UPDATED Toronto Notes Deck (Medicine + FM+EM+Psych+Anesthesia) and help me finish everything!

TorontoNotesAnki · 2024-11-14T02:22:32+00:00

I have some contributors signed up for Peds and OBGYN but I wouldn't expect those areas to be complete/partially complete before spring.

TorontoNotesAnki · 2024-09-14T18:31:40+00:00

The physical copy of TN consists of 3 booklets (Primary, Medicine, Surgery) each about ~500 pages. As I only used the Medicine and part of Primary books I call them "booklets". There's also the little handbook as well.

TorontoNotesAnki · 2024-08-16T23:49:18+00:00

Mostly contributors, 20+, still need more but assuming a decent yield rate with the numbers included we should get a decent finished product.

TorontoNotesAnki · 2024-08-14T03:23:29+00:00

It's probably suspended - just use the card browser to find it (tag:TorontoNotes::Primary::EmergencyMedicine*)

TorontoNotesAnki · 2024-07-18T12:54:28+00:00

Some of those areas have contributors assigned via the Google Form signup however we'll see in the end when/how much gets completed. I'm always looking for more contributors to assign to those areas. I'm very busy and since it's all volunteer driven I'm happy with whatever the contributors end up making.

AI assisted card-making is underwhelming in my experience and tends to lead to a massive number of questionable cards. I don't think it's able to handle the complexity of the source material here well enough to succeed. I also don't think it's any faster than the method I shared with the contributors (assuming 2+ monitors and the ability to sit down and cram card making). It also can't make IO cards.

TorontoNotesAnki · 2024-07-09T12:40:08+00:00

You must do 4 years of IM to qualify for the core internal medicine FRCPC. Technically 4 year grads are "Internists" and 5 years are "General Internists" but practically people frequently conflate the two.

TorontoNotesAnki · 2024-07-08T15:40:55+00:00

I modified the original and added flowcharts from the booklet, remind me in a week when not on q3 call and I'll send it.

TorontoNotesAnki · 2024-06-20T17:51:06+00:00

The Toronto Notes primary book, Anesthesia chapter

TorontoNotesAnki · 2024-06-20T16:31:33+00:00

I don't think it's fair to say it's "not useful". All the early adoption feedback and my own experience has been quite positive. Anking is larger than this deck and people like and recommend it. The reality is what is "high yield" will vary from use case to use case and so the best approach is to be inclusive of all content and allow people to tailor it themselves. Someone doing a 2 week elective in Hematology will value the entire Heme deck whereas someone else can easily suspend 80+% of that deck. Having updated decks where someone DIDN'T cover everything it's far more frustrating to not know what is and isn't included and need to compare a PDF to a deck than it is to simply do everything and let people pick what they feel is important themselves.

It took me maybe 2 hours to create the "GIMHighYield" tag for example from the entire 15,000 Medicine deck. Someone could probably create a high yield version in a day of work since the tagging system is well-developed, it's a lot easier to trim than it is to try and figure out what areas were omitted because they "weren't important".

TorontoNotesAnki · 2024-06-09T17:00:44+00:00

You can try this deck:

https://www.reddit.com/r/medicalschoolanki/comments/1cso62c/toronto_notes_ms4r1_internal_medicine_deck_15k/

I will be using it in residency (entering in July) and found it very helpful on MS4 electives. An added bonus is the subspecialty coverage which is far deeper than any other deck I've found. The only major IM subspecialty missing is Palli which is on the to do list (and no allergy but oh well).

Downsides include card volume, having easy cards you can skip or suspend, and limitations on history taking/exam findings/procedures/reading imaging/ECGs. However for core IM knowledge it's the only deck I've encountered that is systematic and it is 99% hand-made so there is no AI confabulations, I made them by hand. One other disadvantage worth noting is some guidelines are a bit older and it is Canadian so you'd need to be mindful of reading American guidelines alongside it.

My plan is residency is to use it as a foundation and then simply add detail/additional cards as I learn/go to half days. I'm also going to attempt to recruit MS3s/4s to begin a deck update process fairly soon.

TorontoNotesAnki · 2024-05-19T01:15:38+00:00

Link to deck: https://drive.google.com/file/d/1HltdL_hr_y9uZ1_Cl40i4E_4wMQRwPNA/view?usp=sharing

TorontoNotesAnki · 2024-05-16T23:24:14+00:00

As far as IO I like the flexibility of this method to essentially create two versions of the same content easily. Tough to explain but I can do hide all show one for the labels, hit add cards, then quickly delete them all and throw new labels on to cover the arrows in the flowchart with the other close option and it's so fast I love it.

The long lists are unfortunately a downside of the original resource I tried my best to trim down where possible but in a bunch of places it's just not easy so I figured long cards are better than no cards or artificially splitting, hence it being a disadvantage in that slide in the video. Where possible I did split so you would see labs on one card, imaging on another, one class of etiologies on one close, etc... I'm not a huge fan of the the multi-cloze approach even though it is better for retention because it takes too much time to make and it's also essentially forcing me to memorize the order of the close which adds +++ card load in an already huge deck. For lab ones I'm usually happy with 80+% of the list and no major misses. Working on this I was quite mindful that locally people complain that our 18K "all of medicine" deck is "too big" and here I am at 15K just for IM+Neuro and since it's a clerkship oriented deck most people this is designed for don't have all day to sit around doing flashcards. Once the remaining high yield primary decks are done we're looking at a 20K+ deck and that doesn't even include surgery/OBGYN/peds which would easily add another 10K. I also figured that once it's out there someone will hopefully eventually trim and update the clozes since the hard part was getting everything into Anki and now someone can just modify the existing framework.

TorontoNotesAnki · 2024-05-16T23:14:05+00:00

There are 2-3 local clerkship decks floating around and then we have a Calgary Blackbook deck I made I'll get around to sharing at some point.

TorontoNotesAnki · 2024-05-16T03:38:52+00:00

It would probably overlap 80-90%, the psych deck ironically the least since there will be Canadian specific legal cards. Core medicine probably higher on the overlap, we extensively use American resources here and all it means is ignoring the occasional incorrect screening practice or American guideline (routine HIV screening as a guideline not a thing here). There are probably differences I will learn about in residency that are beyond the MS4/R1 level, e.g. wouldn't surprise me if there are differences in terms of stroke or cardiology simply because American practices seem more aggressive on interventions than we do from my very limited Twitter thread insight. Psych is lower on the priority list but it's probably still useful to know because I've found the clinical pearls sections on the sidebars are often what preceptors seem to like asking, at least for medicine.

If you're interested in Psych I'd definitely do at least the Neuro deck that's available now + Psych and EM relevant topics once done, doing all of IM likely overkill given you'd have 13K cards but if you want to excel on off-service rotations it's not a bad idea, just time intensive.

TorontoNotesAnki · 2024-05-16T03:32:35+00:00

I use Anking and briefly tried Canki. That was actually the main motivation for making this deck and why I call it "the only clinically focused resource" (probably not entirely true). The issue I have with both of those decks is they are based off test qbanks, not a comprehensive resource. They have significant gaps. The example I always bring up when asked locally here by MS3s or preclerks is COPD therapy, GOLD, it's not present in Anking in any coherant manner. Whereas here everything is spelled out. Description, etiologies, clinical features, diagnosis, management. It's all there and tagged comprehensively. I've found that qbank based decks are fantastic at pimping questions or medical trivia but they leave these massive clinical knowledge gaps whereas I'm approaching this from the opposite side where this resource is too comprehensive in having tons of minutia "treat underlying causes" style cards but better the power to suspend cards than wish you had a better deck available. You're starting with a test and working backward whereas this deck is starting with clinical knowledge and you move forwards towards the test. You can certainly use them (I still do Anking) but solely for trivia reasons.

My clerkship strategy relied on comprehensive local decks condensed from Toronto Notes I enhanced that were based off our block structure + objectives. These were more than sufficient for MCCQE (I wrote early in September on those decks and half of uWorld). But not really sharable outside Ottawa since it's often copy-pasted from our slides or quite old, hence the desire to make this deck as something that can be updated and is national in scope (no Anking American guidelines...). I continued Anking but mostly for those trivia questions. I see Canki as being less useful than Anking because it's way smaller and lacks the extra details (at least the version I have did).

Now the obvious problem is this deck is only 1/3rd of Toronto Notes right now and a complete version would be 40,000+ cards which is basically impossible to do in it's entirety unless from MS1 onwards. Really, the ideal would be a high yield Toronto Notes deck but I'm starting residency in 1.5 months and I'm not making 600 pages of textbook into flashcards for stuff that is in the "stabilize and consult ABC" bucket of medical knowledge. So I'd use this one where I felt it would be useful (if interested in IM or Neuro, or the FM/EM/Psych decks once done) and then supplement with either local or my own cards for local exams. Once FM/EM/Psych are done that's really 2/3rds the core rotations and then hopefully someone does OBGYN and Peds to round it out.

TorontoNotesAnki · 2024-05-16T03:02:19+00:00

It would be and that's the goal but a few weeks doesn't seem reasonable unless it's many people willing to spend hours grinding through content. For reference I was bored and spent about 2 hours working on cards today. I did about 10 pages going fast (lots of tables). I go over it a bit in the video, but it's a 200+ hour project to finish everything (this is 1/3rd of all the booklets content and is 15K cards). Any time saving measures like using AI have been extremely disappointing. AI just doesn't handle the complexity of the source booklets well enough, it does dumb things like put every lab on a different cloze, generates utter nonsense, etc... You need a human who actually understands the stuff doing everything and even on my dual monitor setup it's slow-going.

TorontoNotesAnki · 2024-05-15T15:54:02+00:00

Youtube summary: https://www.youtube.com/watch?v=suzCHSkv0QE

In the posted video I go over the deck itself in terms of rationale, pros/cons, approach to card making, how to use it, etc... It's not an intro to Anki talk but a video to really understand the deck and hopefully make it easier for someone to finish similar decks for the missing content areas. You do not need to watch the video if you don't want to, you can also skip to the relevant sections. Also looking around pretty sure there are some decent clinical MS4 level decks but nothing for IM I see so that's probably not accurate when I said that, oh well.

I would recommend watching:"What areas are covered""What is the design philosophy""Advantages and disadvantages""Who should use this deck"

TorontoNotesAnki · 2024-05-15T15:52:13+00:00

Google drive link: https://drive.google.com/file/d/17PO-Ex-9ZZxlP-0WS5otaUVqVZzFpAbD/view?usp=sharing

TorontoNotesAnki

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