If you know me in real life, you’d know that I’m obsessed with apps. I use a paper planner for organization and to-do lists but other than that, everything lives on my iPhone. I know some medical students worry about using a smartphone/ tablet on the wards. The concern is that their team will think that they’re scrolling through Instagram or sending texts instead of looking up clinically relevant info. Personally, I’ve never had an issue with that. And if for some reason I was worried that my phone-use looked suspicious, I’d casually say something along the lines of “I’m looking XYZ up on UpToDate real quick” or “Let me open Pocket Medicine on my phone to double check this”. But truthfully this rarely happens and I think that in this day in age, most residents and attending physicians use apps regularly and know that students are usually looking something up. Anyways, today I’m sharing what I consider to be the best apps for Internal Medicine and what I reference on a day to day basis. I use some of these more than others, but these are all great apps that I think every MS3 on their Internal Medicine rotation should have, or at least check out. By the way, this is not an all-encompassing list so if I missed anything feel free to recommend it in the comments below.
This is probably my most used app. UpToDate is like a medical Wikipedia. Most hospitals and medical schools have an UpToDate subscription. Usually this subscription requires that you are using the computers at school or at the hospital. Thankfully, my school also pays for the students to have remote subscriptions, which allow us to access UpToDate, even if we’re not on campus or in the hospital.
I really love this app because it is a great way to get an organized and detailed summary of nearly every topic. For instance, I had to work up a patient who had a near-drowning experience and UpToDate really helped with determining the management. My only complaint about this app is that it is a bit too detailed sometimes and the search feature could be a bit easier to use. If I am searching “pleural effusion” I get a million and one things that pop up. Yes sometimes, I need to know “the management of refractory nonmalignant pleural effusions” and having this exact article is amazing if I have a patient with this specific diagnosis. But sometimes, I’m simply trying to get a brief overview on what the disease is, what causes it and the general treatment. Because there is SO much information on UpToDate, I feel like this basic information gets lost in all the details.
I still use UpToDate each day and I think it’s great for management. It’s also great for searching random but specific things like treating pneumonia for dialysis patients. However, if you’re trying to do a quick brush up on a specific diagnosis then it may be easier to do a google search or use Medscape (more on Medscape later).
I think you can pay for extra features, but I use the free version. This is good for figuring out drugs (i.e. a patient comes in with pills and you have to identify them). But I use it to look up dosing for drugs I’m not familiar with. I didn’t use this often at my old site because I rarely needed to prescribe/ dose things. But my new site allows me to place orders by myself (don’t worry, the residents have to approve them in the computer before the nurses give the meds) so I think this will be much more handy now that I’ll have to figure out dosing and prescribing on my own.
I LOVE this app. In medicine there are always studies going on and a lot of these studies help determine risk and benefit of certain situations, procedures, or conditions. As a result, we get a bunch of calculators and assessment tools to use. For instance, a CIWA score, calculates the severity of alcohol withdrawal and a HAS-BLED score calculates the bleeding risk with AFib anticoagulation treatment. These scores are hard to keep track of and allocating points and remembering the grading scales for each can be overwhelming. MD CALC tells you what each scoring system is used for, it helps you calculate the score, and it lets you know what that score means such as increased risk vs. decreased risk. I’m sure they’re other medical calculators out there, but I love MD Calc. Plus I can favorite my most used calculations so they’re easy to access.
This is the app for the USPSTF Preventative Services Database. When you open the app, you type in the patient’s age, sex, if they’re pregnant, if they have a history of tobacco use, and if they are sexually active. This will then populate all the recommended screenings for that age category. For instance, for a 25 year old non-smoking, non-pregnant, non-sexually active female, it recommends that she get a Pap smear, folic acid supplementation, HIV screening, and blood pressure screening. When you click each recommendation, it goes more in-depth about the recommendation, who should be screened, how often they need screening, and any risk factors for that condition or disease they’re trying to prevent.
I don’t use this app as much in the wards but health maintenance issues do come up occasionally and USPSTF guidelines are tested on the Internal Medicine shelf (the standardized exam at the end of the rotation). Even though I don’t use this app everyday, I like having it around in case I need it, plus I know it will be essential once I switch to outpatient medicine.
JOHNS HOPKINS ABX GUIDE
I’m particularly interested in infectious diseases so this app was very enticing to me. Looking back, I could have saved $30. I rarely use it but I’m including it here because it is an amazing resource and I will definitely try to use it each day at my new internal medicine site that I started this week. This guide is a direct competitor to the Sanford Antibiotic Guide so if you have that in paperback or app version, you really don’t need the Johns Hopkins one. This guide is amazing for figuring out antibiotics and dosing schedules. It also helps with forming a differential. So for instance, if I have a patient coming in with community acquired pneumonia, the app lists the most common pathogens, the clinical picture of a patient with pneumonia, what I can expect to find on imaging, a few scoring calculators that can help determine outcome/ prognosis, diagnostic methods to rule out specific pathogens, outpatient treatments, inpatient treatments, ICU treatments, pathogen specific treatments, and then comments on select drugs, patient follow-up information and references. Honestly as I type this now, I’m kind of regretting not using this before.
In addition to all of this, this guide also includes a very thorough vaccination guide. This app isn’t a must have, but after 4 weeks on the wards, I can really see how using this as a resource can help you “shine” during your rotation.
iBOOKS + POCKET MEDICINE
iBooks is a pdf/ ebook reader that comes for free with the iPhone. I use this for my pdf book references. Usually I like to keep my textbooks in Notability (the app I use to write and type my notes on my computer and iPad). However, I find that Notability is a bit too “fancy” for me to use on the wards and I just wanted somewhere to keep a pdf copy of some of my books that I reference in the hospital. Truthfully, iBooks is only okay. You can highlight and flag pages but that’s about it. If you want note-taking capabilities then I’d recommend uploading your books into Notability or a comparable app.
The book that I use the most in iBooks is Pocket Medicine. If you’re on the wards you’ve probably seen your residents and attendings pull this out. It’s a small binder that fits in your white coat and each year the color changes. I’ve seen a few older doctors with purple, green, and red versions but the newest edition is orange. For me, Pocket Medicine is most useful for management once I have an idea of what the diagnosis is.
The one pet peeve I have about this book is it’s very succinct and there are a ton of abbreviations. If you want to understand pathophysiology or if you need a refresher on a disease then you need to look it up elsewhere. But if you want a very quick, bulleted reference for diagnosis, clinical presentation, management, and treatment, then this is your book. This is a pretty good guide, so if you’re going into Internal Medicine you might as well just buy a hard copy.
So I actually just found out about this app. It is also a website so if for some reason you don’t want to download the app, you can just go to allacronyms.com on any internet browser. I was a medical scribe before starting medical school so I’m familiar with a lot of medical acronyms, but from time to time, some of them have me stumped. All Acronyms is a great way to figure them out without bugging your team. There’s so many categories to choose from in this app so just be sure that you’re searching under the “medical” category and you should be fine.
This is another app that I don’t use often, but after writing this I remembered why I downloaded it and I made a mental note to use it more often. Medscape has drugs + dosing, conditions, drug interaction checker, pill identifier, calculators, and a few more features. I vaguely remember one of my supervising physicians telling me this app wasn’t as updated as some others. I’m not sure if that’s true or not so maybe do your own research if you want to make this your go-to app. Truthfully, if I do use this app, I don’t use any of the special features. I mostly use this app if I’m searching for information on a specific topic. For example, if I have a patient with a pleural effusion I would do a quick read on Medscape. For each condition, Medscape has an overview, clinical presentation, differential diagnosis, workup, treatment and management, guidelines, and medication. It is VERY similar to UpToDate, but I find this to be better at giving an overview of a condition. If you’re looking for a lot of details and specific information then UpToDate shines. But if you want a quick and easy to read summary of a particular condition then Medscape would suffice.
Medscape also has a bunch of physical exams, so if you need to brush up on your clinical skills like I do, it may be helpful to do a quick skim of some of the physical exam sections.
I hope this posts helps you with your medical journey. Whether you’re in med school, PA school, nursing school or any other health profession school, I think these apps may come in handy for you. Keep in mind that these apps are RESOURCES and are sometimes not accurate or up to date. Also, sometimes the real world and the textbook world are different. So your patient may not always look like the typical case. At the end of the day these are supposed to supplement your knowledge so try to exercise your brain and come up with as much of the differential, assessment, and plan by yourself before turning to apps for the answer. Let me know if you found this post helpful! And don’t forget to let me know some of your favorite apps in the comments below!