Happy New Year (MS1 Recap #1)
“I hope you will have a wonderful year, that you’ll dream dangerously and outrageously, that you’ll make something that didn’t exist before you made it, that you will be loved and that you will be liked, and that you will have people to love and to like in return. And, most importantly (because I think there should be more kindness and more wisdom in the world right now), that you will, when you need to be, be wise, and that you will always be kind.” -Neil Gaiman
I hope everyone had a merry Christmas and happy New Year! Since we finished up our first semester of med school, I thought I’d do a little recap of the classes completed so far. Just a heads up, this post will probably only be interesting to students who are going to take these classes. Or people who are really interested in my life/writing…thanks and I love you too, Mom and Dad. If you’re not my parents or a future med student, save yourself from boredom and check out the previous posts. Or some viral youtube video.
For those of you still reading…without further ado, here we go:
Block Schedule: One of the unique things about the Muncie campus (and a few of the other campuses) is we have block scheduling. So instead of taking multiple classes at once (like college), you take one class at a time at an accelerated speed. The advantage is you have less time to forget things. The disadvantage is you have less time to learn everything. At the end of the block, you take a NBME Shelf exam. In between blocks, we have a day off. That day off is gold.
ICM (Monday mornings, all year): Intro to Clinical Medicine. During orientation, you and 7 other people are assigned to a doctor. There are 3 doctors, and from what I hear they all have pretty different styles. I’m biased, but I think Dr. Williams is the best because he’s really chill and doesn’t sugarcoat stuff. The class is Monday mornings at 7am in the hospital. You have assigned readings that are discussed during that time and depending on the doctor, you usually see patients. Dr. Williams has us go in groups of 2. We talk to the patient and basically get their story about what brought them to the hospital. The next week, we “present” our patient to Dr. Williams, meaning we talk about what we learned. Sometimes he’ll pull up their chart and we can find out what happened to them since we last saw them. Every week is a different patient.
This class is definitely not something to stress about; it’s basically meant to teach you the practical aspect of being a doctor (i.e. how to talk to patients and deal with various scenarios, such as ethical issues). It also prepares you to take the OSCE. Our first OSCE was on November 14. It was one of the highlights of the semester. They have standardized patients come in and you have to pretend to be their doctor obtaining their history. It’s basically like dress up except you’re graded and you have to memorize how to take a history. I had a blast doing mine and I think everyone enjoyed the experience.
Quick recap/advice: This class is early, but it’s fun. Don’t stress about it at all. Even the OSCE is nothing to stress out about. Just a little bit of memorization…oh, and you should know how to talk to people ;)
Anatomy (7 weeks): So the first day (Monday) was just an orientation day, but we started with anatomy on Tuesday. So our first day of class involved us cutting into a cadaver. Not many students can say that (or would want to say that!). I’ve seen cadavers before, but it was a weird experience actually working on one. We were assigned to tables 1-6, each containing one cadaver. There were 4 people per table. So the first day, you show up excitedly in scrubs or old clothes, walk into the lab, find your table, look at the strangers in your group, and then look down at the stranger on the table. Then it will slowly hit each person in your group that you’re about to cut into a human body. The first step is skinning. Obviously no one has done this before, so you’re filled with questions. Our professor demonstrated on one cadaver and told us the connective tissues will look like the white stuff under an orange peel. Then we were supposed to go at it. We had a great TA who walked around and helped us with technique. After the first few days, everyone becomes a pro at skinning. Which is super weird, but good because a large amount of dissection involves skinning and clearing the fat. And let me just say…you will despise your smelly scrubs by the end of anatomy…
The first week of anatomy is pretty cool because there’s no test, so everyone is kind of just getting used to being in lab. The official lab time is 1-4, but people can stay late or leave early, as long as you get the assigned dissection done eventually. The next week, people were a lot more tense because we had our first lab practical that Friday. One really important thing you’ll learn quickly is knowing when to tune out other people. There will always be someone in the class who is way more stressed out than you or someone who is not nearly as stressed as you. Paying too much attention to the stress level of others will only stress you out. So it’s best to just focus on what you need to learn instead of getting caught up comparing yourself to others. And don’t forget to be nice!
The lab practicals involve Dr. Wilkins getting to the lab super early and pinning certain structures/vessels on the various cadavers or models. The day before a practical, everyone walks around the lab and reviews the other bodies and models. You’re responsible for identifying all the bold terms in the dissection book in every body (not just from your own body). For the practical, you have a clipboard and numbered sheet of paper. He has 50 questions set up. So you go from station to station in whatever order you want (there’s no time limit per station) and identify the marked structure/vessel. Most of our practicals (except for the last one) were on a Friday, and he usually had them graded by the following Monday.
The way the schedule worked is we were in lab every day, occasionally had a Clinical Correlation lecture (a doctor gives a presentation relating to what we’re learning), lab practicals every other week, and lecture exams on the Fridays that we didn’t have lab practicals. So the second week we had a lab practical, the third week was a lecture exam, fourth week was a lab practical, etc. There is no lecture for anatomy, so you’re on your own for learning the material tested on the lecture exam. My struggle with anatomy was knowing which book to study from because everyone had different advice. Some said BRS, some said the textbook (Essential Clinical Anatomy), some said the dissection book (Grant’s) and Netter’s Atlas. I guess my advice is to pick one book and stick with it. There’s no way to learn everything, so learn as much as you can as well as you can.
The NBME Shelf exam for anatomy is ridiculous. Everything is clinical, but you’ve just spent 7 weeks memorizing every single thing (very scientific term, I know) in the body. Your brain is slightly to totally fried (again, very scientific) and now you need to apply your memorized terms to clinical situations. I say the best thing to do is try to learn the material really well during the weeks leading up to the shelf, because you have almost no time to study for it: we had our last lab practical on Tuesday and the shelf exam was Wednesday morning. Oh yeah, and the anatomy shelf exam includes embryology. Except we hadn’t taken embryology yet. It was one of those situations where a sense of humor is absolutely a necessity. Thankfully, although it’s considered your final, the shelf isn’t really meant to fail anyone. If you’re passing the class going into the shelf, then you will most likely pass the class. Talk to your professor if you’re struggling. They want you to succeed. Just be grateful for the curve. The curve is your friend.
Quick recap/advice: Anatomy is hard, but I’m glad we got it over with first. Make sure you remember to sleep, exercise, and enjoy your life even though you have a lot to learn. I was a psych major in college and never took anatomy, so I was learning everything for the first time. If you can take an anatomy course prior to med school, it would help you slightly because you’d at least be familiar with the terms. But if you don’t take an anatomy course, look at it like a new relationship: you get to discover everything for the first time. And if your relationship with anatomy is anything like mine was, you’ll be ready to break up and move on pretty quickly ;) But overall, you will learn a lot about yourself and it truly is a unique opportunity. You’ll also get some fun stories out of it and become best friends with the people at your table.
Ok, reliving anatomy has taken a toll on me. Is it just me or do you guys suddenly smell formaldehyde? ;) Let’s move on to happier times…
Histology (3 weeks): I loved histology. Anatomy was so intense that it almost made histo feel like vacation. Thankfully, we were back to wearing normal clothes and smelling like civilized people. Every day, you pick up your powerpoints from your mail slot then sit through a lecture. The lectures basically consisted of Dr. Kim reading from the powerpoints. They usually lasted between 1-2 hours. Class started at 10, so you’re always out by noon. On the days when we had lab, she would usually just incorporate lab into our lecture time. Instead of having to look through microscopes at slides and have no idea if you’re seeing what you think you’re seeing, she puts all the relevant images on a powerpoint presentation. So lab consisted of Dr. Kim going through the powerpoint with us and pointing out the things we should be able to identify from each slide. She then puts that presentation online so you can access it to study. Her lecture tests came straight from the powerpoints, so you should do well if you know those notes. The computerized exam portion was worth 80 points and then you have a lab test right after for 20 points. If you go through the powerpoint with the images a couple of times (you usually have enough time to do that in between the two tests), you’ll probably be fine. She would put up an image and point to something and then you have to identify it. All the images come straight from the powerpoint (and she only tested on things that she pointed out in the powerpoint images…so for each image, you know what she expects you to be able to identify on there) and then she usually had a few extra credit questions too.
I always tried to go over the material 3 times: first time–in class, second time–later that day at Starbucks, I would go through the notes and take additional notes or make up mnemonics until I felt I had mastered that day’s material, third time–on Saturday I would go through all the notes from the week and review. I’d also write down any problem areas. Then I’d take Saturday night and Sunday morning/afternoon off. Sunday evening, I’d go through the chapter summaries (those were from the textbook…it’s the only thing I used the textbook for…and it’s all available online for free) and review the problem areas I had written down the day before. Finally, I usually got together with a friend Sunday night and went through all the lab images. The first and second test were on a Monday morning and the third test was on a Tuesday, but I pretty much stuck to that plan.
You have one day to study for this shelf exam. It covers histo and cell biology. Dr. Kim’s has one powerpoint on cell bio that covers the basics. She also covered embryology, but that isn’t tested on this shelf exam (since it was tested on the anatomy shelf). Your best bet is to learn the material well during the course and score well on her tests so you have some wiggle room on the shelf exam. The shelf is only worth 20%, so you can calculate what score you need to get on it to pass the class (you need a 70% overall to pass). I felt more prepared for this shelf exam than for the anatomy one, but just keep in mind that there will still be a lot you may not know. Do your best and then enjoy the day off!
Quick recap/advice: Enjoy histology. Study the lab images with a friend so you can quiz each other. Skipping class is allowed, but I thought it was helpful to go to class because even just hearing someone read through the powerpoint is a form of studying.
CMB (2 weeks): Histo takes up the month of October, so CMB (Cell and Molecular Bio) starts in November and ends a week before Thanksgiving break. Dr. Fromm teaches this part of the course. He’s a really good professor–definitely knows his material–and has multiple resources for studying. There’s no lab for this course. So each day, you grab your powerpoint from the mailbox and sit through lecture. Lecture is from 9am-12pm and sometimes there’s a 1-2:30pm session if necessary. Most days you’re out by noon. After each lecture, Fromm puts up his notes: a Word document that covers everything he wanted you to understand from the lecture. He also has a list of objectives that tells you what concepts you should understand. The list of objectives can be filled out using the notes. He also has practice problems that he goes over in class. These problems are similar to what you will see on a test. My study method for this class was similar to histo. Monday-Friday, I would try to master the material from that day’s lecture by going through the powerpoints slowly and taking my own notes. Once I had gone through the material necessary for the problem set, I would answer those problems so I’d be prepared when he reviewed them the next day. On Saturday, I would review all the powerpoints and take note of any problem areas. Sunday afternoon, I would look at his notes (the Word document) and go through them slowly. Then I would review the objectives list and make sure I could answer all of them. Sometimes I’d write out the answers. The morning of the test, I would glance over the objectives one last time and make sure I understood the big picture. I’d also look through the practice problems. Fromm’s tests aren’t easy, but they’re definitely fair. The tests, like the Histo and anatomy lecture tests, are computerized so you get your score right away. You only have 2 tests for the CMB portion and it counts for 40% of your grade. Another 40% comes from the 2 tests in the Biochem portion. The last 20% comes from the shelf exams.
CMB and Biochem are counted as one block, so instead of taking a shelf exam at the end of CMB, you take 2 shelf exams after biochem. One for CMB, one for Biochem. Together, the exams count as 20%.
Biochem (2 weeks): This class starts a week before Thanksgiving break. You have 2 teachers for this part. Dr. Pederson is really chill and his notes are great. He teaches the traditional biochemistry portion. Dr. Kandiah is one of the greatest teachers you will ever meet (in my opinion). She teaches about nutrition (she’s a dietician) and complements what you’re learning in Pederson’s part. She’s kinda all over the place because she gets really excited, but I loved that because she talks the way I think. You won’t be bored, that’s for sure. My study method similar to CMB, except there weren’t really any practice problems or extra notes to go over. Again, like histo and CMB, I didn’t buy any book for this class. There was a link to the free e-book for this class and I used it a little. But really, their notes were sufficient…and there’s always Google and youtube if you’re still confused. I mainly studied Pederson’s material during the week and I looked over Kandiah’s the night before the exam. Pederson’s portion was harder for me to master. Just sitting through Kandiah’s lecture will make you learn a large amount of her material, so you don’t need to put in that much more time for her part…just a half hour to an hour for some memorization. For the test, I think about 40 questions came from Pederson’s and 10 from Kandiah’s.
At the end of biochem, you have 2 shelf exams. Thankfully, you have 2 days to study for this. This is how the week went down: Monday, we had our last biochem lecture. Tuesday was the last biochem exam. Wednesday and Thursday were our days off for studying. And the 2 shelf exams were Friday…and then Christmas break! I drove to Indy after our exam on Tuesday, so I didn’t start studying until I got back to Muncie late Wednesday afternoon. I used Wednesday evening to review all of Fromm’s objectives and notes. I didn’t go through any of his powerpoints, because his notes covered all the material. Thursday, I used First Aid and just went through the Biochem chapter. I was surprised at how helpful First Aid was for reviewing. I didn’t even glance at any of the powerpoints from class…all I used was First Aid. But I highly recommend it–all relevant material is covered there and they give you mnemonics. It really prepares you well to answer clinical questions. On Friday, we took the CMB shelf first then the Biochem shelf (side note: although shelf exams are computerized, you don’t get your score when you finish the exam…you find out your score online when the prof posts it along with your class grade).
Quick recap/advice: Pay attention in class. Try to stay on top of things–it makes life a lot easier and less stressful. If you have questions, write them down and ask the next day in class. USE FIRST AID. This was my favorite class of the semester because it was the most clinically relevant. But it’s also a hard class because there’s a lot of material and very little time to learn it. So just do your best and don’t forget to enjoy life.
…And then began Christmas break. I went home, packed quickly, and hit the road for home! It was a glorious day. I hope you all had a very blessed Christmas and happy New Year! Sorry for the long post, but I wanted to make sure I recapped everything before I forget!
The views expressed in this post content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.