How to study as an IM intern?

[Espressso]

Not so much talking about boards. I know the importance of questions and mksap and uw and all that. But what about general day to day studying/reading? I've heard of journalwatch to get new articles sent to your email weekly or so. And then just uptodate or harrisons. But is there anyone who can expand on that? Like in a given week as an IM intern, how do you approach your studying/reading?

Thanks in advance!

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[Redpancreas]

Not so much talking about boards. I know the importance of questions and mksap and uw and all that. But what about general day to day studying/reading? I've heard of journalwatch to get new articles sent to your email weekly or so. And then just uptodate or harrisons. But is there anyone who can expand on that? Like in a given week as an IM intern, how do you approach your studying/reading?

Thanks in advance!

It's mainly driven by your patients. Don't try to formalize the process. If you want a primer:

Primers:
1.) ACP's In Clinic provides solid review articles for ambulatory issues.
2.) Society guidelines: Ex.) IDSA, ACG, ACC, ASCO, NCCN, etc. provide guidelines for each specialty. You can print those and mark them up if you'd like but know they change.
3.) There is no good primer for Hospital Medicine. I have tried ACPs Guide to Hospital Medicine, NEJM for Residents, etc. None of them are practical. OnlineMedEd's residency version is pretty bad too.

Selected Topics:
>UptoDate is really king. Make sure to use it liberally on rotations
>Curbsiders Podcast sometimes has good topics on pain control, stress testing, etc. to fill in gaps, but they don't replace on-the-job training.
>I really like the blue "Current Medical Diagnosis and Treatment" (UCSF Internal Med book) as a desk reference for advanced reading into topics. The cons are it's not a portable reference like the Washington Manual or Sabatine's Pocket Medicine (both of which I also use/have).

Pre-Patient H&P:
It's nights and you have a patient admitted with anemia, you realize it's pancytopenia and want to know what to ask/order/do. These are the best.

>UptoDate
>Sabatine Pocket Medicine >> Washington Manual IMHO

I want to emphasize 99% of your experience will be developed through on the job daily! This frustrates a lot of people because of everyone's trying to find the UFAP of IM residency but none has developed because you learn on the job.

Best of luck.

 

[gutonc]

The above advice is fine, but it's way too complicated.

Read something, relevant to a patient, every day. 10-15 minutes, more if you have the time. Once a week, spend an hour or so going more in-depth. This could be a review article of acid-base physiology or current ACC guidelines on management of HTN or HLD. It could be a chapter or 3 in UTD or 30 MKSAP/UW questions with deep dives into the answers, right or wrong.

TL;DR - 15 min a day on a patient, an hour a week in depth. Profit!

 

[Redpancreas]

The above advice is fine, but it's way too complicated.

Read something, relevant to a patient, every day. 10-15 minutes, more if you have the time. Once a week, spend an hour or so going more in-depth. This could be a review article of acid-base physiology or current ACC guidelines on management of HTN or HLD. It could be a chapter or 3 in UTD or 30 MKSAP/UW questions with deep dives into the answers, right or wrong.

TL;DR - 15 min a day on a patient, an hour a week in depth. Profit!

To be fair at the beginning and end I emphasized how it's really driven by OPs patients and the meat of it was giving specific resources OP could use, not outlining a curriculum of saying OP needs to use all of them.

 

[AlbinoHawk DO]

I used a reference manual like Pocket Medicine when on the wards having to do it fast. Then when I was writing notes and stuff just read DynaMed or UpToDate. At home, I just studied for the boards or listened to curbsiders. I wouldn't go to crazy on studying as most stuff you will pick up by simply working during intern year

 

[HemeOncHopeful19]

The actual MKSAP text is very underrated for reading up on topics IMO, especially at the intern level. I found it very well organized and more importantly it hit the important points without getting lost in the weeds.

 

[BorntobeDO?]

The actual MKSAP text is very underrated for reading up on topics IMO, especially at the intern level. I found it very well organized and more importantly it hit the important points without getting lost in the weeds.

The one board basics is trying to make me the kind of doctor I should have been as an incoming intern lol. Man there is so much to know.

 

[Osteoth]

The one board basics is trying to make me the kind of doctor I should have been as an incoming intern lol. Man there is so much to know.

Start with the general internal medicine stuff too, it's useful for both clinic and hospital and covers some nebulous diagnoses like syncope, dizzyness etc.

 

[Chads2]

I want to emphasize 99% of your experience will be developed through on the job daily!

I agree wholeheartedly but would advise against the bad habit of “doing what we always do” or learning non-EBM from an attending.
I often tell residents if I’m doing something that is not evidence-based.