How to keep learning after medical school?

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gwjib04

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To EM residents and attendings out there: Going into EM intern year, I'm expecting even less structure in learning than there was in medical school.

How do you actually continue medical education? Not the CME for credit stuff but the real stuff.

Looking for a structure or method that might be out there. Probably best if it is for EM but open to any.

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As an intern? Show up. Learn. Read what your program gives you to read. This isn't something you really need to worry too much about as it is literally someone's job to figure out how to do this for you.
 
To EM residents and attendings out there: Going into EM intern year, I'm expecting even less structure in learning than there was in medical school.

How do you actually continue medical education? Not the CME for credit stuff but the real stuff.

Looking for a structure or method that might be out there. Probably best if it is for EM but open to any.
Read or listen to podcasts as needed.
 
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A lot of it is learning the system of your hospital. There are usually intern specific things based on the curriculum. ALIEMU, Foundations, etc are all places. The basic EMRAP is also a good place to start as an intern. Most important is showing up early and having a good attitude. The rest will follow.
 
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My advice for an attending would be different than for an intern. At your stage, you need to solidify and master your EM fundamental core. If you don't have time to read your assigned readings from whatever text you guys are using, pick a good review book like AAEMs board review book (the black one). It will serve two purposes... Reinforce your core knowledge, and help prep you for ITE and your future board exams. If you have trouble sticking to a reading plan, then pick a couple of cases you had during a shift and read related reference material. It will stick better because you associate it with a memorable case/patient. Obviously, you always want to read about whatever is related to your rotation...so if you are MICU that month, the blue book, vent management, anything CCM related, etc.. Always be referencing a procedure source like Roberts and Hedges, etc..

As an attending, you will have mastered most of your EM fundamental knowledge base, so you don't really need to read an EM text per say. Most "real world" learning I do these days is looking something up that I'm interested in either during or after a shift. Most of the times it's related to a case or something I want to understand a little better and want to dig into the details. For me, I use UpToDate to reference a lot of things because it has a lot of detail, is very evidence based and "up to date", doh! It also tracks my CME so I can use it to print out hospital and/or state requirements. I got a subscription for free in residency and used it a lot to look up things during shifts and I still have an account to this day and although I may not use it every shift, I use it often enough that it continues to be relevant.
 
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My advice for an attending would be different than for an intern. At your stage, you need to solidify and master your EM fundamental core. If you don't have time to read your assigned readings from whatever text you guys are using, pick a good review book like AAEMs board review book (the black one). It will serve two purposes... Reinforce your core knowledge, and help prep you for ITE and your future board exams. If you have trouble sticking to a reading plan, then pick a couple of cases you had during a shift and read related reference material. It will stick better because you associate it with a memorable case/patient. Obviously, you always want to read about whatever is related to your rotation...so if you are MICU that month, the blue book, vent management, anything CCM related, etc.. Always be referencing a procedure source like Roberts and Hedges, etc..

As an attending, you will have mastered most of your EM fundamental knowledge base, so you don't really need to read an EM text per say. Most "real world" learning I do these days is looking something up that I'm interested in either during or after a shift. Most of the times it's related to a case or something I want to understand a little better and want to dig into the details. For me, I use UpToDate to reference a lot of things because it has a lot of detail, is very evidence based and "up to date", doh! It also tracks my CME so I can use it to print out hospital and/or state requirements. I got a subscription for free in residency and used it a lot to look up things during shifts and I still have an account to this day and although I may not use it every shift, I use it often enough that it continues to be relevant.

Thanks this was very helpful
 
avoid podcasts, they tend to be highly focused and cover sexy procedures and rescus stuff, you need basics, not that. If you have time read the core EM stuff or short versions of Hedges, Rosen, Tint. My program paid for Rosh Review which was really helpful and hippoED videos which was also awesome for reviewing bread and butter stuff. I watched all the hippo vids and made an outline which I reviewed every year and I scored above the national and program average every year on the ITE. I also did the entire rosh set every year. If you don't get hippo PM me I may be able to help.
 
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You may be overwhelmed by trying to use too many sources for your foundational reading. Pick one thing (whether it be watching Hippo videos, reading Rosen's, etc.), and just stick with it. As others have alluded, cutting-edge podcasts are cool, but they cannot replace the basics.
 
To EM residents and attendings out there: Going into EM intern year, I'm expecting even less structure in learning than there was in medical school.

How do you actually continue medical education? Not the CME for credit stuff but the real stuff.

Looking for a structure or method that might be out there. Probably best if it is for EM but open to any.

Similar to the above posts.

Pick one or two resources and stick with it. More is not better, especially at early stages. Agree with rotation-specific learning (when in the ICU, focus on CCM, obviously; similar for peds/trauma/etc). I was always a huge question bank guy, so for me, some of the biggest bang for my buck came from use of Rosh and PEER question banks, with quizzes tailored towards subject matter depending on my rotation or residency-guided system for that block. Kind of like so many people do with UWorld and whatever other newer qbanks are out there now for med school boards, Step and otherwise.
 
I think for an intern, if you are at a solid residency program, they have you covered. That's the whole point of residency.

If you are a young attending, it is a real challenge. How do you eventually become a "PGY-25" and not a PGY-3 who practices for 22 years?

The most instructive thing I have found is continuing to follow patients you saw. If they are admitted, read the inpatient notes and the specialist consultations. I call a small percentage of patient's I discharge back in follow up to check on them and see how they are doing. Not everything specialists do in the hospital or in the clinic is relevant to what we do as ER physicians; however, I find some things insightful and have further illuminated my ER practice and what I need to do in the initial workup or at least better or more deeply understand a pathology and the basis of treating and dispo'ing it.
 
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The most instructive thing I have found is continuing to follow patients you saw. If they are admitted, read the inpatient notes and the specialist consultations. I call a small percentage of patient's I discharge back in follow up to check on them and see how they are doing. Not everything specialists do in the hospital or in the clinic is relevant to what we do as ER physicians; however, I find some things insightful and have further illuminated my ER practice and what I need to do in the initial workup or at least better or more deeply understand a pathology and the basis of treating and dispo'ing it.

Awesome, thanks for this.
 
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