerkship guide. It assumed that I had already known or learned much of the material outside the main basic science subjects.

I'm also a Caribbean student, and I know lots of people from similar schools who didn't approach their clerkships in the direction you're looking towards. Meaning that for the most part, the school didn't give any "pre-clinical" training and kept the "focus" on strictly basic science subjects OR the students never gave a "hoot" on what to read or pick up. Bunch of people end up graduating after their clerkships feeling that they never really learned anything well. I definitely would like to avoid that mistake too!

Frankly speaking, it kind of sucks that some schools don't adequately prepare for the jump after 2nd year - at least you're taking the initiative!

Some friends of mine from other schools had recommended to read up first aid for the boards & wards prior to starting each core.

There's lots of threads here for what everyone's using in terms of a "text" for each particular core - I skimmed through a bunch, but it appears there is no "gold standard." Some people like this series, and others not - etc.

I haven't seen FA for CK or Step-Up for Step 2 yet since CK will be many months away. I do have however Step-Up to Medicine, and that's a pretty good book - almost everything I've seen on some of my rounds with plan/management-treatment have been fairly on point. The latter book definitely helped many of my friends pick up some good points on CK too. There are errors in there, and there is a thread on that here too.

Any other recommendations that help ease that transition in situations like ours are most welcome! I've checked the other valuemd forums - but not much activity over there for topics like this.

 

[rahulb]

Thanks for the reply. I think Im going to take your advice and find an easier read.

FA step 2 CK... really rahulb? I compared step-up for CK and FA and thought Step up was superior. Thats the word on the street as well. I'll take another look if you say so. Thanks man

Thanks for the replies everyone. For a minute there, I thought I was going to get smashed for saying I can't follow the text. Gd luck

yea i heard about most people's success with step-up but after my experience with first aid for step1 i couldn't disregard it. i went to barnes and nobles for an hour and just thumbed through whatever they had. step-up was mostly straight recall whereas FA was outline style similar to the step1 edition. there were a few other texts (deja vu and blueprints) that weren't too great.

step-up may work for a lot of people but i'm familiar with the FA style and like having tons of information on each page.

 

[ucsfstudents]

You'll get there eventually. Just remember to take things a step at a time.

Here's a sample note you will write on your family medicine rotation. Included are helpful resources for each section.

Patient Name
MRN#
Chief complaint: written by the nurse; ask the patient
HPI: This is based on the chief complaint. For specific questions to ask based on the chief complaint, use Current Clinical Strategies History and Physical Examination (CCS H&P)

Physical Exam: Use CCS H&P for focused physical exam

Labs: CCS H&P ; For lab interpretation use LANGE Pocket Guide to Diagnostic Tests

Imaging: CCS H&P; other resource

Assessment & Plan
Problem #1: Related to the chief complaint
DDx: CCS H&P
Diagnostics: Saint-Frances Guide to Outpatient Medicine or similar resource
Treatment: Saint-Frances Guide to Outpatient Medicine ""

Problem #2, etc. Their chronic illnesses and what you plan to do about them

You do not have to review every topic in medicine to start your family medicine rotation. Only review what you are most likely to see. Talk to your classmates or family medicine attendings to get an idea of what medical conditions you are most likely to encounter. Know those extremely well.

If you don't know what a medical condition, procedure, etc is, quickly look it up. If you need a place to keep track of your notes, I recommend flashcardmachine.com (free).

Other resources: UpToDate and AccessMedicine