 Today's video is brought to you by Picmonic. After training to be a doctor for four years in medical school and three years of residency, there is still a lot of things that I don't know or don't know well. But today I want to walk you through all the ways I like to teach or reteach myself as a full-time physician. Hey friends, welcome back to the channel in case you're new here. My name is Lux. I'm an internal medicine physician. And here on this channel on the MD journey, we make videos and content to help people like you succeed on whatever journey you're on. And today's episode is really going to be about probably the biggest change I had to make from being a medical student to being a full-time doctor, which is how in the world do you actually have to learn these topics while you're really busy and there's still so much that you have to master or remaster. So in today's episode, I want to go over not just one, but all of the different techniques and approaches that I use as a full-time doctor to really both learn and relearn the technique. And so hopefully you can get some ideas on how you can use these techniques both as a student as well as when you're a future provider. Now again, you have to remember that there really is no right way because in medicine there's so much to learn, but also every different topic has a different way of how we learn the best. There are some topics, for example, that is super easy for me to just watch a video on and say, got it, like for example, if I have to do a procedure, going to a video on YouTube is really nice to see somebody do it and explain at the same time. But on the flip side, there are going to be topics that you and I may learn better by simply reading and looking at graphs and figures or doing a practice question on and saying, oh, that's why I missed it, that makes sense. And there are going to be some things that you just learn through plain old experience. And so to make sure that I hit on my goal of being the best provider I can possibly be, I want to make sure I'm combining as many of those different techniques into my doctor kind of learning. So let's get into it. Probably one of my favorite ways of learning medicine as well as just realizing like, yeah, you're really terrible at that luxury is simply making a very question-heavy approach to learning medicine. My time is already fairly limited as a full-time physician. Sometimes I don't have time to read an entire journal article or read a textbook, much less. But on the flip side, if I can find some time to do a really question-heavy approach, even if the day is busy and hectic, I always feel like I'm learning and making some progress. So just to share one of the many ways that I do a very question-heavy approach, similar to your world or studying for like the MCAT or step one, one of the resources that a lot of residents get things like mixed up, essentially, I have one for internal medicine, which is the entire kind of collection of questions that are fair for my internal medicine boards to have in just a few months. And so whenever I'm on a rotation, for example, as I'm GI before I was just on refrology, and so I will go and have these questions available to me whenever I have some downtime. So there's about 80 questions. You can see I did about half of them and it doesn't really matter what I get right or wrong or how well I do, but simply whenever I miss something, then not only do I learn something, it's like, oh, this is what you need to do. But I also have a system of how I collect that information. And so one of my favorite ways of storing all the things I get right and wrong, as well as other things I will talk about in this video is using Notion. Now, if you're not familiar with Notion, I'll make an entire new video on how to use it as a student step by step. So make sure if you haven't subscribed to the channel or the podcast, whichever you're listening to. But as you can see here, if I'm going ahead and doing questions, then every time I miss something or if I read something, the explanation was like, oh, you want to make sure you remember that for your upcoming board exams. I'll essentially put my epiphany or the takeaways from the explanation and then I'll mark or tag what that individual question was related to. So then in a few months, when I have to come back to studying for my board exams, saying, oh, well, actually you really sucked at renal stuff. Let's make sure that you master that first. I can just simply go into this table that I created in my medical topic section and go, oh, let's go ahead and just do just renal questions. I can add a filter and I can go by my tags and then I can go ahead and just do all the renal questions. And if I ever wanted to just do my endocrine questions, I could do that, which there's not too many rheumatology, et cetera. And just go down the list and the more and more questions I do, the more I can add them to my database. And again, nice thing about using this really question-heavy approach using Notion is that doesn't really matter where the question comes from. I can use Mixapp, I can use U-World, I can use an Anki card, or I can use questions for my attending or PowerPoints, but I can simply put it in here. And then when it's time to study for boards or try to be a better doctor and make sure I don't make the same mistakes again, I can quickly look over these based on the topics I want to. And I wanted to talk about this approach first because it's not really time-sensitive. If I have a lot of time, I can do more questions and if I have little time, I can try to do one question and just store my big takeaway and then move on and feel like I still have learned something for my future patients as well as my board exams. Now on a similar note of using a very question-heavy approach to learn medicine is really thinking about learning medicine as like a second brain. There's way too much information for you to actually be able to retain any of it and then remember it 24, 7, 365 days. So instead, what I like to think of is like if I learned something or missed something or I want to make sure I remember for later, I just need to have a way to store it. And that way, if I have to confront myself with that topic again, I can just find that information quicker and feel like I know it. So for instance, one of the rotations that I have to do as a resident internal medicine is a heart failure ICU. So in the future, if I ever have to go back to that rotation, I've stored a lot of information and topics that I've learned into this little section notion. So if I go to open, I can find really every topic that I've learned, whether it's on cardiogenic shock, if I learned it through AmBoss, if I learned it through something about LVADs, if I learned something about right heart failure, cardiac amyloid. If I ever have to go back to that rotation ever again or take care of a patient with this specific problem, then I'm not gonna go to a PowerPoint or slides or anything of that sort. I'm just gonna go back to my notes because these are the things that the luxe from six or seven months ago thought to be really important. And I'm gonna go ahead and store them because again, medicine is not so much about how much you can store in your brain but really know where to look for the answer and make it quicker each and every time. So just like heart failure, this entire medical topics and notion is filled with topics that I can easily go back to and some of them are really in depth like heart failure or some of them are really short and just to the point like hepatitis A or for example, if I have to take care of a patient with cystic fibrosis, I can go back and look at all those notes that I created. And later in this episode, I'll also talk about where I got this information from so you could try to use the same approach if you're interested in. Now like any brain, there are gonna be things that you store that you know but you also wanna store because you wanna remember to remember it later. So if there's something that I experienced that's like, ah, you're not really good at that. I wanna make sure that I spend some time in the future reminding myself of it. So if I wanna learn how to duplex or take care of TTP or sickle cell, I may add it to the list of things I wanna look up so I can make it into one of these longer pages and then whenever I have a second or if I need to take care of a patient then I can go back to those techniques. And again, I'll show you which methods and strategies I like to use to fill in these specific topics. And personally for me, it won't matter if I'm a doctor for three years or 10 or 30 years. If I have a resource like this, I can always come back and think about all my ideas. If I'm ever exposed to a topic that I've technically learned before like cystic fibrosis and I learned something that's even more valuable or a clinical pearl I can use in the future, then I'll go ahead and put it into my already created kind of database of that individual topic. Now so far we've talked about a really question-heavy approach as well as having a very second brain kind of mindset on how to learn medicine but both of those really require that I get exposed to something. Either a question and saying, oh, you don't know this or if I just have to remember to learn something then I can store it later. But a lot of times in medicine you're just kind of faced with a patient or a problem and saying, ha, I have no idea how to take care of that and those are instances where you have to look up things. So now I wanna share the four different approaches that I like to use whenever I'm faced with a topic that I have no idea about. Now the first one has to be using up-to-date. Now most of you guys are familiar with up-to-date. Essentially think of it as like the Wikipedia but for medical topics. You can essentially type in anything whether it's a medication or a specific topic. Now since I just finished nephrology we'll talk about RTA or renal tubular acidosis which is a topic that you'll learn and you'll forget and you'll learn and you'll forget. And so if I ever have to take care of a patient about this in the future I can learn about diagnosis and management and et cetera. And then I can click on any of these links and it'll send me to either somewhere else in the article or another article altogether. So if I wanna learn about urin ammonium excretion not sure who in the right mind so I actually wanna click on that, then here we go. Now before we get into the three other strategies that I like to use to learn things that I really had no idea about first we have to talk about today's sponsor which is Picmonic. Now in case you're not familiar with Picmonic it's great resource for really anyone on their medical journey to help you learn essentially anything because I have hundreds and hundreds of videos on any topic. So if you're on musculoskeletal or nephrology that would have been great for me on my recent rotation or if you're on pediatrics you can go and find the appropriate videos. That's also great for me as a physician because I can go to those videos on topics that I know I'll have to learn for an instance. In a few weeks I'll have to go back to the ICU and just put the setting of how the world is. COVID and Omicron and everything else are taking over and so to make sure that I know how to manage ARDS which is a complication from COVID I can go ahead and say, oh, do you have any videos? And absolutely they do. They have a video on the management and intervention of ARDS and I can watch this video which is a minute and 53. I can do the quizzes and the reviews and I also have linked below all the different related videos and topics that I could want to go to. So if you're interested in checking out Picmonic whether it be for school, for a board exam or is still to use it as a full-time physician and our friends at Picmonic have also graciously thrown an extra 20% for anyone who uses the link down below and uses the code AMDJourney at checkout. But thanks again for Picmonic for being today's sponsor. Now in addition to up-to-date sometimes I just need the answer really quickly but if I Google something I'm not really sure how good of a website it is to answer it for a practicing provider. So instead what I like to do is instead of Googling actual webpages I actually like to Google the images and this is a great way because usually the images will be PowerPoints and people who are trying to teach the topic so again if I'm trying to teach about renal tubular acidosis or learn about it and saying how do I actually treat it I can come up to these cool charts and saying oh here is my patient let's see what I need to order while I need to order a urine pH I need to see what their plasma potassium is maybe I need to look at their in-own gap and calculate it and be able to differentiate okay this is what my patient has and then if I find the image to be really useful I can find other related images that are very similar and if I find the table to be great then it's likely that the website that came with it is also gonna be great and super helpful. And so again being a great doctor sometimes is finding the right answers really quickly and so using Google images has been a really big hack and key that I've used especially as an upper level resident. Now sometimes I may need an answer that's a little bit more in-depth than Google images but sometimes up-to-date gets a little bit too crowded so one of my favorite third techniques I like to use is simply using a review article that I'd come back to later. So if I wanted to learn about renal tubular acidosis I can look up articles and usually I will try to bias myself to things that are a little bit more recent just in case there's new treatments or new managements that I have to know but here are two articles for example that are written in 2020 or 2022 and I can see okay is this something that is going to be good and I don't have to read it word for word I just simply have to one look for the main things that I want usually it's about how it works or how I diagnose somebody or how I evaluate them and obviously mainly how I treat them. And now if I don't have time to read it or if I want to reference it for later I can use this save to notion kind of extension that I have for Google Chrome and essentially add it to my medical topic section and then be able to sort it and create as individual folder for a topic like renal tubular acidosis. Now strategy number four to learn something and I'm a big visual and kind of like learn by doing kind of person has to be YouTube videos. So again, in a few weeks I'm going to go back into the ICU and so I may have to learn and remind myself how do you take care of ventilators that crams of something that I found early in residency that really made a lot of complicated topics a lot easier. And if you want to know all of my recommended YouTube channels that you should check out on your medical journey I'll link that video down below as well. Now in the last part of this episode I really want to talk about learning medicine just through accidental experiences. So for example sometimes you just can't learn something until you're saying oh this is something worth learning as simple as that sounds. So one of my favorite ways of liking to do this is making myself do actual cases from real life patients. And one of my favorite resources of doing this has to be New England Journal Medicine case studies. So this is something that comes out with each and every issue so you don't have to use any New England Journal if you're still school gives you access I highly recommend them because they gave me great kind of problems that I've never seen before and then in addition I'll be able to actually learn from individual providers. So Dr. Zauer for example is probably a neurologist or a radiologist who's commenting on different things. I'll be able to say this is what an expert in this field considers to be important. I should keep that in mind. And again if I don't have time to actually read this entire case usually what I'll use is my saved to notion database right here and saying oh I have this page and if I come back to my notion database I'll be able to go to medical topics and go into there and I'll be able to find all those relevant cases that I had. And then as soon as I'm done with the case and adding my notations and my thoughts I can just go ahead and move it into my completed sections that way this stays nice and clean. Now in addition to doing cases in a text form I also like to do them in an app form so one of my favorite resources that I recommended before is Human DX app and this is essentially an app where it's made with cases from real life physicians and real life patients. I can say oh let's go ahead and do this case about a 39 year old lady with a rapid onset of psieties and I'll essentially be able to see okay like what is she coming in with? This is actually a case I've already done but you can see the first thing they presented to me was the symptoms and I was able to look at okay what are our primary conditions or physical exam and each step along the way I was able to say okay these are the differentials that I think it is. Now I definitely didn't get this correctly but that's the beauty of it. I've never heard of make syndrome in before so I can go ahead and read about this person's thoughts and teaching points from this individual thing. If I wanted to I can go ahead and add it to my Notion database. And to wrap this episode off I want to quickly list a few ways of what I call subconscious learning. This is essentially being exposed to something and saying oh that's cool to know and probably wouldn't have thought about that but I'm glad somebody wrote or talked about it. One of my favorite ways of doing this on an online platform are finding some amazing blogs and websites that really are just honing on all these topics. So if you go to emcrit.org you'll be able to find stuff regardless of your emergency medicine or a Palm Crit and I can essentially look at all these topics that people found to be relevant like how to intubate somebody and all the things I need to know about cardiogenic shock after atrial flutter. One of my favorites has to be on this thing called Brash Syndrome which I actually saw when I was an intern and I read about it and I was like this is freaking cool. And now every time I see somebody that has hyperkalemia and bariocardia I automatically think of this article because it taught me about this without me ever being exposed to this in a book or anything of that sort. So if you're in an internal medicine definitely recommend checking out the emcrit.org website or finding that kind of website for whatever specialty you're in. Now other forms of subconscious learning that I really enjoy include things like podcasts where my favorites has to be the clinical problem solvers. Basically think of it the human DX app but in audio form so if you wanna do it while you're kind of driving to work which I do often it's a great way to do it as well as taking advantage of clinical cases that are presented to me during my training whether it be things like morning report this is essentially where I have a resident in my program who presents a patient that they've taken care of and gives me one bits of information and all of us have to give our thoughts of what we think could be it. And sometimes I think of a diagnosis and somebody else may not and they may actually present something that I may not have thought of and you learn from each other in a similar fashion every afternoon in residency I have a lecture presented by one of my attendings and any type of field and in addition to having the PowerPoint slides I also get to understand how they think about their clinical pearls whether it be on acid base, ventilation, ARDS so many more topics. And finally and probably most importantly the best way of learning is position simply by taking care of more and more patients simply looking at each patient opportunity of saying what type of things does this patient have that I'm not comfortable with I've never seen before I don't know how to take care of and then using the different resources that we talked about in this video to really say okay this is how I'm gonna fill in this gap so I can take care of this patient as well as any patient like them in the future. But those guys are all the different techniques and approaches that I like to use to make myself a better doctor by learning the medicine in a quick and sometimes in a slow fashion. Hopefully you guys enjoyed this episode in this kind of step-by-step format and covering all the different techniques. If you're watching this on YouTube go ahead and let me know in the comment section down below which technique or strategy do you see yourself using as a future provider be really interested and see your thoughts. But hopefully you guys enjoyed this video if you did my friends all I ask before you click off as you go ahead and hit that like or subscribe if you listen to the podcast consider hitting that subscribe follow and leaving an honest review on iTunes really appreciate all of your support if you're new here welcome if you haven't joined consider hitting that subscribe button hitting the notification bell but as always my friends thank you for being a part of my journey hopefully I was a little help to you guys on yours if you did enjoy this video check out this video on how to use onky like a pro step-by-step as well as if you're studying more step check out this video on how to study for step now that it's past fail you'll enjoy it and while you guys enjoy these videos I'll catch you guys in the next one take care my friends peace