When do you get to learn to write like a doctor?

[Dr McSteamy]

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I'm talking about in addition to all those cryptic abbreviations (which i loathe), and knowing which meds to give to your patient?

we learned a bunch of crap in pharm, but how do you select which is best for a particular condition? there are so many drugs. Do your preceptors teach you?

What is the turning point during 3rd/4th year when you go from feeling lost, to being ready for internship?

 

[pillowhead]

I'm talking about in addition to all those cryptic abbreviations (which i loathe), and knowing which meds to give to your patient?

we learned a bunch of crap in pharm, but how do you select which is best for a particular condition? there are so many drugs. Do your preceptors teach you?

What is the turning point during 3rd/4th year when you go from feeling lost, to being ready for internship?

honestly, a lot of pickign what drug to use will be based on your hospital's formulary. for example, the only statin on my hospital formulary currently is simvastatin (zocor). so i never even consider giving the other ones. simple as that.

other conditions which are more complicated like hypertension have somewhat of a formula for example with HTN, always start with the first line drug with is HCTZ. However, this drug won't work well in people with renal disease and if the patient is diabetic and has no other contraindications, start with an ACE inhibitor. If they have other indications for a beta blocker (atrial fib, migraines, etc), you could start with that instead. If they have severe renal disease and can't tolerate a beta blocker (causes bradycardia for example), you go with the direct vasodilators like hydralazine. then there's Ca channel blockers with their own set of indications and contraindications but you get my drift.

antibiotics are completely different and you'll go by 1) Sanford guide to antimicrobials, 2) your own hosptial's local floral and senstivity patterns, and 3) the patient's own cultures and sensitivities.

 

[treasurefull2]

I'm talking about in addition to all those cryptic abbreviations (which i loathe), and knowing which meds to give to your patient?

we learned a bunch of crap in pharm, but how do you select which is best for a particular condition? there are so many drugs. Do your preceptors teach you?

What is the turning point during 3rd/4th year when you go from feeling lost, to being ready for internship?

On the first day of every residency, there is a "write like a doctor" workshop...

 

[Midwest Medic]

You will slowly pick up the abbreviations as you go through your rotations and are writing notes. As for the drugs, it seems like each person has a few drugs from each class that they prefer, and usually only write for those drugs. So even though there may be 5-6 different drugs in that category, you will usually only write for 1-2 on a regualr basis. Like the above poster said, it is typically determined by your hospital's formulary which ones you write for in the hospital, out of house it usually depends on many other factors.

 

[Dr JPH]

I would encourage you NOT to use abbreviations...at least not at this point. Wait until the responsibility for a misinterpreted abbreviation is on YOU, then you can write whatever you want.

When Im cosigning a students note and they use abbreviations I circle them and write in what it means.

I dont want students confusing abbreviations. Some specialties use abbreviations that mean different things to different people.