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.

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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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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The 4^th Edition of Handbook of Fractures by Egol, Koval, and Zuckerman, is a must-have for interested medical students and orthopaedics residents everywhere.  It contains the essentials for an orthopaedic rotation and will give you a great foothold on the foundation of the specialty.  Note that it is not an all-knowing book of knowledge, despite being a “go-to guide” for the fundamentals.   It is a very condense text of fractures, dislocations, and stabilization techniques for upper and lower extremities, pediatric cases, axial fractures and dislocations, and also general considerations for the important categories of gunshot, pathologic, and multiple trauma cases, just to name a few.

This handbook is divided into 5 major divisions with chapters under each division: I. General Considerations (7 chapters including: GSW, closed reduction/casting/traction, periprosthetic fractures, orthopaedic analgesia), II. Axial Skeleton Fractures (3 chapters including: general spine, cervical spine, thoracolumbar spine), III. Upper Extremity Fractures & Dislocations (14 chapters including: scapula fractures, distal radius fractures, hand fractures), IV. Lower Extremity Fractures & Dislocations (17 chapters including: acetabulum, femoral shaft, patella, calcaneus, talus), and V. Pediatric Fractures & Dislocation (11 chapters including: shoulder, elbow, hip, knee, ankle, and many more).

Egol’s Handbook of Fractures has a lot of text, but is easy to read because important words are bolded and there are quite a good set of illustrations that go along with essential concepts.  Most chapters are subdivided, very logical, touch on epidemiology, anatomy, mechanism of injury, clinical evaluation, radiographic evaluation, classifications of fracture/dislocation, treatment, nonoperative vs operative cases, complications, and rehabilitation.

The primary target audience of the Handbook of Fractures is orthopaedic residents.  It covers a wide range of important and must-know concepts needed to succeed in orthopaedic residency.  The ambitious MS3 who wants to end up on top in an orthopaedic elective clerkship may also find this book enlightening and useful for impressing some attendings and residents (don’t show off too much though, jealousy must be kept at bay!).

This book is certainly not recommended for medical school courses in general, as time spent reading it would be low yield for general surgery rotations. This book is also pretty much useless for the USMLE exams because orthopaedic fractures, dislocations, and other material presented in this book are just not the materials you’ll see on the boards.  If you want to use it to get ready for an elective in orthopaedic clerkship or plan to go into orthopaedic residency, then go right on ahead and invest in one. Otherwise, it is recommended that you skim a library copy as needed.

 

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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.

The 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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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.

Secondly, 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.

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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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.

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.

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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It’s application season, and while this takes place every year, we only go through it once (thankfully), and thus the >25,000 participating med students are unfamiliar with the process. There are a TON of considerations on selecting individual residency programs to put on your ERAS application. It can seem daunting to wade through the list of endless programs out there unless you are certain of a smaller specialty from the start. We’re going to start with the basics, for those of you who are really lost.

First, head over to FREIDA Online. It’s a searchable sortable database produced by the American Medical Association with over 9000 residency and fellowship programs.  After scrolling to the bottom of and agreeing to their policies, users can select their desired specialty (including sub-specialties and combination residency programs), geographic area, program size, and academic affiliation. Results can be further filtered by benefits, ERAS or NRMP participation, research requirements, or specialty training tracks.

Searches can be saved for later viewing, although this is generally not necessary. For the more popular specialties such as Internal Medicine, paring down the perceived 3 billion possible choices by all of these options still produces a list that still feels like 567,902 programs. In actuality, you should come out with a list of less than 100. It’s still overwhelming, but much better than when you started. Trimming that list down to your “short list” of about 20 total programs to which you will apply. The final push should come from academic advisors in your desired field. If all else fails, post a question to this post, and we’ll have someone look into it.

Hopefully though, FREIDA Online will be a highly useful first step. For those of you wondering, the AMA application name stands for “Fellowship and Residency Electronic Interactive Database.”  Sounds about right. Good luck on the application process!

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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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So it’s Wednesday afternoon. After weeks of waiting, you’ve been checking your e-mail today Q3minutes or hitting refresh on the NBME site repeatedly, and finally find what you’ve been seeking: the link to the PDF that you think determines everything.

You hastily open the file to find….   a large block of text. After the second it takes you to realize the date and your USMLE ID number at the top have nothing to do with your actual score, your eye catches a glimpse of the following:

A good sign! You’ve joined the >90% of MD students (and about 80% of DO students trying for an allopathic-residency program) who passed. Congratulations! Chances are though, the page opened up just short of showing the box directly underneath the pass/fail: your score. In your excitement, you struggle with getting the mouse accurately (or was it precisely?) to the scroll bar to find…..  two numbers?  One of them a three digit score, the other a two digit score.  So…  you were aiming for some three digit goal, but now that you have passed and your score is permanent, what does it actually mean?!

In med school, the right answer usually starts with “it depends.” Let’s start with the three digit score, as that’s the important one that gets sent to residency programs with your application. As you know by now, certain medical specialties are more competitive than others. We’ll discuss interpreting below expected or failing scores in another post, but for now, you should start by checking out The National Residency Match Program (NRMP) and Association of American Medical Colleges (AAMC) document on charting match results.  It comes out around September each year and gives a breakdown of the previous year’s match statistics.  Right now, you’ll be most interested in the section that shows the average and distributions of Step 1 scores by specialty.

As for the two digit score, this is the number that is most likely to be misinterpreted. The first thing to know is that this is NOT a percentage nor a percentile. The former refers to the number of questions correct on the test divided by the total, and the latter (percentile) refers to how well you scored in relation to other students. The two digit score is neither. Don’t feel too confused – if you got this far, you already know you’re pretty smart. The two digit score is a near-arbitrary number, whereby the National Board of Medical Examiners deems the number 75 to be the cutoff for passing. This roughly corresponds to a three digit score of 188. Is it useful?  Not really.  It’s more historic than anything, and the confusion surrounding it is the reason why it is no longer sent with residency applications to program directors.

If you are interested in learning more about USMLE Step 1 percentages and percentiles, we strongly recommend checking out the MedStudentBooks.com USMLE Step 1 Percentile Calculator to help make some more sense of your score.

Congratulations to all those who passed – you’ve quite literally taken your first step to becoming a physician.

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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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