MS1-2 as a career

[circulus vitios]

WRONG! I was taught in my pre-clinical curriculum against aggressive A1c targets for everyone. It depends on the age of the patient and other comorbidities.

My memory is fuzzy, but I don't think we were taught what notbobtrustme posted.

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[spik]

My memory is fuzzy, but I don't think we were taught what notbobtrustme posted.

It is because you are an MS1. You will learn about it as an MS2.

 

[spik]

Learning to help people, sure. Sacrificing "a lot?" Hahahaha.

You will feel the sacrifice once you become and MS3 and realize that you have no control over your time whatsoever, and residency will be even worse.

 

[circulus vitios]

You will feel the sacrifice once you become and MS3 and realize that you have no control over your time whatsoever, and residency will be even worse.

My school has an alternative way of scheduling third year. I've heard it is MUCH more conducive to having a life, when compared to the traditional block method.

 

[spik]

My school has an alternative way of scheduling third year. I've heard it is MUCH more conducive to having a life, when compared to the traditional block method.

Regardless, you will feel the brunt in residency and be even more surprised if your school makes your life easy.

 

[seminoma]

If offered the chance to do MS1-2 as a paid vocation perpetually for the rest of your life, would you take it? You would be paid accordingly:
A's/Honors: $175k/yr
B's/High Pass: $125k/yr
C's/Pass: $100k/yr
Failure: $20k/yr

In this hypothetical thought experiment, the material would change significantly enough that only every 8 years would you repeat information (I know, doesn't make sense). In this way, it would "feel" similar to actually going through MS1-2 repeatedly, with the fire-hydrant style of info feed and lack of familiarity with material.

Going through the pre-clinical years was sucky. But after thinking about it a bit, I realized that the primary sources of my stress at the time were related to pressure to perform for a residency spot. But if we take that pressure away, what's left?

While not contributing to society significantly, you might feel some fulfillment from the intellectual satisfaction. You could publish, volunteer, and teach on the side.

Thoughts?

Yes, absolutely. Getting a C/Pass takes minimal effort.. probably less effort than any other obtainable job that pays $100k.

This x1000. I wish clinicians taught pre-clinical coursework.

No thanks. I just finished a class (MS2) taught entirely by clinicians and it was awful.. We were taught a mixture of Step 2CK level material and residency level material regarding decision making, drug routes of administration, drug dosages (wtf, right?), etc. We were left on our own to self-teach the basic science material. Fine, no big deal, lots of schools teach worthless stuff and students end up self-teaching the bulk of the material anyway. But having to waste time learning drug doses, etc was ridic.

Edit: I see now that you're an MS1. Makes sense more sense. Learn board relevant clinical scenarios during MS1/MS2 and leave the rest of it to MS3 and beyond. There's more than enough to learn for Step 1 without having to get bogged down in the opinions of clinicians who often teach "real life" even though it disagrees with textbooks/Step 1.

 

[Ismet]

no it's not. Staying awake in your pharm class and having a rudimentary understanding of pathology is what you really need. You can talk all you want about the factors involved in lung fibrosis (TNF-a and all that jazz), but can you interpret a spirometry report? Likewise, you can know all about how IgG is made in the endoplasmic reticulum, followed by glycosylation in the Golgi apparatus, but can you interpret a Rubella titer of 1:6 in a pregnancy and what to do about this? Knowing what phase of the cardiac myocyte's contraction is governed by what ion channels is great for Step 1, but can you read an echocardiogram worth a damn? And before you talk to me about how anti-arrhymatic therapy can be guided by this knowledge, know that 95% of all problems can be solved by either amiodarone, lidocaine or a beta blocker. We know a bunch of useless facts about warfarin, but we can't even dose warfarin properly. Valuable lecture time is spent on how warfarin inhibits vitamin K epoxide reductase but not what an INR of 6 means and how to approach this problem.

The first two years spend so much time on worthless minutia, but we can't cover the basics of how to approach a patient in septic shock. A new M3 is less than useless when confronted with such a scenario. No one gives a rat's ass that you know LPS stimulates TNF receptors, causing massive vasodilation and shock. That's a worthless factoid that's worth great points on Step 1 but utterly meaningless for patient care.

The first 2 years are hyped up big time by professors who either have zero clinical experience or spent the past 20 years researching a problem of tangential importance to clinical care. That's why a fresh MD graduate is literally worth less than a new NP or PA. The fresh MD can't get a job without a massive government subsidy, otherwise the hospital wouldn't be able to justify the cost of teaching us. That, despite the fact that we spend >2x the time on patient care than a new NP or PA. However, a new NP or PA commands a salary double that of a resident's while working half as much. A fresh MD is literally worth less than 1/4th a new NP or PA. You can put anyone through residency training and have them be as qualified as a physician despite the fact that they will have very little basic science training.

Most of MS2 at my school is taught by clinicians, and we learned plenty of clinically useful information that I draw on for MS3. You weren't taught how to interpret PFTs and EKGs in MS2???

You learn the basics in MS1 and MS2, and apply those things to patient care in MS3 and MS4. We learned all about INR and anticoagulation in MS2. Why does an MS2 need to know proper dosing of warfarin? You learn that when you have your first patient on warfarin in MS3 and you go home and read about it. You already have the basis of understanding of the coag pathway, how warfarin acts on it, and how to measure coagulation, so it's a pretty small leap from that to learn about proper dosing.

 

[Ismet]

mediocrity hurts patients. it's not about scoring well on tests or aiming for a competitive field/location. it's about having work ethic and knowing things so that you can provide quality care for your patients. the fact that your only aim is to tiptoe over a low barrier is scary. you have a lot of maturing to do

This. I recently worked with a 3rd year FM resident (not at my home institution) who, after receiving my presentation of a patient and my A/P and after talking to and examining the patient himself, would excuse himself by saying "let me talk to my attending, I'll be right back." This happened with every single patient, he either wasn't sure what was going on or he wasn't sure how to treat it, so he had to ask the attending for help. And this is basic bread-and-butter outpatient FM, stuff I'm sure he's seen and treated in the last 2 years of his residency. Stuff I have seen and remembered how to manage in just my first 4 months of MS3. This is someone who will be an attending in less than a year. Isn't that scary?

"I'll just look it up" is a dangerous way to go about your medical education.

 

[Apoplexy__]

This. I recently worked with a 3rd year FM resident who, after receiving my presentation of a patient and my A/P and after talking to and examining the patient himself, would excuse himself by saying "let me talk to my attending, I'll be right back." This happened with every single patient, he either wasn't sure what was going on or he wasn't sure how to treat it, so he had to ask the attending for help. And this is basic bread-and-butter outpatient FM, stuff I'm sure he's seen and treated in the last 2 years of his residency. Stuff I have seen and remembered how to manage in just my first 4 months of MS3. This is someone who will be an attending in less than a year. Isn't that scary?

"I'll just look it up" is a dangerous way to go about your medical education.

Some of the residents I know really ease my feelings of inadequacy as a student.

 

[Promethean]

I would take that deal without a second thought. I really, really enjoy learning. Yes, yes, I know, I have to check back in after I've actually experienced the drinking from the firehose effect, no one can possibly know the horror until they've lived it, yeah I get it. Except that for the past two years I've been working 50+ hour weeks while carrying 22+ credits per term post-bacc, running and then selling a small business, studying for the MCAT, and keeping house / taking care of a large family. When I get to medical school, my responsibilities shrink down to just school. I will have more free time as an MS1-MS2 than I have in the past decade, possibly combined. It is blasphemous to say, but I think I might actually get to relax a little, if only for a few hours on a weekend here and there.

 

[Apoplexy__]

I would take that deal without a second thought. I really, really enjoy learning. Yes, yes, I know, I have to check back in after I've actually experienced the drinking from the firehose effect, no one can possibly know the horror until they've lived it, yeah I get it. Except that for the past two years I've been working 50+ hour weeks while carrying 22+ credits per term post-bacc, running and then selling a small business, studying for the MCAT, and keeping house / taking care of a large family. When I get to medical school, my responsibilities shrink down to just school. I will have more free time as an MS1-MS2 than I have in the past decade, possibly combined. It is blasphemous to say, but I think I might actually get to relax a little, if only for a few hours on a weekend.

One of my own kin, alas!

 

[pkwraith]

In fact, the first 2 years puts you in false sense of security.

We all know that DMII is a risk factor for CVD/CAD/atherosclerosis because of glucose toxicity right? So it stands to reason that aggressively treating DMII would reduce the number of complications and improve people's lives. If you said this to any of your pre-clinical professors, they would agree wholeheartedly with you. Glucose toxicity = more CAD/atherosclerosis. Period. Controlling sugars aggressively to be in the normal range (for non-diabetics) would be ideal, right?

Well if you did that, you would be killing patients because that's not what the real clinical evidence is saying.

Getting diabetics to a normal H1AC resulted in more complications and more deaths than a conservative treatment that kept diabetics' A1c's at a diabetic level. The lower your A1c (6.4% vs 7.5%), the worse the populations did.

http://www.nejm.org/doi/full/10.1056/NEJMoa0802743

If you are using only the first 2 years to guide patient care, you are doing your patients a disservice. The real world is paradoxical, it's non-intuitive and it works against what you can reason out.

What a nonsense example. Is this how preclinical professors are like at your school or is this just a poor strawman?

"Hyperglycemia kills, but hypoglycemia kills faster." That is neither paradoxical, non-inuitive, or irrational. The associated mortality/morbidity with aggressive glucose management is something magical/irrational despite pretty reasonable explanations?

If you asked a preclinical professor your hypothetical question, they would cite the ACCORD study and explain it.

 

[DermViser]

My school has an alternative way of scheduling third year. I've heard it is MUCH more conducive to having a life, when compared to the traditional block method.

Even if your school coddles you in M3, you will have no protection during residency. And consdering you're not going for anything "competitive", you will feel the brunt of that sacrifice in terms of lifestyle.

 

[DermViser]

If offered the chance to do MS1-2 as a paid vocation perpetually for the rest of your life, would you take it? You would be paid accordingly:
A's/Honors: $175k/yr
B's/High Pass: $125k/yr
C's/Pass: $100k/yr
Failure: $20k/yr

In this hypothetical thought experiment, the material would change significantly enough that only every 8 years would you repeat information (I know, doesn't make sense). In this way, it would "feel" similar to actually going through MS1-2 repeatedly, with the fire-hydrant style of info feed and lack of familiarity with material.

Going through the pre-clinical years was sucky. But after thinking about it a bit, I realized that the primary sources of my stress at the time were related to pressure to perform for a residency spot. But if we take that pressure away, what's left?

While not contributing to society significantly, you might feel some fulfillment from the intellectual satisfaction. You could publish, volunteer, and teach on the side.

Thoughts?

I would, but I also tend to love basic science, in contrast to almost everyone else on SDN.

 

[DermViser]

You are a complete idiot.

He and EMDO2018 are 2 peas in a pod in terms of complaining and striving for mediocrity.

 

[DermViser]

My memory is fuzzy, but I don't think we were taught what notbobtrustme posted.

Not to mention, you only strive to get a "Pass" so it's doubtful you actually remember what they taught you.

 

[NontradCA]

You haven't figured out by now that I absolutely do not care about honoring or pursuing competitive specialties or competitive programs? Outside of SDN, there are large numbers of people like me in medical school: students who want to learn medicine, but refuse to slave away for diminishing returns for one reason or another. Somehow they manage to pass Step 1, match somewhere, and become practicing physicians at the conclusion of their residency training.

Id say those people are in the minority. A lot of people say they don't care but study 24/7. It's a coping mechanism.

 

[DermViser]

Id say those people are in the minority. A lot of people say they don't care but study 24/7. It's a coping mechanism.

Exactly. It's a defense mechanism. It's a way to let out steam. Most people aren't aiming for a 70 or Pass when they study. It's just how it turns out when everything is said and done.

 

[seminoma]

You're assuming that minute details -- the details that often form the strata between pass, high pass, and honors -- are necessarily relevant to clinical practice, or are necessary components of the foundation upon which clinical medicine is built. If I'm passing my classes, then I presumably have (or am forming) the foundation that is necessary to safely practice clinical medicine. It's not a matter of maturation, it's a matter of looking at the benefits of slaving away and destroying my mental sanity to score an extra 5 percentage points on an exam -- cramming small details that in all likelihood will be irrelevant to how I will choose to practice medicine.

My experience has been depth of understanding, not breadth of minutiae, forms the strata between high pass/honors. We don't have high pass/honors at my school (we have P/F with percentages), but myself and others near the top of the class tend to focus more on understanding things rather than memorizing details. Many of my friends who are in "high pass" territory focus on details (e.g. what percentage of schizophrenics have voices commenting vs voices conversing hallucinations). Other friends, who are in the "pass" territory, also focus on details but they are not as successful at memorizing them as those in "high pass" territory. Still, those "high pass" folks can memorize all the details they want, but they'll never make it into "honors" territory without also understanding everything very well.

I also don't understand why "passing" is beneficial to your mental sanity. You have to understand that MS1/MS2s have no idea what piece(s) of information will be relevant to treating future patients. I try to learn everything I can (save for dumb details like prevalence of commenting vs conversing hallucinations) because I don't want to worry that I didn't learn enough. Scraping by with the minimum would probably make me mentally unstable.

 

[Apoplexy__]

(e.g. what percentage of schizophrenics have voices commenting vs voices conversing hallucinations).

 

[circulus vitios]

Not to mention, you only strive to get a "Pass" so it's doubtful you actually remember what they taught you.

Of course not. "If you don't use it, you lose it." I mean if I asked the 90th percentile students to draw out TCA, glycolysis, urea, malate shuttle, nucleotide synthesis, etc. pathways from memory, I really doubt they could. Can I/they remember overarching concepts and a few key reactions, sure.

 

[Promethean]

Regarding that "voices commenting" thing... my psychiatric nursing professor had me pretty well freaked out when she explained that having an internal voice that blandly discusses the actions one is engaged in is a hallmark of schizophrenia. I thought everyone had one of these narrators.

(He posts his terrible secret for the review of the forum dwellers, and considers how they will respond. Now he loses interest and plans to get up to go check on the laundry. His stomach growls... is it lunch time yet?)

 

[seminoma]

Of course not. "If you don't use it, you lose it." I mean if I asked the 90th percentile students to draw out TCA, glycolysis, urea, malate shuttle, nucleotide synthesis, etc. pathways from memory, I really doubt they could. Can I/they remember overarching concepts and a few key reactions, sure.

Actually, I can draw those out from memory at a level a little more in depth than what's in FA and I'm fairly certain that >10% of MS2s can do it too.

Regarding that "voices commenting" thing... my psychiatric nursing professor had me pretty well freaked out when she explained that having an internal voice that blandly discusses the actions one is engaged in is a hallmark of schizophrenia. I thought everyone had one of these narrators.

(He posts his terrible secret for the review of the forum dwellers, and considers how they will respond. Now he loses interest and plans to get up to go check on the laundry. His stomach growls... is it lunch time yet?)

I don't have anything in my head narrating my life. Maybe you should go see a psychiatrist. Thinking "I'm pretty hungry, should I cook something or just go to Wendys?" is not the same as hearing a voice in my head asking the same question.

 

[Meh.meh]

.

edit: As an anecdote, I was talking to my clinical preceptor (who is involved in teaching FM residents) about CYP2C9/VKORC1 gene variants and recommended warfarin dosage, something we covered in class. He had no idea what I was talking about and said "we don't use that information in the real world."

I don't know much about Mimelim, but from what I've read, I think you're misrepresenting him.

I don't think the message is "don't work you ass off!" I think his message is "don't freak out about pre-clinicals."

I also think that his step 1 score is more a reflection of his being a badass than of pre-clinical education.

He's a ct surgery resident. I don't think he got where he is talking about diminishing returns.

 

[DermViser]

Of course not. "If you don't use it, you lose it." I mean if I asked the 90th percentile students to draw out TCA, glycolysis, urea, malate shuttle, nucleotide synthesis, etc. pathways from memory, I really doubt they could. Can I/they remember overarching concepts and a few key reactions, sure.

You don't have to be in the 90th percentile of students to do that. I also don't know any student that is tested on every single intermediate esp. in the malate shuttle and nucleotide synthesis pathway.

 

[circulus vitios]

You don't have to be in the 90th percentile of students to do that. I also don't know any student that is tested on every single intermediate esp. in the malate shuttle and nucleotide synthesis pathway.

Oh but DermViser, how do you know those intermediates aren't valuable pieces of clinical information? You can't possibly know what is or isn't useful until you're at the tail end of a 30+ year career!

And I could draw out the main ones (TCA/glycolysis/urea/nucleotide/a few others), complete with intermediates and enzymes, if I had a word bank. Doesn't mean it's useful knowledge in the realm of clinical medicine, but it's absolutely testable material -- or rather, I studied it as testable material because they were on our lecture slides -- which is idiotic.

 

[DermViser]

Oh but DermViser, how do you know those intermediates aren't valuable pieces of clinical information? You can't possibly know what is or isn't useful until you're at the tail end of a 30+ year career!

Again, I don't know any PhD professor on in-house exams who test on every single intermediate esp. in pathways such as the malate shuttle. If so, your med school sucks. Your post has nothing to do with what I said.

 

[Apoplexy__]

Regarding that "voices commenting" thing... my psychiatric nursing professor had me pretty well freaked out when she explained that having an internal voice that blandly discusses the actions one is engaged in is a hallmark of schizophrenia. I thought everyone had one of these narrators.

(He posts his terrible secret for the review of the forum dwellers, and considers how they will respond. Now he loses interest and plans to get up to go check on the laundry. His stomach growls... is it lunch time yet?)

Hahaha I don't have this at all. The voice in my head is always 1st person, if there is one.

The more important hallmark of schizo is impairment in social/occupational functioning. Med school acceptance probably rules that out.

 

[seminoma]

Of course not. "If you don't use it, you lose it." I mean if I asked the 90th percentile students to draw out TCA, glycolysis, urea, malate shuttle, nucleotide synthesis, etc. pathways from memory, I really doubt they could. Can I/they remember overarching concepts and a few key reactions, sure.

Hahaha I don't have this at all. The voice in my head is always 1st person, if there is one.

The more important hallmark of schizo is impairment in social/occupational functioning. Med school acceptance probably rules that out.

Hah, don't be so sure!

 

[circulus vitios]

Again, I don't know any PhD professor on in-house exams who test on every single intermediate esp. in pathways such as the malate shuttle. If so, your med school sucks. Your post has nothing to do with what I said.

How? You've been claiming that we can't possibly know what is or isn't minutiae, but then you claim that enzymes and intermediates in metabolic pathways aren't worth knowing because most med schools wouldn't test on the material?

 

[DermViser]

How? You've been claiming that we can't possibly know what is or isn't minutiae, but then you claim that enzymes and intermediates in metabolic pathways aren't worth knowing because most med schools wouldn't test on the material?

You're correct. In terms of what they will use, M1s/M2s have no credibility in deciding what is or isn't minutiae. Like I said, most PhD professors don't test you on every single intermediate of every single pathway. They tend to test much more on the rate limiting step or where an enzyme deficiency causes a metabolic disease.

 

[seminoma]

How? You've been claiming that we can't possibly know what is or isn't minutiae, but then you claim that enzymes and intermediates in metabolic pathways aren't worth knowing because most med schools wouldn't test on the material?

Regardless of what @DermViser is saying (which is probably correct), you and I don't know what's going to show up on Step 1 or what's going to show up in clinical practice. The idea is that MS1/MS2s need to figure out for themselves what is worth studying and what isn't. There is more relevant and non-"minutiae" type material worth studying (read: logic tells you it's likely to show up on step 1 or real life) than you or I could ever learn and reasonably retain. Does that make sense to you? Even if you spent all your time studying FA, Uworld, Pathoma, etc, you will never know all of it. Go ahead and ignore random intermediates and enzymes, but don't justify your goal of mediocrity by saying the 90%+ students get there by studying worthless info.

 

[Mad Jack]

Med school really isn't that bad. I'd do it for the figures listed.

 

[DermViser]

Regardless of what @DermViser is saying (which is probably correct), you and I don't know what's going to show up on Step 1 or what's going to show up in clinical practice. The idea is that MS1/MS2s need to figure out for themselves what is worth studying and what isn't. There is more relevant and non-"minutiae" type material worth studying (read: logic tells you it's likely to show up on step 1 or real life) than you or I could ever learn and reasonably retain. Does that make sense to you? Even if you spent all your time studying FA, Uworld, Pathoma, etc, you will never know all of it. Go ahead and ignore random intermediates and enzymes, but don't justify your goal of mediocrity by saying the 90%+ students get there by studying worthless info.

The justification is what pisses everyone off. It's fine if that's what you use to justify why you're not getting Honors, but that usually is not the case.

 

[Psai]

Oh but DermViser, how do you know those intermediates aren't valuable pieces of clinical information? You can't possibly know what is or isn't useful until you're at the tail end of a 30+ year career!

And I could draw out the main ones (TCA/glycolysis/urea/nucleotide/a few others), complete with intermediates and enzymes, if I had a word bank. Doesn't mean it's useful knowledge in the realm of clinical medicine, but it's absolutely testable material -- or rather, I studied it as testable material because they were on our lecture slides -- which is idiotic.

Yeah and then when you get a patient with an enzyme deficiency in one of those pathways and can't figure it out because you didn't think it was high yield in school, I'm sure your peers will appreciate your dimwitted referral

 

[Mad Jack]

The justification is what pisses everyone off. It's fine if that's what you use to justify why you're not getting Honors, but that usually is not the case.

Preclinical grades aren't all that important to program directors. Board scores, however, are. It makes sense to focus on the boards over grades. Step 1 scores are the most important factor in the decisions of PDs, while class rank/quartile are ranked 11th in importance. If you want to bust your ass for something that doesn't really matter a whole hell of a lot, that's fine, but there's a lot of us that would rather work smarter than harder.

http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf

 

[W19]

Again, I don't know any PhD professor on in-house exams who test on every single intermediate esp. in pathways such as the malate shuttle. If so, your med school sucks. Your post has nothing to do with what I said.

My professor did...

 

[DermViser]

Preclinical grades aren't all that important to program directors. Board scores, however, are. It makes sense to focus on the boards over grades. Step 1 scores are the most important factor in the decisions of PDs, while class rank/quartile are ranked 11th in importance. If you want to bust your ass for something that doesn't really matter a whole hell of a lot, that's fine, but there's a lot of us that would rather work smarter than harder.

http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf

Medical students have no credibility in deciding what will be tested on boards and what won't be. Medical students all use the same exact review books, Qbanks, etc. and yet everyone doesn't get the same score. Preclinical grades factor into class rank, unless you go to a true P/F school, and class rank IS important to program directors although this varies by specialty. Being in the bottom quartile of your class will affect what specialties are effectively closed off to you. Great Step scores won't clinch anything based on those scores alone.

 

[DermViser]

My professor did...

You said you go to a low-tier med school, correct?

 

[W19]

Preclinical grades aren't all that important to program directors. Board scores, however, are. It makes sense to focus on the boards over grades. Step 1 scores are the most important factor in the decisions of PDs, while class rank/quartile are ranked 11th in importance. If you want to bust your ass for something that doesn't really matter a whole hell of a lot, that's fine, but there's a lot of us that would rather work smarter than harder.

http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf

Wow.. I thought class rank was right after board scores and clinical grades....

 

[W19]

You said you go to a low-tier med school, correct?

Yep... Probably lower 10 IMO.

 

[DermViser]

Yep... Probably lower 10 IMO.

Then it's not that surprising that teaching what appears on boards is a priority.

 

[Mad Jack]

Medical students have no credibility in deciding what will be tested on boards and what won't be. Medical students all use the same exact review books, Qbanks, etc. and yet everyone doesn't get the same score. Preclinical grades factor into class rank, unless you go to a true P/F school, and class rank IS important to program directors although this varies by specialty. Being in the bottom quartile of your class will affect what specialties are effectively closed off to you. Great Step scores won't clinch anything based on those scores alone.

Even in dermatology, only 59% of program directors cite class rank as a deciding factor, while 92% cite Step 1 scores as a key factor. You're better off ending up in the middle of the pack with a great Step 1 score than the top 10% of your class with an average one. Hell, we had a guy from a great IM program do a presentation on the match and how they select candidates, and even he said class rank isn't a big factor, but board scores are huge, as are letters of recommendation.

 

[W19]

Then it's not that surprising that teaching what appears on boards is a priority.

I would not call that 'teaching on board is a priority' when they want you to know minutiae... I would not have done well in biochem had I used FA like I heard people do at other schools... I had to read Mark's biochem.

 

[DermViser]

Even in dermatology, only 59% of program directors cite class rank as a deciding factor, while 92% cite Step 1 scores as a key factor. You're better off ending up in the middle of the pack with a great Step 1 score than the top 10% of your class with an average one. Hell, we had a guy from a great IM program do a presentation on the match and how they select candidates, and even he said class rank isn't a big factor, but board scores are huge, as are letters of recommendation.

Of course it's not going to be a DECIDING factor. It's bc the group is so self-selected it's not a differentiating factor.

 

[DermViser]

I would not call that 'teaching on board is a priority' when they want you to know minutiae... I would not have done well in biochem had I used FA like I heard people do at other schools... I had to read Mark's biochem.

Sorry I mistyped. I mean NOT a priority. I don't think anyone has recommended only using First Aid.

 

[seminoma]

I would not call that 'teaching on board is a priority' when they want you to know minutiae... I would not have done well in biochem had I used FA like I heard people do at other schools... I had to read Mark's biochem.

People use FA for biochem review, not for learning biochem. I read Lippincott's and some of Mark's biochem and thought they were great.

FA might be sufficient for doing well on school exams, but doing well on a school exam doesn't mean you learned the material well.

 

[DermViser]

People use FA for biochem review, not for learning biochem. I read Lippincott's and some of Mark's biochem and thought they were great.

FA might be sufficient for doing well on school exams, but doing well on a school exam doesn't mean you learned the material well.

Yup. Lippincott's Biochem for me. First Aid Biochem was more a review, recall tool. I would say using FA only is a sure fire way to fail school exams.

 

[Ismet]

Yeah and then when you get a patient with an enzyme deficiency in one of those pathways and can't figure it out because you didn't think it was high yield in school, I'm sure your peers will appreciate your dimwitted referral

Nahhhhh he'll just look it up.

 

[Mad Jack]

People use FA for biochem review, not for learning biochem. I read Lippincott's and some of Mark's biochem and thought they were great.

FA might be sufficient for doing well on school exams, but doing well on a school exam doesn't mean you learned the material well.

Mark's Basic Medical Biochemistry is way better than Lippincott's by a mile. The explanations and diagrams are way better.