Ahh yes. Renal. My new arch enemy.
You see physics and I go way back. This love-hate relationship (but really more of a hate-hate relationship?). This “I know I need you for medical school but I really really despise you and will never understand you” type of relationship.
Don’t ask me how I got through it. I had to retake physics in undergrad …
But now that physics has left me, renal has since taken its spot. Why you ask? Could be many things. Could be that I simply just don’t understand the kidneys. Could be that I didn’t feel I benefitted from my lectures. Could be I really didn’t understand the link between lectures and the questions come exam time. There could be many possibilities with many combinations.
Could have been I failed both tests. Ya know. Might be that. (If you’d like to check out this story, head on over to my “I survived my first semester of medical school” post).
But either way, me and renal are no longer friends.
To be fair to renal, it was also likely that I simply just did not understand majority of it. No matter how hard I tried to. I definitely employed many different study techniques and switched it up between the midterm and final thinking that would help. But for as much effort that was put in, and attempt to do better by the time the final came around, renal still had me like:
Breakdown of the Exams:
The midterm covered 9 lectures in several different categories.
Biochemistry: 5 questions
Embryology: 5 questions
Histology/Anatomy: 9 questions
Physiology: 41 questions
Total: 60 questions
The final exam covered 10 lectures. This time though, there were not as many different categories.
Immunology: 8 questions
Physiology: 52 questions
Total: 60 questions
There was no lab component/lab practical this time around. We will be covering this in our upcoming GI course in it’s lab component.
Now, I know what you are thinking; Joyce, there were barely any lectures on these tests. Why are you making such a big deal out of it?
Or maybe you aren’t thinking this. But I definitely am.
That’s… that’s a great question. This block had a lot of physiology on it. When we started way back in our MSK block, we had several different components to the exam. So if you did poorly in one section, or didn’t think you would do stellar on a section, you could try to do well on other sections. We had something similar to this for most of cardiopulm and on our midterm for this block. But lately in our blocks, there has been a large portion of physiology.
There really isn’t a ton of additional things to focus on this course. Majority of the other sections (biochem, histo, embryo, anatomy) where pretty straight forward. We had one lecture combining histo and anatomy, so there was only so much they could have pulled from that lecture.
For biochem, our professor marked the important slides, but her in-lecture practice questions (and honestly the 5 test questions) were based off of the boxes from our Panini biochem textbook on diseases. (Which she marked as important and discussed in class for us to know!)
Oh! And there is math. Not quite as much as there was in cardiopulm, but there is math here. And they like to be tricky and put the numbers they give you in different units; meaning you have to spend time converting it to the correct units or you don’t get the correct answer. Another thing is too; is pay attention to the examples they give you in the lectures. They will have some math problems very very similar to how they do those problems.
Studying:
Well, take my advice on this section with a grain of salt. The recommended book (Renal Physiology (6th ed.). Koeppen, Bruce M.; Stanton, Bruce A.) is needed for the DSA readings. For this course you will definitely want to read. The lectures and content are confusing, and you will want to have at least one solid source to go back to. I heard this from several second years (to read that is), and although it didn’t get me all the way there, it definitely got me close enough to an almost passing grade. (Side note: many of my classmates who did do better than I did also had to read a lot).
Some of the lectures are based off of Guyton and Hall Textbook of Medical Physiology [(13th ed.). Hall, John E.]. There were lectures that were almost entirely identical to a chapter or so in this book. For other lectures, they were based off the recommended textbook.
The main thing to take away here is understanding the processes themselves. Which is a giant hurdle in and of itself! The kidney is complex and does a lot of crazy but important things in the body. So the first step is to learn the processes as is.
Next, you need to be able to know that if you change on thing in the process, how this affects everything else. There were not a ton of charts in our lectures, but there were a lot of questions that required chart answers. I would show you, but I can’t seem to figure out how to do it. So imma just explain it to you.
There will be a series of columns with different headings, such as Na, K, renin, angiotensin II, Mg, water in/out, etc. Each subsequent row would be your answer choice, so the first row under the heading would be labeled “A” and each subsequent row will be another possible answer choice. Under each heading will be an arrow up, and arrow down, or an arrow sideways (meaning unchanged). Based off the question asked, you would need to know what happened/how each heading would change.
It’s honestly a pain in the butt. See why you need to spend time with the processes? You have to know what happens to each thing.
I really didn’t like the textbook, so I didn’t do as much reading as I probably should had for the midterm. But, I also had plenty of other subjects to be tested on. For the final however, I read more. I read almost all of the chapters that were tested under the final (and for this block you will read almost the whole book). But I also went to filling out objectives for most of the physiology lectures. Why? Because technically they can only test questions that can be linked back to a learning objective. But really, there is quite the broad interpretation for that. (There were also some learning objectives that happened to be based off of the end of the chapter questions in the recommended book!)
Additionally, just like with every other subject, I wrote a lot. This works for me, although it is quite time consuming. I tried to focus the big picture pathways. And as much as that was needed to answer questions, it was in the additional small details that helped lead you to an answer…
Lastly, make sure you do practice problems as you are going through the information. I’m terrible at this, because I feel like if I’m going to do the questions I want to make sure I know the content first! But apparently, this is not a good way to learn (according to my learning specialist at school).
The practice questions that were given were taken from the back of the recommended book and from the Guyton & Hall review book. I still recommend that you know your processes well and what happens when you change one part (or multiple parts) and how the different moving pieces respond. Otherwise, get your hands on practice questions; you’ll need all the practice and help you can get for this section!
As always, let me know what you liked, didn’t like, or what you would like to see next in the comments below! Hopefully I will have more useful information for you guys in the next block.
