FM academic advice

[MGN]

Hey everyone,

I am a new R1 in FM. I have done 2 off-service rotations and now I am in my FM block. I am not sure if I am struggling academically or not so I wanted to get people's advice on this. I feel that FM is too broad and that everyday I am being exposed to a multitude of new things in clinic. I know that my training is short and I want to take advantage of all the cases I see, but the problem is I simply don't have enough time to read up on everything. The problem in FM is that you really can't learn based on repetition, there a lot of things that are just sporadic and you don't see them often. I just feel that I am being overloaded with information that I don't have time to process. I am hesitant to speak to other residents or my preceptor about this, but I am at a point right now where I am using a significant portion of my weekend to read up on stuff, and I feel that I am way behind and not able to keep up.

So my question is: is this feeling normal?

[1029384756md]

Yup and it never goes away, get used to it sooner the better

[shikimate]

Maybe focus more on approaches and classifications rather than specific disease entities?

For example there are hundreds of causes of neck masses, but basically they're either benign or malignant, so if you know some features that favor either, you can get the workup started. You can also think anatomically: thyroid, parathyroid, soft tissue/connective tissue, lymphoid, metastasis etc. I mean whether it's benign or malignant you can do similar workup such as thyroid function, ultrasound, maybe FNAB. Anything more like nuclear medicine, biopsy, laryngoscopy etc you will probably refer to ENT.

[Egg_McMuffin]

Hey. Fellow FM R1 at a site that follows a longitudinal curriculum (so we've been doing some clinic every week since July). This is completely normal. Even staff are frequently looking stuff up on UpToDate as I review with them. You're not expected to be an expert in everything. My brain feels overloaded too and unfortunately I don't have the bandwidth to think too hard about stuff - partly due to getting used to procedural processes rather than the medicine itself. 

 

 

 

 

 

[bearded frog]

Staff here and even passing royal college I review my notes and uptodate all the time when reviewing with trainees. With specialties like FM with requirements for broad knowledge base as posted above the high yield will be management of the very common conditions you see, and "approach to" the very common complaints you hear. Beyond that, you need to know enough to pass your board exam, but it's ok to look things up in practice, especially when there are guidelines that change over time.

[GH0ST]

Agreed with everyone and in particular when you're starting out that feeling will be more intense... you're just getting used to the new pressure and responsibility.

It will get better but studying in medicine is lifelong. Have a few references you always go to and then branch out from there to incorporate new information. Just focus on a few approaches and slowly build up. Everything else in terms of nuanced interactions require experience... there's no other way to get it. 

Good luck! 

- G

[Arztin]

On 9/8/2022 at 3:39 AM, MGN said:

Hey everyone,

I am a new R1 in FM. I have done 2 off-service rotations and now I am in my FM block. I am not sure if I am struggling academically or not so I wanted to get people's advice on this. I feel that FM is too broad and that everyday I am being exposed to a multitude of new things in clinic. I know that my training is short and I want to take advantage of all the cases I see, but the problem is I simply don't have enough time to read up on everything. The problem in FM is that you really can't learn based on repetition, there a lot of things that are just sporadic and you don't see them often. I just feel that I am being overloaded with information that I don't have time to process. I am hesitant to speak to other residents or my preceptor about this, but I am at a point right now where I am using a significant portion of my weekend to read up on stuff, and I feel that I am way behind and not able to keep up.

So my question is: is this feeling normal?

Yup. normal. Even as an attending, I learn something new almost every shift. it will get better with time. Keep up the good work. It is a lifelong learning journey.

 

[LostLamb]

I look things up every day after clinic, in clinic, or if I have a new consult sometimes pre-clinic!

I humbly admit I do not know it all — but I DO know enough not to make it up as I go and to read up on things so that I continuously learn. 
 

good luck

[NewClerk]

Im in my R1 year of FM as well. I feel this way all the time, and haven't had a chance to talk about it with anyone either. My biggest worry is that I am behind the curve and/or that I didn't study enough during clerkship. I was hoping to do full scope FM but that feels like something out of reach at the moment. I have faith that with time and effort I will get more comfortable and knowledgeable  

[shikimate]

So something I learned is that in residency you are pressured to produce an answer right away in front of attending and other residents, but this is not the case in practice. Likely if I have to look up something I take the time to do reading and research. Unless something is extremely urgent, you can always refer it out or just walk to another colleague's office and ask for advice. I did refer out a lot of cases in the beginning and sometimes even the consultant didn't know the answer either!