Category Archives: Elective Clerkships

Books for medical school electives and specialties

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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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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Deja Review Emergency Medicine: A Great Quick Reminder

DejaReview Emergency MedicineDeja Review’s second edition of Emergency Medicine promises maximum retention with minimum time.  Using a ‘flashcard in a book’ question and answer format followed by a series of clinical vignettes designed to mimic classical presentations of the disorders presented therein, this copy of Deja Review “helps you remember a large amount of pertinent information in the least amount of time possible.”  So how much of this self-promotion is hype and how much is fact?

Emergency Medicine is divided into 18 chapters, each focusing on a particular overarching organ system or concept such as Cardiovascular and Vascular Emergencies or Toxicological Emergencies Each chapter is further subdivided into specific emergencies or presentations within these broader topics.  The subsections cover the most pertinent information regarding a specific presentation, such as etiology, exam findings and management.   It should be noted that the answers to the questions posed are very specific and typically not explanatory.  Following each chapter is a series of clinical vignettes which highlight key concepts of the diseases  or emergencies presented within the chapter.  A ‘Stimulus’ section found at the end of the book features 7 expanded clinical vignettes that include expanded presentations, images pertinent to the topic (MR, EEG, X-ray) and lengthy explanations regarding the answer choice.

emergency-reviewDespite being very bare bones, Deja Review Emergency Medicine, if used exactly as it is intended—as a last minute review solution—will probably serve those who choose to invest.  This is not a book for those who wish to explore the in depth intricacies Emergency Medicine has to offer.  Other comprehensive resources would likely benefit those looking for great detail regarding various case presentations and how to diagnose and treat cases seen in the emergency department.  But for someone who is looking for a quick and effective review of what Emergency Medicine has to offer in the week or so leading up to an exam or for rapid EM review, look no further.

 

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Happy Match Day Everyone

Best of luck to fourth years today.

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Careful Consideration: Pocket Neurology

Pocket Neurology LippincottPocket Neurology (also known as “The Yellow Book”) can be readily found in the white coats of many Neurology residents. Unlike its Medicine counterpart (The Green Book), Pocket Neurology does not seem to hold the same popularity among medical students. There are a few reasons for this. First, it hasn’t been around as long, and thus it hasn’t had time to built up the full extent of its reputation. Few attendings will readily reference it during rounds, and residents simply won’t expect students to own or have access to a copy. Second, Neurology is usually a clerkship of shorter duration compared to Internal Medicine in most medical schools, and therefore comprehensive pocket guides are less bang for the same buck.

What Pocket Neurology covers, it covers very well.  However the target audience for this title is not the same as for Pocket Medicine as a result of the focus in our medical education. We are taught the core principles of Internal Medicine from an early point on entering medical school, including history taking, physical examination, general findings, and many organ system courses focused on Internal Medicine subspecialties. It is because of this focus that new third year medical students can open a copy of Pocket Medicine and understand the more advanced topics without the need for referencing the basics.

This is not the case on a Neurology rotation, where most students are just starting to learn the specialty’s language, techniques, and the significance of common findings. For example, students may be frustrated if trying to use the book to assess the common presentations of migraine prodrome, despite a concise and comprehensive overview of headache differential diagnosis and workup. Getting past the basics quickly to fully utilize this book is highly recommended, as it will certainly be a strong resource to those who can wield it well.

As with all of the titles in the Pocket Notebook series, downsides include lack of space for annotation, and small print font, but these come with the territory of creating pocket reference guides.  Another consideration for this title specifically is an index section that is somewhat lacking.  Topics not contained within tidy concepts involve a good amount of searching in the appropriate chapter.  As a result, many residents will place labeled flags or earmarks on pages to quickly access commonly referenced topics.

Specific sections include neurologic emergencies, lesion localizing in clinical neurology, neuroimaging, vascular neurology, neurocritical care, acute intracranial hypertension, interventional neurology, seizures and other spells, electroencephalography (EEG), delirium, dementia, movement disorders, behavioral neurology, poisons and vitamin deficiencies, meningitis / encephalitis / brain abscesses, infectious diseases, headache, central nervous system vasculitis, pain, dizziness and deafness, demyeliminating diseases of the central nervous system, spine and spinal cord diseases, motor neuron diseases, peripheral neuropathy, radiculopathy and plexopathy, neuromuscular junction disorders, myopathy, electromyography (EMG), neuro-rheumatology, neuro-oncology, sleep medicine, pregnancy neurology, neuro-ophthalmology, consult issues, and selected pediatric disorders.

Overall, this is a title worth purchasing for all Neurology residents and medical students interested in the field. Medical students who wish to excel in their Neurology clerkship or enter a field that uses neurology such as Internal Medicine, Trauma, or Ophthalmology should consider purchasing Pocket Neurology with the above considerations, based on their personal preferences. This is probably not heavily needed for students who have no interest in neurology.

 

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National Residency Match Program Releases 2011 Match Statistics

The National Residency Match Program (NRMP) and Association of American Medical Colleges (AAMC) recently released the 2011 match statistics, which had not been previously updated since 2009. A copy of this latest version can be found here:
 

pdf icon2011 NRMP: Charting Outcomes in the Match
Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2011 Main Residency Match – 4th edition

 
Specific data included in the NRMP match statistics includes:

  • number of applicants and positions in the main residency match
  • match rates by preferred specialty
  • number of different specialties ranked
  • USMLE Step 1 scores broken down by specialty
  • USMLE Step 2 scores broken down by specialty
  • Research experiences, abstracts, and presentations
  • number of work experiences
  • number of volunteer experiences
  • AOA rates by specialty
  • fourth years coming from schools with high amounts of NIH funding
  • fourth years with graduate degrees
  • all of the above information broken down by individual specialties

This last item is particularly helpful, as breakdowns include graphs that illustrate the percentage of fourth years who matched with a given USMLE Step 1 score. While this is not a perfect indicator of matching chances into your given field, the document as a whole is a good framework from which decisions can be made.

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Sites to See: The Eyes Have It

University of Michigan Kellogg Eye Center: The Eyes Have It
As a complement to the latest post on ophthalmoscopes, we are happy to share an excellent online resource for medical students to learn about ocular findings and signs that may pop up on physical exam: The Eyes Have It, from the University of Michigan’s Kellogg Eye Center.

The Eyes Have It is a site that provides a split instructional and quiz portion to both review and solidify ophthalmology knowledge. The information is straight forward, and creates a great overview for med students in the primary care settings, and a starting point for ophthalmology clerkships.

Papilledema and Retinal Artery Occlusion

For the first-year medical students, after you purchase your ophthalmoscope for the first time, take a good hard look in as many eyes as you can.  When something looks weird, this is the site to go to as your first step.  For the third year medical students, here’s a pimp tip that will make you look like a rock star: involvement of herpes zoster on the nose is known as Hutchinson sign, and is a good clue that the eye is involves in the outbreak as well.  Bonus points are given to anyone who can comment on the pathology of the above two images from The Eyes Have It.

Iris Collage

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Jafek’s ENT Secrets, third edition

Jafek's ENT Secrets

Jafek's ENT Secrets

ENT Secrets, now in its third edition, is the next step up in otolaryngology texbooks for medical students.  Previously, this site discussed Primary Care Otolaryngology (reviewed here) as a light read to get through a mandatory ENT rotation or look knowledgeable about otolaryngology in a primary care setting. However, this is not an appropriate strategy for a med student on a sub-internship.  To hit the next level of looking awesome, we recommend ENT Secrets.

The benefit of this text book is that it is comprehensive enough for fourth year medical students to learn the fundamentals of every otolaryngology topic, without becoming a monster hardcover. Residents are more likely to reference Pasha or Lee (>1000 pages!), but these are a bit too large and extensive for most medical students on a one month rotation.  They are better suited for Ear-Nose-Throat boards, whereas ENT Secrets is better used for things like getting pimped, and not looking like a newbie.

As with many other books in the “Secrets” series, the book is broken down into subspecialties and reads in question and answer format, with numbered titles followed by detailed definitions of terms and scenarios.  You’ll get all the usual imaging and diagrams you would expect. This also comes with the online Student Consult.  Some of the features, such as online note taking, seem outright useless (please, someone comment if they disagree).  However the ability to access the text electronically means you can embrace the med student geek inside you and read while waiting for the bus.  It also means you can gank key figures and use them in powerpoint presentations.

If you’re about to hit your ENT sub-internship, this is the recommended book for you.  Otherwise, for mandatory clerkships, stick to the recommended reading, or Otolaryngology for Primary Care.

 

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