Must Have: Dubin’s Rapid Interpretation of EKG’s

Dubin's Rapid Interpretation of EKGsDubin’s Rapid Interpretation of EKG’s is a one-of-a-kind book that is often referenced in medical schools due to its fun and simple methods of teaching the evaluation of electrocardiograms. More importantly, it provides a high-yield, low-stress method of conveying these otherwise difficult concepts.

In each chapter, the fundamental concepts of EKG’s are delineated in a crisp and clear format. What makes up the bulk of the book is actually not free-text but illustrations that significantly help correlate concepts and electrocardiogram images. Individual diagnoses or findings on an EKG are accompanied by full explanations, including clearly delineated criteria and just enough information to teach pertinent core cardiology concepts (without overwhelming the reader). In fact, the information in Dubin’s EKGs is known for being dumbed down and presented in a “flashcard” style so that it is easy to understand and absorb on-the-go.  All concepts are reiterated and presented repeatedly to ensure maximum retention and an appropriate pace. Interestingly, despite the repetitiveness of the material and the seemingly “dumbed down façade, the book covers all the necessary information that students needs for medical school, and even quick review during residency.  Specific chapters include: Basic Principles, Recording of the EKG, Autonomic Nervous System, Rate, Rhythm, Axis, Hypertrophy, Infarction, and a catch-all Miscellaneous section.

While this title remains highly endorsed by the editors of this site, it is important to still note the drawbacks, for completeness.  Due to the ease of use, some students find Dubin’s EKG to not be challenging enough. While it remains a strong primer, some students (especially those with prior cardiology experience) believe that several pages of information can be condensed into a page or less.  It is important to realize that the aim of this title is to teach only the fundamentals of EKG knowledge. For depth and advanced nuances not needed for medical students, a larger, more condensed resources is warranted. As such, Dubin’s Rapid Interpretation of EKG’s should be used as a quick and superficial “top of the iceberg” but “solid foundations” reference guide to learning the basics of EKG’s.

ECG Complex - Learning the Basics

For medical school: exceedingly useful.
For residency: potentially helpful.
For cardiology fellowships: trainees ought to be well past the basics presented within this book.

Reading Dubin’s Rapid Interpretation of EKG’s cover to cover takes about 4 or 5 hours total, but it is more highly recommended that students periodically return to the book over time for increased retention of the repetitious material.  Overall, this earns a strong endorsement and is highly recommended for any new second year medical student learning cardiology.

 

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Recommended Preclinical Pulmonology: Respiratory Physiology

West's 9th edition of Respiratory Physiology, great for medical studentsRespiratory Physisology: The Essentials 9th Edition (2011) by John B. West is a beautifully constructed book for understanding the fundamentals of respiratory physiology in about 1 to 2 weeks.  Initially opening the book may bring a bout of anxiety due to the seemingly dense text and black-and-white (or rather red-and-gray) visual aids and illustrations.  However, when you actually begin to read this book, it is quite easy to follow and learn the essentials of respiratory physiology. Only a few sections seem slightly more difficult to understand despite the explanations provided.  In each chapter, the content is provided in a narrative manner, interjected by diagrams, charts, equations, summaries of main points, and finishes up with a summary of important pulmonary concepts and some relevant review questions for the chapter.  Although the presentation is not colorful, the material is presented clearly and concisely.  All the fundamentals medical students need to know are contained within, and there is very little digression or extraneous material.

The table of contents reveals the comprehensive nature of this book:  structure and function, ventilation, diffusion, blood flow and metabolism, ventilation-perfusion relationships, gas transport by the blood, mechanics of breathing, control of ventilation, respiratory system under stress, and tests of pulmonary function. As you can see, Respiratory Physiology talks about everything from structure to function to regulation of respiration, so it does not skip on the important topics.  However, it is important to note that this resource is more focused on physiology than pathophysiology: a needed fundamental for any system. This book can be used either for a comprehensive review of pulmology for pre-clinical medical school exams and for the USMLE boards.  It is 200 pages of good information, but may take several days to read if you are studying pulmonology and other courses at the same time.

when you actually begin to read this book, it is quite easy to follow and learn the essentials of respiratory physiology

This book is recommended to medical students who really want a comprehensive basis in respiratory physiology fundaments, those who want to have a solid foundation for clerkship in pulmonology, and pulmonology residents who may want to brush up on the important basics of respiration.  It However, it is certainly not necessary for students looking only to pass. Although West’s Respiratory Physiology is not wordy beyond necessity, it is still quite a detailed and complete book on the physiology of respiration.

 

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Just for Orthopods: Handbook of Fractures

Egol's Handbook of Fractures 4th Edition

The 4th Edition of Handbook of Fractures by Egol, Koval, and Zuckerman, is a must-have for interested medical students and orthopaedics residents everywhere.  It contains the essentials for an orthopaedic rotation and will give you a great foothold on the foundation of the specialty.  Note that it is not an all-knowing book of knowledge, despite being a “go-to guide” for the fundamentals.   It is a very condense text of fractures, dislocations, and stabilization techniques for upper and lower extremities, pediatric cases, axial fractures and dislocations, and also general considerations for the important categories of gunshot, pathologic, and multiple trauma cases, just to name a few.

 

This handbook is divided into 5 major divisions with chapters under each division: I. General Considerations (7 chapters including: GSW, closed reduction/casting/traction, periprosthetic fractures, orthopaedic analgesia), II. Axial Skeleton Fractures (3 chapters including: general spine, cervical spine, thoracolumbar spine), III. Upper Extremity Fractures & Dislocations (14 chapters including: scapula fractures, distal radius fractures, hand fractures), IV. Lower Extremity Fractures & Dislocations (17 chapters including: acetabulum, femoral shaft, patella, calcaneus, talus), and V. Pediatric Fractures & Dislocation (11 chapters including: shoulder, elbow, hip, knee, ankle, and many more).

Egol’s Handbook of Fractures has a lot of text, but is easy to read because important words are bolded and there are quite a good set of illustrations that go along with essential concepts.  Most chapters are subdivided, very logical, touch on epidemiology, anatomy, mechanism of injury, clinical evaluation, radiographic evaluation, classifications of fracture/dislocation, treatment, nonoperative vs operative cases, complications, and rehabilitation.

The primary target audience of the Handbook of Fractures is orthopaedic residents.  It covers a wide range of important and must-know concepts needed to succeed in orthopaedic residency.  The ambitious MS3 who wants to end up on top in an orthopaedic elective clerkship may also find this book enlightening and useful for impressing some attendings and residents (don’t show off too much though, jealousy must be kept at bay!).

This book is certainly not recommended for medical school courses in general, as time spent reading it would be low yield for general surgery rotations. This book is also pretty much useless for the USMLE exams because orthopaedic fractures, dislocations, and other material presented in this book are just not the materials you’ll see on the boards.  If you want to use it to get ready for an elective in orthopaedic clerkship or plan to go into orthopaedic residency, then go right on ahead and invest in one. Otherwise, it is recommended that you skim a library copy as needed.

 

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What You Need to Know about Thieme’s Atlas of Anatomy

Gilroy's Atlas of Anatomy by Thieme

Anatomy – the first huge hurdle for many medical students to climb over. The anatomical knowledge gleaned in this first course will be used repeatedly as part of the foundation of medical knowledge. With that in mind, a solid foundation of resources is an absolute must. Frank Netter’s Atlas of Human Anatomy has been the gold standard of anatomy books for many years. Professors stand by the atlas and will expect you to memorize most, if not all, of those beautifully colored structures in the Netter plates.

That being said, it is important to introduce the Thieme Atlas of Anatomy by Gilroy. Its 2,200 beautiful images have been painstakingly drawn by Markus Voll and Karl Wesker, and appear to jump off the page. The book takes a different approach from other atlases, by starting with deep structures and working its way superficially. This allows for an understanding of the foundation of the body and how the other structures add on to it. At the end of each section, questions are posed to allow the reader to integrate the knowledge they have learned.

Thieme's Winking SkullThe book not only covers gross anatomy, but also illustrates peripheral innervations, arterial supply and venous drainage, lymphatics, etc. The anatomy is bolstered by clinical correlations, and important details are summarized in wonderfully easy-to-understand tables.  The Muscle Fact pages organize the essentials of origin, insertion, innervations in one place, making it much easier to memorize and review. The book also comes with access to WinkingSkull.com PLUS,  Thieme’s online resource and study aid, which gives the user access to over 600 plates with removable labels, and quizzing capabilities.

The largest, and only, detriment to using the Thieme atlas is that most professors still stand by the Netter atlas, and reference page numbers during lectures. To remedy this, Thieme has composed a table which compares Netter plate numbers to Thieme’s, allowing students to find similar plates.

Overall, this is a highly recommended book that many students believe far surpasses Netter in providing  comprehensive and integrative anatomy knowledge to beginning anatomy students and pro’s alike.

 

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Ace Anatomy: Free copy of Moore’s Anatomy and Rohen’s Flashcards!

Free Anatomy Book Giveaway

CLOSED! Congratulations to the winning First Year at Indiana University School of Medicine!

We’re continuing the book giveaways, transitioning from general advice for incoming medical students to focused resources for the premier med school course: Anatomy. This site has previously reviewed a head to head analysis of some of the more popular anatomy atlases out there, and they generally come down to personal taste. As a complement, we’re going to provide some of the other supporting resources needed to ace anatomy.

First and foremost, every student needs a good text, and Moore’s Clinically Oriented Anatomy can provide just that. We will be giving a formal review of the title on this site in the upcoming weeks, but for now rest assured that it is a well established and helpful resource.

Rohen Flash CardsSecondly, students should take advantage of study recall, and for that goal we are also giving away a free set of Rohen’s Flashcards. As a reminder: these are graphic images and should not be used in crowded areas in view of the public.

As extra icing on the cake, Lippincott is throwing in a free 6 month subscription to Acland’s Video Atlas of Human Anatomy Online as well, which is a video series of gross anatomy structures to help students better visualize human anatomy with visual manipulation and pertinent narratives.

Acland Video Atlas of Anatomy

Brand new copies of all three of these titles will be given to one lucky winner randomly selected from the comments of this post. To enter, simply leave any comment, and a valid e-mail address so we can contact you if you should win. As usual, we NEVER use e-mail addresses for anything outside of these contests, as we are medical students too and appreciate privacy. Applicants must be US medical students to win.  See our full contest rules for further details. Contest ends August 20, 2012 at 11:59pm. Good luck!

 

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Advice for the New Medical Student

This summer, approximately 25,000 students will begin their first year of medical school in the United States. While the path to medical school was challenging, medical school itself holds a number of additional challenges, as well as significant opportunities. “Concerns about succeeding academically, choosing a specialty, maintaining a social life, and making time for family can certainly cause anxiety among new medical students,” writes Dr. Meg Keeley, Assistant Dean for Student Affairs at the University of Virginia School of Medicine.1 Below, we offer some key advice for the new medical student.

Evaluate your study habits

In one study, researchers found that “in general, study skills are stronger predictors of first-semester total grades than aptitude as measured by the MCAT and undergraduate GPA.”2 There are many reasons for this, but one of the main reasons relates to the immense volume of information to be mastered. April Apperson, Assistant Director of Student Services at the University of San Diego California School of Medicine, explains “The material presented in medical school is not conceptually more difficult than many rigorous undergraduate courses, but the volume flow rate of information per hour and per day is much greater – it has frequently been described as ‘drinking from a firehose.’”3

Utilize active, rather than passive, learning strategies

The USMLE Step 1 exam is a critical factor in the residency selection process. With a strong focus on clinical applications, rather than rote memorization, the USMLE is a distinctive and challenging exam for most students. How should you study for an exam of this importance that’s so distinct from other exams? Drs. Helen Loeser and Maxine Papadakis, Deans at the UCSF School of Medicine, advise: “Use active learning methods as you integrate your knowledge and apply basic science information to clinical vignettes.”4 Research has shown that active learning leads to better long-term retention of information and easier retrieval of information when needed.

impacting communities

Impact your community

Medical students have been able to impact their communities in wide-ranging and meaningful ways, through student organizations, national groups, or through their own initiatives. Student-run health clinics offer one example, in which students often serve an underserved population, including the uninsured, homeless, and the poor.

Maintain your emotional well-being

Studies have shown that students experience significant stress during the preclinical years. This can have real consequences, including depression, anxiety, and effects on patient care. It becomes vital that students develop strategies now to cope with stress and promote their own well-being, in order to maintain resilience and the highest standards of professionalism throughout their career.

Explore different specialties in medicine

In one study of medical students, 26.2% were unsure of their specialty choice at matriculation.5 A similar proportion remained undecided at graduation. Exploring different fields during the preclinical years may help. Students have done so by participating in specialty-interest groups, shadowing physicians, performing research, and identifying mentors.

About the Authors

Samir Desai is the author of Success in Medical School: Insider Advice for the Preclinical Years and writes about residency match success at TheSuccessfulMatch.com.Author Rajani Katta

Rajani Katta is the course director for dermatology in the basic sciences at the Baylor College of Medicine, and the author of
The Successful Match: 200 Rules to Succeed in the Residency Match.


References

1Keeley M. Ask the advisor: How to successfully navigate the first year. AAMC Choices Newsletter August 2011.  Accessed June 18, 2012.
2West C, Sadoski M. Do study strategies predict academic performance in medical school? Med Educ 2011; 45(7): 696-703.
3University of California San Diego School of Medicine. Successful Study Strategies in Medical School. Accessed February 20, 2012.
4University of California San Francisco School of Medicine. Rx for Success on STEP 1 of The Boards. Accessed October 19, 2011.
5Kassebaum D, Szenas P. Medical students’ career indecision and specialty rejection: roads not taken. Acad Med 1995; 70(10): 937-43.

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How to Pick Individual Residency Programs: FREIDA

AMA FREIDA Online

It’s application season, and while this takes place every year, we only go through it once (thankfully), and thus the >25,000 participating med students are unfamiliar with the process. There are a TON of considerations on selecting individual residency programs to put on your ERAS application. It can seem daunting to wade through the list of endless programs out there unless you are certain of a smaller specialty from the start. We’re going to start with the basics, for those of you who are really lost.

First, head over to FREIDA Online. It’s a searchable sortable database produced by the American Medical Association with over 9000 residency and fellowship programs.  After scrolling to the bottom of and agreeing to their policies, users can select their desired specialty (including sub-specialties and combination residency programs), geographic area, program size, and academic affiliation. Results can be further filtered by benefits, ERAS or NRMP participation, research requirements, or specialty training tracks.

Searches can be saved for later viewing, although this is generally not necessary. For the more popular specialties such as Internal Medicine, paring down the perceived 3 billion possible choices by all of these options still produces a list that still feels like 567,902 programs. In actuality, you should come out with a list of less than 100. It’s still overwhelming, but much better than when you started. Trimming that list down to your “short list” of about 20 total programs to which you will apply. The final push should come from academic advisors in your desired field. If all else fails, post a question to this post, and we’ll have someone look into it.

AMA logo, producers of FREIDAHopefully though, FREIDA Online will be a highly useful first step. For those of you wondering, the AMA application name stands for “Fellowship and Residency Electronic Interactive Database.”  Sounds about right. Good luck on the application process!

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Free Book Giveaway: Success in Medical School

Success in Medical School - Insider Advice for the Preclinical Years

This contest is now closed. Congratulations to the University of Pittsburgh School of Medicine student who won!

We’re nearing the big dates for white coat ceremonies and new first year medical students coming into med school! For those of you who read the previous post on Success in Medical School, we’re giving away a free copy randomly to any US med student (including those about to start) who leaves a comment to this post. The comment can say anything (or nothing), but if you have time, please answer the following:

If you could give advice to pre-meds who will be applying to med school to be in your position, what would it be?  What do you feel are the most important aspects of a strong med school application?

You do not need to answer the question to enter – the winner will be selected at random. We just like sharing helpful insights on this site.  Contest ends July 31, 2012 at 11:59pm EST. As usual, e-mail addresses are kept confidential, only used to contact the winner, and never used for spam/evil. Full contest rules apply (but the essentials are that you should be a US med student of 18 years or older). Good luck!

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