Studying during residency?

[milsha]

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Hi everyone,
I was wondering how you guys are managing finding time to study and what you are studying? My co-interns and I always meet up and hang out during our free time, but I feel like that's all we do. Do you guys have a journal club you do or read Kaplan & Saddock together?

Med school was so much different, it was nice to read First Aid & watch Pathoma videos. I seriously think our program is lacking in didactics since it's community based and there are no medical students to teach etc.

I am just looking things up online for my patients or taking home points during rounds, but I feel like my knowledge base is quite poor for a mid-way intern.

 

[Nasrudin]

I recommend getting the Step 3 out of the way forthwith. In terms of studying, I disagree with the older advice--that you don't have to study for step 3--6 weeks of nightly study should be about average, more or less depending on the proximity to your step 2 or general medical education and your natural abilities.

In terms of psych. Studying around patients is, for me, right on point. If I have a patient on a drug I don't know the key points of, I look it up and write the survey of possible AE's in my progress notes. And when you encounter a question in your daily work, like how to cross taper something, you look it up. Etc. Rinsing and repeating. I also look up diagnostic criteria regularly, sometimes with patients present to try to get them involved in their own self-formulation.

Medical students certainly help, because you can relearn basic topics to teach them.

Other than that, I agree with you, we're off map now. Before curriculum had specific necessary goals and objectives. But I personally find this stage liberating and invigorating.

I'm forming a salon--with a very smart, interesting colleague--where we're going to share our explorations in the field.

Currently, I'm searching for the philosophical basis of my own style of practice. Existential philosophy, phenomenological approaches, and everything I can get my hands on from JL Moreno. In addition to keeping up with the academic curriculum of our half day didactics, and reading articles for topics in rounds and the like.

This is the most exciting educational period I can remember. I love that there's no leash. And that the goals are my own self-expression as a professional.

The only thing I can say is.... Isn't this cool?!.

 

[MacDonaldTriad]

Nasrudin’s enthusiasm is infectious and laudable, but probably not so easy to replicate among your classmates. As a beginning resident, I do suggest you stick to a basic text, K&S or the APA books are good for entrance learning. I think you can keep the spirit of Nasrudin’s suggestion and meet as a group and make assignments to summarize different chapter or chapter sections based on cases that are being seen. It doesn’t take a lot of clinical material to get everyone busy reading and presenting. Most texts have an associated question and answer study guide if you really must learn in sound bits.

Please don’t just get out this month’s PRITE test answers and rehash these in the false belief that they are intended to be any sort of a comprehensive curriculum. This strategy can work, but only because of the repetition of questions year to year. This will only defeat the validity of the test as a measure of how you will do on the real boards. Since the test is only for you to know how you are doing relative to other residents across the nation, such behavior makes about as much sense as not counting all of your strokes in golf. You score will not make you feel good and it will not indicate your talent so you will not be able to brag at the end of the game. Despite the new pressure we have been under to keep old PRITE tests from floating around, someone pointed out the they are for sale if you don’t mind cheating yourselves.

Oh, Nasrudin; high five for taking the initiative and doing things other than complain about not being spoon fed enough. I’m sure your program is pleased with your efforts.

 

[notdeadyet]

Milsha- have you or your classmates approached your PD about this?

Nasrudin's enthusiasm is awesome, but it would be great if you could leverage faculty involvement in setting up better teaching. Co-teaching residents is a wonderful thing, but can also become a blind-leading-the-blind situation, often without participants recognizing it. If you don't have teaching-oriented faculty, you may have no other choice, but I'd reach out to verify if you are really out of luck in that regard.

 

[675015]

Milsha- have you or your classmates approached your PD about this?

Nasrudin's enthusiasm is awesome, but it would be great if you could leverage faculty involvement in setting up better teaching. Co-teaching residents is a wonderful thing, but can also become a blind-leading-the-blind situation, often without participants recognizing it. If you don't have teaching-oriented faculty, you may have no other choice, but I'd reach out to verify if you are really out of luck in that regard.

We recently set-up our program so that PGY-3s and 4s give lectures on basic and key topics to the PGY-1s once a week. Its volunteer and so all of the seniors are excited to be doing it and put in good effort. Everyone wins. PGY-1s learn what they need to. Senior residents get practice teaching and review the basics. Attendings don't have to worry about interns knowing the basics and when they do teach can focus on more advanced topics that only more experienced doctors would be as familiar with. It just started this year but its been great so far.

 

[Nasrudin]

Some great ideas here.

I do think modeling clinical judgment is huge. Didactics are great to decent depending on the lecturer.

I think it's important to find a few key mentors. Had I not found them, I wouldn't be so keen on self-education as my main project. Clinical work is full contact immersive process. You can't learn it by doing repetitive katas. You have to see what works and what doesn't and what that means for your unique.... Vibe. (Acknowledged risk of sounding woo-woo'ish). And then comparing that to a consummately effective clinician.

I've been enormously lucky in that regard. But there's more to it than luck.

Some people, not necessarily the OP, think being mentored is the automatic right of being a resident. But that's not the way the world works. You have to make your presence useful, helpful, and inspiring to the potential mentor. Then slowly the relationship deepens and blossoms into them taking special care to communicate to you their special gift.

Again, risk acknowledged. Doubled down. Continuing.

Yes. Special gift. As in can take an emergency psych encounter and make it a therapeutic intervention that is life course altering for certain set of patients. If you see that gift in action. You do whatever it takes to get close enough to gain the insights to do what their doing. And if you miss that opportunity, what are you doing?

Maybe I've been lucky. But I also didn't miss the opportunity. And recognized what I witnessed as unique, passionate, next level work.