BUN/creatinine
>20:1 may support upper GI bleeding or a prerenal pattern; interpret in clinical context.
For students & colleagues
Resources I share during rotations and with fellow clinicians—selected for practical usefulness, not completeness.
Reference shelf
General-purpose assistants, clinical AI tools, ambient documentation, and journals following AI in medicine.
General-purpose AI assistant for questions, drafting, analysis, and summarization.
Open ↗Anthropic assistant with strong long-context reading and writing capabilities.
Open ↗Google's assistant, integrated with Search and Workspace.
Open ↗Microsoft assistant integrated across Bing, Edge, Windows, and Microsoft 365.
Open ↗AI answer engine with web search and inline source links.
Open ↗Research assistant for organizing and asking questions across source documents.
Open ↗Clinician-focused medical evidence search and summarization.
Open ↗Clinician chatbot with drug reference and clinical-document drafting tools.
Open ↗AI-augmented digital cognitive assessment platform.
Open ↗Remote patient monitoring and health coaching for chronic conditions.
Open ↗Peer-reviewed research and commentary on AI in medicine.
Open ↗JAMA Network research and commentary about AI in healthcare.
Open ↗High-yield tools for risk estimation, prevention, prescribing, and shared decision-making.
Medical calculators, equations, and clinical decision-support tools.
Open ↗Preventive-care recommendations searchable by age, sex, and risk factors.
Open ↗Estimates 10- and 30-year total cardiovascular disease risk.
Open ↗Open 10-year cardiovascular-risk calculator incorporating additional comorbidities.
Open ↗Ten-year fracture-risk estimate with or without bone mineral density.
Open ↗Treatment reviews organized around benefit, harm, NNT, and NNH.
Open ↗NCI cancer incidence, mortality, and survival statistics.
Open ↗Frequently used primary-care journals, guidelines, and point-of-care references.
AAFP's peer-reviewed clinical journal for family physicians.
Open ↗AAFP patient-facing health information.
Open ↗Concise, actively maintained primary-care reference.
Open ↗Peer-reviewed radiology reference and teaching-case library.
Open ↗Current diabetes standards, tables, and clinical recommendations.
Open ↗Global strategy for COPD diagnosis, management, and prevention.
Open ↗Global evidence-based asthma management and prevention strategy.
Open ↗Guidance for CKD evaluation and management.
Open ↗Medication access, lactation safety, opioid guidance, immunization, and travel health.
Local cash-price comparison and prescription coupons.
Open ↗NIH database on medications, lactation, and breastfed infants.
Open ↗Clinical practice guidance for prescribing opioids for pain.
Open ↗Destination-specific health and vaccine recommendations.
Open ↗Current child, adolescent, adult, and catch-up schedules.
Open ↗Patient-specific CDC pneumococcal vaccine guidance.
Open ↗Validated screeners and practical clinical tools.
Parent education, preventive-care schedules, milestones, and community prevention.
Nemours-backed information for parents, children, and teens.
Open ↗AAP-backed parent guidance across ages, stages, safety, and nutrition.
Open ↗AAP periodicity schedule, anticipatory guidance, and visit resources.
Open ↗Developmental milestones from 2 months through age 5.
Open ↗Community water-system fluoridation information.
Open ↗Contraception, pregnancy, reproductive care, and cervical-screening guidance.
Patient-centered birth-control information and access support.
Open ↗Practice bulletins, committee opinions, calculators, and clinical tools.
Open ↗Free multilingual patient fact sheets and clinician guides.
Open ↗Risk-based management for abnormal cervical-cancer screening results.
Open ↗Medication review, deprescribing, symptom support, and social-care navigation.
Potentially inappropriate medications in adults 65 and older.
Open ↗Evidence-based deprescribing algorithms and patient handouts.
Open ↗Patient-facing symptom assessment tool.
Open ↗Search for free and reduced-cost food, housing, transport, and financial support.
Open ↗Quick reference
Useful first-pass calculations—signals, not diagnoses. Verify formulas and interpret them in the full clinical context.
>20:1 may support upper GI bleeding or a prerenal pattern; interpret in clinical context.
MCV ÷ RBC count: <13 supports thalassemia trait; >13 supports iron deficiency.
Albumin ÷ (total protein − albumin); an inverted ratio or large globulin gap warrants context and possible monoclonal-protein testing.
Measured Na + 1.6 × (glucose − 100)/100; consider 2.4 at very high glucose.
Measured Ca + 0.8 × (4 − albumin); use ionized calcium when accuracy matters.
AG + 2.5 for each 1 g/dL albumin below 4.
FENa <1% or FEUrea <35% can support a prerenal pattern; diuretics and CKD limit interpretation.
Often referenced
Rotation essentials
Prepare agenda items, likely orders, prior history, and care gaps in advance. Never start the encounter before the patient arrives.
Merge duplicates, resolve inactive problems, reject noise, and distinguish longitudinal problems from diagnoses addressed today.
Alt + Space opens Epic search. Use it for activities, orders, calculators, and trends. Let suggestions populate before pressing Enter.
Use Smart Butler (.?) to find SmartPhrases, SmartText, and SmartLinks. Copy useful phrases, then revise them into your own voice.
MEAT what you address: Monitor, Evaluate, Assess/Address, or Treat. A diagnosis on a list is not adequate support by itself.
Confirm clinic-collect versus lab-collect settings, future dates, available point-of-care tests, and local vaccine workflows.
Local configuration changes. Use current organizational job aids and ask the clinical team when a workflow is uncertain.
UMass-specific
Connected monitoring and coaching through the Digital Health workflow, including hypertension, diabetes, heart failure, and weight management.
Brook Health ↗Medication-access pathways may help eligible patients obtain high-cost therapies. Eligibility and payer rules vary.
HRSA overview ↗Care management may address transport, food, housing, utilities, benefits, and health-related civil legal needs.
Findhelp ↗Massachusetts resource navigation by ZIP code and need, with clinician referral capabilities.
CommunityHelp ↗This page is an informal learning aid, not an official UMass Memorial policy or workflow document. Verify current eligibility and referral steps in Epic or with the responsible team.
External tools, calculators, AI systems, and summaries can be incomplete or wrong. Do not enter identifiable patient information into a tool unless its approved privacy and security status is clear.