Sunday, April 19, 2009
How to succeed IM(Internal Medicine)-pesanan dari Fana hey!
Hmm...so nice of my friends.We r helping each other out.Dats the spirit mannn...nway, ni email yg dpt dari Fana hey.I dont edit this.Saje nk post kat blog ni.At least bleh baca slalu.Enjoy reading(to me)!
How to succeed in IM (hehe, insyaAllah)
1. Read and read n read
- based on ur patient's case
- cth nyer kalau dia ade DM ke HPT ke then read about it and must know
the basic things about it (eg how to dx, what are the types, its definition
- dont forget to refer books and old folios pls..
- recommended books:
--> oxford handbook of clinical med (a must have)
--> kumar n clark or davidson's
--> tally o'connor or hutchinson
--> old folios
2. Getting the history
- get the history right, HOPI very important (LORD SANFARO)
- all the what where when why where who how
- the chief complaint
- assoc sympts n other hx
- after getting all the hx, karangkan n try to present to ur frens
- get their opinion and ask them if there is anything not complete or missing
or if there is a gap in ur hx
- dont be afraid to dig from ur patients
- and dont salah interpret what ur patient is trying to say (u know pening and
sakit kepala might mean something else to ur patients)
3. Doing physical examination (PE)
- the first day u should already know how to perform PE for every system
- they include :
>CVS (paling senang n best)
>abdomen (as in GIT)
>musculo (some r integrated in CNS)
>CNS (upper n lower limbs)
>stethoscope (kalau takde bkn med student la..)
>tendon hammer (optional coz bole pinjam from ward, but its better to hv ur own
or at least share)
>orange stick n cotton n tongue depressor for CNS (can always get it from ward)
- pls jgn buat sorang2 takut nnti syok sendiri
- at least the other frens tgk n check anything yg tertinggal or silap
- this might sound cliché but practice makes perfect
- especially for the patients that u want to present to prof ke dr ke u MUST do ALL the
systems (CVS --> CNS)
- jgn buat short cut buat betul2 cam nak exam
- when ur used to it it will only take few mins (awal2 mmg la slow skit)
- always karangkan the hx [intro, hopi, assoc symt, past med hx, hospitalised/surgical hx,
drug hx, family hx, social hx(wife? anak? work? house where brape tngkat, tepi jln ke?)
dont forget the public health component people, also bout smoking, illicit drugs, sexual promiscuity]
- then followed by the summary of hx
- then present the physical findings (pls include BP, PR, RR, T)
- then PE summary
- finally summary of hx plus summary PE
- a good presentation : by the time uve finished presenting the listeners will have an idea which
system is the prob or at least a differential dx
-not to be included when presenting but have to know:
> must know what drugs patient is having, what doc plan to do, all the investigation findings
must know the nilai dont just say its N or not normal (in case prof or dr wants to know)
5. Long case n short case
- pls do it whole heartedly
- not just cincai2 lorh
- must have good, lengthy, informative, relevant, important, meaningful learning issues (dont
forget the academic n non academic learning issues)
- refer books n include any discussions about the patient
6. Must have your own 'kitab'
- well its actually a notebook (or many notebooks) which contains important n must know knowledge
- knowledge from books, ward rounds, profs n drs, ur own 'michael jackson kene halau balik
india utara' (pneumonics) kinda thing to remember stuff
- the main idea is so that u dont have to refer to books many times because u can just refer to ur
own self made kitab
- u must revise every week n add any valuable new info into the books..
- this is also another cliché but dont study last minute
- prof will give u guys a registered online examination website where there are many questions for
revision.. so bole la practice..
- during ward round, u guys should contribute to any new info from the history that uve taken
- all of u will meet 2 wonderful doctors dr shu and dr rafizi (dr shu's husband). they're really nice
and determined to make all of us pass our IM posting..
- the terendak people..dont take terendak for granted.
- the lack of patients should not be an excuse to be laid back. in fact u should take the opportunity
to know the patients in depth.
thats all. all the best
Yours truly, <----- Ok ni aku yang tambah.
p/s: Thx Fana~~~!