Prepping for ICU rotation

[ReturnToMed]

I graduated med school a long time ago but never did a residency, so now I have to get ready for the match.

The first step is getting back into clinical stuff. I've set up an observership in a local ICU, but it's been so long since med school I don't really feel prepared for it.

What should I do to get ready for this rotation/observership? I'm not allowed to touch patients, so I'll basically be rounding with the team and not doing anything directly with patients.

[CaribMD]

Just read up on labs and know Vents and such yo will be pimped on these things.
Know the current Antibiotics and treatments.

[IMNOTDRPHIL]

I graduated med school a long time ago but never did a residency, so now I have to get ready for the match.

The first step is getting back into clinical stuff. I've set up an observership in a local ICU, but it's been so long since med school I don't really feel prepared for it.

What should I do to get ready for this rotation/observership? I'm not allowed to touch patients, so I'll basically be rounding with the team and not doing anything directly with patients.

What you need to do:

1. Read up on the conditions the patients in the ICU have, such as heart failure, pneumonia, etc.
2. Read up on the management of ICU patients. There are guides and texbooks to use, one that is used in our ICU is a textbook called "The ICU Book."
3. Just pay attention and look up anything you do not know.

[ReturnToMed]

Good advice from both. The two weeks I observed in the ICU was fun - not so stressful since I didn't actually care for patients. It was a good re-introduction to medicine.

Since then I've been with an outpatient neurologist and on an in-patient service. It's surprising how quickly things came back to me.

Next challenge: I take step 1 on Feb. 2. It's been almost 20 years since I took step 1 (passed it then, but it was the NBME step 1, no such thing as usmle).

Wish me luck!

[CaribMD]

Good advice from both. The two weeks I observed in the ICU was fun - not so stressful since I didn't actually care for patients. It was a good re-introduction to medicine.

Since then I've been with an outpatient neurologist and on an in-patient service. It's surprising how quickly things came back to me.

Next challenge: I take step 1 on Feb. 2. It's been almost 20 years since I took step 1 (passed it then, but it was the NBME step 1, no such thing as usmle).

Wish me luck!

What have you done for prep for Feb?
The USMLE is so different in just the last 5 years, 20 years ago was like the difference between a bicycle and a sports car now.

I have advised many to do the intense Kaplan review course with Q bank.

The new USMLE likes picky facts and Buzz words are meaningless, they do not help and only hinder your prep. So many courses are based on the USMLE of 10 years ago when Kaplan is up to date. Yet Kaplan still missed some things in my prep.

[IMNOTDRPHIL]

Good advice from both. The two weeks I observed in the ICU was fun - not so stressful since I didn't actually care for patients. It was a good re-introduction to medicine.

Since then I've been with an outpatient neurologist and on an in-patient service. It's surprising how quickly things came back to me.

Next challenge: I take step 1 on Feb. 2. It's been almost 20 years since I took step 1 (passed it then, but it was the NBME step 1, no such thing as usmle).

Wish me luck!

The Step 1 is a pain in the butt, but it's not impossible. Having been out of the classroom for 20 years is certainly going to make it tougher than for most other people taking the test as almost all of what's on Step 1 is the basic science stuff taught in the first two years of medical school, and much of that is going to have changed since you have been in med school. "Basic science" here really means "non-clinical trivia," such as whether benzodiazepines affect the duration or frequency of opening of the GABA channel. The key to doing well on Step 1 is to spend a lot of time memorizing the trivia and learning the dumb little mnemonics, such as "Benny [benzodiazepines] likes frequency, Barbie [barbiturates] likes duration" so you can correctly pick the right answer to the questions.

I took about four months to study for Step 1. I studied with a friend and we had a system worked out:

1. Go over a chapter in First Aid for Step 1.
2. Go do the questions in that topic on Kaplan Qbank.
3. Keep doing that until you get through all of First Aid.

We did that twice. We had class the first three months of studying and as such, we really only had time to study for Step 1 on the weekends as we had to study for our med school exams as well. My particular med school did not let up any with their exams before the boards, which was apparently unusual. Most med schools supposedly give much easier exams before Step 1 since they want their students to study for Step 1 instead of the med school exams. We had five weeks for a summer break and we used four of them to study for Step 1, seven days a week, about 10 hours a day. We both did reasonably well.

One more thing about board scores. Your Step 1 score is one of the things that determines what residencies you can get into. A good Step 1 score won't get you in, but a bad one will keep you out. That being said, if you know what specialty or specific residency you want to get into, you can modify your studying appropriately. I would say that if you are unsure of what you want to do, aim to get about a 230 so your score is a little above the national average. That should put you in the running for all but the most competitive residencies. I will give a word of caution if you want to do one of the specialties like family medicine that basically requires little more than passing Step 1. You don't want to study just to pass as if you have a bad day, you end up fail, it gets put as a black mark on your record, and have to retake the stupid test and pay another ~$500. Aim to get at least a 200 no matter what you do as it is much better to get a higher score than you needed than to fail the exam and have to retake the exam.

Good luck! You'll be much happier Feb. 3rd, that's for sure

[CaribMD]

One more thought on the USMLE
Do a self assessment with the NBME http://www.nbme.org/programs-services/m ... vices.html
Its cheap at $45 and if you do not do better then 500 on one of them then you will know your not ready for the USMLE, they are easier then the real thing but a good indication of how well you will do.

The NBME is the same organization that writes the USMLE. Do it in a couple of weeks so you can reschedule the test.

[IMNOTDRPHIL]

One more thought on the USMLE
Do a self assessment with the NBME http://www.nbme.org/programs-services/m ... vices.html
Its cheap at $45 and if you do not do better then 500 on one of them then you will know your not ready for the USMLE, they are easier then the real thing but a good indication of how well you will do.

The self-assessment test is very much a ballpark kind of estimate since you generally take it quite a bit before you take the actual Step 1 and you've not studied everything yet. Typically your score on the self-assessment will be about 6-10 points lower than your actual Step 1 score. However, that's dependent on a whole host of factors, such as how much you've been studying already and why you took the self-assessment at that point in time. I took mine about halfway through my studying (~8 weeks before the exam) as a way to see how well I was coming along and try to rectify areas I was particularly lacking in. Thus my score and its predictive ability wasn't going to be all that great compared to others that take the self-assessment a couple of weeks before the Step 1 to better predict their actual score.