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

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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. Getting Started Welcome! 2

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

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

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www.amsa.org How to Thrive Webinar Series What year in medical school are you? A)MS1 B)MS2 C)MS3 D)MS4 E)Pre-med

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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

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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

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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, pen, penlight, stethoscope, scutsheets, reference material, study materials Scutsheets (http://www.medfools.com/downloads.php)

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www.amsa.org How to Thrive Webinar Series

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www.amsa.org How to Thrive Webinar Series

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www.amsa.org How to Thrive Webinar Series

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www.amsa.org How to Thrive Webinar Series 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 INPATIENT MEDICINE

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

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

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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

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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

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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

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www.amsa.org How to Thrive Webinar Series REFERENCES Medicine handbook UpToDate PubMed Read case reports

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www.amsa.org How to Thrive Webinar Series

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

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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

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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

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www.amsa.org How to Thrive Webinar Series 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

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www.amsa.org How to Thrive Webinar Series 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 McGee (https://catalyst.uw.edu/workspace/medsp/3 0311/202905)

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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

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

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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

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

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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

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www.amsa.org How to Thrive Webinar Series QUESTION TYPES 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) Diagnosis (eg, HIV patient coming in with fever, cough, and shortness of breath what is the most likely diagnosis?) Next step (eg, Alcoholic patient presents to ED with confusion, ophthalmoplegia, and ataxia next step in management?) 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

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www.amsa.org How to Thrive Webinar Series RESOURCES

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

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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

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

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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)