Tag Archive: study tool

Picmonic: A Cursory Review

When I heard about Picmonic, I actually let out a little yelp of excitement and anger. Excitement because I wish I had such a tool while I was in the first and second year of medical school; anger because I thought about building just such a company about a hundred times but never went through with it. Picmonic was developed too late for my first years of medical school, but I keep hearing great things about it from our medical students. Because of all the buzz, I recently downloaded their trial software to test it out and I am impressed. The idea behind Picmonic is to develop absurd images in order to help memorize difficult to understand concepts. Each Picmonic image contains a number of important pearls that should be memorized. Picmonic walks the learner through the image to highlight each pictoral 'mnemonic'. The staff at Picmonic were kind enough to send us their image for clindamycin [shown below]. In this way, any time a student is placed in a situation (in the hospital or on an exam) where he/she must remember these important concepts, the absurd image will pop right into their head, increasing memory recall.


Increased memory retention using absurd images is actually a well-known phenomenon in teaching organizations. In fact, the best memorizers in the world often use abstract and absurd imagery to memorize lists of random words and numbers. The developers at Picmonic openly state that their software increases memory retention by "300%" and may increase scores on exams by "50%". These numbers seem a bit outrageous, but they recently published their results in a peer reviewed journal (pub med link) and they seem to have some evidence to support their claims. Thousands of medical students are using their software and I have never heard anyone unhappy with the purchase. Some use it far more than others, but everyone who purchases the resource appears to be quite happy. Of course, the utility of this type of device is likely more useful to those students who are more visual, but its effect on memory retention is likely to be universal.

If you haven't tried it out, go to their website, www.picmonic.com, and download their free trial. This is a great resource.

ophthoquestions.com: A Review


I realized early in medical school that, for me, the best way to learn is by doing questions. USMLE World and Kaplan's QBank got me through Step 1, Step 2, and Step 3. When ophthalmology residency started, I was relieved to hear about www.ophthoquestions.com. A much smaller pool of buyers (US and maybe UK ophthalmology residents) means the company can not have nearly the same profit margin as USMLE World and Kaplan. Nevertheless, I was quite surprised to see that the product was still very good. I have been VERY please with my experience, here are my thoughts…



  • The online format is unique in the field of ophthalmology. There are many great review books and question books to prepare for the OKAPs and the American Board of Ophthalmology (ABO) Exam, but nothing as portable and technologically savvy as ophthoquestions.
  • The questions are well written and parallel very well the questions on the OKAPs. I am told they also parallel well the questions on the written ABO Exam. Having not taken the ABO Board, I can not verify this.
  • For the most part, the explanations are detailed enough to learn the finer points of the pathophysiology without being overbearing. If anything, ophthoquestions errors on the side of being to succinct. They can do better at having more robust explanations. In this regard, USMLE World and Kaplan's Q-Bank are superior products. 
  • The questions are obviously written by subspecialists with knowledge in the specific fields, making the answer explanations very reliable.
  • If you do all the questions in the database you will be VERY well prepared for OKAPs
  • The price may seem steep (~$150 per year) compared to question books, but with 3,500+ questions nothing has the same amount of content


  • In my opinion, the current (May 2015) content on the site does not properly reflect to proportions of subspecialty content on exams. For example, and huge proportion of the ophthoquestions content is devoted to refractive surgery, while very little is devoted to uveitis. This does not reflect the content on exams, and certainly does not reflect the content that ophthalmologists should know.  Of course, you can simply not do all the refractive surgery questions, and this would solve the problem. 
  • The writers occasionally become defensive and personal when defending their questions and answers. I respect their opinions but I really don't think that a question bank is the place for defensive answers. 
  • If you do NOT complete all the questions in the database, the price (~$150 per year) is certainly very high. If you are only going to do a few hundred questions, you might as well purchase a question book like Chern: Review Questions in Ophthalmology


I am very pleased with my ophthoquestions.com experience and recommend it to all new residents. It is the best product on the market for OKAP and ABO board preparation. It has some faults, but to be honest, not that many. I am not someone who will read the whole BCSC series, because I will never remember chapters and books. But the content in ophthoquestions is presented in a memorable and organized way that has CERTAINLY helped me do well on the OKAPs exams.


Some other ophthalmology review tools:

Pre-operative Clearance Checklist

A frequent question in the outpatient setting is whether or not a patient is optimized for surgery. There are a number of things that a physician must check in order to properly send a patient back to a surgeon with a gold star. I recently used the Johns Hopkins Internet Learning Center (HopkinsILC) to study the basic pre-operative evaluation and I highly recommend it (requires access from your school or hospital, many hospitals have access, ask your librarian).  There is a great review pdf available from HopkinsILC which details some of the highlights of the lesson.  Below I will summarize some points from the pdf. To learn more, you should ask for access to HopkinsILC, it is a great resource.


  1. If the patient has any active cardiac issues, surgery should be postponed.  This includes…
    1. Recent myocardial infarction (<30 days)
    2. Active cardiac disease (unstable angina or worse)
    3. An uncorrected arrhythmia
    4. Severe aortic stenosis


  1. The patient must be able to complete 4 or more ‘metabolic equivalents of task’ (METS).  This includes
    1. Climbing a flight of stairs
    2. Walk for 30 minutes
    3. Play tennis, bowling, or other more intense sports
    4. Able to vigorously clean a house (scrub floor, move furniture)


  1. There are a few medications that must be stopped prior to surgery. Some examples (not an exhaustive list) include…
    1. If the patient is on blood thinners (coumadin) or anti-platelet drugs (plavix, lovenox, etc) these may have to be stopped and the surgeon will have to be part of the discussion
    2. Diuretics, ACE-inhibitors, and ARBS are usually held
    3. Oral hypoglycemics are usually held for 1-2 days
    4. Insulin is usually decreased by 50%
    5. Sedatives are usually held


Again, here is the link to the pdf explaining the above points. And here is the link to the HopkinsILC website.



A website for studying radiology

During gross anatomy it is important to find good resources to study pathology and radiology, as many of your test questions will use these applications of anatomy.  There are a few resources that are very good, and many resources that are mediocre.  I have found that learningradiology.com is one of the best ways to study radiology.


The website is totally free and does not even require a login.  It is broken up by organ system, which is perfect for gross anatomy. There are free quizzes that range from simple to very demanding.  Many of their questions and “Cases of the week” are case based problems, and very similar to test formats and USMLE formats.

This would be a great and free study tool for gross anatomy, for reference whenever you need to study a specific radiologic finding, or for a radiology rotation.