I'm a stupid intern... what to do?

[CaptKirk]

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So here's the deal. It is day#3 of my internship. My first rotation is ward medicine and objectively speaking it hasn't been that bad... except that I'm an idiot. I can't remember anything from medical school and it's not coming back. I know, 3 days seems a little fast. But looking around at my peers, I really know I am behind the curve.

I'm just wondering... does anyone have any ideas for how to bring myself up to speed quickly? I can't read Harrison's, that's not realistic in the timeframe I am dealing with. I'm just wondering if anyone has a nice reference that could ideally be read in a couple weeks that touches on most of the bread and butter medical problems, diagnosis and treatment. I'd just review a Step 2 book but I don't think that's enough detail... and like I said, I think Harrison's is overkill for where I'm at (not even going into medicine, just need to survive internship without being a liability for my team).

 

[Blade28]

Easiest thing to do (and best for memory retention) is to read up on the various diseases (especially the common ones) that your patients have. If you're an IM intern and have patients with the usual CAD, DM, HTN, etc., then start by reading up on those diseases.

IM people seem to love Up-To-Date - quick, concise articles that are more digestible than Harrison's (though I actually like the latter). See if your program has an institutional license for this product.

 

[Winged Scapula]

There is a wide amount of variation in skills and knowledge level at the beginning of internship. It almost always seems like everyone else knows more than you. I assure you that you know more than you think you do and that by the end of the year, it will all even out.

In the interim, get yourself a handbook. Many of these have detailed information condensed into a handy size you can carry around...I'll let the medicine people advise you as to which book would be best.

Its just like coming back after summer vacation when you were a kid. You couldn't remember how to write in cursive or how to spell anything, but a couple of weeks went by and you were back to baseline. Make sure you write down everything you are told to do, read up on patients and whatever you perceive to be your weak point, watch, listen and learn from your Chiefs and faculty and you'll see...it will become second nature.

 

[Blade28]

Its just like coming back after going into the lab to do research when you were a resident. You couldn't remember how to write orders or operate or how to dictate anything, but a couple of weeks went by and you were back to baseline. Make sure you write down everything you are told to do, read up on patients and whatever you perceive to be your weak point, watch, listen and learn from your Chiefs and faculty and you'll see...it will become second nature.

Sigh...

😉

 

[Winged Scapula]

Sigh...

😉

Good edit...I actually had to check back and see if I wrote that. Probably a better analogy anyway.

I remember those days as an intern and junior resident, having to tell the 3rd year, just out of the lab, where everything was, how the rules had changed since they were on service, etc. At least you're moonlighting so you will have no excuse for forgetting how to write for IV fluids or to turn off the Hep gtt at 0400 before the OR.😉

 

[Blade28]

At least you're moonlighting so you will have no excuse for forgetting how to write for IV fluids or to turn off the Hep gtt at 0400 before the OR.😉

Good point!

Thank goodness for moonlighting. 🙂

 

[DarthNeurology]

So here's the deal. It is day#3 of my internship. My first rotation is ward medicine and objectively speaking it hasn't been that bad... except that I'm an idiot. I can't remember anything from medical school and it's not coming back. I know, 3 days seems a little fast. But looking around at my peers, I really know I am behind the curve.

I'm just wondering... does anyone have any ideas for how to bring myself up to speed quickly? I can't read Harrison's, that's not realistic in the timeframe I am dealing with. I'm just wondering if anyone has a nice reference that could ideally be read in a couple weeks that touches on most of the bread and butter medical problems, diagnosis and treatment. I'd just review a Step 2 book but I don't think that's enough detail... and like I said, I think Harrison's is overkill for where I'm at (not even going into medicine, just need to survive internship without being a liability for my team).

In Pediatrics the Pediatric Version of the "Hitchhiker's Guide to the Galaxy" is easily the Harriet Lane Handbook. I love this handbook.

I also was fortunate enough to find what I believe is almost the internal medicine equivalent to Harriett Lane,:


The Osler Medical Handbook

I loved this handbook, and it is something you can either read on a lazy (or a couple) lazy golden weekends. heck, I want the new edition, but you know what? Medicine doesn't change much, read this book will help you years later . . .

That being said there is always something better. Remember in GhostBusters when one of the Ghost Busters quoted "Tobin's Guide to the Spirit World", probably not. I think it was fictional, but mean to be an obscure source of everthing. I have and simply love my own medical version of Tobin's Guide to the Spirit World:

The Toronto Notes
by Rebecca Colman and Ron Somogyi (Paperback - Mar 9, 2008)


This gem is written by Canadian doctors for us and canadian medical students. Sorry, but Canadian doctors have to get better grades than US doctors and I got sky high board scores with this baby too, so they must know something.

Now of course I learn by reading journals like NEJM, Pediatrics, JAMA 75% of times and eventually you will need to do this, but the Osler Guide is what will help jump start your brain.

A quote to motivate you:

"Everything which is moveable is mine, anything which can not be moved we will burn."

---Attributed to Ghenghis Kahn, Emperor of the Mongol Empire, the largest contiguous empire in history.

 

[orientedtoself]

agree with other posters- read up to date on the conditions that your patients have. also, get pocket medicine if you don't already have it. it covers most major medical inpatient issues, at the level of depth that would be expected of an intern or resident. it tells you, for example, which labs to order on pleural fluid to determine if it's an exudate or transuate by light's criteria, and has the criteria there for you. it also has some literature references that you can look up if you want.

 

[CaptKirk]

Thanks for the responses, they are much appreciated. 🙂

 

[Finding Chi]

Totally agree with Pocket Medicine. I jot little clinical pearls in the margins. It is a fixture in my white coat pocket, usually with my beat-up copy of Sanford, and (when I'm in the unit - which seems like always lately) the Tarascon Critical Care Pocketbook.

Up to Date is great for quick, reasonably in depth references while you are in house/ in the middle of admitting a patient.

At home, I'd alternate between good review articles (NEJM and JAMA are good resources), and using MKSAP or Med-study for topic reviews.

When I want to get hard-core, then I bust out my Harrison's.

 

[Top Gun]

I'm starting my intern year too. I got Internal Medicine On-Call. I've been looking through it, and it seems pretty useful. I officially start on July 1, but I'm going in Monday to shadow the residents, and get an idea of what I'll be doing.