Wards Survival Series: Developing your Assessment & Differential Diagnosis

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wards4thEditionBy Walter Wiggins

One of the major skills you’ll be expected to develop over the course of your 3rd year of medical school is the ability to formulate an assessment and differential diagnosis (DDx).

During the first couple of months, no one will expect much from your assessment and DDx. If you miss the actual diagnosis or include some obscure things on your DDx that aren’t really plausible or likely for the diagnosis, don’t worry…you’ll get better with practice. Just focus on basic techniques for developing an initial DDx, then prioritize your prime suspects by what is most likely given the patient’s demographics, history, and presentation.

Remember: atypical presentations of common things are way more common than typical (or atypical) presentations of uncommon things.

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Mnemonic Monday: Watch it Grow! Cancer Metastisis

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By Molly Lewis

Cancer- the big “C” word that no patient wants to hear. What could be worse? The big M word: Metastasis! Cancer can start in the kidneys and spread to the bone, start in the colon and spread to the brain, start in the pancreas and spread to the liver, etc, etc, etc.

When you find metastatic lesions in a patient’s bone, brain, or liver, where should you look first to find the primary tumor? Here are a few mnemonics to help you remember what are the most common sources based on the site of the mets…

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Surviving Your Surgery Rotation

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wards4thEditionBy Molly Lewis

Sean gave some great tips in his previous post, A Chance to Cut is a Chance to Cure – Surviving Your Surgery Rotation. Follow his advice, and you will be well on your way to success on your surgery rotation. I’ve got some tips and tricks to add to help you survive your surgery rotation.

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Wards Survival Series: A Chance to Cut is a Chance to Cure – Surviving Your Surgery Rotation

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wards4thEditionBy Sean Martin

Surgery rotations can be intimidating. In my experience (six months), the myth of surgery has grown from a decades-long game of “whisper down the alley” into something that scares many students and discourages them from going into the specialty. Legends of surgeons throwing instruments, residents trying to make students cry, scrub nurses screaming, and weeks without sleep have grown to rival the legend of Paul Bunion. Most of the stories are not true, except the sleep thing…that one is all too real.

My goal in this post is to review a few quick tips to help you look like a rock star on your surgery rotation.

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Audition Rotation: What are they? How do I do well?

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By Sean Martin

One of the biggest differences between applying for osteopathic residencies compared to allopathic residencies is doing an audition rotation. I was recently on a rotation where the program director told me they had not ranked anyone who hadn’t rotated with them in ten years. Audition rotations allow a program to see if you fit into their system. They also allow you the chance to prove you know your stuff. But they can also sink you in a matter of hours. In the osteopathic world, audition rotations are a must, and the first half of your fourth year is going to be filled with high stress rotations.

This post is dedicated to how to schedule your rotations and how to succeed at them.

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Wards Survival Series: Just Go for It!

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By Walter Wiggins

wards4thEditionIn Luke’s recent post, he gave a personal account of one of the more difficult situations you will overcome as a 3rd year medical student in your first few months on the wards – the presentation. In many, if not most, med schools in the US, you’ve likely had some sort of clinical experience during your first two years. At my institution, we had a series of three courses: Doctor-Patient Relationship (DPR) and Physical Examination during 1st year and Bedside Teaching (BST) during 2nd year. These courses taught us the basics of interacting with patients and taking a history (DPR), conducting a comprehensive physical exam, and putting those two things together and formulating a problem list and differential diagnosis (BST). We also had 1-to-2-week “community practice experiences,” during which we worked with a primary care physician out in the community to put these skills into practice.

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Wards Survival Series: The Avoidable Cycle of Self-Doubt

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By Luke Murray

The Avoidable Cycle of Self-Doubt 1“So, Luke, what do you think could be causing her back pain?” the attending asked as I finished stumbling through an HPI presentation of the patient I just saw.

I was frozen. It was the beginning of my third year of medical school, and after being at the bottom of my class since the first anatomy test, I felt certain that this, like most other situations evidenced by the grades I’d gotten in the last 2 years, was not going to end well for me.

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