Category Archive: Preclinical Years

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.

Clindamycin-Picmonic

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.

Video: Empathy as a Physician

Studying your brains out for USMLE Step 1? Are you trying to keep your head above water on your surgery rotation? Are you an intern and can't remember why you ever chose medical school in the first place?

You need to watch this video put out by the Cleveland Clinic. It will help you remember.

Best Books for Anatomy Class

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

This list of books was specifically created to help medical students. However, I would suggest the same books to anyone taking an undergraduate course in anatomy, to dental students, optometry students, podiatry students, physicians assistant students, advanced nursing students, etc. etc.  When you are studying anatomy there are a few things you have to focus on: 1- Learning the name and location of the structures, 2- learning to identify the important anatomic relationships in the body, and 3- learning the clinical correlations related to the important relationships. Your tests will focus on each of these areas, so you must focus on them as well.

  • Updated April 2015

1. An Atlas:

Your first goal when starting your anatomy class will be to find the atlas that will help you learn. I created a separate list of the best available anatomy atlases a few months ago.  I am partial to Netter's because I like bright colors, but each atlas has its own advantages and disadvantages. Below are a few links to the best known atlases.

Grant’s Atlas of Anatomy

Gray's Anatomy

Clemente’s Anatomy

Rohen’s Color Atlas of Anatomy

2. An Anatomy Textbook:

An atlas is essential for learning WHERE anatomy is, but you must also learn WHY anatomy relationships are important; you will be tested on both paradigms. An anatomy textbook will teach you the pertinent anatomical/clinical relationships. I prefer Clinically Oriented Anatomy because it is brief and very high yield.  I have also heard good things about Saladin Anatomy and Physiology.

3. A Dissector:

A 'dissector' is a manual that will guide you through dissection in the anatomy lab. Your class will likely suggest a specific book for the lab itself. Let me also recommend purchasing an extra copy from which to study. Grant's Dissector works just fine. You will want to know all the important structures that you dissected, but you will NOT want to study out of your anatomy lab book! Gross.

4. Flashcards:

To do well in an anatomy class you do not need to think, you only need to memorize. Flashcards are a must. Use them on the bus, trains, waiting in line, brushing your teeth, etc. Don't waste time making your own, you can buy a used box of beautiful flashcards for around $15.  Again, my favorite are the Netter's Anatomy Flash Cards, they are bright and color coated for easy memorization.

As an aside, I have heard of a few people using 'coloring books' to study for anatomy. This actually sounds intriguing to me and I wish I heard about it earlier. Many companies make these books, here is a link to Netter's Anatomy Coloring Book .

5. Anatomy Review Book:

I have raved about the BRS Series of review books before and I will again. The BRS Gross Anatomy review is concise (albeit 500 pages) and high yield review of everything to do with anatomy and its clinical correlations.  The best book for high yield review, however, is likely the First Aid for the Basic Sciences, General Principles. This will include review of many other subjects, but it is very high yield and a fantastic resource. 

6. Other Books:

Depending on the course structure, you may also be required to learn embryology and histology during your anatomy class. If so, let me suggest Langman's Medical Embryology and Ross Histology Text .

 
 
GOOD LUCK!
 
 

 

Comparing the Best Human Anatomy Atlases

Choosing the right anatomy atlas is a stressful decision, and one that is quite important. For many of you (students in medical, dental, optometry, and podiatry school) this will be one of the first decision you must make at your professional school. In order to help you sort through some of the most popular choices, let me highlight some of the pros and cons of each text.  I am a firm believer that education should be tailored to the student. If your school/teacher tells you to buy a certain anatomy atlas, do not listen. This is like telling a left handed student that he/she must take a test using their right hand.  You must find a text that allows you to learn best. There are many options and each has its own strengths.

One IMPORTANT HINT:

Check out each atlas on amazon.com, you can browse the pages of each book in full color by clicking the "Click To Look Inside" tab over each book. This is the best way to see what you are going to like.

  • Updated April 2015

1. Netter's Atlas of Human Anatomy:

The Netter's  Atlas of Human Anatomy is the best selling anatomy atlas in the country, and my personal favorite.  The images are bright and colorful. The detail is crisp and memorable. I am a visual learner, and the bright images helped me focus and remember better. In fact, the images were so vibrant that I could often see them in my head during tests, allowing me to remember specific details in each image.  One downside to this atlas is its relative lack of information and detail. There is no text other than anatomy labels. There are no clinical correlations. There are not as many structures labeled as some other texts.

2. Rohen's Color Atlas of Anatomy:

Unfortunately for me, I did not learn about Rohen's Color Atlas of Anatomy: A Photographic Study of the Human Body until after my anatomy class. Had I known about this book, or seen it at all, I absolutely would have purchased this right off the bat.  Unlike many other atlases, the focus of Rohen's are real life photographs. There are beautifully dissected bodies, bones, and radiographs showing each structure. Where the anatomy becomes confusing, Rohen's uses color labeling to help students understand where structures are located in three dimensions. The images are high definition and very memorable.  The layout is crisp and clear.  I can not think of a downside to Rohen's. Perhaps if you do not want to look at real photos but rather artists' renderings, this would not be for you. Because the text uses photos, it is more difficult to see the fine and subtle differences in some structures. However, in my opinion, this is real life and your practice exam will not be based on artist's anatomy drawings.

3. Gilroy's Atlas of Anatomy

Gilroy's  Atlas of Anatomy does not seem like anything special at first glance. However, I have never met someone who used the Gilroy atlas and did not love it. In fact, it holds the #2 position for Best Selling Anatomy Books on Amazon!  One very useful aspect of the Gilroy text are the clinically oriented tables and boxes. In nearly every section, the text focuses on some of the most important clinical correlations related to the structures being discussed. These tables are clear and concise. While you can achieve the same information with a clinical anatomy book, some prefer to have both sets of information in the same place.  The downside in my opinion are the quite pedestrian images, but this does not bother most students.

4. Grant's Atlas of Anatomy:

Grant's Atlas of Anatomy is a well known text with a great history and crisp images similar to the Gilroy text. Many students use the companion, Grant's Dissector, in the anatomy lab. The images in the dissector are similar to the full text book. Many students at my school enjoyed this text and felt like there was a perfect mix of anatomy plates to clinical correlations in the book.  This is a no-frills purchase: it is one of the cheaper atlases but provides everything a student would need.

5. Thieme's Atlas of Anatomy:

The Thieme General Atlas of Anatomy is well liked by its users, just Google the title and you will find loads of students who love it. However, I have never actually met a student who used it. We had a couple copies in our library, but no one every looked at them.  If you are a textbook lover, you might want to look at the Thieme book. It reads more like a textbook than an anatomy atlas.

6. Clemente's Anatomy:

Little known Clemente's  Anatomy: A Regional Atlas of the Human Body is a sort of cult-favorite atlas. Many believe the illustrations in Clemente are the best on the market. They are clear and straight forward.  There is a good mix of clinical information. The price is low, and the satisfaction is high.  I have not used Clemente's but those who have used it say that they would use it again.

7. Gray's Atlas of Anatomy:

Gray’s Atlas of Anatomy is one of histories best-known atlases. However, I think that the atlases listed above have surpassed this historical text. There are newer versions, but I fear the TV show named after the atlas will forever be more famous than that atlas itself.  The images are nice and there are a number of photos and radiologic images which accompany the anatomy illustrates. Because of Gray's historical status, it warrants a few minutes to flip through the pages, but I would not purchase this text myself.

8. Sabotta Atlas of Antaomy

Sobotta – Atlas of Human Anatomy was introduced to me through a reader of this site. I did not have any exposure to it prior to the comment below. After reviewing the atlas at length I must admit that it is very impressive. The images are clear. There is ample text to explain clinical correlations. And, most importantly, the text can be purchased in a two volume set. This will decrease the load on your back by about 15 pounds every day. This is actually a very nice feature

 
 Did you use a great atlas that is not on this list?  Tell me about it!

Top Ten Books for the USMLE Step 1

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

Before I plunge into the Top 10 books for Step 1 let me first explain that books were only the second best resource for me while studying for Step 1.  I found question banks to be the most efficient means of studying for Step 1. In order to do well on an 8 hour test, you need to be accustomed to doing hundreds of questions in a day.  Doing well on Step 1 is not just a question of learning the info in the books I list below, but also a question of developing the stamina to say focused on the 349th question of the day….it is like preparing for a marathon. USMLEworld and the Kaplan Q-bank in my opinion are the best resources for preparing for Step 1, but you can not do questions for 1 month straight, you need to spend some time in books. Now for the books…

  • Updated April 2015

1. First Aid for the USMLE Step 1:

I don't know how they do it, but the First Aid people have an unbelievable ability to know exactly what is important to the people who write board questions.  First Aid is reprinted each year. I suggest buying one copy early in med school and study from it while you study for your other classes. Then, purchase the new copy when you are studying for Step 1.  First Aid is not sufficient for Step 1, but it should be required reading for all students as it highlights the stuff that you absolutely must know. Some students also recommend Kaplan's MedEssentials for the USMLE Step 1

2. BRS Pathology:

Another required book for Step 1 is a pathology review book. The two most commonly used books are BRS Pathology and Goljan's Rapid Review Pathology (#3). I prefer the BRS book because it is a no-nonsense text with a few pictures and tables but mostly focused on simple and clear text.  You should browse through both books before deciding which one you will use.

3. Rapid Review Pathology:

The other famous pathology review text for Step 1. This book is written by Dr. Goljan of "Goljan Lectures" fame. (If you do not have these lectures, see my article and links about the subject because they are fantastic). The content is similar to the BRS Pathology text but the delivery is quite different. This text is more visually appealing with colors, images, and many tables. Pick your poison.

4. BRS Physiology:

A broad physiology text is another book that most students use when studying for USMLE Step 1. It is unlikely that you will learn anything new when ready a physiology text. However, a physiology text will help you cement concepts in your mind. A great understanding of physiology will help answer the difficult Step 1 questions. I found that reading the physiology text for one organ system, then the pathology text and First Aid for the same was great preparation for questions on that subject.
.

5. High Yield Biostatistics:

You can not forget the small categories that are tested on Step 1. Biostat/epidemiology is one of these areas. I am sure I had 10-15 questions on these topics. The High Yield book is quick and easy; you can get through it in just a few hours. Don't go into the test without knowing all forms of bias and all calculations of a two-by-two table.

6. BRS Behavioral Science:

The behavioral sciences will also take up at least 5-10 of your Step 1 questions. These are hard to study for but you must find a way to do it. There are a few books options in this category, the great asset of the BRS book are about 15-20 questions at the end of each chapter. Many students swear by High-Yield Behavioral Science. This book is also very good, more concise, and easy to read. It does not have questions.

7. MicroCards:

Flashcards will give you a nice break from question banks and books. MicroCards have a ton of information. It may seem like some of the information is superfluous, but after taking the exam you will realize that many Step 1 questions ask very specific questions about bacterial anatomy and antibiotic targets.  I will never forget that on my Step 1 they wanted me to know the treatment for sporothrix schenckii.  So, yea, get some microcards.

8. PharmCards:

This is another set of flashcards that you can use in the bus, at night on the bed, during lunch, etc. Like MicroCards, these cards have a ton of information. However, you will be asked some very specific questions. One example I still remember is being asked the mechanism of action of ethosuximide.  Even though it is "Step 1" they will still ask pharm quesions.

9. First Aid Cases for USMLE Step 1:

You will find a common theme here: find something to break up the books and question banks. Though questions and the first 4 books will be your main ammunition to study for Step 1, you can not do that for a whole month. Flash cards and cases will help break things up while still learning and picking up some questions. The First Aid case book is very good and highly recommended by all. I used case books when my mind was tired of memorizing, and I think they helped me pick up a few questions. Most of you are also familiar with Kaplan's USMLE Step 1 QBook in print format, which is another great distraction of texts and computer questions.

10. USMLE Step 1 Secrets:

I did not use this book. I had heard good things during medical school, but it never made it into my bag. Since I wrote this post I have had numerous students write to me and explain that book became a foundation for them. As the book states in its Preface, it is not a stand-alone resource. The book aims to add clinical context to the data you will glean from texts and First Aid. I place it tenth on my list only because I do not know its true power. After reading through the book after-the-fact, I am convinced that I would have used it quite frequently during my study time.

 
 
 

Top Ten Books for Second Year Medical Students

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3. 

Organ systems will be the focus of most medical students during their second year of medical school. My Top Ten list for second year students follows this trend. In addition, it is never too early to start focusing your studying toward the USMLE Step 1, so a number of my suggests reflect this. For real Gunners who want to have Step 1 review materials during the entire second year, I recommend the Kaplan’s USMLE® Step 1 Lecture Notes 2015. As I have said in other posts, I am a fan of the Kaplan books. I am not paid by them, I just think they have a good product. Good Luck.

  • Updated April 2015

1. First Aid for the Basic Sciences, Organ Systems:

Organ Systems is similar to the First Aid book tailored for first year medical students, First Aid for the Basic Sciences, General Principles. The book is broad review of the systems based courses most often encountered during the second year of medical school. Some schools utilize a completely organ based system and this book might be useful during the first year as well. The First Aid series is a fantastic review tool and something to help drive home the most important points for your tests and for Step 1, but the First Aid series is never sufficient and should be supplemented with other materials. You can get a $40 discount if you buy both the Organ System books together on Amazon. Click Here: First Aid Basic Sciences (VALUE PACK)

2. Pharmcards:

Not only will these save you hours of time you would spend making your own flashcards, they have all the information you need for your first two years and Step 1. I used the Pharmcards brand (link to the right), however many students have told me great things about the competitor, Lange Pharmacology Flash Cards.

3. Clinical Microbiology Made Ridiculously Simple:

A medical student favorite. Nearly everyone uses this book, and for good reason. It makes the 'bugs and drugs' months of med school much more concise and tolerable. It is also great preparation for Step 1.

4. Rapid Interpretation of EKGs:

A must for learning EKG and for reviewing EKG interpretation later in your schooling and career. I learned EKGs first with this book and I still use it for reference during residency. Great book.

5. High Yield Neuroanatomy:

One of the best of the fantastic High Yield Series (Amazon link). I also highly recommend High Yield Embryology, Immunology, and Biostatistics for second year students. Each is rated very well by students.

6. BRS Pathology (or Goljan Rapid Review Pathology):

You will benefit from a basic pathology book during your second year. Use it to get a broad understanding of each subject at the beginning and end of each class you take. I prefer the BRS book, but many students prefer the Goljan Pathology book.  Later in this list I will suggest a full path textbook, but this is more for reference than studying.

7. Lippincott's Microcards:

Like the Pharmcards discussed above, I found these flashcards to be high yield and very efficient. You will save time by not making your own flashcards and they have all the necessary information.

8. First Aid for Step 1:

You should buy this book early in medical school and make it your regular study companion. They publish a new version each year, it is probably not a bad idea to get one edition early and another one to study with for Step 1. Remember, your first two years are there to prepare you for Step 1.

9. Robbins Pathologic Basis of Disease:

Large pathology texts can be dense, but they can be fantastic reference material. I have many times used this book when I have tried to learn a new concept or disease pathophysiology. The Robbins text is well written and easy to understand. It has always had the answer I was looking for.

10. BRS Physiology:

I like the BRS series. I did not learn about them until I began studying for boards. I wished I had bought them earlier because they are a great way to get a broad picture of organ systems and can really help put everything together.  My knowledge of physiology and pathology were much more clear after reading the BRS books.

 

Preparing for USMLE Step 1

I recently read a great article about preparing for the USMLE  board exams an another great medical student website called Medical Student Insider. The author is a soon-to-be psychiatry resident from UCLA name Mike Frazier.  Any time you hear or read advice about studying for boards you should always take it with a grain of salt; this is because we all study and learn differently. However, after scoring above a 250 of Step 1, soon-to-be Dr. Frazier's words pack quite a punch!

Highlights from the Medical School Insider Article:
  1. USMLE Step 1 is the most important factor in determining your competitiveness in the match.
  2. USMLE World is KING. I totally agree! After completing 2,000+ USMLEWorld questions, I sat down at the real Board exam and felt like I was just doing more USMLEWorld questions. They prepared me perfectly.
  3. First Aid for the USMLE Step 1 is a priceless book.  Buy it early, use it your first two years, and then devour it while studying for Step 1.
  4. Set a Goal!
  5. Create a study schedule to help you achieve your goal.

Read the full article to see what else Mike Frazier says about studying for Step 1.  

Dealoz: Textbook Price Comparison

Throughout college and medical school I had to buy thousands of dollars worth of textbooks. During my first year of medical school I came across the world’s best textbook website: http://www.dealoz.com/.  DealOz allows you to search all available websites, auction sites, book stores, and online sites for the textbook you are looking for. All you need is a title or IBSN and DealOz will do the rest of the work.  If you have every used www.kayak.com for flight tickets, DealOz works the same way by comparing all available options.

After inputting the book of choice, DealOz will compare all of these locations and report back to you the lowest price available. You can search for all available books, or you can choose to search only for ‘new’ books. DealOz will then link you to your seller of choice.  Try it, you will like it. I have saved hundreds of dollars using their website.

Again, here it is

http://www.dealoz.com/

The Best Free Software For Students

If you are anything like me, you will do anything to avoid paying thousands of dollars for the next Adobe product.  After ten years of higher education (and at least 4 to go!) I have tested hundreds of software packages; in this post I will list the best free and open source programs I have found.  Learn to love open source software…and you will soon learn how to spend those thousands of dollars you saved!  My software list will certainly not be a comprehensive list of all the great open source programs. For a complete list of free software programs I have three recommendations.

  • The best resource is sourceforge.net which is a nearly complete collection of all reputable free software.
  • FileHippo.com is a free website that lists hundreds of free software packages by category
  • schoolforge.net is a compilation of hundreds of free and open source software programs that is easily searchable.

 

WEB BROWSER

Google Chrome is a no-nonsense, super fast web browser.  Here is just one reference proving Chrome's speed superiority (from cnet.com). For mac users, Safari is a distant second.  While I used to enjoy Firefox, it takes nearly twice as long to load web pages than Chrome.  We all know how terrible Internet Explorer is.

 

WORD PROCESSING, PRESENTATIONS, SPREADSHEETS

OpenOffice is a well known counterpart to Microsoft Office.  The free software includes a fully capable word processor, a presentation organizer, and a fully loaded spreadsheet tool.  In essence, you get Word, PowerPoint, and Excel for free.  An added bonus, you can save any file in OpenOffice format OR in the corresponding Microsoft format so there will never be compatibility issues.

 

CALENDAR

My love for Google products will now show through.  Google Calendar is simple and highly effective.  You can merge nearly all online calendars into your Google calendar account. You can send yourself reminders using email, phone call, or text message. You can list recurring events in any imaginable patter (e.g. same date each year, 2nd Saturday of March each year, etc.)

 

IMAGE MANIPULATION / GRAPHIC EDITOR

1. Gimp is a professional image editor with a student's pricetag.  This free program comes with nearly all the bells and whistles you would find in the newest version of Adobe Photoshop.  The user interface is not idea and takes some getting used to. However, with a price tag of $0 this is a great piece of software.

 

2. I have heard great things about Paint.Net.  I must admit, I have never used it because I have spent so much time using Gimp that I don't need anything else.  However, it is worth a try if you are looking for more free graphic editing options.

 

AUDIO EDITOR

Audacity is a free, open-source program that facilitates the recording and editing of all audio and sound files.  I often use it to make my own 'radio edited' song versions.

 

PDF READER AND WRITER

Foxit Reader is far better than the free Adobe Reader. It requires far less resources when it is running on your computer, and it provides free mark-up tools including text editing, highlighting, commenting, and basic geometric shapes.

 

PDF CREATOR / CONVERTER

CutePDF Writer is the free version of CutePDFs vast line of products. The free writer allows you to convert any image, document, or screen shot to a PDF.  I use this product all the time. I save documents as PDFs and place them on my thumb drive rather than printing everything out.

 

ANTIVIRUS SOFTWARE

There are actually quite a few free antivirus options out there. Many of the web giants (Google, Yahoo, MSN, etc) have their own free antivirus software. My personal favorite is Avast!, which the program that comes with GooglePak.  Just be sure you click on the FREE version, as they have other options.

 

PERSONAL FINANCE

Mint.com allows users to track all bank accounts, credit cards, loans, and investments in one place. The software is similar to costly software like Quicken, but is free and is web-based: which means you can check your information on any computer, any time.

 

 

BIBLIOGRAPHY, CITATIONS, REFERENCE MANGER

The best resource in this category, I must admit, is not free. EndNote is a must-have resource for research and reports. It is user friendly and will save you hours of time by automatically plugging in your references and bibliography. There are a number of free programs that try to mimic EndNote's features. Some are good, but after trying them I ended up purchasing a student edition of EndNote because it is so much better.  Here is a list of free bibliography and reference managers. Or you can check out the wikipedia page which compares all reference managers, free and non-free.

 

STATISTICAL ANALYSIS

R (The R Project for Statistical Computation) is a free text-based statistical computational software program.  It is not for the feint-hearted. The learning curve is steep, but once mastered, this free software provides all the tools to run any statistical analysis, graph, or plot.

 

LaTeX EDITOR

Not all LaTeX editors are created equal.  WinEdt is a clean editor without the frills of other programs. I have used this software for 5 years and I have never had even one problem (something that can NOT be said about most LaTeX editors!)  The free version will frequently ask the operator to purchase the full version, but it is never required.

 

BRAINSTORMING AND MIND MAPPING

XMind assists individuals and teams in keeping track of ideas and goals. If you have never used mind-mapping software, you need to start. XMind creates the prettiest visual map, but there are other options that work just as well. FreeMind is another great one.

 

 

Did I forget something? If you know of more great, open source software please leave a comment.

How to instrument tie: A video tutorial

jpatrick.net

In recent posts I highlighted some great training videos on suturing and on one and two handed knot tying. In this post I will recommend a video tutorial for instrument tying.  As with the other suturing and knot tying skills, it is very important that medical students learn early in their careers how to instrument tie.  This is the bread and butter of knot tying.  If you are proficient with the instrument tie you will impress residents and attendings and they will be much more willing to give you responsibilities in the OR.  The video below is a straight forward review and tutorial of the instrument tie.  As with all other knots, remember that a square knot is not complete until you have made two opposing throws; otherwise you are tying granny knots.

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