Tag Archives: medical students

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.

 

Posted in Core Clerkships, Elective Clerkships | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Used this resource? Leave your impressions.

Must Buy: Bates’ Guide to Physical Examination and History Taking

Bates Guide to Physical Examination and History TakingThe heart of all medical education is centered around a solid foundation in history and physical exam skills. These are not only learned and critiqued early during the preclinical years, but comprise the basis on which medical students are assessed and evaluated during clinical rotations as they are conveyed through presentations. Due to the strong and constant need for excellent history and physical examination skills in producing superior grades, it is highly recommended that all medical students master these abilities early.

Bates’ Guide to Physical Examination and History Taking, now in its 10th edition, represents the best reference resource for this goal. The book itself is rather extensive as a primer for all things history and physical, which makes it perfect for incoming medical students. The text is detailed and straight-forward, with great complementary pictures, illustrations, and tables. It is important to note that the focus extends behind the basic logistics and mechanics of taking a history and performing a physical.  Special attention is placed on normal physiology, as well as the significance of abnormal exam findings. Combined with proper instrument technique and care, this book allows for a deep understanding and mastery of the basic physical exam.

Other benefits of this book include the CD and website access on The Point, which host patient examination and assessment videos, fully searchable text, and cardiopulmonary exam sounds. To a lesser degree, the book is also helpful at providing basic differential diagnosis development. While many medical schools specifically assign chapters in this book as required reading during preclinical years, it remains a fantastic reference source throughout clinical rotations as well, with continued potential for residency.

There are a few drawbacks to this book.  First and foremost is the price.  At around $100, this “must buy” book is often times considered a “must borrow” from the library. Purchasing the black 9th version of this book will offer nearly all the same content for a slightly lower price, but has issues with page discordance when professors assign specific pages from the latest version. Second, Bates’ strength in providing full explanations to completely inexperienced medical students can sometimes become undesirable later in medical school when trying to obtain a quick concise answer for an understood concept.  Along those same lines, the weight of this 992 page book can make constant transport somewhat arduous. It should also be noted that this book does not delve into the depths of specialty exams, but rather focuses strongly on the general history and physical exams needed for core clerkships. For example, the basic eye exam is included, but does not cover the depth that an ophthalmologist might assess. The book does however provide a full and thorough neurologic, pediatric, and gynecologic exam.

The first unit is a general overview, and contains specific book chapters on: Physical Exam and History Taking Overview; Clinical Reasoning, Assessment, and Recording; and Interviewing and the Health History. Unit 2 covers regional examination, with chapters on: General Survey, Vital Signs, and Pain; Behavior and Mental Status; The Skin, Hair, and Nails; Head and Neck; Thorax and Lungs; Cardiovascular System; Breasts and Axillae; Abdomen; Peripheral Vascular System; Male Genitalia and Hernias; Female Genitalia; Anus, Rectum, and Prostate; Musculoskeletal System; and Nervous System. The final unit is dedicated to “special populations,” and includes chapters on: Children – Infancy through Adolescence; The Pregnant Woman; and the Older Adults.

Overall, this is a highly recommended book for incoming medical students to master vital skills. Be sure to use the below links to get a starting price comparison between retailers before making a purchase, as the price can be steep.

 

Posted in Pre-clinical Years | Tagged , , , , , , , , , , , , , , , , , , , , , |
1 Impression on this resource so far. What's yours?

Win a Free Book: Pocket Medicine (AKA The Green Book) Giveaway!

This contest is currently closed – the winner has been contacted. Thank you to everyone who applied. Stay tuned for the next free giveaway, coming this Halloween!

Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine

Win this book free!

Med Student Books is proud to announce our first of many book giveaways: Mark Sabatine’s Pocket Medicine. You have probably already heard it referred to as “The Green Book” (the newest edition after “The Red Book“), and seen it sticking out of white coat pockets. Pocket Medicine has been previously reviewed on this site as a “Must Have” book for third year medical students on the wards.

Thanks to our friends at Lippincott Williams & Wilkins, we are happy to give away a brand new copy of this highly recommended resource. As this site is dedicated to using the experiences of medical students to help one another, Pocket Medicine will be awarded to the US medical student who offers the best advice to incoming first year medical students in a comment to this post.  It can focus on anything, including but not limited to study tips, ways to adjust to med school life, your favorite anatomy resources, or anything else that you wish you had known coming into medical school.  It just needs to be tailored to first years.

As this book is valued at over $50 and we wish to restrict it to the medical community, we ask that you use your medical school e-mail address as verification of your status.  Alternately, you can use another e-mail for now, but winners must verify their med school e-mail when contacted.  E-mail addresses are not displayed publicly, and will not be used for any purpose outside of this contest.  The winning entry will be selected on Friday, October 7th at 11:59pm, and the winner will be notified by the e-mail they provided shortly thereafter.

See our complete contest rules for further details.

Posted in Core Clerkships, Must Have | Tagged , , , , , , , , , , , , , , , , |
28 Impressions on this resource so far. What's yours?

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.

Posted in Core Clerkships, Elective Clerkships | Tagged , , , , , , , , , , , , , |
1 Impression on this resource so far. What's yours?

250 Biggest Mistakes 3rd Year Medical Students Make

Book Review: 250 Biggest Mistakes 3rd Year Medical Students Make And How to Avoid ThemMany will argue that the first mistake third year med students make is buying this book, while others will claim that it is an essential and invaluable survival guide. 250 Biggest Mistakes 3rd Year Medical Students Make and How to Avoid Them by Dessai and Katta is the semi-popular successor of the 101 Mistakes book.  As the title suggests, it reviews all of the big issues bound to cause trouble on the wards. But how helpful is it really?  The answer depends upon the direction and perspective from which the book is examined.

If an attending were to be pulled aside and asked to write a list of all the things that bring down 3rd year med student evaluations, it may very well produce this book.  Therefore, many reason that the opposite must be true: buying this book prevents students from making these 250 mistakes, thereby instantly increasing their grades.  That’s essentially the fear hidden in the title of this book: buy it or you won’t get good evals.

Looking at the same scenario from the medical student’s point of view produces different results.  If a fourth year medical student were asked to write a list of all the things they wish they knew for themselves coming into med school (one of the very goals of MedStudentBooks.com), only a small portion of this book would be reproduced.  The reason for this distinction is because the large majority of “mistakes” in this book are common sense items that the large majority of medical students either don’t make, or adapt to with effortless efficiency.

So why the discrepancy in appreciation of this book from readers?  For medical students who have worked in “the real world” or have been held to rigid professional standards previously, pieces of advice such as “show up on time” or “dress professionally” or “get your work done on time” come as an expectation. Others however need gentle reminders that there is a clear distinction in the environment between preclinical and clinical med school years.  The majority of medical students come directly from college, and may face an actual professional setting for the first time in their lives at third year.  This latter group comprises the students who would most benefit from the nuanced recommendations of 250 Mistakes.

The big picture consists of the following.  First, med students should be professional. Second, they should ascertain the characteristics on which they are evaluated by directly asking residents or attendings at the start of each rotation, and reevaluating methods based on feedback along the course of the rotation. It can be an intimidating process for someone unfamiliar with the culture of medicine, but such open communication is a common occurrence.  Most attendings at teaching hospitals are happy to help, and do not mind offering feedback. It should be noted however that this falls under a common rule of medicine: don’t ask the question if you don’t want to know the answer.  Feedback is only helpful if it is used, and being defensive about feedback is looked down upon.

If you can accomplish these goals of professionalism and open communication that seeks out feedback for improvement, there’s not much else this book has to offer.  If however you are new to the working world or want a few gentle pushes in the right direction, this can certainly help.  Despite it’s 200+ pages, it’s a rather fast read with big bullet points.  The book itself is relatively cheap (compare prices below), but it can usually be found at your local medical library, or borrowed from friends or student lounges.

 

Posted in Core Clerkships | Tagged , , , , , , , , , , , , , , , |
1 Impression on this resource so far. What's yours?

If You Must: Stedman’s Medical Dictionary

Stedman's Medical DictionaryAnother common mistake new medical students make is securing a medical dictionary. Usually these are used as incentives for signing up with one of the medical societies that want your money, but as a whole, they are not needed.  That’s not to say they are inaccurate or unhelpful, so much as outdated.  If you need to look up the definition of a specific medical term, chances are you will be effortlessly turning to Dr. Google or Wikipedia, instead of digging out a book from your shelf and using your mastery over alphabetical order and small print font.

With that being said, there is a small sub-population of people who will argue over which medical dictionary is the best out there. The fact is, they all get the job done to about the same degree and ease.  If you have to pick one because your medical book starter set wouldn’t be complete without it, I would say go with Stedman’s Medical Dictionary.  It’s the one that has been endorsed by the American Medical Association (AMA), and is one of their incentives for joining (as referenced above).  This not only means that you have the opportunity of obtaining it at no additional cost if you were to sign up with them anyway, but it also usually means that they are plentiful and freely given away by other med students who didn’t want it.

Again, it’s a common mistake to buy a medical dictionary.  They just aren’t needed.  But if you insist on getting one anyway, grab a copy of Stedman’s.

 

Posted in Books to Avoid, Pre-clinical Years | Tagged , , , , , , |
Used this resource? Leave your impressions.

Surgical Recall: Ultimate Pimping Handbook

Blackbroune Surgical Recall for Third Year Med StudentsSurgical Recall is one of those third year med student books that can be your secret phone-a-friend ace up your sleeve, and concurrently your downfall. There are a number of books you will encounter throughout medical school where the outcome of that class or clerkship is dependent on how the book is used. Just as you wouldn’t use Netter’s or Rohen’s to replace an anatomy text, Surgical Recall must be used properly.

As the title implies, Surgical Recall is your guide to all things pimping on surgery.  Unless surgery is your first rotation, you should already be aware that the pimping starts on the very first day. Accordingly, you should ideally grab a copy of this during the weekend before your surgery clerkship starts and dig in quite a bit by time you hit the first day.  This is the book that’s going to help you avoid looking like a total newbie, because common surgical etiquette and culture is not taught in preclinical classes.  This is the book that’s going to tell you all the usual abbreviations, the names of all the different scissors you enounter, why you should NEVER touch the mayo tray (and what that is), and all of the common pimp questions you will commonly encounter.

Like other books in the Recall series, Surgical Recall uses a split page question and answer format that quizzes the reader on all the common things seen in surgery.  The book does a good job in its use of pictures, especially on sections dedicated to surgical instruments and consumables.  This is important as most third year med students don’t know what a JP drain is, what JP stands for, what they look like, and how they are different from other drains. You could responsively google “JP drain” right now, but you won’t know the names of all the other commonly used tools, which is why this book is helpful.

The latest edition (as seen above) has taken on a somewhat retro look.  Perhaps market research has shown med students go for books that are already on fire to quell the need to later set them ablaze in frustration, or perhaps this just allows for the subsequent edition to look modernized in comparison. Nonetheless, we can’t judge a book by its cover, else the BRS series of books would have gone extinct long ago. The first section of Surgical Recall is going to touch on the big picture and background of surgery, including abbreviations, surgical signs, syndromes, cutting, suturing, tying, instruments, preoperative requirements, wound care, hemostasis, nutrition, shock, complications, and surgical anatomy pearls.  Section II goes over the main general surgery areas, including GI hormones, GI bleeds, hernias, laparoscopy, trauma, burns, bariatric surgery, appendicitis, ostomies, fistulas, IBD, portal hypertension, other hepatobiliary diseases, the breast, endocrine, melanoma, vascular, and intensive care unit knowledge.  The third and final section hits the surgical subspecialties, including pediatrics, plastics, hand, otolaryngology, thoracic, cardiovascular, transplant, orthopedics, neurosurgery, and urology.  This book is around 800 pages long, and while the question and answer format allows for a faster read, you should generally focus on the general surgery knowledge and the topics that specifically correspond to your surgical service.

Surgical Recall Illustrations: JP drain and Scalpels

Included with this latest version is the promise of free “Mobile Access.”  As of now, the jury is still out as to whether this is legitimate, as a number of students have had a hard time actually accessing it through their phones without paying the additional ~$45 app price through Android or Apple. It may be fixed in the future, but don’t purchase this book thinking it will instantly be on your phone.

Surgical Recall can be the downfall for the occasional medical student who believes this is the only book needed during surgery.  Indeed it will seem like a cheat sheet, whereby memorizing this book will produce superstar results in the operating room and floors (and it will).  However, the NBME Surgery Shelf Exam doesn’t care about the things that make awesome operating room medical students that get all the obscure attending questions. There is no Surgery Shelf question on one-handed ties, no Surgery Shelf question on drain choices, and no Surgery Shelf question on how your attending likes their coffee.  Make the distinction: there is OR / floor knowledge, and there is NBME Surgery Shelf exam knowledge, with a minority of overlap.  You need both to go for the gold on your surgery clerkship, and Surgical recall is the tool to help with the former.

 

Posted in Core Clerkships | Tagged , , , , , , , , , , , , , , , , , , , , , , |
1 Impression on this resource so far. What's yours?

Compare Welch Allyn Series: How to Pick the Best Light Source

This is the third installment of a series of posts on comparing Welch Allyn products that will help incoming first year medical students learn about and select different medical instrument components to construct the right Welch Allyn diagnostic kit (otoscope and ophthalmoscope). The focus of this discussion is on Welch Allyn diagnostic kit light sources, which are the physical bulbs that illuminate the ear canal or retina through the otoscope and ophthalmoscope, respectively.

Choices here are limited throughout the industry to either halogen bulbs, which have been the long-standing default in the field, or the newer sexier light-emitting diode (LED) technology. If you’re interested in the bottom-line short version, scroll to the bottom.


Welch Allyn Halogen BulbFirst let’s hit the older (read: cheaper) option that is still the default for diagnostic kits today. Halogen bulbs have been the standard for otoscopes and ophthalmoscopes for a while now, and Welch Allyn has (in their usual fashion) claimed theirs is the best. Halogen lights in general produce a yellow or off-white softer light. This actually comes in handy when viewing a retina, as brighter lights will constrict the pupil, thus making it more difficult to actually see the retina.

The downside to halogen bulbs is that they are somewhat easy to break, and they degrade and burn out faster than LEDs. Historically, halogen bulbs have cost up to $60 to replace, making this a sub-optimal option that doctors just had to put up with. Today, the price has thankfully lowered. Overall, this is now the cheaper option simply because it is the older technology, even though it works reliably well.


Welch Allyn LED Bulbs for Diagnostic KitsDiagnostic kit LED lightsaber bullets bulbs on the other hand are the more expensive option, which is somewhat surprising simply because LED technology of this variety has been around for a lot longer than it has been used in otoscopes, and should theoretically be cheaper. Welch Allyn had previously scoffed at LED lights, but are now making the transition over since competitors have been offering this option. Due to these recent changes, you can still find contradictory representatives that claim LED lights are not needed, while portions of their website claim LED lights as superior. They have however taken some time to create shiny exaggerated graphics, which I will share below. Regardless, do not be surprised if this newer option is not yet offered by most retailers.

Not quite sure how to interpret this one…

LED bulbs produce whiter and brighter light, allowing for clearer visualization of ears and noses. Check out the direct comparison of the two light sources in the top image. The LED is like a light-bazooka in comparison. Med students can just use their LED otoscope and actually forgo carrying a separate penlight to check pupils or look in someone’s throat, as they run on similar LED bulbs (that only cost the expected $2). LEDs use a fraction of the power compared to halogens (which means your handle battery lasts longer), are near-impossible to burn out, and don’t degrade in light quality during extended use. In almost every way, LED bulbs produce harder, better, faster, and stronger light.

The first real downside at this point is the cost, but that is expected to dramatically drop as soon as generic options are created that fit Welch Allyn diagnostic kits. Refuting the claim that the LED can be “too bright” is as easy as dimming the bulb on the power switch. As an aside, I find it amusing that Welch Allyn believes that dimming a halogen bulb, as seen in their demo on the right, somehow produces black-light (I said they were exaggerated). My personal solution, and the setup that I use in my instruments, is keeping the ophthalmoscope halogenated, and using an LED only with the otoscope. I get the best of both worlds. Keep in mind that you may need to open your instruments to insert the LED bulb yourself if your retailer does not provide this service for you. If you have the smarts to get into med school, this shouldn’t be too difficult to figure out. I’m sure there’s a “how many med students does it take to screw in a light bulb” joke somewhere in there.

Selecting an LED bulb may seem like a no-brainer. However, choosing this optional component in your diagnostic kit should come down to the question as whether this sexy super-light is actually needed. For the large majority of medical students, the answer is no, and the prices offered by Welch Allyn should serve as a deterrent, if the option is offered by retailers at this point.


In summary, the direct comparison is as follows:

Approx. Price Lifetime *
Color and Intensity
Halogen Bulb
$25 ~7 months Soft yellow
LED Bulb
$90 ~25 years Bright white
* refers to the total time when the bulb is actually on and in use

Still can’t decide? Let us help! Check all that apply:

My retailer doesn’t even offer LED, and I’m not really a do-it-yourself kinda person.
Money is of no concern in the purchase of my instruments.
I have a habit of dropping my cell phone frequently.
I want to learn on the same components as everyone else, including the people teaching me.
I want to learn physical exam techniques using the absolute best equipment at my disposal.
I’m never going to use this diagnostic kit after med school, and will probably not use it that much in med school either.

Suggestion:

Posted in Medical Instruments | Tagged , , , , , , , , , , , , , , , , , , , , |
1 Impression on this resource so far. What's yours?