Resources for M1

With so many medical schools starting classes within the next few weeks, I thought I’d reblog some tips I had for last year’s incoming MS1s before I publish some tips for MS2s. This is what worked best for me, after lots of trial and error; pick and choose what is best for you. I know med school is stressful and there will always be a gunner or two, but the goal of your training should be to become a competent physician, and not to ace every exam. Good luck to all the incoming first years!

BOOKS:
We don’t technically have a book list or a website that lists the books, because most people don’t use them. I’d imagine that most schools are like that, at least for the first year. Our profs’ notes are generally pretty good, so even though they may say that some books are “required” in the syllabi, it’s not necessary to have them to do well in the courses.

With that being said, there were several books that I used in this past year that I thought were really helpful.

Anatomy:
-Everyone will say to get a Netter’s Atlas. It’s pretty much the gold standard, but one of the authors is actually our main professor so if there’s something in Netter’s that you don’t understand, she’s an incredible resource.
-They recommend a Grant’s Dissector–don’t buy it. There will be a group copy in the anatomy lab, but it’s not especially helpful for studying in class, and I didn’t find it very useful for lab either, because your instructor for the day will tell you how to go about the dissection, which is usually a bit different from Grant’s.
-I cannot recommend Rohen’s Color Atlas of Anatomy enough. It’s a compilation of pictures from expert dissections so you can see the same structures from many perspectives. I hated staying long hours in the lab, so this source was invaluable.
BRS Anatomy was a great resource for practice questions; highly recommended.

Embryo:
I bought the High-Yield Embryo book and it was the only resource I needed besides the class notes.

Neuroanatomy:
-You’ll need a Sidman’s and Sidman’s at our school (one of our profs is also an author) which is a self-study workbook. Hold off on buying it though, since your MS2 mentor may give you theirs (I’m giving mine to my MS1).
-I used the High-Yield Neuroanatomy and that’s all I needed besides the notes.

ICM:
Dr. K suggests Bates’ Guide to Physical Examination, which I’ve heard that most schools suggest, but I don’t think anyone used it. I didn’t.

Histology:
-I don’t think many people bought/used an outside book, but I did. The one suggested by our profs was Ross and Pawlina’s Histology, and I thought it was really helpful. I did extremely well on the exams because I’d used more than just the slides provided in class, so I thought it was worth it. I only bought it in the beginning because I found it for dirt cheap on Amazon.

Biostats (Incorporated into ICM):
High Yield Biostats was definitely worth it since our biostats is a self-study model.

Biochem:
BRS Biochem for practice questions was helpful.

Physiology:
-Personally, this was the hardest class for me, so I felt like I needed a little extra help. I bought the Medical Physiology book they recommended and used it for practice questions and clarifying things I had a bit of trouble understanding.
BRS Physiology was also great for practice questions.
-PreTest Physiology was also great, but I borrowed a copy from the Student Affairs office.

I also had a copy of First Aid (came with my AMA membership for free) that I used to review before exams.

That is all that I can think of. Books aren’t really necessary (except for Anatomy), but I do think the books I used to supplement my lecture notes definitely helped me to succeed this year.

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The Correct Answers

“Have you ever seen….. ?”  NO

“Do you want to see…. / Do you want to do….” YES

Just do it! You’ll get to do and learn so much more if you stay open to all options. Even if you’re tired. Even if you’re bored. Even if you’ve seen/done whatever it is already. Even if it’s the end of a call day. 

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Full Disclosure

I love being a mom in med school. It’s not easy. Lots of people have told me that they are proud of me for making all of these facets of my life work together so smoothly. But that’s not always the case…. far from it. So here’s my full disclosure.

Yesterday, our little Ladybug got sick at daycare. Kids get sick, not a big deal, right?

Since third year has started, I’ve had a really hard time balancing working + studying + “me” time + husband time + baby time + family time….. a really hard time. I’m behind in studying. I’m behind in UWorld questions. We still aren’t fully unpacked yet. I have a mountain of stuff to donate/sell/trash since we are downsizing (basically because I don’t want to move all of this stuff again when we move for residency). And no energy to do any of those things once I get home. It doesn’t help that we won’t have wifi until this coming weekend–and I wasn’t going to watch a 3 hour Tegrity over how to work AllScripts over my phone’s hotspot. All of these things have been weighing on me, even if I haven’t really been thinking about it.

Yesterday after getting out of my rotation, I really wanted to knock out some work and catch up a bit. So naturally, the Ladybug got sick. When we got home, we cuddled on the couch. And we watched Despicable Me 2 for the millionth time (it’s her favorite movie… she adores the Minions). My plans were derailed, I was disappointed that I couldn’t get much done, but everything was just fine.

Today we also had clinic after seeing our inpatients, so I got home a lot later than I usually have so far into this rotation. The Ladybug is still having belly issues so she is taking a nap. My first thought: I should study! My second thought: I could take a nap! My third thought: I could veg out and watch a movie and do whatever I want to do!

What really happens? A mix of things. Last night I held her while the movie played, and I read a few cases out of Case Files: Internal Medicine. Once she finally went to sleep, I spent the night in her room on the inflatable bed (not my favorite way to sleep, but she needed me and I wanted to be close)–I had no more energy to study, and I could barely keep my eyes open. We ran late this morning getting to daycare but I still managed to preround and be prepared for work rounds with my attending (who forgot to tell me we also had clinic this afternoon). She had a good day at daycare, didn’t eat much, and fell asleep on the way home.

Now, I am using my ten minutes of “me” time to write this blog post while I eat dinner. I hope to get a few cases knocked out before Ladybug’s nap is over, because I know she will want more cuddle time (totally fine by me!). I feel like a bad student because I am so far behind in my goals for studying and knocking out cases, but my daughter needed me and of course I was going to be there for her.

There are a lot of times where I feel like I’m not good at anything…. that I’m not a good mom, a good wife, med student, etc. It probably happens at least once a day. I still have not prepped freezer meals so I can enjoy family time when I get home. I still have yet to make it to the gym this week. Last year, I was almost sick over whether or not I should take a leave of absence for the first year of my daughter’s life because I didn’t think I could handle everything, all at once, and still be functional and sane. Personally, I feel like I would be a happier, better person/friend/wife/mom if I could get a 5 minute neck and foot rub every day. However, I am so glad that I didn’t postpone my education for a year, and I am ever so thankful that we decided to try for a family three years before we had originally thought. She’s made life so much fuller and richer in ways I had never expected–I really thought that when people told me how much babies change your life was just a bunch of blah, blah, blah…. but they were right. It isn’t always rosy, but most of the time it is pretty fun. I doubt myself all of the time. I don’t have my life put in order, not at all. But it’s a pretty happy life, even if I am behind in studying.

My ten minutes are up…. Back to working cases.

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What Motherhood in Med School is Really Like 

When you’ve had a great day on the wards, and leave feeling inspired and motivated to knock out a bunch of work when you get home….

… to arrive at daycare just in time to see three children, including your own, projectile vomit all over the place.

It’s going to be a long night. 

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We’ve Moved!

so in the midst of studying for Boards, gearing up for third year, and leaving on vacation… We found a new place to live. The old place, despite it’s convenient location, was getting smaller by the day with a mobile toddler and didn’t have any room outside for her to run. So we found a place a few miles away that was nearly twice the square footage for less rent, and sat on 4 acres in the country with a gorgeous view of the hills at sunset. So we were sold. We moved over the weekend between orientation and my first day on the wards. It’s been an adjustment but I really like it so far! Even with the longer drive to daycare, it takes no time to get from home to the hospitals. 

The past two weeks have been really rainy, and early this morning we were walloped by a pretty nasty storm. Our backyard was transformed into lakefront property fairly quickly. 

  
All in all, I’m loving the new place and we plan on staying til I graduate & (hopefully!) we get to move again to someplace awesome.

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It Can’t Be Found in These Pages

In the first week of M3, I have already learned that this year will be MUCH different than the previous two years of medical school. At the end of each rotation we take a “shelf” exam over common topics in that rotation, so while we might not be sitting in a classroom, we do still need to read and study.

When a patient comes in, I go take a history and physical, report to the team, and write a note. THIS is why I came to medical school! I am loving third year so far! 

However, what has become blatantly obvious in the past few days is that no book or lecture can teach compassion, empathy, or the right words for a suffering family. That comes strictly from spending time with your patients.  There is SO much to learn this year.

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Autopsy

(Don’t worry, no graphic descriptions or pictures, just details about the procedure.)

For our pathology class, we had to attend an autopsy at the coroner’s office. I was really not looking forward to this assignment; I had a hard enough time with Gross Anatomy lab and the Fresh Tissue lab during first year (and to be honest, just thinking about it makes me nauseated, because I remember having morning sickness while having to go to those labs… yuck!). So I, along with some friends, scheduled our date to go early in the year to get the assignment out of the way since second year is so busy.

We arrived at the Office of the Chief Medical Examiner bright and early at 7:30. We signed in and donned our gear, gowns, gloves, masks, bouffants, and booties, while we waited to be called into the autopsy room. While we were getting ready, the pathologists were setting up and taking pictures of the body. It’s important to document any lesions, bruising, or anything else that may be of importance later, especially if there’s a chance the pathologists will need to testify in court if need be.

When we were called in, I noticed that the room was really cold, and it didn’t smell anything like the anatomy labs we’d had before, not even the fresh tissue labs. It looked a lot like the autopsy room on Dr. G, Medical Examiner (so, no surprise there). The body was on the autopsy table in the supine (or anatomical) position.

The pathologists follow a systematic approach. We observed how they opened the body and examined the internal organs, taking them out one by one, weighing them, and placing them on the table for the attending. The most senior member of the team was standing on a platform at the foot of the table, on a raised stand, that had a flat top to work on. She would take an organ, like the heart, and make consecutive linear cuts with her scalpel through the muscle and along the coronary arteries. (I heard the residents call it “breadloafing”.) This way, she can see if there are any lesions and if so, how it changes or how extensive it is through the tissue. (We could actually see plaque buildup in the coronary arteries of this particular heart.) pieces of tissues were saved to go to the pathology lab, and notes were taken about damaged organs or any other findings. 

I have always thought surgery was awesome because you can open someone up, fix a problem, and restore them. I think what jarred me so much about anatomy lab was that we couldn’t restore the person’s structures. Autopsies, for me, are nearly the same–it still doesn’t appeal to me because there is no way to restore, although pathologists do provide a valuable service to patients and families.

I think it would have been fine if the coroner wouldn’t have shared the details of the case with us. The more he spoke, the more I didn’t want to know. The case was complicated and heartbreaking, and I wound up crying on the drive home. I’ve thought about that case many times since then, and it still breaks my heart.

What I was surprised by most is that this was yet another version of death that felt different than any of the others I had experienced. Being with a patient when they die, attending a funeral, dissecting in anatomy lab, observing an autopsy… each has had its own, different effects on me. I’m fairly confident that I can forego pathology (or at least forensic) off of my specialty list.

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On the Road Again

With Step 1 behind me and the first birthday celebrated with family and friends, it was time for another adventure. 

It wasn’t necessarily planned to be a great adventure like our previous trips to Yellowstone National Park or the Grand Canyon, but it was planned to be special for another reason: we were taking the sweet Ladybug to Asheville, North Carolina (where David proposed 5 years ago on the Biltmore Estate) and Gatlinburg, Tennessee (where we spent a few days after the wedding 4 years ago, since our original honeymoon plans were scrapped due to moving and immediately starting new jobs) for hiking and to visit the Ripley’s aquarium. The Ladybug got to add a 6th state to her list, and even though we’d been there before, we got to try some new things too.

It may not have been the mountains I was really longing for, but they have soothed my soul anyway. 

So instead of boring you with more words, here are some pictures from the first part of our trip, since I am currently the copilot as we push on to TN today:

   
                       

  

   

   

   

   

   

  

  

   

  

  

  

  

  

  

  

  

  

  

  

         

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To the Mom at the Pool

To the mom at the pool today in the bikini, with the rounded yet sagging stomach and faded stretch marks… I commend you for being far braver than I am in my postpartum body that I refuse to accept so comfortably. 

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Second Year Resources

*Once Step 1 was over, I took a couple of weeks to veg out and be human again, so this list is a bit late in its arrival. However, I hope all of the new second years that read this find some of it to be helpful. Good luck in your second year of medical school! Don’t worry too much about Step 1 just yet, you have plenty of time to prepare well for it!*

Now that second year is over, grades are in, and that silly Step 1 is out of the way, I thought I’d share the list of resources I used for second year that helped me to be successful. I’m pretty sure that I’ve mentioned before that first year was difficult… mostly, I think, because I was pregnant, hormonal,  and preoccupied with things outside of medicine beyond my control, so I felt like I performed below what I could have. Second year, though, was a totally different beast. Everyone I’ve talked to has said how horrible second year is, how it is so much worse than first year… so if you are a rising second year and have heard upperclassmen say these things, I’m going to contradict that and say that I absolutely LOVED second year. I really, truly did. Second year, I knew a lot more about what I was doing in clinic, I had more freedom to study at my own pace and in my own style, I found that I actually had more time to do fun things like explore different specialties, and overall I had a really great time. I may be the oddball, but that’s ok. :)
Anyway, these are the resources I used and my general strategy, and I included the links to Amazon for most of them so you’d have access to the exact book I was talking about, since some of them are confusing (like Blue Robbins versus Red Robbins). As always, use what works best for you.
Path:

Path for me was like Anatomy all over again: Too dense, too many resources, not enough time for it all. So after Block 2 I stopped going to class and studied on my own.
Pathoma: Last year Pathoma was a required text and we had dedicated time to watch the lectures online. This is a very good resource and most people really like it. I did, but I found that Dr. Sattar hits the highlights and sometimes I needed more than that to understand things. http://www.pathoma.com/
Blue Robbins: This is the actual required textbook, if I remember correctly. Not a whole lot of people used it from what I heard, but I really liked it. Pathoma made more sense after I read the corresponding chapter here. http://www.amazon.com/Robbins-Basic-Pathology-STUDENT-CONSULT/dp/1437717810/ref=sr_1_1?s=books&ie=UTF8&qid=1437434628&sr=1-1&keywords=robbins+basic+pathology
Red Robbins: This one is literally just extra questions to make sure you master the material. Also very good. http://www.amazon.com/Robbins-Cotran-Review-Pathology-3rd/dp/1416049304/ref=sr_1_2?s=books&ie=UTF8&qid=1437434739&sr=1-2&keywords=Robbins+pathology+questions
WebPath: Not a book, but a question bank that was REALLY helpful. http://library.med.utah.edu/WebPath/GENERAL.html
A lot of people also swear by Golijan (http://www.amazon.com/Rapid-Review-Pathology-STUDENT-CONSULT/dp/0323087876/ref=sr_1_7?s=books&ie=UTF8&qid=1437434628&sr=1-7&keywords=robbins+basic+pathology) but I simply didn’t have enough time.
For block 1, I only did Pathoma + attended classes + red Robbins questions + Webpath and I didn’t do nearly as well as I wanted. So for Block 2 I quit going to class and did Blue Robbins then Pathoma then WebPath and Red Robbins (and then reviewed the same material in First Aid) and my grades went up 15%.

Pharm:

I used the Katzung book (http://www.amazon.com/Katzung-Trevors-Pharmacology-Examination-Review/dp/0071789235/ref=sr_1_1?s=books&ie=UTF8&qid=1437434837&sr=1-1&keywords=katzung+pharmacology) which I really liked because it gave you everything you needed to know concisely. This was really all I needed for Pharm.
Micro/Immuno:

Immuno was covered in Block 1 last year. I used this book: http://www.amazon.com/How-Immune-System-Works-Desktop/dp/0470657294/ref=sr_1_4?s=books&ie=UTF8&qid=1437439812&sr=1-4&keywords=immunology+textbook and I really wish I would have read it over the summer, or focused just on it during the class. It’s a thin book and a quick read and it gives lots of drawings to show all of the signaling that would have made Immuno so much easier.
For Micro, what I thought was most helpful was Clinical Micro Made Ridiculously Simple (http://www.amazon.com/Clinical-Microbiology-Made-Ridiculously-Simple/dp/1935660152/ref=sr_1_1?s=books&ie=UTF8&qid=1437439962&sr=1-1&keywords=clinical+microbiology+made+ridiculously+simple) and I loved it. The silly pictures really stuck in my mind (and made the Antibiotics section SO EASY compared to what we got in Pharm).
I’ve also heard good things about Sketchy Micro and that people love it, but I didn’t have the time and didn’t want to shell out more money for yet another resource when I already had so many.
CNS:

We didn’t really need any books for this class, but I basically reviewed the neuro and pysch sections in first aid and grade-wise this was one of my best classes out of both years of med school.
*After studying the specific material for class for each block, I also reviewed the corresponding chapter in First Aid, and wrote down any notes or mnemonics that I found were helpful. I also used the First Aid Cases for the USMLE Step 1 and found it to be helpful in understanding how patients would present and drawing out which facts were important.

And now, for the monster that breathes down your neck the entirety of second year:
Step 1:

You’ll start hearing about Boards and Step 1 from the first day. It gets annoying. But work hard this year and figure out your study schedule and you’ll have no worries. Some schools may allow some of the commercial test prep companies to come to campus to talk about their products, if you choose to go that route. Last year Kaplan, Becker (formerly Falcon) and DIT came to our campus. I used UWorld + First Aid + Pathoma + DIT and felt really prepared for my exam. Becker was too expensive for me and I hated Kaplan when I used them for my MCAT (and they use the same setup for Step 1) so I didn’t want to use them. Personally, I liked the format of DIT and I liked the corny jokes too, so I went with them. Plus they have an outline that is basically your study schedule, so I didn’t have to make my own. But plenty of people just used UWorld + First Aid and passed the test, so any of that is up to you; you know how you learn best. There are also plenty of online sample study schedules if you take a few minutes to browse for them. For the most part, focus on studying for your classes very well, as that will be a big help for when you go into your dedicated Step 1 study time.
People will be freaking out about Step 1 as soon as classes start. Don’t let the white noise get to you. I found that if I was around someone and they were talking about focusing on UWorld while I was studying for Block that I would have a momentary freak-out, so I just had to tune it out. I think our administration really helped us to prepare over the course of the year, so that was also a big help when I was having panicky thoughts about the exam.
The most in-depth study strategy I found for Step 1 was the Two Think method, found here: http://blog.think2x.com/2011/08/31/the-think-twice-strategy-guide-for-usmle-step-1/. I think it’s a bit overkill, but elements of it worked for me.

One thing I didn’t know until after Step 1: UWorld has an app and you can work questions on your phone. I’ve been working Step 2 questions on my phone during down time on rotations. The app itself is free, but you do have to have an active account with them to be able to use it.

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