Advice for Doctors : What, When, Why, Where, How to Read and Learn

Some one asked me this question Anonymously in 2017 August. I had replied to it in Facebook. Since the Second Part of the Reply is applicable for All Courses, I have decided to Post it here.

Doctors Medicos Learn Read
Doctors Medicos Learn Read

//Sr how do u relentlessly spread medical awareness instead of so many negative comments and setbacks.//

If there are no negative comments and setbacks, it means that the attack has not reached the target. Negative Comments and Setbacks less from 0 to 5 % prove that the attack is very successful

இவ்வே, பீலி யணிந்து மாலை சூட்டிக்
கண்டிர ணோன்காழ் திருத்திநெய் யணிந்து
கடியுடை வியனக ரவ்வே யவ்வே
பகைவர்க் குத்திக் கோடுநுதி சிதைந்து
கொற்றுறைக் குற்றில மாதோ வென்றும்
உண்டாயிற் பதங்கொடுத்
தில்லாயி னுடனுண்ணும்
இல்லோ ரொக்கற் றலைவன்
அண்ணலெங் கோமான் வைந்நுதி வேலே.(95)

இவ்வே – இவைதாம்;
பீலியணிந்து – பீலி யணியப்பட்டு;
மாலை சூட்டி – மாலை சூட்டப்பட்டு;
கண் திரள் நோன் காழ்
திருத்தி – உடலிடம் திரண்ட வலிய காம்பை அழகுபடச் செய்யப்பட்டு;
நெய் அணிந்து – நெய்யிடப்பட்டு;
கடி யுடைவியன் நகர – காவலையுடைய அகன்ற கோயிலிடத்தன;
அவ்வே – அவைதாம்;
பகைவர்க் குத்திக் கோடு நுதி சிதைந்து – பகைவரைக் குத்துதலாற் கங்கும் நுனியும் முரிந்து;
கொல் துறைக்குற்றில என்றும் – கொல்லனது பணிக்களரியாகிய குறிய கொட்டி லிடத்தனவாயின எந்நாளும்;
உண்டாயின் பதம் கொடுத்து – செல்வ முண்டாயின் உணவு கொடுத்து; இல்லாயின் உடன் உண்ணும் – இல்லையாயின் உள்ளதனைப் பலரோடுகூட உண்ணும்;
இல்லோர் ஒக்கல்தலைவன்
வறியோருடய சுற்றத்திற்குத் தலைவனாகிய;
அண்ணல் எம்கோமான் வ நுதி வேல் –
தலைமயையுடய எம் வேந்தனுடய கூரிய நுனியையுடைய வேல் எ-று.

That is
Your weapons are all decorated, Oiled and proper
His weapons are all broken due to use in warfare

-oOo-

Why Am I saying this is different ways ?
It is because, you being a doctor, will come across setbacks and negative comments.
Medicine is a natural science and hence 100 percent perfection is never possible.
There will be always a better way to do
So
Never Give Up, Never Get Dejected for Setbacks
They are bound to happen.

But
Make sure you document them, analyse them, find out YOUR fault, if any for the setback, correct it and make sure that you don’t repeat it
And
If you find that the setback is NOT DUE TO YOUR FAULT, please firmly inform those at fault

They may call you rude or arrogant for this, but nevertheless, call a spade a spade and point the finger where the actual blame lies

That is the only way you will improve and that is the only way society will improve

And Make sure that Setbacks are within acceptable numbers (5 % Alpha Error is usually safe limit. . . . You can aim for six sigma, but make sure that it is never less than alpha error)



-oOo-

//And ur 1 valuable advice to young budding doctors??//

There are lots of valuable advices for doctors
But Since You have asked me Only one, let me limit it to one
The One Advice is Learn.

Learn , Learn, Learn, Learn, Learn., Learn Learn., Learn

Learn for your theory Exams
Learn for your MCQ Exams / Entrance
Learn for your Clinical Exams / Orals
Learn for your Career
Learn for your Knowledge
Learn Government Rules and Regulations
Learn Economics
Learn Inter Personal Communications

-oOo-

Time has to be allotted for the first four Jobs DAILY
The other Four can be learnt in spare time

-oOo-

1 : Learn for your Theory Exam

This is the first and foremost work you need to do
And This is the most simple of the lot
1
Go to University Website, Locate the section where they have old question papers, download them,
2
Buy an A4 or Foolscap (Yes, this is the right spelling) 4 Quire Paper Note
and Start writing the answers
Write One Long Answer or 4 Short Answers each day
Do this *daily*
After you complete this, start revising them . . . .
Believe Me, this worked for me !

-oOo-

2 : Learn for your MCQs – Multiple Choice Questions / Objective Exams

Preparation for MCQs is different from Preparation for Theory
You need to allot one hour for this *daily*
Again
Start from Past Questions . . .
There are lots of Books out there

Learn at least 100 MCQs each day
Have a diary, (or Google Calendar) and note down what you learn. Revise it after one week and then again after one week
So
Each day, you will be learning 100 MCQs and revising 200

© www.chennaipaleodoctor.com
-oOo-

3 : Learn for your Clinical Exams – Long Case / Short Case / Spotter / Viva / Instruments / Specimens / Radiology

Preparation for Clinical Exams is different from
the above two
For this, you need to be sincere in attending the OP and Ward Classes
And
Prepare Case wise Note

For the Most Common Cases, Practice saying the History and Clinical Examination again and again so that it comes naturally and fluently

For Example consider the following two presentation
Scenario 1:
Candidate 1 : Examination of Right Fundus with Ophthalmoscope reveals and Papery White, Pale Disc with Clear Cut, Well defined Margin and the Physiological Cup is Seen Well. The Lamina Cribrosa is Prominent and the vessels around the disc are minimal and attenuated with Kestenbaum’s Sign. The Peripheral FUndus and Vessels else where are normal. These Findings are suggestive of Primary Optic Atrophy
Examiner : Proceed

Candidate  2 : Disc . . . . . Papery White, Pale

Margin . . . . . Clear Cut, Well defined
Lamina Cribrosa Prominent

Examiner : What about the Cup
Candidate 2 : It is seen well sir

Examiner : OK
Candidate 2 : The vessels are less

Examiner : What about Pulsation
Candidate 2 : . . . . . .

Examiner : What do you think it is
Candidate 2 : Primary Optic Atrophy Sir

Examiner : Did you examine the rest of Retina
Candidate 2 : Yes Sir, Peripheral Fundus is Normal

Which of these presentation, do you think will be less interrupted ?
Even though both candidates have told the same findings, the latter is likely to face more questions about Fundus
And
Remember, if you don’t know answers to those, you will be in trouble

So
To avoid this
Prepare, Practice, Prepare, Practice, Keep on Saying Repeatedly till it becomes natural . . . As natural as ordering நாலு புரோட்டா, ஒரு காடை, ஒரு கலக்கி

-oOo-
© www.doctorbruno.net



4 : Learn for Your Actual Clinical Practice / Your Career / Your Future

The above three are for Passing the Exam or Getting the seat.
Unfortunately, they will not be enough for your Practice, once you step out of the comforts of Medical College
The Medical Skill needed will be vastly different and it is imperative that you prepare yourself for that too in addition to the above three

Since this fourth learning is different for different specialties,
I am not going to deal this in detail, but let me give few simple examples

1
If some one is coming with Complaints of Dry Cough, Before Auscultating all over his lungs and heart and doing Sputum for AFB and CECT Chest, ask whether he is taking ACE Inhibitors . . . This knowledge needs to be nurtured based on sound theory and repeated interactions. Another Small Trick is to know the use of Lasix (Frusemide) in this case

2
Treatment for a disease varies as per the setup. You need to know the different treatment in each setup
Treatment for fever in a Medical College is Different from treating the same in a PHC. So Learn all the variations. Not just the one which is being followed in your college in your department.

For Each and Every Case you see during your Student Period,

  1. Learn what has to be done in that Unit,
  2. What has to be told in your exam and
  3. what you have to do when you are alone in a PHC or in your Own Clinic

Remember that
What you do in the Unit may not be the same what you are supposed to say in Exams
And
You may have to do a third plan (different from these two) when you are in a PHC all alone

So
For each and every disease, you need to learn at least three treatment plans
And
This is the fourth learning you have to do

© www.brainsurgeon.in
-oOo-

The above four are Mandatory and have to be done in each and every day of your student Life

After your student life is over, you can forget the first three learnings and concentrate on four to eight

-oOo-

5: Learn for Your Development

The Fifth Learning you need to do is to learn for your development . . . Both professional and personal development

There are lots of ways to do
But I prefer Books and Travel and Social Media (Some like movies, That too is an option) Update : These days I watch Many Serials in Netflix / Amazon Prime. Recent Favourite is Money Heist !

As far as Medical Books are Concerned
Irrespective of your Speciality, You need to have a firm grasp of Anatomy (My Favourite are Books by AS Moni Sir). Physiology (Ganong, Guyton, Chaudhuri), Biochemistry (Harper, Chaterjee and Lippincott ), Pharmacology (Chaudhuri, KD Tripathi) Pathology (Robbins, Harsh Mohan) , Medicine (Harrison லட்சியம் Davidson நிச்சயம்) and Surgery (Bailey and Love, Das)

If you are going to practice in India, Parasitology Protozoology & Helminthology | Book by K.D. Chatterjee is a must

Non Fiction Includes Atul Gawande’s CheckList Manifesto, and Siddhartha Mukherjee’s Emperor of Maladies
In Fiction, Read all the books of Michael Crichton – “A case of Need” in mandatory.

If you want to know why people behave like how they behave ( in other words, if you want to understand family and hospital politics) Try Harry Potter Series . . .

If you want to know why Politicians and Bureaucrats behave like how they behave, please read All the Books of Frederick Forysth. Mario Puzos Godfather gives more management lessons than most management books

And these books have to be read few times for you to understand the real grasp the world around you . . . believe me . . . once you read these and get the crux, you will be able to see everything with a different perspective and that will help in understanding things easily

These are more important than “that book” by Erich Segal

-oOo-
© www.doctorsandlaw.com

6. Learn Law

Learn Government Rules and Regulations
Learn what is Clinical Establishment Act
Learn about Consumer Protection Act
Go to the Consumer Forum Web site, read the last 100 judgement (at least) and see the world for yourselve
Learn what are the various regulations you have to be aware of based on your specialty (eg Transplant, USG etc)

-oOo-

7. Learn Economics

Money Saved is Money Earned

Learn Basics of Tax Rules
State Budge, Union Budget,
Know which way the wind is blowing



-oOo-

8. Learn Inter Personal Communications

The Most Important Skill which decides how successful you are in Practice

-oOo-

And then

9. Learn Every day, Learn from Every One

Not just books, Not just patients, Not Just teachers, Not just PGs, Not just students. In a Hospital, every one has something to teach. The Staff Nurse, The OT Assistant, The LGS, the X Ray Technician, the CT Scan Technician

I have learnt from every one

Many of the OT Staff would have assisted the same surgery with your professor as well as his professor. And their knowledge would be invaluable

Once I had completed the evacuation of Hematoma and waiting for the hemostasis. The OT Assistant, a senior man about to retire was standing behind me. The anaesthesiologist asked me when i will close and I replied. The OT Assistant told me “மூடுங்க சார், ஒன்னும் ஆகாது” (Close it Sir, Nothing will happen) in a casual manner
. I jokingly said “சரி, க்ளோசர் தான்” (OK Let us Close) He pointed to the base, Sylvian Fissure, Sinus and said “இங்கல்லாம் ப்ளட் வந்தாத்தான் சார் வெயிட் பண்ணனும் மீதி இடத்துலலாம் ஒன்னும் பண்ணாது” (Wait only if there is blood in these areas. You can close if there is ooze in other areas) and then told me a list of surgeons starting from Prof BRM to my Immediate Senior and said that these surgeons wont mind Surface ooze and that those patients had all been fine

It was 40 years of Experience in One Line
This is just one example

Same way, every one, has something to offer.
You should be like a sponge absorbing the *Correct*
knowledge

(I waited for fifteen minutes, and then closed. Later I got the point clarified from my teachers and it was right. Now I follow this)

//And sr u remember me of bruce wayne of dark knight!! Inspired sr !! Thank u 🙏🏻//

🙂 🙂