Books for IM

[Stinger86]

I used Prescription for the Boards Step 2 and read over all the chapters except psychiatry, OB, and Pediatrics. Other than the fact that the medicine shelf was the first third-year shelf I've ever taken (and it was a lot different from the second year ones), I think I probably scored above average. Nothing too great, but nothing terrible.

In retrospect, I probably should've used MKSAP, as I did see it in the bookstore and liked what I saw, but I just didn't want to buy yet another review book. Other people highly recommend it though, so I'd go with what they say

---

Members don't see this ad.

 

[14022]

anyone else think this book sucks?

it seems that the questions are more for step 1 than a clinical rotation...its all epidemiology and basic science type questions...short stems with crappy explanations...did anyone find it helpful

what are the questions on the shelf like...are they more similar to mksap or a&l...

any advice would be appreciated...i would like to know if it would be a good idea to trash t he a&l and just focus on pretest and mksap

 

[HiddenTruth]

so i just started IM--my first rotation. I was just wondering how you guys were studying/reading for this rot? I don't take the shelf this year--we take another 2 months of IM in M3 and that's when we take the shelf. So, I am just wondering what I should try to read on the side just to keep up and learn stuff? The thing is that i am so tired (it's so difft from studying)--like with rotations and being in the hospital for nearly 11-12 hours a day, you are so PHYSICALLY drained...and i like to sleep early so i can get there early and do a thorough note and examination before morning report and rounds. How are yous managing to study/read. Fill me in--i guess i am getting kinda' lazy too cuz not much is required of us this year in this rot and i just got done with BMS--but i def. gotta start reading...so gimme some tips. Thanks guys.

HT

 

[Halaljello]

whats the newest edition to this book? i keep running into a yellow book from 2001. Isn't there a newer edition you guys are using? i just can't find it online!! can anyone gimme a link?

 

[grayce79]

Mine has a blue cover and I ordered it off Amazon.com It has 2002 for the copyright date.

 

[Halaljello]

this is all i could find

http://www.amazon.com/exec/obidos/tg/detail/-/0071364218/102-2360019-5074526?v=glance

seems like the older edition.... anyone have a link where i can get a newer one?

 

[bigfrank]

Beware, though. This book is CRAP!!!

 

[EctopicFetus]

I beg to differ. I felt the book as well as my hard work helped me get my A. I did well on the shelf thanks to utilizing only this book. Just my $0.02. Also, bigfrank is mr step I. He did much better than me so maybe his standards are higher!

 

[PACtoDOC]

Hey guys,
I am starting IM on Monday of next week, and would like to know what some of you would do to prepare for it (those of you who have been through it already). Are there any good references on IV fluid replacement in adults, and how to choose which fluid? Thanks in advance.

 

[D.R.HiFlo]

I read Acid-Bases,Fluid,and Electrolytes made ridiculously simple and MKSAP 2 for Students. I also did the questions in Pre-Test for medicine and looked over the medicine section of Boards and Wards. This is more that sufficient for the wards and the shelf exam.

 

[12R34Y]

Work through MKSAP 2 and pre-test during the rotation and then a couple of days before the shelf you can easily read the 80 pages on IM in boards and wards. It is a nice way to finish with high-yield stuff. I did great on the shelf doing this. Our department hands out MKSAP .....it rocks.

later

 

[Willamette]

Hey guys,
I am starting IM on Monday of next week, and would like to know what some of you would do to prepare for it (those of you who have been through it already). Are there any good references on IV fluid replacement in adults, and how to choose which fluid? Thanks in advance.

Hey P2D!! Long time, no talk..er write...er you know what I mean.

Give a looksee at "Clinician's Pocket Reference" a.k.a "the Scut Monkey Pocket Reference." It's got a succint and fairly thorough section on fluids and electrolytes, and is REALLY a good reference to have in "the ol' short and white" we all have to wear. I hope your holidays are going well!!


Willamette

 

[Boomer]

Harrison's--cover to cover.

Mix in a little of Cecil's whilst you're on the can.

You should be fine with reading both of these in the next week.

 

[greets fr. nyc]

Just finished 3 months on IM...

i agree with the OPs about brushing up si/sx/ddx/dx/tx on electrolyte issues and acid base problems (if you haven't done surgery yet, or still need work on this)

as for reading up in general (not specifically for the shelf that is),
1) check out a review book on the "core" bread and butter topics in IM to get an idea what topics a one should know.

2) next, i found it helpful to print out and read through the articles in emedicine.com, they're succinct, contain really useful tidbits, and easily accessible (although bit more general than something like up-to-date, emedicine is very well organized, and its outline format with sentences enable one to cover lots of info in a short amount of time.)

it'll save you a BUNDLE of money too!

2.5) i guess my mantra is, any-which-way, get a strong grasp on the BASIC pathophsy, presenting si/sx's, workup, and tx/mangement issues before delving into the details (save that for the cases that come up in your patients).

3) as the shelf appoaches 1 or 2 months down the road, check out other good threads in this forum for people's experiences with this god-forsaken bubble exam.

good luck!

 

[AtomKr]

Hey guys,
I am starting IM on Monday of next week, and would like to know what some of you would do to prepare for it (those of you who have been through it already). Are there any good references on IV fluid replacement in adults, and how to choose which fluid? Thanks in advance.

[This is a post using my friends account.] As a first year IM resident looking back at that shelf exam I have to cringe. That was one of the more difficult shelf exams. When I studied for that shelf, I used First Aid for the IM rotation, the A/L question book, and I read a lot of clinical vignette books. I scored in the 95%tile which corresponded to a two digit score of something in the 80's. My recommendation to all of the students that rotate with me on the wards is to pick your source early and learn it as best as possible. For the rotation, read up on your patients and know every pain-staking detail about their care. If you are at a program where you are able to enter orders - do so. The way to get a first rate eval is to know your patients and act as if you are an intern.

 

[AF_PedsBoy]

Also the studying cases you're involved with really does work since you remember the patients and what symptoms they were having and can link the info. UpToDate has excellent summaries and, well, up to date guidelines so not only can you learn the material, you can look like a star in front of your team when you start coming up with your own treatment plan (which isn't REALLY expected until 4th year).

Study a little bit every day and then cram like crazy the last week and a half, and don't forget to take some time to play!

 

[ginger_flower]

Dude....UptoDate saved my ass on the wards in medicine!!!

 

[LotaPower]

Our school was nice enough to give us a bunch of books for our medicine rotation. They highly recommend reading "Essentials of Medicine" by Cecil and Andreoli...I wouldn't have any problem but this book is a more than a 1000 pages....it reminds me of Robbins Pathology!!!! I can't read somthing like this and actually retain anything. Anyone have any suggestions as an alternative for this freaking monster?

 

[AF_PedsBoy]

I definitely read Cecil's for the patients I carried - UpToDate and Harrison's for presentations. And you'll definitely need MKSAP - I thought they were a little harder than the shelf but excellent preparation

 

[Legion560]

Hi guys,

I need to buy something in addition to the harrison's I have. What do people think of FA for medicine? I know the caveat: You cant use FA by itself, but I need a quick and dirty resource because Id like to increase my fund of knowledge pretty quickly (i.e. know a little bit about everything), while I am reading out of harrison's for the big topics. I like reading harrison's but for me to cover most key topics using only that book would be impossible given that the clerkship lasts only weeks not months.

Also, what about the wash manual vs ferri? which one is better?
Any help would be appreciated.

Thanks.

 

[NutsNBolts]

I bought a copy of the new StepUp book for medicine and it's really good. I had bought First Aid before but the StepUp book seems much more complete. It covers everything and the coverage is more thorough. It has sections on really useful stuff like reading xrays, iv lines, enteral nutrition, etc. I would recommend this book highly.

 

[imtiaz]

i dont know anything about ferri, but i have a washington manual and used it pretty heavily during medicine and again on surgery. it has pretty much anything that youll come into contact with. it really helped me out a lot, i would recommend it.

 

[kc361]

Try Mass General's Pocket Medicine . You'd be amazed at how much information they cram into a tiny little book, and most topics fit onto a single page, so you can absorb it all in one glance. It's a book that not just the students, but also most residents at our hospital carry with them at all times.

 

[melvindo]

Pocket Medicine is very nice, and it can actually fit in your pocket, unlike Ferri's. I bring a Ferri but keep it in my backpack where I can get to it quickly but don't have to lug it around, and then carry the Pocket Medicine with me. That seems to be more than sufficient.

ditto on pocket medicine, great book and you will use it multiple times each day. If you want another book I would recommend Ferri's b/c it has differetial Dx and a section that explains what each lab tes is and what they are looking for. This may be helpful if you see that someone has ordered a test you have never heard of on your pt.

 

[souljah1]

Also recommend Pocket Medicine. I use that on the wards in addition to UCSF's Housestaff Handbook. And as far as references at home, I use uptodate and CMDT. More than plenty.

I just got home from call, in my third week of medicine. Loving it.

 

[PACtoDOC]

Anyone use Kaplan IM Q Bank? Our school basically requires us to use it but I am finding it to be ridiculously difficult. I am happy using First Aid for the Medicine Clerkship and it seems very reasonable. This Qbank crap is above resident level I swear!!

 

[deleted50478]

Saint Frances Guide to Inpatient Medicine is better than all those discussed above in my opinion.

 

[kristing]

I prefer Ferri's over Washington manual (I have both). I don't know anything about the Pocket Medicine they are referring to.

 

[bulldog]

what's a good brs-path type of book for the medicine rotation/3rd and 4th year? I've looked thourhg nms and it's too long. People have said blueprints didn't have enough info. any 'just right' books? thanks.

 

[12R34Y]

your patients. You should be reading uptodate and/or emedicine on every patient's condition (not just your patients, but your teams patients). this is how you learn.......you also learn a TON from pre-test and MKSAP explanations.

later

 

[community]

MKSAP2 all the way!!!!!!

 

[PACtoDOC]

I concur that mksap is the way to go...


Willamette

MKSAPS? What is that?

 

[community]

Medical Knowledge Self Assessment Program 2 (MKSAP2). You can purchase it on the American College of Physicians Website. Also, if you become a member before purchase you can save 20%.

 

[Willamette]

MKSAPS? What is that?

From Amazon.com (where you can buy it from too, if you don't feel like going through the ACP): MKSAP 2 For students offers self-assessment questions with answers, each beginning with a clinical vignette organized into 28 categories, corresponding to the Core Medicine Clerkship Curriculum Guide. Designed primarily for third-year medical students participating in required internal medicine clerkship.

Essentially, it breaks things down into diagnoses or chief complaints and asks you questions about them. For example, once you do the "dyspnea" questions you'll feel comfortable with the multitude of disease states that cause said complaint. It's a REALLY good resource in my opinion. Best of luck!

Willamette

 

[Arthur12]

Hi...can anyone suggest a good book to use for the medicine rotation? I bought first aid for medicine and I'm not too pleased with it. The coverage is very superficial. I've been reading Harrison's and looking for review articles but this is very time consuming.

Also, last week my resident told me I need to speak up more in conference. But naturally I'm pretty quiet and reserved. Will this hurt me with my grade? During conference I don't feel comfortable just blurting out stuff, it's just not me. I feel like it's best to stay quiet rather than say something stupid.

Thanks for any help.

 

[Kate007]

I assume you're using MKSAP. As far as books go, I've been using Step Up to Medicine and find it ideal because of the indepth coverage. It covers everything you encounter in question books and has an appendix that's really helpful, covering things like IV lines, central lines, how to read chest xrays, and how to approach common problems you see on call, like shortness of breath, hypotension, etc. etc. I recommend it highly. Definitely supplement it with question books.

as far as conferences, there's not much advice other than do what your resident said. Speaking up sometimes just means "ask more qeustions"...this conveys interest and med students are supposed to be enthusiastic to get the honors. Don't overdo it or it will appear forced.

Hope this helps.

 

[GiJoe]

Has anyone used appleton and lange for medicine? they've got like a 1000+ questions and was wondering if anyone found the book beneficial.

thanks

 

[Hawk22]

Has anyone used appleton and lange for medicine? they've got like a 1000+ questions and was wondering if anyone found the book beneficial.

thanks

Honestly, I felt that A&L for Medicine has been the WORST of the question books I've used thus far. The key to the medicine shelf is doing all the MKSAP questions and making sure you understand the answers. Pretest was pretty good too overall.

 

[Clevername]

Use MKSAP and pretest. Questions are key. Step up medicine is good. It has what you need. Supplement it with articles and references as needed.

The key to medicine rotation is preparation. Know your patients, be prepared for conference (read up on topic beforehand). it's not necessarily the smartest student that does well, but the most clever. Be on your tip toes, pay attention, and always be prepared.

good luck.

 

[TruckGirl]

If you've got a PDA, you could carry around a whole library of books in your pocket.

 

[double elle]

As for reading while at the hospital - I usually use uptodate.com (your hospital/school may have a subscription) and print out what I need at the beginning of the day.

If you are discussing pocket books....it may be a little thick, but I carry Mosby's Care for the Medicine Patient by Ferri. I like it because it's a quick reference when procedures come up (central lines, thoracentesis, etc).

Also, by printing out the stuff from uptodate, you can easily fold and carry, pulling it out to read during the times your attending stops and talks to everyone and makes you wait.

As for reading at home....harrison's is always good and I like it when I really need to look into something. However, my favorite series is the Lange series or the Current medical diagnosis and treatment 2004 (CMDT 2004)...or 2005 - what ever is the newest. Both Lange and current are easy reading. CMDT has case scenerios as well.

 

[DrB]

Try The House of God by Shem

 

[Benzo4every1]

MKSAP is a must for the shelf
Also, IM pretest, First AID, Medicine Recall, and NMS Medicine

Dubin is helpful too
Last but not least, Cecil's
I don't know if they carry a baby Cecil

 

[multitasker]

I bought both First aid and Step up medicine...step up is more complete and has clinical vignettes. My impression is that first aid is good for last minute cramming. Step up just came out recently, has more information and in my opinion is much better for the clerkship itself and the shelf exam. But you have to buy it in the beginning of the rotation because it is longer and you should give yourself time to get through it. NMS medicine absolutely stinks so don't waste your money. It is so incredibly dry and low yield.

 

[Samir Desai]

The key to medicine rotation is preparation. Know your patients, be prepared for conference (read up on topic beforehand). it's not necessarily the smartest student that does well, but the most clever. Be on your tip toes, pay attention, and always be prepared.

good luck.

That's great advice. Having been a student years ago, I know how tough it is to push yourself to study and prepare, especially after a long day on the wards. With the little time that you have, it's important to not just prepare but prepare the right way. That means using the right types of resources and making sure that you are processing what you are reading.

I think most students have been in situations where they've read something but the next day when they were asked about it, they couldn't come up with the right answer. I believe some of this has to do with the way we study. When you study for basic science exams and shelf exams, you know you're going to have a number of answer choices to choose from. But when you are asked questions on the wards, the attending, of course, doesn't give you five choices. So you basically have to regurgitate the information and that's not an easy thing to do.

When I have had students struggle to answer questions during rounds I expect them to be able to answer, after talking with them, I learn that most are putting in the time to study. For many, the problem seems to be in recalling the information that they have read. One thing I usually recommend is to practice and prepare the night before by asking themselves questions that an attending might ask. In other words, feed yourself questions to make sure that you've not only understood the material but can convey the answers confidently.

Preparation and practice are two keys to increasing your confidence level.

Samir Desai, MD

 

[punjabiMD]

take excellent care of your patients. don't rely on following your interns by example on everything; oftentimes they are too busy to be able to really get know their patients very, very, well. You, however will probably carry only 3-4 patients (max.). Make use of the extra time.

Read up on the common things that you see; not only on your patients, but other patients as well (SBO, pneumonia, COPD, CHF)... and take some time in the beginning of your clerkship to review your renal, cardiac, and pulmonary physiology.
You may also find that even some attending physicians are weak in pathophysiology... review in Harrison's for each of the common problems you encounter.

The combination of books that I found worked best for me was NMS Medicine and MKSAP (I felt that First Aid was garbage... remember, the majority of material in the series is submitted by students... it's just a big scrapbook of facts and mnemonics). If you're discplined, read all of NMS (it's 400 pages but trust me). If you're not disciplined (like me), do as much of MKSAP as you can early on (these aren't shelf-like questions but still useful); regarding NMS, read as much as you can, but MAKE SURE you do all the clinical cases (9 or so) and the comprehensive examination in the back, and cross-reference the cases and exam with the subject material in the book (DKA, SOB, CP, BIG emphasis on differential diagnosis). NMS is solid stuff... but I only recommend if it you want to really shine in the clerkship and do very well/learn a lot. If you don't care about your grade/what you learn, just use First Aid and cram.

Don't gun. Play hard but be fair. Establish a rapport with your team. If you really work hard and show interest your evals will shine.

Also- stay organized. I used the sheets from scutwork.com and they were amazing.

 

[calot's 3angle]

take excellent care of your patients. don't rely on following your interns by example on everything; oftentimes they are too busy to be able to really get know their patients very, very, well. You, however will probably carry only 3-4 patients (max.). Make use of the extra time.

Read up on the common things that you see; not only on your patients, but other patients as well (SBO, pneumonia, COPD, CHF)... and take some time in the beginning of your clerkship to review your renal, cardiac, and pulmonary physiology.
You may also find that even some attending physicians are weak in pathophysiology... review in Harrison's for each of the common problems you encounter.

The combination of books that I found worked best for me was NMS Medicine and MKSAP (I felt that First Aid was garbage... remember, the majority of material in the series is submitted by students... it's just a big scrapbook of facts and mnemonics). If you're discplined, read all of NMS (it's 400 pages but trust me). If you're not disciplined (like me), do as much of MKSAP as you can early on (these aren't shelf-like questions but still useful); regarding NMS, read as much as you can, but MAKE SURE you do all the clinical cases (9 or so) and the comprehensive examination in the back, and cross-reference the cases and exam with the subject material in the book (DKA, SOB, CP, BIG emphasis on differential diagnosis). NMS is solid stuff... but I only recommend if it you want to really shine in the clerkship and do very well/learn a lot. If you don't care about your grade/what you learn, just use First Aid and cram.

Don't gun. Play hard but be fair. Establish a rapport with your team. If you really work hard and show interest your evals will shine.

Also- stay organized. I used the sheets from scutwork.com and they were amazing.

what are the sheets from scutwork.com? thanks!

 

[punjabiMD]

what are the sheets from scutwork.com? thanks!

my apologies. not scutwork.com, but medfools.com (under the download section)

 

[Spiff]

For the wards (and all of 3rd year), you really need a reference which is going to give you more than the NMS bullet lists. That stuff is ok for studying for the shelf, but for knowing about your patients you really need something more. Uptodate online is a great resource if you institution has it available, but I just prefer to have a good dead tree in my hands.

What worked for me was having a copy of Current Medical Diagnosis & Treatment and using that as my patient reference for the whole year. It certainly isn't a shelf/board review but it is deep enough to give you the essentials you need to know about your patients and their management without having to wade through something like Harrison's or Cecil's. I actually wish I had it during second year as it really breaks down essential pathophysiology into understandable chunks.

On medicine, IMO it was a perfect study companion for MKSAP as the topic coverage seemed to correlate very closely. It also has good (but basic) sections on OB/GYN and Pediatrics, and it also covers most all of the medical management topics applicable to surgical patients (CMDT also has a "surgery" version but it isn't as great as an all-around reference). I found that even if I was covering only 3-4 patients, each of those patients had enough issues to cover a ton of shelf-related topics.

Also I completely agree with the poster who advised not getting sucked into doing things like the interns. That will be us soon enough, but for now, take advantage of your student status to get to know about the patients. Figure out what sorts of problems they have and use your patients to study for the shelf (i.e. how did they get worked up for their GI bleed or treated for their pneumonia, why were they hypernatremic). When they present something crazy in morning report, go home that night and look up the differential for the problem presented that morning. I found that I remembered facts I learned this way far better than the bullet list stuff. Even if your team is wrong/cutting corners in their management you will remember the right facts even better for the shelf.

 

[punjabiMD]

I second the CMDT. It's great for reading up on your patient and it's actually written in a way that's very easy to understand and quickly absorb! I forgot to mention it since I didn't touch it for the week or so before the shelf.