KCU – Page 16 – We're All Med Here

Second Half of MSK…

IT’S FINALLY DONE.

YAYAYAYAYAY!!!!

This block, which was brutal in content and in length, is finally freaking over. I have never been so excited for a course to end. In fact, right now MSK (or musculoskeletal) makes biochem look a brisk breeze in late summer in comparison (for me anyways). They both definitely sucked, but MSK by far took the cake for the most suckage that occurred. And if you ask the second years or my classmates looking for validation, MSK is the hardest course of this semester. So, I’m double glad it’s over.

A brief recap from the first half: MSK is a 6 week-long course. We had our midterm at 3 weeks in and then had our final a couple of days ago. If you are interested in my mindset, how I studied, what I could have done differently, etc, check out the first half of this post here: “First half of MSK”.

Exam Breakdown:

We again had our written exam in the morning and then had our anatomy practical in the afternoon. It was the same set up as the midterm where we all take the written together in the lecture hall, but since we have to do the anatomy lab in smaller chunks (not all of us can fit at all 50 stations in one go) we were broken up into 3 separate testing times. Last time I was in the middle group to go, this time I was the last practical group to go.

Written Exam Breakdown:

Anatomy questions: 39 [From 10 lectures]

Biochemistry questions: 4 [From 1 lecture]

Histology questions: 20 [From 5 lectures]

Pharmacology questions: 7 [From 1 lecture/DSA]

Physiology questions: 22 [From 4 lectures]

Total: 92

Yes, we had biochemistry this time on this test. Which honestly was one of the easier lectures to digest because our professor discussed what we had already talked about in biochem, just in less detail and more oriented for musculoskeletal use/correlation.

Anatomy Lab Breakdown:

There isn’t a set breakdown for how this section works, but I will explain how the lab practicals run. I’ve drawn a diagram that shows how we move in the lab during the practical. There are 50 stations, and several rest stops. There is 1 minute (or about 1 minute) at each station for you to find the pin/tag, figure out what it is, and write it down. In Joplin this year, we wrote down our answers on paper instead of using iPads. So we each started at a station and rotated through until we hit every station.

The structures that can get tested are all on a printout that they gave us at the start of this section. Technically, they are not supposed to tag things that are not on the list. However this also means that when you put down your answers because we have a printed list, it needs to be referred to in the term they specifically give and spelled correctly (which is according to how they spell it on the sheet).

In order to study for this, we would take the structure lists and just go around to different bodies and see if we could identify what was on the list. Some bodies had things that other bodies did not, either due to it being cut or removed at that tank, or not being dissected out.

Rotation through the lab during practicals.

Key: Purple boxes are the tanks. Tanks are what we call the tables that have our cadavers on them. The row on the bottom of purple boxes simulates the back wall in the lab. On the back wall are usually bone models, ligament models, skeletons, or radiographs for us to look at. Things that we cannot see on the cadavers or cannot see well on the cadavers but they still want to test us on.

Red x’s are rest stations. There is a rest station right before the start of the tanks, a rest station right before the back wall after all the tanks, and rest stations after each row of tanks.

Blue indicates the numbers or questions. So for each body, there would be something tagged on each side. That way they could use one body for multiple questions.

Black arrows indicate the flow of the lab. So if you start at #1 and follow it down, you will see a snake rotation around the tanks.

How I studied:

I had greater motivation this time around, although unfortunately my written scores were still lower than I would have liked. I increased my percentage by 7% from the midterm though! So that means my hard work paid off…just not to the degree I was hoping for.

Due to my motivation early on (which most definitely dwindled closer to test time), I was able to really learn the first 2 days of material on Sunday before we started. Since I did that, I was mostly on top of material for that first week. In week one for this section, we had a total of 11 lectures that first week. They did tend to pile on the lectures heavily at the start of that week, as we would have 3 or 4 lectures in a day. Thankfully that first Friday we had off, and things weren’t as intense going forward. There was a fair amount of gross anatomy and histology lectures though this week, and the histology was definitely harder to digest for me. The second week we had 7 lectures to learn, and the third week we had 2 lectures of required material.

You are probably thinking Joyce, you had SO MUCH TIME then. Why was this so hard to manage? You are just being lazy here.

Yes, yes I was lazy to a degree. We did have lectures for other courses interjected into that schedule, and we also had an OS exam (osteopathic skills) on the second Friday. The day before a test they usually give us at least half a day if not the whole day off from lectures to study, which is why there weren’t as many lectures that second week. We also had an SP encounter in the third week, so we were practicing on actors with taking histories and exams which cut into lecture time. Lastly we had an injection lab skills check-off and an exam check-off sprinkled in there too!

Check-offs or competencies are where we demonstrate skills, in this case injecting different ways and doing different exams for a specific complaint, and we get graded on how well or competent we are in those skills.

So even though the anatomy load in and of itself was less as the weeks for this section went on, we still had several things to do. To be honest, because we had an OS exam on that second Friday and I had been punting OS so hard before, I mostly studied for OS that second week instead of keeping up on anatomy. And I hadn’t gone through everything for the first week either, so I was a bit behind.

But hey, at least this time around I actually got to go through all the lectures more than once!

Lecture:

I did not attend most lectures this time around. I found the other campus’ material to be more in-depth with more detail, and would watch their lectures after sleeping in a bit. If I was feeling well enough to get up, I would go to my campus’s lectures. Otherwise, most of lectures were watched on campus later and then I would review both sets of slides to make sure I got the information presented to both campuses.
I did more objectives for my histology lectures and physiology lectures this time around. It made it easier to put these confusing sections into my own words and arrange it differently than what was on the slides.
I spent more time looking at the slides for histology so I could identify them on the test (for histology, sometimes we get identify this slide questions and other times it is multiple choice on text about histology concepts).
I drew out all of the anatomy. I ain’t no Picasso baby, but drawing it was much more helpful than just starting at an atlas 50 times. I didn’t necessarily keep drawing out muscles and things every time I reviewed them, but I did in my notebook while doing my first pass/in-depth notes for the gross anatomy lectures.
I wrote out my notes more this time. It worked in biochem, and I was hoping more would stick/I would understand more this way. I completely used up more than half my sketchbook/notebook this time though due to it. So I’ll have to get another one!
I did more than one pass on the material this time.

Lab:

I spent more time dissecting on my own time, or trying to find structures on my own while we were still dissecting. I also found it MUCH MORE HELPFUL to learn some of the structures (if not all of them) before that day’s lab. It made going to lab much more beneficial and didn’t feel wasteful of my time as I had an idea of what I was looking for and dissecting.
My group and I also made sure that we tried to dissect as much as possible in the allotted lab time, and if we couldn’t get it done we decided to split up the work and come in later to finish it. That way, we weren’t behind and everything was dissected.
On top of going in and dissecting outside of lab, I went in and just reviewed structures on the list on a few different bodies. I would start with my own, and then work to other bodies to see if I could find the structures.
A few days before the test, a group of friends and I went in together and just quizzed each other on structures on the cadavers. This was great because we each knew something that someone else didn’t, and we were able to point the structures out on the cadavers and teach one another a bit.
I most definitely utilized the bone boxes again for the bones.

Overall Thoughts:

Like I said, overall I did do better, just not by much. I was able to go through more material, spend more time with it, and understand it a bit better. I’m happy that I improved on my studying technique as well. There was definitely much less crying happening this time around. They have yet to officially release the scores (I just have my raw score after taking the written) and they have not graded the practical yet either. So we will see!

Let me know what you liked or didn’t like about this post! Make sure to comment down below to let me know what you would like to see or if you have questions.

First Block of Medical School: Biochem

Whoa…

Just whoa.

Holy shit balls I did not expect this block to be so intense. I have never felt this perpetually tired yet able to function at the same time. What day is it? Who am I? Do I have an assignment due today? IDK anymore.

These first 3 weeks of medical school have been way more intense than I expected it. I got tired of everyone telling me how hard it was going to be, that it “was like drinking from a firehose”, and that you will feel so incredibly overwhelmed and to remember why you wanted to be here in the first place. At the time, I was thinking “yeah, yeah, I know it’s hard. Getting here was hard and I’m prepared for the hard road ahead.” I was ready to start and to get on with my medical training so I could finally become a doctor.

But my god, there was absolutely no way to prep myself for this.

The only way to describe this is to you is you think you are prepared to get your ass handed to you, but there is no way to prepare or explain it other than you just get through it. You just kind of have to wade through it. It will feel like a lot. Some of you will feel like you won’t be able to handle it. Some of you will be able to handle it but not very well. And others of you will on the outside look like its no big deal, but on the inside be questioning your every move. (I really don’t think anyone gets through their first block completely unscathed here; even for former master’s students who had the same professors the year prior).

Remember: there are thousands, hundreds of thousands of physicians that came before you. There are hundreds of those student doctors who went to your school through the same curriculum who made it through before you. If they can do it, so can you.

Scheduling:

Below is the schedule for our week 1. It was intense, and the first day they started us out with a pretty full plate. Over the course of this week, we had 11 biochem lectures and 1 DSA (or additional reading material/lecture material that did not have time to have a set lecture dedicated to itself).

We also had several PCM lectures (or the “how to be a doctor” class), some OMM lectures and labs (or the osteopathic manipulation course), a med informatics course (a library course? or how to utilize the library resources), and a bioethics class.

Week one schedule (I know my editing is terrible). This is as big as I can get it.

The way my schedule is set up is there is a main course, in this case biochemistry (blue), and there are several ongoing courses running at the time. Biochemistry usually had 1-3 lectures every single day. The next two biggest courses are the PCM (gold) and OMM (purple). We have OMM lab once a week and usually at least one PCM lab and/or interactive group involved each week as well. Everything else is either integrated every other week or at a lesser frequency than 1-2x a week (med informatics- forest green, bioethics- highlighter yellow, tutoring- muted green).

Both in OMM and biochem we had DSA’s. So things to learn outside of lecture itself that are testable material and usually either foundational to learn further knowledge or supplemental to help augment another main idea. So important stuff to put in that brain.

This first week we learned basically nothing but metabolism of the body. We did have the foundational enzyme kinetics, delta G, and things of that nature. But for majority of the week it was metabolism (with the exception of heme metabolism). There was a lot of drawing out pathways to try to understand the steps and process itself, and then ultimately how it all inter-related. As a student doctor, you have to know how things are inter-related in the body in order to see if something goes wrong, does it affect more than one thing? (The answer is usually yes).

We had a quiz on the Friday of the first week. We had our midterm on the Monday of the second week. We had another quiz on the Friday of the second week.

This week, it was less hardcore biochem and more molecular and genetics that were integrated in. So for the whole first week, all of our lectures were straight biochemistry. But this second (and third) week, we had genetics, some biochem, physiology, and histology integrated in.

I did not do a schedule for the third week, but there was a biochemistry quiz on the Thursday of the third week and our biochem final was the following Friday. In total, we had biochemistry and molecular all in 3 weeks.

Compared to COB: we had 15 weeks (1 semester) of biochemistry and another 15 weeks of molecular alone. So yea, it was a wild ride. We did not go as heavily in-depth as we did in COB on the science side, but it helped knowing the background of how it worked which made it a little easier to just focus on what I needed to focus on.

How I Studied:

I mean, I was all over the place. For some lectures I did objectives. For most of them I would write out what was highlighted in lecture in my book as writing for me does more to actively get it in my brain than mindlessly typing. I have a blank sketch book that I have written my notes in so it is all in one place. This way I can easily refer to my notes and what I’ve highlighted and have everything in one place in my own words. That way I could re-organize it in a way that made sense to me and also add in information that I’ve remembered or could easily find to connect different lectures together.

I also drew out a lot of the pathways. The only way to really cement them in my brain was to keep drawing them out. If any of them connected together, I needed to physically see it (the second photo of notes shown is an example).

For most of the diseases, for learning what vitamins needed what cofactors or what diseases are caused by vitamin deficiencies/symptoms, and a few definitions, I used notecards. For biochem specifically I used the Anki flash cards. The computer the app was free, but if you use it on your iPad or your iPhone I believe there is a hefty price of $25. Since I’m cheap, I only used it on my computer.

Why did I use this one? Well for biochem since I had limited time and needed to get more in my brain, Anki has the option to immediately redo the card, come back in 10 minutes to show you, or bring it back in a few days time. It’s designed to help space out your learning for maximal memory and retention. Plus it tracks my progress and I would try to do flash cards everyday. If I needed to make a chunk of them, I didn’t study as many of them. But if I was making less flash cards or didn’t need to make any flash cards, I would do a lot of running through them. The nights leading up to the tests I would try to run through all of them. Anki also has the option of how many cards to provide you each day, and the ones you struggled with the most re-appear more often. So there are new ones that get added in to your pile, a chunk that get reviewed, and the ones you struggle with. If you do well on that block or a chunk of it, they will use different cards.

I do use study blue or quizlet for my OMM course information though, but this one I’m less pressed to learn the information in a small amount of time.

Then on the weekends or the night before a quiz, I would review as many flash cards as possible and read through my book of notes. If I needed clarification, I would go back to the slides.

The more passes on the information you do, the better you will learn it. I have a rule of 3: If I can see the lecture material at least 3 times then I will get a good portion of it in my brain; or at least enough to reason through and make some connections when prompted on a multiple choice test.

I.e.: If I look at the material the night before (which only happened a few times) that would be pass #1.

Attending lecture would be pass #2.

Doing my own notes would be pass #3.

Reviewing repeatedly would be additional passes.

Not gunna lie, it’s hard to fit in that many passes of your lecture when you have several lectures a day to get through and a very limited amount of time. But this way most definitely works. Your brain will make the connects faster (or more connections) the more exposure you have to it. Unless you are one of those loser people who have that weird gene/protein in their brain and they only have to read something once and recall everything–> you suck. I wish I had that ability.

Why didn’t objectives work as well for me this year as it did in COB? Time. I simply did not have enough time to go through all of the objectives and type them out. The ones I did do I filled out during lecture. This helped re-organize things for me so that when I went back to write them in my book they were already organized. However, most lectures I was too busy going “What the fuck is going on?” to be able to really sit there and do objectives and “oh my god I don’t have time to look at all of these”.

So ya know, typical thought process for me on the daily.

Testing:

We had 3 quizzes worth 5 points. After our quiz we would sit for a review. This was still the testing environment so we couldn’t take notes, but our professors would go over each question and why the correct answer was the correct answer. These were here for us to judge how well we were getting along in our studies and where we needed more work.

Midterm was 60 questions. The breakdown was 56 straight biochemistry questions and 4 clinical questions (from our CIS lectures–> they integrate real life cases with what we are learning in biochemistry).

For our final exam it was 90 questions. The breakdown was 43 questions of straight biochemistry, 5 clinical medicine questions, 30 genetics questions, 4 histology questions, and 8 physiology questions.

For both the midterm and final exam, there was a post-exam review. In this review, the questions that you got wrong would re-appear, and you could look at the explanation given to why the answer is what it is. During this the professors do not lecture us, but instead it is in text format on our testing app. You can leisurely look at this and go back to look at each question you got wrong multiple times.

How it is different from COB: well we get reviews. Whether that is instructor lead (after quizzes) or not (tests). We also see our raw scores as soon as we hit submit. Now, this does not take into account if we had an answer that wasn’t multiple choice, because the program (the same one you use in COB) doesn’t grade anything that is in essay format or short answer. That has to be physically graded by someone. But since everything was multiple choice in this block, we did not need to wait on additional answers to be graded. However it is still raw, you usually get 1-2 points back on a test because of ambiguous test questions/answers or the class as a whole did poorly on some questions. Or it was keyed wrong. The class average needs to be 85% (or at least that is what I have been told). So if the class average at the end of the course doesn’t hit this, the class as a whole will be bumped to an 85%.

Passing grade for the courses are 70%.

But thankfully with my raw scores I passed 🙂

Please let me know what you liked about this post or any questions you have in the comments down below!