My wife, Heide, was just made Editor-in-Chief of Fine Cooking. She’s the right woman for the job. She’s a brilliant chef and a charismatic teacher, and she has a Master’s in journalism from Columbia. That’s a recipe for success.
I know very little about cooking, myself, but I can say this: Heide has cooking genes, inherited from her mother. Beyond that, she was immersed in cooking from an early age, apprenticed in the kitchen, creating Eastern European specialties like zwetschgenknoedel and chicken paprikash. After that came decades of practice and experimentation- stirring, salting, seasoning, simmering, and sautéing. She also reads constantly. According to one of my daughters, Heide has more than a thousand cookbooks, covering cuisines from the Americas to Europe to Africa to Asia. She reads to learn and she reads for inspiration.
Medicine is like that. The best internists read constantly. Knowledge drives our work- the diagnoses we make, the treatments we implement, and the suffering we relieve. To do our job well, we have to read.
Which brings me to the In-Training Exam, or ITE, which most of you will take later this summer. The purpose of the ITE is to assess what you know. It’s a low stakes exam, and the results have no bearing on promotion or graduation. Instead, the ITE gauges how much you’ve learned and the results tell us what you need to study. For interns, the results largely reflect your work in medical school. For everyone else, they reflect the knowledge you’ve acquired in residency. For PGY3s, the results provide crucial feedback as you prepare for the Boards.
You should all be studying, but not just for the test. You should study to become the best internist you can be. Don’t be fooled by the misleading observation that “you can always look things up.” You can’t. Yes, you should look things up when you don’t know something, but you won’t always know what you don’t know. There’s no substitute for knowing. You need knowledge in your head when you interview patients, when you weigh differential diagnoses, and when you listen critically to consultants.
Think of it this way: anyone can pull out a recipe to make a sauce, but the best chefs already know how to make a sauce. Because they know the basics, they’re positioned to take it to the next level, to cook up something spectacular.
Try to set time aside each day to study, even if it’s just 15 minutes or a half hour when you’re busy. Here are some strategies:
- Read about your patients. Patient care raises questions all the time. If you don’t have time to read at work, jot down topics to explore at home. Great resources include UpToDate, the residency blog, YOBM, NEJM Rotation Prep, PubMed, key topic reviews, and standard textbooks.
- Stay informed. No one has time to read all the journals cover to cover, but many excellent resources are available to keep you informed, including NEJM Journal Watch, NEJM Resident 360, QxMD, the JAMA Network, on-line Tables of Contents (e.g., for The NEJM, JAMA, JAMA-IM, The Annals, and The Lancet), and podcasts such as The Curbsiders and our very own, The Moonlighters.
- Use study guides and practice tests. Great resources include MKSAP, NEJM Knowledge+, and UWorld. Take practice tests to reinforce your knowledge and to boost your confidence for high stakes exams like the Boards.
So just a final word to the wise about studying. My wife immerses herself in cookbooks because she has a passion for creating inspired recipes. Medicine is similar. We work in a rapidly evolving field, which covers broad expanses in the sciences and humanities. So read, read, read. Knowledge alone doesn’t create a great internist, but it’s a key ingredient. Acquire it, stir it in, and use it well.
And now it’s time to bike down to work to join my phenomenal Fitkin Team,