实习医生的两大法宝

在医学论坛上看到讨论“临床见习和实习时看什么书”，看到推荐华盛顿手册，不由参加了一下讨论，给一点自己的心得，希望对今年开始的同学们有帮助。

如果是见习，华盛顿手册也许就够了。但是如果真正开始实习，我觉得这个还是不行。这本书只是给出疾病的大体诊断标准和治疗方向，覆盖面广但是细节是不够的，当然这是一个掌握平衡的问题，毕竟不是哈里森内科学。

大多数住院医生实习的医院，都有uptodate的，这个是一个非常非常有用的网站，总结最新的研究结果，从诊断，治疗，前景都有专门的分析，还附有详细的reference。如果对某个疾病有疑问，棘手的治疗，药物的效果总结，这个网站无疑是首选。

另外，口袋里放书，不如放PDA，epocrates软件我觉得我们中国住院医生每个人都应该注册一个，药物的计量（成人/儿童/肝肾调节用量），毒副作用，相互作用，市场价格，药理机制，都在里面了，而且每过一段时间就会更新。这个软件还有详细齐全的实验室检查结果分析资料，疾病症状和治疗，常用的计算公式，等等。在值班的晚上收病人，和护士在电话里给医嘱，真是救命的，呵呵。有时候开会无聊，也掏出来复习复习疾病名字，诊断。

有了这两个法宝，回家再看看哈里森，我觉得其他的书都没有什么必要，呵呵。

PS:
some prgrams including mine offer free PDA with epocrates installed already,so i didn't pay for it. make sure ask the program after match, so that you don't waste money.:)

if your program does not pay for it, i will stronly suggest get one anyway, most program refund the money because residents have education allowance every year.

http://www.epocrates.com/,

above is their website, they have free download so you can try it out.

they do have requirement for PDA, listed in the website, as well as different price range.

[sunydays]

It is better to have PDA cell phone, or Blackberry, not a sepearate PDA. Before entering the residency, I wodered if to buy a PDA, hestitated for a while. Finally decided to buy a PDA phone, I like the PDA phone lot. Double function in one item.

Although my program gives us a iPOD Touch, I barely use it. Too much to carry during on call. One cell phone, one PDA, one pager. too much.

[PsychyDoctor]

Good Point. Uptodate is pretty good. Actually, American Board of Family medicine https://www.theabfm.org/ is also a good site to check practice guideline. Even I am in the different specialty I still use Uptodate and abfm a lot as my references. Enjoy your residency! Also, both sites are good for step3 study reference.

[zhaoju2000]

收藏了！

[青海子]

休假近一个月,又要回国了.看了许多,觉得在病人角度,一个专科医生的是更具有意义的.不过,情况似乎也有例外,优秀的专科医生,好比一个优秀的战士,能起到的作用如放在战役的角度,却也有限.鲁迅先生弃医从文的,也是这种考虑.但如今就不必如此,能把先进的体制和概念引入国内,那简直是大功德了.

[落花飘零]

hehe, it's not your area, no wonder you are confused.:)

[selang2]

what are you talking about