Preparing for Clinics and Differentials as a 1st year

[No Imagination]

Taking a break from Path, and thought I would ask a ‘loaded’ question…

I keep hearing how things will change once we enter clinics, with differentials being huge. Some people tell me having a strong understanding of the current material (first two years for us) will be HUGE. While others say that only 20 – 30% of any class will be relevant.

Putting that debate aside for a moment – what is the best way to prepare for this aspect of clinical medicine? Is there a ‘holy grail’ book? My thoughts are, if I can spend a few minutes every time I study some basic science material, and go through common differentials, it will both help me when I get to that phase, as well as assist in understanding and putting into context the stuff I am learning now.

I.e. hepatic Physiology is SO BORING – but if I had a good understanding of the common aspects that will be important in the clinical arena, I will be both more interested and more likely to learn, i.e retain it.

Any thoughts? Or just trudge through and deal with 3rd year when 3rd year happens?

P.S. They do an ‘ok’ job of explaining why something may be important to us as vets, but mostly is rote memorization

Thanks!

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[Mistoffeles]

Putting that debate aside for a moment – what is the best way to prepare for this aspect of clinical medicine? Is there a ‘holy grail’ book? My thoughts are, if I can spend a few minutes every time I study some basic science material, and go through common differentials, it will both help me when I get to that phase, as well as assist in understanding and putting into context the stuff I am learning now.

I.e. hepatic Physiology is SO BORING – but if I had a good understanding of the common aspects that will be important in the clinical arena, I will be both more interested and more likely to learn, i.e retain it.

i feel much the same, so what i've done is taken one notebook, and started making one page summaries of any disease or condition that gets mentioned. For example, when we did our genetics lectures, the prof mentioned hyperkalemic periodic paralysis, canine muscular dystrophy, and canine narcolepsy (plus one more that i can't recall right now! ).

i take the info for these summaries from ettinger's, the five-minute consult, and any other species specific internal or clinical med book i can find. i don't expect the summaries to be perfect, nor even contain all the information. just hope that they get me thinking in terms of etiology, progression, clinical signs, prognosis, etc.

Any thoughts? Or just trudge through and deal with 3rd year when 3rd year happens?

P.S. They do an ‘ok’ job of explaining why something may be important to us as vets, but mostly is rote memorization

wheras we're told fairly explicitly that if we try to survive on memorization, we decrease our chances of making it. perhaps it's as a result of this that they really try to keep clinical relevance even in basic sciences lectures, and we even have the occasional lecture that's purely clinical (e.g., we had one on exocrine pancreatic insufficiency, and another on diarrhea - both fit nicely in with last term which was our "normal systems" nutrition and alimentary block).

 

[StealthDog]

My suggestion would be to get a good clinical medicine textbook (i.e. 5 Minute Vet Consult, Clinical Veterinary Advisor), and when professors mention specific diseases or disorders, check it out from the clinical perspective. What will the animal likely present to you with? How do you make a definitive diagnosis? What are the treatment options? It might not all make sense now, but the sooner you can transition from didactic-type thinking (i.e. these are all the diseases that can affect the liver) to clinical-type thinking (how do I know it's the liver causing disease, and not the GI tract or the urinary tract? what is the prognosis for the animal? what medications help with this condition?) the easier clinics will be.

My other favorite book for clinics is this one. It's literally just a book of lists, organized by organ system and also by clinical signs. So, if you have an animal come in with diarrhea, you flip to diarrhea and find a list of possible causes. If you have an animal present with difficulty breathing, you flip to dyspnea and find another list. It really helps you start to think in terms of differentials, especially early on in clinics, and comes in really handy for writing SOAPs and things. There's also a section with lab values (i.e. causes of hypercalcemia and hypocalcemia, causes of increased ALP, etc) that's really helpful. It might not be useful until you hit clinics, but I like it a lot and still reach for it regularly.

 

[Electrophile]

I LOVE YOU! I had a left over gift certificate from Barnes & Noble from Christmas and now I know just what to spend it on.

 

[StealthDog]

Happy to help It seems like a bit of a rip-off ($50 for a little paperback?!), but it's totally worth it for how often I use it. And it fits just right into a white coat pocket

Some people really like this little guy- I don't have it, but it seems handy for those random factoids that are hard to remember (i.e. how many mEqs of potassium are in a bag of LRS, etc).

 

[dyachei]

The other one that I have heard awesome things about is the veterinary nerdbook. Its a tiny binder of common clinical problems that also fits in a lab coat pocket.

 

[sofficat]

Happy to help It seems like a bit of a rip-off ($50 for a little paperback?!), but it's totally worth it for how often I use it. And it fits just right into a white coat pocket

Some people really like this little guy- I don't have it, but it seems handy for those random factoids that are hard to remember (i.e. how many mEqs of potassium are in a bag of LRS, etc).

$50?! We get those free here! Actually, I have two... both free! I feel lucky!

 

[rileyroo]

$50?! We get those free here! Actually, I have two... both free! I feel lucky!

do you get it right before you enter clinicals?