Nov 3, 2009

Progress?

Though hopefully enough progress to net me a decent grade on my Internal Medicine oral exam tomorrow.

IM is strange in that I'm learning medicine without really feeling like I'm learning medicine, and then the knowledge manifests itself in strange ways. It's also giving me odd moments of confidence when I get lists of lab values on UWorld before smacking me down by the fact that I'm still getting the wrong answers, just in a more efficient way. So far my most reliable sources of "WRONG" relate to picking antibiotics (there's a frigging billion of them!) and prioritizing diagnostic studies (Ohhhhh, abdominal CT before cholelithocystopancreatoduodenogenography, sucker! Your 'Gold Standard' is not welcome here!)."

I'll explain...

A great deal of time on pathology, pathophys, and USMLE questions was spent on getting a list of lab values, looking up the list of lab values (which are generally provided), figuring out which ones are buggy, separating those out, THEN coming up with a list of differential diagnoses for buggy lab values, THEN coming up with a definitive treatment or test. This understandably takes a lot of time.

Now, due to just random patient follow up in IM, when I see charts of lab values, I'm like "blah blah chloride giant who cares blah blah, hoo-damn that's some high calcium!!"

I'm also learning which abnormal lab values are associated with which chronic conditions and which abnormalities are not *that* abnormal, thus no longer look like such an idiot quite as often when I'm presenting to an attending with "OMG THE PLATELETS ARE 125K!!! GET THE CODE TEAM READY!!"

Which, I suppose, is the point.

7 comments:

arg said...

what are you on next?

Ishie said...

OB-Gyn. Hooray human larvae...

Anonymous said...

hey Ishie..love ur blog..i was wondering if you had good text book suggestions for each of ur rotations so far...keep bloggin!

Anonymous said...

Thanks!!

So far... blueprints for psych and allegedly for OB/Gyn, though first week on OB so though it looks good, I haven't gotten a lot of time to go through it yet.

IM, Blueprints actually isn't great for it. Step up to medicine is really good; Pocket Medicine is good to have in the coat pocket for reference, and Case Files are good for subway reading. Also U-World, U-World, U-World. I got a lot of good stuff out of that.

-Ishie

Anonymous said...

Thanks!!!

mike said...

Hey Ishie,
Happy birthday from your friends at Annexcafe

Ishie said...

Thank you!!!!!