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  Fundamental MedicineTeresa Gryder, ND

The Black Book -- How to -- for Naturopathic Medicine Students

5/26/2022

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Organizing your medical knowledge is a big project. If you are unsure why you'd want to make a Black Book for yourself, please read the previous post. I think most students don't start because they don't know how--and because the schooling process leaves you with so little time for synthesis. Organizing it all is intimidating and seems impossible. Besides, everything is searchable now. You can look it up on the internet. You can search for terms in digital documents. 

What you cannot locate or organize using technology is your mind. The only way to synthesize the things you learn is by using your brain. You decide which information is most valuable by processing every bit of it through that giant calculator in your skull. I process data by writing it in my own words, and organizing it into my own categories. Making Black Book pages is a good way to do that.

Before you start making a black book page for any one condition, create your Template. Use a familiar word processing program. Choose a format that suits you--font, size and overall style. Make your own original header and footer and decide on the headings you will use. Date it. Then improve it as you go along.  Put your logo or byline in there.

Save your Template somewhere accessible. You will duplicate it whenever you want to make a new Black Book Page. At the beginning you will create a lot of documents filled with mostly empty space. Don't worry about that. Start one any time you learn something useful about a condition that you don't have notes on yet. It will grow.

Here are the parts of a template:
  • Name the template document. I name mine AA_Template so that it's always at the stop of the alphabetical stack of documents.
  • Title. In the template I have the word TEMPLATE as my title, and I center the title in the header.
  • Your name, business name and byline. This also goes in the header.
  • Date updated. I like to put in a date that I can just click to make it today.
  • HEADINGS. I capitalize my headings so they stand out from all the other stuff, because sometimes the sections get long.
  • Page numbers in the footer if you care.

Picking the headings is important.  These notes will become your protocols. For each condition or diagnosis you collect information and your headings will influence what information you seek. That information guides prevention efforts, assessment and treatment. As long as you practice medicine, there are opportunities to expand.

Below are the headings I use most. The PDR (Physician's Desk Reference) or Merck Manual will show you the categories and organization that are used conventionally. Start with a lot of headings in your template and delete any you don't use. After a while you'll change your template to match your way of thinking. Reorganize however it suits you.

Category headings are in ALL CAPS in my BB, and they differ depending on the condition.  Many of these are in there:

DEFINITIONS
ETIOLOGY
RISK FACTORS
PREVENTION

EPIDEMIOLOGY
HISTORY
INCIDENCE
TRANSMISSION

NORMAL PHYSIOLOGY
PATHOPHYSIOLOGY

PRESENTATION
DIFFERENTIAL DIAGNOSIS
RELATED
EVALUATION (HISTORY, PHYSICAL EXAM, LABS, IMAGING)
COURSE & PROGNOSIS (PARQ)
TREATMENT (ends up being a big category, I use an outline)
SOURCES
RESOURCES

I will explain more about what goes under each heading in a future post. ​If you are new enough to medicine that you don't fully understand the meanings of these headings, a smart first project is to learn the words. I didn't know them all when I started, and it would have helped.
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The Black Book - Why to - for Naturopathic Medicine Students

5/25/2022

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There are students working in the medicinary again. Due to covid we had no workstudy students for a couple of years. It's good to have them back, to be teaching again. And it's a heads up about all the things they just haven't been taught, don't know, don't have any way of knowing. I have a few pieces of advice that I have given to lots of ND students in the past, and I decided it's time to write them down because their shifts are shorter than ever, and we are so understaffed that we rarely have much time to talk.

There's one piece of advice that I wish someone had given me before I even started Naturopathic Medical school. This tidbit could be useful for anyone studying medicine, or really, for anyone studying something complex that they hope to be really good at. This is it: find a way to organize your knowledge, and do it persistently for your whole life.

In medicine, like in any large field of knowledge, there is more to know than any one person can. There is more than you could possibly remember. This is why there are specialists, and reference books. But an ND degree is preparation to be a primary care doctor, and in primary care, anything or anyone could walk through that door. You have to be ready. You want to do right by your patients.

To develop deep knowledge you need to approach your subject from lots of different perspectives. To practice naturopathic medicine, you need to understand the conventional approach and something about all the alternatives. You must do the work of sorting through what works, what doesn't work, and what we don't know yet. Sometimes the conventional approach is the best, and sometimes it fails. You need to know that.

But back to that tidbit of advice I wish I'd had. Start your Black Book. The Black Book is a term for whatever system you use to organize your notes about conditions and treatments. I don't know where the term black book comes from, but I do know that Wiccans write out their spells in actual black books. Farmers keep notes on their plantings and when things bloom or fruit, which is how we know that the grape harvest in Napa Valley is a whole month earlier than it was a decade ago. These days my notes are in documents stored on dropbox, accessible anywhere I can get online.

​I suggest that every student of Naturopathic medicine begin while you are in school. Ideally you'd start before you are in school, or in your first year, but most students don't because they don't know what information is important, yet. They don't know how to organize it. If this describes your situation, the next post is the How To of the Black Book. You are expected to know not only how the body/mind/spirit works, but also the conventional standard of care, and enough about a myriad of alternatives to pick the best ones for patients who don't want to do what convention dictates.

If you start while you are in school, you can use your black book as a study tool. Make black book pages relevant to whatever therapeutic targets are mentioned. Don't worry if you don't have information for every heading, just put in what you have learned. When you are preparing for yet another test, get the useful bits into your Black Book. Use the clinical board exams as another occasion to build your understanding. Study up on any conditions that you or your dear ones have, because that could well end up being your specialty. Later you will study the same way for your patients, each time one comes in the door with a new concern. Continuing Education requirements are an attempt to force even complacent doctors to update their knowledge. The practice of medicine is best done by life long learners.

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    Author: Teresa Gryder

    Integrative Physician and Student of Life, Medicine, and the River.

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