So a few weeks ago, the hashtag #TipsForNewDocs was trending on Twitter. A portion of those tips were recommending apps for new medical interns who were due to start their orientation and “Buddy Week” (in NSW). Next week, at the beginning of February, they’ll be starting work proper, at least in New South Wales.
A lot of the apps that were recommended then, were, in my opinion, irrelevant and totally useless for interns. No intern needs to know the National Institutes of Health Stroke Scale, as they will be calling their registrar for any and all strokes. Similarly, the Oxford Handbook of Anaesthesia, while useful for anaesthetists and anaesthetic/critical care registrars/SRMOS, would be overkill for the brand new intern.
Those apps are useful. Extremely useful. But not for an intern in their first term. They will trying to find their legs in the brave new world that they’ve entered. They have the stems of knowledge, but not the experience of how to use all that they have learned in university. As any doctor can tell you, it’s one thing to read about it, it’s a whole different ball game when it’s in front of you. They have the lives of people in their hands and they will be afraid of making a mistake that could end up severely injuring or killing a person. I know. I was an intern once.
The apps I recommended are, in my opinion, the most useful that any intern can have available at the beginning of their career. In fact, these apps would be useful for the rest of their careers too. They’re simple, but extremely useful apps. Of course, there may be someone out there scoffing at my choice of apps. I would be happy to hear their point of view.
The following apps are available on iOS, and may be available on other mobile operating systems too.
iMIMS is the one of the most commonly used apps by any doctor in Australia. It has virtually any medication that is sold in Australia in its database and includes the dosages, side-effects, contraindication as well as any other information one would like to know about any drug.
The only problem with the app is, well, it sucks. The current version is slow and cumbersome. Downloading a database update is very annoying. The app has to be in the foreground with the screen turned on or otherwise the entire half a gigabyte download will be cancelled and have to be restarted from scratch. Now, depending on your Internet connection that can take anywhere from a few seconds to a couple of minutes, if you’re lucky. You cannot use the app if you don’t have Internet connection and have not downloaded the entire database. I should note here that the database is separate from the app that you download from the App Store.
However, for all its flaws, this app is still an invaluable resource. It definitely has to be in every doctors repertoire of apps.
Price: Free, but requires either a personal subscription, or an enterprise token from your employer/CIAP.
This app is the latest version of an app that has been in the app store for many many years. In fact it is one of the earliest medical calculators on the App Store. With each generation the user interface has improved and the number of formulas within it grows exponentially. There are formulas that range from the most common ones like the CHA2DS2-Vasc2 score to some of the more obscure ones that exist. If you need a calculator for a medical formula or score, chances are pretty good it’s in this app.
It also has a feature that I have had no reason to use which is that you keep a record of scores for each patient. I have never found the need for such a feature, but undoubtably there will be some of you out there who will find a use for it.
I will admit, this app was not in my initial list of apps that every intern should have. It is not because I did not think this app was useful, it was because I did not know it existed. The Opioid Calculator is published by the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (FPM ANZCA). Converting the dosage of one form of obviate do another can be quite confusing if you’re not used to it. Sure there have been tables published attempting to make it easy to convert from one form to the other, but unless you’re used to using them they can be quite confusing. This app removes the confusion and makes it extremely easy to convert from one form to the other, be it from oral to parental or even rectal.
All you have to do is insert the current dose of any opioid, hit the convert button and it will give you the equivalent doses in all of the other opioid forms. This is extremely useful when converting the total dose of immediate release opioids administered over a 24 hour period to the appropriate extended release formulations. It is also useful at the end of life, when a patients total oral opioid dose has to be converted, if needed, to a parental formulation.
CIAP isn’t really an app. However it is without a doubt the most useful resource any doctor can have. In the state of New South Wales, NSW Health provides it free of charge to every public hospital for every staff member to use. They even allow offsite access for free if you sign up for it. (Note: the registration has to be renewed yearly for offsite access to ensure that you are still an employee of NSW Health).
CIAP provides access to MIMS, the Australian Medicines Handbook, Electronic Therapeutic Guidelines (eTG), hundreds if not thousands of journals, and a whole host of other resources. Even whole text books like Harrison’s Principles of Internal Medicine are available, for free, via CIAP.
CIAP is truly the ultimate resource for any medical professional.
Price: Free for employees of NSW Health.
The above are just a few of the many apps that I use relatively frequently on the wards and in the clinics. If anyone has any other suggestions, I would love to hear from you.