Tag Archives: clinical vignettes
Deja Review’s second edition of Emergency Medicine promises maximum retention with minimum time. Using a ‘flashcard in a book’ question and answer format followed by a series of clinical vignettes designed to mimic classical presentations of the disorders presented therein, this copy of Deja Review “helps you remember a large amount of pertinent information in the least amount of time possible.” So how much of this self-promotion is hype and how much is fact?
Emergency Medicine is divided into 18 chapters, each focusing on a particular overarching organ system or concept such as Cardiovascular and Vascular Emergencies or Toxicological Emergencies Each chapter is further subdivided into specific emergencies or presentations within these broader topics. The subsections cover the most pertinent information regarding a specific presentation, such as etiology, exam findings and management. It should be noted that the answers to the questions posed are very specific and typically not explanatory. Following each chapter is a series of clinical vignettes which highlight key concepts of the diseases or emergencies presented within the chapter. A ‘Stimulus’ section found at the end of the book features 7 expanded clinical vignettes that include expanded presentations, images pertinent to the topic (MR, EEG, X-ray) and lengthy explanations regarding the answer choice.
Despite being very bare bones, Deja Review Emergency Medicine, if used exactly as it is intended—as a last minute review solution—will probably serve those who choose to invest. This is not a book for those who wish to explore the in depth intricacies Emergency Medicine has to offer. Other comprehensive resources would likely benefit those looking for great detail regarding various case presentations and how to diagnose and treat cases seen in the emergency department. But for someone who is looking for a quick and effective review of what Emergency Medicine has to offer in the week or so leading up to an exam or for rapid EM review, look no further.
To kick off the USMLE Step 1 advice, we present the big picture overview of studying. Some of the below are well known strategies, but we hope to present some clever caveats that have been compiled by a number of med students along the way. Over the next few weeks, in depth articles will detail more of the little tricks that offer that competitive test taking edge. For now, let’s stick to the basics.
Early in the study process, you will be bombarded with different strategies and study practices. The problem will always come back to figuring out what works best for your specific learning style and knowledge base. Before you even decide where to start, you should have a basic idea of big-picture learning goals. After all, it would be silly to dedicate the same amount of time to a topic you despise as one you already know really well. Don’t guess. That’s an easy and common mistake. Get evidence.
The National Board of Medical Examiners (NBME), the same guys who bring you the Step 1 exam, have created a number of helpful exams for this goal called the Comprehensive Basic Science Self-Assessment (CBSSA). They use Step 1 style questions and provide performance profiles (above) similar to that found on your actual Step 1 assessment. It lays out a visual representation of strengths and weaknesses. Hopefully your med school provides them to you for free (if they don’t, petition for it).
It is recommended that you take an untimed enhanced CBSSA exam early on or even before you start studying. Assessing your Step 1 knowledge before studying, and seeing the score and performance profile early on will definitely sting, but the purpose is to push you in the right direction. It can serve as a strong motivator, and has been shown to increase board scores at certain med schools by 1/4 of a standard deviation. If desired, take another one about 10 days before the actual exam for comparison and reevaluation of focus. Using a question bank to accomplish this goal is an alternate option, but they are focused on teaching topics, and nothing is as authentic and insightful as an exam coming directly from the NBME.
Once you figure out strengths and weaknesses, creating a study schedule is the next essential step. We’ll cover the various types of plans more extensively in future posts, as there are many out there. The big picture point is that it should keep you focused but remain flexible. This can be a large stress-inducing topic for med students, as gunner plans will require no sleep and IV hydration. Construct something right for you that also maintains sanity.
It has been reviewed and highly recommended on this site, and even given away in a contest. This should be at the core of every med student’s study plan, and can be purchased confidently, regardless of your individual study strengths. However, this absolutely cannot be the sole source of information for Step 1 studies. Every commercial question bank and review course will cite some arbitrary number that suggests First Aid doesn’t hold 100% of the needed knowledge. They’re right.
The proper way to use First Aid for the USMLE Step 1 is as a guide. The sections corresponding to the subject of your focus should be lightly overviewed first. This should then be followed by in-depth learning from a dedicated resource. Some students like returning to review First Aid after that, and/or in the days just before the exam. Either way, it should be used as your starting marker to point you in the right direction, not your end point. Furthermore, it should be annotated thoroughly, which will be discussed with tips in an upcoming post.
Now that we convinced you that First Aid won’t make you a Step 1 superstar by itself, let’s look at what else to consider. You will find that there are about three million medical books out there. After narrowing down the list to those designed specifically for med students studying for the USMLE Step 1, you will find yourself left with about 43,943 books. Pro-tip: you can’t read them all.
Feuds have started over which books present the highest of yields. You could sink a lot of time into researching every title, and fall prey to the gunners and trolls of the SDN forums, never wanting to hear the term “high yield” ever again. Here at MedStudentBooks, we like to keep things simple. Below is a list of recommended titles to support various Step 1 topics. As always, we highly recommend using the titles you already know and love to jog your memory. But if you don’t have a favorite, the following is a list of highly recommended titles from the MedStudentBooks team, surveyed med students, and med school administrators that you should consider first:
|MedStudentBooks Recommended Step 1 Resources|
|Lippincott’s Biochemistry||(full review here)|
|Q&A Review of Biochemistry|
|Clinical Microbiology Made Ridiculously Simple||(full review here)|
|Q&A Review of Microbiology and Immunology|
|BRS Physiology||(full review here)|
|BRS Behavioral Science|
|BRS Pathology or Goljan’s Rapid Review Pathology||(full review here)|
|Robbins and Cotran Review of Pathology (question book)||(full review here)|
|MedMaps for Pathophysiology||for true visual learners|
|Lilly’s Pathophysiology of Heart Disease||(full review here)|
|High-Yield Gross Anatomy with your favorite atlas for reminders|
|High-Yield Neuroanatomy||with this gem|
Clearly you should not seek out every book on this list. In fact, purchasing too many books can stress you out if you have a large pile of materials you feel you must get through, without the time to actually do it. These are just top recommendations for the subjects with which med students tend to need extra help. The key is to figure out what topics need to be strengthened as mentioned above, and focus on them from the above list appropriately. We’ll go over general question and case books in another post.
Do not be that med student who waits until the day before they are scheduled to start reviewing a topic to buy the associated book. You should not dedicate any brain power on bookstore trips or figuring out why the postal service didn’t deliver your Amazon order in the middle of your studying. Added stress is not welcomed. Figure out what books you need from your self-assessment, and purchase them early.
Your med school may host an obligatory Kaplan lunch talk, or notify you of a USMLERx “scholarship” (?). Maybe you’ve heard some rumors about a new and upcoming question bank weapon for gunners. Like books, there are several options out there, but this choice is even simpler than books: use USMLE World.
Much like First Aid, this is not a question of learning style. If you’re a visual learner, use UWorld. If you’re an auditory learner, use UWorld. If you work for Kaplan… use UWorld. We’ve previously mentioned that we’re not a fan of their company policies or prices, but the high quality of their question bank is undeniable, which is why they are the gold standard. Unless your exam is scheduled within the next 8 weeks, get a 3 month subscription. We’ll discuss question bank strategies and alternatives in upcoming posts, but for now rest assured that you don’t need to worry about other companies unless you’ve blown through UWorld and come out hungry for more. Again, the price is unfortunately high, but it is an absolute necessity.
So far we’ve covered basic science subjects that are largely conceptual. Unfortunately, Step 1 (and the rest of your career) will require straight up no-thinking-through-it memorization. By this point in med school, you’ve probably created lists that you’ve stared at for so long that you not only remember the factoid, but the irregularities of the paper as well. This will most likely come up for Step 1 in pharmacology and microbiology. It is an unfortunate necessity, however it can be improved slightly. Just remember that large amounts of rote memorization are best retained with spaced repetition. In other words, you should identify the long lists somewhat early, and continue to review them in short bursts throughout your study schedule instead of dedicating large chunks of time without returning to the information.
A lot of us really neglect this one, and it can have devastating effects on productivity and exam scores. We’ll be discussing burnout in greater detail soon, but you should start thinking of things that keep you sane now. Step 1 sucks, but you are awesome.
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.