Tag Archives: MS-IV

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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Déjà Review: USMLE Step 2 CK – Perfect for Some

Deja Review USMLE Step 2 CKStudents preparing to study for the USMLE Step 2 CK  should be well accustomed to the type of question encountered on the boards and shelf exams, and should have a decent sense of their own study habits and strengths. This is immensely important when deciding on a study plan for Step 2. The seemingly infinite clinical knowledge can be overwhelming, and a structured study plan truly helps.

Deja Review USMLE Step 2 CK, now in its second edition, continues to get mixed reviews by students studying for the boards. The format of the book is very straight forward: alternating sections of clinical vignettes, and rapid-fire two-column recall question and answers. The book goes through each of the core clerkship specializations that will be found on the USMLE Step 2 exam, starting with Internal Medicine, and progressing through Surgery, Neurology, Psychiatry, Obstetrics and Gynecology, Pediatrics, and finally Emergency Medicine. It is not a text book, or even a comprehensive review book such as First Aid, and as such should not be relied upon to learn new concepts. Its strength is purely in aiding with recall and making buzz word connections, and it does that very well.

However, the lack of teaching can be frustrating for students who do not already know or remember the material. DejaReview Step 2 CK shouldn’t replace question banks either. There are no answer explanations or experience in testing. Furthermore, the book is often times seen as unhelpful to students who do not learn well with recall type resources.

It is due to these reasons that there exists a split in outlook about this book. People who excel at rapid recall questions can easily carry this in a wide white coat pocket during the months preceding the USMLE Step 2 CK exam, for high yield on-the-go studying. It is a very strong review text that complements First Aid and USMLE World question banks, but it is not for everyone. Learning style really matters with this book, which is why there are such mixed feelings about it. If you are unsure of your learning style, it is recommended that you check out the format of the book before purchase. Try to browse through a copy at your medical library, or if you want to decide sooner, head over to Amazon, which gives a few of the question type pages found in the book. As far as price, Deja Review USMLE Step 2 CK gives a lot of bang in its 300+ pages for a low cost, so finding out it is not for you won’t set you back too far. Check out the links below to see what I mean.

 

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Guest Post: Dr. Stephen Goldberg, Publisher of the “Made Ridiculously Simple” Series

It is with great pleasure that MedStudentBooks would like to introduce Dr. Stephen Goldberg, creator of MedMaster publishing company, best known for the “Made Ridiculously Simple” series. He is not only an entrepreneur, but an award winning teacher as well. More of his writing can also be found online at the Goldberg Files. Without further adieu, Dr. Stephen Goldberg: 

Stephen Goldberg, MedMaster Publishing, Made Ridiculously Simple SeriesAfter graduating from the Albert Einstein College of Medicine in 1967, I practiced neurology, ophthalmology, and family medicine at one time or another. I also did research and taught at the University of Miami School of Medicine for 25 years in the Cell Biology/Anatomy department, where I taught neuroanatomy, and was an attending in the Family Medicine department.

In 1979, I formed the MedMaster publishing company after my first book, Clinical Neuroanatomy Made Ridiculously Simple, was rejected by multiple publishers for making a serious topic funny and being too brief. Strangely, the aspects of the book that were criticized were the same ones that my students appreciated. The book went on to become a best-seller in the U.S. My students awarded me the George Paff Award for Most Outstanding Professor eleven times.

Other authors of like mind, including my students Mark Gladwin and Bill Trattler, who wrote Clinical Microbiology Made Ridiculously Simple, submitted books that went on to become the MedMaster “Made Ridiculously Simple” series. I was invited to give the commencement address at the Washington University at St. Louis School of Medicine in 2004 in appreciation of the MedMaster contribution to medical student education.

MedMaster Logo

It occurred to me that when a publisher receives a book, it is often sent for review to someone who may be expert in the field, but not necessarily expert in understanding the needs of a student learning the topic for the first time. Such experts often feel a book is “incomplete.” Hence, the student is often left with very large texts with a lot of clinically irrelevant information, and has difficulty grasping the subject as a whole. One study indicated that the leading cause of stress in medical school is that there is so much to learn and so little time to learn it. Another study showed that if a first year medical student actually did all the reading that was assigned, this would entail reading more than 24 hours a day. So MedMaster embarked on publishing books that are brief, clinically relevant, enjoyable to read, and promote understanding.

The medical student needs 3 kinds of books:

  1. The reference text. While such large books provide essential reference information, the student can get lost and not achieve an overall understanding of the subject. Understanding is very important. The human brain is better at understanding than at memorizing huge numbers of esoteric facts. Computers are better at facts; humans are better at understanding. Understanding not only helps in dealing with the many variations on patient problems, but also facilitates the learning of facts.
  2. The Board review book. I’ve noticed that many of the student forums focus on study for the USMLE. Passing the Boards is necessary; indeed, MedMaster publishes its own review books for USMLE Step 1, 2, and 3. But simply relying on the rote facts in Board review books is insufficient for practicing medicine, because Board review books do not promote understanding, which is vital in dealing with patients.
  3. The small conceptual book, which provides understanding in addition to key information useful not only for exams but for practical application throughout one’s career. MedMaster emphasizes such books, which can be found at www.medmaster.net. MedMaster’s blog, the Goldberg Files, deals with methods to promote rapid learning and other ways to deal with the stress of medical school.

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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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5 Reasons Why You Shouldn’t Overlook Netter’s Anatomy Flash Cards

Netter's Human Anatomy FlashcardsAt this point in the year, most medical students have already started Gross Anatomy and have gotten a feel for many of the resources available to them.  A review was previously written that compared some of the more popular anatomy atlases, and only a brief mention has been made on this site so far regarding anatomy flash cards. For many students, the idea of atlas flash cards seems redundant.  You should be familiar enough with your study and learning habits to get a feel of this already.  However, there are some benefits to this resource which are best shared by people who have already gone through the full experience of medical school.

1. Size Matters… for Anatomy

Regardless of which atlas you have selected, you are most likely going to be bringing it around with you, or using the local library copy. However, this has its limitations.  Pulling out a copy of Rohen on a crowded bus can not only be disturbing to those around you, but produce a serious issue of professionalism. Similarly, waiting for a bus or standing around somewhere makes balancing a thick anatomy atlas somewhat annoying. The first strength of Netter’s Anatomy Flashcards (now in their third edition) is their size.  Reviewing them is not only easy to manage, but they are also easy to hide.

2. Grab ‘n Go Learning is Key

Chances are, your anatomy class will focus on one particular organ system or anatomic area at a time.  The full Netter’s Anatomy Atlas text is 620 pages, which is overkill for your specific study needs in any given week. While it is a great resource, carrying it around along with a syllabus is going to get tiring pretty fast. A better tactic is simply grabbing the color-coded stack of flash cards dedicated to your current area of interest. The latest version already has hole punches, which keeps organization manageable. At some point in med school, most medical students realize the usefulness of portability. Stack a few cards on top of your snack bars, and you’re set for the day.

3. Instant Access

Netter's Atlas of Human Anatomy smartphone AppPurchasing Netter’s anatomy flash cards new grants access to the studentconsult.com online version of this resource from any computer.  Even if you forgot your cards at home, you can still review them. This basically creates a second copy of the cards, which you can access indefinitely, even if you want to share the hard copy with a friend.  Some will argue that this is especially useful when accessed remotely on a smart phone, but most med students would disagree. The detail of the structures combined with the small font makes for a suboptimal viewing and thus learning experience. This is precisely the reason the iPhone and Android app of any atlas is usually contraindicated.

4. Reusability

While most first year resources are rarely used by med students on the wards, anatomy is something that will need to be reviewed for a number of clerkships, including surgery, ob/gyn, neurology, as well as elective rotations in any surgical subspecialty. Again, a full atlas is always best, but not something easily stored in scrubs pockets and referenced between cases in an operating room.

5. It’s cheaper than you think

A set of anatomy flash cards can usually be purchased new for $25. Because they tend to be in moderate demand every year, they have a resale value that will allow you to recover the majority of its initial cost. Furthermore, selling your set used does not remove access to studentconsult.com, which means you can continue referencing the electronic version.  Even when new versions come out, older sets can usually still be sold.  With that in mind, it is perfectly reasonable to purchase the previous version of these flashcards. Human anatomy hasn’t changed too much since 2006.

As a runner up reason not to overlook Netter’s Anatomy Flashcards: They go particularly well with people in the Rohen camp of anatomy atlases, as it offers a little bit of Netter drawings to complement and enhance the Rohen experience, producing the best of both worlds.

 

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