Tag Archives: usmle pathology
For 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. We 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.
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.
Lange’s Case Files Pathology is a book whose purpose is to integrate our knowledge of pathology for diagnosing realistic scenarios in medicine. There are 50 clinical cases written in clear USMLE-style format. For each clinical case, there are four parts: 1) a summary with straightforward answers and clinical correlations, 2) basic science concepts including objectives and definitions followed by a brief discussion of the topic of interest, 3) a few comprehensive questions that reinforce key points, and 4) “pathology pearls”, which are important take-home points. When going through each case, important information is bolded for emphasis and explanations are concise and precise—eliminating the trivial concepts that should have become second nature by the end of organ systems. This means that this book is not for learning materials, but rather more effectively used as a tool for review, reinforcement, and integration of learnt information to allow for synthesis.
Although all Case Files books may or may not fit the needs of boards review, Case Files Pathology is a book that can only help. With key take-home points and short-and-sweet explanations of case material, you should have little problem learning the essentials—the fundamental architecture of clinical pathology. For example, you may come across a case of ventricular septal defect (VSD), requiring you to utilize your knowledge of epidemiology, embryology, physiology, and the clinical presentations of cardiac defects. Of course, take note that this book is for pathophysiology and not just for lab-based pathology, so a good foundation in second year organ blocks material would make this book much more useful for synthesis of all the loosely connected information.
The downside of Case Files Path includes: 1) lack of pictures and images to allow the medical student to truly appreciate the clinical appearance of certain diseases, 2) lack of explanations for various diagnostic tests that may be useful for understanding the diagnostic and elimination process, and 3) the multiple choice review questions at the end of each case are generally very simple and superficial questions asking more for recall than synthesis, despite the fact that the case itself is pretty good at elucidating the more detailed aspects of disease.
Overall, Case Files Pathology would be great to have for some last minute studying or USMLE Step 1 board review, but definitely not for the initial phase of studying. Get the foundation down solid, and then use this book to cement everything together. As for where to use this book, it is not a useful resource for studying for medical school classes since the cases in the book is written in USMLE format rather than in the format of questions on medical school examinations. However, it is definitely a good book to have at the end of your studies for USMLE Step 1 to get the bigger picture and practice applying medical knowledge to realistic medical cases, uncertainties and all.
It is finally time to review Goljan: Epic King of Pathology. All of the legends and rumors you heard were true. He’s an arm wrestling champion, rides a white stallion around his massive pathology fun house, and can break a man’s finger clean off during rectal exam. Indeed, some believe that the mere act of saying his name aloud increases their board score by one point every time. If you don’t understand these things, it is simply because you are not yet enlightened.
Edward Goljan is a world class Pathology Chair from Oklahoma State University. Back in the day, he began doing pathology review courses for his medical students, which have been condensed over the years into the most comprehensive yet concise pathology review available. More importantly, it is perfectly tailored to the USMLE Step 1, USMLE Step 2 CK, and even USMLE Step 3 boards exams, as Dr. Goljan has further refined his teachings based on constant feedback he receives from students after they take the boards. As he states:
These notes took 25 years to put together over time. And it dwindled down to the absolute quintessence. It’s like espresso. You just have a little drop and you’re already fixed.
At some point, one of his students recorded his epic lecture series, which continues to float around the internet and med school back-alleys to this day, obtained and abused like crack for the boards. To complement his lectures, he handed out his condensed notes, mentioned above. Over time, these notes coalesced into Edward Goljan’s Rapid Review Pathology book.
The book itself is newer than the audio and has undergone further revisions, whereas the audio remains in its temporally frozen preservation.
Specific chapters of Goljan’s Rapid Review Pathology include: Cell Injury, Inflammation and Repair, Immunopathology, Hemodynamic Disorders (Acid, Base, Electrolytes, Water), Genetic and Developmental Disorders, Environmental Pathology, Nutritional Disorders, Neoplasia, Vascular, Heart, Red Blood Cells, White Blood Cells, Lymphoid Tissue, Hemostasis, Immunohematology, Upper and Lower Respiratory, Gastrointestinal, Hepatobilliary and Pancreatic, Kidneys, Lower Urinary Tract and Male Reproductive Disorders, Female Reproductive Tract and Breast Disorders, Endocrine, Musculoskeletal and Soft Tissue, Skin, Nervous System, and Special Sensory Disorders.
Goljan’s Rapid Review Pathology also comes with Student Consult, the online portal and electronic copy of the book, giving you access to all of the text remotely, as well as the images (which come in handy for powerpoint presentations). Student Consult for Rapid Review Pathology also comes with a little over 400 USMLE style pathology questions related to the book itself. However, to truly lock in the information with a fantastic complementary USMLE style pathology question bank, Robbins and Cotran’s Review of Pathology (reviewed here) is the recommended book of choice.