I've added a lot of programs to it, which means I've also spent a lot of money on the resources. I still think it was a good idea. There isn't a lot of practical info on which programs work best for med students doing their clerkship. I'm going to throw my opinion into the mix.
The 3 apps I used most often on CTU were Diagnosaurus, 5 Minute Clinical Consult and Dr. Drugs.
Scenario, my Senior Medical Resident pages me with the following..."Hi Imposter, I have a 58 year old female in emerg with hyponatremia and decreased level of consciousness. Please come down and do the admission to your team."
I'd start with my Diagnosaurus app and look up the Differentials for hyponatremia and decreased LoC. I used those lists to direct my questions, physical and investigations. Diagnosaurus lets you look things up according to symptoms (like hyponatremia) or disease (like renal tubular acidosis. It also has things divided by organ system which I didn't use at all.
If there were conditions on the differential I wasn't familiar with - err, WHEN things showed up I waasn't familiar with, I'd look them up on 5MCC. 5MCC has the disease described by the Basics (description, epidemiology, risk factors, general prevention, pathophys, etiology, associated conditions), Diagnosis (signs and symptoms, diagnostic tests & interpretations, differential diagnosis), Treatment (meds, additional treatment, in patient considerations), Ongoing Care (follow up, patient education, prognosis, complications) and references for the material given.
The diagnosis section was especially helpful in directing my investigations and the ongoing care was useful once the patients hit the wards. Reading through the basics made me look like less of an idiot before going to the morning report and being pimped by the consultants.
Patients come in on a huge list of medications sometimes, often ones I've never heard of. I used Dr. Drugs to help me figure out what the heck was going on. It's on the Skyscape app as well (pay extra for it though) so it's in one place and links to 5MCC. Very useful. The information is given in terms of Indications, Contraindications/Precautions, Adverse Reactions/Side Effects, Interactions (drug/drug, drug/natural products), Availability (tablets etc.), Dose (adult, paeds, geriatric, etc.), US Brand Names, Classifications (therapeutic and pharmacologic), Pregnancy Category, Pharmacokinetics (absorption, distribution, protein binding, metabolism/excretion, half-life), Canadian Brand name, Time/Action Profile (onset, peak, duration), Patient/Family teaching, pronunciation.
Interactions came in handy quite a few times when trying to sort out why a patient was having problems with their new meds, the dose is priceless for obvious reasons, and the time/action profile made it possible to predict when to check back on a patient to see how the meds were working.
I love clerkship. I have so many stories to tell. As soon as I get more time, I promise to update!
