First Year Content...Wish I had a better background..

[spooty1189]

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Med Students,

Congratulations on completing the first year of medical school! Many physicians will say the first was the hardest. Looking back now, I'm curious as to what you all think are the most important concepts of the first year curriculum and those of which you wish you had a better foundation before matriculation. For those of you replying, please those concepts that were particularly challenging for you or classmates and of which you would have like to have seen prior to med school. Thanks so much for replying, I certainly do appreciate your time. If you don't mind, please list your medical school as I'm trying to figure this out for all US medical students.

Thanks guys.

 

[witzelsucht]

Harvard Medical School

 

[Awesome Sauceome]

Welp, thanks for dissolving all confidence that I had towards being able to pass medical school lol

 

[Porfirio]

All of that is useless. Factoids only there to be annoying and weed out the people who can memorize trash and those who cannot. There is no medicine there.

The same goes for most of first and second year of medical school. Looking back now, as a 4th year, you realize you only did it because you had to, and you gained very little.

 

[Merely]

We actually have to learn that stuff above..?

 

[Porfirio]

We actually have to learn that stuff above..?

Yes. Then you get to forget it. All I remember about it is the following:

Mid Brain - III, IV, V (sensory)
Pons - V (motor), VI, VII, VIII
Medulla - IX, X, XI, XII
(I don't even know if this is right. This is just what I remember)

Lesion anywhere = you're f*cked
<3.5 hr-4 hr being f*cked with no brain bleed/contraindications = TPA
Anything else = Make peace with God

 

[Jabbed]

All of that is useless. Factoids only there to be annoying and weed out the people who can memorize trash and those who cannot. There is no medicine there.

The same goes for most of first and second year of medical school. Looking back now, as a 4th year, you realize you only did it because you had to, and you gained very little.

Sometimes you really have to hunt for the clinical value in the curriculum, but it is there. Even somethings as esoteric as the TCA cycle and glycolysis have their role in the foundational understanding of the pathophysiology and management of disease (alcoholic ketoacidosis for instance).

 

[Dares Dareson]

[omgwtf pics of brain]

Harvard Medical School

😢

 

[Psai]

I used to know those. Not anymore though

 

[Pacna]

I used to know those. Not anymore though

Same, and the neuroanatomy final was less than 2 months ago!

 

[Roxas]

Welp, thanks for dissolving all confidence that I had towards being able to pass medical school lol

Neuroanatomy is teh suck

 

[Roxas]

Yes. Then you get to forget it. All I remember about it is the following:

Mid Brain - III, IV, V (sensory)
Pons - V (motor), VI, VII, VIII
Medulla - IX, X, XI, XII
(I don't even know if this is right. This is just what I remember)

Lesion anywhere = you're f*cked
<3.5 hr-4 hr being f*cked with no brain bleed/contraindications = TPA
Anything else = Make peace with God

An excellent summary

 

[Porfirio]

Sometimes you really have to hunt for the clinical value in the curriculum, but it is there. Even somethings as esoteric as the TCA cycle and glycolysis have their role in the foundational understanding of the pathophysiology and management of disease (alcoholic ketoacidosis for instance).

And this is the problem - I should not have to hunt for clinical value in the curriculum. It should smack me in the face.

 

[sunealoneal]

And this is the problem - I should not have to hunt for clinical value in the curriculum. It should smack me in the face.

Many times a pathology lecture would reference the biochem we learned. I think if they had to stop each time and name all the pathologies associated with the biochem then they'd get nothing done. I'm probably only recalling the biochem that we went over again in path though.

 

[operaman]

For you soon-to-be MS1s freaking out about the pics above: don't. All of that is ridiculously easy. I came into medical school with no science background -- I was a music major -- and had no trouble at all. It just looks complicated because of all the terms you don't recognize and the fact you have nothing else to relate it to....yet. You will, though, and it will make sense when you get to it and wrestle with it for a few days. Neuro probably has the steepest learning curve simply because of the new language and less intuitive spatial relationships, but you'll all get it or at least find a way to get past it.

There's definitely clinical value in it, though how many details you remember long term will vary depending on your specialty of choice.

 

[Kaustikos]

For you soon-to-be MS1s freaking out about the pics above: don't. All of that is ridiculously easy. I came into medical school with no science background -- I was a music major -- and had no trouble at all. It just looks complicated because of all the terms you don't recognize and the fact you have nothing else to relate it to....yet. You will, though, and it will make sense when you get to it and wrestle with it for a few days. Neuro probably has the steepest learning curve simply because of the new language and less intuitive spatial relationships, but you'll all get it or at least find a way to get past it.

There's definitely clinical value in it, though how many details you remember long term will vary depending on your specialty of choice.

Uh. No, it wasn't easy. It wasn't impossible but I'll be damned if someone thinks neuro anatomy and physiology was easy. The clinical questions were a nightmare that I drew a picture of myself pointing a gun to my head because of how difficult the questions were.
Ugh

 

[charmiedermie]

Harvard Medical School

You win SDN for today. Couldn't have said it better.

Uh. No, it wasn't easy. It wasn't impossible but I'll be damned if someone thinks neuro anatomy and physiology was easy. The clinical questions were a nightmare that I drew a picture of myself pointing a gun to my head because of how difficult the questions were.
Ugh

+1000

You're not alone. Neuroanatomy and Physiology were very difficult with the type of med school test questions that can be written for them. Like you said, not impossible, but can be difficult. I couldn't understand at the beginning why people thought Neuroanatomy was so bad, when we started, until we hit the brainstem chapter, and had to memorize every cross-section.

If operaman really finds memorizing brainstem sections ridiculously easy, then he's truly gifted.

 

[ortnakas]

And this is the problem - I should not have to hunt for clinical value in the curriculum. It should smack me in the face.

I wish I agreed with you, but I don't. I think as a first-year, you don't have the ability to determine what's clinically valuable, or what's building the base for something that's going to be clinically relevant. I just finished first year though, so I may just be telling myself that to make myself feel better.

 

[Ace Khalifa]

Lol yep I'm crossing Neuro off my potential specialty list.

 

[charmiedermie]

We actually have to learn that stuff above..?

Didn't you have to?

I wish I agreed with you, but I don't. I think as a first-year, you don't have the ability to determine what's clinically valuable, or what's building the base for something that's going to be clinically relevant. I just finished first year though, so I may just be telling myself that to make myself feel better.

I told myself that a lot to justify the insane level of memorization we had to do in the first 2 years (i.e. memorizing brainstem slices). It would help on Step 1, it was essential for third year, I'd be a wonderful doctor if I knew this little fact, etc. I was wrong.

 

[Ace Khalifa]

Are we f**ked for step 1 if we don't memorize this **** or just our neuroanatomy class? The school I'm going to is one of those "P/F on transcript, but the numerical scores are used for internal class rank and AOA" type schools.

 

[The Kraken]

Are we f**ked for step 1 if we don't memorize this **** or just our neuroanatomy class? The school I'm going to is one of those "P/F on transcript, but the numerical scores are used for internal class rank and AOA" type schools.

You'll learn all the pathways that use everything on the above cross sections and it's much easier memorizing the picture standalone. Yes we all need to know neuro for step, including the brain stem. I found it similar in difficulty to biochem pathway memorization, but neuro sticks better in my memory.

 

[NontradCA]

Harvard Medical School

 

[RedPhys]

Are we f**ked for step 1 if we don't memorize this **** or just our neuroanatomy class? The school I'm going to is one of those "P/F on transcript, but the numerical scores are used for internal class rank and AOA" type schools.

good luck in Biochem
MS3 at UM told me half his class basically flunked the course (the professor had to curve things to allow most people to pass, though maybe they were just a really bad batch of students)

 

[Successful BM]

I don't know how it works at other schools, but brainstem anatomy is one of the last things we learned in neuro. Before that, we had a few months of indoctrination with cranial nerves/nuclei, motor/sensory tracts, and other neuro anatomy. By the time you get to figures like that, it's more like "oh, so that's where that is in the brainstem," rather than, "wtf is this? I have to know this?!" It looks like a lot, but once you get there, you're familiar with all the terms and the wiring so it's really just like finally being able to match nuclei and tracts you already know with their location in the brainstem. Then it's just a matter of deducing what kind of symptoms your patient will have if you knock out the medial medulla, cerebral crus, etc...

tl;dr it's not like they throw everything at you at once, so don't sweat it. Take it one step at a time and you'll be solid.

Micro, on the other hand, is a complete **** show. I'd be sunk if it weren't for sketchy micro.

 

[Ace Khalifa]

good luck in Biochem
MS3 at UM told me half his class basically flunked the course (the professor had to curve things to allow most people to pass, though maybe they were just a really bad batch of students)

Challenge accepted. I was fairly good at memorization during undergrad. Shouldn't take too long to pick up some better active studying techniques and refine my memorization skills.

 

[22031 Alum]

And this is the problem - I should not have to hunt for clinical value in the curriculum. It should smack me in the face.

It smacks you in the face once you have the knowledge and experience to understand the relevance. Unfortunately, you don't have that until later.

 

[Psai]

And this is the problem - I should not have to hunt for clinical value in the curriculum. It should smack me in the face.

What do you think third and fourth year are for? Window dressing?

 

[operaman]

Uh. No, it wasn't easy. It wasn't impossible but I'll be damned if someone thinks neuro anatomy and physiology was easy. The clinical questions were a nightmare that I drew a picture of myself pointing a gun to my head because of how difficult the questions were.
Ugh

I guess my experience was a little different, or maybe I was just lucky and had really good professors. I can imagine that this is the kind of material one could teach very badly.

I actually liked the clinical questions about this stuff for one simple reason: I knew I could always get the right answer. I don't mean that in a cocky way, just that if you know the pathways and the basics of the anatomy, you can easily use the vignette to localize the lesion and eliminate all the distractors. My pet peeve was ambiguity in questions, but the clinical neuro questions never really had any.

 

[Psai]

I guess my experience was a little different, or maybe I was just lucky and had really good professors. I can imagine that this is the kind of material one could teach very badly.

I actually liked the clinical questions about this stuff for one simple reason: I knew I could always get the right answer. I don't mean that in a cocky way, just that if you know the pathways and the basics of the anatomy, you can easily use the vignette to localize the lesion and eliminate all the distractors. My pet peeve was ambiguity in questions, but the clinical neuro questions never really had any.

I think it's hard for you to understand because you're among the smartest and most hardworking people out there

 

[Roxas]

You'll learn all the pathways that use everything on the above cross sections and it's much easier memorizing the picture standalone. Yes we all need to know neuro for step, including the brain stem. I found it similar in difficulty to biochem pathway memorization, but neuro sticks better in my memory.

I had a similar experience, but the other way around. Biochem just makes so much more sense, but neuro....no way

 

[Mad Jack]

Welp, thanks for dissolving all confidence that I had towards being able to pass medical school lol

It's not nearly as hard as it looks. And it's a lot easier to learn with some cadavers and prosections to help you.

It's also the worst course in the first two years, fwiw.

 

[Mad Jack]

And this is the problem - I should not have to hunt for clinical value in the curriculum. It should smack me in the face.

Not every patient smacks you in the face with an obvious diagnosis. I was dealing with a zebra-on-zebra level case over the weekend that we still haven't figured out, despite weeks of tests and cultures, everything coming up negative. And I'm wondering what esoteric fact all the physicians are missing, what seemingly nonsensical Step I question would lead us to the answer...

 

[W19]

Neuroanatomy is an interesting class, but schools should teach it in 2.5-3 months--not 5-6 weeks like many schools do while having other classes...

 

[nontrad1986]

The hardest part of first year was being burnt out. You need to memorize basically everything lol and that gets a little boring. I suggest always taking a few minutes to gain a big picture before reading notes of watching lectures, ask youself.. What do I know? What would I like to know? And do I know anyone who is or has suffered from a disease related to this topic. These all tie emotion and motivation with your memory and facilitate long term memory. Also, try to connect th dots between all of your classes; it makes it fun and helps you understand how the body reacts as a whole. That way if you forget one thing you can reason correct answers based off what you know about other systems. It's really easy to ge burnt out and bored of studying all the time.. When that happens and you need to study for a test.. Watch a YouTube video about a patient suffering from a disease in whatever module you're doing, it helps you appreciate why you're doing all this in the first place. Also, revuew a gross anatomy book before starting; don't study it hardcore but familiarize youself with the journey you'll embark on in that class lol; that class is a beast. Gluck

 

[Kaustikos]

I guess my experience was a little different, or maybe I was just lucky and had really good professors. I can imagine that this is the kind of material one could teach very badly.

I actually liked the clinical questions about this stuff for one simple reason: I knew I could always get the right answer. I don't mean that in a cocky way, just that if you know the pathways and the basics of the anatomy, you can easily use the vignette to localize the lesion and eliminate all the distractors. My pet peeve was ambiguity in questions, but the clinical neuro questions never really had any.

No, don't get me wrong. My professor was great. She knew her ****. She just made her exams that difficult. In the end, it made me more confident with neuro. But it still wasn't easy. I'll say her exams were significantly more difficult than the neuro shelf exam. Her clinical questions were so much more difficult (in a good way).
It did help that the first portion involving neuro anatomy was beyond fun with her.
Memorable quote:
"mammory bodies... Well we all know why they called them that hahahaha"

 

[Kaustikos]

You win SDN for today. Couldn't have said it better.

+1000

You're not alone. Neuroanatomy and Physiology were very difficult with the type of med school test questions that can be written for them. Like you said, not impossible, but can be difficult. I couldn't understand at the beginning why people thought Neuroanatomy was so bad, when we started, until we hit the brainstem chapter, and had to memorize every cross-section.

If operaman really finds memorizing brainstem sections ridiculously easy, then he's truly gifted.

Yeah. Neuro portion of anatomy was a nightmare. Knowing the entire head in two weeks... I was having dreams where I was going through each nerve pathway and vasculature. Ugh... I'm having ptsd thinking about.

 

[charmiedermie]

good luck in Biochem
MS3 at UM told me half his class basically flunked the course (the professor had to curve things to allow most people to pass, though maybe they were just a really bad batch of students)

Memorizing Biochemistry is fine, memorizing squigglys on brainstem sections is ridiculous.

 

[drmak89]

Any review books you guys used along side your classes to help make sense of it/use for step 1?