Dr. Cranquis' Mumbled Gripes
(Disclaimer: Questions related to medical topics will be answered to the best of Dr. Cranquis' (and Google's) knowledge, but the internet-delivered wisdom on this blog CAN NOT AND SHOULD NOT SUBSTITUTE for your Real-Life Doctor's personal attention + examination, and your own common sense too! If you think you're having a medical emergency, hang up and go email 911. The author of this blog takes no responsibility for any medical, relationship, scholastic, financial, or other decisions you may make based on information found in this blog.)
And since people seem to be a bit confused about this: any "real-sounding" patients names are just horrible puns, and not HIPAA violations.
this is epic. (a fib and torsades are my personal faves)
“The What’s What of The The Heartbeat Dance” — even the title is biphasic! I’m pretty sure Backstreet Boys used that Torsades routine in a music video once. :)
For more cardio-related musical fun, check out “Diagnosis Wenckebach”.
Spending too much time on Tumblr? Well now you can make your procrastination time a little more productive by perusing USMLEpathslides. It’s well organized and pretty useful for studying, from what I’ve seen, so check it out!
Ok, I’ll admit, my first reaction to this recommendation was: “Ugh, pathology slides. So glad I don’t have to pretend to understand those anymore.”
Then I checked out the website. HOT DIGGITY DOG, it’s not JUST pathology slides! There’s gross anatomy pictures, physical exam findings, radiology images — it’s a veritable cornucopia of visual study aids! And so well-organized that it just about makes me nauseous with envy.
“YOU NEED STUDY FOR STEP 1, YOU HATE READ BOOK? YOU GO THIS WEBSITE FOR WHILE!”
Abdominal Aorta’s Branches
Have you ever wished you could’ve started following a great med-student/science blog from its infancy? Are you curious about the insane types and amounts of data that a second-year US med student needs to memorize and understand in order to pass the USMLE Step 1 exam? Do you have an appreciation for hand-drawn charts and tables?
Then perhaps My Notes 4 Usmle Steps is a blog for you! It has a quality which makes up for its small quantity (since it apparently just went live a couple weeks ago). Check it out, see what you think.
MED SCHOOL FAILURE
Hello,
I am a medical student, that failed two of my 1st year courses (last year). As a result I’m solely repeating these two courses this year, Gross Anatomy and Neuroscience. I have a few concerns: will I be prepared for step 1 if I have such a gap between 1st and 2nd year? And how will my failure in these subjects affect my choice in residency/interview options? Also, how common is it for med students to fail a course? I feel like I’m the only one and that I’m not qualified to become a doctor. Any input you can give me would be greatly appreciated. Thank you.
Wow, I feel your frustration and fear, friend — I came THIS close to failing biochemistry/genetics in my 1st year med school (I needed 65% cumulative to pass the year; I scored 64.6%, which rounded up to 65%!), and I had quite a few classmates who failed courses in 1st year and had to repeat the ENTIRE year. I’m glad your school just lets you repeat the two failed courses, instead of also having to retake all the other classes that you passed the first time (with all the additional studying and stress that would entail!). I never looked into the statistics on “Med Students failing courses/repeating years”, but anecdotally I’d estimate that 2-5% of every med school student body has to repeat a class/year (and out of that 5%, maybe 30-50% will drop out rather than repeat? But again, I’m just guess-timating based on experience and rumor in my med school.) I think you could get that data easily by just asking your school’s Dean’s Office, though — and perhaps it would help reassure you that failure does happen in med school, even in people who go on to become excellent doctors.
And why shouldn’t there be failure in med school? Sure, you were probably in the top 10% of your undergraduate class scholastically — but SO WERE ALL OF YOUR MED SCHOOL CLASSMATES. Statistically, someone has to be at the low end of the Bell Curve.
But does failure in a med school class (or two) equal “no doctor potential”? HELL NO. Just think about how much stuff you learned in college that is barely/not-at-all relevant to med school (even within the basic science prerequisites that you “had to know” for the MCAT — oh, but don’t get me started on the essential uselessness of organic chemistry again. Or wait, maybe you SHOULD get me started, because that linked post contains a lot of reassurance for you, I think. Go read it.)
In a similar way, while the 1st-year classes in med school provide a lot of the foundational “hard science” knowledge for your future medical learning, the actual data is probably not quite as important as the skills you acquire while learning the material: how to accumulate knowledge and then recall it, how to integrate what you know in order to make inferences about what you don’t know… and equally important — how to accept the fact that you will never be an expert in everything. (I’m kinda repeating myself from that linked post, I know, but really, this is an important truth.)
Example: I am very good at ENT (Ear Nose Throat) issues, I can diagnose many skin conditions just by looking at them, and I am downright awesome at suturing skin lacerations — but I would never want to be a nephrologist, because I STINK AT ACID-BASE CHEMISTRY. It’s just the way it is. I could probably muddle through acid-base stuff if I were to review it every day before work, but it just has never “clicked” for me, and that’s that. Thankfully, I am in a job where this data is rarely (if ever) used in my day-to-day work, and my patients/colleagues/nurses still seem to think I’m a good doctor. And I’m humble enough to admit that, if a situation arose where a thorough knowledge of Acid-Base Chemistry would be essential to managing a patient’s condition, I would immediately find someone else to help me or take over the case, because it would be out of my realm of competence.
As for your other questions: A gap between 1st and 2nd year basically means that you’re going to have to review the 1st-year material a lot more before taking USMLE Step 1 boards. More time will have elapsed, so you’ll have to work harder to drag up the old knowledge from the depths of your memory pond. But everyone has to spend extra time on the 1st-year data anyways, so this is probably not a deal-breaker for your Step 1 scores.
Your choices for residency may take more of a hit, depending on what types of residency you’re hoping to pursue. The more competitive a residency is (surgical subspecialties, dermatology, ophthalmology, basically non-primary care stuff), the more important/potentially-interview-losing the “little glitches” become. But if your grades and clinical performance really shine from here on out, you probably still have a good chance for all but the most cut-throat residencies.
Good luck to you, and remember that you’re not the first person (or even within the first 10,000 people) to retake classes in med school. You can still do this.
***Pending Cranquis-Mails: 3; InBox: Closed***
thisismehidingfromtheworld asked:
and here’s a real question : how did you survive med school? i’m in my second year and i just want to know how did you survive this thing ;)
Ok, as promised, the first in a 4-part reply to this question: Tips for Surviving 4 Years of (American) Med School.*
*(Disclaimer: Dr. Cranquis graduated from an American med school over 6 years ago; there is a lot of variety in how various med schools structure their learning exposures, depending on their location, their financial resources, and their ballsiness. Use my advice if it applies to your particular med school situation, twist it or chuck it if it doesn’t!)
2nd year of med school: In my case, it was an “easier” time because (a) I now knew I could survive one year of medical school, so certainly I could survive another one, right? and (2) because the classes in 2nd year seemed more inter-connected: pathology and physiology and pharmacology and pathophysiology and psychopathology (it was an -ology orgy!) — so when I studied liver physiology, I felt like I was also reinforcing my knowledge of liver pathology and pharmacology at the same time! Bonus! The big focus for this year is preparing for the USMLE Step 1.
- Study from review books instead of textbooks
As you start preparing for your Step 1 USMLE exam, you want your pile of “things I need to review before Step 1” to get smaller, not bigger! Even if you have the best of intentions to “skim through Harrison’s one more time” or “re-read the PathoPhys lecture notes” before your exam, trust me: you won’t. So, get yourself a good review book for each 2nd-year course, take it with you to the lectures, and write comments/highlight important stuff directly into the review book. (Plus, everybody knows that the info in textbooks is usually out-of-date by the time the book hits the shelves. Review books are usually updated yearly, so their info will more closely match what you need to know for the exam).
- Get a “bare bones” review book too
Even if you are just studying from your review books, that’s still a lot of paper to lug around! So, get a “general summary of all the classes from the 1st 2 years of med school” book that transports easily! I loved the “First Aid for the USMLE Step 1” review book, but there’s lots of options out there. Keep it in your car or bookbag, so that when you have some downtime and you didn’t remember/want to bring along all your review books, you can still hit the high points with your general summary book. (Oh, and when it comes to this book, and the review books mentioned above, don’t be a cheapskate: buy the latest editions!) (For those of you whose study-style includes doing lots of review questions, I think the Kaplan Qbank is awesome too)
- Use weekends and holidays wisely
After 2nd year, you will NEVER be able to count on having a particular day off. Your 3rd and 4th year rotation schedules will remain nebulous, often until the actual day when you start that rotation — and as for having any control of your schedule in intern year? Fuggedaboutit! So, if you have certain calendar-related commitments (family vacation, camping trip with your buds, soul-searching excursion to Las Vegas, wedding) that you want to be SURE to accomplish, get them done in 2nd year. Also, if you’re into volunteering your time to charity work (I always recommend visiting sick kids on the Peds ward!), do it NOW: I know you might feel like you should be giving up that extra-curricular stuff now that the curricular responsibilities are piling up, but it’s only going to get harder from here on out to make any concrete plans.
- Get your life in order for 3rd year
Speaking of weddings… So, come 3rd year, your life will not be your own. Depending on what rotation your currently doing, you will be told when to sleep, when to eat, how often to shower, and what to wear. It is very much like having your mom move in with you (if your mom is a total slob who doesn’t care if you haven’t showered in a week, as long as you have memorized Mr. Thompson’s potassium levels for the past 10 days). This means that, in 2nd year, you need to deal with anything that might need extra attention (girlfriend/boyfriend, spouse, children, pet) or brain power (financial planning, advance directives, possibly also beings listed under “extra attention”) NOW, so that you don’t have to stress about it during 3rd year.
- GF bugging you to get engaged? Put it off until 4th year.
- Fiancee pushing for a wedding? Do it early in 2nd year, so you’ve got some together time before 3rd year, or delay until 4th.
- Spouse bugging you to spawn a child? Let me ask you this: do you really want to come home from the hospital after being on call all weekend, just to find out that Junior is teething and won’t let you sleep? DELAY THE BABY-MAKING; surely the ovaries involved can wait another year.
- Parents/Extended Family nagging you to call more often and be available for trivial medical consults? Explain to them that you will be either working or sleeping for the next year, so you’ll see them in 4th year to catch up on Aunt Glinda’s latest hemorrhoid horrors.
- Try to get your credit-card debt consolidated (or better year, paid off!)
- Take care of your pet-and-child-care needs now so you don’t have to worry about them when you end up staying extra late in the clinic.
- And listen: be classy about the process of preparing your loved ones to NOT be able to depend on you for a while — take your significant other (and children if applicable) out for an awesome weekend shortly before 3rd year, and explain to them that this is a “Thank You in Advance for your Patience with Me” for your lack of social skills and time in 3rd year.
- Get ready for the pimping.
Read this article on “pimping”, the art of pop-quizzing medical students to test their knowledge and/or prove how awesome of an attending you are. YOU WILL BE DEALING WITH THIS FROM DAY ONE OF YOUR 3rd YEAR. So, to prepare yourself for this, start thinking like a doctor, and not just a student. At the end of a study session, ask yourself “How could this knowledge help me take care of a patient?”. Don’t just memorize lists to spew out on an exam — attendings and senior residents will not be impressed by your photographic recall of the Krebs Cycle (well, they might be, a little bit) if you cannot also USE that information in a way that makes a difference for a patient’s medical care. (Also: be aware that SOME pimping attendings don’t actually care if their question pertains to anything remotely medical — for those bizarre questions, just admit you don’t know, let them show off their intricate knowledge about the U.S.S. Enterprise’s warp drive, act impressed, and move on with your life.)
- Get some experience as a patient.
If part of your reason for entering medical school was to “improve the quality of care received by patients in the American Medical System” (or however your mom phrased it when she edited your application essay), then you need to see what it’s like to be a patient. At least once during your first 2 years of med school, get sick enough to require a visit to an ER — or for bonus points, get admitted for a few days to the hospital, have surgery, and/or take a prescription medication for more than 2 weeks and experience some side effects from it. True, this particular piece of advice requires a high level of dedication on the part of the student, but it will provide invaluable perspective on what your patients will truly experience at your own hands. (By the way, no cheating: go through the entire experience WITHOUT telling anyone that you are a medical student.) Be sure to apply what you learn here to your behavior in 3rd year!
- Enjoy the experience of being cool
Remember WAYYYYY back when you were first starting med school? Remember how suave and self-assured those 2nd-year students seemed to be during your orientation? Well, now YOU are THEM. You have survived 1st year, and the current freshmen envy you. Enjoy their jealous glances and mewling pleas for “tips on surviving gross anatomy lab finals”. You are currently at the top of the totem pole. Come 3rd year, you will be (at) the bottom of a much bigger totem — so enjoy this fleeting moment of pride as hard as you can!
Hope this helps you 2nd-year folks. Coming up next time: 1st year survival tips.
(Do you have any 2nd-year-specific tips to contribute? Use the Comments&Reactions link below!)
