Top 8 Scrub Notes Posts Of 2008

As 2008 winds down, here are the top 8 posts of this past year! 

• Pope's Blessing Vs. Claw Hand
• Sarah Palin's Birthing Guide
• Why Monica Bellucci Might Take Atropine
• Maladies Of The Rich And Famous, Part I
• Dale Dubin: Pornography And Prison
• How To Write A History And Physical
• Medical Marvel: Craniofacial Duplication
• Practical Gifts For Medical Students

I do have a quick favor to ask of you, the readers of this blog. I try to view the blog on a few different browsers just to make sure it looks alright, but I can only check so much. If you happen to notice any formatting issues, please email scrubnotes(AT)gmail(DOT)com or comment below. Please include a brief description of the issue, your browser and OS. Thanks!

Happy New Year!

Most Stressful Medical Specialty?

Stress is hard thing to judge within a medical specialty. Various factors play a role in creating stress, from the patients and procedures themselves, to one's work environment and career path. I'm not sure how to weight all these factors, but here's the sense I've gotten from the specialties I've been exposed to. 

5 Most Stressful Medical Specialties

1. General Surgery - perhaps I'm biased by the training, but I think given the career, it seems like a lot of stress, considering the income and hours down the road.

2. OB/Gyn - the training is hard, the hours are long, the liability high, and there's relatively less 'control' / predictability over how patients will do from what I've seen. 

3. Internal Medicine - again, just biased by what I see the residents go through. 

4. Surgical Subspecialties - stressful to train, but I think it gets easier in the career itself.

5. Emergency Medicine - while the career is good, I think the fact that these are 'emergencies' is stress inducing on its own, plus who wants to do overnight shifts when they're 60?

As for the least stressful medical specialty, I don't think you can wrong with the old "ROAD" mnemonic (radiology, ophthalmology, anesthesia, and dermatology). Some people would also throw pathology (heh, PATH / ROAD, get it?) and emergency medicine in there as well. While all are competitive to train for, I think the lifestyle down the road more than makes up for it, leading to less stress overall.

What do you think? Perhaps there are stressful specialties that I just haven't been exposed to?  

Books For Surgery Core Clerkship / Rotation And Shelf Exam

As underclassmen have increasingly started asking me for advice on rotations, I thought I'd put together a few guides on good review books for surgery. The surgery core clerkship / rotation is one of the most important in medical school. The grade you receive on this rotation is on par with your medicine grade and second only to the USMLE Step 1 score in terms of factors that residency program directors evaluate. Your grade will likely be a mix of clinical evaluation and your shelf exam score. However, since the evaluations tend to average out to the same values, the shelf exam is what separates the great students from the good ones.

To do well on the rotation requires the usual medical student qualities of diligence and compassion, but the three main things to know are: know your patient, know your anatomy, and know the procedure. If you know those three things and study hard, you will succeed. But, how does a medical student acquire all that knowledge in short period of time? The key is studying good resources efficiently. Here are my recommendations:


Books For Surgery Core Clerkship / Rotation

For any rotation, I would suggest starting off by reading a clinical vignettes book initially, to get familiar with the cases seen most commonly by the specialty. Then, read a general textbook or review to learn more details about the patients and procedures. Finally, do practice questions in the weeks leading up to the test to solidify your knowledge. These principles are especially important during the surgery core clerkship, when your time is limited. Here are the books I used primarily:

Essentials of General Surgery
by Peter F. Lawrence

This textbook covers the major areas of general surgery in an easy to read fashion. The early chapters on fluids and electrolytes are also important, as many questions on the shelf exam deal with management of patients on the floor.  I read this book during the first half of my surgery clerkship and it served me well.

Case Files Surgery (Second Edition)
by Eugene Toy

If you are familiar with the Case Files series, then you know that these books are a good way to get up to speed on any clerkship. They are quick to read, but really help you understand the basic concepts and cases within a specialty. Read this book right before your rotation starts or during the first week. 

NMS Surgery Casebook

by Bruce E. Jarrell

An excellent book full of different cases and their variations. I personally liked the clinical case format, especially how the book managed to discuss common complications. The pictures and diagrams are also quite helpful.

Surgical Recall (Recall Series)

by Lorne H. Blackbourne

This book is particularly handy while you are on service with some time to spare, like me on my minimally invasive (ie bariatric / laparoscopic) surgery rotation. Put it in your whitecoat pocket and pull it out during those little pauses during the day. Flip to the section that covers your next case, and learn all the answers to common pimp questions. You'll look like a rockstar in the OR. 

Other Books For Surgery Core Clerkship / Rotation

For me, these books either overlapped with the ones I listed above, or were too advanced for my tastes. However, if you are interested in surgery or want to honor the surgery clerkship, then it is worth considering whether you want to obtain these texts. Sorry to those of you who see the list twice; the images do not show up in some browsers. 

• First Aid for the Surgery Clerkship (First Aid Series)
  
• Schwartz's Principles of Surgery
  
• Sabiston Textbook of Surgery

If you are interested in good books for other rotations, check out Books For Pediatrics Rotation / Clerkship And Shelf Exam.

Find other books useful on your surgery clerkship? What books helped you the most on the surgery shelf exam? Share your knowledge!

Updated 2015-12-18