I have mentioned before that PA school is difficult (I may have actually compared it to the apocalypse once or twice). Of course you will survive it. You are just going to have to trust me on that.
But wouldn’t it be nice to have a set of tools to help you along the way? No, not a barbwire-wrapped baseball bat (although honestly that might help too). I’m talking about software and websites that can serve as seriously useful study-aids.
Here is a list of all of the technology that my classmates and I use, along with a few notes about the advantages/disadvantages of each. Browse through them and see if there is something that you could use. I will probably update this list as the year continues.
Anki – I am putting this program first because it pretty much saved my ass second semester. Anki is a flashcard program that you can download for free (just Google search Anki). The advantages of this program are that it has a built in algorithm that forces repetition as you move through the flashcard deck. Rather than have you see the card once and then click to go to the next one, Anki makes you rate the card you just saw as either “Again”, “Good”, or “Easy”. If you rate the card anything but “Easy” it will shuffle the card a few spaces ahead in the deck and force you to repeat it until you get it right. Another advantage is that you can export your decks and share them with your classmates. The major disadvantage is that the program looks like it was built in the 70’s. The interface is extremely basic and you will struggle a little with the preferences to figure out how to get it to work like you want. But again, I put this program first in the list because, once you learn to use it, it is invaluable! I went from making C’s on tests to making A’s. Seriously.
Quizlet – While we are on the subject of flashcards, Quizlet is a great program. Also available online for free. The best part about this program is its simple, user-friendly interface. It saves all of your decks online so that you can access them from any computer, and you can easily share them with your classmates by simply posting a link or giving them your username. The only downside to Quizlet is that there is no built-in algorithm to force repetition. When I use this program, I tend to move through slide decks more quickly but I feel like the information is less ingrained by the time I finish studying. That being said, I am using Quizlet more than I am using Anki this term because the interface is so much better.
Google Drive – This one is pretty obvious. But if you have not used it before, Google gives you 15 GB of free space with every email account you own. And the best part is that you can easily share documents/files/programs with any other GMail account holder. My class has a folder shared between all of us where we exchange notes, Anki decks, PowerPoints, etc. We even have a document full of class quotes for fun. This program is also great for doing group projects (just share a document and all five of your group members can type/edit it at once).
Dragon Naturally Speaking – I’m sure you have heard of this one before. It is a dictation software that allows you to speak to your computer while it types (pretty accurately) what you are saying. Great for making flash cards. A friend of mine uses it to pump out Anki decks for every single test we have. He also claims to be able to write a 12 page essay in about an hour. I am not that gung-ho about it. I bought the program too, but stopped using it at some point during second semester. To each his own, though. You may find this useful like my classmate. And if you are worried that it won’t recognize medical terms, don’t fear. The program has a scan feature that allows it to learn new words from documents you select. You can download a medical dictionary and it will learn every word in about 10 minutes. Or just quickly scan the PowerPoints from your classes before you dictate flashcards. It is easy.
Epocrates – Though I have a category for Apps below, I wanted to mention Epocrates separately since it is such a useful tool (our program director uses it daily in her practice). Epocrates is a reference database for information on drugs. You can use it to quickly look up dosages, side effects, contraindications, adverse reactions, monitoring, retail prices, etc. It is a handy tool when patients have questions about their medications. And it might make you look like a hero if you are in the room with your attending and can look this information up for her on the spot. The only downside is that while there is a free version of this app with information about the more generic drugs, it does cost $174.99/yr for the full version! Still download it though, the free version is extremely useful and you will want to spend the money on the full version when you are out practicing. The full version includes disease information and practice guidelines.
Other Apps – Your program may recommend that you purchase a tablet for your clinical rotation year. I personally have found it useful in my didactic year as well. There are a great many apps in addition to Epocrates (mentioned above) that can come in handy during rotations. For instance, there is an app that gives you the normal lab values for every type of study you might order (Quick LabRef). Another called Cheif Complaint (by Escavo) provides you with algorithms to diagnose/treat just about any chief complaint (it tells you what to consider in your differential diagnosis, what labs to order, recommended treatments, etc.). Another app provides you with images and information on any eye complaint (Eye Manual). There are also apps for research databases such as UpToDate, DynaMed, and PubMed. Also try searching for agileMD, Sepsis (by escavo), ACP Clinical Practice Guidelines, ACEP Toxicology, Touch Surgery, CDC Vaccine Schedule, etc.
AHRQ – The Agency for Healthcare Research and Quality has a website that allows you to enter just a few facts about a patient and see all of the USPSTF screening recommendations for that patient. I will post the link here: AHRQ. This was recommended by a second year student and will likely be more helpful in your clinical year. Apparently there is an app that you can download from this agency with similar features.
Dr. Najeeb Lectures – I have never actually watched a Dr. Najeeb lecture, but one of my best friends is an Emergency Medicine doctor, and he swears by them. You have to purchase a subscription to the site for $59. I never did. But my friend made this his number one suggestion for me when I started PA school, so it may be something you want to consider. Just search Google for his site.
Research Databases – Every school has different research databases that they subscribe to, so the options available to you may be different from the ones mentioned in this post (most are probably the same, though). We took a class in our program that taught us about the resources available and how to use them in a clinical setting. They are great when a patient has a question and you want to quickly search the latest recommendation or study for an answer. They may also help you understand the material you are studying during didactic year. While it is beyond the scope of this blog post to go into detail about every resource available, I will give you a brief rundown of my top two and list some the others for your consideration.
My favorite resource is DynaMed because it is easy to navigate and uses the latest research to publish clinical recommendations. Every recommendation on DynaMed is linked to the research study that the recommendation is based on, in case you want to dig deeper. It is great though because it is easy to read, trustworthy, and to-the-point in guiding patient care. TRIP Database is my favorite resource to use when I have a specific research question. It searches all of the published guidelines, systematic reviews, research trials, and articles related to your search query. I prefer this over other research databases because it gives you information about the “level of evidence” presented in the study with a graphic next to the article and also categorizes your search results by type and quality in the side bar. This allows you to select to select ONLY systematic reviews or ONLY US guidelines. The resource tabs at the top show you results in other databases such as PubMed or DynaMed. And there is a tab for patient information where you can print out informational leaflets for your patients. I use TRIP over other research databases because it is so easy to navigate. DynaMed and TRIP are my go-to resources so far in my didactic year; that may change when I am on rotations. Some other resources for your consideration are ClinicalKey, PubMed, Lexicomp, the USPSTF website, the Cochrane Library, JAMA evidence, and MicroMedex.
YouTube – This one is a no-brainer. Everyone knows that in this day and age you can learn just about anything on YouTube. There have been many times that I didn’t quite understand a lecture and I would come home and search YouTube for a video by some world-famous professor on the topic. Try checking out the USMLE Step 1 videos. They have creative suggestions to help you memorize facts about drugs/disease processes.
Exam Master – Not every program does this, but our program pays for us to have access to Exam Master, a bank full of questions to help us prepare for our exams. I honestly have not used it much, but some of my classmates find it helpful. See if your program has something similar.
Primal Pictures (Anatomy TV) – Again, your school may or may not give you access to this exact application, but most schools have something similar. Anatomy TV is essentially a 3-D mock up of the human body. You can use your mouse pointer to move the body around and select to remove layers such as skin or connective tissues just as if you were doing a dissection in lab. You can also click on structures to read relevant information about them. And there is a collection of actual cadaver images to view. If your program doesn’t provide this, there is a similar program you can buy online called 3D4 Medical’s Essential Anatomy.
Kurig – Seriously, you will drink a lot of coffee. And if you are not a coffee drinker, you should start.