Student co-writes book and app
Like most third-year medical students, Francoise Marvel scribbled notes in a little black book when her first rotation introduced her to the wards where internal medicine was practiced. Such pocket-size books become personalized gold mines of facts, memory aids and wisdom from mentors in white coats.
But what if you had all of the content from your mentor’s medical black book, packed with about 20 years of know-how? And what if you could access it from your iPhone?
That’s what Marvel, a fourth-year student at the College of Medicine’s Orlando campus, and faculty member Mario Madruga, M.D., director of Orlando Health’s Internal Medicine Residency Program, have created. It’s called “Madruga and Marvel’s Medical Black Book: Guide to Differential Diagnosis, Mnemonics, and Clinical Pearls.”
Back in 2010, Madruga offered to give Marvel access to the internal-medicine information he’d been gathering in his medical black book since 1993. She was thrilled. “Dr. Madruga is a clinician-educator legend,” she said, “for his trademark encyclopedic clinical knowledge, diagnostic expertise, intelligence and talent at solving the toughest internal medicine cases.”
So she leaped at the offer of his black book, and sent him an email outlining what she was thinking. Here’s an excerpt: “Actually, my idea was to make a photocopy of it, type it up, and work on creating an electronic version of your black book. Maybe the final electronic version would even be available for publishing or turning into something electronic like an application for an iPhone/smart phone.”
Which is exactly what happened. After about a year of work, the 101-page book was ready. Students, residents and physicians can get it in print, as an e-book or as an app for Apple’s iPhone, iTouch, and iPad. It’s divided into four chapters:
- Differential diagnosis. Among more than a dozen diagnoses listed for consideration under “cramping disorders,” for example, are alcohol, cirrhosis, heat, pregnancy and thyroid.
- Mnemonics, or memory aids. Listed under “atrial fibrillation” is I SMART CHAP, which helps students remember these main causes: Inflammatory (Pericarditis/Myocarditis); Surgery (Post-coronary artery bypass); Medications; ASCHD (Atherosclerotic coronary disease); Rheumatic valvular disease; Thyroid; Congenital heart disease; Hypertension; Alcohol; and Pulmonary disease.
- Clinical pearls of wisdom. Example: “Adrenal masses are common and increase in frequency with age…. If adrenal mass is large, biopsy it. Definitely do so if >6cm after ruling out Pheochromocytoma.”
- Clinical cases, such as Case 5: “40-year-old female with history of asthma for two years. Also diagnosed with allergic rhinitis one year ago. Now presented to the Emergency Department with a severe asthma attack, purpuric type rash over her lower extremities, and a right foot drop. No history of smoking.” After providing six lab findings, along with lists of asthma exacerbators and mimickers, it offers – and defines – a final diagnosis of Churg-Strauss Syndrome.
There’s also a section for notes, allowing users to expand the content with observations from their own medical experiences.
“The Black Book is destined to become a classic quick-reference guide to differential diagnosis,” said Michael Muszynski, M.D., dean of the College of Medicine’s Orlando campus. “This is the product of the teachings of a master clinician and the creative skills and vision of an exceptionally talented FSU medical student.”
Positive reviews are coming in from medical students, residents and physicians in Orlando’s internal medicine wards, said Marvel, who estimates several hundred books and apps have been sold or distributed.
“If you wanna survive your residency (’specially those night calls when you are alone and your senior is not accessible), this app comes in very handy,” reads a review posted on itunes@apple.com by Amit Badiye, M.D., Orlando Health’s chief resident in internal medicine.
Coley Sheriff, Marvel’s classmate, posted this comment on lulu.com: “As a med student I used this book every day on my internal medicine rotation and know it will be a great resource for residency. I especially love the section on clinical pearls. The small size makes it a perfect fit for your white coat.”
Marvel says she’s not getting any money from this project. She explains her motivation: “If this book/app could positively influence how medical students, residents and attendings manage challenging cases, there is a better chance that a critical factor will not be missed and accurate diagnosis and management decisions can be reached sooner.”
Link to the app and the book.
