You’re given feedback to “read more.” What do you do next?

Doctors are life long learners. The feedback to read more is often heard by medical students and residents in their quest to acquire the knowledge to understand health and disease processes and direct patient care.

With so many demands on a resident and early career physician’s time, how do you make the most of the directive to read more? During residency training and throughout your medical career, the patient case mix guides your reading and learning.

1. Read to complement your workflow. Here’s an example.  Medication orders are renewed every Wednesday on a particular rotation. On Tuesday night, dedicate 30 to 45 minutes to read and learn about the medications commonly prescribed on that rotation. Focus on the mechanisms of action and the side effect profile.  Then on Wednesday’s work rounds instead of merely clicking the renew button for each medication, consider the patient’s diagnosis, response to therapy, and the presence or absence of side effects. Think critically about whether the patient should remain on the previously prescribed medication or not.  Integrate the medication knowledge you’ve acquired from reading to expand the discussion of the case on attending rounds.

2. Read to understand disease progression. This is so important when you are on call. As a resident, you assume more independence with less direct attending supervision when on call.  Understanding disease progression allows you to anticipate how a patient’s hospital course may progress while you are on duty.  For example: You admit a patient with a seizure disorder whose current illness results in taking a new medication that increases the metabolism of the seizure medication.  As an intern or resident, it is critical that you know medication interactions.  Knowing disease progression, you anticipate that the seizure medication may now be at sub-therapeutic levels predisposing the patient to seizure.  When you round with the team, you can discuss the clinical parameters to look for and the interventions needed to stabilize the patient.

3. Read to enhance your doctor-patient relationship.  A good doctor-patient relationship is one of the ways for medical students and residents to build their confidence.  It is a relationship where you get to share your knowledge with patients and their families and help them understand their illness and create realistic expectations from their illness and from the medical community.  The doctor-patient relationship is a sacred bond that is enhanced when the medical student, resident, or attending physician is honest about their level of understanding and trust between the two is built.  Continuing education for doctors is critical for the sanctity of the relationship, particularly in this era of medicine when patients and families have easy access to medical information.  Doctors help patients navigate the abundance of information they have access to, so they make the best health care decisions for themselves.

Stephanie Wellington is a physician and can be reached at Nurturing MDs.

Image credit: Shutterstock.com

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