Month: October 2018

Immunology Block

Oy Vey!

I tell myself I’m going to do better every single time, and that I’m going to change into better study habits, go to class more, stay on top of things, and live my best possibly healthy self while here.

Courtesy of giphy.com

Yea that’s a joke. Maybe I should look into hiring a personal life coach/motivator, because my self techniques are definitely NOT working right now.  I’m halfway through my first semester of medical school and I still have a lot of work to do. Not sure if I’ll ever get on top of things, but just like always, I’m at the crossroads of just finishing a block and about to start another. So of course I think I’ll miraculously change my current set-in-stone habits when in reality they will probably just get worse.

But let’s get into what you are all really here for. How does immunology in medical school go and how did I approach it?

COB Immunology vs COM Immunology

For those of you new here, I did a one year master’s program at KCU, which happens to be the current medical school I attend. The master’s program I attended is affectionately called “COB” for college of biosciences, while the medical school is designated as “COM” for college of medicine. If you are interested in going into the COM program like most of the students who partake in the COB program, then here are some things you should know:

Books

The authors of the book(s) that you use in COB and COM for this course wrote 2 versions: A large, very detailed more molecular based version of things and a smaller, more condensed version of things. As you can see, the blue book is larger and thicker, and it has a TON more text in it. The purple one is smaller and thinner, and honestly even though the chapters are about 20-25 pages each, the figures take up a lot of space/pages. In reality there really isn’t that much text.

The figures are the same. The content is the same, with the exception that one is paired down. And of course the authors are the same, so literally it’s the same book, just one is more detailed and one isn’t.

Why? Well in COB, it is a program designed to yes, help you get into medical school because it’s all hard sciences, BUT it is also geared towards those that are interested in becoming scientists and researchers. The whole time you are in COB quite honestly you learn SO.MUCH.MORE.DETAIL about a lot of these core classes, because they are assuming you may decide to research. You need this background and minute detail in this case.

Whereas in COM, you really only learn a very general overview of things and then at the end they hit you with a lot of clinical stuff which honestly, I did terrible in.

Detail:

Again, you learn more detail in COB than COM as noted above. Say for example, the molecular pathways of activating T and B cells, we had to learn every single step in COB. Every step! And then only ended up getting like 2 questions on it. Ugh I was so mad that I spent all that time on it. But, we needed to know those pathways in molecular for the next test block, so it just made me lazier in studying for molecular at that point in time.

In COM, you kinda learn the activation pathways for T cells, but it’s really general. There aren’t really any specific names for the enzymes involved (there are a few key ones to know/go over) and then it’s like here’s the pathway but you just need to know what happens in the end. For B cells, the book didn’t even really discuss it much. We had a few practice questions on it but NONE on the exam.

What I’m saying is the focus is very different between COB and COM, even though it is taught by the same people.

Questions:

Dr. Shnyra teaches the COB immunology course AND the COM course at the Kansas City campus. Dr. Bowden teaches the immunology course for the COM students here in Joplin. They teach slightly differently, but overall it’s the same stuff as they go off the books. Both teachers ask questions very similarly on exams. Just like in COB, in COM Dr. Shnyra sends out practice questions. And just like in COB, you need to pick the most correct answer out of the bunch. Dr. Shnyra has a ton of questions by the way in a bank, so if you go from COB to COM, you will get new questions when he sends out the practice sets. Most COBer’s used both the old questions from COB and the new ones sent to us during our COM course.

Breakdown of the Exam:

The midterm consisted of 65 questions:

Histo: 15 questions

Immunology: 50 questions

This first test heavily tested if you understood the difference between innate and adaptive immune systems, and if you could tell the difference between MHC class 1 versus class 2. It is very similar in COB, as this course tends to be taught more broadly at first then narrows in to more detail as you progress.

Final: 85 questions from immunology only.

The final was cumulative, minus the histology information.  Unfortunately because the midterm was easier for me I didn’t try to hard on the second test. Which was a massive mistake for me (I seem to making a lot of those here). Either way, in both COB and COM they really like to test hypersensitivity, because that is very relevant to your future patients that you will be treating. In COM there are more diseases you are tested on, but are more rare when treating patients in real life (but still need to be aware of).

How I studied:

#notsponsored

I completely filled up my sketchbook between biochemistry and musculoskeletal, so I had to get a new one. They are by this company called Denik, which you can find at Michael’s craft stores.  I like that the covers have more strength and girth to them than the hardcover sketchbooks, but are still soft and mold-able enough that I can move them fairly easily. They are a bit more expensive, but the money you pay goes towards schools in less privileged countries. Which really means I feel less awful about spending the money. Totally wish this was sponsored but long story short, I like their sketchbooks.

So much so I ended up buying 3.

I didn’t attend class very much although I heard great things about the Joplin professor for this campus. I found myself not able to focus very much sitting in class over the past few weeks, and felt it was better to try to self-study. There are pros and cons with that though.

Immuno notes

Pros include that I could sleep in and go at my own pace. Especially since I had a hard time paying attention in class, it was better that I didn’t feel I was wasting valuable study time and using it for something else instead.

Cons include that I am a terrible self motivator. And really didn’t stay on top of things very well.

But because I self studied, I actually ended up reading the book from cover to cover. Each lecture was correlated with one lecture, so instead of reading the powerpoint slides and just trying to piece things together from there, I read the book. There was some great background and explanations with doing it this way, but also a lot of additional information that wasn’t super necessary/on the lecture slides.

The extend of signaling, which my version was more detailed than the class version.

I also didn’t really feel the need to look at both campus’ lectures this time. Because each lecture has to correlate with the learning objectives posted, each of those learning objectives came from the book. If I felt I needed more explanation and couldn’t get it from the book or my campus’ lecture slides, I would hop on over to the other campus’ slides to see if there was a better explanation there!

I also did a lot of concept maps and drawings for immunology to help organize my thoughts in my book. My first pass was reading the chapter, the second pass was making notes on that chapter, and the third pass was reviewing the notes and/or looking at lecture slides. I would have done slightly better if I spent more time on the last 2 lectures as there were many questions about diseases and disease pathology that I just couldn’t answer on this year’s test.

If you have never taken immunology before, I still stand by using “How the Immune System Works” by Lauren Sompayrac (which was mentioned in one of my COB posts). It doesn’t matter which edition you get, in fact you could still get the 2nd or 3rd as it is much cheaper than the newer one. They don’t really change. I currently have the 4th and I believe E has the 5th version. Literally the same book except a different color cover.

This breaks things down really easily and helps explain some basic concepts in immunology. There are also some great figures in this book regarding pathways that sometimes Dr. Shnyra uses (not sure about Dr. Bowden) but in general can help make things understandable. I recommended this book to several other first years and they got great mileage out of it.

Scheduling:

This was a 3 week course. Our midterm was on the second Monday of the course, and our final was on the last Friday of the 3 weeks. As medical school is progressing, we increasing have other testing and competencies thrown at us that aren’t just involved in the core course we are in.  During this block, we had our first experience with 2 tests in one week on top of an SP encounter (or our practice sessions on how to interact with patients using actors). If you head on over to my Testing Schedule in Medical School post, this will give you a broader view of the amount of testing/competencies I’ve had so far.

Thankfully we didn’t have anatomy lab this time around on top of learning how to deal with juggling multiple testing situations this time.

As always, comment down below for things you found helpful or would like to hear about next! 

Testing Schedule in Medical School

Hello Med Hatters!

This segment will be quite short compared to my other posts. Since starting medical school several weeks ago, both my classmates and I have noticed that as time has gone on, the amount of competencies and tests in a week have increased. If you are looking for a more realistic view of the testing schedule that occurs in medical school, then I hope this can clear some things up!

Kansas City University of Medicine and Biosciences, or KCU, is known to have one of the hardest curriculums in the D.O. sphere. Rocky Vista is another school with a very difficult curriculum. So even though going through this particular schedule is difficult due to the intensity, the board scores for our school are pretty damn high. Consistently. In fact, our school brags about it quite a bit!

So if you are just roaming the internet looking for information on scheduling for medical school, you are particularly interested in KCU’s scheduling and testing, or you are just curious in general, then you’ve come to the right place.

Some Background:

For those of you who haven’t been poking around my site, let me clarify what some of the things on the schedule mean.

PCM– this is our Principles of Clinical Medicine course or our “how to be a doctor” course. This includes learning how to take histories and write notes, to learning how to do exams, and trying to critically think and figure out what our patients have. Eventually we will learn to incorporate treatment plans, but for now we are still learning how to do basic interview and assessment skills. This course not only has exams in it, but things called SP encounters.

SP encounters are where we have an actor who has a script they stick to and play the part of a sick patient. The scenarios are relevant to what we have learned so far in medical school. Even though they aren’t completely random like it is in the real world, as first years we’ve only learned so much, so they pick from one of the many possible scenarios we’ve learned so far and see if we can figure it out. We need to hone in on our interview skills, professionalism, directing the flow of the visit, and learning to exam. All of these things come with plenty of awkwardness and terrible time management, so that is why we practice! As a first year, we aren’t really graded except to make sure we show up. They know we are all terrible at this, so they don’t have much to actually grade us on yet.

{Update on this: We did have one graded SP encounter in our first semester. This basically was graded by our SP, or our fake patient/actor. We were graded on if we could get 70% of the history and could get up to 70% of the exam for the complaint given. We were also graded on how we communicated. In order to pass we had to get 70% on both parts. There is clearly some variation in grading as each person was graded by a separate SP during the groups. If the SP deems we didn’t pass, our instructors will watch and grade the video to make sure it was fairly graded.}

Another component besides exams and SP encounters include competencies. This can be done for a range of things, but is mainly used to test a certain set of skills. Skills that we’ve been tested on so far in competencies include taking vital signs, doing injections, and performing certain exams.

OS– OS stands for osteopathic skills course. This is where we learn and get tested on osteopathic manipulation/treatment that all D.O.’s are required to learn. Not every D.O. chooses to use this skill in their real life practice, but many can incorporate even just small amounts of it into their practice. Some physicians choose to only do OMM or osteopathic manipulation as their practice.

In OS, we have lectures and labs. The lectures are like your typical lectures that you have in other medical school courses or even college in general. The labs are where we learn and practice the techniques, and we are required to keep and fill out a log outside of lab time to make sure we are practicing on a range of people.

In OS, we have quizzes, exams, and things called CPA’s. I wish I could tell you what a CPA stood for, but basically it is an exam where we have to explain and do a technique on another classmate. So we learn a bunch of techniques to get tested on one or two of them during the CPA, and we generally have no idea which one(s) they are going to choose for us to do. It is different for each partner and each testing group.

Block Courses-These are your typical “classes” in medical school. Such as your biochemistry course, your musculoskeletal course, etc. These courses usually only consist of quizzes and exams, but if there is a lab component to it (meaning the anatomy lab), then we also get a practical which tests our laboratory knowledge as well.

Med Info- This is our medical informatics class. It is a pass/fail class and we don’t have regular or rigid classes with this. But we do get a lecture every once in a while that results in us having to take a quiz. The quizzes aren’t very hard, but they do take time out of your day and other studies in order to do them.

Bioethics– I did not include my bioethics course as the quizzes don’t tend to show up on my schedule, and I would have to hunt on blackboard to find them (I’m too lazy at the moment to do that). Similar concept occurs where as with our med info course. We have a lecture course (or sometimes a small group discussion) every once in a while, and then we get quizzed on the information. The bioethics quizzes can be taken more than once thankfully, so if we are really stumped on something we can re-take it.

Click the link below to be taken to the general schedule.

Medical School Schedule-First 3 Months 

{Update: I have added up through my first semester to give you a full idea of how our semester went!}

Let me know what you think in the comments below or what you would like to see in the future!