1) True learning is not about reading a lot of books, checking out many Tweetorials or listening to a lot of podcasts.
If that was so, everybody would have been 'successful' and not creating content about 'success'.
2) True learning is based on something I called the retention percentage --> the percentage of your knowledge that you can actually use in your day to day life.
3) I have applied this retention ratio to medicine since the day I started --> 10 years back in 2022.
Whatever you learn, until and unless you are comfortable with it --> that you can use it in day to day clinical practice --> you have not really learnt it.
4) For example --> let's talk about familial colorectal Ca syndromes like Lynch syndrome/FAP/Cowden/PJ etc etc.
Its okay to read about it.
Its more important to think about it when you see a patient with Ca colon!
5) If you think about it, you will read about it again maybe using POC guides like UpToDate --> this consolidates your knowledge!
This is real learning --> knowledge that goes beyond your hippocampus and into the neocortex.
6) The next time you see another patient with Ca colon --> these encoded memory pathways are strengthened again and maybe you get to diagnose a syndrome!
Your peers laud your skills --> but its just a different way of thinking!
7) Remember, that our cognition is like a searchlight!
If you don't think about something, you will always miss it!
So don't overload your brain with information, learn to what you already have!
1. TB can invade every organ system with a bewildering array of manifestations --> requires great diagnostic skills.
2. Dx methods like microscopy and even PCR often fail in case of paucibacillary disease.
3. Serology = useless
2)
4. The interaction between the TB bacillus and the immune system is complex.
Why some people can contain it within granuloma and why it spreads hematogenously in others --> this is not well known.
Research is less focused here since TB is not a First World problem.
3) 5. ATD is hepatotoxic (among others) and relies on the same 1st line drugs since the 1950s --> HIV appeared in 1981 but we already have more drugs than we can handle. PLHIV are now dying of ASCVD, like the gen popn!
1) Somebody just asked me about the management of scorpion bite --> something I have never dealt with before.
Apparently, they are divided by species and by presentation --> autonomic storm/neuromuscular toxicity or DIC!
India --> Mesobuthus spp --> autonomic storm!
2) How did I learn all this within 5 minutes?
UpTodate.
The single most important resource for internists everywhere.
I love textbooks, but this is the digital age.
3) Textbooks will help you with the deep diving but for POC medicine where time is of the essence and you need high fidelity, organized information --> you will need UpToDate.
Unpopular opinion and @stethospeaks may skewer may for this --> but this is what I stand by!
3) Long story short, his attending doctors were forced to operate within the confines of royal etiquette --> while dealing with a breech delivery --> with the patient under chloroform --> a relatively unknown substance.