tips on key things to learn from patients?

[bulldog]

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Just started medicine rotation and I'd say it's pretty tough for me. I'm like a fish outta water. any general tips on what I should be learning from each patient? So far, seems like the interns have been pimped on dosages of drugs. I've been asked about differential diagnosis, which is still pretty weak...i.e. "so what do you think is wrong".... and the assesment and plan questions about what new things i should do for the patient. thanks.

 

[ttumed]

Most of this will become intuitive throughout the year. Really just keep doing what you are doing. I always tried to read up about what my pts. problems were, and then did general outside reading when I had time. You will never know enough, there is always someone who can pimp you. Don't bothered by it. Use it as a learning experience. Also don't spend all your time reading. have fun, live life, and look forward to 4th year. I didn't belive it, but it is true, 4th year so far is the holy grale.

 

[YouDontKnowJack]

u ever try Harrison's internal medicine and CURRENT Medical Diagnosis & Treatment 2005 books?

 

[Daiphon]

best thing to learn from the first rotation - how to talk to patients and how to function within a hospital.

other than that, just try to build your DDx database, and maybe start thinking about how you might try to differentiate the DDx's

and, IMHO most important, don't be afraid to be wrong... we don't learn by being right or by guessing, we learn best from our mistakes.

my $0.02 (froim someone who's been there, done that, and got the t-shirt)

-t

 

[electra]

I agree with all of the above posters. Much of this will be become clearer as you go forward with your education. One thing that I found helpful was to try and figure out:
1) what do I think is going on with this patient? (A differential - this is not a single diagnosis, it is a global idea)
2) what is the acute problem (i.e. electrolyte abnormality/hypertension/hypOtension, etc) and how do I fix it?
3) what tests/imaging/etc could I order that would help differentiate this for me?

It may seem silly, but review things like fluid balance and replacement (which is good for medicine and surgery) and electrolyte abnormalities. Those are things that need fixing or maintenance every day, and can kill people while they're waiting for that CT/MRI/surgery.

And, make sure to have fun and ask questions. Don't feel bad about people asking you questions, they are a tool for figuring out where you are on the knowledge scale and also motivating you to learn more. There's nothing like clinical medicine after being in the classroom.