Problems with remembering patient details

[MixedUp]

I'm hoping for some advice on keeping patient details straight in my head... I'm a PGY-3 surgical resident and have had this problem all along but it is starting to become more obvious as I enter my senior resident years.

I'm fairly organized so I know how to write things down, but I have huge difficulty in remembering which details are associated with which patients, especially when they are not germane to the patient's primary problem. E.g. lab tests, social history, etc.

Has anyone else had this problem and made any headway? I looked it up in a few psychiatry textbooks and I believe this type of memory is called "recall discriminability."

I'm in my 30s, sleep 6-7 hrs a night, chronically tired like the rest of us. Could be a function of fatigue/alertness but I seem to be much worse than my peers in this respect.

Open to any and all ideas... Thanks everyone!

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[dragonfly99]

Not sure if you have time to do this as a surgical resident, but I got a tiny notebook that basically consists of 4 x 6inch or so index cards that are spiral bound. I keep one on each patient with name, age MR#, date of admit and a 1-liner on why they are there, and any important admission labs/imaging tests. If they have a surgery, major procedure, etc. I try to write that down the same day. Ditto for important past med hx, social history, etc. Not EVERYTHING that would be in an H and P, but whatever I need to know as the supervising fellow. This may help you if you have time to do this.

Sleeping a bit more may help more than you think. Try sleeping 30 minutes extra a night, skip watching TV or other distractions. Break the bad habit of staying up too late.