Cardiopulmonary

Okay. This block was intensely fast with a lot of heavy and difficult things to digest, with all of it being really important. I mean, you can’t function without a working heart or working lungs, so learning these things are vital (literally… haha get it? as in vital signs? no? … okay never mind…) to being able to understand how the body itself works. (I chose not to try to post during this time just to try to stay on top of my course work.)

Currently, my class is a test class for trying out a new scheduling block. What this means, is they took 3 whole weeks out of the academic year to give us 3 weeks back during the summer. Now, this was done so we could use this time to build up our CV’s in-between our first and second year so we look more competitive for residency. They initially explained it as they took out parts of the course that absolutely weren’t vital for the boards, and that is how they could condense the time.

Where and how they took it out is still a bit of a mystery for me. I heard through the grapevine that they took a whole week out of cardiopulm, a whole week out of neuro, and a whole week out of MOD (which I think is more disease related and is structured to transition us for second year- I’ll let you know what it is when I get to it). All 3 courses are pretty important. Well actually, pretty much every course in medical school is important. So, if the above rumor of a week was taken out of each of these courses is true, why these were the 3 blocks chosen to have days removed beats me! There are a few current second years who state that not an entire week was taken out of cardiopulm (given how it lands with Thanksgiving), but it has definitely been a wild ride so far this block. Either way, the course directors chose to shrink down the curriculum and our class is the first to see if it works or not.

Initially it didn’t really bother me for the courses, since other than in MSK, there was a fair amount of time for things (in retrospect here). So it was no big deal. Now that I am in one of those courses where a whole week (allegedly) was removed, its kinda a big deal. It could also just be that there is so much to learn, that it was going to feel intense anyways, but I digress.

My Mindset During this time

Before the Midterm:

Okay, this is a lot. Like a lot a lot, but I might be able to power through it. I’m pretty much staying on top of it, and I’ve had multiple passes, so I think I might actually do decently on this test! (I even did a ton of practice problems too btw…so proud of me.)

I was confident. I felt like I knew a lot of the material, and the fact that I spent multiple times with each lecture made me feel pretty damn good.

Right after my Midterm: 

Imposter syndrome is real. Feeling inadequate is real. Feeling like the dumbest person in med school is exactly how I’m feeling at the moment.

I was feeling pretty defeated. I cried a lot after the exam and practical. I had spent so much time with the material only to feel like I knew nothing on the test. Or at least I was confident enough when answering questions only to find out I had answered them wrongly.

During this test our time was cut down per question. We also had an increased number of test questions, so overall the odds of finishing with much time to spare was slim. I finished answering my last question with 2 minutes to spare and that was after I had to quickly read through questions and make a gut answer because I didn’t have a ton of time to read them.

Not to mention I thought the practical was pretty hard, and I almost started crying the second I turned in my paper for the practical. It was just a bad day for me, I let a few things get to me, and it shot down my confidence pretty badly.

Fast forward a few weeks later…

Right after my final:

I’m finally done. I’m happy to be on break but upset that I feel like I studied so incredibly hard for these tests this round for it to not really show. I’m not asking for A’s here people, but I would like to think I could do a bit better prior to the curve setting in.

The funny thing about this test block is some of the weird graphs/cycles we learned I’ve seen before in COB. However last year, I didn’t really understand them very well despite the amount of time I put into it. This year thankfully, they made much more sense. Maybe it was because I really spent a lot of time with it. Maybe it was because it was my second time seeing it. Who knows? But I did finally learn or at least understand some of those important concepts I was supposed to grasp last year (lol).

Lecture and Exam Breakdown

For the lecture midterm:

Anatomy= 29

Embryology= 21

Histology= 4

Physiology= 46

Total: 100

I gotta tell you, the histology and embryo are not my favorite things to learn. I love the professor teaching them, but I really dislike the topics. They make pretty much zero sense to me in all aspects no matter how much time I spend with them. It really is quite a damper on my spirit at times, especially when there are a large amount of questions dedicated to the material on the exams.

For the anatomy practical: 50 questions, similar to all the other practicals I’ve mentioned in other posts.

For the lecture final:

Biochemistry= 8

Clinical medicine= 19

Histology= 10

Pharmacology= 9

Physiology= 54

Total: 100

The physiology portion of the first test was very much focused on pulmonary, which interestingly had a lot of math involved in it. The math on the test didn’t always make sense, and turns out I think I spent way to much time trying to mathematically figure it out than what I actually had time for. Because of this, I finished my 100th question with 2 minutes to spare, and that was only because I gut answered a fair amount of questions.

The second time around there was much much less math (since we focused on cardio physiology this time, and also didn’t have embryo and gross anatomy which was a plus!), I made sure to get about halfway through the questions or more by the first hour in. This way, I would (hopefully) have more time at the end to go over my flagged answers and see if I could rethink through them or get an extra point.

As stated above, we had our time cut down this time. In actuality, we’ve had our time chipped away at slowly since starting school, it just had the biggest impact on me (and a lot of my fellow colleagues) this time around. Maybe it felt worse because we had a lot more questions this time around. Maybe it felt worse because of the heavily involved math for certain questions. Either way, the time cut down on top of the actual tested material and types of questions asked made it very difficult for I would say about 85-90% of my class to finish before the time was up for the first test. I didn’t see very many people on the midterm get up and leave before everything timed out. There were a lot more people on the final that finished before time ran out, given the type of questions asked. And personally in my opinion, I think because there was much less math.

How I studied:

Hmm, I did a varying degree of different things with this test block. Now, I’m not in the top 10% of my class, so for all I know I could be studying absolutely horribly. In all honesty, how I studied in COB was much more lax than how I have to study in medical school. But as mentioned in prior posts, each person has their own way of digesting the material and their own way of accomplishing their goals for medical school. Actually, I kinda wish our school would get rid of school rank and go to a pass/fail system, this way I couldn’t be categorized based on the specific nuances of each course, just if I passed or not. But, I’m pretty sure they aren’t getting rid of the class rank system any time soon.

Prior to the midterm I didn’t go to every class. However, I did make sure to stay on top of the lectures. There was a lot packed into the first midterm (26 lectures and DSA’s), so I needed to stay on top of the material to get through it all! For the second half, I mostly went to class to get my first pass in. We had 23 lectures and DSA’s the second half, which didn’t feel nearly as awful as the first half (which is weird, because its only 3 lectures/DSA’s less).

For Histology:

I would go to class for these lectures. I really really don’t get histology, so at least going to passively hear it is better for me so far. Although if I’m really tired, I’ll just watch the lecture later. The second pass for histology would be to fill out the objectives/in-depth look at the lecture again. Third plus pass would be to review my filled out objectives and look at the histo specific slides.

There is a book for histo but I don’t find reading in the book super helpful for histo for me. I just gives me more details to confuse me with! So I stick to the information on the slides and the practice that our professor gives us.

For embryo:

I mean, I don’t understand embryology either, but I feel I have to write down every other word during the lecture. Because of this, I actually won’t  go to lecture, and instead will watch the recording. I find I have to stop the recording so often to type things down/ get the full picture that I would most definitely miss 75% of what was said if I went to class, making me more confused. So first pass was to watch the lecture and take notes. Second pass was to fill out objectives (if I could) to try to digest the material better. Third plus pass was to review the objectives and/or watch the recordings multiple times.

There is a set book for embryo, but just like histo, all the extra details actually confuse me.

For anatomy:

Oh man, blue boxes. I ignored this in MSK and learned the hard way on it. For some tests, they test heavily on blue box material from Moore’s book (one of our required texts, also happens to be the same author/book from the COB program). Other tests they don’t test as heavily on them, but its always when I don’t pay attention to them that they happen to pick out more to test on.

For anatomy lectures, I have learned that I can either actually sit in on the lecture in real-time or just watch it. The first pass (just like for histo) is to in-depth look at the lectures and take notes. The second pass I will fill out objectives and draw certain structures in my book. The third plus is reviewing the objectives and my notes/drawings.

Since we had anatomy lab for the midterm portion, constantly reviewing the anatomy or at least keeping up on it was very helpful. I tried to use my anatomy time to reinforce what I learned in lecture. I also made sure to start trying to look for structures on my structure list while in lab. That way, if I had questions I could try to flag down a tutor or an anatomy fellow.

In addition, we had less labs for CP this round in lab, and way less structures to learn or things to do in lab. Because of this, we had more time in lab to actually review/look at structures than we did in MSK.

For physiology:

Oh man, this information was a lot, and it was very detailed and heavy. I had to do multiple passes. Pretty sure I needed at least 3-4 or more for each lecture to really get it to sink it. Which is partly why I was mad when I didn’t get a higher score on my midterm. The pulmonology information was very math heavy and a lot of numbers to remember/understand. The cardiac was more conceptual and less math which was nice. For the midterm I did a lot of practice problems (again, math related and tbh I suck at math). For the final, I didn’t do many practice questions other than during our Q & A sessions because there wasn’t nearly as much math. It as mostly interpreting the cardiac cycle/venous return curve questions that I was able to understand quite well.

For biochemistry:

I honestly did this stuff last-minute. We had 2 lectures right before the test (and by right before I mean the Thursday and Friday before our Wednesday test…) that I watched and just took notes on. There were some practice questions hidden in the lecture that I used, but other than drawing out the pathway and just taking plain old notes, I didn’t do anything additional.

For clinical medicine:

I learned how to read EKG’s this block!! YAY!!!!

Learning this was actually a lot of fun. In fact, I’m pretty sure I did the EKG lectures and practice about 4-5x just because I was happy to finally be doing doctor-y stuff. I attended all of these lectures because I was so excited, and I believe I only got 2 of the EKG questions wrong (if my memory serves me correctly from the review early today). Basically, attending lecture and just reviewing the slides was enough. We have 2 really awesome physicians who are still practicing ER medicine when they aren’t teaching, and they are all about teaching us the “quick and dirty” way of going about things to make sure we get the correct answers, understand, and don’t do extra work. I really really like these professors.

For pharmacology:

Attending lecture/viewing the recording was my first pass. For this time around, we had one actual lecture. This lecturer tends to give us a pre-recording/lecture to view AND DSA material to digest before the actual lecture, and then during the lecture has case studies/questions available. I honestly took forever to digest the pre-material before looking at the recording, but after going through all of this initially, I just needed to refer back to my notes that I took to review. I didn’t bother with doing objectives or anything like that for this.

What I would change if I could do it over again:

I needed to spend much more time with embryo. I feel like this was a huge downfall my first test and even though I tried to spend time with it, it was very complicated and warranted more time to really try to understand it. I also likely would have benefitted from watching the other campus’ lectures on the material as well, but I don’t super love how the professor teaches. Because of this, I usually don’t watch their lectures on top of mine for embryo, but in this case, it could have helped.

The other big thing I could (or should) have changed was asking my professors more questions. I had plans to go to office hours and ask questions, but I’m really bad at doing this. My pride usually gets in the way. My reasoning is always “I haven’t caught up yet and I need to catch up first before asking questions” or “I just need to spend more time with it to understand it… I can figure it out myself”.

Only one more course to go before the end of my first semester guys! So excited!

As always, let me know in the comments below what you liked or didn’t, what you found helpful, and what you want to hear about!