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My Palm PDA has been a great asset during the last year, both on and off the wards. Thanks to an abundance of free or trial software, I’ve had a chance to try out a large range of reference tools and trim down my list of favourites based on my usage. It’s always very easy to become swamped with information, so I believe strongly in keeping things simple and using only a select few tools. In writing this Top 5 article and reflecting on my usage patterns over the last year, I was surprised at how narrow this list really was.

1. Drug Information: MIMS + DrDrugs

Whether I’m on a ward round, at a meeting, or at my desk studying, my most-used reference is a drug guide. As a student, the task of coming to terms with dozens of drug classes is complicated by a seemingly endless sea of drug trade names. Unlike students and residents, both consultants and patients live by trade names, and I often find myself reaching for my Palm to decipher this coded language.

For this category I have found that I need two programs. One (MIMS), is the standard drug formulary in Australia, while DrDrugs is a Skyscape program of U. S. drugs. DrDrugs gives a to-the-point summary of indications, doses, mechanisms and more for each drug, and if I were in the U. S. would be all I’d need. Given the differences in drug names between the countries however, I find myself regularly checking MIMS to translate Australian to American. An alternative to both would be the Australian Medicines Handbook, but this text is only available on the Windows Mobile platform, and is as such useless to me.

2. Evidence-based practice: miniTG (iSilo)

My second-most-used reference is the excellent Therapeutic Guidelines (known as miniTG for PDAs). The Guidelines are independent, Australian, evidence-based recommendations on patient management, covering both diagnosis and treatment. They are updated a few times per year and cover 13 fields of medicine. The PDA version includes all text from the full version, with the exception of the clinical calculators.

miniTG runs on the iSilo document reader, and therefore a licence for this is also required. iSilo itself is a must-have, as there are a large number of medical texts available in this format, many of them free. Unfortunately, the legality of many of these is questionable. Other than miniTG, the only other iSilo document I use on a more than seldom basis is Harrison’s Principles of Internal Medicine (see below).

3. Internal Medicine: 5MCC

A year ago, the decision to use Griffith’s 5-Minute Clinical Consult as my main internal medicine reference would have surprised me. Everyone knows Harrison’s Principles of Internal Medicine is the physician’s bible, and this was one of the first Skyscape programs I trialled. Unfortunately, the port to a PDA version is quite limited, both in content and organisation. I struggled with it for some time before finally trying, and committing to, 5MCC.

The interface in 5MCC allows for very quick browsing of all major medical conditions. It utilises the Skyscape quick-link buttons perfectly, and allows instant switching between sections such as Basics, Diagnosis, Treatment, Follow Up and more. This was something Harrison’s on Skyscape sorely lacked. Whenever a consultant mentions a condition I need a refresher on, 5MCC gives the right answers within a few seconds.

As mentioned above, I do occasionally use Harrison’s in iSilo. Unlike the Skyscape version, the iSilo version contains the full text of the hard copy volume. It is therefore far too wordy for a quick in-corridor peek, but whenever I need a deeper understanding of a topic, I can always sit down with a cup of coffee and read the appropriate chapter. Again, the legality of this is probably not on my side, but given that I own the hard copy textbook and have access to the online version, I can justify it to my conscience.

4. Personal reminders: MemoPad

This may come as a surprise, but the above three (or four) tools are the only third-party applications I routinely fire up. It certainly was a surprise to me, as I certainly have more than three applications installed. Nonetheless, I can’t deny that one of the most-useful tools on my Palm is the trusty old MemoPad. I use this for both obvious reasons, such as jotting down the odd memo, but more often as a quick look-up for reminders I have written. These include things which I need to know, but can’t quite fit in my brain, such as bits of ECG interpretation wisdom, the MMSE questions, latest immunisation schedule, common drug dosages and more. The reason this tool is so handy, is because it is personalised and fast. The time it would take me to look up the same information in miniTG, 5MCC or elsewhere would be many times more than the few taps it takes in MemoPad.

I have tried other third-party MemoPad replacements, most notably WordSmith. While WordSmith offered some advantages, such as colour, these did not outweight the usability issues. I did write to the makers of WordSmith at the time about this and offered a constructive solution, but they were particularly unhelpful. If you can’t make your software work properly on Palm’s latest generation of PDAs, then you aren’t worth my business. At the end of the day, MemoPad does everything I need, and is faster and more responsive than any alternative.

5. Exam preparation: MedRecall

This final tool is a bit of an outlier, in that it is not a reference text but a study tool. Because the above four sections covered all of the tools I regularly use, this is one that I fire up less often but find particularly handy nonetheless. MedRecall is another Skyscape application and is a port of a textbook by Dr James D Bergin (Lippincott Williams & Wilkins). It is written for senior medical students as a study guide for final exams and covers all major topics in internal medicine. Unlike standard textbooks, the format follows a question-answer style and I find it excellent for revision. Often we find ourselves reading the same things over and over, and by posing common exam questions, this book uncovers gaps in our knowledge we didn’t know we had. I highly recommend it.