resources to get up to speed before clerkship starts

[simulatedoperation]

hi everyone. I had a tough preclerkship experience. Barely passed, but phew, passed. I feel like there are a LOT of gaps in my knowledge. And I promise Im not just being hard on myself. I feel like I didn't retain much compared to my peers, I never used things like anki, etc. Now when we do cases and look at the patient as a whole, I struggle with coming up with differentials. In particular, I feel like I know nothing about GI, cardio, or renal. I have a few months before clerkship and I (unfortunately) start it off on my medicine/CTU block so I don't want to be completely lost. GI in particular was taught SO bad in my school. I know about toronto notes, but anything else anyone would recommend? websites, links, handbooks, anything. 

[No Name Brand]

Congratulations on getting through pre-clerkship! Don't fret at all regarding knowledge - totally a common feeling going into clerkship. A lot of learning comes from repetition seeing cases over and over while using point-of-care resources (ie. UpToDate) to read up around your patients when you have a chance. At the beginning of clerkship, expectations are very low and your priority (for the most part) should be to learn how to function in the hospital and as a clerk. This usually entails taking a good history, practicing your physical exam skills, presenting cases at rounds, writing notes, working in a team, learning how your EMR works, etc. 

That being said, if you are keen on doing some reading beforehand, here are some things that I found helpful... For CTU in particular, a good resource is "Approaches to Internal Medicine" by Hui. For FM, this is a good resource that I found online to be helpful from UCalgary: https://learnfm.ucalgary.ca/wp-content/uploads/2020/10/LearnFM-Clinical-Card-Book-2020.pdf. 'Case Files' are also good from my experience. Try reading around one approach a day and the knowledge will slowly come. All the best in this next chapter.

 

[plsaccept]

I will second what was said above, knowledge expectations are low but being willing to learn new things and functioning well in the hospital and as part of the team are probably the most important things, so don't worry if you don't have the knowledge base yet. There are some more common presentations that I would start off reading about slowly if you have time, just to get a general sense of the differential and what to do. They would include AKI, heart failure exacerbations, sepsis and all the different infectious syndromes (pneumonia, pyelo, bacteremia, cellulitis, etc), GI bleeds, decompensated cirrhosis, elevated liver enzymes, delirium/altered LOC, COPD exacerbations, anemia, thrombocytopenia. But again, don't worry too much about the knowledge - residents and staff are there to teach you and help you, and you usually have time to look things up on the fly that you don't know.

In terms of resources, Approach to Internal Medicine is good, although I found it mostly useful for practical purposes (i.e. when you're doing a consult and trying to frantically look up the differential, appropriate investigations, and management to present to your staff) than actual learning, since there isn't much detail there. A book that I found useful more for learning was Symptom to Diagnosis: An Evidence-Based Guide, which goes through the approaches to some common problems in slightly more detail. The OnlineMedEd videos were also pretty helpful for a number of different rotations including IM.

Surgical Recall was helpful for getting pimped in surgery lol. Another more niche book that was useful was Felson's Principles of Chest Roentgenology for understanding the basics of CXR/CT chest. It's pretty short and very easy to read, and once you've read it you'll crush it when people ask you to try to read a chest X-ray (admittedly, it does not help for anything else, so your time may be spent better elsewhere).

[Gimli]

I really enjoy podcast and there's a ton of good ones in IM. If it's a way that you retain information it can be interesting. For example, Curbsider internal medicine, the Internet book of critical care (IBCC - also a really great website to keep on your phone even when you're not on ICU rotation), the clinical problem solvers, the curious clinicians (even more nerdy that your average IM podcast), Run the list (I don't listen to this one as much, but heard good things). don't worry about it too much, you'll learn on the way

[frenchpress]

I found online med ed to be the most helpful for succinct high-level intros to core clerkship topics. I used it to review for my lmcc and I found it hit many of the most relevant points. Osmosis is also helpful, but it gets a bit into the weeds and there’s almost too many videos now - if you have a list of topics to guide which ones you watch then that can be helpful. 

[Synth1]

I found First Aid for the USMLE Step 2 CK to be the most helpful resource for clerkship. Quick overview of high yield info for all rotations without getting in to the weeds with two much detail you don't need as a clerk. If you are willing to pay shipping I would gladly give you my copy.