Yes. I lived in a different world from residents today. We didn’t have all the electronic resources such as virtual flashcards, digital ebooks for almost everything, Radexams, Case stacks, Radprimer, question banks, and other online electronic resources. In addition, there were fewer texts for every topic than what we see today. And, we had only one general review text for the boards (Dahnert). But, as I remember, almost all radiology residents back in my day would read these topic-based physical textbooks to understand the fundamentals of radiology. We needed to read this material to grasp the essence of what we needed to know. Many of today’s residents no longer ascribe to this philosophy and jump right into other ancillary electronic material.
Moreover, without reading the textbooks that I did when I started, I would never have had the fundamentals I have today to synthesize findings and differentials quickly. By skipping out on reading the fundamental texts, residents build knowledge layered upon a flimsy thin base. They can’t answer the why and how of what we do. And they are much less likely to pass the written board examination. This result is precisely what we ultimately find. So, let’s talk about why returning to reading primary physical textbooks is critical before jumping into all the electronic resources.
Active Learning With A Physical Textbook Is Better For The Fundamentals
Reading with a physical textbook rather than electronic reading material is more efficient. If you are not convinced, take a look at my former article, eBooks vs. Printed Radiology Books- A Death Match Part II. In this article, you will find evidence that using physical texts is better than electronic material for learning material. Holding a book in your hand, highlighting, and taking active notes on flashcards, is more efficient for remembering the material. So, although more portable, electronic resources may not give you the same bang for your buck.
Putting Your Money Where Your Mouth Is!
I know. Many of you have tons of debt from medical school. However, when you pay for something, you establish an unwritten commitment to it. So, when you buy your textbook, you are much more likely to feel like you have to use it, read it, and mark it up. Sharing ebooks with your colleagues is just not the same. Therefore, you should consider going back to the old-fashioned concept of owning your textbooks to increase your retention and maximize the possibility of passing the written boards.
Much Better To Have Conceptual Learning Than Learning Lists!
To this day, I can still remember where and when I learned certain concepts, such as features of extra-axial vs. intra-axial brain tumors (check out Osborn!) or patterns of arthritis (Arthritis In Black And White). When you go directly to the electronic references without reading these source textbooks, you are much more likely to see random lists without knowing the why behind the finding. And, you are much less likely to remember the key concepts that will help you make diagnoses later on. You know what they say – give a man a fish, and he will eat for a day. Teach a man to fish, and they will be able to eat for a lifetime! It’s true! So, make sure to learn the concepts from the text first!
More Difficulties With Complexities And Artifacts
It is much easier to figure out complex problems that don’t follow the rules if you know the basics. And, in radiology, very few cases are precisely what the literature describes. When you know the concepts behind the images, you can adjust your ideas to suit the case and allow you to make the appropriate differential diagnosis because you understand why it can fit what you are seeing. When you are reading electronic material distilled down to the bare bones, you lose out on this ability to make the diagnosis when it doesn’t necessarily follow the rules!
Getting Back To Fundamentals!
I am a purveyor of electronics. It is fun to play around with cell phones, computers, and gadgets. But, based on real-world experience with resident success, I implore residents from the first through third years to opt into reading primary textbooks to establish foundations in their knowledge base. Electronic media does play a role in learning. But, residents should consider delegating that role to the reinforcement of knowledge and not as a place to start. In the end, it is your choice. But, residents that read the introductory texts do better on the boards and make themselves better radiologists!
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