I will be starting my OMS 3 year next month and I would like to know what you would do differently and anything you would tell your younger self. I am interested in IM & FM.
Congratulations on making it past preclinical years.
- Which platform would you use for studying/questions and how would you use it?
- OME is essential in my opinion. Same goes for UWORLD. Personally I would suggest watching the OME videos and simultaneously unsuspending the corresponding cards from ANKING. UWORLD try and finish the questions prior to your COMAT.
- Would you use anki, and if so, which deck do you recommend? Would you suspend cards after finishing a rotation or keep it going?
Again my opinion is that anki is essential. Use the ANKING deck and unsuspend cards for the OME videos that you watch. After you finish the cards for the videos for the specific specialty youre on then go to the shelf tagged deck. Unsuspend all of the "No dupes" for that specific rotation. The OME decks are not extensive enough but after adding in the "No dupes" cards it filled all the holes I had in content. Keep the cards going, I would not resuspend cards after a rotation unless you get to be too overwhelmed and are scoring poorly on COMAT.
- Would you recommend any great YouTube channels to follow for specific rotations?
- OME and Boards and Beyond for anything that you want more extensive info on. Maybe Dirty medicine closer to Level 2.
- Do you have any tips for specific rotations or 3rd year overall?
Dont feel bad for being overwhelmed. Once you get closer to finishing 3rd year, everything seems to start falling into place.
- IM: There is a lot to know so just be ready to read every night. Read up on how to manage the typical hospitalist patients (COPD exac, CHF, etc). Be there early and round before your preceptor gets there and have your notes done and printed out for them to look over. Work on presenting patients with the pertinent lab information. Dont be shy. Everyone has been through this and no one is looking at you to make fun of you. Be aware of your surroundings and read up on your patients before going to see them, if a patient has a wheelchair in the room dont ask them to demonstrate their gait.
- FM: Pretty similar to the above. Read up on some peds pathology, vaccine schedules, pertinent screening tests that need to be done based on certain patient parameters.
- Surgery: Read up on the cases the night before and look over the pertinent anatomy so you know some of whats going on. Know the indications for the surgery that is happening as well as the common complications and ways to avoid/treat them. Be familiar with which diagnostic imaging to get based on trauma presentations (blunt vs penetrating, neck/abdomen/chest). Review anatomy, again. Read up on how to present a surgical patient and what is necessary to tell the surgeon (No he doesnt care that they stubbed their toe 3 years ago and their aunt is a lunch lady). Know how to evaluate a post op patient. I's and O's, I's and O's, I's and O's.
- Obgyn: Similar to surgery with respect to the surgeries and reviewing the indications etc. Know what GTPAL is. You can get fetal heart rate by listening to doppler for 6 seconds and multiplying by 10. Know indications for C-section, what active vs latent, vs protracted vs arrested are. VEAL CHOP. 15x15 2 in 20. Always wear shoe covers when delivering or in the OR. Less is more when it comes to US gel. DONT DROP THE BABY.
- Psych: Keep your head on the swivel. If you ever feel uncomfortable in a situation make sure to get out of it and let your preceptor know. Listen to what the patient is saying. Make sure you not to invalidate their feelings when they are telling you about something they are hallucinating or scared of. If they ask you if you can see what they see say "No but I believe that you are" or something along those lines. Again, head on a swivel and no pens/pencils on the ward.
- Peds: Do your best. Dont proceed with any portion of the physical exam that you are uncomfortable with (ie otoscopic examination in a child pitching a fit). Keep your head on a swivel here too, those little brats like to throw things when youre charting. Know vaccine schedule. Look up developmental questions to ask. CHOP has a really solid interview format for medical students.
This is not at all even close to an exhaustive list and a lot carry over to other specialties as well (ie make sure youre there early, etc) Also make sure you are not a statue in the background. Take initiative. You are part of the care team and these are your patients, yes YOUR patients, too. Make sure you are listening to the patients and you dont just make them feel like an OSCE patient. Inquire about their life (when appropriate), be caring, be inquisitive. Enjoy this time and make sure to have fun (appropriately). Also DONT DROP THE BABY.
Good luck!
