Tag: otolaryngology

Surgery Shelf

Hey ya’ll.

This will be a super short blog post but I’m currently studying for my surgery shelf and need a distraction. 🙂

Because surgery is a 2 rotation requirement (at least at my school) I didn’t need to study for a shelf when I did my general surgery rotation. However, since ENT was my second surgery rotation, I did need to study. I am incredibly thankful that I did have two weeks off to study, because ENT kicked my ass. See that post if you want to know what that was like!

The biggest topic that I thought I understood and clearly I didn’t were fluid questions. There are more on there than I thought there would be. So understanding fluids is a big topic. Otherwise, burns, trauma, and general surgery are what the remainder of the questions focused on. A lot of, what is the next step? How do you treat? What type of imaging is best? etc.

What I used:

So, I have required assignments in third year. It was my school’s attempt to equalize learning. On top of that as a 2+2 or hybrid student I have more assignments. The additional assignments really aren’t helpful. Sometimes the assigned topics are, but usually they aren’t.

Useful assigned content:

  • Online med ed (OME)
  • Case X (OME)

Initially I just did the assignments and hoped that it stuck. Some of it did, most of it didn’t. Additional resources I used:

  • Truelearn questions (good place to start but not sure they are very similar to the shelf questions)- COMQUEST are better
  • Dorian Deck from Anki

Not useful content:

  • Assigned standardized patients (useful in 1st and 2nd year, not useful at all as a third year when you start regularly seeing patients)
  • assigned powerpoints
  • assigned case presentations
  • aquifer cases – not much for the second surgery rotation, but wasn’t helpful from my first rotation in surgery
  • Wise MD and Wise MD on-call: these are videos. Some of my assigned videos would have been SUPER HELPFUL if they were assigned for my first month of surgery. Like what are the instruments you are using in the OR and how to suture… The rest were supposed to be case-based assignments but I just personally didn’t jive with the way they were presented.

How I studied:

So the first two weeks I was in ENT, and didn’t get much studying for my shelf in. I was mostly trying to stay afloat in ENT. Which my “give a shit meter” would drop significantly after 1.5 weeks- not going to lie.

After that I worked on my assignments. This was a good base, but I really wasn’t retaining as much as I’d hoped.

About 1.5 weeks out was the following:

  • 200-500 Anki reviews a day (brutal yes – probably should have spread that out more)
  • About 10-25 Truelearn questions a day (there are only like 140 total. Most of my classmates bought COMQUEST which gives you a simulated shelf score)

Few days before:

  • 2-3 days before I rewatched all the surgery videos and trauma videos on OME to refresh my memory (super helpful after doing so much Anki)
  • Watched the Emma Holliday presentation for surgery on YouTube. Even just listening to them or attempting to answer the question myself before she stated the answer was helpful for me.

I was going to add in some Uworld questions but didn’t have the time or energy. The procrastination game is strong on my end. I’ve always been a last minute blitz studier. Wish I wasn’t as it is stressful, but it is what it is. I’m 30 and I doubt I will change that habit.

Hope this was helpful!

Scribe Series: Full Chart Examples!

Hello hello!

I decided I was in a very giving mood and wanted to give some examples of full SOAP notes. Since a chunk of you who show up to my site are here for the scribing practice and explanations, I figured I’d try to give you some more resources.

I have added a blank or a general SOAP note template here. This full out SOAP note is pretty in-depth. It would likely be used more for general wellness exams at a family practice office, internal medicine visit, or possibly a pre-operative full H&P. Many other specialties do take the same format as this note, they just don’t necessarily have as much information or as detailed of information.

Here is an example of an ER note.  I based this one off of my posts *scribe series: HPI practice case 2*. Which you can check out by clicking the link.

Here is an example of an ENT focused note. It is not quite as in depth as the charts I used to write were simply because I can’t remember every detail of how I did those notes. The pathology for them as well is getting hazy too. I used to work in several ENT subspecialties and I have to tell you, this was one of the hardest scribing jobs I had. Each specialty was so incredibly specific yet all in the same small area of the body. I chose to do a hearing related one as neuro-otology was one of my favorite subspecialties. Rhinology/sinus was my second favorite, only because I then spent the most time here. It took me forever to cross train scribes as their providers also usually only worked 1-2 days a week. [Insert your favorite eye rolling emoji here].

Here is an example of an ortho follow up note.  This one is a little more rough (I know). It’s been a hot minute since I did an ortho note so take it with a grain of salt. But basically the first paragraph you want to summarize all the previous history/surgeries and the second HPI paragraph you want to give an update for how they are doing in the office the day you are seeing them. The goal is to continue to add on to the first paragraph with pertinent information from the last visit so you have it all in one note.

Here is an example of an urgent visit note . Say from a level 3 ER case, an urgent visit at the family/internal medicine office, or possibly at an urgent care.

What are some differences that you notice between these charting types? What are some similarities? Do you notice how the more focused notes don’t have as many ROS and PE systems as a full generalized well exam would?

Look at how I tend to word my HPI’s or how I might put things in the physical exam. There are definitely some findings that can go under multiple systems on the PE; pick one for that chart or try to pick one system that you would generally put it under.

I personally liked to bold the abnormal findings when doing charts in programs that do not automatically bold them or highlight them in red. As a scribe, this is a nice touch to help your provider or other medical staff see the abnormal findings more quickly. But by all means, this is not necessary to have in your chart.

*As a side note, these will be read only. You may feel free to print them off and mark them up. Or make a copy on your own drive and mess around with them.

Cheers!