http://www.residencyworld.com Forum Support for residents in training en-us Hi...where can I get info on off cycle vacancies in IM? for PGY1,PGY2? thanks. http://www.residencyworld.com/thread/35 Sat, 19 Jan 2008 14:51:25 PST http://www.residencyworld.com/topic/35/ does anyone know about matcharesident.com?? Is it a good website to use?? http://www.matcharesident.com/main.php 80(2nd)/80(2nd)/cs pass(1st) 2001 grad with MPH in 2007 and 3 yrs USCE. So far applied to 60 programs with 32 rejections and 1 interview. 27 programs still pending a response, but may be rejections. No idea what is going on with FM this year. http://www.residencyworld.com/thread/34 Thu, 01 Nov 2007 18:55:17 PDT http://www.residencyworld.com/topic/34/ where is neurology residency?how can u forget that one sir... http://www.residencyworld.com/thread/33 Sun, 21 Oct 2007 20:36:35 PDT http://www.residencyworld.com/topic/33/ May be people will come soon :nod: http://www.residencyworld.com/thread/32 Tue, 26 Jun 2007 22:44:09 PDT http://www.residencyworld.com/topic/32/ My resident colleague Dr.Mary Yang started this Intern Survival Guide at Kaiser Santa Clara and was very kind to let me post the guide here. Thank you! [font='Times New Roman'; mso-bidi-font-family: Arial; mso-font-kerning: 0pt][color=#000000]Introduction[/color][/font][font='Times New Roman'; mso-bidi-font-family: Arial; mso-font-kerning: 0pt]<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />[/font] [font="Times New Roman" color=#000000 size=3] [/font] [color=#000000][size=3][font="Times New Roman"] Welcome to Kaiser Santa Clara internal medicine residency! We are all very excited that you are here. Intern year can be scary. But, it can also be one of the most rewarding and fulfilling year of your life. [/size][/color][/font] [font="Times New Roman" color=#000000 size=3]As residents, we are here to help you. Please feel free to come to any of us with questions or concerns. This booklet was created to help make your transition from medical school to residency a little easier. If you have any suggestions, comments or recommendations for this booklet please e-mail Mary Yang ([/font][email]ymy999@yahoo.com[/email][font="Times New Roman" color=#000000 size=3]). Your input will be much appreciated by next year’s interns. [/font] [size=3][color=#000000][font="Times New Roman"] Special thanks to Karen Leu (night float section), Jessica Murphy (ICU section) and Joanna Chan for their contributions.[/size][/color][/font] [font="Times New Roman" color=#000000 size=3] [/font] [font="Times New Roman" color=#000000 size=3]Sincerely,[/font] [font="Times New Roman" color=#000000 size=3]Mary Yang [/font] [font="Times New Roman" color=#000000 size=3]Resident III[/font] [font="Times New Roman" color=#000000 size=3][/font] [font="Times New Roman" color=#000000 size=3][/font] [font="Times New Roman" color=#000000 size=3][/font] [font="Times New Roman"][color=#000000 size=4][b]Tips on surviving floor rotations[/b][/color][/font] [b][font="Times New Roman" color=#000000 size=4][/font][/b] [b][font="Times New Roman" color=#000000 size=4][/font][/b] [i][size=3][font="Times New Roman"][color=#000000]Tips on surviving floor rotations: [/size][/color][/font][/i] [font="Times New Roman"][color=#000000][size=3]1)[/size] [size=3]Be organized AND always write things down! You need to develop a good system to keep track of your patients’ information/daily labs/ ‘to do’ list. Some suggestions: [/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]a.[/size] [size=3]Copy your dictated H/P, fold it in half and write your daily vitals, labs, studies and ‘to do’ list on the back. You can also have a separate ‘to do’ list (examples on page[/size][/color][size=3][color=red] [/color][color=#000000]31.32).[/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]b.[/size] [size=3]There are pre-printed H/P and daily sheets you can use but many find them too time consuming. (http://www.medfools.com/downloads/medicine)[/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]c.[/size] [size=3]Copy every pt’s H&P, daily progress note and put it in a folder. Just don’t lose your folder. You may want to put your contact information so that they can page you if it is found.[/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]d.[/size] [size=3]Use your daily sign-out sheet and put whatever important information on the sign-out sheet during the day. [/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]2)[/size] [size=3]Pre-round: <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />6:30-9:00AM (You have to pick up your sign-out sheet by 7:00AM)[/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]a.[/size] [size=3]Get to work early and get your notes started or finished before rounds. It really helps to have your notes done before rounds so you can work on other things after rounds.[/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]b.[/size] [size=3]Many people pre-write or pre-type their progress notes. This makes a lot of sense particularly for chronic patients where the plan does not change very much. If you do this, leave some room under the active issues so that you can hand-write additional thoughts based on that morning’s labs. You don’t have to have the perfect plan or have all the labs in the morning. You can add addendum to your notes later if the plan changes during rounds. [/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]c.[/size] [size=3]Correct abnormal electrolytes early. At the beginning of the year you may feel a little uncomfortable so call your resident. Below are some recommendations. [/size][/color][/font] [color=#000000] [font="Times New Roman"][size=3]i.[/size] [/color][font="Times New Roman"][size=3]Potassium: Each 10 mEq is equivalent to 0.1 increase on the lab level.[/font][/size][/font] [font="Times New Roman"][color=#000000]1. Supplement all potassium below 3.8-4.0 unless pt has renal failure (3.0-3.4 may be acceptable, check with resident)[/color][/font] [font="Times New Roman"][color=#000000]2. KCl 10mEq IV (run over one hour) [/color][/font] [font="Times New Roman"][color=#000000]a. If pt has a central line you can run IV per protocol [/color][/font] [font="Times New Roman"][color=#000000]b. Can give 1ml of 1% lidocaine with each 10mEq bag if it’s painful: be careful with pts with cardiac conditions[/color][/font] [font="Times New Roman"][color=#000000]3. K-Dur 10mEq PO (tablet)[/color][/font] [font="Times New Roman"][color=#000000]4. K-Lyte 25mEq PO (liquid)[/color][/font] [font="Times New Roman"][color=#000000]a. Has a lot of bicarb so if pt is alkolotic give KCl[/color][/font] [font="Times New Roman"][color=#000000]5. K-Phos 2 tabs PO[/color][/font] [font="Times New Roman"][color=#000000]6. K-Phos 10mmol IV (run over one hour)[/color][/font] [font="Times New Roman"][color=#000000]7. Give 10mEq for every 0.1 below 4.0[/color][/font] [font="Times New Roman"][color=#000000]8. Watch potassium closely in pts on lasix.[/color][/font] [font="Times New Roman"][color=#000000]9. You can also add 20mEq KCl to each 1L bag of IV fluid [/color][/font] [font="Times New Roman"][color=#000000]10. Remember K+ will not correct unless you replace Mg[/color][/font] [font="Times New Roman"][color=#000000]11. Make sure to correct potassium cautiously in patients with renal disease, particularly those with end-stage renal disease.[/color][/font] [color=#000000] [font="Times New Roman"][size=3]ii.[/size] [/color][font="Times New Roman"][size=3]Magnesium[/font][/size][/font] [font="Times New Roman"][color=#000000]1. Supplement all Mg below 2.0 unless pt has renal failure (around 1.6 is fine, check with resident)[/color][/font] [font="Times New Roman"][color=#000000]2. For every 0.5 deficit, give 1 g of Mg[/color][/font] [font="Times New Roman"][color=#000000]3. Magnesium Sulfate 1 g IV (run over 1 hour) or 400mEq MgOxide po BID or TID[/color][/font] [color=#000000] [font="Times New Roman"][size=3]iii.[/size] [/color][font="Times New Roman"][size=3]Phosphorous[/font][/size][/font] [font="Times New Roman"][color=#000000]1. Consider supplement if less than 2.0[/color][/font] [font="Times New Roman"][color=#000000]2. Particularly important for patients in respiratory distress (ATP).[/color][/font] [font="Times New Roman"][color=#000000]3. K-Phos 2 tabs PO q daily [/color][/font] [font="Times New Roman"][color=#000000]4. Neutra-Phos 2 packs PO q daily [/color][/font] [font="Times New Roman"][color=#000000]a. only helps pts taking po[/color][/font] [font="Times New Roman"][color=#000000]b. give it with meals[/color][/font] [font="Times New Roman"][color=#000000]c. K-phos 10mmol IV[/color][/font] [font="Times New Roman"][color=#000000]5. Na-phos 10mmol IV[/color][/font] [color=#000000] [font="Times New Roman"]iv. [/color][font="Times New Roman">Calcium[/font] [font="Times New Roman"][color=#000000]1. check albumin to correct level [/color][/font] [font="Times New Roman"][color=#000000]2. calcium carbonate [/color][/font] [font="Times New Roman"][color=#000000]a. Tums: 500mg tab = 25 mEq cal[/color][/font] [font="Times New Roman"][color=#000000]b. Os-Cal: 650mg = 13 mEq cal[/color][/font] [font="Times New Roman"][color=#000000][size=3]3)[/size] [size=3]Progress Notes: (sample on page [/size][/color][size=3][color=red]31[/color][color=#000000])[/size][/color][/font] [font="Times New Roman"][color=#000000][size=3]a.[/size] [size=3]SOAP note[/size][/color][/font] [color=#000000] [font="Times New Roman"][size=3]i.[/size] [/color] http://www.residencyworld.com/thread/31 Sun, 10 Jun 2007 16:11:13 PDT http://www.residencyworld.com/topic/31/