Uptodate

[Dr Dazzle]

Curious to know how most people use Uptodate or other similar sites during med school. My school provides Uptodate in preclinical, but I hear that a lot of students/residents reference it during rotations and residency on a regular basis. Perhaps it's helpful to reference it more in preclinical when learning concepts in classes?

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[Jabbed]

Yes, yes, a thousand times yes.

 

[Cytarabine]

Uptodate is the shiznit. Gets used multiple times a day

 

[CherryRedDracul]

I use it multiple times per day as well. It's more useful during clinical years rather than preclinical years though.

 

[Dr Dazzle]

How should it be used during M1 + M2 versus M3 + M4 versus residency?

 

[Cytarabine]

How should it be used during M1 + M2 versus M3 + M4 versus residency?

During M1 and 2 - to find information

During M3 and 4 - to find information

During residency - to find information

 

[JJMrK]

In medical school I used it to read about diseases my patients had or look up information for presentations. Don't find it as useful now; I use it almost solely to look up drug dosing information. Probably would be more useful to a medicine resident though.

 

[Jabbed]

During M1 and 2 - to find information

During M3 and 4 - to find information

During residency - to find information

But how would you use UpToDate as an attending? 😕

 

[Jabbed]

Minor hijack: does anyone use DynaMed? I'm curious as to how it compares.

 

[Cytarabine]

Minor hijack: does anyone use DynaMed? I'm curious as to how it compares.

My institution just switched to it from uptodate. I have an individual UTD subscription though, sooooooo, yea

 

[Jabbed]

My institution just switched to it from uptodate. I have an individual UTD subscription though, sooooooo, yea

As in you were too attached to bother giving Dyna a try or you tried DynaMed and it blew by comparison?

 

[Cytarabine]

As in you were too attached to bother giving Dyna a try or you tried DynaMed and it blew by comparison?

As in I probably shouldn't have even commented because it wasn't a helpful post. Too used to uptodate to even try dynamed

 

[DermViser]

But how would you use UpToDate as an attending? 😕

Latest guidelines, keeping up with the latest literature, reviewing pathophysiology, you know doctor stuff...

 

[sinombre]

Minor hijack: does anyone use DynaMed? I'm curious as to how it compares.

I haven't used it, but an IM attending recommended it to me a few days ago. I was told it's basically a more condensed version of UpToDate

 

[TooMuchResearch]

Curious to know how most people use Uptodate or other similar sites during med school. My school provides Uptodate in preclinical, but I hear that a lot of students/residents reference it during rotations and residency on a regular basis. Perhaps it's helpful to reference it more in preclinical when learning concepts in classes?

Just keep in mind sometimes the management recommendations given are the evidence-less opinion of the authors. Often, the info is very useful.

 

[Beacopp665]

I haven't used it, but an IM attending recommended it to me a few days ago. I was told it's basically a more condensed version of UpToDate

Our institution switched to dynamed from UTD when they increased their subscription price...let me tell you, you definitely get what you pay for. Dynamed is "condensed" in the sense that it just gives bullet points and doesn't contain near as much info as uptodate. Presentation, content, and ease of use hands down better with uptodate, but I guess it's better than nothing

 

[Dr Dazzle]

I haven't used it, but an IM attending recommended it to me a few days ago. I was told it's basically a more condensed version of UpToDate

By the time you're an attending, how much do you really need Uptodate on a daily basis? How is the level of use at that stage different than would be at an earlier level? I'm assuming this depends on what specialty you're in as well.

 

[Awared]

They're basically the same information, just presented differently and with a little different grading.

Dynamed uses info gathered by primary care providers so it is a little more clinically relevant and updated with the most relevant information for practice. Dynamed uses three levels of grading as opposed to uptodate and is modeled more after EBM.

The other reason why I like dynamed more is because of the bullet points they use for summaries are quick and to the point, as opposed to the paragraph format on uptodate.

You might also want to check out the national guidelines clearinghouse for best practice recommendations (which is free).

 

[Jabbed]

By the time you're an attending, how much do you really need Uptodate on a daily basis? How is the level of use at that stage different than would be at an earlier level? I'm assuming this depends on what specialty you're in as well.

I really don't understand where you're going with these questions. Are you contemplating somehow getting a lifetime subscription to UpToDate?

 

[Dr Dazzle]

I really don't understand where you're going with this question line. Are you contemplating somehow getting a lifetime subscription to UpToDate?

No, just getting a better feel for how reliance on these sources changes as you progress in medicine. Surely, practicing physicians don't have time to reference Uptodate much when decision making needs to occur fast.

 

[JimmyB123]

Do you get access to a UTD automatically as a U.S. Medical student?

 

[Beacopp665]

Do you get access to a UTD automatically as a U.S. Medical student?

No, depends if your institution gives you access. We do get a discount though if we go for individual subscription

 

[chronicidal]

No, just getting a better feel for how reliance on these sources changes as you progress in medicine. Surely, practicing physicians don't have time to reference Uptodate much when decision making needs to occur fast.

It depends on the specialty you go into. Uptodate has less info the farther away you get from internal medicine. I tried using it during my rotations in ophthalmology, radiology, etc., and it felt really inadequate for even basic topics.

 

[jdh71]

Just keep in mind sometimes the management recommendations given are the evidence-less opinion of the authors. Often, the info is very useful.

Just keep in mind MOST of what we do in medicine has little to no evidence.

Where is your god now???

 

[jdh71]

I mean it depends what you're talking about.

Do attendings need uptodate to figure out how to manage run of the mill problems that they deal with every day? No, of course not.

But you're not going to reach some magic threshold in your career where you know enough and get to just stop learning. Treatment options and management change over time; you'll see rare pathologies that you haven't encountered in years.

I was in there twice today. Once making sure I was covering all of the work-up for a diagnosis of primary pulmonary hypertension and the second looking for which antibody tests to order looking for scleroderma (I never remember them off the top of my head).

 

[Jabbed]

I was in there twice today. Once making sure I was covering all of the work-up for a diagnosis of primary pulmonary hypertension and the second looking for which antibody tests to order looking for scleroderma (I never remember them off the top of my head).

Big day you were having.

 

[jdh71]

Big day you were having.

I saw 14 patients in clinic. Didn't need it for everyone else. Cough, asthma, COPD, and lung nodules I can do standing on my head. Pulmonary hypertension and ILD is a bit more complicated and less common. Both of the patients I did some extra looking on are both screwed, just in separate ways.

 

[NickNaylor]

I never really used UpToDate during the preclinical years. It's an incredible resource, but it's more clinically focused than anything else (though it does have reviews of relevant basic science/pathophys stuff) and I don't think as a pre-clinical student you really have the knowledge or experience to get the most out of it. A lot of the articles can be way more information than you need, but if I have the time I like to print out an article and read it over the course of the day. It's a great collection of information - if somewhat incomplete in some ways.

 

[Mr. Mojo Risin]

Got a free subscription through my school, which assigns us articles to read in each system as self studies. It was required reading and we were tested on the content of the article. I guess they were trying to get us familiarized with using it or something.

 

[chronicidal]

Got a free subscription through my school, which assigns us articles to read in each system as self studies. It was required reading and we were tested on the content of the article. I guess they were trying to get us familiarized with using it or something.

that's amazing, what school?

 

[VisionaryTics]

It depends on the specialty you go into. Uptodate has less info the farther away you get from internal medicine. I tried using it during my rotations in ophthalmology, radiology, etc., and it felt really inadequate for even basic topics.

Yeah, I think I used it a couple of times during SICU and general surgery, but otherwise I haven't touched it as an intern. Largely useless for surgical fields.