APPENDIX
MEDICINE IS AN inherently dynamic field—thus the information sources are eternally changing and growing. This appendix lists some of the most fundamental resources premed students, med students, and residents will draw on during their journey. But the list is only the tip of that ever-changing iceberg. Talk to your fellow students, talk to your colleagues, faculty, and mentors, and you will discover a world of resources available to you.
We would be remiss if we did not also add a note of warning. As you well know, the Internet is awesome in its breadth and variety, but sometimes questionable in its quality. Before you depend on a resource make sure that is it is reputable and has up-to-date material. Furthermore, medicine is big business, and medical training is in and of itself a major industry. There are many companies out there trying to sell you the one resource you can’t do without. You will discover that in your mild paranoia and desire to succeed, you can spend a small fortune on references and materials only to be eternally burdened by a library you never get around to reading or a resource that tells you what you already know. Be a cautious consumer and consider who’s offering the advice before you take it. To this end, it should be noted that the authors have no association with any vendors, organizations, or individuals listed here, nor can we vouch for the ever-changing content of these resources. Nonetheless, many, many students have found these links and resources useful in their journey, and we hope that they will offer at least a starting point for your exploration into the world ahead of you.
FUNDAMENTAL REFERENCES
These Web sites offer comprehensive information on the medical training experience from stem to stern. They should be among your go-to resources throughout your journey for up-to-date, high-quality information and guidance.
Association of American Medical Colleges (www.aamc.org): This should alvays be your first stop when shopping for any information regarding the premedical, medical, or postgraduate training and experience. The breadth and depth of this Web site is awesome. Even though it is directed more specifically at allopathic training, osteopaths will find much of its content extremely useful as well.
American Association of Colleges of Osteopathic Medicine (www.aacom.org): This is the osteopathic version of the AAMC Web site. It, too, contains a fantastic array of information, resources, and links. Make it your launching point for any osteopathic investigations.
Student Doctor Network (www.studentdoctor.net): SDN is a nonprofit organization that started as a grassroots Web community at the University of Kansas in the mid-1990s. Since then it has emerged as one of the most comprehensive and most useful student-driven resources out there. Perhaps its strongest feature is the incredible “Student Doctor Forums.” These e-mail forums detail literally every aspect of the premed and medical student experience and provide a real-time community to raise questions, vent frustrations, and learn from the collective wisdom of those around you and before you.
TEST PREP
There’s a wide range of MCAT prep courses and books out there. These resources change all the time, so talk to your colleagues and advisors about what they feel are the best options currently. For test prep courses, Kaplan and Princeton Review remain the heavy hitters. Their courses may not be perfect, but they do put you through the paces, enforce proactive studying, and offer full-length simulated tests to get you ready for the big day. For specifics about registration and test content, go to the governing organizations directly and download their materials.
The Princeton Review: www.princetonreview.com
Kaplan: www.kaplan.com
MCAT home page: www.aamc.org/students/mcat/start.htm
USMLE home page: www.usmle.org
COMLEX home page: www.nbome.org
PREMED CURRICULUM AND MED-SCHOOL APPLICATIONS
Your premed advisor is your best initial source of premed information. They typically will have a library of reference materials and a wealth of experience in guiding you through the process. Additional resources are listed below.
The AAMC Web site (www.aamc.org) is probably the best single premed resource. They publish the official tome Medical School Admission Requirements, which is widely regarded as the bible on facts about medical schools and what it takes to gain acceptance to one. Again, your premed advisor may have a copy of this book, so look before you invest. The AAMC Web site also lists every premed program available in the country.
Online you will find a wide variety of course synopses and study materials for all the different premed classes. Again, quality may vary, so consider who’s offering the information before you rely on it. Amazon.com is a good first stop for these materials.
The Student Doctor Network (www.studentdoctor.net) has extensive reviews of online material and entire forums that discuss each course you’ll have to take. Learn from the legions that have gone into premed battle before you.
Clinical References
By the time you’re enrolled in med-school classes, you’ll have an entire cadre of fellow students clamoring to find the best study resources available. Use the collective wisdom of those who have gone before you. Try out any reference before you invest a lot of money in it—some books and materials may suit your learning style better than others. When in doubt, buy fewer rather than more general reference books. Your best bet, by and large, will be high-yield, topicspecific review books that will help focus your studies on the most pertinent material for tests and clinics. Remember to gradually and continuously study for the upcoming USMLE tests as you go—you’ll thank yourself later. Here are some of the classics, always a good place to start.
Web Sites
There are a number of excellent online reference sources that provide ubiquitous access and up-to-date materials. Your medical school likely has subscriptions to these services already through its library. If not, you may want to consider subscribing yourself—the information can be so high-yield that it can save you literally hours of searching at critical times.
UpToDate (www.uptodate.com). While generally focused on internal medicine, this site contains succinct reviews of current thinking and treatment about most major disease processes. Their articles are only a couple of pages long and are generally authored by leaders in the field. They include bibliographies for each entry, substantiating their recommendations and making further research a breeze. This should be your first stop at 2 A.M. over a cup of coffee as you begin to write up your fourth admission H & P for the night.
MD Consult (www.mdconsult.com). This site is literally an entire library at your fingertips. They provide a wide array of the major textbooks for most medical specialities in an online searchable format. The material is dense (i.e., it’s straight from the textbook), but its searchable format allows you to hone in on specific information quickly.
Micromedex (www.micromedex.com). This site is best known for its comprehensive database of drugs and toxins. It provides concise, current information on thousands of compounds and their impact on humans—both therapeutic and toxic. Micromedex also offers a range of other products, including differential diagnosis utilities, treatment guidelines, and patient-education databases.
eMedicine (www.emedicine.com). This site is similar to UpToDate but offers a wider range of subspecialty topics. It, too, prides itself on keeping its content current by recruiting its authors from a wide range of experts in the field and conducting regular reviews of its articles.
The Merck Manual of Diagnosis and Therapy (www.merck.com/mrkshared/mmanual/home.jsp). First published in 1899, this book has remained a solid general medical reference for medical practitioners around the world. The online version is easily searchable and quite succinct.
PDA Resources
PDAs have emerged as a more efficient and less weighty means of carrying an entire library in your white-coat pocket. Many schools now require or provide them as part of the curriculum. Again, there are a wealth of products out there, some good, some not so good. Here are a couple of the most tried-and-true, as
well as some good clearing houses for more products and information.
Epocrates (www2.epocrates.com). This is probably the single best freeware drug reference for the PDA. There are certainly others to pick from, but most require a subscription of some sort and offer relatively little more for your money. Epocrates also offers additional subscriber-only functions, such as Infectious Disease references, if you feel the need.
Griffith’s 5-Minute Clinical Consult (www.5mcc.com). You will encounter countless moments in your medical training when you find yourself in the elevator on the way down to the ER to admit a patient with Kawasaki’s disease, and you think to yourself, “Uh oh, what the heck do I remember about Kawasaki’s disease?” Witness Griffith’s five-minute clinical consult to the rescue. It’s concise, it’s easy to navigate, and it consistently hits the high points you need to know before you walk into the exam room or sit down to write orders on a patient. It won’t replace reading a good review article or textbook to really learn about a disease process, but it can easily serve to jog your memory and get you out of a pinch in a hurry.
Medical PDA Software. There is a wide range of Web sites dedicated to medical software for your PDA. There are huge volumes of freeware, some if which is high-quality and extremely
useful, some of which is liable to crash your system or provide faulty information. There are also numerous commercial products that all claim to be the one, indispensable PDA resource. Remember that there’s no information panacea out there—in the end, you’ve got to know what you need to know. These PDA programs will serve as excellent quick-reference tools and calculators, but don’t be fooled into thinking they’ll solve any problems for you. Used judiciously to fill information gaps, your PDA will be your best assistant. If you load it with extraneous programs and reams of data in hopes of never being caught off guard for a pimping session, you’ll quickly find you’ve wasted money and time when you should have been paying attention to patients and learning what you need to know.
Pocket Reference Library
Let’s face it, sometimes nothing beats flipping through the pages of a well-worn, trusted book to find that drug dose immediately. Plus, you never have to worry about crashes or battery life. Here are a couple of classic, all-around pocket reference books, most of which should be available through your school’s bookstore.
Sanford Guide (www.sanfordguide.com). This is probably the preeminent guide to antimicrobial therapy. It’s dense and in very fine print, but ultimately you will find exactly the right bugto-drug combination if you spend some time scrutinizing it.
Tarascon (www.tarascon.com). This company is most renowned for its pharmacopoeia, but it also produces a range of specialtyspecific quick-reference books. When your PDA crashes and you need to know the dose, here’s a quick and cheap backup.
Practical Guide to the Care of the Medical Patient, edited by Fred F. Ferri (Mosby); The Washington Manual of Medical Therapeutics (Lippincott, Williams, and Wilkins); The Harriet Lane Handbook [Mosby]. These three books are among the most popular of the generic hard-copy clinical pocket reference books. To the thirdand fourth-year student embroiled in a clinical rotation, they can be indispensable sources of information on what needs to be in an admission order set, the exact steps to put in a subclavian central line, or how to safely rehydrate a child with IV fluids. There are many similar books out there, but these have stood the test of time and developed a legendary status among generations of students. Find one that suits your thinking and have it at the ready in your bag.
FINANCES
As we mentioned in chapter 11, there is a wide range of funding sources available to make it feasible for almost anyone to undertake a medical education. The key is sorting through your options and crafting the best financial-aid package. Start by looking for scholarships and grants, then move to on to federal loans and private loans. You may be surprised by the scholarship and grant monies you discover if you hunt around. Remember, even a relatively small $10,000 grant from a local civic organization can save you tens of thousands of dollars over the thirty-year time frame of your loan package repayment. Here are a few places to start, but search the Internet, talk to your school, and reach out to your community to see what you can find.
Federal Student Aid (www.studentaid.ed.gov). This is the place to start for any federal support. You will have to fill out the Free Application for Federal Student Aid in order to get a needs evaluation and package proposal. Your financial-aid advisor can help you navigate these waters, but this Web site will also give you reams of information on how to apply for loans and how to manage your loans come repayment time.
Scholarship Resources. There are a number of scholarship clearing houses on the Internet that will allow you to access their databases for a fee. This may be worth your while, but it’s probably best to first check with your financial-aid advisor on resources they already have available. Again, don’t forget to investigate your hometown resources, particularly civic organizations, churches, and schools.
Service Repayment Options. Want to wipe out your loan debt completely and serve your country at the same time? Consider a stint in the National Health Service Corps (http://nhsc.bhpr.hrsa.gov) in exchange for a partial or complete loan repayment. Or you might wish to join a branch of the armed services. They will help support you while you’re in school, assist with residency placement, and repay your student loans in exchange for several years of active-duty service. The commitments to any of these programs are significant and may change your life, but then again so will being debt free.
RESIDENCY AND THE MATCH
By now you will have a deep working knowledge of the medical education system as well as an entire Student Affairs office at your school assisting you with entering and competing in the match. Use these resources well, and ask many, many questions. Here are a few additional sites you may want to consider.
FREIDA Online (www.ama-assn.org/ama/pub/category/2997.html). This portion of the AMA Web site is dedicated to a fantastic database on all the available fields of training. They not only provide useful statistics on the field and the lifestyle, they also provide links to all the approved residencies in that field. This is a great place to start shopping around and exploring your interests.
Electronic Residency Application Service (ERAS) (www.aamc.org/students/eras/start.htm). Yet another part of the monolithic AAMC Web site, ERAS is your gateway to residency acceptance. The system is analogous to your medical-school applications, with the exception of those miserable secondary applications. Early in the application process (i.e., before it truly begins), spend some time on this Web site learning about the ERAS application, the system for submission and interviews, and most important, the deadlines and requirements. Don’t let inattention to detail allow you to miss a critical step or deadline and derail this most important, life-changing process.
National Resident Matching Program (Error! Hyperlink reference not valid.. This is the counterpart to the ERAS application. The NRMP are the folks who will take your rank list, crunch you and the thousands of other applicants through a wickedly complex algorithm, and single-handedly determine your future. Again, early on in the process you should scrutinize this site and make sure you understand the system and what you need to do to successfully complete the requirements.
RESOURCES FOR FAMILY, FRIENDS, AND SUPPORTERS
As we discussed in part seven, the stress and strain of medical training affect not just you but also those closest to you. Here are a few Web sites dedicated to creating a network of support for those you rely on. No one can dissolve the stress and strain, but sometimes a voice of solidarity and experience can ease the burden and offer guidance.
AMA Alliance (www.ama-assn.org/ama/pub/category/2109.html). This is by far the oldest organization dedicated to addressing the well-being of physicians and their families. The original “Women’s Auxiliary to the AMA” was started in 1922. Since then the organization has grown to encompass all physician families in any stage of t
raining from medical school to retirement. They offer regional chapters, publications, guidance, and opportunities to get involved in health policy. It’s definitely worth checking out, and it may help your significant other feel like he can be a more active part of the medical training process.
MomMD (www.mommd.com). While this site is dedicated to the issues of women in medicine and the unique challenges they face, it offers a wealth of information about how to achieve balance in your life, no matter your gender or living situation. It offers extensive tips and resources for every stage of training invaluable to both would-be physicians and their families.
ABOUT THE AUTHORS
ROBERT MILLER graduated with distinction from Yale University in 1993 and from the University of Pennsylvania Law School, where he served as a senior editor of the Law Review and chairman of the Executive Committee on Student Ethics and Academic Standing, in 1998. He is presently a trial lawyer at Sheehan, Phinney, Bass & Green in Manchester, New Hampshire, where he specializes in constitutional law and intellectual-property issues. He is the author of Law School Confidential, Business School Confidential, and Campus Confidential. Mr. Miller lives in Hopkinton, New Hampshire, with his wife, Carolyn, and their two children.
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