Tag Archives: MS-II

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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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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USMLE Step 1 Series: What Does My Step 1 Score Mean?!

Navigating Step 1 Scores

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:

Passing the USMLE Step 1 Exam

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.

Is my Step 1 Score good?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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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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USMLE Step 1 and 2 Studies on the Go: Utah Web Path

University of Utah Web PathologyFor 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. Utah WebPath QR CodeWe 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.

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USMLE Step 1 Series: Making a Withdrawal at the Question Bank

How to Choose USMLE Step 1 Question BanksYou’ve heard whispers around your medical school of a variety of question banks to use during boards, and there are a lot. To be specific, this article is going to hit on the main points of question banks only, not to be confused with the variety of coaching or training programs out there.

As mentioned in the opening article of the USMLE Step 1 Series, choosing a question bank has little dependence on your individual learning style. Before we get into the individual options, it’s important to note that this can be one of the largest detriments to your student loans for the Step 1 exam, outside of the exam itself. While we always encourage smart purchases, this is not a time to be frugal. You should purchase a question bank, and round up on the time compared to your exam (e.g. if you exam is 1.5 months away, get a 2 or 3 month subscription). Never try to “exact fit” a question bank with your pre-determined study time. Overestimate slightly.

This is our top recommendation, without question. When groups of medical students are surveyed about resources, this is consistently rated the highest of the question banks, with around 95% of students who used it rating it “Very Good” or “Excellent” after taking the Step 1. (Evidence for the win!) Buy it.

Review: The interface and question types are the closest approximation to the actual FRED2 format you will find on the actual Step 1 exam. More importantly, the question stems and content are in a similar style. Difficulty overall is slightly higher than the real deal, but at an appropriate level that doesn’t feel ridiculous like some of the other question banks. Answers are comprehensive, high yield, and fulfilling. Performance is tracked by subject and topic, but overall analytics leave something to be desired at times as improvement-graphing is not a feature. While tracking progress can be reassuring during this stressful time, it’s not why students should purchase a question bank. This is a large cost, so as a (repeated) point of disclosure, MedStudentBooks receives absolutely no benefit or compensation from USMLE World.

USMLE World Step 1 Question Bank

Usage: You should do questions every day you study, with a heavy focus on the topic you just reviewed. Some questions every day should be general (randomly chosen) questions. This number should increase as you get closer to the exam date. Number of questions should be tailored to individual learning style. However, if you find yourself burning through the question bank quickly and expect to finish it early, we recommend saving approximately 300 for the very last week of studying. Purchasing a second question bank (see below) is only recommended for this scenario for those who really excel by doing questions.

USMLERx comes from the group that makes First Aid for the USMLE Step 1. Questions are true to the exam in content and difficulty, with great answer breakdowns. This corresponding question bank to First Aid does extend past the book’s knowledge and can be used as a true supplement (not just rehashing the exact same content), which is why it represents our runner-up question bank recommendation. When surveyed, about 60% of students who used this question bank rated it as Very Good or Excellent. One money-saving tip is to use the corresponding book First Aid Q & A for the USMLE Step 1 (often referred to as “paper USMLERx”) and/or First Aid Cases for the USMLE Step 1. This last title is actually not a question book, but rather goes over cases with multiple questions that could come up for any given question stem. Unlike question banks, this is usually self-selected by those whose learning style works well. Furthermore, either of these titles can be picked up used or borrowed from friends. Keep a lookout for your medical school hosting a USMLERx “Scholarship” which is code-word for “promotional free qbank subscription that coincidentally creates free advertising.”

Kaplan tends to get extreme opinions. People either love it or hate it. When a class of med students were surveyed, 30% of those who used Kaplan Qbank rated it as Very Good or Excellent. As opposed to the above two options, Kaplan takes a different approach, by asking questions that do NOT approximate the Step 1 exam in style. Questions usually focus on specific factoids, and are sometimes perceived as being detailed minutia. Nevertheless, some people swear this is a helpful method of studying. If you are curious about this option, you can use the above link or below banner ad to check a free trial before purchasing it. Either way, it shouldn’t be your first choice.

NEW Step 1 QBank- Only $99-$199!

Other Questions Banks to Mention

What about the NBME?! As we mentioned in the opening article in the Step 1 series, everyone should take an initial Comprehensive Basic Science Self-Assessment (CBSSA) exam to get some hard evidence of performance. While these are great at providing a big picture of strengths and weaknesses, these exams unfortunately do not provide great answer descriptions or aid in learning. The NBME has started rolling out exams with “Enhanced Feedback” but they still don’t match up to any of the above as learning tools, and wind up being more expensive per question.

USMLE Consult: This is the question bank famous for being backed by the Great Goljan. We love Goljan’s teaching, but we don’t have enough evidence on USMLE Consult to say it’s necessarily a strong choice. Without the Goljan stamp of approval, this option would probably fade into the background with many other countless banks. 

Exam Master: Many med schools provide this to students for free. The price tag reflects the quality. This has a lot of negative reviews and responses associated with it. Questions are unfocused, unclear, and often times have poor answer explanations. Learn from med students who came before, and avoid dedicating time to this option. If you are interested in free questions, hit up the question banks that come with many new books (check for scratch-off areas on the inside cover) or use the Lippincott free 350 question set.

USMLE Weapon: This Pittsburgh startup gets a curious honorable mention as a rising question bank gaining popularity. While USMLE Weapon has not yet stood the test of time or produced a lot of evidence regarding its perceived value, it has impressive analytics and may yet give USMLE World a run for their money one day. At this point though, MedStudentBooks cannot endorse this option, but we will be following it for future years.

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