time for a stethoscope upgrade?

[xhlmzr]

I have a littmann classic that has served me well for MS1 so far but I keep hearing people say that you need something like a cardiology III for upper years. Is that true or would my classic get me through, at least until residency?

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[NickNaylor]

I'd recommend getting a Cardiology III if only because they're relatively cheap. I got an all black one with engraving from Steele for less than $200. Yes, that's a lot of money, but in the long run it's really not that much money. Take good care of it and don't leave it around and it should last you through medical school and beyond.

Many people will say that you don't need the world's best stethoscope while you're in training. I would agree, but given the relatively cheap cost of even a decent stethoscope, I don't really see why you wouldn't buy one. It's worth the investment IMO.

 

[JJMrK]

Tend to disagree. There's no reason to spend more money on a "nicer" stethoscope as a medical student if you already have something reasonable. If you end up going into medicine, peds, FM, etc and feel that you'll be using it everyday, maybe it's worth it. I use a stethoscope prob once every two weeks on average, and when I do typically borrow one from a nurse. Certainly would have been a waste of money for me if I had been asking your question and chosen to spend the cash.

 

[AlmostAnMD]

A cardiologist demonstrated very nicely he can listen to heart sounds better than us with a $10 throwaway stethoscope than us M3's with a littman III.

I think the main issue is what's between the ears, not what's on the ears....

 

[Dave89]

I have a littmann classic that has served me well for MS1 so far but I keep hearing people say that you need something like a cardiology III for upper years. Is that true or would my classic get me through, at least until residency?

I don't think that you'll need it. Wait for third year to buy it - if you do at all. Attendings and residents aren't going to expect you to appreciate those barely-perceptible murmurs, anyway.

Also, do not buy those ophthalmoscope/otoscope kits in the event that your class chooses to do a mass purchase.

 

[WhippleWhileWeWork]

I bought a trusty $15 lightweight MDF, I can't wait to miss all the heart sounds that well trained ears can hear and then lose this thing somewhere between my car, my house, and a hospital in one of the three cities we do our rotations in....so that I can buy another one just like it.

 

[PL198]

I bought a trusty $15 lightweight MDF, I can't wait to miss all the heart sounds that well trained ears can hear and then lose this thing somewhere between my car, my house, and a hospital in one of the three cities we do our rotations in....so that I can buy another one just like it.

just smile and nod when they say " do you hear that murmur?" also always guess it's 3+ or they probably wouldn't show it to you anyway as most 2nd years wouldnt hear it anyway

 

[PL198]

A cardiologist demonstrated very nicely he can listen to heart sounds better than us with a $10 throwaway stethoscope than us M3's with a littman III.

I think the main issue is what's between the ears, not what's on the ears....

Yeah I don't really see significant difference in stethoscopes between higher and low besides having a dedicated bell. It's surprising the tech hasn't improved, I would think incorporating something similar to a horn speaker would be very useful as crappy horn speakers are literally just designed for the purpose of being louder. Had a cardio attending that made his own with materials from home depot so I have a hard time believing that it's such a demanding design that you're actually going to hear a difference with a $100 one vs a $400 if the dude whose jobs is to learn to heart sounds says "nah I'll just DIY it"

 

[Mr. Mojo Risin]

Yeah I don't really see significant difference in stethoscopes between higher and low besides having a dedicated bell. It's surprising the tech hasn't improved, I would think incorporating something similar to a horn speaker would be very useful as crappy horn speakers are literally just designed for the purpose of being louder. Had a cardio attending that made his own with materials from home depot so I have a hard time believing that it's such a demanding design that you're actually going to hear a difference with a $100 one vs a $400 if the dude whose jobs is to learn to heart sounds says "nah I'll just DIY it"

Interesting. What did it look and sound like? Details...

 

[Psai]

as a second year i couldn't hear heart murmurs when i had a cardiology fellow as a preceptor until he pointed it out
after spending some time with a cardiologist, i can hear murmurs now by listening way more carefully than i did before and they seem so loud that i get surprised when i read notes that say +s1,s2 rrr, no mrg
then again i've seen notes from people that said "patient endorses shaking chills" and then the ROS says no fevers, chills, weight loss so i guess people are just clicking through since most people don't seem to read that stuff anyway

 

[PL198]

Interesting. What did it look and sound like? Details...

I mean it looked like a normal stethoscope, except he made it himself and used zip ties to hold the tubes in place. I'm sure it sounded ok since he was teaching me

 

[TooMuchResearch]

just smile and nod when they say " do you hear that murmur?" also always guess it's 3+ or they probably wouldn't show it to you anyway as most 2nd years wouldnt hear it anyway

Grade it as x/6 or x/VI if you want to get old school. It is most likely a 2/6 murmur. 3/6 or greater are impressive. Most likely the preceptor wants you to place it in the cardiac cycle.

 

[Mad Jack]

I own both. The only time I ever use my Cardiology III is when I'm going to be doing peds and adults frequently and it can save me the trouble of switching scopes constantly. Generally I work with adult populations and just stick with my Classic II SE.

 

[Mad Jack]

Grade it as x/6 or x/VI if you want to get old school. It is most likely a 2/6 murmur. 3/6 or greater are impressive. Most likely the preceptor wants you to place it in the cardiac cycle.

Grade it 6/6 while you hold the stethoscope a foot away from the chest for extra points

 

[Ismet]

I have a littmann classic that has served me well for MS1 so far but I keep hearing people say that you need something like a cardiology III for upper years. Is that true or would my classic get me through, at least until residency?

My $50 MDF stethoscope has served me perfectly well through pre-clinicals and over halfway through 3rd year. Unless it breaks/I lose it, I'm not buying a new one until residency (planning on peds). I can hear 3-4/6 murmurs just fine on my own or when pointed out, I've even identified a couple 2/6. A better stethoscope is not going to make a world of difference, the difference is in a well trained ear, which a med student does not have, and the proper conditions (silent room, patient positioning, etc).

 

[PL198]

same attending as previously mentioned said something like(not word for word but same essence): " if a 2nd year can hear it it's a grade 6; if a 3rd year can hear it its a grade 5; 4th year, grade 4; intern or resident, grade 3;other cardiologist, grade 2 and if only you can hear it, grade 1"

 

[Cytarabine]

same attending as previously mentioned said something like(not word for word but same essence): " if a 2nd year can hear it it's a grade 6; if a 3rd year can hear it its a grade 5; 4th year, grade 4; intern or resident, grade 3;other cardiologist, grade 2 and if only you can hear it, grade 1"

Eh, I pick up on about half the grade 2's I later see documented or that get confirmed to me by the attending. They're louder than you think. As far as the stethoscope, sure, a cardiologist can use a 10 buck steth and detect and characterize a murmur. Why handicap yourself as a med student though? The price of something like a decent Littman or Welch allyn is fairly insignificant long run unless you can't not lose them

 

[xhlmzr]

thanks for the input guys. Also another thing, is there an unwritten rule that they can't be longer than 27 inches? The longest one I could find was 27 and it is too short for my neck. I found a vet version that was 32 inches but couldn't find any for humans

 

[Cytarabine]

Are you super tall or something? Shorter tubes are clearer, 27 should be plenty to not be right up in a patients business

 

[xhlmzr]

it's just an issue that when I hang it around my neck, it barely reaches to the other side. Ideally I'd want it to come down all the way to my chest when I wrap it around my neck. It's not really an issue, just makes it look better 😀

 

[PL198]

All the old attending I'm with say they auto don't take anyone who wears their stethoscope as an accessory seriously

 

[xhlmzr]

then they would have to not take a lot of people seriously considering everyone from doctors to nurses wear a stethoscope in the hospital...

 

[Psai]

then they would have to not take a lot of people seriously considering everyone from doctors to nurses wear a stethoscope in the hospital...

PAs, EMTs, respiratory therapists

 

[TooMuchResearch]

then they would have to not take a lot of people seriously considering everyone from doctors to nurses wear a stethoscope in the hospital...

Not as an accessory. It's not there to look cool.

I started using a holster towards the end of third year. Keeps it out of the way the 99% of the time it's not in use.

 

[DrBowtie]

Given the amount of pts on MRSA or VRE, you might as well get good at using the disposables.

 

[PL198]

then they would have to not take a lot of people seriously considering everyone from doctors to nurses wear a stethoscope in the hospital...

I said wear as an accessory. you can just put it into a lab coat pocket.

 

[Cytarabine]

I said wear as an accessory. you can just put it into a lab coat pocket.

Lots of people just wear scrubs or business casual. I'd say about half of the house staff toss it around their necks at the hospitals I've been in. The other half put it in a pocket or don't have one. I've seen maybe 2 of the steth holsters

 

[alenastude]

Littmann Classic II SE Stethoscope average price $ 78.95.
Littmann Cardiology III Stethoscope average price $ 163.95.
If you have economic conditions, I recommend that you buy "Littmann Cardiology III Stethoscope".
It was a really quality stethoscope.
If in the long run, it is worth to invest in learning, as well as future work.
Without economic conditions, the "Littmann Classic II SE Stethoscope" is the choice for you.
Before purchasing any product you should consider the information, customer reviews on forums, blogs. I often see personal information on site mystethoscopereviews.com.
Here is the information you need to see before you buy a stethoscope: mystethoscopereviews.com/littmann-cardiology-iii-stethoscope
mystethoscopereviews.com/littmann-classic-ii-se-stethoscope

 

[tiedyeddog]

Lots of people just wear scrubs or business casual. I'd say about half of the house staff toss it around their necks at the hospitals I've been in. The other half put it in a pocket or don't have one. I've seen maybe 2 of the steth holsters

Put it in the white coat or jam it into a scrub pocket. Otherwise it looks like you're trying too hard.

 

[Cytarabine]

Put it in the white coat or jam it into a scrub pocket. Otherwise it looks like you're trying too hard.

To who? The patient? Nursing and RT do the same thing. If you're not wearing a coat or holster, around the neck is a considerably better option than trying to stuff it into the tiny back pocket that our hospital scrubs have and having it pull down your scrub pants, or stuffing it into slacks pocket with phone, keys, etc. I'm convinced this is just a cultural thing

 

[jakeislove]

I have a very nice Cardiology but upgraded to the Cardiology III because of hearing impairment. It made a huge difference.

^ Being said. Now that I've had more practice, the old one would be okay. Just okay, though. Occasionally on rotations I'd get stuck with someone's stethoscope and heard less. There were also many times others couldn't appreciate what I was talking about until using mine.

 

[tiedyeddog]

To who? The patient? Nursing and RT do the same thing. If you're not wearing a coat or holster, around the neck is a considerably better option than trying to stuff it into the tiny back pocket that our hospital scrubs have and having it pull down your scrub pants, or stuffing it into slacks pocket with phone, keys, etc. I'm convinced this is just a cultural thing

You aren't a nurse or a RT. I would advise anyone to not sling their stethoscope around their neck during a surgery rotation, especially. I had a vascular attending once tell me to take it off my neck during rounds because it is a "flea collar".

 

[jakeislove]

Put it in the white coat or jam it into a scrub pocket. Otherwise it looks like you're trying too hard.

Mine wold get lost or fall out of the pocket. I typically wore it around the neck, covered by the white jacket. It's never been an issue.

Additionally; we were instructed (by the Philadelphia orientation staff) to put them around our necks for the CS exam.

 

[NickNaylor]

Somewhat off topic, but has anyone had any experience with the Littmann 3200 (inb4 "tryhard," "you'll look like a dweeb," etc.)? I have a Cardiology III that I'm happy with but I'm very much a gadget guy and am interested in this thing. The price tag is a bit steep and I've read some reviews that complain that the "noise reduction" features distort normal physiological sounds, but I've yet to talk to anyone that has any significant use with it.

 

[Psai]

i haven't seen a single psychiatrist with a stethoscope within 10 feet of them

 

[jakeislove]

i haven't seen a single psychiatrist with a stethoscope within 10 feet of them

That's unfortunate.

 

[cidem2065]

i haven't seen a single psychiatrist with a stethoscope within 10 feet of them

I've always wondered how many people carrying them around actually have a need or use for them. Thinking about non-physicians in particular.

 

[Psai]

I've always wondered how many people carrying them around actually have a need or use for them. Thinking about non-physicians in particular.

it's a fashion accessory for most