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TPA16

Best books to deeply understand internal medicine?

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I am starting my first rotation (in internal med) and feel an overwhelming sense of excitement yet anxiety.

 

I have a 14 day break before rotations and would like to really get lost in some good reads on internal medicine to further and deepen my understanding of patho, causation of sx, treatment, ddx,, not just some mnemonics and tricks (although they could help)

 

thank you in advance

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I subscribed to both Uptodate and 5MCC for two consecutive years just for the education. I think it is worth the investment. People on this forum often talk about finding free or cheap CME. I understand the need to save money but most PA programs today have tuition bills in the tens of thousands. Skimping the rest of your career on education seems like a contradiction in values. I think one should buy the resources he or she needs to grow professionally. Forget about the money. You won't think about it in five years when it is paying you back. I realize the OP is a student but this applies in school and out. To the OP, I strongly suggest you study before rotations with things that offer questions for study that have explanations. You can read all day but until you test your knowledge, you don't know what you haven't learned. Finally, you are only 14 days out from the rotation. You cannot master all of internal medicine. Try to focus on the bread and butter that you will see all day every day. That is one reason I like Blueprints for each rotation (including internal medicine). Quick read with questions two weeks before rotation helps reduce anxiety.

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I agree with the above statement that for rotations you should stick to the PAEA blueprint rather than read a resource cover to cover. Use the blueprint to focus on common and need-to-know topics then use some resource to study these in depth. UpToDate and Merck manuals are good online resources (Merck is free, and you may have access to Uptodate through your school or hospital). Obviously Harrison's Principles of Internal Medicine is highly recommended by many. You may have access to it through your school's library and it would be a great resource to reference from time to time (not sure if it goes over treatments, though). Probably a more practical resource, in addition to the online resources, is Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine. It is small enough to fit in your white coat pocket but covers a bunch of disease processes.

 

Tip: if you decide to buy your own Uptodate subscription (as I did), the AAPA gives a huge discount for students. After joining AAPA as a student member I was able to get Uptodate 2 year student subscription for about $160. Worth every penny.

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Good luck on your rotation! I too am starting my first rotation soon, also in internal medicine! I was trying to think of bread and butter topics to review like hypertension and diabetes. Does anyone have any other items they would recommend?

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If in-house, know labs (hematology and CMP and what values imply), including blood gases, UA including 24 hour collections, CSF parameters, and be able to identify basic rhythm disturbances and structural alteration indicators of EKG's (LAE/RAE, LVH/RVH, BBB, AF, different rhythm blocks, PVC vs. PAC).  For T1DM, pay attention to insulin dosing, components, and how doses are modified.

 

Back in the stone age one half of my IM rotation was attended by the head of the IM dept..  We had a cardiac patient that everyone focused entirely on his chest.  On rounds, the attending walks in, goes directly to the side of the bed next to the patient's chest, and while addressing the patient asks if anyone has any issue with the patient's feet.  No one has even looked at the plantar surface of his feet.  Secondary syphilis.

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