Developing Your Peripheral Brain

This is a guest post from David who writes an excellent blog called The Physicians Library. Thank you David!

“What did you use on the floors?” This is a common question I have been getting recently from the recent third year medical students. Third year is a great time to begin building your “peripheral brain” – the pocket references and device apps you use to quickly look things up on the floors. Of course, your own personal preferences will depend on things like specialty interest, how much you want to spend, what do you have available, etc. If you want to use technology some things may be device dependent but in general there is a lot of overlap between Apple and Android apps available. I also used to have a Blackberry Torch and had some apps on there so perhaps there is good news for any holdouts out there. Here’s what I ended up using this year:

Pocket Books

Maxwell Quick Medical Referenceclip_image001

At my school, the fourth-year class usually presents this as a gift to the new third-year students and I have some other schools doing this as well. Don’t worry if you can’t get this for free – it is dirt cheap. Really, there is no reason not to have this book. It’s a lifesaver for everything a student or resident needs to do from writing orders to the mini-mental status exam.

Pocket Medicine

clip_image002This may be more relevant for those interested in internal medicine but there are also similar books for other specialties. I also used the Pocket Pediatrics book. I liked these books because of the charts and algorithms presented. References for primary literature are also provided which can be useful if your attending asks you to look up the article for that particular recommendation. Another nice feature is that these books are in binders which you can open up and add your own pages. A common alternative I have seen others use is the Washington Manual of Medical Therapeutics.

Device Apps

Medscape

clip_image006This is a free app and all you need is a Medscape username and password. Although not quite as good as Up-to-Date it is fairly complete and well-organized. For most diseases it will have labeled sections on diagnosis, work-up, and treatment or management. It also includes its own drug monograph database and a host of calculator tools such as Ranson criteria or Centor. The one drawback is that it is not as searchable as I would like. For example, you cannot search for the aforementioned criteria as Ranson or Centor. You have to look for “pancreatitis prognosis” or “strep throat evaluation”. However, usually the search pulls a list as you are typing so you will likely find what you are looking for before you even completely type in a word.

AHRQ ePSSclip_image004

This stands for Agency on Healthcare Research and Quality Electronic Preventative Services Selector. This app is essential for a rotation with a primary care component (e.g. outpatient medicine, family medicine). You type in the patient demographic data including gender, age, smoking status, and sexual activity and it pulls the current USPSTF recommendations for preventative services that patient should or should not be receiving.

ePocratesclip_image008

This was my preferred drug monograph database during third year. It has a nice interaction checker, calculators, reference tables, and more. There are others like Micromedex and the one on Medscape. Whatever you do, have one and understand how it works.

Rotation Specific Tools

Surgical Recall

I actually am ambivalent on this book. For future surgeons, it may be more appropriate. I found it useful to a point but it had only decent yield for “pimping” and was not quite appropriate for the NBME shelf exam.

Quick Reference to the Diagnostic Criteria from DSM-IV-TR

I am not sure if all medical students will still be working with DSM-IV but either have a pocket reference (check if your school provides one) or download an app. Learning the specific criteria is particularly high yield for a psychiatry rotation and standardized tests.

Final Thoughts

Whatever you decide to use for your peripheral brain make sure you keep it tight to a select few resources and know how to find the information in each. It does you no good to be overloaded with tools and spending too much time figuring them out while you need information. Take some time on a weekend to really play with your tools and familiarize yourself with them.

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