What to study during IM residency?

[danvasta]

Just wondering how people go about their studying being so busy. I'm 5 months into internship and I pretty much feel like I don't know anything (okay I know some stuff but I still feel behind compared to my peers). How do I go about studying when everything is so overwhelming at this point? I learn better through questions / being able to apply myself. I do read uptodate but I feel like its vast and I forget maybe a week or 2 later. Anyone heard anything about UW for IM or knowledge plus. Both pretty expensive so I want to kind of figure out how good it is before investing in it !
Any suggestions are welcome!

---

Members don't see this ad.

 

[CatFactorial]

I like qxread to search for relevant articles to my patients.

 

[IMreshopeful]

MKSAP gives good broad strokes.

 

[HelpPleaseMD]

I used uptodate as an intern to help with management issues. You probably know more than you think. All admissions fit into a frame work that you will see over and over again, and should become second nature to you pretty soon if it has not already. I am not a big fan of mksap.

seriously look over https://onlinemeded.org/home, intern content. it is very quick and he does a good job imo. It provides a good frame work to work up common problems that some interns may not have learned in med school. it is very basic though

 

[PDIsani]

I used uptodate as an intern to help with management issues. You probably know more than you think. All admissions fit into a frame work that you will see over and over again, and should become second nature to you pretty soon if it has not already. I am not a big fan of mksap.

seriously look over https://onlinemeded.org/home, intern content. it is very quick and he does a good job imo. It provides a good frame work to work up common problems that some interns may not have learned in med school. it is very basic though

the contents seem outdated in a lot of areas

 

[Crayola227]

the contents seem outdated in a lot of areas

LOL who cares

like an intern halfway through the year that feels clueless doesn't have time to read, rounded on 10 patients on census, dc'd 5, and now has 5 back to back admissions, and carrying the cross cover pager for 30 patients that aren't theirs until nightfloat gets there.... yeah, totally a set up for some quality EBM, get this kid the most recent Cochrane review

if we really gave a **** about the quality being practiced.... time. time. time.

the same residents that were quoting the latest whatever the **** paper stats were also the ones who didn't have time to read the nursing notes that the GOMER they were going to send home was pissing frank blood for no good reason & choking on their own vomit. everything so half hazardly thrown into damn EHR it's a miracle if there's orders let alone the best ones supported by the most recent evidence

I had a mentor that really pushed questioning resources like UptoDate and going through the literature, I put that on my attending to do list
I made peace with the fact that as an intern I was going to be practicing cookbook medicine
meaning whatever Dr. Google or Dr. Grampa Attending MD suggests is the recipe is how the patient gets cooked
"good enough"

that said, I don't give a **** if PocketMedicine is the best, it is always handy, fast, and attendings haven't told me yet I'm an ass-clown for using it... and no one has died. Something about its format sinks into my brain and I now have multiple pages problems and admissions memorized from it. Are they the best? Best is admitted and better than they were when they showed up. If I had a traumatic brain injury tomorrow and only got one book to know, it would be that one just for pure convenience.

 

[235009]

You're learning a lot more than you think. Patients are better than any qbank you can do at this point. Keep reading uptodate and pocket medicine. When you're a resident you can start doing mksap.

 

[LilSebastian88]

My go to's for reference material:
-uptodate
-harrisons if I have a lot of time
-mksap17
-nejm - to pretend I am keeping up with current events
-i got my hands on the mgh housestaff guide - crazy helpful
-reviewing each subspecialty (asge, idsa) guidelines for the disease of choice

Doesn't matter what you read. If you can read an hour a day and survive intern year, you're golden.

 

[smartparts]

I've been listening MKSAP audio on my 20-30 min commute every day since the second month of intern year and I think I've learned a TON. OP, if you really don't have time to read every day, try the audio. They skip over the big tables and stuff that you have to memorize for boards but what they do talk about gives you an excellent foundation for an intern.

 

[FutureInternist]

MKSAP

NEJM Review articles that take you from A-->Z of a particular disease (I would summarise the article myself, then attach them together & place in my DropBox, since you will get asked to present/discuss the same topics over & over again)

UpToDate

 

[Crayola227]

My go to's for reference material:
-uptodate
-harrisons if I have a lot of time
-mksap17
-nejm - to pretend I am keeping up with current events
-i got my hands on the mgh housestaff guide - crazy helpful
-reviewing each subspecialty (asge, idsa) guidelines for the disease of choice

Doesn't matter what you read. If you can read an hour a day and survive intern year, you're golden.

I like this. I pretend to keep up with current events with AMA & Medscape daily email update bulletin subscriptions thingies they have... they have different categories of what they send out you can customize, so you can get specialty specific bulletins, ones meant for residents...

The Medscape one has little daily quizzes that are free and 5 questions a piece, it's practice oriented so that's helpful

 

[IMreshopeful]

I've been listening MKSAP audio on my 20-30 min commute every day since the second month of intern year and I think I've learned a TON. OP, if you really don't have time to read every day, try the audio. They skip over the big tables and stuff that you have to memorize for boards but what they do talk about gives you an excellent foundation for an intern.

Haha my commute is when I like to chill and listen to music or the news. I'd go nuts if I had to listen to MKSAP every day on my commute.

 

[Crayola227]

yeah Oprah calls the time you spend taking a bubble bath or listening to music in the car "remembering your spirit"

that stuck with me some reason

 

[majahops]

For point of care guidelines on the wards: uptodate.

For in depth understanding of diseases and their management: uptodate plus an nejm review article if available

For board review (which you should start intern year): mksap questions on phone and mksap audio while driving

For staying TRULY on the cutting-edge: glance at jwatch.org every single day for 1-3 minutes

Sent from my SM-G920V using Tapatalk

 

[smartparts]

honestly, i dont know how anyone studies uptodate. 50% of each entry is superfluous for the resident on wards and 90% is not on the boards. as others have suggested, NEJM reviews/clinical practice articles are better for learning a disease one of your patients has and MKSAP is better for boards. uptodate was designed as a POC resource for answering specific questions without a lit search.

 

[majahops]

honestly, i dont know how anyone studies uptodate. 50% of each entry is superfluous for the resident on wards and 90% is not on the boards. as others have suggested, NEJM reviews/clinical practice articles are better for learning a disease one of your patients has and MKSAP is better for boards. uptodate was designed as a POC resource for answering specific questions without a lit search.

I respectfully disagree about uptodate. In its modern form, it is effective as both a point of care reference and a disease overview on essentially all major topics in medicine. If I need to learn about diagnosis and management of COPD, Sjogren's syndrome, suspected acute GI bleeding -- I can learn all I need to know from uptodate entries, and quite efficiently. While some of the points may be superfluous, even when considering the contributions of these points, the entries are as concise as you will find from any professional reviews. There is the age old argument that the entries on uptodate are biased by the authors... And that is true, but the biases usually regard those matters upon which there is not general agreement in the medical community. The generally-agreed upon points - those which residents should be primarily concerned with learning - are not typically affected by author bias on uptodate... When they are, authors have become much more cognizant of explicity recognizing this in their entries. I would say that up-to-date authors do as good a job of acknowledging multiple variations of practice as most other literature resources do.

It is important to differentiate between studying target disease topics and studying for boards. Of course one should not use up-to-date to study for boards, because it is not laid out to give a board-depth review of every topic on boards. Also, it doesn't give precendence to classic board fodder. For this, board-directed resources, such as MKSAP questions and audio reviews and USMLEWorld questions should be used.

I do agree that NEJM reviews, and their case presentations, are terrific. They are generally of the highest quality you will find in medical literature.

 

[smartparts]

im not contesting the accuracy or completeness of uptodate, but OP is saying they are overwhelmed and having trouble retaining information from uptodate. i love uptodate for the reasons you listed, but i do sympathize with OP with regards to how long and forgettable the average entry is.

 

[majahops]

im not contesting the accuracy or completeness of uptodate, but OP is saying they are overwhelmed and having trouble retaining information from uptodate. i love uptodate for the reasons you listed, but i do sympathize with OP with regards to how long and forgettable the average entry is.

Ohhhh got it. Wow disregard what I said then. Myyyyyyyy baaaaaad

Sent from my SM-G920V using Tapatalk

 

[HelpPleaseMD]

if uptodate is hard to retain I honestly doubt he will have time for NJEM review articles/mksap book. it takes less than 5 mins to scroll to the summary points