Top 5 Apps for Internal Medicine Residents
Technology is nothing. What’s important is that you have a faith in people, that they’re basically good and smart, and if you give them tools, they’ll do wonderful things with them.
Steve Jobs
So, I am here to give you a list of tools that will equip you to provide the best care to your patients and you will learn a great deal while using these resources. These are the tools that attending physicians are using to carry out their daily patient care responsibilities. I am myself using these Apps since I started my journey as a resident and now as attending.
The list of top five Apps is by no means a complete list, but these are the tools that will make your day go a lot smoother and in return you will acquire knowledge from these resources over time.
Abraham Lincoln famously said, “If you give me six hours to chop down a tree, I will spend four hours to sharpen my axe.”
This is how important it is to have a right set of tools to get the job done right. I have created this list for internal medicine residents in USA.
1. UpToDate
Uptodate is a massive resource of medical knowledge. You can obtain in depth knowledge on numerous topics from uptodate. Most of the residency programs provide this subscription for free. Also, it is available in EPIC (electronic medical record). It is primarily a resource for Internal Medicine and its specialties. Here is introduction about Uptodate on it’s About page,
UpToDate is the most trusted evidence-based clinical decision support resource at the point of care
More than 100 studies concur: patients receive better care when clinicians use UpToDate. Healthcare professionals around the world turn to UpToDate to answer even the most complex questions.
2. Epocrates
We are in an era where we rely on smartphones for phone numbers instead of memorizing or keeping a physical list. Same way, in medicine we’re no longer memorizing the medication dosage. I am sure many of newer generation physicians have not seen a physical copy of Pharmacopia (encyclopedia for drugs). Nonetheless, ordering appropriate medication and the knowledge of dosage, route of administration, adverse effects, drug interactions, safety during pregnancy etc. is absolutely necessary in order to practice safe medicine. Epocrates provides all these information in a very simple format.
In addition, it gives insurance coverage and pricing. That is important in outpatient practice to ensure which medication is on formulary list for your patient’s insurance. If it is not on the list that would mean your patient will have to pay out of pocket and that can be a big hurdle in ensuring compliance to medication.
In addition, Epocrates also has calculator for things like osm gap, A-a gradient, corrected Na etc.
A new feature is Bug + Drugs that gives empiric antibiotics based on the Zip code of the patient.
Another notable Apps available for medication information is Drug.com.
Image from Epocrates
3. Notes
You need some app to take notes of important stuff on your smartphone. Any note taking app will do the job. I personally use Apple Notes because of its simplicity and availability across Apple devices.
If you’re using iPad, Goodnotes or Notability are also great. And by the way if you’re planning to write with Apple Pencil, using Paperlike is highly recommended. I use it and it really gives a paper like feel. One drawback is that the screen feels like paper while reading as well. If that doesn’t bother you, then get Paperlike and enjoy the scribble.
AnkiApp is very effective for spaced learning. It is like making cards while reading a topic and reviewing them at intervals. This process reinforces the synapses thus solidifying the knowledge.
4. MDCalc
This App comes in handy when you have to make decisions on the go. You don’t need to memorize long equations for calculating A-a gradient or FeNa unless you’re a Nephrology fellow. Scoring systems that we use on daily basis like MELD criteria, RCRI score for preoperative risk calculation are also available. Over time you will be able to memorize these scores but, in the beginning, you need a tool to aid in this process.
Disclaimer: If you do not want a separate App for calculations, Epocrates can do the job.
5. MKSAP
MKSAP from APC is available in App form for your mobile devices. It is a set of books for Internal Medicine and specialties. It has separate sections on General medicine, Cardiology, Nephrology, Rheumatology etc. You can access it on desktop and can order printed books. It is an essential resource in general for improving your knowledge and especially for ABIM preparation. It provides the most up to date guidelines. Virtual Dx is a very good tool to utilize on smartphone. Also, you can do Multiple-choice questions.
There are many other Apps available to supplement your knowledge and to reduce friction from learning process and getting your job done. I haven’t added EPIC is top 5 list as not all the hospital systems are using EPIC as EMR but it is still the EMR system that most of the hospitals use, 36% to be precise.
With App on your mobile device, you can reach patient chart at any time. You can also set up notification for when new test result or note is available. You can even use it during rounds while discussing cases. Most of the hospitals have IT staff who are responsible for downloading EPIC on your mobile devices.
I keep App for NEJM to read weekly issue of the journal. It is very convenient.
American College of Cardiology has a Guideline App. It has latest guidelines for cardiac conditions like ischemic heart disease, heart failure, valvular disease, vascular medicine, Electrophysiology etc.
Other society and journal Apps are also available. These can be very helpful while rotating through a specialty service.
And it is a good idea to ask your colleagues, senior residents and attendings what Apps or resources they’re using.
Using these resources overtime, you should be able to memorize the essential knowledge. Afterall, you need your knowledge to be memorized and readily available to solve a problem at hand to become an expert.