Monthly Archives: March 2012
Lange’s Case Files Pathology is a book whose purpose is to integrate our knowledge of pathology for diagnosing realistic scenarios in medicine. There are 50 clinical cases written in clear USMLE-style format. For each clinical case, there are four parts: 1) a summary with straightforward answers and clinical correlations, 2) basic science concepts including objectives and definitions followed by a brief discussion of the topic of interest, 3) a few comprehensive questions that reinforce key points, and 4) “pathology pearls”, which are important take-home points. When going through each case, important information is bolded for emphasis and explanations are concise and precise—eliminating the trivial concepts that should have become second nature by the end of organ systems. This means that this book is not for learning materials, but rather more effectively used as a tool for review, reinforcement, and integration of learnt information to allow for synthesis.
Although all Case Files books may or may not fit the needs of boards review, Case Files Pathology is a book that can only help. With key take-home points and short-and-sweet explanations of case material, you should have little problem learning the essentials—the fundamental architecture of clinical pathology. For example, you may come across a case of ventricular septal defect (VSD), requiring you to utilize your knowledge of epidemiology, embryology, physiology, and the clinical presentations of cardiac defects. Of course, take note that this book is for pathophysiology and not just for lab-based pathology, so a good foundation in second year organ blocks material would make this book much more useful for synthesis of all the loosely connected information.
The downside of Case Files Path includes: 1) lack of pictures and images to allow the medical student to truly appreciate the clinical appearance of certain diseases, 2) lack of explanations for various diagnostic tests that may be useful for understanding the diagnostic and elimination process, and 3) the multiple choice review questions at the end of each case are generally very simple and superficial questions asking more for recall than synthesis, despite the fact that the case itself is pretty good at elucidating the more detailed aspects of disease.
Overall, Case Files Pathology would be great to have for some last minute studying or USMLE Step 1 board review, but definitely not for the initial phase of studying. Get the foundation down solid, and then use this book to cement everything together. As for where to use this book, it is not a useful resource for studying for medical school classes since the cases in the book is written in USMLE format rather than in the format of questions on medical school examinations. However, it is definitely a good book to have at the end of your studies for USMLE Step 1 to get the bigger picture and practice applying medical knowledge to realistic medical cases, uncertainties and all.
Family medicine can be a tricky clerkship in many medical schools due to the vastly different experiences based on location. Some are heavily procedure driven, while others are very hands-off. Some experiences are well balanced, while others exclusively focus on family medicine subspecialization such as dermatology, sports medicine, or ob/gyn clinics. Regardless of whether you experience an urban or completely middle-of-nowhere rural practice, all students at a given med school take the same final exam, and often times that exam is an NBME shelf.
It is not uncommon for students to feel that clinical experiences on a family medicine rotation do not comprehensively prepare them for the exam, especially when the specialty has such a wide breadth and oftentimes unknown depth. For students who know they learn best with practice questions, the below two titles tend to come up for comparison.
PreTest Family Medicine by Doug Knutson continues on in the same style as other titles in the series, providing high yield questions and helpful answers that are geared specifically towards medical students. As each book is written by a different author, there is some variability within the series, but Family Medicine is one of the stronger PreTest titles.
The book is about 5.5 inches wide, which allows it to easily slip into a white coat pocket. This really came in handy during canceled patient appointments that created a good amount of downtime. The 500 USMLE styled questions in the book specifically focus on preventive medicine, doctor-patient issues, acute conditions, and chronic conditions. Question explanations generally go into both right and wrong answers, which helps solidify learning.
The National Medical Series for Independent Study (NMS) produced their own Q&A for Family Medicine, written by David Rudy. The book is full sized, meaning there’s no way it can fit within a white coat pocket. However, it does come with a scratch-off on the inside cover, and every owner is a winner! The prize? Online searchable access to every question and answer in the book, making it easy to use from any computer (if your Family Medicine practice happens to have available computers).
It is important to note that the “nearly 500 exam-style questions” advertised on the cover is actually over 900 questions. This brings up one of the larger complaints of the book. Previous editions had a number of spelling errors and even outdated content. While the content appears accurate, some of the typo issues have remained.
Answers in the NMS question book similarly overview all of the right and wrong answers, allowing for a full learning experience. However, the feel of the questions doesn’t parallel USMLE format as much as PreTest. Content seems to be more advanced overall, with more detail. It can probably serve as an effective learning tool well into residency.
The winner: This round goes to PreTest Family Medicine.
Overall, PreTest provides questions that are more geared towards the NBME Family Medicine shelf exam, in both format and content. For a third year medical student who benefits from practice questions and wants a white coat resource, PreTest is the way to go. For those who anticipate blowing through all of the PreTest questions and coming up hungry for more, try out NMS Q&A Family Medicine for more in-depth content as a subsequent resource. Special consideration should be taken by those who plan to enter family medicine as their chosen specialty, in which case the breadth and depth of NMS Q&A may provide a larger challenge with greater long term benefits. Keep in mind that neither of these titles is recommended for USMLE Step 2 CK study, despite both of them advertising it.
For those interested in making corrections to information in your copy of First Aid for the USMLE Step 1 2012, the official FA errata is now posted to the FirstAidTeam.com website. You can check out the webpage to learn more about the process, or RSS subscribe for updates. If you’d like to bypass the site and just go straight to the errata, the document can be found here (pdf).
Keep in mind that you can send in a correction for any mistake you find by clicking on the “Contribute” button on the right side of their site or this post (both bring you to the same place on their site). While they promise $20 Amazon gift cards for new information, someone else has probably already beaten you to any given correction. Nonetheless, making any submission will get your name printed in the preceding version of Step 1.
Has a scholarship or program been asking for a USMLE Step 1 “percentile” even though no such number can be found on your Step 1 score report? Perhaps you’re simply interested in tracking progress of USMLE World practice tests. Whatever the reason, head over to our new USMLE Percentile Calculator to convert between three digit score and percentile.
It uses some recent national data, but can be customized for your specific needs, and extended for Step 2 percentiles. Have a look, and if you find it useful, be sure to share with friends!
Students preparing to study for the USMLE Step 2 CK should be well accustomed to the type of question encountered on the boards and shelf exams, and should have a decent sense of their own study habits and strengths. This is immensely important when deciding on a study plan for Step 2. The seemingly infinite clinical knowledge can be overwhelming, and a structured study plan truly helps.
Deja Review USMLE Step 2 CK, now in its second edition, continues to get mixed reviews by students studying for the boards. The format of the book is very straight forward: alternating sections of clinical vignettes, and rapid-fire two-column recall question and answers. The book goes through each of the core clerkship specializations that will be found on the USMLE Step 2 exam, starting with Internal Medicine, and progressing through Surgery, Neurology, Psychiatry, Obstetrics and Gynecology, Pediatrics, and finally Emergency Medicine. It is not a text book, or even a comprehensive review book such as First Aid, and as such should not be relied upon to learn new concepts. Its strength is purely in aiding with recall and making buzz word connections, and it does that very well.
However, the lack of teaching can be frustrating for students who do not already know or remember the material. DejaReview Step 2 CK shouldn’t replace question banks either. There are no answer explanations or experience in testing. Furthermore, the book is often times seen as unhelpful to students who do not learn well with recall type resources.
It is due to these reasons that there exists a split in outlook about this book. People who excel at rapid recall questions can easily carry this in a wide white coat pocket during the months preceding the USMLE Step 2 CK exam, for high yield on-the-go studying. It is a very strong review text that complements First Aid and USMLE World question banks, but it is not for everyone. Learning style really matters with this book, which is why there are such mixed feelings about it. If you are unsure of your learning style, it is recommended that you check out the format of the book before purchase. Try to browse through a copy at your medical library, or if you want to decide sooner, head over to Amazon, which gives a few of the question type pages found in the book. As far as price, Deja Review USMLE Step 2 CK gives a lot of bang in its 300+ pages for a low cost, so finding out it is not for you won’t set you back too far. Check out the links below to see what I mean.
After graduating from the Albert Einstein College of Medicine in 1967, I practiced neurology, ophthalmology, and family medicine at one time or another. I also did research and taught at the University of Miami School of Medicine for 25 years in the Cell Biology/Anatomy department, where I taught neuroanatomy, and was an attending in the Family Medicine department.
In 1979, I formed the MedMaster publishing company after my first book, Clinical Neuroanatomy Made Ridiculously Simple, was rejected by multiple publishers for making a serious topic funny and being too brief. Strangely, the aspects of the book that were criticized were the same ones that my students appreciated. The book went on to become a best-seller in the U.S. My students awarded me the George Paff Award for Most Outstanding Professor eleven times.
Other authors of like mind, including my students Mark Gladwin and Bill Trattler, who wrote Clinical Microbiology Made Ridiculously Simple, submitted books that went on to become the MedMaster “Made Ridiculously Simple” series. I was invited to give the commencement address at the Washington University at St. Louis School of Medicine in 2004 in appreciation of the MedMaster contribution to medical student education.
It occurred to me that when a publisher receives a book, it is often sent for review to someone who may be expert in the field, but not necessarily expert in understanding the needs of a student learning the topic for the first time. Such experts often feel a book is “incomplete.” Hence, the student is often left with very large texts with a lot of clinically irrelevant information, and has difficulty grasping the subject as a whole. One study indicated that the leading cause of stress in medical school is that there is so much to learn and so little time to learn it. Another study showed that if a first year medical student actually did all the reading that was assigned, this would entail reading more than 24 hours a day. So MedMaster embarked on publishing books that are brief, clinically relevant, enjoyable to read, and promote understanding.
The medical student needs 3 kinds of books:
- The reference text. While such large books provide essential reference information, the student can get lost and not achieve an overall understanding of the subject. Understanding is very important. The human brain is better at understanding than at memorizing huge numbers of esoteric facts. Computers are better at facts; humans are better at understanding. Understanding not only helps in dealing with the many variations on patient problems, but also facilitates the learning of facts.
- The Board review book. I’ve noticed that many of the student forums focus on study for the USMLE. Passing the Boards is necessary; indeed, MedMaster publishes its own review books for USMLE Step 1, 2, and 3. But simply relying on the rote facts in Board review books is insufficient for practicing medicine, because Board review books do not promote understanding, which is vital in dealing with patients.
- The small conceptual book, which provides understanding in addition to key information useful not only for exams but for practical application throughout one’s career. MedMaster emphasizes such books, which can be found at www.medmaster.net. MedMaster’s blog, the Goldberg Files, deals with methods to promote rapid learning and other ways to deal with the stress of medical school.