1) You'll need a stethoscope. I recommend a Littmann Cardiology III. I think it's good to have a stethoscope with a dedicated bell so that you can show evaluators in OSCEs and such that you know how to use it (for carotid bruits and stuff). That's the reason I don't like the master cardiology. Whatever works though. You could easily get by fine with one of the lightweight Littmann stethoscopes for less money. In any case, your school might get you a discount on this stuff. I've even heard of some schools giving stethoscopes out as gifts, so you might want to wait. You won't need it from day one anyway.
2) I'm a rising MS4 and I don't own a reflex hammer. They'll probably be provided in the room for your OSCEs. On wards, unless you're on neurology, nobody carries a reflex hammer. It's cool if you want to, but nobody does. I'll probably buy a cheap one from the bookstore before my neurology rotation.
As far as how much the quality matters if you're gonna get one? It doesn't. Unless you're a neurologist, it will not matter at all. If people even check reflexes on the general wards, the most you're checking for is essentially "eh, that's normal" versus "hey, nothing really happened on this side" versus "holy ****, that dude almost kicked me in the face." I can get a patellar or triceps reflex with the tips of my fingers. Usually I (and most people) use the stethoscope for this on the occasion it's needed.
3) Absolutely not.
Totally disagree about the reflex hammer!!!
You are a med student and there will be MANY times you will be asked if you checked reflexes for a lot of very common presentations/concerns
(stroke admits & low back pain pop to mind)
I wouldn't skip checking for a plantar flexor response either
You will use that hammer any sort of musculoskeletal/odd sensation type complaints (very common!)
on peds & FM a lot for well child exam, physicals, neuro, IM wards, EM, ICU (almost daily), surg clinic, ob/gyn (part of tracking the progression of pre-eclampsia)
a lot of your core rotations
I always made a very favorable impression on neurologists & EM docs by carrying this little beauty:
recommended to me by an EM doc, the fact that you can elongate it means, by golly, you are gonna pound that reflex out of the patient! (It resembles the neurologist's beloved Queen's hammer for length but is portable). Unless they have flaccid paralysis and zero tone, they *will* have a reflex you can elicit if you have proper technique. Eliciting reflexes is a two handed job, by placing your fingers over the tendon/muscle you are testing, you can feel a contraction even if it is not strong enough to move the joint appreciably).
You can buy it for $10. Downside is it might break/not last as long as the tomahawk models, and the way the head can articulate you occasionally need to tighten it up with a screwdriver and you have to strike a certain way or the head glances off. Docs will love it and always want to borrow it but be disappointed by the head moving so you just have to point that out when you hand it over to them.
I have never regretted owning it and it has served me well for my medical career to date.
Don't be the chump that uses the side of your stethoscope either, you might see an attending do this but most I know will chastise you if they see you doing this.
Part of appropriately testing reflexes is having a fair amount of control over the amount of force you use and being able to approximate applying symmetrical force. Remember, if you check one side's reflexes you must always check the other side for comparison and it's a useless comparison if you're not applying approximately the same amount of force. The best way to do this is to hold the hammer between your fingers at the same spot and allow the head to sort of "fall" the same distance onto the site you're testing. You are letting gravity and physics standardize your strike this way, as opposed to "hitting" using the force of you striking using your muscles, hence why a longer lever and a longer drop allows you to more easily add more force to elicit more difficult responses without fudging it up with you trying to "hit" twice the same way.
I might see PMR & ortho guys not using a hammer, but let's just say the neurologists still don't like it, and if they can get away with it it's because of how much experience they have that you don't.
Trust me, buy the nice hammer and feel confident in the quality of your neuro exam. It can make the difference.
Some schools will tell you to have your own BP cuff because part of the curriculum can include rural medicine or health fairs where there aren't enough. I've been in some lean volunteer clinics where there was one cuff between 4 rooms. So it really depends if you will need it or not otherwise I would skip it do to cost if possible. One the other hand, I have not regretted owning mine for a moment as I rest easier being able to check all of my loved ones who might not otherwise go to the doc, and I have used it in health fairs and international medical missions. I might have saved a life when someone told me outside the hospital they were having an acute GI bleed "that wasn't that serious" and I was able to check their BP and convince them they needed to go to the ED. I like having that degree of control but you don't need one unless your school insists.
As far as tuning fork, I have never regretted investing in the 256 Hz one and carrying it with me. For diabetic foot exams, you can substitute testing for vibratory sensation over proprioception ("am I moving your toe") with it which I find easier and more reliable. The forks can be found cheap.
MS2 I bought this pack of 6 penlights for $8 and I've still got 3 left.
Amazon product ASIN B003F13FMQ
I bought Maxwell's Pocket Guide and it has the eye chart I use but I don't know if that chart is a Snellen or acceptable to your school but it's a very practical thing to have.
Get yourself this for your stethoscope, it WILL be a nice thing to have and might save your $150 stethoscope. Plus it looks snazzy and is only $7.
Amazon product ASIN B0030UV3P8
I use the White Coat Clipboard but everyone has their own system. I had to sew a custom pocket into my white coat for it though.
I address buying your own otoscope/opthalmoscope last. It's the most expensive item ahead of the BP cuff but one of the coolest things to own although you won't use it often. I found it very valuable on wards because you often can't find one and I would have mind charged up in the workroom. It allowed me to practice and become more proficient with eye exams compared to any of my peers. As a poster noted, I like being able to check eyes/ears outside of clinic anywhere I like.
I can do a full annual physical outside the clinic except for a speculum exam. DISCLAIMER: Not that you should.
