How to prepare for intern internal medicine year

[JibsGuy52]

Hey all,

I know this has been posted before but does anyone recommend anything to prepare for intern year in an internal medicine residency?

ill keep it broad as that. I’d be willing to do anything.
Thanks!

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[popopopop]

I'm going IM too and although I'm studying other things, I want to get better at ekgs and imaging for sure before intern year. I've never been comfortable with them as much as I wanted to be. I also decided that I'll be organizing my notes digitally via Onenote so I got that ready for didactics. I'm also going to make a bit of a home gym in my rented duplex as I don't see myself ever driving to the gym during residency.

 

[JibsGuy52]

I'm going IM too and although I'm studying other things, I want to get better at ekgs and imaging for sure before intern year. I've never been comfortable with them as much as I wanted to be. I also decided that I'll be organizing my notes digitally via Onenote so I got that ready for didactics. I'm also going to make a bit of a home gym in my rented duplex as I don't see myself ever driving to the gym during residency.

What else are you studying out of curiosity?

 

[thepoopologist]

I'm not an internist but nightmares of my medicine months still abound.

Pimp questions included: reading imaging, reading EKGs, hyponatremia ie what happens if corrected too fast, what about high glucose low sodium what's that about, diabetes management, acid/base questions i.e. do you give bicarb in respiratory acidosis, what to watch out for in advanced liver failure, lots of questions about heart stuff CHF, how to treat certain rhythms, heart attack. Some pimp questions had to do with thought process, ie someone comes in with a brain abscess, whats the ddx how do you work it up.

Better you than me. Anyways at my hospital once you answered most of the pimp questions right, you were then free to actually learn and make mistakes without a magnifying glass on you

 

[popopopop]

What else are you studying out of curiosity?

I'm going through all my resources and compiling notes on general medicine complaints that I think I'll encounter. I'm working on strengthening my framework for pathologies basically. I know there are many reference books/resources for this type of stuff, but having something condensed and in my own writing makes it a bit more accessible. I went through a lot of Strong Medicine and can see why he's popular. I'll probably check out other youtubers if I get the chance.

 

[ciestar]

If youre gonna brush up on anything, get better with EKGs.

 

[Chads2]

Bugs and Drugs

1. What is the likely organism(s) causing the infection?
2. What Abx can empirically cover for those organisms?
3. What are the narrowest Abx that can cover the organisms?
Bonus: know your local antibiogram

Ex: Community Acquired Pneumonia. Likely organisms: S. Pneumo, less so H. influnenzae B, Mycoplasma PNA, legionella, other atypical. Coverage: Ceftriaxone for S. Pneumo, add macrolide for atypicals. Unlikely MRSA or pseudomonas, so you don’t need Vanco and Cefepime.

 

[Chads2]

One of the most important thing I teach interns: know how to call a consult. Ask a pointed question. No “GI consult for elevated LFTs,” but rather “Cholestatic liver injury pattern, imaging negative for CBD or intrahepatic ductal dilatation, chronic liver disease workup ordered and pending. Is MRCP also recommended or is ERCP indicated?”

Edited to make sense / for typos.

 

[aaronrodgers]

I'm not an internist but nightmares of my medicine months still abound.

Pimp questions included: reading imaging, reading EKGs, hyponatremia ie what happens if corrected too fast, what about high glucose low sodium what's that about, diabetes management, acid/base questions i.e. do you give bicarb in respiratory acidosis, what to watch out for in advanced liver failure, lots of questions about heart stuff CHF, how to treat certain rhythms, heart attack. Some pimp questions had to do with thought process, ie someone comes in with a brain abscess, whats the ddx how do you work it up.

Better you than me. Anyways at my hospital once you answered most of the pimp questions right, you were then free to actually learn and make mistakes without a magnifying glass on you

what anime is that gif from tho?

 

[thepoopologist]

what anime is that gif from tho?

Ghost in the shell

 

[Chads2]

Oh it’s almost July again. Time for me to get back to basics as far as teaching.

 

[Lost in Translation]

Ignore rereading stuff about specific organ systems. You can do that on the fly. What you cannot do on the fly is learn how to take care of 5x more patients than you were carrying as a med student. Learn to be efficient now. Make a workflow. Consults -> orders -> call the RNs to execute said orders -> notes. Learn to prioritize relevant information. You’ll order the same 5 labs on every patient every day; do you really need all of them? Or are you only trending one or two of the values? Remember to followup on tests you order. You are now the doctor, the patient is now your responsibility.