Tag Archives: First Year Medical Student Books

Rao’s Rational Medical Decision Making: Just Right for Med School

Rao's Rational Medical Decision Making: A Case-Based ApproachRao’s Rational Medical Decision Making (MDM): A Case-Based Approach by Lange is a narrative textbook on biostatistics. Chapters include A Brief History Lesson, Biostatistics for Medical Decision Makers, Scientific Approach to Diagnosis, Design of Research to Evaluate Therapies, Understanding the Results of Studies of Therapies, Etiology, Survival, Systematic Reviews, Decision Analysis, and Clinical Practice Guidelines.

Within these chapters is a comprehensive review of biostatistics in an applied fashion.  Whether it’s T-tests or ANOVA or Chi-squared tests, you’ll find realistic applications and examples to help you understand and to fortify your learning.  Even if you plan to do a masters degree in epidemiology or PhD and need in-depth knowledge of statistics, you would still find this book a good starter or review of the main biostatistics concepts with relevant examples.

This book does not take the traditional “textbook” format.  Given that the book takes the narrative format, it does not present information in a bland, isolated manner where synthesis and understanding of the information are secondary to (and seems less important than) information overload.  Rather, Rao’s MDM is a narrative and all the relevant information is presented with equally applicable case examples.  The major concepts, from T-tests to ANOVA to research design are paired with exemplary cases in which Rao helps med students learn biostatistics through realistic and practical examples.

In the narrative format, Rao’s Rational Medical Decision Making is easy to read, easy to understand, and yet still provide all the information you’ll need as a medical student to succeed in biostatistics.  Of course, if you dive below the depth of the main concepts, then you may need help from some supplementary sources. But for the purpose of medical school biostatistics and the USMLE Step 1, this book is perfectly sufficient and is, in fact, quite a comprehensive book for the beginner medical scientist or a great review for the intermediate medical student biostatistician.  The practice questions at the end of each chapter can help any reader solidify concepts and practice real problems.

The downside about this book is that it is not a textbook.  Since it is much more focused on the application of biostatistics, it is less focused on providing every nit-picky detail (in biostatistics in case you are the person who likes to learn everything about everything).  This book also does not go that far in depth for the math genius who wants to learn the theories, derivatives, and fundamental basis of the biostatistics formulas/concepts.  Furthermore, because the book is a narrative, it does not present information in a condensed manner, because interspersed between major and minor concepts are examples that are meant to help explain the application of the concepts.  So if you are looking for a five page hyper-condensed review booklet, this book is not that.

I would definitely recommend Rational Medical Decision Making as it was well written, concise, and relevant, making it an adequately comprehensive starter or review book for biostatistics.

 

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What You Need to Know About Lippincott’s Biochemistry

Lippincott Illustrated Reviews BiochemistryBiochemistry can be defined as the study of metabolism, and metabolism is the sum of all chemical reactions in the body. That’s a pretty wide field to cover.  Even if your professors clearly explain what you’re expected to know, there will always be information beyond your curriculum that could help you solidify your knowledge. With biochemistry in particular, you can go in two directions, ‘down’ to the chemistry and energetics (repressed undergrad memories bubbling up) or ‘up’ to the clinical correlations and differentials which we hope to know by the time rotations start. Faced with a bewildering array of review books at every point on this spectrum, you might ask yourself, what is the best book to help me in my class, for the boards, and for the wards?

A common recommendation from biochem professors and older students alike was Harvey and Ferrier’s Biochemistry, part of the Lippincott’s Illustrated Reviews series, now in its 5th edition.  The bulk of the book is a thorough review of proteins, enzymes, and the metabolism of the macronutrients. It describes and comments on important reaction pathways such as glycolysis, the pentose-phosphate pathway, the citric acid cycle, and mechanisms of amino acid synthesis, combination, and degradation. Later in the book, one unit is devoted to integrating these pathways. For example, one chapter looks at the effect on all systems of insulin and glucagon in the fasting and feeding cycle, with chapters covering diabetes, obesity, and nutrition. The last unit covers the special chemistry of genetic information which aims at preserving and expressing information rather than procuring energy or achieving certain concentrations of building block molecules.

My initial look through the book brought an immediate sense of relief. The book seemed organized with a huge number of clear and helpful illustrations. The text itself is succinct but vigorous, like an old-fashioned news anchor might sound if the news of the day for some reason involved the emulsification of dietary lipids. Blocked out in chapters, sections, and subsections, the writing never feels rote or forced but manages to retain a readable, almost “listenable” tone that contrasts favorably to how some other books smother murmur beneath an avalanche of facts. Throughout the text, the authors build on previous topics and indicate points of intersection between pathways, often in the form of strategically placed charts and figures. At the end of every chapter, there is a summary with keywords highlighted, “key concept map” for the chapter, and a few questions and explanations. When that isn’t enough, the thorough index was often handy.

After spending a lot of time with the book, it becomes evident that the editors spent a lot of time designing the reader’s experience. This has the unexpected consequence of making students read more than intended when looking up a particular topic. Often, the next related topic is familiar but not completely solidified. In context, you make a connection you otherwise wouldn’t have, and you can cross one more topic off your list of things to review.

This attention to the reader’s experience is also responsible for what may be the book’s only downside. The details on the diagrams are so focused on making a point that they sometimes have less information than it would appear. In a larger textbook, a chart showing the effect of a drug on blood glucose concentrations over time would probably be large, simple, uncluttered, and accompanied by a lengthy description of the experiment. Here, it is small, marginal, and crowded with word bubbles with arrows overlappingly pointing out features on the graph to which they’re relevant. The effect is that of a comic book: bold, practical, attention-grabbing, but a little bit tiresome all the same.

Nonetheless, this book is very good for its purposes. Though it is an ideal adjuvant to a textbook, it probably is not a substitute for one if you’re being introduced to biochemistry for the first time. Opinions about it for Boards Review are mixed: though it covers all the topics that are likely to come up, some students feel that it is perhaps too thorough for high-yield review. On the other hand, if you use this book during your biochemistry class, you will probably know where to look for what you need to review. Its lucidity and completeness would then be a plus.

Overall, if you’re looking for a book to help you make sense of biochem – to help you know what’s important and give you a sense of how the discipline is used in medicine – Lippincott Biochemistry is highly recommended.

 

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Free copy of Bates’ Guide to Physical Examination and History Taking!

This contest is currently closed – the winner has been contacted.

Bates Guide to Physical Examination and History Taking

Continuing our trend of offering absolutely free books to fellow med students, we are happy to be giving away a free copy of Bates’ Guide to Physical Examination and History Taking.  We recently reviewed Bates Physical Exam on the site, and have gotten great feedback from it so far.

In our last giveaway, a student from the University of Pittsburgh took home a free copy of Pocket Medicine by giving great advice to incoming first year medical students. In a similar fashion, the winner of this contest will be able to provide the best feedback for the following challenge.

If you could improve MedStudentBooks.com to help med student readers from around the world, what would you add to the site? The winner not only gets a free copy of Bates, but may also have their idea implemented on the site.

Please check out the About section to get an idea of the original site goals, but keep in mind that the winner will be chosen based on the helpfulness of their ideas. We not only host reviews, but create new applications as well, so anything is fair game.  All contest ideas can be submitted by replying in the comment section of this post, and you may submit multiple ideas for this contest. While it doesn’t improve your chances of winning, be sure to also subscribe via RSS or click on any of the social network links at the bottom of this post or top of the page.

As this is valued at nearly $100, the winner will need to provide a valid US medical school e-mail address to confirm their status. E-mail addresses are never displayed publicly, and will not be used for any purpose outside of contests.  The contest will end on Friday, November 18th at 11:59pm, and the winner will be notified by the e-mail they provided shortly thereafter.

See our complete contest rules for further details.

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Must Buy: Bates’ Guide to Physical Examination and History Taking

Bates Guide to Physical Examination and History TakingThe heart of all medical education is centered around a solid foundation in history and physical exam skills. These are not only learned and critiqued early during the preclinical years, but comprise the basis on which medical students are assessed and evaluated during clinical rotations as they are conveyed through presentations. Due to the strong and constant need for excellent history and physical examination skills in producing superior grades, it is highly recommended that all medical students master these abilities early.

Bates’ Guide to Physical Examination and History Taking, now in its 10th edition, represents the best reference resource for this goal. The book itself is rather extensive as a primer for all things history and physical, which makes it perfect for incoming medical students. The text is detailed and straight-forward, with great complementary pictures, illustrations, and tables. It is important to note that the focus extends behind the basic logistics and mechanics of taking a history and performing a physical.  Special attention is placed on normal physiology, as well as the significance of abnormal exam findings. Combined with proper instrument technique and care, this book allows for a deep understanding and mastery of the basic physical exam.

Other benefits of this book include the CD and website access on The Point, which host patient examination and assessment videos, fully searchable text, and cardiopulmonary exam sounds. To a lesser degree, the book is also helpful at providing basic differential diagnosis development. While many medical schools specifically assign chapters in this book as required reading during preclinical years, it remains a fantastic reference source throughout clinical rotations as well, with continued potential for residency.

There are a few drawbacks to this book.  First and foremost is the price.  At around $100, this “must buy” book is often times considered a “must borrow” from the library. Purchasing the black 9th version of this book will offer nearly all the same content for a slightly lower price, but has issues with page discordance when professors assign specific pages from the latest version. Second, Bates’ strength in providing full explanations to completely inexperienced medical students can sometimes become undesirable later in medical school when trying to obtain a quick concise answer for an understood concept.  Along those same lines, the weight of this 992 page book can make constant transport somewhat arduous. It should also be noted that this book does not delve into the depths of specialty exams, but rather focuses strongly on the general history and physical exams needed for core clerkships. For example, the basic eye exam is included, but does not cover the depth that an ophthalmologist might assess. The book does however provide a full and thorough neurologic, pediatric, and gynecologic exam.

The first unit is a general overview, and contains specific book chapters on: Physical Exam and History Taking Overview; Clinical Reasoning, Assessment, and Recording; and Interviewing and the Health History. Unit 2 covers regional examination, with chapters on: General Survey, Vital Signs, and Pain; Behavior and Mental Status; The Skin, Hair, and Nails; Head and Neck; Thorax and Lungs; Cardiovascular System; Breasts and Axillae; Abdomen; Peripheral Vascular System; Male Genitalia and Hernias; Female Genitalia; Anus, Rectum, and Prostate; Musculoskeletal System; and Nervous System. The final unit is dedicated to “special populations,” and includes chapters on: Children – Infancy through Adolescence; The Pregnant Woman; and the Older Adults.

Overall, this is a highly recommended book for incoming medical students to master vital skills. Be sure to use the below links to get a starting price comparison between retailers before making a purchase, as the price can be steep.

 

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Otoscope and Ophthalmoscope Set Alternatives: Med School Supply

Compare halogen and LED diagnostic kit bulbsWelch Allyn is the leading manufacturer of otoscopes and ophthalmoscopes, however the quality is also reflected in their higher prices. While many medical students want to purchase top name-brand equipment, and indeed this should be the case for such instruments as stethoscopes, this strategy is not always needed for diagnostic kits. Here’s the usual scenario: second year medical students from AMSA or some other group organize a “money-saving fundraiser” (let’s ignore that blatant oxymoron) and only highlight larger, more expensive, name-brand companies.   Often times there are even incentives to purchase the more expensive $500-$800 diagnostic sets to “save” on smaller instruments such as tuning forks or reflex hammers.

As mentioned in the Compare Welch Allyn series, it is incredibly important to talk to senior medical students at your school to ascertain the actual usage of instruments. This cannot be accurately assessed from manufacturer representatives, or even the second year medical students running the instrument sales.  If third and fourth year students carry their diagnostic sets with them at all times, a Welch Allyn set may be more beneficial.  If such diagnostic kits are used in a small handful of learning sessions that teach physical exam techniques during first and second years and are never utilized throughout the rest of medical school, we recommend the following.

Med School Supply Fiberoptic LED Otoscope Ophthalmoscope SetThe company Med School Supply (completely unrelated to this site despite the similar name) sells full-sized otoscope and ophthalmoscope sets for around $100.  Their standard model works just fine, although their LED otoscope set is actually more highly recommended due to the brighter, better lighting it produces.  You can clearly see the difference between their fiberoptic LED bulb and an older Welch Allyn halogen bulb in the top image of this article, and read more about the differences in the article How to Pick the Best Light Source.

Both kits work with standard otoscope tips, which means there is no reliance on this company for tips after purchasing one of their models.  Like the Standard Otoscope in the Welch Allyn description, Med School Supply otoscopes use a groove system to hold tips internally.  The ophthalmoscope uses the same halogen bulb for both kits, and is a solid basic model, without the bells and whistles as its WA counterpart. Unlike Welch Allyn, there is no built in rechargeable option for the handle.  These models take two C batteries, and that will last the entirety of medical school for the average user.

It is important to note that this company does not have the same quality control standards as Welch Allyn, so it is possible for them to sell and ship a set with a suboptimal component.  Nonetheless, they have a full lifetime warranty on all of their products, so any piece will be replaced free of charge with free return shipping at any point during your use of the instrument.  For the $400 difference between this and the Welch Allyn version, some find this compensated downside to be more than tolerable.

 

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5 Reasons Why You Shouldn’t Overlook Netter’s Anatomy Flash Cards

Netter's Human Anatomy FlashcardsAt this point in the year, most medical students have already started Gross Anatomy and have gotten a feel for many of the resources available to them.  A review was previously written that compared some of the more popular anatomy atlases, and only a brief mention has been made on this site so far regarding anatomy flash cards. For many students, the idea of atlas flash cards seems redundant.  You should be familiar enough with your study and learning habits to get a feel of this already.  However, there are some benefits to this resource which are best shared by people who have already gone through the full experience of medical school.

1. Size Matters… for Anatomy

Regardless of which atlas you have selected, you are most likely going to be bringing it around with you, or using the local library copy. However, this has its limitations.  Pulling out a copy of Rohen on a crowded bus can not only be disturbing to those around you, but produce a serious issue of professionalism. Similarly, waiting for a bus or standing around somewhere makes balancing a thick anatomy atlas somewhat annoying. The first strength of Netter’s Anatomy Flashcards (now in their third edition) is their size.  Reviewing them is not only easy to manage, but they are also easy to hide.

2. Grab ‘n Go Learning is Key

Chances are, your anatomy class will focus on one particular organ system or anatomic area at a time.  The full Netter’s Anatomy Atlas text is 620 pages, which is overkill for your specific study needs in any given week. While it is a great resource, carrying it around along with a syllabus is going to get tiring pretty fast. A better tactic is simply grabbing the color-coded stack of flash cards dedicated to your current area of interest. The latest version already has hole punches, which keeps organization manageable. At some point in med school, most medical students realize the usefulness of portability. Stack a few cards on top of your snack bars, and you’re set for the day.

3. Instant Access

Netter's Atlas of Human Anatomy smartphone AppPurchasing Netter’s anatomy flash cards new grants access to the studentconsult.com online version of this resource from any computer.  Even if you forgot your cards at home, you can still review them. This basically creates a second copy of the cards, which you can access indefinitely, even if you want to share the hard copy with a friend.  Some will argue that this is especially useful when accessed remotely on a smart phone, but most med students would disagree. The detail of the structures combined with the small font makes for a suboptimal viewing and thus learning experience. This is precisely the reason the iPhone and Android app of any atlas is usually contraindicated.

4. Reusability

While most first year resources are rarely used by med students on the wards, anatomy is something that will need to be reviewed for a number of clerkships, including surgery, ob/gyn, neurology, as well as elective rotations in any surgical subspecialty. Again, a full atlas is always best, but not something easily stored in scrubs pockets and referenced between cases in an operating room.

5. It’s cheaper than you think

A set of anatomy flash cards can usually be purchased new for $25. Because they tend to be in moderate demand every year, they have a resale value that will allow you to recover the majority of its initial cost. Furthermore, selling your set used does not remove access to studentconsult.com, which means you can continue referencing the electronic version.  Even when new versions come out, older sets can usually still be sold.  With that in mind, it is perfectly reasonable to purchase the previous version of these flashcards. Human anatomy hasn’t changed too much since 2006.

As a runner up reason not to overlook Netter’s Anatomy Flashcards: They go particularly well with people in the Rohen camp of anatomy atlases, as it offers a little bit of Netter drawings to complement and enhance the Rohen experience, producing the best of both worlds.

 

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Compare Welch Allyn Series: Building a Full Diagnostic Set

This is the sixth and final part of a series of posts on comparing Welch Allyn products that will help incoming first year medical students learn about and select different medical instrument components to construct the right Welch Allyn diagnostic set (otoscope and ophthalmoscope).


By now, you should have reviewed the other five articles in the series, and noted your preferences:
Compare Welch Allyn Series: How to Pick the Best Battery and Handle
Compare Welch Allyn Series: How to Pick the Best Case
Compare Welch Allyn Series: How to Pick the Best Light Source
Compare Welch Allyn Series: How to Pick the Best Otoscope
Compare Welch Allyn Series: How to Pick the Best Ophthalmoscope


Trade-offs of Pricing and Usage

It is important to remember that many medical schools only require use of personal diagnostic sets while learning how to perform a physical exam during preclinical years. Many rotations will either not require use of these instruments, or provide them to medical students and staff if needed. You should contact senior medical students at your school to ascertain the usage of these instruments when considering the price. For minimal use, you may want to consider purchasing from another manufacturer entirely. It is also a common mistake for incoming med students to assume these instruments will be used after med school. Specialties that use these instruments have more expensive versions or wall mounted models, and many specialties won’t need them at all.


Selecting Your Model

Most retailers do not carry all diagnostic kit combinations of the above Welch Allyn components. Most local companies will carry about 4 of the 75 total diagnostic kits manufactured by Welch Allyn, and that is actually sufficient for the large majority of med students. It is not uncommon for retailers to highlight the more expensive components, such as the PanOptic ophthalmoscope, and to list all other options by their model number. This can be a rather confusing selection process, which can be remedied below.

The following application is designed to assist in putting it all together and selecting the Welch Allyn diagnostic kit that is best suited for your needs and desires based on the results of the above articles. You may input your selections and the application will output the specific model number for your use with retailers. It will also output a list of the closest matches to your selection, in case your first choice is not carried by your retailer.


Please click one of the following from each category:

Relative Price $
$$
$$$
Case
Handle
Otoscope
Ophthalmoscope

Recommended Diagnostic Kit Model Number:

 

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If You Must: Stedman’s Medical Dictionary

Stedman's Medical DictionaryAnother common mistake new medical students make is securing a medical dictionary. Usually these are used as incentives for signing up with one of the medical societies that want your money, but as a whole, they are not needed.  That’s not to say they are inaccurate or unhelpful, so much as outdated.  If you need to look up the definition of a specific medical term, chances are you will be effortlessly turning to Dr. Google or Wikipedia, instead of digging out a book from your shelf and using your mastery over alphabetical order and small print font.

With that being said, there is a small sub-population of people who will argue over which medical dictionary is the best out there. The fact is, they all get the job done to about the same degree and ease.  If you have to pick one because your medical book starter set wouldn’t be complete without it, I would say go with Stedman’s Medical Dictionary.  It’s the one that has been endorsed by the American Medical Association (AMA), and is one of their incentives for joining (as referenced above).  This not only means that you have the opportunity of obtaining it at no additional cost if you were to sign up with them anyway, but it also usually means that they are plentiful and freely given away by other med students who didn’t want it.

Again, it’s a common mistake to buy a medical dictionary.  They just aren’t needed.  But if you insist on getting one anyway, grab a copy of Stedman’s.

 

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