Book Review. Better: A Surgeon’s Notes on Performance

In "Better: A Surgeon's Notes on Performance", Dr. Atul Gawande (General Surgeon, Brigham and Women's Hospital, Boston) attempts to provide the reader with a bird's eye view of what it takes to be better. He uses a vast array of interviews and historical perspectives to highlight what he believes are the pillars of become better in everything we do. Of course, the stories and perspectives revolve around medicine and hospitals, but you will be surprised to learn how diverse the various examples are in pinpointing what it means to become better. He uses examples of hospital teams improving the survival of patients with a certain disease, the historical accounts of improving health care through hand washing, an inspiring story of an attempt to eradicate Polio in India, and even a riveting tale of a physician-turned-malpractice lawyer who abandoned the stethoscope for law school. Though eclectic in their descriptions, each aims to hone in on the skills one needs to improve.

I think the goal of "Better" is noble. I also think the core content is interesting and through provoking. I even agree that physicians and medicine should be the ones to be pushing this envelope, trying every day to be better and to improve. It seems like this should be our job in society, if nothing else. And for this, I applaude Dr. Gawande and the goal of this book. However, I must admit that the product did not quite meet the goal of this book.

I have hesitated to write this review, because I know that so many other people, including many other docs, loved "Better". But, I must be honest and admit that this is not one of Gawande's better books. Perhaps I have held him up to an unhealthy standard after "Being Mortal", the book that got me started on Dr. Gawande, and one I think is a must-read for everyone, not just those in medicine. The problem with "Better" is that in the midst of all of its fascinating mini-stories (a hallmark of Dr. Gawande's writing) the actual goal of the book is lost on the reader. He can't quite pull all of the information together to drive home his ideas. It is almost as if he has not quite formalized the ideas of how to become better in his own head. For this I do not fault him. Certainly, he has come much closer to organizing the idea of improvement much better than I, or most other people can. But, unfortunately, mini-stories in this book are sporadic and, in the end, the sum of the parts of "Better" probably equals more than the whole.

Conclusion: "Better" by Dr. Atul Gawande is a good read, but not a must read. I give it a ShortWhiteCoat Step 1 score of 225.

 

 

How to Match into a Great Emergency Medicine Residency

Emergency_room

An Emergency Medicine Attending Physician's Perspective:

From an interview with an Emergency Medicine physician in Colorado. Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

 

How competitive is the Emergency Medicine match?

Emergency Medicine has increased in competitiveness over the last 5-7 years, and seems to fluctuate somewhat in competitiveness. I personally think that competitiveness will maintain or increase as graduates are more attracted to specialties that compensate well while maintaining a good lifestyle (with minimal call), but that remains to be seen.

 

What must a student do to match into a great Emergency Medicine residency?

As with all specialties in the match, a good score on Step 1 is a must, but additionally a good Step 2 score is also important. EM program directors value this clinical-based test and your ability to perform in a clinical environment. Some say that this score is even more important than Step 1.

More important than either of those is your performance on clinical rotations, shelf exams, and letters of recommendation.  Emergency Physicians greatly value working with partners and colleagues who push themselves to be not only be great physicians, but team players who give the effort to help their fellow physicians. You have to go above and beyond with a solid knowledge base, evidence-based practice, and great interpersonal skills. 

The core 3rd year rotations are especially important (in addition to a sub-internship in EM) as our scope of practice really does encompass a significant portion of every other specialty.

 

What are residencies looking for in an Emergency Medicine applicant?

See the above – work ethic, integrity, clinical acumen, decisiveness, procedural competence, and being a team player.

 

What should students look for in an Emergency Medicine residency?

This will vary; you have to prioritize what is most important to you. Important considerations include location, reputation, research and leadership capability / opportunities, faculty, etc. Compensation is a consideration, but I think you (like me) will find that the variability is slight. Some programs offer coverage of meals while working, and some offer full health insurance benefits including dependents.  You will find a litany of differences – some of which may be deal breakers, some of which will only be perks – it's up to you to decide what's important.

Most programs have some subtle differences in their rotation schedule, which may make or break the decision for some, but I find that the differences are small, and many programs will provide excellent training. There are some programs which rise above the others for one reason or the other, but these reasons may be different for each applicant.  I found that focusing on subtle schedule differences created frustration, and got away from the more important consideration, which was fit.

In my opinion, the most important consideration is how you feel you fit with the program. Does your personality mesh well with your fellow residents and those of the faculty? If you have a family, will they be welcomed at events, or is every out-of-work gathering going to be held at a bar? What is your overall impression of the program, and how does that fit with your goals?

 

Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

With regards to ranking programs, most of that in my opinion is answered above. It's important to make a list of priorities and stick to it. As for the application, LORs, and personal statement: LORs should be obtained from practicing Emergency Physicians who know you and can speak to your clinical skills as well as personal attributes. Having an impersonal letter from a "big name" in Emergency Medicine is not nearly as important as one from someone who can write a strong letter touting your abilities as a provider as well as a person.

Your personal statement should be concise (no more than a page) and clearly demonstrate WHY you are going to be a rock star EP. However, you should not explicitly write all that out. Find a case that will grab the attention of the reader, demonstrates why you think EM is a no-brainer choice and why you are committed to it, and also showcasing your talents and skills.  This is your chance to express how you stand out from your peers, so you need to do that without sounding egotistical.  This is not a time for straight humility, but you must represent yourself with quiet confidence.

 

What do you wish you knew before application/interview season?  

Be familiar with the results of the match from recent years, and discuss with your faculty mentors how many programs you need to apply to / interview with.  Currently, 9-12 interviews is likely sufficient for the average applicant, but that may vary in coming years, and depending on the applicant. Interviews can be expensive, so consider your top picks ahead of time, but don't be afraid to adjust that list as you visit programs and formulate your impressions. You will likely be surprised about which programs stand out, or which will fall in their rank (I know I was…).

 

What other advice do you have for students applying for Emergency Medicine residency?  

This is a great specialty and profession. While we tout fun procedures, fast-paced shifts, and a great lifestyle, you should make no mistake and know that we work hard. Very hard. We do work that no one else does, and that many shy away from. We are not experts in every field of medicine, but we are masters of resuscitation, emergent airway management, trauma, and critical care. You will hear some people bash Emergency Medicine for not being "experts" in their specific area of expertise – that's by design! I was never trained to be an OB/GYN, but I am trained to recognize and treat OB and GYN related emergencies, referring those non-emergent cases for outpatient follow-up.  This does not give us room to slack and provide substandard care, but rather excellent care of urgent and emergent problems, leaving more obscure and less urgent problems to the specialist. Emergency medicine is awesome, enjoy it!

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the MatchThe Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

Why did you go into Emergency Medicine?

Glidescope_02

An Emergency Medicine Attending Physician's Perspective:

From an interview with an Emergency Medicine physician in Colorado. Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

 

What attracted you to Emergency Medicine?

Emergency Medicine is the perfect combination of acuity and generality. I'd like to say that every patient I treat has an emergent reason to be in the ED, but unfortunately, that's not the case.  However, many do.  We evaluate, stabilize, and initiate treatment for critically ill patients every day. We hold difficult discussions with families, provide reassurance to parents, and address a large spectrum of medical illnesses. We are specially-trained to address any potential problem that could walk through the door, be it trauma-related, pediatric, geriatric, or anything in between. 

 

Describe an emergency department physician's typical work day?

The typical day is quite variable, depending on the day of the week and time of day that you are working.  As emergency physicians, we work in shifts. This means that our work days have predetermined start and end points. While those end points may flex slightly depending on the flow of the department on any given day, and you may be required to stay an hour or so late, when you leave you are done and no longer have to worry yourself about patient care responsibilities. 

I usually arrive 10-15 minutes early for a shift to provide the off-going doctor with a few extra minutes of relief, knowing just how busy his or her day could have been. After signing PA charts and verbal orders from the day before, I get right to seeing patients, or asking around to see if there's anything pending that my partners might need assistance with.  From that point, it's moving from room to room, patient to patient, providing counsel, instruction, reassurance, and at times, bad news. The number of patients seen in a typical shift will vary from day to day, and depending on where you work whether it be a busy urban / suburban ED or a more rural setting, but even in the rural setting any given shift can become incredibly busy; it all depends on the day. 

The hallmark of the emergency physician is the disposition.  At the end of every patient encounter, the patient will either be discharged home, admitted, or transferred.  There are typically no loose ends to worry about or results that will be pending for tomorrow that require attention. Each day brings a new census of patients that will come and go according to their respective disposition, and the cycle repeats itself. 

 

What type of lifestyle can an Emergency Physician expect?  

As a result of "shift work", the lifestyle of an emergency physician is largely customizable by the individual.  In my group, it's fairly easy to request certain days off for sporting events, school performances, or other special occasions. When those come up unexpectedly, fellow physicians are very accommodating of shift trades. This allows me to be present for my family when I want / need to be. When I'm off during the day, I have time with my wife and young child, and I am home to help with school-aged children, homework, as well as afternoon trips to the park and bike rides, etc. 

Saying that an emergency physician never takes call is a bit of a misnomer; our group does have a back-up call system for unexpected illness, emergency, or even a horrendously busy day in the department when we need an extra person to decompress the waiting room.  I take one 24-hr period of call each month, and find that I very rarely get called in.  Specifically, in the last year I cannot remember being called in, and have only seen 1 or 2 of my partners called in. 

Our group is very equitable about how we disperse shifts.  We do have several dedicated night-docs who take the majority of our night shifts, and the rest are dispersed equally among the rest of us. I work a mixture of shifts, and find that I work on average 14-15 shifts a month (mostly 9 hour shifts), with 4-5 of those being overnights or late evening shifts. This varies by month of course, but on average my number of night shifts is very manageable. 

There will be times when you will have to work nights, weekends, and holidays, but the trade off is time off on weekdays 

 

What is the potential salary of an Emergency Physician?

Specialty-specific salary information is available from many sources, and this varies by region as well as the collecting agency. The most current numbers from Medscape (http://www.medscape.com/features/slideshow/compensation/2014/emergencymedicine) show a competitive salary averaging at $272,000. It is not unheard of for a partner in a private group to exceed that, but that's the posted average.

 

What is the job market like for Emergency Medicine?

Honestly, it's great.  You can literally get a job anywhere in the country.  Having said that, not all jobs in EM (or medicine in general) are created equal.  There are certain markets that are more difficult to break into because of a given reason (i.e. mountains, beach, prestigious academic institutions, etc.) but those doors can open by pursuing fellowship training, other post-graduate experience, networking, and sometimes just persistence and demonstrating proficiency above that of your competitors. 

 

What can you tell us about Emergency Medicine subspecialties?

Post-graduate fellowship training is currently available for Critical Care, EMS, Ultrasound, Administration, Research, Toxicology, Pediatric Emergency Medicine, Disaster medicine, Simulation and Education, Sports Medicine, Health Policy, Emergency Cardiology, International Emergency Medicine and Global Health, Hyperbarics, Legal Medicine, Emergency Neurology, and Wilderness Medicine. 

Most of these are 1 year, some are 2 (CCM, Peds). Salary numbers will vary greatly depending on your chose practice site (private vs Academic, geographic location), and as you subspecialize, your job market narrows significantly (i.e. if you train in Peds and need to work at least part of your shifts in a large children's ED, that limits you geographically), but at the same time some of this post-graduate training can give you quite the edge over other applicants to help you break into more difficult markets. It's all about what you want to build your practice into. For example, if you want to be a toxicology or legal expert, you can likely work in either an academic or private group while still taking call at the poison center / consulting with a malpractice firm. 

 

What are the potential downsides of Emergency Medicine that students should be aware of?

Every specialty and every job will have some downsides. There are times when dealing with consultants can be challenging, or when patients come to the ED with a chronic problem, sometimes having had a thorough workup, expecting you to be able to solve their problem in an hour or two. You have to be able to take these experiences with a grain of salt, knowing that they will come occasionally, but are greatly outweighed by the opportunity to positively impact both the critical and not-critical (but still ill) patients.

Most people also quote chronic narcotic-seeking patients as a downside. These patients can be challenging as well, but in all reality many emergency departments have policies in place that make this much easier, and you have the backing of your administration and the nurses in the department, making disposition without narcotics on these patients easier.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

Best Books and Resources for the Internal Medicine Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal Medicine, Family Medicine, OB/GYN, General Surgery, Neurology, Psychiatry, Pediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Internal Medicine)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks (PreTest Medicine).
  3. The BluePrints Series:  The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Medicine).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (First Aid for the Medicine Clerkship).

Best Books for Internal Medicine Rotation

So, we agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Lets review the best books and resources for your Internal Medicine rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

There are actually a number of great resources to help you prepare for the internal medicine rotation and shelf exam. The exam will focus heavily on inpatient internal medicine but you can not completely disregard the outpatient material.

 

1. Step-Up to Medicine:

The reputation of the Step-Up series for the medicine rotation is tried an true. It has been a stable of medical student study lists for decades and continues to produce a well-recieved review manual that I consider as close to a 'must-have' as there is in the third year of medical school.

 


 

2. MKSAP Book or Online Q-Bank:

These questions are produced by the Internal Medicine governing body, the American College of Physicians (ACP). The MKSAP Book is a well known resource, but recently the ACP released a digital edition of the MKSAP questions that can be used any of your electronic devices or computers.

3. Internal Medicine Essentials for Students:

This book was a collaboration of the American College of Physicians in conjunction with the Internal Medicine clerkship directors from across the country. The clerkship directors lay out a plan to succeed while on your medicine rotation. As you might expect, the content is very relevant and is generally ranked very highly by students.

 


 

4. Case Files Internal Medicine:

Most students agree that the case-based CaseFiles series is very good for the medicine shelf exam. I would rate this book very highly and feel like it was specifically responsible for a few correct answers on my shelf exam.

 


 

Best Books and Resources for the Family Medicine Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal MedicineFamily MedicineOB/GYNGeneral SurgeryNeurologyPsychiatryPediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Family Medicine)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Family Medicine).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Family Medicine).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (There is no First Aid book for the Family Medicine rotation).

Best Books for Family Medicine Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your Family Medicine rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Family Medicine is a difficult rotation to study for because it emcompasses nearly all of medicine. It would be a reasonable expectation to receive questions on this shelf exam about basic general surgery and post-operative concepts, OB/GYN, pediatrics, internal medicine, and emergency medicine. As such, it is difficult to narrow down resources to study from. My best advice is to focus on the medical aspects of family medicine. You can not learn all of OB/GYN and Pediatrics and Family Med on one rotation; you must focus your time to some degree.

 

1. AAFP Board Review Questions:

The American Academy of Family Physicians provides free membership to all medical students. With membership, you have access to great online board review questions.These are certainly not a sufficient study tool, but they are very good questions.

 

aafp
 

2. Ambulatory Section of StepUp to Medicine:

If you have not yet purchased this book for your Internal Medicine rotation, you probably will as it is the most highly recommended for that clerkship. In it there is a great section on ambulatory medicine that is highly relevant to the Family Medicine rotation. Likewise, the "General Internal Medicine" section of the MKSAP Book or digital edition are also very relevant to family medicine. 

3. Case Files Family Medicine:

The Family Medicine book from the CaseFiles series is very highly rated by medical students. I found the cases to be broad in their categories but deep in their explanations. I recommend it highly.

 


 

4. PreTest Family Medicine:

The Family Medicine rotation is one instance where the PreTest Series does a very good job. This is probably the best available question bank that will prepare you for the breadth and depth of the Family Medicine shelf exam.

 


 

Best Books and Resources for the Pediatrics Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal MedicineFamily MedicineOB/GYNGeneral SurgeryNeurologyPsychiatryPediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Pediatrics)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Pediatrics).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Pediatrics).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (First Aid for the Pediatrics Clerkship).

Best Books for Pediatrics Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your Pediatrics rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Studying for the pediatrics rotation is not nearly as daunting as other rotations because the material is better partitioned than the more broad rotations. You will have to know both inpatient and outpatient peds very well, but do not spend all your time memorizing milestones, vaccine schedules, and inpatient conversions. There are quite a large number of highly rated books for this rotation, so choose one that fits your learning style. 

 

1. PreTest Pediatrics:

Probably the best in the PreTest series, the PreTest Pediatrics book is well rated by every metric. I remember 3-4 questions on my shelf that were near duplicates of PreTest questions; this is high yeild material. It is not, however, sufficient for your shelf. You must find a more complete text to study from as well.


 

2. Blueprints Pediatrics:

This is a very complete text and highlights well both the inpatient and outpatient concepts in pediatric medicine. If you have time to get through and remember the information in this text it will lead to a good score on the shelf.

3. Case Files Pediatrics:

A well written book that is highly regarded by students. There is nothing special about this particular volume of the Case Files Series, but if you like the series this is a good bet.


 

4. BRS Pediatrics:

This is an interesting addition to our Best Books list. Students in my medical school and on annual book surveys rave about this book. It is a bit outdated (last edition printed in 2004) so I did not read it, but even though it is older, students still swear by it.


 

Best Books and Resources for the Neurology Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal MedicineFamily MedicineOB/GYNGeneral SurgeryNeurologyPsychiatryPediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Neurology)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Neurology).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Neurology).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (There is no First Aid volume for the neurology clerkship).

Best Books for Neurology Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your Neurology rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Not every medical student will have to complete a neurology rotation during the third year. Therefore, the number of survey responses is a bit less than with the major six rotations. 

 

1. AAN Question Bank:

The American Academy of Neurology (AAN) provides students with a very good clerkship review in the form of a 100 question quiz. A few medical schools will provide this service to their students. If your school does not, the cost is small (only $25 right now). 

aan
 

2. Blueprints Neurology:

A solid addition to the Blueprints library, the Neurology volume can be considered a stand-alone review manual for the neurology shelf exam. I would supplement the information in this book with a good question bank either online or in print format.

3. PreTest Neurology:

It is difficult to find quality questions for any shelf exam, and the neurology exam in particular. This q-bank is solid and would be a great companion to the Blueprints text.


 

Best Books and Resources for the Obstetrics and Gynecology Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal MedicineFamily MedicineOB/GYNGeneral SurgeryNeurologyPsychiatryPediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files OB/GYN)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest OB/GYN).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints OB/GYN).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (First Aid OB/GYN).

Best Books for Obstetrics and Gynecology Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your OB/GYN rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Obstetrics and Gynecology is one of those rotations that has very little to do with other rotations. Therefore, you can not rely on your knowledge from other clerkships or the first two years of medical school to impress on rounds and do well on the shelf exam. Every student needs to spend a significant amount of time studying OB/GYN, which can be difficult as this clerkship tends to be very time consuming at most medical schools. Luckily, there is a wealth of good texts and question banks for this unique clerkship. One good text in combination with good question should be sufficient if you spend enough time studying.

 

1. APOG (uWISE) Question Bank:

The Association of Professors of Obstetrics and Gynecology (APOG) have produced a fantastic online question bank they call uWISE. If your medical school has access to the qbank you are in luck because it is a great resource. If your school does not subscribe, you sould ask them to, because the cost to you might be a bit too high to handle.

apog
 

2. Blueprints OB/GYN:

As obstetrics and gynecology is nearly independent from all other specialties, it is important to read a complete text, not just rely on question banks. The Blueprints volume on OB/GYN is very highly recommended by students, and I agree. Some students recommend even more complete texts like the Hacker & Moore text I describe below, but I found Blueprints to be sufficient.

3. Case Files OB/GYN:

The CaseFiles volume on OB/GYN is also very highly recommended as it addresses unique clinical scenarios that you will not see in other parts of the hospital. However, though I really like this text, in my opinion it should not be thought of as sufficient. 


 

4. Hacker & Moore:

Hacker & Moore Essentials of Obstetrics and Gynecology is a complete and in-depth OB/GYN text. Normally, students would not have time or desire to read a complete text for one clerkship. However, given the unique characteristics of the OB/GYN clerkship, this text is actually a very good resources and many students at my school used it and love it (I did not, the size scared me away). 


 

Best Books and Resources for the General Surgery Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal MedicineFamily MedicineOB/GYNGeneral SurgeryNeurologyPsychiatryPediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Surgery)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Surgery).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Surgery).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (First Aid Surgery).

Best Books for General Surgery Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your General Surgery rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

The General Surgery clerkship is unique in that the most highly recommended books and resources are completely different than for all other rotations. In fact, none of the book series mentioned above are very highly recommended for the general surgery rotation. One reason for the difference is that you will not only have to prepare for the shelf exam and hospital rounds, but you will also need to prepare for pimping in the OR, which is a total different animal. Below are some resources that will help

 

1. Dr. Pestana's Surgical Notes:

Dr. Pestana's book started as a pdf document that was passed around nearly every medical school in the country. His insight into high yield topics in general surgery is unmatched. His clinical scenarios are all relevant and his explanations are all clear and concise. I consider this a must-have resource for medical students.  


 

2. NMS Surgical Casebook:

One of the most widely used clinical resources, the older edition of the NMS Casebook is known and respected by almost every graduating medical student. The reception of the new edition (linked to the right) is still to-be-determined. The casebook portrays clinical scenarios commonly seen in the OR and on the post-operative floors. It is a great companion to the NMS Surgery Textbook, which is a more complete review of clinical and operative general surgery.

3. Surgical Recall:

While question banks and text books will help students prepare for the clinics, wards, and shelf exam, they are not great resources when preparing for the operating room. I found Surgical Recall to be an excellent resource to prepare for intra-operative pimp sessions.


 

4. Case Files Surgery:

The CaseFiles Surgery volume is a quick read and could be a very good resource at the beginning of your rotation so that you get a broad introduction to common surgical problems. However, it is not sufficient for the shelf exam and will not prepare you very well for specific operating rooms.


 

Best Books and Resources for the Psychiatry Rotation

 

This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal MedicineFamily MedicineOB/GYNGeneral SurgeryNeurologyPsychiatryPediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Psychiatry)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Psychiatry).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Psychiatry).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (First Aid Psychiatry).

Best Books for Psychiatry Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your Psychiatry rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Psychiatry is one of the very unique clinical clerkships that you will encounter during medical school. There is little overlap of the material you will need to know in psychiatry with the rest of your clinical rotations. The good news is that the material you must master for your psychiatry clerkship is not intellectually demanding. The truth is, the material you need to impress on rounds and on the shelf exam are simple lists of diseases, drugs, and side effects. You must master the psychiatric diagnosis and you must know how the differ from each other, even though the differences are very subtle. You must also master the side effects of the psychotropic medications, this is very high yield information. Luckily, all of this material is easily packed into a single review book.

 

1. First Aid for the Psychiatry Clerkship:

This is, by far, the best volume in the First Aid Clerkship series. First Aid for Psychiatry is truly fantastic. This is my own personal belief and the believe of nearly all medical students, as the book tops all my lists. The bullet-list format of First Aid is perfect for the bullett-list information you need to learn about psychiatry. Rather than reading a second book, I actually read through this book two times and this was my best shelf.  


 

2. Case Files Psychiatry:

Many students belive Case Files Psychiatry is a great book and can be a great companion to the First Aid text. However, nearly all students agree that it should not take the place of the First Aid text. 

3. Lange Q&A Psychiatry:

Both Kaplan and USMLE World have great questions for psychiatry. If you are looking for great questions in print format, the Lange text is a great choice. This book has a wide variety of great questions and is very highly rated by students.


 

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