Category Archive: Family Medicine Rotation

Best Books and Resources for the Family Medicine Rotation

Categories:

Third Year, Family Medicine, Family Medicine Rotation

July 13, 2015

by

 

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 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.

 


 

Tags:

Leave comment

Spotlight Interview: How to Match in Family Medicine (Oregon Resident)

Categories:

Choosing a Specialty, Family Medicine, Family Medicine Rotation, How to match in....?, The Match

June 1, 2012

by

A Family Medicine Resident’s Perspective:  From an interview with a family medicine resident at the Oregon Health Science University Hospital in Portland, Oregon.

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 Family Medicine match?

Family medicine is not very competitive. I was offered interviews at every school I applied. I ended up turning down many of the interviews I received. I interviewed at 11 residencies and got my first choice.

 

  •  What must a student do to match well in Family Medicine?

The usual stuff, good board scores, good clerkship grades, some research. Interviewing well may be even more important in FP because the specialty is so focused on personal relationships. Networking can be helpful as well, so you should try to get to know people early.

 

  • What are residencies looking for in a Family Medicine applicant?
I really think they are looking for just two things: 1- competency: they need to know you can do the work, w- personality fit: they are going to be working with you for 3+ years, they need to know you will fit in.

 

  • What should students look for in a Family Medicine residency?

A program that is interested in allowing you to be sane and healthy.

 

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

Most people rank according to geography and then dive into specifics. Family medicine residencies are very different from one another, even more so that other specialties. For instance, at one program where I interviewed, the interns do 5 months of surgery their first year! That is kind of weird.  Because the field is so broad (peds, surgery, OB/GYN, hospital, outpatient) there is a great diversity in training programs.

 

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

The Northwest is probably the best place to do family medicine. Lots of space, lots of prestige for family medicine residents and a great place to live.

 

  • What other advice do you have for students applying to Family Medicine residency?

Feel out the resident “culture” as much as possible, it wil have a significant effect on your health.  

 

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


 

Tags: , ,

Leave comment

Spotlight Interview: Why Did You Choose Family Medicine? (Oregon Resident)

Categories:

Choosing a Specialty, Family Medicine, Family Medicine Rotation, Why did you choose....?

June 1, 2012

by

 

A Family Medicine Resident's Perspective: From an interview with a family practice resident at Oregon Health Sciences University in Portland, OR.

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 Family Medicine?
Autonomy. Mobility. I wanted the sense that I was choosing a specialty that would allow me to work as much or as little as I wanted and that would allow me to place my family in a town of our choosing (likely a small town).
 
I also love the tradition in family medicine of trying to manage a patient by yourself as much as possible. There are a lot of efficiencies and preventative virtues in this approach to care. I feel like so much can be done in a small community that keeps thousands of people from ever having to be admitted to a hospital.
 
I love the intellectual challenge of receiving a patient into my office and managing all of their complaints. The situation demands that I be fluent on a variety of medical topics and able to comment on the current state of the medical literature. I really enjoy the challenge to read broadly and competently on a range of medical issues, it allows me to possess a synthesized view of medicine and patient care, to be sure I am not engrossed in too many minute details.

 

  • Describe a Family Physician's typical work day?

Most days will start at 8:00 am. We see patients until 11:00 and then break for Lunch until 12:30. We see patients after lunch until 4:30. A large number of family docs will have a half-day on Friday.

 

  • What type of lifestyle can a Family Doctor expect?  

Your lifestyle will be pretty good. Weekends are virtually always free if you do not do hospital work. You will have regular call, but you rarely have to go in.  Most problems while you are on call are resolved over the telephone.

 

  • What is the average salary of a Family Practice Physician?

There is a great range of earning potential in FP.  The average salary is around $150,000.  However, you can see fewer patients in a day, or work fewer days in a week and earn less than this. If, however, you see patients quickly, become medical director of a nursing home or two, work extra on the weekends, etc, it is very possible to make much more than this.

 

  • What is the job market like for Family Medicine?

Honestly, it couldn't be better. Family docs can go anywhere they want. Lots of recruiters will call you throughout your residency. There is a great need of primary care docs in every corner of this country.

 

  • What can you tell us about Family Medicine Sub-specialties?

There are a few options as a family medicine physician. Some of the fellowships include hospital medicine (i.e. become a 'hospitalist'), geriatrics, adolescent care, and Sports medicine. For the most part, fellowships are one year in length. Sports medicine doctors end up making a bit more money than a generalist and the other sub-specialties.

 

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

In family medicine there is a lot to the business side of things. You will be responsible for managing much of the business side. If you are not a good businessperson, not organized, or dislike that type of thing, this part of the job could be a real drain. The salary is on the lower end for physicians, but it is still a very good living.

 

  • What else would you tell medical students who are considering Family Medicine?

If you want to do outpatient care in a small community, this is a great field.

 

 

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.

 

Tags: , , ,

Leave comment

Top Ten Books for Third Year Medical Students

Categories:

Third Year, Books, Emergency Medicine Rotation, Family Medicine Rotation, General Surgery Rotation, Internal Medicine Rotation, Neurology Rotation, OB/GYN Rotation, Pediatrics Rotation, Psychiatry Rotation

April 27, 2012

by

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3. 

Choosing a top ten list for the third year of medical school was a lesson for me in biting off more than one can chew. I will soon be compiling top ten lists for each of the core rotations in medical school, which will be a more manageable list. However, there are common themes during this very important year of training, and you will be testing the waters of many potential future specialties. I think these books will help with these endevours. 

  • Updated April 2015

1. First Aid for the Wards:

Beginning the third year of medical school is a daunting task. I shook like a little kid the first time I had to present on rounds. In retrospect, I wish I had read this book before I ever started third year. It provides great advice about prerounding, rounding, presenting patients, and working with your clinical team. It also gives rotation specific advice for each of the main third year clinical clerkships.

2. Pocket Medicine:

I consider pocket medicine a must-have for all students and residents. I used it during medical school and am still using it in residency. It highlights all the most common clinical illnesses and presentations. For each illness it describes the clinical presentation, signs and symptoms, diagnostic tools, and treatment plan.

3. Maxwell Quick Medical Reference:

A small book with a big role. Nearly every medical student I know carries this book in their white coat. It contains clinical pearls and references that are very high yield. Additionally, it contains sample notes (progress, transfer, procedure, admission, etc).  It is about the best $10 you can spend.

4. Case Files:

The Case Files Series (Amazon link) is my favorite clerkship study series. Similar to the Pretest Series (#5) and the Blueprint Series (#6), Case Files publishes one book for each medical student clerkship. The book teaches principles through a series of 50-60 cases.  After each case is presented, the relevant clinical teaching points are discussed and followed with a series of questions. For my style of learning, this was the ultimate study tool during third year. I particularly recommend Case Files Neurology and Case Files Family Medicine. .

5. PreTest:

Another series of books for each medical student rotation, the PreTest Series (Amazon Link) are simply question banks in print form. Their questions are very good and hit on relevant material. Although I prefer USMLEworld as a straight question bank tool, the Pretest books allow you to always have questions at your side for bus rides, downtime at the hospital, etc. Along with many medical students, I particularly recommend PreTest Pediatrics, which was eerily similar to the shelf exam.

<

6. BluePrints:

The BluePrints Series is a third series with one book for each medical school clerkship. Unlike the case-based presentation of Case Files and the q-bank format of PreTest, the Blueprints series are more like textbooks. They aim to teach the most pertinent clinical facts without becoming too dense. Each book is about 300 pages and contains a wealth of information…if you can get through it. Blueprints Obstetrics and Gynecology is widely considered the most useful; I used it and did very well on the shelf.

7. Surgical Recall:

If you are interested in surgery or just interested in obtaining a good grade in your surgery rotation, you need to know what is going on in the OR. Surgical Recall provides step-by-step details of surgical procedures including surgical indications, pre-operative management, intra-operative management including a walk-through of the surgery, and post-op management. It will really help you shine in the OR.

8. First Aid for the USMLE Step 2 CK:

Yes, you will probably find a 'First Aid' book in each of my Top Ten book lists. This is because I have found them to be the best tool at solidifying the most important points of each phase of medical school. During third year the First Aid for Step 2 CK (Clinical Knowledge) was a great way to make sure I knew the most important facts. It is certainly not sufficient to study alone.

9. Dr. Pestana's Surgery Notes:

Dr. Pestana's notes are an absolutely necessary resource for students on the Surgery rotation. The notes provide real-world examples that combine pathophysiology with surgical patients. Complications, surgical decision making, and post-operative care are all addressed. I was shocked at how high yield these notes were when I took the shelf exam.

10. Step-Up to Medicine:

You will also find this book at the top of my list for the the internal medicine rotation. However, it is so good that I thought I should mention it here too. The book comes highly recommended by nearly every student that has ever used it. It will give you a great base to study from and find out what you need to study more.

 
Honorable Mention:
  1. I can not create a list of study tools for third year medical students without mentioning USMLEworld.  After using many Q-banks, many question books, and other resources, I have concluded that USMLEworld provides questions most consistently similar to the real shelf exams and boards as well as provided the clearest explanations.
  2. Success on the Wards: 250 Rules for Clerkship Success is a highly rated book for third year students
  3. 250 Biggest Mistakes 3rd Year Medical Students Make and How to Avoid Them is written as the same authors as "Success on the Wards" and also comes highly recommended.
  4. The Ultimate Guide to Choosing a Medical Specialty. Really, this books should be in the Top Ten.  I left it off because it is not specifically for third year medical students. However, it is one of the best resources available for deciding what is important to you in a specialty, and comparing variables across all medical specialties. I highly recommend it.
 
 
 

Tags: ,

2 comments

Pre-operative Clearance Checklist

Categories:

Residency, Family Medicine Rotation, General Surgery Rotation

February 6, 2012

by

A frequent question in the outpatient setting is whether or not a patient is optimized for surgery. There are a number of things that a physician must check in order to properly send a patient back to a surgeon with a gold star. I recently used the Johns Hopkins Internet Learning Center (HopkinsILC) to study the basic pre-operative evaluation and I highly recommend it (requires access from your school or hospital, many hospitals have access, ask your librarian).  There is a great review pdf available from HopkinsILC which details some of the highlights of the lesson.  Below I will summarize some points from the pdf. To learn more, you should ask for access to HopkinsILC, it is a great resource.

 

  1. If the patient has any active cardiac issues, surgery should be postponed.  This includes…
    1. Recent myocardial infarction (<30 days)
    2. Active cardiac disease (unstable angina or worse)
    3. An uncorrected arrhythmia
    4. Severe aortic stenosis

 

  1. The patient must be able to complete 4 or more ‘metabolic equivalents of task’ (METS).  This includes
    1. Climbing a flight of stairs
    2. Walk for 30 minutes
    3. Play tennis, bowling, or other more intense sports
    4. Able to vigorously clean a house (scrub floor, move furniture)

 

  1. There are a few medications that must be stopped prior to surgery. Some examples (not an exhaustive list) include…
    1. If the patient is on blood thinners (coumadin) or anti-platelet drugs (plavix, lovenox, etc) these may have to be stopped and the surgeon will have to be part of the discussion
    2. Diuretics, ACE-inhibitors, and ARBS are usually held
    3. Oral hypoglycemics are usually held for 1-2 days
    4. Insulin is usually decreased by 50%
    5. Sedatives are usually held

 

Again, here is the link to the pdf explaining the above points. And here is the link to the HopkinsILC website.

 

 

Tags: , ,

Leave comment