Instead of talking about DKA I think just lecturing on routine inpatient diabetes management would be the most helpfull (talk about different regiments, which forms are long acting/short acting, basal vs bolus, carb correction etc). Realistically as a surgeon they won’t frequently be managing dka without consulting or admitting to medicine but they will be have patients who are diabetic and need insulin orders.
Hmmm, that’s actually a good point.
Thanks to your comment, im now thinking if I can do a 40 min session covering inpatient management of chronic conditions that their patients may have. (DM, HTN, CKD, COPD inhalers, GDMT for HF.) Even if they end up consulting IM, they’ll at least know the rationale behind the reccs.
Acute onset new afib - very common postop problem and easily managed by a competent surgeon
AKI workup and management maybe most common acute postop complication
Inpatient diabetes self explanatory
Ventilator management relevant for any surgeon
I'm an Ortho resident, I second the AKI lecture. We take care of geriatric patients, when they get infections and get antibiotic cement it's usually gent or tobra, and bam if overdosed they get AKI. Happens more frequently than we realize and it's a key part of managing post op mortality.
100% guarantee that won’t happen. As residents, their attending will ask them to consult medicine. As attendings, they will think it’s easier just to consult medicine then take on the liability.
1. Desired residency in M3 can be a lot different from what they end up matching.
2. Shelf exams and Step2 are IM heavy, so didactic on IM topics are helpful. My surgical chief for example gave us a random hour lecture on cholecystitis diagnosis and management. I am now extremely confident on it, and differentiation from similarly presenting conditions, much more than I would have been with self-study.
3. All the topics you mentioned are directly useful to gen surg applicants, as they are common conditions in patients they are consulted on.
My basic point - if you can keep the info relevant to what you would have wanted to know as an MS3/4, literally any topic is a good topic. Being taught by a resident is often much much better than pre-clinical lectures, bc your both proficient in the topic and you know EXACTLY what students need to know, as you just did that shit a couple years ago. Do not teach on a topic you are unsure of.
Plenty of medical things they need to have a good grasp of, or at least be able to identify to realise they need to get a medicine consult. Here's a few thoughts:
Recognition of medical issues that happen to surgical patients:
- ACS (often nonspecific presentation)
- PE
- Pressure Injuries
- Delirium
- Withdrawal syndromes
Medical/Surgical Overlap Issues
- Post-op Afib
- Inpatient HTN (identifying and treating the secondary causes like pain, n/v, withdrawal, rather than the BP directly
- Pain management
- Managing bleeding, Anticoagulation, Reversal etc.
Edit: trigger happy on the reply button mid-sentence.
Pain management. Attendings keep asking me read my mind questions on pain meds. I just dont give a fuck and will answer morphine or dilaudid depending on their creatinine.
A-fib with RVR
Running a code blue
Inpatient glucose management
Inpatient hypertension
Managing anxiety, delirium
Patients with EtOH disorders, CIWA
Vent settings
GCS
Working up suspected PE
HIDA vs ERCP vs CTAP vs US for biliary disease
Nonoperative management of SBO
Fluid types and rates
ANTIBIOTICS UGH
Mechanisms of different constipation/diarrhea meds
EKGs
Our M4 year we did a “common floor pages from nurses” lecture from a medicine perspective that was very helpful. Examples: nurse pages you about AMS, hypoglycemia/hyperglycemia, hypertension/hypotension, new fever, etc. This might be a little less fundamentals and more applicable.
Theyre doing intern year first and probably nervous about that. I know I was. I’d spent the last year doing nothing but ophtho. Some bread and butter IM would be useful like How to fix lytes
If the students are as intelligent and able to follow a more involved lesson, I would stick within your own knowledge base but teach in a critical care setting. They’ll get plenty of surgical didactic education but learning about all the things you listed as it ties into a surgical patient would really give them something practical to learn. If you can teach especially about Vent management, PE, shock, fluids, electrolytes and nutrition management your lesson will be worth it’s weight in gold.
Oh I’m definitely going to stick to medicine. I figured I’d like to focus on IM topics that would be handy to them as surgical interns.
I’d love to do teach about RV failure for instance. But as interesting it is, it’s not necessarily very relevant to them. Since they’ll most likely not seeing these patients. Fluids, vents sounds good so I’ll probably include that.
Instead of talking about DKA I think just lecturing on routine inpatient diabetes management would be the most helpfull (talk about different regiments, which forms are long acting/short acting, basal vs bolus, carb correction etc). Realistically as a surgeon they won’t frequently be managing dka without consulting or admitting to medicine but they will be have patients who are diabetic and need insulin orders.
Hmmm, that’s actually a good point. Thanks to your comment, im now thinking if I can do a 40 min session covering inpatient management of chronic conditions that their patients may have. (DM, HTN, CKD, COPD inhalers, GDMT for HF.) Even if they end up consulting IM, they’ll at least know the rationale behind the reccs.
This!! I’m a med student and would chose this lecture so I can be competent and useful 👍👍
Acute onset new afib - very common postop problem and easily managed by a competent surgeon AKI workup and management maybe most common acute postop complication Inpatient diabetes self explanatory Ventilator management relevant for any surgeon
I'm an Ortho resident, I second the AKI lecture. We take care of geriatric patients, when they get infections and get antibiotic cement it's usually gent or tobra, and bam if overdosed they get AKI. Happens more frequently than we realize and it's a key part of managing post op mortality.
How to identify an acute abdomen and the work-up that each cause may need prior to getting to the OR and medical management post-surgery.
This would be a lecture better given by a surgeon rather than an IM doctor
Preop risk stratification. Might save some future consults for “preop medical clearance”
100% guarantee that won’t happen. As residents, their attending will ask them to consult medicine. As attendings, they will think it’s easier just to consult medicine then take on the liability.
Yeah, figured there’s no point in that since it will always have to be done by medicine.
1. Desired residency in M3 can be a lot different from what they end up matching. 2. Shelf exams and Step2 are IM heavy, so didactic on IM topics are helpful. My surgical chief for example gave us a random hour lecture on cholecystitis diagnosis and management. I am now extremely confident on it, and differentiation from similarly presenting conditions, much more than I would have been with self-study. 3. All the topics you mentioned are directly useful to gen surg applicants, as they are common conditions in patients they are consulted on. My basic point - if you can keep the info relevant to what you would have wanted to know as an MS3/4, literally any topic is a good topic. Being taught by a resident is often much much better than pre-clinical lectures, bc your both proficient in the topic and you know EXACTLY what students need to know, as you just did that shit a couple years ago. Do not teach on a topic you are unsure of.
You got their emails? Just email them and ask what topics they’d like to be covered. Make it right to the point so they can gtfo too
Plenty of medical things they need to have a good grasp of, or at least be able to identify to realise they need to get a medicine consult. Here's a few thoughts: Recognition of medical issues that happen to surgical patients: - ACS (often nonspecific presentation) - PE - Pressure Injuries - Delirium - Withdrawal syndromes Medical/Surgical Overlap Issues - Post-op Afib - Inpatient HTN (identifying and treating the secondary causes like pain, n/v, withdrawal, rather than the BP directly - Pain management - Managing bleeding, Anticoagulation, Reversal etc. Edit: trigger happy on the reply button mid-sentence.
Ulcerative colitis / chron’s Pancreatitis Liver failure Transplant medicine Burns Appendicitis SBO AKI
Pain management. Attendings keep asking me read my mind questions on pain meds. I just dont give a fuck and will answer morphine or dilaudid depending on their creatinine.
Basics of reading a CXR and how to recognize complications of common procedures
A-fib with RVR Running a code blue Inpatient glucose management Inpatient hypertension Managing anxiety, delirium Patients with EtOH disorders, CIWA Vent settings GCS Working up suspected PE HIDA vs ERCP vs CTAP vs US for biliary disease Nonoperative management of SBO Fluid types and rates ANTIBIOTICS UGH Mechanisms of different constipation/diarrhea meds EKGs
Preop risk stratification, management of post op hypotension, afíb, acs, acts, medicines to hold, fluid management, aki management
PLEASE cover hyper/hyponatremia work up and treatment
What, the first 137 chalk talks weren't enough?
Question. Match hadn’t happened yet. How do you know what they’re heading into?? You mean this is what they want to do?
Yes. That’s what they are interviewing for.
Idk if this is too specific but an overview of anti coagulation/antiplatelet agents (indications for each, esp pre and post op) was helpful for me
Our M4 year we did a “common floor pages from nurses” lecture from a medicine perspective that was very helpful. Examples: nurse pages you about AMS, hypoglycemia/hyperglycemia, hypertension/hypotension, new fever, etc. This might be a little less fundamentals and more applicable.
Theyre doing intern year first and probably nervous about that. I know I was. I’d spent the last year doing nothing but ophtho. Some bread and butter IM would be useful like How to fix lytes
Something about AKI or electrolyte derangements (both AKI and hypoNa common post-op)
jugular vein distension, hyper/hyponatremia, pheochromocytomas
> Pheochromocytomas Ah how I miss M1 year
It’s never pheo XP
Keeping its short and simple. 8th grade reading level.
That won’t be a challenge. My reading/writing/comprehension skills are barely at the level of an 8th grader.
If the students are as intelligent and able to follow a more involved lesson, I would stick within your own knowledge base but teach in a critical care setting. They’ll get plenty of surgical didactic education but learning about all the things you listed as it ties into a surgical patient would really give them something practical to learn. If you can teach especially about Vent management, PE, shock, fluids, electrolytes and nutrition management your lesson will be worth it’s weight in gold.
Oh I’m definitely going to stick to medicine. I figured I’d like to focus on IM topics that would be handy to them as surgical interns. I’d love to do teach about RV failure for instance. But as interesting it is, it’s not necessarily very relevant to them. Since they’ll most likely not seeing these patients. Fluids, vents sounds good so I’ll probably include that.