Category Archives: Pre-clinical Years

Books for the first two years of medical school.

Must Have: Dubin’s Rapid Interpretation of EKG’s

Dubin's Rapid Interpretation of EKGsDubin’s Rapid Interpretation of EKG’s is a one-of-a-kind book that is often referenced in medical schools due to its fun and simple methods of teaching the evaluation of electrocardiograms. More importantly, it provides a high-yield, low-stress method of conveying these otherwise difficult concepts.

In each chapter, the fundamental concepts of EKG’s are delineated in a crisp and clear format. What makes up the bulk of the book is actually not free-text but illustrations that significantly help correlate concepts and electrocardiogram images. Individual diagnoses or findings on an EKG are accompanied by full explanations, including clearly delineated criteria and just enough information to teach pertinent core cardiology concepts (without overwhelming the reader). In fact, the information in Dubin’s EKGs is known for being dumbed down and presented in a “flashcard” style so that it is easy to understand and absorb on-the-go.  All concepts are reiterated and presented repeatedly to ensure maximum retention and an appropriate pace. Interestingly, despite the repetitiveness of the material and the seemingly “dumbed down façade, the book covers all the necessary information that students needs for medical school, and even quick review during residency.  Specific chapters include: Basic Principles, Recording of the EKG, Autonomic Nervous System, Rate, Rhythm, Axis, Hypertrophy, Infarction, and a catch-all Miscellaneous section.

While this title remains highly endorsed by the editors of this site, it is important to still note the drawbacks, for completeness.  Due to the ease of use, some students find Dubin’s EKG to not be challenging enough. While it remains a strong primer, some students (especially those with prior cardiology experience) believe that several pages of information can be condensed into a page or less.  It is important to realize that the aim of this title is to teach only the fundamentals of EKG knowledge. For depth and advanced nuances not needed for medical students, a larger, more condensed resources is warranted. As such, Dubin’s Rapid Interpretation of EKG’s should be used as a quick and superficial “top of the iceberg” but “solid foundations” reference guide to learning the basics of EKG’s.

ECG Complex - Learning the Basics

For medical school: exceedingly useful.
For residency: potentially helpful.
For cardiology fellowships: trainees ought to be well past the basics presented within this book.

Reading Dubin’s Rapid Interpretation of EKG’s cover to cover takes about 4 or 5 hours total, but it is more highly recommended that students periodically return to the book over time for increased retention of the repetitious material.  Overall, this earns a strong endorsement and is highly recommended for any new second year medical student learning cardiology.

 

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Recommended Preclinical Pulmonology: Respiratory Physiology

West's 9th edition of Respiratory Physiology, great for medical studentsRespiratory Physisology: The Essentials 9th Edition (2011) by John B. West is a beautifully constructed book for understanding the fundamentals of respiratory physiology in about 1 to 2 weeks.  Initially opening the book may bring a bout of anxiety due to the seemingly dense text and black-and-white (or rather red-and-gray) visual aids and illustrations.  However, when you actually begin to read this book, it is quite easy to follow and learn the essentials of respiratory physiology. Only a few sections seem slightly more difficult to understand despite the explanations provided.  In each chapter, the content is provided in a narrative manner, interjected by diagrams, charts, equations, summaries of main points, and finishes up with a summary of important pulmonary concepts and some relevant review questions for the chapter.  Although the presentation is not colorful, the material is presented clearly and concisely.  All the fundamentals medical students need to know are contained within, and there is very little digression or extraneous material.

The table of contents reveals the comprehensive nature of this book:  structure and function, ventilation, diffusion, blood flow and metabolism, ventilation-perfusion relationships, gas transport by the blood, mechanics of breathing, control of ventilation, respiratory system under stress, and tests of pulmonary function. As you can see, Respiratory Physiology talks about everything from structure to function to regulation of respiration, so it does not skip on the important topics.  However, it is important to note that this resource is more focused on physiology than pathophysiology: a needed fundamental for any system. This book can be used either for a comprehensive review of pulmology for pre-clinical medical school exams and for the USMLE boards.  It is 200 pages of good information, but may take several days to read if you are studying pulmonology and other courses at the same time.

when you actually begin to read this book, it is quite easy to follow and learn the essentials of respiratory physiology

This book is recommended to medical students who really want a comprehensive basis in respiratory physiology fundaments, those who want to have a solid foundation for clerkship in pulmonology, and pulmonology residents who may want to brush up on the important basics of respiration.  It However, it is certainly not necessary for students looking only to pass. Although West’s Respiratory Physiology is not wordy beyond necessity, it is still quite a detailed and complete book on the physiology of respiration.

 

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What You Need to Know about Thieme’s Atlas of Anatomy

Gilroy's Atlas of Anatomy by Thieme

Anatomy – the first huge hurdle for many medical students to climb over. The anatomical knowledge gleaned in this first course will be used repeatedly as part of the foundation of medical knowledge. With that in mind, a solid foundation of resources is an absolute must. Frank Netter’s Atlas of Human Anatomy has been the gold standard of anatomy books for many years. Professors stand by the atlas and will expect you to memorize most, if not all, of those beautifully colored structures in the Netter plates.

That being said, it is important to introduce the Thieme Atlas of Anatomy by Gilroy. Its 2,200 beautiful images have been painstakingly drawn by Markus Voll and Karl Wesker, and appear to jump off the page. The book takes a different approach from other atlases, by starting with deep structures and working its way superficially. This allows for an understanding of the foundation of the body and how the other structures add on to it. At the end of each section, questions are posed to allow the reader to integrate the knowledge they have learned.

Thieme's Winking SkullThe book not only covers gross anatomy, but also illustrates peripheral innervations, arterial supply and venous drainage, lymphatics, etc. The anatomy is bolstered by clinical correlations, and important details are summarized in wonderfully easy-to-understand tables.  The Muscle Fact pages organize the essentials of origin, insertion, innervations in one place, making it much easier to memorize and review. The book also comes with access to WinkingSkull.com PLUS,  Thieme’s online resource and study aid, which gives the user access to over 600 plates with removable labels, and quizzing capabilities.

The largest, and only, detriment to using the Thieme atlas is that most professors still stand by the Netter atlas, and reference page numbers during lectures. To remedy this, Thieme has composed a table which compares Netter plate numbers to Thieme’s, allowing students to find similar plates.

Overall, this is a highly recommended book that many students believe far surpasses Netter in providing  comprehensive and integrative anatomy knowledge to beginning anatomy students and pro’s alike.

 

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Ace Anatomy: Free copy of Moore’s Anatomy and Rohen’s Flashcards!

Free Anatomy Book Giveaway

CLOSED! Congratulations to the winning First Year at Indiana University School of Medicine!

We’re continuing the book giveaways, transitioning from general advice for incoming medical students to focused resources for the premier med school course: Anatomy. This site has previously reviewed a head to head analysis of some of the more popular anatomy atlases out there, and they generally come down to personal taste. As a complement, we’re going to provide some of the other supporting resources needed to ace anatomy.

First and foremost, every student needs a good text, and Moore’s Clinically Oriented Anatomy can provide just that. We will be giving a formal review of the title on this site in the upcoming weeks, but for now rest assured that it is a well established and helpful resource.

Rohen Flash CardsSecondly, students should take advantage of study recall, and for that goal we are also giving away a free set of Rohen’s Flashcards. As a reminder: these are graphic images and should not be used in crowded areas in view of the public.

As extra icing on the cake, Lippincott is throwing in a free 6 month subscription to Acland’s Video Atlas of Human Anatomy Online as well, which is a video series of gross anatomy structures to help students better visualize human anatomy with visual manipulation and pertinent narratives.

Acland Video Atlas of Anatomy

Brand new copies of all three of these titles will be given to one lucky winner randomly selected from the comments of this post. To enter, simply leave any comment, and a valid e-mail address so we can contact you if you should win. As usual, we NEVER use e-mail addresses for anything outside of these contests, as we are medical students too and appreciate privacy. Applicants must be US medical students to win.  See our full contest rules for further details. Contest ends August 20, 2012 at 11:59pm. Good luck!

 

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Advice for the New Medical Student

This summer, approximately 25,000 students will begin their first year of medical school in the United States. While the path to medical school was challenging, medical school itself holds a number of additional challenges, as well as significant opportunities. “Concerns about succeeding academically, choosing a specialty, maintaining a social life, and making time for family can certainly cause anxiety among new medical students,” writes Dr. Meg Keeley, Assistant Dean for Student Affairs at the University of Virginia School of Medicine.1 Below, we offer some key advice for the new medical student.

Evaluate your study habits

In one study, researchers found that “in general, study skills are stronger predictors of first-semester total grades than aptitude as measured by the MCAT and undergraduate GPA.”2 There are many reasons for this, but one of the main reasons relates to the immense volume of information to be mastered. April Apperson, Assistant Director of Student Services at the University of San Diego California School of Medicine, explains “The material presented in medical school is not conceptually more difficult than many rigorous undergraduate courses, but the volume flow rate of information per hour and per day is much greater – it has frequently been described as ‘drinking from a firehose.'”3

Utilize active, rather than passive, learning strategies

The USMLE Step 1 exam is a critical factor in the residency selection process. With a strong focus on clinical applications, rather than rote memorization, the USMLE is a distinctive and challenging exam for most students. How should you study for an exam of this importance that’s so distinct from other exams? Drs. Helen Loeser and Maxine Papadakis, Deans at the UCSF School of Medicine, advise: “Use active learning methods as you integrate your knowledge and apply basic science information to clinical vignettes.”4 Research has shown that active learning leads to better long-term retention of information and easier retrieval of information when needed.

impacting communities

Impact your community

Medical students have been able to impact their communities in wide-ranging and meaningful ways, through student organizations, national groups, or through their own initiatives. Student-run health clinics offer one example, in which students often serve an underserved population, including the uninsured, homeless, and the poor.

Maintain your emotional well-being

Studies have shown that students experience significant stress during the preclinical years. This can have real consequences, including depression, anxiety, and effects on patient care. It becomes vital that students develop strategies now to cope with stress and promote their own well-being, in order to maintain resilience and the highest standards of professionalism throughout their career.

Explore different specialties in medicine

In one study of medical students, 26.2% were unsure of their specialty choice at matriculation.5 A similar proportion remained undecided at graduation. Exploring different fields during the preclinical years may help. Students have done so by participating in specialty-interest groups, shadowing physicians, performing research, and identifying mentors.

About the Authors

Samir Desai is the author of Success in Medical School: Insider Advice for the Preclinical Years and writes about residency match success at TheSuccessfulMatch.com.Author Rajani Katta

Rajani Katta is the course director for dermatology in the basic sciences at the Baylor College of Medicine, and the author of
The Successful Match: 200 Rules to Succeed in the Residency Match.


References

1Keeley M. Ask the advisor: How to successfully navigate the first year. AAMC Choices Newsletter August 2011.  Accessed June 18, 2012.
2West C, Sadoski M. Do study strategies predict academic performance in medical school? Med Educ 2011; 45(7): 696-703.
3University of California San Diego School of Medicine. Successful Study Strategies in Medical School. Accessed February 20, 2012.
4University of California San Francisco School of Medicine. Rx for Success on STEP 1 of The Boards. Accessed October 19, 2011.
5Kassebaum D, Szenas P. Medical students’ career indecision and specialty rejection: roads not taken. Acad Med 1995; 70(10): 937-43.

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Free Book Giveaway: Success in Medical School

Success in Medical School - Insider Advice for the Preclinical Years

This contest is now closed. Congratulations to the University of Pittsburgh School of Medicine student who won!

We’re nearing the big dates for white coat ceremonies and new first year medical students coming into med school! For those of you who read the previous post on Success in Medical School, we’re giving away a free copy randomly to any US med student (including those about to start) who leaves a comment to this post. The comment can say anything (or nothing), but if you have time, please answer the following:

If you could give advice to pre-meds who will be applying to med school to be in your position, what would it be?  What do you feel are the most important aspects of a strong med school application?

You do not need to answer the question to enter – the winner will be selected at random. We just like sharing helpful insights on this site.  Contest ends July 31, 2012 at 11:59pm EST. As usual, e-mail addresses are kept confidential, only used to contact the winner, and never used for spam/evil. Full contest rules apply (but the essentials are that you should be a US med student of 18 years or older). Good luck!

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Success in Medical School: for a push in the right direction

Success in Medical School: Insider Advice for the Preclinical Years is the latest title from the MD2B publishers.  The book is laid out across 17 chapters, and explains the basics of how to excel in the first and second year of medical school. Notable chapters specifically include History and Physical Exam techniques, the importance of research, community service, extracurricular activities as they relate to residency applications, professionalism, what to do in the summer between first and second years, and tackling the USMLE Step 1 or COMLEX Level 1 exams.  The book is laid out in list format, making it a particularly easy read, as topics are concisely broken into the most important take away points. These lists are generally composed of three types of information: anecdotal evidence, data-driven concepts, and general good advice.

Success in Medical School - Insider Advice for the Preclinical Years

The data-driven points tend to vary. Some can be incredibly insightful for someone new to a particular topic. They can range from subjective surveys of medical students, course directors, and residency program directors, to more objective histories and statistics. These last two categories are useful when referencing chapters on the USMLE Step 1 and COMLEX Level 1 exams, as they address many of the common questions this site receives through our contact form about them. What is average? Why are there two reported scores for Step 1? However, a small minority of the fact-driven points can be underwhelmingly simplistic. One point, for example, quoted the Merriam Webster definition of the word plagiarism as its take home message. These types of low-yield facts almost suggest that there is a fact-quota, and makes the book feel fluffy every so often.  For most of the book though, the thorough references are insightful, and incredibly helpful on topics that involve describing different specialties or best practices in medical school.

Anecdotal experience can be a huge benefit for rising medical students. This website is largely built around that very idea. However, a lot of the med student comments in Success in Medical School tend to be unhelpful, and focus on the personal opinions of the cited med student on a particular seemingly-trivial question (e.g. “my favorite course in medical school was…”). While these types of opinion-comments are scattered throughout the book, they are thankfully not a large majority, and don’t detract from the surrounding value.

Lastly, the book offers some general advice which isn’t necessarily reference or backed by data. Often times these can be a good starting point for med school success, but they can be rather vague for someone seeking specific means of improvement.  However, there’s no way for any single book to offer specific methods of studying that would work for all students, let alone up to date, so this generalization is somewhat understandable.

Much like MD2B’s other titles, the goals of this book are quite similar to this site: giving rising medical students an edge. However, the target audience is clearly different, as Success in Medical School: Insider Advice for the Preclinical Years is really geared towards students who have absolutely no understanding of the basic med school concepts.

So how should one reconcile this mixed review?  Well, the book isn’t for everyone, and can’t be endorsed accordingly. However, there are a few key audience types that would benefit from reading Success in Medical School, and almost all of them are self-selecting:

  • pre-medical students who are nervous or unsure about what is expected in medical school (especially those about to matriculate)
  • students entering a medical school that does not provide a lot of orientation, support, or guidance on expectations or succeeding
  • medical students who find they are consistently not able to excel or who consistently produce lower than average grades and evaluations in the first semester of medical school
  • students who want some extra reassurance that their interpretation of academic expectations is accurate before entering situations that are evaluated
  • the nervous-gunner types who are doing fine but feel compelled to find any and all resources they perceive may be of help

Based on the content type of the book, we would normally recommending renting/borrowing it. However, as it really does cover all areas of the preclinical years, we instead recommend having it on hand and referencing sections that are relevant to a student’s stage in medical school as they arise. After all, there’s really no reason a pre-med student should be reading about Step 1, but that section could be helpful during the summer after first year. Purchasing the book used would save some money without losing value, but since it is so new, that may be difficult to do.

For those who feel they may benefit from Success in Medical School, check back on the site over the next week, as we will be giving away a free copy of this title.

 

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The High Yield Series: Histopathology, Cell and Molecular Biology, & Embryology

High Yield Histopathology (2nd Ed), High Yield Cell and Molecular Biology (3rd Ed), and High Yield Embryology (4th Ed) are three books in a series whose purpose is to provide high yield topic and content review to prepare us for the boards.

Histopathology topics are covered in 30 chapters and about 300 pages, some of which cover nucleus, cell membrane, bone, blood, muscle, blood, thymus, small intestine, large intestine, respiratory system, eye, and ears.Cell and Molecular Biology topics are covered in about 140 pages consisting of 16 chapters, including, but not exclusively: chromosomal replication, meiosis, mitochondrial genome, mutations, proto-oncogenes, cell cycle, molecular biology techniques, and identification of human disease genes. Finally, the book on Embryology, consisting of about 140 pages, includes topics on overview of fertilization, development of organ systems, and teratology resulting from various external factors such as drug side effects.

These books are fairly comprehensive as far as review books go, but may not be the best books of choice for learning the material for the very first time. Certain topics may require reference or background information from a more comprehensive textbook. The range of topics covered in these books can be described as having more breadth than depth, although depth is generally sufficient for review purposes. Note that these books are in gray scale, which means if you need colorful pictures to keep you entertained, then you probably shouldn’t use these books since they are condensed material with black and white images. However, the inclusion and highlighting of clinically relevant concepts in the “Clinical Considerations” makes these books good sources for review, and helpful for the wards.

Perhaps one of the larger benefits is that these books are much shorter than their corresponding texts. Although many med students will tell you they are too dense or too much to read, other people will tell you that they are perfect for studying. The reason for this disagreement is that people tend to use these books in different ways, for different reasons, and with different backgrounds or expectations. These High Yield books do contain quite a bit of information, which may be considered too dense for those people who are simply looking for a flashcard style review book. However, people who use the High Yield series for learning the material for the first time may find that the information contained in it is insufficient to fully explain the concepts (which is an obvious feature with review books). Few review books are perfect, since there are so many possible topics to be covered, and any topic that one person studied but didn’t get tested on (either in class or on the boards) becomes “excessive material” even though another student may hit questions requiring that knowledge on their Step 1 exam. It’s important to disregard single outlier reports from other med students who took the boards before you. The boards can’t test everything every time.

The fact that these books are black and white makes them a less appealing to study from, but the material included are condensed and easily accessible. Again, they sometimes require some reference/background books from time to time, which is reasonable given that they are review books and not textbooks.

This subset of the High Yield series is good to use for a comprehensive review of the corresponding topics that are likely to be tested on the USMLE and preclinical med school classes. Using these titles by themselves for medical school curriculum may be insufficient, although using them as a “big picture” review for medical school exams is probably fine. Since medical schools rarely teach to the USMLE, it is prudent to keep in mind that these books may not necessarily produce the Honors that you may be aiming for. Use this book when studying for the USMLE, but in conjunction with First Aid and in ways mentioned elsewhere on this site. That way, you can better gauge the highest of High Yield topics and prioritize material to optimize learning for the boards.

 

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