TOO MANY THINGS: dont know what I should be reading??

[thadarknyte]

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So I am an intern, started in July, havent touched a book yet because Ive been getting killed during residency. The one rotation I had that was fairly easy I basically recovered from the rest of the rotations. Anyway, I am having a really hard time trying to figure out what I should read. I know I should just read "something" instead of nothing, but I need a plan otherwise I am not productive. My options are:

1. Rosens
2. Articles
3. kaplan step 3
4. the icu book (little)
5. ekg book
6. or just plain step up to medicine

I feel like ive lost some fundamentals so thats why step up is there, but I wont be taking my boards any time soon, so I dont know if I should focus on JUST EM...any advice greatly appreciated

 

[pseudoknot]

I'd try to read a chapter a day of either Tintinalli or Rosen's no matter what. In my opinion Rosen's is much better edited and more up to date, but it seems longer and it may be better to just read Tintinalli if that's all you have time for. Otherwise, additional reading as needed.

 

[EM Basic]

This is very self serving (see my signature line) but its worked for me. If you are looking to supplement (not replace) your reading- start listening to podcasts. There are a bunch of free and low cost podcasts that will teach you a lot about EM. You can listen to them in the car or while you work out- they have pretty much replaced listening to the radio for me while I drive. I learn a ton and I put my time in my car to good use.
Ones I recommend- EM:RAP and EMA- join EMRA and you can get them for free. EMCrit is awesome and talks about EM critical care (emcrit.org and on iTunes). For others- see my website linked in my signature line- I just did a post on the podcasts that I find helpful.

 

[thadarknyte]

Thanks guys. Yea, initially I was listening to podcasts because I was finding that I don't have time to read, or even if I have time, I am just too tired after a 12 hour shift to sit there. But the problem I found with podcasts, rather I guess the problem was with me, was that they were too advanced and that I was missing the basics. I was listening to EMCrit and ERCast. So I ended up having to read more before I could truly get the benefit of the pods. But EMBasic, thanks, I think your podcasts might be a good starting point for me! just listened to CP and it was right on point.

I think my problem is just getting started and then sticking with it. Because once I start, there are so many options to read for chest pain that I get overwhelmed. I wish I had a copy of rosens, 200 for a book is way too much haha, and I think having to either print or copy each chapter wastes time and then I get more frustrated. Anyways, I'll keep you guys updated. Thanks.

 

[EM Basic]

I understand about some of those podcasts being too far advanced- I'd still recommend EM:RAP- they do a good mix of the basics, cutting edge, and more advanced topics- its the one everyone listens to. 55 bucks a year to join EMRA/ACEP is worth it just to get EM:RAP but you get a bunch of other perks as well. Or someone in your residency probably has access to EM:RAP (hint,hint). Thanks for listening to my podcast as well- hope it helps.

 

[Nervous Ned]

We use Rosen's at UMass too, but any of the major EM textbooks would be just as good. Just use whichever one you have access to. I agree with pseudoknot; you have to try to do a little every day, even if you can only manage a page or two on days when you work. Then you can read more on your days off. I also agree about listening to podcasts. There are lots of good ones for free or cheap besides EMRap, like ERCast, SmartEM, Emergency Medicine Cases, etc. Listen to them at the gym, while driving, cooking, etc. As for podcasts being too advanced, you don't have to get every little detail. You'll still pick up some things. Plus, what I try to do is match the podcast topics to what I'm reading about and what rotation I'm on. For example, when I did my OB rotation, I read the OB section of Rosen's and listened to OB-themed podcast episodes. If you do that, the topics will be more relevant to what you're seeing at the hospital, and you'll be able to follow the discussions better.

 

[MSmentor018]

stick with 1 book like tint or rosens and use a review guide like first aid, carol rivers, just the facts to help you though some of it when time gets short but you want to finish the chapter.

last yr i tried to read rosens cover to cover. absolute disaster! it was just too much material in a short period of time. this year i am trying tint b/c its more concise and try to make my brain a little more active by taking notes or drawing stuff in first aid.

there's a ton of stuff like online ebmedicine (free), podcasts, rad cases, visual /clinical dx...etc. and I love them all but stay on track. good luck, try to learn something new each day but most of all have fun doing it

 

[WilcoWorld]

The first thing to do if you feel like you want to learn is to attend conference and pay attention. There's a reason that it's required by the RRC.

As for reading (which is also essential) - I found the best way for me was to identify one patient from every shift that I wish I'd had a better handle on & to read the applicable section of my preferred textbook before my next shift (occasionally uptodate or something else if it wasn't covered well in an EM text). This allowed me to connect what I read to clinical experience. With this dual approach I felt like I got a good handle on the corpus of EM knowledge by the end of my three years. Plus it built good habits - I'm several years out and I still read-up on EM topics multiple times a week.

 

[pinipig523]

What I do is read 1 chapter of Tintinalli everyday.. or at least I try to.

 

[Venko]

The first thing to do if you feel like you want to learn is to attend conference and pay attention. There's a reason that it's required by the RRC.

As for reading (which is also essential) - I found the best way for me was to identify one patient from every shift that I wish I'd had a better handle on & to read the applicable section of my preferred textbook before my next shift (occasionally uptodate or something else if it wasn't covered well in an EM text). This allowed me to connect what I read to clinical experience. With this dual approach I felt like I got a good handle on the corpus of EM knowledge by the end of my three years. Plus it built good habits - I'm several years out and I still read-up on EM topics multiple times a week.

I echo this. Starting with organized curriculum is a must. As for reading, having a specific patient in mind as you read helps you hang new learning to existing experience. As for what to read from, my bias is get the overview of the subject from a condensed review text such as Block First aid for EM or other and then read a journal review of the controversial points and or cochrane for systematic reviews on the subject.

Either way, I think it is best to read about a patient everyday as opposed to a "chapter" of a large text without context in which to place it. However, we are all biased; pick whatever method you want and stick to it though.

TL

 

[pinipig523]

I echo this. Starting with organized curriculum is a must. As for reading, having a specific patient in mind as you read helps you hang new learning to existing experience. As for what to read from, my bias is get the overview of the subject from a condensed review text such as Block First aid for EM or other and then read a journal review of the controversial points and or cochrane for systematic reviews on the subject.

Either way, I think it is best to read about a patient everyday as opposed to a "chapter" of a large text without context in which to place it. However, we are all biased; pick whatever method you want and stick to it though.

TL

This is a good idea too. I tried this but I found that I need more structure.

What I do now is as I've said above - I read a chapter a day and I move from one big section to another based on interest and usefulness.

I also read about a patient or two from that day - just a quick 5 minute review (though I don't go into as much detail as to look into controversial literature).

I found this works best for me. I need the structure.

 

[Venko]

This is a good idea too. I tried this but I found that I need more structure.

What I do now is as I've said above - I read a chapter a day and I move from one big section to another based on interest and usefulness.

I also read about a patient or two from that day - just a quick 5 minute review (though I don't go into as much detail as to look into controversial literature).

I found this works best for me. I need the structure.

Certainly, if this works for you, continue it. The problem with placing all weight on textbooks is that they are the most out of date with regards to practice. The reason being it takes so long for the information to filter into it. With that said, even though its not cutting edge medicine, its also unlikely to be as difficult to decipher. It certainly takes work to decipher whether the evidence in a journal or review supports the conclusions being made. At some point in your residency though you will want to transition to reading the medical literature as opposed to medical textbooks. The information is simply more current.

TL

 

[Pinner Doc]

I think you are underestimating the amount you are learning just by showing up to work!

I remember very little unless it's contextual, so I try to read something every day about a patient that a saw that particular day. Such as, I admitted a woman for temporal arteritis workup. I remembered enough to be concerned and admit her for it, but I read more at night so I would know more about the initial management from the ED, the long-term sequelae of missing the diagnosis, etc etc etc.

I also enjoy podcasts, especially during my long runs and my commute.

 

[Tiger26]

I'll be the devils advocate and say that my studying has absolutely no structure whatsoever.

Mostly, I read whatever I'm interested in and when faced with things in the ED I'm a little unsure about.

In addition to that, I stay current on emrap and subscribe to emcorecontent.com and uscessentials.com, and have seen most of the episodes on there.

Aside from that, I try to pick out a few articles in annals and I look at pepid a few times during my shift.

 

[Venko]

I'll be the devils advocate and say that my studying has absolutely no structure whatsoever.

Mostly, I read whatever I'm interested in and when faced with things in the ED I'm a little unsure about.

In addition to that, I stay current on emrap and subscribe to emcorecontent.com and uscessentials.com, and have seen most of the episodes on there.

Aside from that, I try to pick out a few articles in annals and I look at pepid a few times during my shift.

It sounds like you are succeeding through sheer effort. The structured format is for those who would rather just sleep or mess around than read or study or learn.

 

[Hamhock]

It sounds like you are succeeding through sheer effort. The structured format is for those who would rather just sleep or mess around than read or study or learn.

Actually, I do exactly the same thing as the Tiger.

emcorecontent can't be valued enough.

In contrast to Thyme's perspective, I find "structured" reading and study to require "sheer effort", while reading about topics relevant to my patients, my embarrassment (I read like crazy when a consultant know more about an EM topic than I do), and, most importantly, my interests effortless.

In fact, I never feel like I am studying when doing the above. I am just interested and focused.

...However, I do admit, with the ABEM exam approaching, I am about to enter "study" mode with structured review of 1000 Qs and such...but that's not really about learning EM. That's about passing some exam.

HH