10 essential apps for clinical years of medical school

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1. UpToDate: The UpToDate website is a phenomenal resource for medical students, residents, and attendings (even those sticklers for “primary sources”). It is amazing for getting an overview of pathophysiology, clinical presentation, diagnostic tests, management for just about every condition under the sun. It lives up to its name and contains updated literature and practice guidelines. Smartphone app interface is well built and easy to use. The app now has institutional access, so if your library pays for it, you can create an account and conveniently access UpToDate on your smartphone/tablet. One annoyance is that the login credentials expire after a month and you can only renew while logged on to your institution’s wireless network.

2. Epocrates: Have you wondered about the adult dosing for Plavix? Or if it is renally cleared? Or what drugs interact with it? Or what are the most common adverse reactions? Epocrates has answers to all these questions and more! It will show you pictures of the pills in all available strengths so you can make your patient’s life easier and not prescribe some weird dose that requires them to cut the pills into thirds. ‘Interaction Check’ feature allows you to enter in your patient’s med list and check for interactions between any of the medications. This app also has many additional features like medical calculators and tables. In summary, this app is the workhorse for everything pharmacologic.

3. Elsevier Clinical Pharmacology: Very similar to Epocrates for pharmacologic content. Like Epocrates, Clinical Pharmacology will answer the same basic questions about any drug. Like Epocrates, you can check for drug interactions. Unlike Epocrates, this is strictly a pharmacologic app and it lacks the bells and whistles like medical calculators and tables. But it excels at what it does. The drug information is much more comprehensive than Epocrates. Epocrates only lists the main indications for a drug, while Clinical Pharmacology lists off-label usages as well. In Clinical Pharamcology ‘Mechanism of action‘ contains much greater detail than Epocrates. For instance, Epocrates just tells you that carvedilol is a selective alpha-1 and non-selective beta antagonist. Clinical Pharmacology also tells you the ratio of beta-to-alpha blockade is in the order of 10 to 100:1. Both the website and app can be accessed via institutional login.

4. MedCalc: This app has all the basic calculators like A-a gradient, GFR calculator, Winter’s formula etc that can be found in Epocrates, but it also has many other calculators not found in Epocrates. Have a patient with shortness of breath and want to know if you need to worry about pulmonary embolism? It has a calculator for Wells Score – both the original 3 level and simplified 2 level score. Would your patient benefit from statin therapy? You can evaluate the ACC/AHA ASCVD risk based on the latest 2013 guidelines. The app is free and comes with some basic calculators, but to unlock all calculators costs $4.99.

5. OB Wheel: Both MedCalc and Epocrates have an OB wheel. The additional useful feature in an app specifically dedicated to obstetric calculations is versatility of data entry. Epocrates and MedCalc will both let you enter the day of last menstrual period (LMP) to calculate estimated due date. This app lets you specify the gestational age by ultrasound to get both the LMP and estimated due date. This app is currently $1.99 on the iOS app store.

6. ASCVD Risk: This is another specialized calculator app that does one specific thing very well. The atherosclerotic cardiovascular disease (ASCVD) calculator replaced the ATP III Framingham risk score in 2013. Both the ASCVD and ATP III are available in MedCalc. The ASCVD calculator in MedCalc provides the 10 year risk score. That number is not very useful if you don’t know what to do with it. This dedicated app, also available via web browser, provides an interpretation of the score, lifestyle recommendations and statin recommendations based on the score.

7. QxMD: This app makes it easy to keep up with the latest research in your field! You can set it up to follow the areas and journals of interest. You can also link this app to your institutional login and access full text pdfs with the convenience of your phone or tablet. It can also be accessed via web interface. You can share papers (including pdfs) with colleagues via email or Facebook/Twitter. You can create collections of articles in topics of choice or follow other people’s curated collections.

8. Journal Club: A pulmonologist will love to educate you on the finer points of emphysema drugs – UPLIFT trial showed Spiriva improved survival, TORCH trial showed Advair reduced hospitalizations but didn’t alter mortality. For busy clinicians and medical students, this app presents a streamlined and efficient way to keep up with clinical trials. Along with a one sentence bottom line, it summarizes a trial into design, inclusion/exclusion criteria, outcomes etc. The weakness of this app is that it is not very complete, and depending on the area of interest it could be completely useless. Cardiology and critical care seem to have the most trials. Prepare to be underwhelmed in obstetrics, ophthalmology, anesthesiology among many other subjects with just one trial each. In general medicine or cardiology, the $4.99 price may be very worthwhile, but not so for other specialties. It can also be accessed via the website, which is available for free.

9. NEJM: If you had to read one journal in internal medicine, New England Journal of Medicine (NEJM) would be an excellent choice. While you can follow NEJM papers in QxMD, NEJM app is worth mentioning. The iphone version provides free access for browsing the current issue in text format instead of having to download pdf files to read papers.

10. Medscape: This app does a little bit of everything. Disease overviews. Drug dosing and toxicity. Medical calculators. However it can’t beat the apps specializing in their areas. Like a good generalist, this app does a little bit of everything and will meet your needs 70-80% of the time. But if you are looking for something specific, then the specialist app will serve your needs better.

PS: I tested all these apps on the iOS (ipad/iphone).

PPS: Are there apps I am missing that are on your essential list?

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  • Legalese

    The purpose of this blog is to share interesting bits from around the web and beyond. All opinions expressed on this site are my own, unless credited to someone else. The images and artwork have also been created by me, unless credited to the sources. Oh! And please don't hold me liable for your actions resulting from any information on this site. As with everything else on the internet, read with the requisite amount of skepticism.
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