Tag Archives: Tips and Tricks

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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USMLE Step 1 Series: The 7 Essentials of a Solid Study Strategy

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.

Figure Out Your ACTUAL Strengths and Weaknesses, with Evidence.

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.

Get a Plan, and Stick To It.

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.

Get a Copy of First Aid for the USMLE Step 1 2012

First Aid USMLE Step 1 2012 reviewIt 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.
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Stock Up on the In-Depth Books NOW

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
Lippincott’s Microcards
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.

Use a Question Bank to Complement Your Studies and Track Progress

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.

USMLE World Step 1 Question Bank

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.
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Learn by Rote Memory Over Time

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.

(Try to) Relax

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.
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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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Tips for Surviving your Obstetrics and Gynecology Rotation

To complement the recent release of our book recommendation for Ob/Gyn clerkship and Step 2 review, we offer the below experiences in hopes that rising medical students can learn from past mistakes and successes. Obstetrics and gynecology is usually perceived as one of the more labile rotations you will face in medical school.  While there are clear differences between hospitals across the nation, and even great variability between teams within the same hospital, this tends to generally be the case with respect to other rotations.

In distinction to many other clerkships, most medical schools rotate students through a number of different ob/gyn sites and settings, usually highlighting outpatient gynecologic exams, inpatient or surgical gynecology, outpatient obstetrics, and labor and delivery. This generally prohibits cohesive or longitudinal teamwork, and leaves residents and attendings with very little exposure time from which they must draw their evaluations. As such, the first piece of advice is to pre-read before starting obstetrics and gynecology.  This is in distinction to other stable rotations where reading can be done along the way. You will get pimped on day 1, and have few days past that to redeem yourself. Come in knowing your basic terminology and abbreviations.

Outpatient Clinics

Outpatient ob/gyn clinics are usually mixed.  Some will probably be shadowing, while others are primary care based, where focus should be on prevention and good planning.  For gynecology, you should know your in-office STD and vaginosis screenings, what to look for on microscopy, and how to treat each. Every exam should have a complete history on sexual partners, obstetrics (G’s and P’s), contraception, pap smears, STDs, vaccinations. If you’re uncomfortable talking about these topics, now is the time to get over it. Be sure to bring your stethoscope.

For obstetrical checkups, you should go in knowing your screening tests, timeline, and the most common reason for first and third trimester bleeding.  Presentations should always start with something sounding like “28 year old G3P1011”.  G (gravity) stands for the number of total pregnancies. P (parity) has four numbers which correspond to full term pregnancies, pre-term pregnancies, abortions/miscarriages, and live children, in that order. You will be commonly treating bacterial vaginosis and trichamonas with flagyl (metronidazole). You should remember this medication has a disulfiram effect, so it should not be taken with alcohol.  Some patients will actually forego treatment until the weekend is over because of this unwanted reaction.  Yes, really.

Gynecology Surgery

Experiences are usually divided between benign and gynecology-oncology. You should have a pair of gloves and lube packets in your back pocket at all times. Each surgery will start with a pelvic exam on your unconscious unconsenting patient. When the resident lubes up, extend your pointer and middle fingers towards them like a handshake for a “high two” to share their lube. This is how Ob/Gyns bond in the wild, along with matching surgeon caps, black zip-up tops, and playing their favorite game: “find then avoid the ureter.” The pre-op exam is a great opportunity to get your pelvic exam down, so don’t pass it up.

You will most likely need to be able to gown up yourself. If you haven’t had surgery, ask an intern or fellow med student to teach you on the first day of your rotation, regardless of whether you’re starting on something surgical. You should also come into this rotation knowing basic knot tying techniques, regardless of whether you’re going into anything surgical. It’s just a good basic skill to have throughout medical school.  If you aren’t familiar with knot tying, a quick search on youtube and spare string or sutures will be helpful.  If you have these basic skills down, you will be allowed to do a few things aside from retract. Remember, if you are down below, it is considered “dirty” even though you are in sterile garb. Never move from pelvis to abdomen without changing gloves. Crazy pimp question: most med students are taught in anatomy that nothing runs with the round ligament, so naturally many attendings love asking about it. The correct answer is the Sampson artery.

Labor and Delivery

obgyn clerkship fetal ultrasoundIf you are interested in catching babies, try to take shifts when there are minimal residents, such as nights. If your hospital has private attendings who allow medical students with them, jump at those opportunities. They’re the ones who will let you actually deliver, whereas many of the interns (especially new interns around July) will soak up the opportunities with staff attendings. A lot of labor and delivery is just going into rooms and asking “is there anything I can get you?” and then fetching ginger ale. However you should push into the action when it starts.

The best way to learn how to deliver a baby is to find someone who will let you put your hands on top of theirs for a few deliveries so you get an idea of just how much pressure and movement is needed. Next step up is having your hands under theirs. Once you have a good feel for that, you’re good to deliver with observation. This technique isn’t necessarily offered or known to many residents, so be sure to ask, but it really works well. Be careful when you put on gloves in the room, because it is not uncommon to get surprise-lubed by one of the nurses, whether you wanted it or not (although you almost always want it). If you have the opportunity, try to spend a little time on triage (be sure you know the signs of labor!).

If you have tips or suggestions you would like added to this article, please add them in the comments.

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