Welcome We will begin the session shortly For

Welcome! We will begin the session shortly. For audio, please call: 1 -855 -747 -8824 Code: 446423# OR you can listen through your computer. While you wait, what worries you most about the family/internal medicine clerkship? Let us know in the chat box (please reply all)

Getting Started – Welcome! § If calling into the conference line, please make sure to turn down the audio broadcast volume to the lowest setting or adjust your computer volume. § If you wish to sit back and listen to the webinar through the computer, you can do so. You will just be able to hear, not speak through the computer. § Audio Line 1 -855 -747 -8824 Code: 446423# § Your phone line will be muted. If you wish to ask a question or make a comment, you will need to type into the chat or Q&A. § You can ask questions by typing in the Chat or Q&A box located on the right side of the webinar room. § If the screen is being shared by the presenter, you will find the chat tools at the top tool bar. Just move your cursor to the top of the screen and the toolbar will appear. 2

How to Thrive Webinar Series Family/Internal Medicine Dr. Mark Duncan, author of Shelf -Life Medicine “How to Thrive” Webinar Series

WELCOME AND INTRODUCTION www. amsa. org “How to Thrive” Webinar Series

What year in medical school are you? A) B) C) D) E) MS 1 MS 2 MS 3 MS 4 Pre-med www. amsa. org “How to Thrive” Webinar Series

BEFORE WE GET STARTED • Qualifiers • Wellbeing during the rotation and avoiding burnout • Doing well in each clerkship depends on your interaction with the patient, the team, and scoring well on the shelf exam www. amsa. org “How to Thrive” Webinar Series

OUTLINE • • • Background Part 1 – The Patient Part 2 – The Team Part 3 – The Shelf Exam Q&A www. amsa. org “How to Thrive” Webinar Series

PREPARATION • Know your team, where to meet the first day, etc. • Know what resources you will use to study for the shelf exam in advance • Have all your equipment ready to go – Maxwell, penlight, stethoscope, scutsheets, reference material, study materials • Scutsheets (http: //www. medfools. com/downloads. php) “How to Thrive” Webinar Series www. amsa. org

www. amsa. org “How to Thrive” Webinar Series

INPATIENT MEDICINE • Very different than ambulatory medicine and family medicine • Structure: – Non-call days: pre-round, run the list with the intern/resident, rounds, help with the workload (calling consults, procedures, outside records, etc. ) + educational activities – Call days: same structure as above while admitting new patients throughout the day (may formally present the patient that day or the next day) • THOROUGHNESS is key “How to Thrive” Webinar Series www. amsa. org

AMBULATORY AND FAMILY MEDICINE • Ambulatory medicine and family medicine are similar • Structure: short patient visits, on-thespot assessment and plan, may work directly with the attending • EFFICIENCY is key www. amsa. org “How to Thrive” Webinar Series

PART 1 THE PATIENT www. amsa. org “How to Thrive” Webinar Series

GENERAL PRINCIPLES • The patient ALWAYS comes first • It may not feel like it, but you have much more time than your residents, so read about your patients and know each of them well www. amsa. org “How to Thrive” Webinar Series

PATIENT CARE • Good rapport goes a long way • Take full responsibility for your patients, but still rely on the rest of the team • A good history and physical exam, documented in a well-written note and presented during rounds, is FOUNDATIONAL – Medical students are expected to be good information-gatherers www. amsa. org “How to Thrive” Webinar Series

PROBLEM LISTING • Inpatient: – First problem: chief complaint, or most serious problem – Any other patient complaints, abnormal physical exam findings, abnormal labs/studies – Chronic problems – Finish with FEN/GI/PPx, code, disposition • Outpatient: – Finish with health care maintenance www. amsa. org “How to Thrive” Webinar Series

REFERENCES • • Medicine handbook Up. To. Date Pub. Med Read case reports www. amsa. org “How to Thrive” Webinar Series

www. amsa. org “How to Thrive” Webinar Series

PART 2 THE TEAM www. amsa. org “How to Thrive” Webinar Series

“Show me a [med student] who only triples my work and I will kiss his feet. ” - Law #11, House of God www. amsa. org “How to Thrive” Webinar Series

GENERAL PRINCIPLES • Team structure, inpatient vs. outpatient • How to impress your attending – Good patient presentations and notes – Teaching – Staying engaged during rounds – Being a team player and NEVER throwing your coworkers under the bus • Ask for feedback, letters of recommendation “How to Thrive” Webinar Series www. amsa. org

PRESENTING YOUR PATIENTS • Inpatient vs. outpatient presentations • There is no perfect presentation, each attending is different and has different expectations! • A concise presentation is the hallmark of clinical maturity, but you have to first earn the trust of your team – Include only the pertinent items – Exclude extraneous information • HOWEVER, you must first earn the trust of your team before making your presentations concise “How to Thrive” Webinar Series www. amsa. org

PRESENTING YOUR PATIENTS • Assessment/Plan section is where you display your reasoning, and is how attendings will judge you • A good A/P sets you apart from many students that act only as information gatherers • Oral presentation guidelines, Steve Mc. Gee (https: //catalyst. uw. edu/workspace/medsp/3 0311/202905) www. amsa. org “How to Thrive” Webinar Series

TEACHING • Provide teaching to the team: – Short summary of a topic – Presenting a paper • When and how this is done is team and workload dependent www. amsa. org “How to Thrive” Webinar Series

PART 3 THE SHELF EXAM www. amsa. org “How to Thrive” Webinar Series

OVERVIEW OF THE EXAMS • Inpatient Medicine: 110 questions, 2: 45 • Ambulatory Medicine: 100 questions, 2: 30 • Family Medicine: 80 -100 questions, 2 -2: 30 www. amsa. org “How to Thrive” Webinar Series

How do you feel about the Shelf exam ? A) B) C) D) Prepared Alright Nervous Freaking out www. amsa. org “How to Thrive” Webinar Series

GENERAL ADVICE • Studying begins on day 1 (kind of) • Read to learn, not just to finish the material • Pick the resources that fit your learning style the best • Flashcards for important topics/questions www. amsa. org “How to Thrive” Webinar Series

QUESTION TYPES Ü Pathophysiology (AKA Step 1 type questions; eg, patient presents with hemoptysis and hematuria – mechanism by which this condition causes renal damage is most similar to which other disease process? – bee sting, Graves disease, SLE, poison ivy) Ü Diagnosis (eg, HIV patient coming in with fever, cough, and shortness of breath – what is the most likely diagnosis? ) Ü Next step (eg, Alcoholic patient presents to ED with confusion, ophthalmoplegia, and ataxia – next step in management? ) Ü “Health and health maintenance” (Other category with random questions about disease screening, prognosis, ethics, etc. ; eg, Older male patient presents with UTI, found to have urinary retention relieved with catheterization, prostate exam revealed a diffusely enlarged prostate – he asks you about his chance of having prostate cancer – or he asks you about screening with PSA “How to Thrive” Webinar Series www. amsa. org

RESOURCES www. amsa. org “How to Thrive” Webinar Series

Which of these resources would you consider using? (Check all that apply) q Step-Up to Medicine q Case Files Internal Medicine q Blueprints Medicine q Pre. Test Medicine q USMLE World www. amsa. org “How to Thrive” Webinar Series

RESOURCES • Text: Step-Up To Medicine, Case Files, (Master the Wards, Blueprints) • Questions: USMLE World, MKSAP, (NBME Practice Exam, Pretest) • Coming soon: Shelf Life Medicine www. amsa. org “How to Thrive” Webinar Series

Q&A ? ? ? www. amsa. org “How to Thrive” Webinar Series

Thank you for joining us! Make your calendars for the next Thrive webinar on Physiology with Dr. Linda Costanzo, author of BRS Physiology, Tuesday January 20 th at 8 pm (ET) www. amsa. org “How to Thrive” Webinar Series