MD & DO Goro’s guide to success in medical school (2017 ed.)

Goro

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For those of you who have been accepted and are preparing at this point for matriculation and orientation, congrats! Good luck! You’ve earned it. You did it! You WILL be doctors!!!
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So pull up a chair and grab another cold one; I was asked by an SDNer about the big DOs and DON’Ts of being a med student. Here are my thoughts:

As you know, you have along hard road ahead of you, but you can do it! Many of are probably still wondering “what have I gotten myself into?”

Well, for starters, that cliché of “drinking from the fire hose” is true. Actually, it’s more like “drinking from a fire hose while running after the fire engine.” We’re going to throw everything at you, in a very short period of time. I had a friend who was a graduate of U WV, and he told me that medical school “took him to his intellectual limits.”

Here are some tips that I have gleaned from my successful students, and helpful SDNers. In no particular order:

[EDIT: the advice here is for the pre-clinical years. Yes, I actually have had to put a qualifier on that this year!]

Identify your optimal learning style. Not everyone learns best by sitting on their butts for 6-8 hours a day. More importantly, what worked in college might not work in med school. I have tons of students who have troubles in the first third of their first semester not only because the sheer overload of material clobbers them.

The key thing here is go to lectures if you're struggling; conversely, if you really get nothing from being at lectures, then by all means, do something else in that time period (unless you're at schools with required lecture attendance).

Studying in med school isn’t merely adding more studying hours, but studying in a way that is best attuned to your learning style. Some people have to hear things, and so they may do best in study groups teaching their friends, or listening to lectures on video playback.

Others are visual learners and do best by making tables charts figures, writing out pathways, etc.

Every one of my clinician colleagues has told me that repetition is the key to learning. And don’t worry about not learning everything at once, you’re not radio actors with live air time tomorrow afternoon. We realize it takes time to get your material down. Yes, given the nature of the beast, some cramming will be impossible to avoid, but be aware if you cram, you don’t retain. And it’s not enough to memorize, you have to apply what you’ve learned. So merely reading and re-reading your PPT files to try to memorize them like you're learning the lines from Othello and Titus Andronicus isn't going to work.

You have taken and done well enough on the MCAT to have been accepted. However, some of you still have challenges with standardized testing. If you have test taking anxiety, get help for it NOW.

Always try to get a good night's sleep before exams. This helps retention and test performance.

Most of you are where you are right now because you love learning about the human body. Don’t ever lose that.

I post this all the time here, but this is important enough to repeat: your schools will have special resources to help struggling students. One is a learning or education center, to help you with time mgt, learning styles, test taking anxieties, mind mapping, etc.

Med school is stressful. I like to point out that it has broken even healthy students. The other resource to use, and this is just as important, is the counseling or therapy center. Med school can be a soul crushing meat grinder, especially when you’re floundering. Don’t be afraid of losing face; don’t be afraid to seek out help. Don’t be a non-compliant patient. You’re going have plenty of these on your own!

Have or develop good coping skills in case family or relationship issues intrude. As a medical student you have to be somewhat selfish. This is especially pertinent for students who come from cultures where extended family is important. You can’t always run home if Uncle Joe gets sick.

In addition, it's best to have or develop a support group. Your fellow students are your family now. You can turn to them.

Yet another resource: Seek out your professors if you're struggling; they're there for you!

Always be able to look at the big picture. I have seen so many students get lost in the weeds trying to memorize every detail. You simply can’t do it. He who tries to learn everything will end up learning nothing. Use resources other than your PPT files, like Pathoma, Anki, Sketcy, etc. High scorers on Boards tend to use more of the external resources than just than their lecture notes.

Bone up on what you're weakest in. This is why practice tests are so helpful. Qbank, Testweapon, USMLE World, ComBank, ComSAE, whatever the resource, make sure use to them. We and others find that our best students take lots of practice questions, and the weakest students don’t. If you feel you know particular material, it's OK to spend less time with it, and better to work on your weakest areas. But identifying those holes in your knowledge base is extremely important.

If textbooks are required, buy them. [EDIT: as can be seen later in the thread, this is a controversial subject this year. Some people are outright offended by this suggestion.]

Board review books are exactly that; do NOT use them in place of a required text. We’ve found that our weakest students always try to make do with just review books. Avoid the mindset of of “if it’s not in FA, it’s not important”. This is just wrong.


[EDIT: some people may be interpreting this as "if you don't buy textbooks, you're a dab student" I hope that's not what they're thinking. If true, it would make me wonder who on Earth they made it past the VR and CARS sections of MCAT. I'm just pointing out what my weakest students seem to have in common].

Every one of my students who have taken Boards tell me that there’s stuff on Boards that is NOT covered in FA.

Review books are for review, and that’s it. And BTW, First Aid for USMLE I has lots of errors in it!
[EDIT: As you can read later on, for some people, FA generates near religious devotion. Go figure].

Study with your friends, unless they’re too distracting. Otherwise, seek out the people in your classes who really impress you, and ask them “how they do it?” Even if you get a single tip that help, that’s worth it.

What makes medical students fail? The most common reasons at my school are mental health issues, especially depression, or poor work ethic; less seen is an inability to separate outside life issues from med school (ie, poor coping skills), or repeated failure on Boards. A handful lost interest in Medicine, or never were fully committed to the path in the first place.

But to quote Queen Victoria, “We are not interested in the possibility of failure!

And good luck to you all!
 
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AcademicNeurosurgery

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The legend, thanks for saving us from the onslaught of MS0 threads. Also, remember to enjoy the ride. It's easy to get in a cycle where you believe the next phase will be better - premeds can't wait until they are in medical school so they don't have to worry about whether or not they'll ever be doctors, med students can't wait to match so they are at least in the specialty of their choice, residents can't wait to be attendings with better hours, attendings can't wait to build a steady patient base and make partner, and established physicians are waiting for retirement.

Find a way to enjoy today.
 
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If textbooks are required, buy them. Board review books are exactly that; do NOT use them in place of a required text.
During my M1 year our Assoc Dean for Medical Education put it in perspective: the course and board exams will test us on the content in the textbooks but not in the review books. Know the textbooks and you'll be well prepared for the exams. Rely on the review books and you will not be.
 
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During my M1 year our Assoc Dean for Medical Education put it in perspective: the course and board exams will test us on the content in the textbooks but not in the review books. Know the textbooks and you'll be well prepared for the exams. Rely on the review books and you will not be.
Yup!
 

.hematoma.

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If textbooks are required, buy them. Board review books are exactly that; do NOT use them in place of a required text. We’ve found that our weakest students always try to make do with just review books. In fact, the weakest students have an attitude that “if it’s not in FA, It’s not important”. [email protected] Every one of my students who have taken Boards tell me that there’s stuff on Boards that is NOT covered in FA.
This is so wrong to me on so many levels. Not many students are able to read through entire textbooks, and in fact I think there's little value in doing so. If it's not in FA/Pathoma/Uworld/Bros deck, in my mind, it's low yield for the boards. Will low yield material show up on the exam? Hell yes. Will that prevent you from getting a good score? Hell no.

Every student is different, it's wrong to make a blanket statement like that.

Source: A "weak" student who rarely used textbooks and got a 250 on step 1
 
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Goro

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This is so wrong to me on so many levels. Not many students are able to read through entire textbooks, and in fact I think there's little value in doing so. If it's not in FA/Pathoma/Uworld/Bros deck, in my mind, it's low yield for the boards. Will low yield material show up on the exam? Hell yes. Will that prevent you from getting a good score? Hell no.

Every student is different, it's wrong to make a blanket statement like that.

Source: A "weak" student who rarely used textbooks and got a 250 on step 1
Please do not engage in the sin of solipsism. Note that I also didn't say "Buy all the textbooks and read them cover to cover." This statement was made from nearly two decades of observation that our weakest students tend to try to make do with Board review books only.
 

DBV

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During my M1 year our Assoc Dean for Medical Education put it in perspective: the course and board exams will test us on the content in the textbooks but not in the review books. Know the textbooks and you'll be well prepared for the exams. Rely on the review books and you will not be.
Tell that to deez scores. Don't know when you went to school but the review books get sharper every year. Of course I'm talking about board exams because nobody cares what you got on your biochem mid term
 
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Goro

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Tell that to deez scores. Don't know when you went to school but the review books get sharper every year. Of course I'm talking about board exams because nobody cares what you got on your biochem mid term
My own student who just took Boards told me that "there was stuff on both Step I and COMLEX that wasn't in FA".

I can't argue with a case in point. All I can give is my experience, or rather, relay the experiences and comments of > 1500 of my students. Your mileage may vary.
 
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.hematoma.

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My own student who just took Boards told me that "there was stuff on both Step I and COMLEX that wasn't in FA".

I can't argue with a case in point. All I can give is my experience, or rather, relay the experiences and comments of > 1500 of my students. Your mileage may vary.

Yes there will be stuff that isn't in FA, of course there will be. Have you taken the boards? If you haven't, I'll let you know that there is no resource (textbook or otherwise) that covers everything. The best bet is the review resources to perform well on the boards (and form a decent foundation for medicine), with googling and occasional (read very occasional, like 1 page every so often) out of a textbook. Play the odds.



Please do not engage in the sin of solipsism. Note that I also didn't say "Buy all the textbooks and read them cover to cover." This statement was made from nearly two decades of observation that our weakest students tend to try to make do with Board review books only.
The fact that you are using only your experiences with your students at your specific school when you formulate your advice is solipsism lol. I'm just returning it to you.


I also want to take this moment to let you know that observation is VERY different from reality. Medical students will say random **** to their professors and colleagues. Some will say they are reading review books thoroughly and still not doing well when in reality they facebook 80% of the time they are studying. Some students will say they read a bunch of textbooks when in reality they are lying to rile others up. The fact of the matter is that there are several students who are able to do well with mostly review resources (yes, some of them will lie and say they are only doing that, but again people like me only used review resources with the occasional paragraph read in a book). You have to go through the process of medical school to really understand that textbook reading is super low yield unless you specifically choose a couple pages here or there to read on rare occasion; again, you may have but I'm not going through your post history to find out your credentials.
 

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My own student who just took Boards told me that "there was stuff on both Step I and COMLEX that wasn't in FA".
That is absolutely true as to Step 1. I wouldn't know about COMLEX. FA was a nice guide as one resource to review but it created more work for their many errors and omissions. I threw it across my office many times totally frustrated that it could be so misleading despite its hype.

What's the MOA of Metformin? FA says "unknown". If you believe that for Step 1, you will miss a question.
How do Diltiazem & Verapamil differ? FA says their location of MOA is the same. UWorld says otherwise (Verapamil @ cardiac muscle / Diltiz @ vascular smooth & cardiac muscles).
What is the signaling pathway for mTOR? FA doesn't state. Become familiar with PI3K / Akt / mTOR and then you'll get that question right.

Knock yourself out.
 
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Yes there will be stuff that isn't in FA, of course there will be. Have you taken the boards? If you haven't, I'll let you know that there is no resource (textbook or otherwise) that covers everything. The best bet is the review resources to perform well on the boards (and form a decent foundation for medicine), with googling and occasional (read very occasional, like 1 page every so often) out of a textbook. Play the odds.


The fact that you are using only your experiences with your students at your specific school when you formulate your advice is solipsism lol. I'm just returning it to you.


I also want to take this moment to let you know that observation is VERY different from reality. Medical students will say random **** to their professors and colleagues. Some will say they are reading review books thoroughly and still not doing well when in reality they facebook 80% of the time they are studying. Some students will say they read a bunch of textbooks when in reality they are lying to rile others up. The fact of the matter is that there are several students who are able to do well with mostly review resources (yes, some of them will lie and say they are only doing that, but again people like me only used review resources with the occasional paragraph read in a book). You have to go through the process of medical school to really understand that textbook reading is super low yield unless you specifically choose a couple pages here or there to read on rare occasion; again, you may have but I'm not going through your post history to find out your credentials.
*sigh*...I tried, SDN.

Placing on Ignore. You'll feel some slight pressure between the eyes.
 
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Crayola227

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it continues to be ridiculous how much emphasis is placed on FA and how much trashing of the didactic years

yes, the Step 1 score plays a big role in specialty and residency placement
however, since the majority of students should be and will be planning on primary care careers, and should ultimately be happy wherever they are lucky enough to match and become licensed and certified, (or be sorely disappointed).....
then for the most part passing and being average will be fine for most students

so then, can we put aside Step 1 and focus on what *really* matters??
you need to know a **** ton of material, yes, even basic science, to be really effective clinicians

I hate to break it to you all, but I crammed and dumped most of the didactic years, did fine on standardized tests, and it didn't do me any favors starting intern year

yes there's a lot of crap you don't need to know, that doesn't mean there isn't a ton YOU DO NEED TO KNOW from your classes and textbooks

TLDR:
I'll repeat: doing well on Steps will not make you prepared to be a good doctor.
Learning the majority of the material presented to you during ALL four years will.
Period.
 
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Crayola227

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Classic SDN. Time tested valuable advice freely put together by actual med school faculty for *overall* success for rising med students

---AND---

the whole thing devolves into obsessing about Step 1 and FA, as if medical school and those scores are the the whole point, when it's really missing the point

not to mention the opinions of people who haven't graduated medical school and entered practice, about what's important to learn, is really taking a microscopic view and pretty much the height of solipsism in medicine

the issue isn't disagreement, it's outright disrespect, plus it's just stupid to veer the thread into "the best ways to prepare for Step 1" as though that's synonymous with thread title -it isn't
 

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I'll repeat: doing well on Steps will not make you prepared to be a good doctor. Learning the majority of the material presented to you during ALL four years will.
Period.
What does not get mentioned are the relationships a medical student can build with physicians precisely because a student is able to have a free flowing conversation (unlike MPQ) and demonstrate some knowledge, keen interest and ask "dumb" questions that reflect hunger. Those add fodder for a LOR. Studying just for Step 1 regardless of the resource cheapens you. Going the extra mile to research the MOA of Metformin to understand why it is being investigated for cancer, how pathways like mTOR, JAK-STAT, MAP-Kinase, etc open cytokine therapies as plausible options, all these build a foundation to have those conversations with far smarter / driven physicians who have power and influence on an aspiring physician's career. It isnt just Step 1 that serves as a metric. Your interactions with key physicians can open opportunities down the way.

A Hem-Onc MD/PhD Faculty PI is blazing a trail on molecular targeted therapies. He is all over the molecular pathways when it comes to Mab (particularly Herceptin), Tyrosine Kinase Inhibitors (e.g. Gefitinib) and others. His knowledge is beyond impressive. His confidence is palpable. His humility intact because he laments there is so much we dont know in medicine.

When he is in my presence I stand at attention, am very measured with my words and ask questions apologetically because I seek understanding. His answer: "most physicians dont even know these pathways but at least you are interested. Keep at it"

Rotations and Residency are a great leveler of egos. How you present yourself is really key, i.e. interpersonal skills. Witness the cavalier contempt some display on these boards towards experienced Attending Physicians, SOM Admins, people who are here to help others. Character matters far more than Board scores


IMG_0542.JPG
 
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AcademicNeurosurgery

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it continues to be ridiculous how much emphasis is placed on FA and how much trashing of the didactic years

yes, the Step 1 score plays a big role in specialty and residency placement
however, since the majority of students should be and will be planning on primary care careers, and should ultimately be happy wherever they are lucky enough to match and become licensed and certified, (or be sorely disappointed).....
then for the most part passing and being average will be fine for most students

so then, can we put aside Step 1 and focus on what *really* matters??
you need to know a **** ton of material, yes, even basic science, to be really effective clinicians

I hate to break it to you all, but I crammed and dumped most of the didactic years, did fine on standardized tests, and it didn't do me any favors starting intern year

yes there's a lot of crap you don't need to know, that doesn't mean there isn't a ton YOU DO NEED TO KNOW from your classes and textbooks

TLDR:
I'll repeat: doing well on Steps will not make you prepared to be a good doctor.
Learning the majority of the material presented to you during ALL four years will.
Period.
Classic SDN. Time tested valuable advice freely put together by actual med school faculty for *overall* success for rising med students

---AND---

the whole thing devolves into obsessing about Step 1 and FA, as if medical school and those scores are the the whole point, when it's really missing the point

not to mention the opinions of people who haven't graduated medical school and entered practice, about what's important to learn, is really taking a microscopic view and pretty much the height of solipsism in medicine

the issue isn't disagreement, it's outright disrespect, plus it's just stupid to veer the thread into "the best ways to prepare for Step 1" as though that's synonymous with thread title -it isn't
What does not get mentioned are the relationships a medical student can build with physicians precisely because a student is able to have a free flowing conversation (unlike MPQ) and demonstrate some knowledge, keen interest and ask "dumb" questions that reflect hunger. Those add fodder for a LOR. Studying just for Step 1 regardless of the resource cheapens you. Going the extra mile to research the MOA of Metformin to understand why it is being investigated for cancer, how pathways like mTOR, JAK-STAT, MAP-Kinase, etc open cytokine therapies as plausible options, all these build a foundation to have those conversations with far smarter / driven physicians who have power and influence on an aspiring physician's career. It isnt just Step 1 that serves as a metric. Your interactions with key physicians can open opportunities down the way.

A Hem-Onc MD/PhD Faculty PI is blazing a trail on molecular targeted therapies. He is all over the molecular pathways when it comes to Mab (particularly Herceptin), Tyrosine Kinase Inhibitors (e.g. Gefitinib) and others. His knowledge is beyond impressive. His confidence is palpable. His humility intact because he laments there is so much we dont know in medicine.

When he is in my presence I stand at attention, am very measured with my words and ask questions apologetically because I seek understanding. His answer: "most physicians dont even know these pathways but at least you are interested. Keep at it"

Rotations and Residency are a great leveler of egos. How you present yourself is really key, i.e. interpersonal skills. Witness the cavalier contempt some display on these boards towards experienced Attending Physicians, SOM Admins, people who are here to help others. Character matters far more than Board scores


View attachment 221998
These points are all well-taken but they miss reality - Step 1 is an extremely significant part of matching and learning to "play the game" gets you into the residency you want in the location you want.

You can't fault students for a faulty system. If they fight against, they risk not matching. It would take systemic changes from the people in power (adcoms, PDs, faculty, attendings) to change what they value in applicants.

It's a systemic issue, and the blame doesn't fall on students. It's to up and coming docs to rock the ship and make changes. And it will happen, the current trend is unsustainable.

Also, with regards to the heme/once physician pushing the frontiers - the vast majority of us won't do that. I'd argue that most physicians implement the status quo "standard of care" while research-minded physicians push the field forward. Neither is superior to the other, and both are equally valuable.
 

neoevolution

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I have a friend who did UFAP plus sketchy, an extra q bank and Bros and got 99th percentile on Step 1. There are going to be some questions that aren't covered between the major resources, but your score if you know those can be high enough that it doesn't matter that you missed a few.

Textbooks are also so much harder to review quickly that I don't think you'd be able to retain it well. I know our faculty always is recommending textbooks but I don't see the value for the average student.
 

ACSurgeon

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For those of you who have been accepted and are preparing at this point for matriculation and orientation, congrats! Good luck! You’ve earned it. You did it! You WILL be doctors!!!
View attachment 221979View attachment 221976View attachment 221981View attachment 221978View attachment 221980View attachment 221977


So pull up a chair and grab another cold one; I was asked by an SDNer about the big DOs and DON’Ts of being a med student. Here are my thoughts:

As you know, you have along hard road ahead of you, but you can do it! Many of are probably still wondering “what have I gotten myself into?”

Well, for starters, that cliché of “drinking from the fire hose” is true. Actually, it’s more like “drinking from a fire hose while running after the fire engine.” We’re going to throw everything at you, in a very short period of time. I had a friend who was a graduate of U WV, and he told me that medical school “took him to his intellectual limits.”

Here are some tips that I have gleaned from my successful students, and helpful SDNers. In no particular order:

Identify your optimal learning style. Not everyone learns best by sitting on their butts for 6-8 hours a day. More importantly, what worked in college might not work in med school. I have tons of students who have troubles in the first third of their first semester not only because the sheer overload of material clobbers them.

The key thing here is go to lectures if you're struggling; conversely, if you really get nothing from being at lectures, then by all means, do something else in that time period (unless you're at schools with required lecture attendance).

Studying in med school isn’t merely adding more studying hours, but studying in a way that is best attuned to your learning style. Some people have to hear things, and so they may do best in study groups teaching their friends, or listening to lectures on video playback.

Others are visual learners and do best by making tables charts figures, writing out pathways, etc.

Every one of my clinician colleagues has told me that repetition is the key to learning. And don’t worry about not learning everything at once, you’re not radio actors with live air time tomorrow afternoon. We realize it takes time to get your material down. Yes, given the nature of the beast, some cramming will be impossible to avoid, but be aware if you cram, you don’t retain. And it’s not enough to memorize, you have to apply what you’ve learned. So merely reading and re-reading your PPT files to try to memorize them like you're learning the lines from Othello and Titus Andronicus isn't going to work.

You have taken and done well enough on the MCAT to have been accepted. However, some of you still have challenges with standardized testing. If you have test taking anxiety, get help for it NOW. And get a good night's sleep before exams, too. This helps retention and test performance.

Most of you are where you are right now because you love learning about the human body. Don’t ever lose that.

I post this all the time here, but this is important enough to repeat: your schools will have special resources to help struggling students. One is a learning or education center, to help you with time mgt, learning styles, test taking anxieties, mind mapping, etc.

Med school is stressful. I like to point out that it has broken even healthy students. The other resource to use, and this is just as important, is the counseling or therapy center. Med school can be a soul crushing meat grinder, especially when you’re floundering. Don’t be afraid of losing face; don’t be afraid to seek out help. Don’t be a non-compliant patient. You’re going have plenty of these on your own!

Have or develop good coping skills in case family or relationship issues intrude. As a medical student you have to be somewhat selfish. This is especially pertinent for students who come from cultures where extended family is important. You can’t always run home if Uncle Joe gets sick.

In addition, it's best to have or develop a support group. Your fellow students are your family now. You can turn to them.

Yet another resource: Seek out your professors if you're struggling; they're there for you!

Always be able to look at the big picture. I have seen so many students get lost in the weeds trying to memorize every detail. You simply can’t do it. He who tries to learn everything will end up learning nothing. Use resources other than your PPT files, like Pathoma, Anki, Sketcy, etc. High scorers on Boards tend to use more of the external resources than just than their lecture notes.

Bone up on what you're weakest in. This is why practice tests are so helpful. Qbank, Testweapon, USMLE World, ComBank, ComSAE, whatever the resource, make sure use to them. We and others find that our best students take lots of practice questions, and the weakest students don’t. If you feel you know particular material, it's OK to spend less time with it, and better to work on your weakest areas. But identifying those holes in your knowledge base is extremely important.

If textbooks are required, buy them. Board review books are exactly that; do NOT use them in place of a required text. We’ve found that our weakest students always try to make do with just review books. In fact, the weakest students have an attitude that “if it’s not in FA, It’s not important”. [email protected] Every one of my students who have taken Boards tell me that there’s stuff on Boards that is NOT covered in FA.

Review books are for review, and that’s it. And BTW, First Aid for USMLE I has lots of errors in it!

Study with your friends, unless they’re too distracting. Otherwise, seek out the people in your classes who really impress you, and ask them “how they do it?” Even if you get a single tip that help, that’s worth it.

What makes medical students fail? The most common reasons at my school are mental health issues, especially depression, or poor work ethic; less seen is an inability to separate outside life issues from med school (ie, poor coping skills), or repeated failure on Boards. A handful lost interest in Medicine, or never were fully committed to the path in the first place.

But to quote Queen Victoria, “We are not interested in the possibility of failure!

And good luck to you all!
Agree that review materials should only be used for review AFTER one has learned the material in a more comprehensive fashion.

I also agree that learning from a textbook is very inefficient. I got through all my training without ever relying on textbooks. Residency was the first time that I used textbooks and read large chunks from 3-4 different texts, in addition to board review materials.

You don't have time in Med school to read 3-5 textbook chapters per lecture. I was fortunate that my med school provided excellent lecture summaries that were comprehensive but focused at the same time. The professors summarized the verbose unfocused textbook chapters into more manageable and more focused chapters. These were in paragraph form with some images (i.e. Not first aid format). This was also helpful because when you studied 300-500 pages, you knew it covered everything your professor wanted you to know.

I understand most schools don't do this, and students are left sifting through piles of poorly prepared PowerPoint slides and trying to make sense of it all. It's no surprise that students gravitate towards board materials, because they're concise and organized.

@Goro, can you explain how schools justify taking $30-50k a year from each student (3-10 million dollars per class per year) and fail to provide usable, high quality materials for the students to learn from? Most med students can drink from the fire hose while chasing after the fire truck just fine. It's the not knowing which hose to drink from or which truck to chase that gets students in trouble.
 

Crayola227

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lol, the funny thing was how much those textbooks came out for me intern year

that's right, I had to review some of that ****

some of those resources made their way to my clinic where I would use some of it for patient education
to this day, that **** comes off my bookshelves when I am educating friends and family in the comfort of my home

before that, in med school, I needed textbooks some of the time - some lecturers or course blocks are put together like crap
lecture notes or PPT slides can be really inadequate
I learned all of physiology from textbooks as a result

I'm not really saavy on this newer stuff like Sketchy, etc, but
I do know physiology and other complex topics you cannot learn from question banks or flashcards

I don't deny the importance of Step 1 in terms of career placement, however I have not found much correlation with Step scores and physician performance on the job, and I mean that as far as knowledge base or application

TLDR:
Goro's point stands.
Don't let money or relying too much on other materials, particularly question banks or review books, be the reason you don't buy textbooks.
Buy them when you need them, namely when you need to master a topic more than what other methods will allow.
Be open to the idea that not all the recommended books are crap.
Please care about learning medicine beyond the minutia that will get you a good Step score.
Care beyond the grades.
 

IsWhat

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Classic SDN. Time tested valuable advice freely put together by actual med school faculty for *overall* success for rising med students

---AND---

the whole thing devolves into obsessing about Step 1 and FA, as if medical school and those scores are the the whole point, when it's really missing the point

not to mention the opinions of people who haven't graduated medical school and entered practice, about what's important to learn, is really taking a microscopic view and pretty much the height of solipsism in medicine

the issue isn't disagreement, it's outright disrespect, plus it's just stupid to veer the thread into "the best ways to prepare for Step 1" as though that's synonymous with thread title -it isn't
Well, we play the game laid out before us. Step 1 determines your specialty and future - it's that simple. Not to mention the medical school curriculum is bloated beyond belief and obscenely expensive. My spouse is a pediatric PA and basically practices autonomously with two years of training. It'll take me 7+ years of training to the same damn thing. Pardon those of us who choose to prioritize our education.

As for Goro, most of his pre-med advice is pure gold. However, he's a Non clinician faculty member and giving step 1 advice - or any advice beyond step 1 - is not his to give, IMO.
 
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@Goro, can you explain how schools justify taking $30-50k a year from each student (3-10 million dollars per class per year) and fail to provide usable, high quality materials for the students to learn from? Most med students can drink from the fire hose while chasing after the fire truck just fine. It's the not knowing which hose to drink from or which truck to chase that gets students in trouble.
It's extremely difficult to answer this question because different students learn in different ways, and different faculty teach in different ways, and each faculty member has to arrive at the decision point of "what is the most import thing an M1/M2 needs to know for Boards AND Wards?" (as we can see in thread hijack, for some people, medical education begins and ends with Step I).

Or is your question "why can't Faculty spoon feed us in nice digestible chunks?" If so, we're doing you a disservice in that. We now realize that passive learning is not a good way to learn material. hence the recent shift in medical school curricula to the flipped classroom/TBL style learning. Active learners retain the material better, and become better suited to life-long learning...which is a required competency now for both medical students and residents.

I agree that there are faculty who can't be bothered to fix spelling mistakes, or update material, or even figure out what is the most important thing to learn. But I think that they're outnumbered by better faculty. As I'm writing this, the notion is striking me that many of you are thinking about your worst professors, but forgetting about the best.
 
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It's extremely difficult to answer this question because different students learn in different ways, and different faculty teach in different ways, and each faculty member has to arrive at the decision point of "what is the most import thing an M1/M2 needs to know for Boards AND Wards?" (as we can see in thread hijack, for some people, medical education begins and ends with Step I).

Or is your question "why can't Faculty spoon feed us in nice digestible chunks?" If so, we're doing you a disservice in that. We now realize that passive learning is not a good way to learn material. hence the recent shift in medical school curricula to the flipped classroom/TBL style learning. Active learners retain the material better, and become better suited to life-long learning...which is a required competency now for both medical students and residents.

I agree that there are faculty who can't be bothered to fix spelling mistakes, or update material, or even figure out what is the most important thing to learn. But I think that they're outnumbered by better faculty. As I'm writing this, the notion is striking me that many of you are thinking about your worst professors, but forgetting about the best.
Not spoon feeding. More consolidating and organizing resources so that the student doesn't have to spend significant amounts of time trying to figure out what to study. Again, I was very lucky in that my med school was incredibly organized and had user friendly materials. I've spoken with many students who had an entirely different experience of having power points with diagrams and no words, having no clear syllabus to follow, having to rely on tutor notes and review books. Just seems wrong for the amount of money charged. Each school should be able to chose or even develop from scratch high quality materials.
 

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Personally, I dont really like textbooks. I always like to stay current and actually google the official guidelines. It's always good to be uptodate with everything (PUN INTENDED :D) .

Textbooks are nice to get a sense, but to stay current, you gotta keep up with the official literature all the time.
 
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Not spoon feeding. More consolidating and organizing resources so that the student doesn't have to spend significant amounts of time trying to figure out what to study. Again, I was very lucky in that my med school was incredibly organized and had user friendly materials. I've spoken with many students who had an entirely different experience of having power points with diagrams and no words, having no clear syllabus to follow, having to rely on tutor notes and review books. Just seems wrong for the amount of money charged. Each school should be able to chose or even develop from scratch high quality materials.
I don't think that it's my job to write textbooks for students. PPT files, outlines, objectives, online flashcards, micro quizzes, labs, and TBLs, fine.

At my school, we're mandated to have syllabi! They're contracts with the students. Our Dean has mandated that "if it's not in the syllabi, it can't be tested on". This keeps us honest.

I do think it's the student's responsibility to contact Faculty to clarify opaque or confusing materials. At my school, the students have Class representatives for each major class and discipline.

Back to having textbooks, I have seen no end of students who can't be bothered to crack open a text for clarification when Professor A says X, and Professor B says Y on a particular subject (and often, both are correct!)

EDIT: A lot of people are homing in on my suggestion about textbooks, moth-like to flames. I reiterate that my observation is that it is the weaker of my students who tend to not buy or even use textbooks.
 

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Goro, can you explain how schools justify taking $30-50k a year from each student (3-10 million dollars per class per year) and fail to provide usable, high quality materials for the students to learn from? Most med students can drink from the fire hose while chasing after the fire truck just fine. It's the not knowing which hose to drink from or which truck to chase that gets students in trouble.
In before: "it is the students' job to find the resource that works best"
 
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I don't think that it's my job to write textbooks for students. PPT files, outlines, objectives, online flashcards, micro quizzes, labs, and TBLs, fine.

At my school, we're mandated to have syllabi! They're contracts with the students. Our Dean has mandated that "if it's not in the syllabi, it can't be tested on". This keeps us honest.

I do think it's the student's responsibility to contact Faculty to clarify opaque or confusing materials. At my school, the students have Class representatives for each major class and discipline.

Back to having textbooks, I have seen no end of students who can't be bothered to crack open a text for clarification when Professor A says X, and Professor B says Y on a particular subject (and often, both are correct!)

EDIT: A lot of people are homing in on my suggestion about textbooks, moth-like to flames. I reiterate that my observation is that it is the weaker of my students who tend to not buy or even use textbooks.
The issue with the bolded is that this is not consistent with many medical schools. The question becomes how specific are the syllabi? Are they saying "know the mechanism of X disease process" or just saying "study disease X", because there's a significant difference in terms of directing students as to what is relevant within those areas. The issue of having goal-directed learning is a very valid one imo as I've heard complaints from friends at schools all over the country who have encountered the issue. So what would you recommend to students whose schools basically say "Learn chapters X,Y,Z of this book" but provide little direction as to what is actually relevant for classes and boards?
 

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I had a traditional curriculum (anatomy/phys in MS1, pathology dominating MS2) and I used the textbooks frequently. We overall had good lecturers with well thought out and organized slides emphasizing key points. I found myself using textbooks (ie Robbins) for further reading on areas I did not quite grasp. This was a safer bet than googling as you could almost guarantee that if a question came of it, the rationale could be found in the recommended textbook. Sometimes the end product would be the same with internet sources, but the way they got there would be different and could lead to wrong answers. YMMV, but if you are not a P/F curriculum and you're gunning for derm/plastics/whatever you might want to consider it.

I studied for step I with FA supplemented by class notes, UWorld, and a few review books like BRS embryology and anatomy and ended with >250.

You may end up with a great step I score by just doing review books all year, but sometimes when you get pimped on rounds and pull out one of those esoteric nuggets from lecture notes you can look like a rock star. It might favorably impact your clinical grade...so long as you're not a complete douche bag who constantly tells the attending that what they are talking about isn't HIGH YIELD. Step I is a pivotal test and can absolutely dictate where you end up, but there is more to medicine than that. Obtaining that high score that keeps doors open is very important, but so is a lot of the other material for reasons other than looking good on rounds.
 
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The issue with the bolded is that this is not consistent with many medical schools. The question becomes how specific are the syllabi? Are they saying "know the mechanism of X disease process" or just saying "study disease X", because there's a significant difference in terms of directing students as to what is relevant within those areas. The issue of having goal-directed learning is a very valid one imo as I've heard complaints from friends at schools all over the country who have encountered the issue. So what would you recommend to students whose schools basically say "Learn chapters X,Y,Z of this book" but provide little direction as to what is actually relevant for classes and boards?
Go talk to the professor and tell them that they need to be more specific.
Then complain to the school's Curriculum Committee, and the Dean.
See how the Chapters compare with the PPT notes. Consider most chapter have sub-chapters, sections, etc, and these often have key points. Start with those and work outwards.
For example, on say, vomiting and diarrhea, start with the normal physiology, then work out to pathophysiology, and then to causes, and thence to Dx and Tx.

And I expect you to know the anatomy of the GI tract too!
 
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The issue with the bolded is that this is not consistent with many medical schools. The question becomes how specific are the syllabi? Are they saying "know the mechanism of X disease process" or just saying "study disease X", because there's a significant difference in terms of directing students as to what is relevant within those areas. The issue of having goal-directed learning is a very valid one imo as I've heard complaints from friends at schools all over the country who have encountered the issue. So what would you recommend to students whose schools basically say "Learn chapters X,Y,Z of this book" but provide little direction as to what is actually relevant for classes and boards?
Totally agree. My school just switched up the curriculum to where all PowerPoints must include "learning objectives" for us and every test question must correlate to those objectives. Keeps everyone accountable and on the same page. Fortunately both students and faculty are excited for this change too. We don't have to worry about professors pulling stuff out of their a$$, and we don't bug the crap out of them with questions about testable material.
 
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Go talk to the professor and tell them that they need to be more specific.
Then complain to the school's Curriculum Committee, and the Dean.
See how the Chapters compare with the PPT notes. Consider most chapter have sub-chapters, sections, etc, and these often have key points. Start with those and work outwards.
For example, on say, vomiting and diarrhea, start with the normal physiology, then work out to pathophysiology, and then to causes, and thence to Dx and Tx.

And I expect you to know the anatomy of the GI tract too!
You forgot complications :p
 
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Totally agree. My school just switched up the curriculum to where all PowerPoints must include "learning objectives" for us and every test question must correlate to those objectives. Keeps everyone accountable and on the same page. Fortunately both students and faculty are excited for this change too. We don't have to worry about professors pulling stuff out of their a$$, and we don't bug the crap out of them with questions about testable material.
We're mandated to give objectives because we're tired of Faculty doing exactly that, and also to protect them from Faculty who simply don't know who to write good test questions. For example, how many time have you seen this type of question?

The dose of penicillin to treat X infection is:

5 mg/kg
7.5 mg/kg
10mg/kg
15mg/gk
20mg/kg


Sometime clinical Faculty will teach at the level of MS4 or resident, and the poor kids are just lost.
 

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For those of you who have been accepted and are preparing at this point for matriculation and orientation, congrats! Good luck! You’ve earned it. You did it! You WILL be doctors!!!
View attachment 221979View attachment 221976View attachment 221981View attachment 221978View attachment 221980View attachment 221977


So pull up a chair and grab another cold one; I was asked by an SDNer about the big DOs and DON’Ts of being a med student. Here are my thoughts:

As you know, you have along hard road ahead of you, but you can do it! Many of are probably still wondering “what have I gotten myself into?”

Well, for starters, that cliché of “drinking from the fire hose” is true. Actually, it’s more like “drinking from a fire hose while running after the fire engine.” We’re going to throw everything at you, in a very short period of time. I had a friend who was a graduate of U WV, and he told me that medical school “took him to his intellectual limits.”

Here are some tips that I have gleaned from my successful students, and helpful SDNers. In no particular order:

Identify your optimal learning style. Not everyone learns best by sitting on their butts for 6-8 hours a day. More importantly, what worked in college might not work in med school. I have tons of students who have troubles in the first third of their first semester not only because the sheer overload of material clobbers them.

The key thing here is go to lectures if you're struggling; conversely, if you really get nothing from being at lectures, then by all means, do something else in that time period (unless you're at schools with required lecture attendance).

Studying in med school isn’t merely adding more studying hours, but studying in a way that is best attuned to your learning style. Some people have to hear things, and so they may do best in study groups teaching their friends, or listening to lectures on video playback.

Others are visual learners and do best by making tables charts figures, writing out pathways, etc.

Every one of my clinician colleagues has told me that repetition is the key to learning. And don’t worry about not learning everything at once, you’re not radio actors with live air time tomorrow afternoon. We realize it takes time to get your material down. Yes, given the nature of the beast, some cramming will be impossible to avoid, but be aware if you cram, you don’t retain. And it’s not enough to memorize, you have to apply what you’ve learned. So merely reading and re-reading your PPT files to try to memorize them like you're learning the lines from Othello and Titus Andronicus isn't going to work.

You have taken and done well enough on the MCAT to have been accepted. However, some of you still have challenges with standardized testing. If you have test taking anxiety, get help for it NOW. And get a good night's sleep before exams, too. This helps retention and test performance.

Most of you are where you are right now because you love learning about the human body. Don’t ever lose that.

I post this all the time here, but this is important enough to repeat: your schools will have special resources to help struggling students. One is a learning or education center, to help you with time mgt, learning styles, test taking anxieties, mind mapping, etc.

Med school is stressful. I like to point out that it has broken even healthy students. The other resource to use, and this is just as important, is the counseling or therapy center. Med school can be a soul crushing meat grinder, especially when you’re floundering. Don’t be afraid of losing face; don’t be afraid to seek out help. Don’t be a non-compliant patient. You’re going have plenty of these on your own!

Have or develop good coping skills in case family or relationship issues intrude. As a medical student you have to be somewhat selfish. This is especially pertinent for students who come from cultures where extended family is important. You can’t always run home if Uncle Joe gets sick.

In addition, it's best to have or develop a support group. Your fellow students are your family now. You can turn to them.

Yet another resource: Seek out your professors if you're struggling; they're there for you!

Always be able to look at the big picture. I have seen so many students get lost in the weeds trying to memorize every detail. You simply can’t do it. He who tries to learn everything will end up learning nothing. Use resources other than your PPT files, like Pathoma, Anki, Sketcy, etc. High scorers on Boards tend to use more of the external resources than just than their lecture notes.

Bone up on what you're weakest in. This is why practice tests are so helpful. Qbank, Testweapon, USMLE World, ComBank, ComSAE, whatever the resource, make sure use to them. We and others find that our best students take lots of practice questions, and the weakest students don’t. If you feel you know particular material, it's OK to spend less time with it, and better to work on your weakest areas. But identifying those holes in your knowledge base is extremely important.

If textbooks are required, buy them. Board review books are exactly that; do NOT use them in place of a required text. We’ve found that our weakest students always try to make do with just review books. In fact, the weakest students have an attitude that “if it’s not in FA, It’s not important”. [email protected] Every one of my students who have taken Boards tell me that there’s stuff on Boards that is NOT covered in FA.

Review books are for review, and that’s it. And BTW, First Aid for USMLE I has lots of errors in it!

Study with your friends, unless they’re too distracting. Otherwise, seek out the people in your classes who really impress you, and ask them “how they do it?” Even if you get a single tip that help, that’s worth it.

What makes medical students fail? The most common reasons at my school are mental health issues, especially depression, or poor work ethic; less seen is an inability to separate outside life issues from med school (ie, poor coping skills), or repeated failure on Boards. A handful lost interest in Medicine, or never were fully committed to the path in the first place.

But to quote Queen Victoria, “We are not interested in the possibility of failure!

And good luck to you all!
Some of this so called advice isn't going to benefit anyone in their pre-clinical years.

I take a large issue with, "If textbooks are required, buy them." Are you serious? Have you ever read a syllabus. Some instructors list five or more books as "required." At my school, one could easily spend $1000-$2000 on textbooks based on Goro's advice. Terrible misleading advice. Here is some advice 80% or more of medical students will agree, DON'T BUY ANY TEXTBOOKS. I have done exceptionally well in medical school and have purchased ZERO textbooks.

As far as board review books are concerned, IMO he is wrong again. First Aid was very useful in studying during my preclinical years. In fact, I would say that your first pass through First Aid should no be during the spring before step 1/level 1, it should be as you go through preclinical years. First Aid doesn't tell you anywhere near everything you need for exams, but it does help to point out important facts. It also serves as an organizer for outlining aspects of the curriculum that are unclear or you can't figure out where they fit. Bottom line, get First Aid during the first semester and use it as a reference. Just to name a few examples of how it helped me, my school was terrible at teaching some topics such as anti-fungals and collagen synthesis. I spent a few minutes looking at these pages and it made those topics soooooooo much more clear.

I would caution against taking advice from those who tell, but have never done.
 
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It's interesting how people post on discussion forums yet don't want to discuss.
Goro simply gets off on announcing to all when he wants to ignore someone. Rather than simply ignoring the and/or putting them on ignore, he finds it much more self gratifying to make a public announcement.

Like when people leave Facebook, and have to first announce this on Facebook.
 
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Some of this so called advice isn't going to benefit anyone in their pre-clinical years.

I take a large issue with, "If textbooks are required, buy them." Are you serious? Have you ever read a syllabus. Some instructors list five or more books as "required." At my school, one could easily spend $1000-$2000 on textbooks based on Goro's advice. Terrible misleading advice. Here is some advice 80% or more of medical students will agree, DON'T BUY ANY TEXTBOOKS. I have done exceptionally well in medical school and have purchased ZERO textbooks.

As far as board review books are concerned, IMO he is wrong again. First Aid was very useful in studying during my preclinical years. In fact, I would say that your first pass through First Aid should no be during the spring before step 1/level 1, it should be as you go through preclinical years. First Aid doesn't tell you anywhere near everything you need for exams, but it does help to point out important facts. It also serves as an organizer for outlining aspects of the curriculum that are unclear or you can't figure out where they fit. Bottom line, get First Aid during the first semester and use it as a reference. Just to name a few examples of how it helped me, my school was terrible at teaching some topics such as anti-fungals and collagen synthesis. I spent a few minutes looking at these pages and it made those topics soooooooo much more clear.

I would caution against taking advice from those who tell, but have never done.
*sigh* I have tried, SDNers.

Applying "Ignore" function. You'll feel a slight stinging sensation.
 
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Yes there will be stuff that isn't in FA, of course there will be. Have you taken the boards? If you haven't, I'll let you know that there is no resource (textbook or otherwise) that covers everything. The best bet is the review resources to perform well on the boards (and form a decent foundation for medicine), with googling and occasional (read very occasional, like 1 page every so often) out of a textbook. Play the odds.





The fact that you are using only your experiences with your students at your specific school when you formulate your advice is solipsism lol. I'm just returning it to you.


I also want to take this moment to let you know that observation is VERY different from reality. Medical students will say random **** to their professors and colleagues. Some will say they are reading review books thoroughly and still not doing well when in reality they facebook 80% of the time they are studying. Some students will say they read a bunch of textbooks when in reality they are lying to rile others up. The fact of the matter is that there are several students who are able to do well with mostly review resources (yes, some of them will lie and say they are only doing that, but again people like me only used review resources with the occasional paragraph read in a book). You have to go through the process of medical school to really understand that textbook reading is super low yield unless you specifically choose a couple pages here or there to read on rare occasion; again, you may have but I'm not going through your post history to find out your credentials.
100% Accurate
 

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it continues to be ridiculous how much emphasis is placed on FA and how much trashing of the didactic years

yes, the Step 1 score plays a big role in specialty and residency placement
however, since the majority of students should be and will be planning on primary care careers, and should ultimately be happy wherever they are lucky enough to match and become licensed and certified, (or be sorely disappointed).....
then for the most part passing and being average will be fine for most students

so then, can we put aside Step 1 and focus on what *really* matters??
you need to know a **** ton of material, yes, even basic science, to be really effective clinicians

I hate to break it to you all, but I crammed and dumped most of the didactic years, did fine on standardized tests, and it didn't do me any favors starting intern year

yes there's a lot of crap you don't need to know, that doesn't mean there isn't a ton YOU DO NEED TO KNOW from your classes and textbooks

TLDR:
I'll repeat: doing well on Steps will not make you prepared to be a good doctor.
Learning the majority of the material presented to you during ALL four years will.
Period.
Completely agree, If you only know First Aid, you're not going to be happy with your board score. Many of the questions on board exams you will be unsure of, but your broad knowledge of preclinical topics will lead you to select the correct answer. Having First Aid in front of you wouldn't help. During clinical rotations, only knowing First Aid will make you look like a dunce.

More advice, think of preclinical years as what separates you from midlevel practitioners. Clinical years teach you "how" and preclinical years teach you "why." The "why" is what makes you a doctor and the ability to think through complex convoluted situations.
 
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Goro simply gets off on announcing to all when he wants to ignore someone. Rather than simply ignoring the and/or putting them on ignore, he finds it much more self gratifying to make a public announcement.

Like when people leave Facebook, and have to first announce this on Facebook.
Right on cue:

*sigh* I have tried, SDNers.

Applying "Ignore" function. You'll feel a slight stinging sensation.
What about the pressure between the eyes?
 

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It's extremely difficult to answer this question because different students learn in different ways, and different faculty teach in different ways, and each faculty member has to arrive at the decision point of "what is the most import thing an M1/M2 needs to know for Boards AND Wards?" (as we can see in thread hijack, for some people, medical education begins and ends with Step I).

Or is your question "why can't Faculty spoon feed us in nice digestible chunks?" If so, we're doing you a disservice in that. We now realize that passive learning is not a good way to learn material. hence the recent shift in medical school curricula to the flipped classroom/TBL style learning. Active learners retain the material better, and become better suited to life-long learning...which is a required competency now for both medical students and residents.

I agree that there are faculty who can't be bothered to fix spelling mistakes, or update material, or even figure out what is the most important thing to learn. But I think that they're outnumbered by better faculty. As I'm writing this, the notion is striking me that many of you are thinking about your worst professors, but forgetting about the best.
The correct answer is NO JUSTIFICATION EXISTS. Preclinical curriculum doesn't change significantly form year to year and yet my school's was incredibly unorganized and confusing. Charging $50k or more per year is simply legal theft and no justification for this exists. Schools get away with this because of federal loans.

It isn't about "spoon feeding," but it is extraordinarily frustrating to watch a lecture and realized you didn't learn a thing and are unsure of the topics you should have learned. This is pure laziness. I'm paying a lot of money and shouldn't have to spend my time filling in the curriculum blanks. At the very least, I should know what I need to learn after each lecture.
 

12glaucoma34

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I don't think that it's my job to write textbooks for students. PPT files, outlines, objectives, online flashcards, micro quizzes, labs, and TBLs, fine.

At my school, we're mandated to have syllabi! They're contracts with the students. Our Dean has mandated that "if it's not in the syllabi, it can't be tested on". This keeps us honest.

I do think it's the student's responsibility to contact Faculty to clarify opaque or confusing materials. At my school, the students have Class representatives for each major class and discipline.

Back to having textbooks, I have seen no end of students who can't be bothered to crack open a text for clarification when Professor A says X, and Professor B says Y on a particular subject (and often, both are correct!)

EDIT: A lot of people are homing in on my suggestion about textbooks, moth-like to flames. I reiterate that my observation is that it is the weaker of my students who tend to not buy or even use textbooks.
One of my favorite situations, professor A says X and Professor B says Y. Then you look it up and google says Z. Guess what are the answer choices are on the exam? X, Y, Z, and D. That happened repeatedly at my school. Super annoying and 100% avoidable for schools with a structured curriculum.
 
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Crayola227

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Maybe it's learning styles. I'll try to add to what @Goro is getting at, I think.

Oddly, I didn't realize consciously what worked for me in college would be all that would work for me in med school: writing everything by hand.
I tried a lot of easier, faster, more efficient, more digital methods that made more sense.
It didn't work and ultimately you have to do what gets results even if it takes 80% more time, gives you hand cramps while destroying the rainforest.
I only remember what I type if it's original to me - typing the Krebs cycle, no. My last novella on SDN about dating? Sadly, yes.

I had the chance to use both an online dissection guide with computer at tableside for gross anatomy, and Grant's classic text.
I preferred text because of the detail, words, abstract diagrams, not just pics.

I know some use only digital resources for gross anatomy, but that just wouldn't work for me.
I have "photographic memory" in that at times I can pull up an image I've seen in a paper book, a handout, or something I've drawn on paper (not whiteboard) in my mind for a test. I suspect there's a tactile quality to this, as it doesn't work almost at all for digital screens.

Since I need paper and to write to learn, I preferred paper for everything - syllabi, ppts, lectures, books.

If I read a section of text in a book, I'm getting a lot of benefit.
-Tactile paper I can take notes on
-I have almost zero auditory retention (wha? you say, how does that work, doc? Thank God EMR and typing for once! I always have a clipboard), so lectures don't do jack unless I'm writing a lot down by hand.
-Plus lectures are hit or miss anyway.
-I'm not a morning person.
-Text may not be concise, but by having more words it is frequently more clear. Frequently you can come to totally understand a very complex topic just by reading the text.
-Text can more easily stand in for lecture compared to other materials in learning what you need to know as a doc on the topic. If this wasn't true I'm not sure why U2D is so ****ing useful. Yes of course you can totally miss what the lecturer wants to test you on and bomb the test anyway.

Review books in my experience don't lend themselves to a lot of first time learning, complex topics, "brain chewing & condensing" and "summary by hand."
You can annotate to try to engage with it (as I did in FA with little success), or you can just repeat what's there since there's no fluff, but as I said, this is rote repetition by comparison to taking notes on a full text. The process of digesting a wordier text can be the necessary thing your brain needs to internalize the concept.

For me, since I really didn't consider cost of textbooks in deciding if I needed them for my learning and success after already borrowing $62,ooo for the year, the main downside, as mentioned, is the time for the text. That doesn't mean that the time isn't high yield. Like all the rest of your time in your medical career, you will never have enough time, so its management will always be a challenge.

If you just don't learn from texts, then go ahead, be picky which ones you buy and there's tons of other resources.

If you learn from texts (and most of us do to some extent or another, given that is how most college courses are structured), bite the bullet and buy them when they're needed.

I knew way too many people that were just trying to save money using a lot of scattered online resources, when we had a crappy course director, when they could have just bought a small $30 book, easily read it cover to cover, and done well.

Sometimes you're gonna learn better by a flowchart pic, and other times you need 5 paragraphs of solid text. There's no one size fits all topics or learners in med school.

TLDR:
Why all the detail? Each person is unique, there is a lot of material, you can't even begin to use the same techniques to teach all the material, let alone learn it.
The sheer volume and variety will likely teach you more about your intellectual strengths/weaknesses & learning styles than you have ever learned about yourself in your lifetime. Maybe some of you will read what it was like for me, and you can better identify, as I have here, what the particulars are for you, just by having something to compare to.

On a plus side, medical school taught me sooooo much about who I was that I didn't even know, and it transformed me.

Goro is not wrong to suggest that students that struggled often hadn't bought the associated text. If you can learn from everything but a book, more power to you. If you are NOT learning, one would hope when it all comes down to it, time with a well written textbook can lead you on the path out of the woods. This is not unreasonable when you look at how textbook-trained the average incoming med student is.

I just want to challenge the "textbooks are crap" in med school party line, because that isn't always true and it can really bite people in the ass. Also, if you're reading this and feel like I do, don't feel bad if you find yourself buying a lot of the texts. It's OK.
 

sliceofbread136

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Hmmmm not sure I agree with a lot of this. In my opinion the less resources you use the better. For years one and two I endorse studying almost solely from the lecture powerpoint presentations and major points from the syllabus. Knowing these two very well will help you achieve good class grades, there is simply no need to introduce any outside resource and they will mostly serve as distractions from what you should be doing (learning exactly what you lecture tests will be on). At most some skimming of FA can be included.

Come step time UFAP is key (plus atleast 2 nbmes). No other resources are needed except possibly USMLERx. Someone who has memorized FA and the pathoma written manual and meticulously completed Uworld is almost guaranteed to do well on step 1 barring poor test taking skills.
 
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Goro

Goro

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Hmmmm not sure I agree with a lot of this. In my opinion the less resources you use the better. For years one and two I endorse studying almost solely from the lecture powerpoint presentations and major points from the syllabus. Knowing these two very well will help you achieve good class grades, there is simply no need to introduce any outside resource and they will mostly serve as distractions from what you should be doing (learning exactly what you lecture tests will be on). At most some skimming of FA can be included.

Come step time UFAP is key (plus atleast 2 nbmes). No other resources are needed except possibly USMLERx. Someone who has memorized FA and the pathoma written manual and meticulously completed Uworld is almost guaranteed to do well on step 1 barring poor test taking skills.
I don't have the citation handy, but there is published data on high Step I scores that reports that they use a multiplicity of resources. We and others see the the same thing from surveys from students.

Gawd, I've been posting the same advice for med student success for about three years running. Who'd think such a can of worms would be opened???!! And so many raw nerves? People are actually wounded! The outrage! You'd think that textbooks were made from human tissue!
 

sliceofbread136

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I don't have the citation handy, but there is published data on high Step I scores that reports that they use a multiplicity of resources. We and others see the the same thing from surveys from students.

Gawd, I've been posting the same advice for med student success for about three years running. Who'd think such a can of worms would be opened???!! And so many raw nerves? People are actually wounded! The outrage! You'd think that textbooks were made from human tissue!
Mind posting said studies? There are also the probable confounder that people who use more resources are simply studying more than people who use less resources. I've seen multiple threads from 270+ people who devoted hundreds of hours memorizing multiple resources which is simply not possible in the typical 6 week test prep period. In my experience for the typical us Med student with 6 weeks of step studying the answer is ufap ufap ufap. Mastering that material definitely puts one in 260+ territory with good test taking skills.

And I think people are just discussing your claims and the validation behind them. No need to get so defensive...
 

VA Hopeful Dr

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Some of this so called advice isn't going to benefit anyone in their pre-clinical years.

I take a large issue with, "If textbooks are required, buy them." Are you serious? Have you ever read a syllabus. Some instructors list five or more books as "required." At my school, one could easily spend $1000-$2000 on textbooks based on Goro's advice. Terrible misleading advice. Here is some advice 80% or more of medical students will agree, DON'T BUY ANY TEXTBOOKS. I have done exceptionally well in medical school and have purchased ZERO textbooks.

As far as board review books are concerned, IMO he is wrong again. First Aid was very useful in studying during my preclinical years. In fact, I would say that your first pass through First Aid should no be during the spring before step 1/level 1, it should be as you go through preclinical years. First Aid doesn't tell you anywhere near everything you need for exams, but it does help to point out important facts. It also serves as an organizer for outlining aspects of the curriculum that are unclear or you can't figure out where they fit. Bottom line, get First Aid during the first semester and use it as a reference. Just to name a few examples of how it helped me, my school was terrible at teaching some topics such as anti-fungals and collagen synthesis. I spent a few minutes looking at these pages and it made those topics soooooooo much more clear.

I would caution against taking advice from those who tell, but have never done.
I think better advice would be to ask the class above you what they did. If no one bought book A, then you're probably OK. If lots of people bought book B, I would suggest buying it.
 
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