Author Archives: Med Student Gunner
For those of you who have not yet found a good source for quick free online pathology review, we recommend checking out the University of Utah WebPath site.
The site breaks down major path areas and provides images with specific gross images and histological slides of most major pathology items that come up on Step 1 and Step 2. We don’t recommend this as a sole pathology study suite, but there’s no better place that helps with image pattern recognition. The site is easy enough to navigate without an explanation here. Check it out.
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.
We recently received a question through the contact form about the previous neurology book review, Haines Neuroanatomy Atlas. It was recommended that Haines not be brought into the lab, and the question asked what resource should be used instead. This post is the answer.
Coming into med school, you’ll be told of all the required books and be handed a syllabus. However there are a few hidden resources hoarded and protected by the gunners of the class that generally aren’t as readily known. Cindy Montana’s Interactive Neuroscience Review (very large powerpoint file!) is one such free gem.
After downloading the epic powerpoint presentation from the above link, be sure to view it in slide-show mode. This interactive and animated file is wired together much like the neurology system it teaches, and is horribly confusing and dysfunctional if the slides are just viewed outright.
The presentation really speaks for itself, but the animations are a fantastic and color-coded way to review the neuroanatomy pathways and basic concepts. This should not replace Haines Neuroanatomy Atlas, which is still highly recommended, but rather used as a complement and alternative. This is perfect for places and times when taking out Haines just doesn’t work. Most neuro labs have computers, which means you won’t have to dirty your own books. Similarly, this is a great review for all the crammers and gunners who like to study on the go, as it can be pulled up on many smart phones.
There are many more hidden gems to come. To all you gunners out there: you’re welcome.
Histology has generally fallen out of favor and focus for many medical school curricula these days. Some med schools still have dedicated histology courses and mandatory histo labs with ridiculously priced slide sets, but most have transitioned to incorporating histology within other broader classes, and offer newer digital versions of labs. Due to this transition, as well as the driving field of pathology, countless databases and software packages have been developed to allow for histopathological visualization of electronic slides.
Whether your school’s applications allows for “real time” zooming and scrolling, or just splatters the screen with images, most software options are not particularly great at teaching the topic. All too commonly, we as med students have instructions that go along with slides and read something like “as it is clearly seen, the eosinophilic uptake shows…” Most of the time however, we have no idea what we are “clearly” looking at. Short of capturing a live histologist and forcing them to use the neon microscope arrows to directly point out key structures to make sense of it all, the next best thing is using a database that directly points to, circles, colors in, and directly labels what you need to know.
There are few free online databases out there, but the Histology Learning System from Boston University is among the best. Sure the background is a dull gray and the site navigation is a bit static, but the content and (more importantly) label system are a sure fire way to both learn and teach the material. This is especially useful when you find yourself needing to put together that annoying last minute power point presentation for some small group show-and-tell the next day.
The database breaks down all of histology by system, and also has a sitemap with every image listed. Upon loading an image, users have the option of clicking on the LABEL button to figure out what they’re actually viewing, or click on a black rectangle on the image to increase magnification (enhance!) that structure. Some structures are rather straight forward and have no enhanced images, while others can go several layers deep. Chances are, the histology professor or local guru at your medical school can recognize the BU histology database images on sight, as they are relatively well known in the community and characteristic.
Whether you need a complementary learning tool to be used with your class syllabus, a stand alone reference as you go through medical school, or a database of “normals” to contrast with pathology studying, the BU Histology website is highly recommended.
To prove your gunnery and attain bonus internet points, name the structures contained within this post by commenting here.
The age old debate once again emerges. This post will attempt to sort out the confusion to help you make the best decision on your first year med school anatomy atlas purchase. While the main issue is almost always Netter or Rohen, there are actually a few other contenders that will be briefly discussed as well.
First, it is important to specify that there are both better books, and different books. What that means is that Netter’s Atlas of Human Anatomy (reviewed in full here) is going to be a better learning tool than most of its low budget imitators. However there are also apples-and-oranges comparisons, which is where Rohen’s Color Atlas of Anatomy (reviewed in full here) comes into play.
So which to choose? Rohen or Netter? The difference lies in how you like to study. Rohen’s Color Atlas of Anatomy is going to excel at providing actual cadaver pictures, so what you study in the book is exactly what you will be tested on in your anatomy practical exams. Rohens’ also has the benefit of only numbering structures that require a legend, so it is perfect for quizzing – simply cover the answer sheet. However, anatomy is hard for a number of reasons, one such difficulty being that multiple flesh colored structures easily blend together. As a solution, Frank Netter produced his famous Atlas of Human Anatomy, which covers all the same anatomy as Rohen, but with drawings. His illustrations have the benefit of being able to clearly show the borders of structures with differences in coloring, making the anatomy easier to understand (whereas Rohen paints a small minority of structures to a less effective degree). Tiny anatomy like nerves or vasculature pop off the page with contrast from their backgrounds with Netter. The down side is that Netter’s Atlas of Human Anatomy isn’t completely representative of anatomy practicals, as exams are not so conveniently color coded.
This ultimately comes down to a decision of clarity or authenticity. In the end, the debate will always be split based on this and how each individual person studies. It is recommended that you use both, depending on the situation, to get the best of both worlds. Specifically, Netter’s is a great first-pass reference book to help identify structures when initially exposed to the material, whereas Rohen’s is going to solidify existing understanding based on the actual visuals. In other words, a good strategy is to use Netter’s first, then go to Rohen’s. As owning both books can get costly, try to own the one that appeals most to you, and borrow the other from an opposite-minded friend or the library.
Rohen’s and Netter’s Anatomy Atlases are not the only Anatomy books out there, though they are generally better than most. Some other options deserve honorable mention.
The Sobatta Atlas of Human Anatomy (volume 1 and volume 2) is a hidden gem that breaks up the entire body into tremendous detail across two volumes. Many believe the quality of the illustrations themselves actually surpass Netter’s. It is important to note that this book distinguishes itself from the others by identifying all of the anatomical structures by their latin names. For a surprising majority of structures, this naming system is perfectly fine, as a good amount of anatomy is already latin. If you can use this book effectively, you will come out with a deeper understanding of the anatomy, its function, and its naming system. For example, ab muscles are called Rectus Abdominis because “rectus” comes from the latin for “straight.” Keep in mind that these will increase understanding, but at the time-cost of mastering part of a different language. Own both volumes if you can afford them, but otherwise it is worth going out of your way to find them in your school’s medical library.
Grant’s Atlas of Anatomy is another illustrated book. Unlike Netter, Rohen, and Sobatta, there’s just nothing really special to speak of. It highlights the anatomy and will help your studies, but generally doesn’t bring anything more to the table compared to the above books. Grant’s Dissector, (not to be confused with the Atlas) works particularly well for anatomy lab, but should not be purchased if your med school requires a different book. If they do require Grant’s Dissector, or you purchase it because they don’t require any book at all, you’re in good hands.
Lastly, honorable mention must be given to the epic original (but currently outdated) Gray’s Anatomy, originally named Gray’s Anatomy Descriptive and Surgical. No, it was not named after the TV show. Since the original, a number of revisions and companion books have been produced by new editors under the same name, including Gray’s Atlas of Anatomy, Gray’s Anatomy Review, Gray’s Anatomy for Students, and Gray’s Anatomy: The Anatomical Basis of Clinical Practice (seen right). See that sticker on the front cover that says “150 years?” That’s there because the original author, Henry Gray, was born in 1827. While anatomy hasn’t changed much since then, our understanding and technology has improved slightly past the mostly black-and-white images from the original Gray’s Anatomy, which can be found for free at Bartleby’s Online Gray’s Anatomy of the Human Body. As you go through med school and use Dr. Wikipedia, you’ll see many of the original images from Gray’s Anatomy used as a reference (example below). The above book and many of its similarly name renditions contain up to date text and illustrations, but they are generally anatomy textbooks and not dedicated atlases like the abovementioned publications, to be reviewed at a later time. Gray’s Anatomy is mentioned here for historic reference as the influential publication that really pioneered the way of the illustrated Anatomy Atlas.
It is finally time to review Goljan: Epic King of Pathology. All of the legends and rumors you heard were true. He’s an arm wrestling champion, rides a white stallion around his massive pathology fun house, and can break a man’s finger clean off during rectal exam. Indeed, some believe that the mere act of saying his name aloud increases their board score by one point every time. If you don’t understand these things, it is simply because you are not yet enlightened.
Edward Goljan is a world class Pathology Chair from Oklahoma State University. Back in the day, he began doing pathology review courses for his medical students, which have been condensed over the years into the most comprehensive yet concise pathology review available. More importantly, it is perfectly tailored to the USMLE Step 1, USMLE Step 2 CK, and even USMLE Step 3 boards exams, as Dr. Goljan has further refined his teachings based on constant feedback he receives from students after they take the boards. As he states:
These notes took 25 years to put together over time. And it dwindled down to the absolute quintessence. It’s like espresso. You just have a little drop and you’re already fixed.
At some point, one of his students recorded his epic lecture series, which continues to float around the internet and med school back-alleys to this day, obtained and abused like crack for the boards. To complement his lectures, he handed out his condensed notes, mentioned above. Over time, these notes coalesced into Edward Goljan’s Rapid Review Pathology book.
The book itself is newer than the audio and has undergone further revisions, whereas the audio remains in its temporally frozen preservation.
Specific chapters of Goljan’s Rapid Review Pathology include: Cell Injury, Inflammation and Repair, Immunopathology, Hemodynamic Disorders (Acid, Base, Electrolytes, Water), Genetic and Developmental Disorders, Environmental Pathology, Nutritional Disorders, Neoplasia, Vascular, Heart, Red Blood Cells, White Blood Cells, Lymphoid Tissue, Hemostasis, Immunohematology, Upper and Lower Respiratory, Gastrointestinal, Hepatobilliary and Pancreatic, Kidneys, Lower Urinary Tract and Male Reproductive Disorders, Female Reproductive Tract and Breast Disorders, Endocrine, Musculoskeletal and Soft Tissue, Skin, Nervous System, and Special Sensory Disorders.
Goljan’s Rapid Review Pathology also comes with Student Consult, the online portal and electronic copy of the book, giving you access to all of the text remotely, as well as the images (which come in handy for powerpoint presentations). Student Consult for Rapid Review Pathology also comes with a little over 400 USMLE style pathology questions related to the book itself. However, to truly lock in the information with a fantastic complementary USMLE style pathology question bank, Robbins and Cotran’s Review of Pathology (reviewed here) is the recommended book of choice.
Robbins and Cotran Review of Pathology, 3rd Edition, AKA “Red Robbins,” is the best pathology USMLE style question bank/book for the boards, and a great complement to Goljan’s review books and audio. The true strength is mixing clinical scenarios with pathology concepts, which makes a topic that is easily boring for many medical students into a very relevant and high yield exercise in the thought process necessary for excelling in pre-clinical class exams, USMLE Step 1, USMLE Step 2 CK, and USMLE Step 3 boards.
The pertinent questions is: should this be used with a question bank such as USMLE World or Kaplan? The answer is definitively yes. At some point, you’re going to hit up Goljan (to be reviewed later), and this book is what will lock in that information with an alternate perspective on the same topics. This should not replace or be used as a substitute for a primary question bank. As for using it with “Big Robbins” or “Baby Robbins,” neither are really needed for the boards past Goljan. At times you may want to reference these resources for topics that require a bit more detail, but they are not a necessity, and can usually be borrowed from friends or the library. (Both of these will also be reviewed in more detail later.)
Robbins and Cotran Review of Pathology does a particularly good job of pulling glossy high resolution color microscopic and gross images that are actually representative of the pathology being reviewed. This really is one of the most important aspects of any pathology teaching. Explanations are thorough, including why the wrong answers are wrong, and the questions are representative of what comes up on the boards.
The three major pathology review sections are comprehensive. Unit 1, General Pathology, covers Cellular Path, Acute and Chronic Inflammation, Tissue Renewal and Repair, Regeneration, Healing, Fibrosis, Hemodynamic Disorders, Thromboembolic Disease, Shock, Genetic Disorders, Diseases of Immunity, Neoplasia, Infectious Disease, Environmental and Nutritional Diseases, and Diseases of Infancy and Childhood. Unit 2, Organ Systemic Pathology, has individual chapters on Blood Vessels, the Heart, Diseases of White Blood Cells, Lymph Nodes, the Spleen, the Thymus, Red Blood Cells and Bleeding Disorders, the Lung, Head and Neck Pathology, the Gastrointestinal Tract, Liver and Biliary Tracts, the Pancreas, the Kidney, the male and female lower urinary tract, the Breast, the Endocrine System, the Skin / Bones / Soft Tissue Tumors, Peripheral Nerve and Skeletal Muscle, the Central Nervous System, and the Eye. Clearly, all of these chapters combined hit every organ system from the large to the microscopic, but I listed them as a reference. The final Unit III, Integrative Reviews, has two long chapters on Clinical Pathology and a Final Review and Assessment that combines information from prior chapters. Robbins and Cotran Pathology Review can also be purchased for Kindle as an eBook on Amazon, but that is not recommended.
Primary Care Otolaryngology by Mark Wax is one of those great tiny books to just breeze through in an afternoon, regardless of your specialty. It has a great balance of brevity and high yield knowledge, specifically highlighting otolaryngology surgical emergencies and general ENT knowledge. The information is easily applied to a number of non-ENT rotations, specifically in regards to outpatient primary care, and reading x-rays. ENT topics in general are pretty straight forward: easy to learn and easy to teach, which means you look like a star med student when you point out a concha bullosa on a random CT in the emergency room, floors, or outpatient setting, and then explain what it means.
You can buy a physical copy, or get the eBook for free online through The American Academy of Otolaryngology Head and Neck Surgery.