Learning during residency

[academicalias]

What tips would you recommend for learning during residency? There is obviously a lot of hands on "experience" learning that comes by completing residency.

- Did you write anything down during residency that you learned during didactics, rounds etc?

- Did you have any tips about learning during residency in general?

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[survivordo]

One word, read! Dedicate 30 minutes a night to reading something pertinent to the day or a topic you struggle with. If you do this every night you will develop life long learning habits which is probably the most important part of residency.

Survivor DO

 

[tallash]

I put a lot of stock in independent study and recommend the following:

1) Have some form of a pocket text (i.e., Pocket Medicine) with you and read the corresponding section before you start a pertinent rotation (i.e., cards for your cards month, renal for general medicine, etc.)

2) I picked up MKSAP at the beginning of intern year and have been trying to read along in corresponding sections in that for a few minutes on a regular basis every night. I think having a text between the level of Pocket Medicine (too little) and Harrison's (way too much) is useful to read along with rotations.

3) I have a list on my "To Do" list on my iPhone (I use Wunderlist) called "To Read" - it has a list of topics that I have questions about on rounds and such. I try to knock one of those suckers off the list every couple of days.

4) I UpToDate like crazy in the hospital as well, during rounds on my iPad if the attending isn't a good teacher and I don't have any responsibility for that patient, etc.

5) I try to attend our conferences as much as I'm able - at the very least I learn from the conferences. I can also read stuff on my own during conference on my iPad if the speaker sucks.

Bonus:
I try to skim through JAMA, NEJM, and a specialty journal of interest on a weekly basis. I focus on resident-specific type articles (reviews, game changing studies, etc.). Takes maybe 2 hours total a week.

I definitely haven't been able to always do all of the above on a nightly basis as I'm in a service-heavy program (in between research and working out, having a social life, etc.) but that's my general approach. I also don't really watch TV or anything which helps with finding time for independent stuff.

 

[anonymousdoc]

Thanks for these great comments. Very, Very helpful.

Any other suggestions out there from others for things that have worked for you?

 

[ArcGurren]

How should the reading material/amount of material change as you progress through residency? I feel like during intern year it'll be tougher to do a lot of reading so a small amount per day (like 30 mins) makes sense, but how about further on?

 

[ROBINHO]

Every admission you make is a learning opportunity. If possible take some 15 minutes at least to read about the admitting diagnosis. For first 6 months of residency I used up todate (Pocket Medicine is popular among my mates but I dont like it). After 6 months of residency I switched to the Wash manual. It is too pick to carry in pocket (I do though 🙂 ) but I have noticed that reading relevant information to patient am seeing on the ward has helped me a lot. Figure out what book works out best for u...once u find it....just make sure you read based on the patients you have!!!

 

[wyme84]

Does anyone use Harrison's? Is it an impossible goal to read through it? Or is it used as a reference?

 

[gutonc]

Does anyone use Harrison's?

No

Is it an impossible goal to read through it?

Yes

Or is it used as a reference?

No...it's used to prop up your couch.

 

[wyme84]

Great, thanks for the clarification

 

[DrDave]

When seeing pts - Uptodate; if you can't read the whole thing - read summary and guidelines at the bottom

Make a habit of reading abstracts from NEJM.

Pick up some question source like MKSAP or UWorld. Do 1-2 qts a day, especially now with mobile apps very easy to read either uptodate articles or qt explanations.

 

[flipmd]

Sunscribe to Journal Watch starting your second year (after you've figured out the basics in intern year with Uptodate etc). Read the abstracts of the email JW sends you, and if nothing else, you'll sound smarter when you spout off the new evidences that inevitably will be applicable to one of your patients.

 

[anonymousdoc]

Do you dedicate any particular time to step 3 study? Or is the normal day to day learning from admissions etc good enough for a study plan. Just trying to get a sense of the balance that exists between these two( assuming they are different)

 

[DOk1ng]

doubel post

 

[DOk1ng]

have u guys read review articles from NEJM, Cleveland Clinic, mayoclinic proceedings instead of MKSAP or textbook chapter ?

Other than looking up stuff in hospital, do you guys use uptodate as a primary reading source for reading along during residency ?

 

[Babyelephants]

Can anyone post an amazon link to the Washington Manual? Just want to make sure I get the correct one, thanks.

 

[survivordo]

have u guys read review articles from NEJM, Cleveland Clinic, mayoclinic proceedings instead of MKSAP or textbook chapter ?

Other than looking up stuff in hospital, do you guys use uptodate as a primary reading source for reading along during residency ?

I read uptodate quite often but primary texts are important as well (i.e. Schwartz or Sabiston for Surgery). Another resource to check into is "The Clinics" review articles, you can get them through MDConsult if your library provides this for you.

Survivor DO

 

[PlutoBoy]

I've been doing the following:

- I have the Uptodate app for my phone. I read about most patients on a daily basis. It's easy to do and you can just skim through the chapter to the particular question that you have or read the whole thing and build upon what you read before. It's just so easy to go and read the summary for any topic. As a bonus, it has all the calculators that you can possibly need and It will also make you look smarter 😛

- I also have MKSAP's qbank and textbook app on my phone and the Board Basics app as well. Good to practice questions during any off time. I don't use Board Basics often but it is good when I want to do a one minute refresher.

- During the first half of my intern year I carried Pocket Medicine. I really liked it and it helps with admissions. You will outgrow it pretty fast, though.

That's it. I read on the patient's I see on a day to day basis. I rarely study at home or topics that I don't see except when there is a specific concern. I'd rather master the things that I'll see on a daily basis. It seems to work since I scored pretty well on the In-service exam and I didn't prepare for it. In fact, I wasn't even doing questions at the time.

I've never read Harrison's during residency 😳

🙂

 

[AashooKM]

Continuously reading reference materials and staying on top on the latest news is always a great idea. I would add staying up on medical news by reading related blogs.

Finally, you should also write about your experiences and what you learn. This will help you retain the information longer.

 

[VentdependenT]

Pick up MKSAP audio off ebay. Theyre pirated copies but make tackling the more mundane material palatable. Tremendously helped me on inservice.

 

[dozitgetchahi]

A few things I've been using that seem helpful are the docalert/Medscape News features in the epocrates/Medscape apps respectively, and ACP journalwise. The ACP email blasts also give you concise summaries of medical news relevant to internal medicine.

 

[sylvanthus]

Any good IM podcasts? Seems there are a few for EM (EM:RAP EMCrit etc) Any good ones for internal med you guys recommend?