MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'interns'. Sat, 03 Sep 2011 02:32:58 +0100 http://www.medworm.com/index.php?rid=4992691&cid=t_203062_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-be-a-good-doctor-10-rules-of-the-road%2F2011.07.01 He sat in a crisp white coat, staring at a computer screen, note cards in his lap. Occasionally, I noted him jot a note to himself as he compiled his list. A nurse sat next to him, pounding feverishly on the keyboard as she recorded her nurse’s note. He tentatively moved his mouse, then clicked, still staring. I recall my first day in clinical medicine: no computer, an ER rotation, a white board filled with names and abbreviated medical problems next to them with little magnetic color-coded labels nearby. Room 1: Head trauma. Room 2: Abscess. Room 3: UTI, Room 4: Rash. I got room 2. It was the biggest, bad-est infected sebaceous cyst on a guy’s back a newly minted doctor had ever seen. Can you say “softball?” “See one, do one,” they told me. And off I went. Much in medicine ha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992691 Fri, 01 Jul 2011 14:00:00 +0100 4992691 http://www.medworm.com/index.php?rid=3463640&cid=t_203062_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F04%2F13%2Fbest-of-our-blogs-april-13-2010%2F It’s a brand new week. Glad you made it! April’s a pretty hectic month, but we’re nearly halfway through. You’ve already gotten through April Fool’s Day, hopefully your taxes are finally done, spring break’s about over and well Earth Day is still to come. May the rest of this month be all about relaxing and enjoying the sun! For me, getting a little R&R means sitting down in a cafe and reading various chapters in my ever-growing stack of books. My shelf contains every subject including memoirs and psychology books. There’s a handful of fresh reads as well as a number of good old favorites. Have you ever gone back to reread an oldie to discover a new gem, some new found insight that makes you rethink your life? I recently flipped through The Dr... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3463640 Tue, 13 Apr 2010 11:08:46 +0100 3463640 http://www.medworm.com/index.php?rid=3456719&cid=t_203062_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F04%2F09%2Flook-whos-depressed-now-interns%2F As though medical school wasn’t difficult enough, now new research suggests that internship is even more difficult. In a study of 740 medical students who were on internship, researchers (Sen et al., 2010) found that nearly 4 percent of the students met the criteria for depression before their internship started. That number jumped to over 25 percent of students when the researchers measured their depression level at four points over the course of the internship year. That’s right — 1 in 4 medical students on internship suffer from serious, clinical depression. Most of the students who met criteria for depression were classified as moderately depressed. That’s in-between mild and severe depression, and in most people, means their daily functioning is significantly ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3456719 Fri, 09 Apr 2010 20:38:54 +0100 3456719 http://www.medworm.com/index.php?rid=2977225&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2009%2F11%2F10%2Fwarning-signs%2F M&M last week was scary. Scary as in, I don’t let myself say, I would never have made that obvious of a mistake. Instead I say, someday I will be the one to make that mistake, so I better watch out. No details at all, just the lessons I got: Never believe anyone. Verify everything for yourself. Seriously, not just an axiom. Look at all xrays as a matter of course. In addition, I must personally look at every CT done on every patient I’m caring for (let’s say done within the last week), regardless of whether radiology has read it, and regardless of whether other surgeons have told me it’s ok. Every CT, slowly, head to toe. Then on lung windows, head to toe again, slowly (this is a different penetration view of the CT, to show lung findings, abdominal findings in... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=2977225 Tue, 10 Nov 2009 15:17:35 +0100 2977225 http://www.medworm.com/index.php?rid=2836151&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2009%2F09%2F26%2Finescapable%2F One of my friends, an intern, is struggling with the belief that they killed their patient. I’ve thought that more than once, and in cold reflection I believe it to be true in at least one and two halves. That is, one I’m personally responsible for, and about two others I’m definitely responsible for significant failings. There were several other times that I felt very guilty about for a week, but as time passes I think my responsibility is less weighty in those. I haven’t written about them before because, in close temporal proximity, I was too upset to write, and I didn’t want any time correlation for the lawyers to find. The one patient that I think of particularly, I personally failed to notice something, and that thing being overlooked led to another thin... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=2836151 Sun, 27 Sep 2009 01:15:48 +0100 2836151 http://www.medworm.com/index.php?rid=2441825&cid=t_203062_111_f&fid=34716&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNurseRatchedsPlace%2F%7E3%2FenkoWyibHds%2F I wrote this post a long time ago when I first started blogging. I’m recycling the post because this information bears repeating. I’ve been seeing some behavior lately that is inappropriate, and I’m telling you this stuff for your own good. Please, never roll your eyes at a nurse who is old enough to be your mother. She may be going through menopause, and it could be the last thing that you ever do. Just sayin.’ Don’t make waves at the nurses station. I worked as a neurosurgical nurse many years ago at a teaching hospital in the Midwest, and twice a year a new crop of interns descended upon our unit. It was the best show in town. The spectacle began with the chief of neurosurgery, Dr. Holier Than Thou, strutting on to the unit with his entourage marching behind him. ... Nurse Ratched's Place blogs http://www.medworm.com/rss/comments.php?id=2441825 Thu, 28 May 2009 12:00:40 +0100 2441825 http://www.medworm.com/index.php?rid=2441004&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2009%2F05%2F27%2Fwork-ethic%2F Last year, I mostly viewed the scutwork the seniors demanded as an exercise of their power, nothing else. I did it, of course, but I couldn’t really see why they didn’t just do it themselves. Why the interns and juniors had to write all of the notes in the morning, write most of the post-op orders for the seniors’ own cases, write the post-op notes on the patients the seniors had just been operating on – it seemed rather pointless; or rather, too pointed: they got the fun of operating, and I got all the busywork. Now, with a little more experience in the OR, I can see more reason to it (or perhaps, now only a year away from being a senior myself, I’m starting to rationalize giving a lot of the work to the intern). For one thing, the work hour limits hurt the c... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=2441004 Wed, 27 May 2009 13:28:34 +0100 2441004 http://www.medworm.com/index.php?rid=2404956&cid=t_203062_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F05%2F14%2Floca-congress-for-interns-loca-co-assistenten-congres%2F Last Sunday I was an invited speaker at a national congress for interns, the LOCA congress. LOCA stands for “Landelijk Overleg Co-Assistenten”. This congress has been initiated to facilitate the contact between interns of all Dutch universities and to cover in depth subjects that usually don’t get much attention. The LOCA congress offered a diverse program, varying [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2404956 Thu, 14 May 2009 09:13:35 +0100 2404956 http://www.medworm.com/index.php?rid=1809786&cid=t_203062_113_f&fid=34933&url=http%3A%2F%2Fpalmdoc.net%2F%3Fp%3D1819 Sometime back Palmsource (now Access) posted “Expert Guides” and you could refer to these for ideas on how to use your handhelds - I think there were expert guides for Medical students (by Matt Delaney), Doctors (Kent Willyard), Anesthesia and Dentistry. However since Access has bought over Palmsource, I cannot locate the Expert Guides anymore, so I think this is an opportune time to resurrect the Expert Guides and with medical PDA community input I think we can put together some useful ideas, tips and links to software for the needs of all (students and doctors alike). I thought we could start off with a collaborative effort on an Expert Guide for Medical Students and Interns/House Officers. The work is licensed under a Creative Commons Attribution 3.0 Unported License and any... The Palmdoc Chronicles blogs http://www.medworm.com/rss/comments.php?id=1809786 Fri, 19 Sep 2008 04:00:00 +0100 1809786 http://www.medworm.com/index.php?rid=1639556&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F07%2F19%2Fbalancing-2%2F I thought it was hard being the intern and figuring out how to relate to the attendings and all the various levels of residents senior to me. Figuring out what to do with my intern is even more complicated. He’s not brilliant, but he tries hard enough that I can’t just write him off as a bad job. But how do I balance between pushing him hard enough that he learns what he needs to do to make a surgical service work, and being friendly? How do I let him make enough mistakes that he takes things seriously, but keep anybody from getting hurt? There are so many things that he ought to be doing, that we’ve told him about, but he forgets or doesn’t know how. So do I just do them myself, which would be the simplest, remind him endlessly and start looking like his mother or... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1639556 Sat, 19 Jul 2008 21:49:25 +0100 1639556 http://www.medworm.com/index.php?rid=1594128&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F07%2F07%2Fwhat-not-to-say-on-rounds%2F There’s really not much to say about this academic year, so far. I haven’t gotten to do really any more surgeries. The chief keeps intending to let me, but then the case turns out so wildly complicated that I can’t honestly say it would be a good idea to let me in, so I can’t complain. I don’t know any more now than I did a week ago, it’s just that the amazingly naive intern at my heels makes me look relatively well-informed, and even almost sophisticated. (One thing I learned the painful way: you do not have to tell the attending every single detail of what happened in the last 24 hours, such as, we wanted to check such and such a lab, but it took forever to draw, and then the lab lost the blood sample, so it was twelve hours after admission before we d... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1594128 Tue, 08 Jul 2008 00:35:42 +0100 1594128 http://www.medworm.com/index.php?rid=1472833&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F05%2F27%2Fadvice-for-medical-students%2F I wrote kind of a depressing post, about being tired, and not having any days off for several weeks, and worrying about next year. No fun. Just as well, the computer ate it. I guess the computer knows best. In response to requests (and because I actually know more about this subject than about advice for interns), here we go. . . Bear in mind that this advice is specifically directed to students on surgery clerkships. Some things would get you high praise from medicine doctors, but will only get you laughed at by the surgeons (writing three page history and physicals, taking care to include a detailed social history; mentioning the eye exam or neuro exam in your report, if it’s not specifically relevant). Conversely, some things will fly very well with surgeons, but will not get you ... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1472833 Wed, 28 May 2008 01:05:33 +0100 1472833 http://www.medworm.com/index.php?rid=1446632&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F05%2F15%2Fadvice-for-surgical-interns-part-six%2F Barbados Butterfly wrote some eleven or twelve posts on advice for interns (incidentally way more valuable than mine, since she wrote from a few years’ seniority, rather than only ten months, like me). If I could remember more of them, I’d try to reprise them a little more precisely. But the one that sticks in my mind most vividly contained her song, “Call A Code.” The words went something like this: “if the patient looks blue, call a code. . . if you can’t find a pulse, call a code. . . if you think you need help, call a code. . .” only much more poetically. (Does anyone else remember the words better?) The basic point was that the intern should not hesitate to call for help, even as dramatically as calling a code, if they have any suspicion that ... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1446632 Thu, 15 May 2008 13:31:02 +0100 1446632 http://www.medworm.com/index.php?rid=1437239&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F05%2F12%2Fadvice-for-interns-in-general%2F Get a PDA of some kind, and put Epocrates on it. This free downloadable PDR gives all the essential information: drug names (brand and generic), indications, dosing, adjustments for renal/hepatic failure, side effects, contraindications, interactions, and pharmacology. There are also some nifty medical calculating gadgets that come with it, which will calculate FeNa for you, calculate equivalencies between different narcotics or steroids, and other mysterious details. This program is tremendously useful for those times when, as usual, the patient gives you some funny spelling of their medication, or only knows the brand name and it’s a very tiny brand, or can’t remember the dosage. You can look up variations on the names, and find out what the usual doses are (if something onl... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1437239 Mon, 12 May 2008 13:27:31 +0100 1437239 http://www.medworm.com/index.php?rid=1434679&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F05%2F10%2Fadvice-for-surgical-interns-part-five%2F Another piece of advice that you won’t get from many attendings: invest in some good shoes. It will make your life much more bearable. There’s a reason Danskos are so popular. They really do feel much better than any other shoes I’ve tried. Back for the first several months, I had “nurses’ shoes,” which did absolutely no good. My feet used to be so bad, by the end of a 14-hr day, that it hurt more to sit down in the car to drive home, than to keep standing up. When I finally decided to pony up ~$100 for some Danskos in January, this improved dramatically. As any surgeon will tell you, the problem with sitting down is that you fall asleep much faster sitting down than standing up. So when you’re going to be tired a lot, you have to be able to keep s... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1434679 Sun, 11 May 2008 02:03:35 +0100 1434679 http://www.medworm.com/index.php?rid=1423974&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F05%2F05%2Fadvice-for-surgical-interns-part-four%2F Learn to tie knots really well. Admittedly, I’m a slow learner, but I was a couple of months into the year before I really grasped the meaning of a square knot, and I’m still working on how to pick up the threads so that they naturally fall into a square when I tie them. Privately with bare hands, and under observation in the OR with bloody gloves on, are two different things. The nature of surgery is that the senior person is guiding what happens, and the junior is left doing a lot of the mechanical work: tying off vessels that the other surgeon has clamped, for instance. And believe me, they notice what you’re doing, especially the first few times you work with that attending. They notice how easily you tie, and how smoothly the knot falls, even if they don’t say ... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1423974 Tue, 06 May 2008 00:11:50 +0100 1423974 http://www.medworm.com/index.php?rid=1415116&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F05%2F01%2Fadvice-for-surgical-interns-part-three%2F Always be prepared. Practically, this means you should at all times have the following basic supplies about your person: - Trauma shears, because trauma patients are not the only things that need to be cut. Vascular dressings can be taken down with these; and I have found them handy for cutting JP stitches when it’s impossible to get ahold of a proper kit (after first cleaning them asepticly, of course). Attendings and chiefs tend to get testy when no one, not even the intern, can produce scissors upon demand. We live to cut, after all. Keep something semi-sharp handy. - Lube. You’re a surgery intern, and there’s something else that you should be doing with practically every patient you see, especially the ones with abdominal complaints. (Which is one thing I love about g... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1415116 Thu, 01 May 2008 23:28:26 +0100 1415116 http://www.medworm.com/index.php?rid=1408359&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F04%2F29%2Fadvice-for-surgical-interns-part-2%2F Here’s something important, which not many attendings will include in their list of valuable advice: Enjoy the last two free months of your life. Get out in the sun, get some exercise, spend time with family and friends - because that’s the last you’ll see of them. Maybe not quite that bad, but after July 1, you’ll have to plan ahead and ration your time carefully, between errands and housekeeping, to get time with people outside of the hospital. (I have to plan for a week to get to the store for bread. Maybe I’m worse at time management than some other people.) Having only four days off a month, and those randomly assorted depending on your chief’s whim, makes it difficult to get things done outside of the hospital. Again, maybe I lack willpower; but I... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1408359 Tue, 29 Apr 2008 23:06:51 +0100 1408359 http://www.medworm.com/index.php?rid=1405522&cid=t_203062_83_f&fid=36527&url=http%3A%2F%2Fcutonthedottedline.wordpress.com%2F2008%2F04%2F28%2Fadvice-for-surgical-interns-part-1%2F Since this is what I’ve been asked most often, we’ll talk first about good books to read in the month or two you have left, and also in the first year of residency. Right now, I would recommend getting started on a basic surgical textbook, like Schwartz, Sabiston, or Greenfield. I’ve been using Sabiston this year, and it’s ok, but I was recently pointed towards Greenfield, and I like it much better. The chapters are a more manageable size, and the writing overall is better organized and more focused on useful information. These books will give you a lot of basic science information: some anatomy, a lot of physiology and pathophysiology, and the decision-making tree, how to diagnose, how to treat, when to do surgery, when not to do surgery. This covers the informatio... Cut On The Dotted Line blogs http://www.medworm.com/rss/comments.php?id=1405522 Mon, 28 Apr 2008 23:13:52 +0100 1405522