What/how to study first year? (Or, I'm a dunce)

[cytoborg]

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Someone posted recently about the tremendous amount of knowledge we must acquire as pathologists. I am somewhat of a dunderhead when it comes to memorizing stuff, and am anticipating that my learning curve 1st yr will be pretty much vertical. I need a plan of attack. I've heard it's not worth it to buy Ackerman or Rosai since most programs will have copies sitting around. What do you all think? What are the best resources for first years? I've heard Outlines in Pathology is useful, but others say this is basically crap with a lot of errors in it. Opinions?

 

[b&ierstiefel]

Someone posted recently about the tremendous amount of knowledge we must acquire as pathologists. I am somewhat of a dunderhead when it comes to memorizing stuff, and am anticipating that my learning curve 1st yr will be pretty much vertical. I need a plan of attack. I've heard it's not worth it to buy Ackerman or Rosai since most programs will have copies sitting around. What do you all think? What are the best resources for first years? I've heard Outlines in Pathology is useful, but others say this is basically crap with a lot of errors in it. Opinions?

Yes you should buy the 2 volume Sternberg and Rosai and read it before you start residency. I've already read both volumes twice.

 

[cytoborg]

😀 OK OK I know I'm being anal. (Wow - I guess I really do have it in me!) C'mon, humor me though...I'd rather look like a ******* on this board than a ******* in front of faculty and fellow residents.

 

[LADoc00]

Wow, you need to relax. You arent piloting the friggin space shuttle, you will be a gopher the first year regardless.

Unless you are Juan Rosai, who supposedly walked out of a South American jungle with little to no formal training and pulled a version of Neo from Matrix Revolutions when he showed up at Barnes Hospital in St. Louis...or at least thats how the story goes. 😉

 

[cytoborg]

Wow, you need to relax. You arent piloting the friggin space shuttle, you will be a gopher the first year regardless.

I guess I'm asking because I just got the crap scared out of me by a recent path rotation at my home institution. The first year residents were reading like crazy every chance they got. It seemed pretty insane trying to balance the caseload and read too. Since I am sort of a slow learner, this is a bit intimidating to me. Yes I made it through med school, but I'm sure that was cake compared to what residency will be like. Hence the request for advice from more experienced folk such as yourself.

Unless you are Juan Rosai, who supposedly walked out of a South American jungle with little to no formal training and pulled a version of Neo from Matrix Revolutions when he showed up at Barnes Hospital in St. Louis...or at least thats how the story goes.

Now THAT would be cool!

 

[RyMcQ]

I guess I'm asking because I just got the crap scared out of me by a recent path rotation at my home institution. The first year residents were reading like crazy every chance they got.

If you are like me (and you might not be), I have to have the context before reading does any good. That is, if I just try to study things cold without a difficult case to go along with it, my mind won't absorb it. Fortunately, residency is long enough that you will get plenty of reading in when you look at cases. Of course, there will be things that are so rare that you won't encounter them. But when you get an aggressive looking smooth muscle tumor of the uterus, you can take the opportunity to read about stromal tumors and anything else in the differential.

By the way, I know only a few residents that read at home regularly. The exception is for Tuesday morning unknown conference when everyone reads about the cases, knowing that they are going to get pimped mercilessly. (Context, baby!)

 

[garfield]

Robbins is a nice, basic book to start with and isn't nearly as huge or expensive as Rosai or Sternberg. Wait to buy the big stuff till after starting residency and the book fund kicks in.

 

[yaah]

Someone posted recently about the tremendous amount of knowledge we must acquire as pathologists. I am somewhat of a dunderhead when it comes to memorizing stuff, and am anticipating that my learning curve 1st yr will be pretty much vertical. I need a plan of attack. I've heard it's not worth it to buy Ackerman or Rosai since most programs will have copies sitting around. What do you all think? What are the best resources for first years? I've heard Outlines in Pathology is useful, but others say this is basically crap with a lot of errors in it. Opinions?

No matter how much you read or study, you will still feel fairly clueless when first year starts. Rosai has some good chapters early on in the book which are fairly basic and good overviews. While it is true that most places have Rosai and sternberg lying around, that can be variable. They tend to disappear at opportune times, and most residents do have their own copy of one of them. Of course, here we are given our choice of them first year, so of course everyone is going to have one. The first few months of residency are a learning experience, and you will be expected to be somewhat ignorant. One attending to me on day one of a rotation: "Do you know how to use the microscope?" Another attending on day one of another rotation: "This is a fibroblast. This is a smooth muscle cell."

I would, if you are looking to read something, review your histology, normal and abnormal. This will help.

 

[b&ierstiefel]

Robbins is a nice, basic book to start with and isn't nearly as huge or expensive as Rosai or Sternberg. Wait to buy the big stuff till after starting residency and the book fund kicks in.

I like that answer garfield. This whole interview process is really gonna set me back quite a bit financially. And those books are big and heavy. Who wants to move them? I say buy them AFTER you move (i.e., after residency starts).

Oh, and cytoborg, hasn't 3rd year med school taught you and reminded you countless times that you are a dunce? I thought that was what med school was all about! ... oh wait, this belongs in another thread...

 

[stormjen]

I am in my third Path rotation of my 4th year of med school. Already I've learned quite a bit, just from observing hours of sign-outs and reading up on cases now and then. My theory is that you will see the more common things over and over again throughout residency, so you will learn it even without trying. I'm personally trying to kick-start the learning process by keeping a running tab of the disease entities I see that I need to know more about, then, when I get some time to sit down, I read about them. Eventually I'll know enough about things that I don't need to jot them down anymore. Continue this process for four years and, voila, you're a Pathologist. Now some might say that you'll see the same disease processes frequently and never see some of the more rare entities. This might be the case at some programs, but at the ones I've seen, the more rare cases come up at unknown conferences, tumor boards, etc, even if they don't necessarily appear in the grossing room. So, while I agree that the amount of information we'll have to know is mind-boggling, I'm not stressing out about it since I think we'll have plenty of time, and I think my learning method will work for me.

 

[DrBloodmoney]

1. Surg Path dissection guide (Lester or Westra)
2. Baby Demay
3. DDx in Surg Path by Haber
4. Practical Guide to Txn Med by Petrides
5. Histo for Path by Sternberg

Pretty much required reference

 

[Doctor B.]

Neither Sternberg nor Rosai made much sense to me for much of first year. I didn't understand enough to get much out of them. So don't try to slog your way through them yet. I agree with others above that Robbins is a great book to start with. So is some book to review normal histology (Wheater's is one I liked alot). Also, DrBloodmoney's list is a good one; all of those are good books.

At some point, I would buy either Rosai or Sternberg (or both if you like and use both). You will likely need them in your future practice and if you're like me, you read at home. But don't go out and buy them right off the bat. Wait and see which you like better. I'm glad I waited or I'd have been stuck with the older editions.

 

[LADoc00]

New Rosai is sweetnessss. Buy it, read it front to cover. Im completely serious. If you want the super secret on the major down low tip to be the best resident in your program: Do Osler your first year, yes your first year. Trust me on this, trust me like Im your own mom, just a bigger hairer version.

 

[Smitty]

Do Osler your first year, yes your first year.

Do many residents use Osler during residency to prepare for boards? I know residents read/study throughout the 4 years, but when do most really start cranking it for the boards? As an MSIV, I'd be happy just to get through Robbins 😀 Also, I'm taking anatomy as an elective and trying to decide whether actually showing up and dissecting will somehow help me in the future, or should I just spend time with a microscope looking at normal histology?

 

[b&ierstiefel]

I'm personally trying to kick-start the learning process by keeping a running tab of the disease entities I see that I need to know more about, then, when I get some time to sit down, I read about them. Eventually I'll know enough about things that I don't need to jot them down anymore. Continue this process for four years and, voila, you're a Pathologist.

Totally agree with you there. I would do the same thing during signouts, except I only did it for one month. Still, I walked out of signout each day with a pretty impressive list on my daily index cards. Especially at our stage, some (or in my case, a lot) of what goes on during signout kinda flies over your head. It's cool to read about it because it gives you a sense as to what aspects of the slide they were looking at when making a certain diagnosis. Now doing that for a few years during residency, it'll be hard work but I think it'll be really fun too.

 

[RyMcQ]

Do many residents use Osler during residency to prepare for boards? I know residents read/study throughout the 4 years, but when do most really start cranking it for the boards?

Most residents do not use Osler. The experience of two programs that I have trained in is if you apply yourself during your rotations and attend all your conferences, you will have no problem passing boards. I started reviewing 2 weeks before boards. I would guess on average people start 2 or 3 months before.

The highest yield facts were the blood bank numbers (how long is deferral for a tattoo, how many platelets per apheresis unit). Otherwise, the test was just too broad to cram for. I did study hard, but I would have passed without studying, for sure. I guess in a sense, I studied for 5 years to prepare for the boards.

But trust me, even if you believe me on this, you will study too long. (You are a medical student and therefore you are obsessive compulsive like the rest of us.)

 

[Doctor B.]

People at our program are more obsessive. Most people take the Osler course and start studying several months in advance. Then again, alot of us don't read as much as we should during rotations.

 

[RyMcQ]

People probably thought that I studied for 4 months. I had a lot of starts and stops, a lot of paper shuffling to get my materials together. There was much anxiety, but not enough to put me into a state of mind where the studying would be useful. Again, I'm probably more of a crammer than most of you...

 

[cytoborg]

Thank you very much everyone for the study tips, advice on resources, etc. I am not going to be buying ANYTHING (besides plane tickets and ramen that is) until I have a book fund to take the edge off. I figure my 2 path rotations will serve me just fine for starters (although the paranoia returns as I see one of you is doing FOUR path rotations 😱). But it is nice to have a mental game plan so that I can prepare myself for the road ahead, and avoid flying into a book-buying frenzy on day 1 of residency. 🙄

 

[Non-Trad DO]

Cytoborg,
Some times the library will give away out texts (last editions). This is how I got my copies of Rosia and Sternberg. I even got a 3rd edition Koss. Its a easy to read but most of the pictures are b-n-w.
I just figured, even if they are out dated there is still more good info in them than bad and I can re-learn the bad **** later. 🙂

 

[yaah]

I got a couple of older books (old Sternberg version -the black covered edition, and old GYN path book, cardiac path, others) from attendings who had gotten newer versions or were cleaning out their offices.

 

[Smitty]

People at our program are more obsessive. Most people take the Osler course and start studying several months in advance.

What do you use during those months?

 

[Smitty]

How many of you residents got thru big Robbins before you started residency? I've been trying my best, but am only about 1/4 done. If I'm going to re-read it in 1st year residency anyway, I'm thinking seriously of scraping it for now and just going over some normal histo, etc. What do ya'll think?

 

[yaah]

I didn't read much of anything. I think anything you read will help somewhat, Robbins is good to remind you about a lot of info - normal histo is always helpful to review.

Depending on where you go for residency, you may also start off with CP rotations. The thing is, there is so much info out there that no matter what you read, it will have some relevance. As for what is most practical? Dunno. The first few chapters of Rosai are good for introductory purposes.