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Neuro Block 2

Hello MedHatters!

I am posting this months after this course ended, but I did initially start writing for this block while it was occurring. Although I still have very strong feelings about this course, (and so do a lot of my fellow classmates), take what I say with a grain of salt.

Or a lot of grains of salt. Because I was definitely very salty during this course. So without further ado…

Okay.

I’m definitely burnt out and not giving a flying kahuna lately about school. Or anything really. But, this is probably the first time in a few months where I’ve felt like I don’t need to be super rushed with learning everything. It still stinks the way that they scheduled things this year, that hasn’t changed. But in general, my class rallied together to get several things moved/changed on our schedules so it doesn’t interfere with both this upcoming Neuro exam and our final exam in a few weeks. Go class!

For this section, you are learning basically tracts. You start learning actual neuroanatomy (not the head and neck stuff like on last test). And the big thing you learn include the somatosensory and motor tracts.

Yikes!

Now, if you are anything like me, you are or will be freaking out when you see this. It looks like a foreign language. I know. Just do me a favor and take in a big deep breath.

Now let it out.

Good.

ExamS:

I’m going to lump both exam 2 and 3 here just because the third exam was more of the same strugglebus as this one.

Exam 2:

38 anatomy questions
6 embryology questions
4 histology questions
32 physiology questions.

Total: 80 questions.

Exam 3:

47 Anatomy
4 Histo
33 Physiology

Total: 80 questions

*They are going to ask you A LOT on lesions on the tracts. Know those tracts forward, backward, and inside out. Know what symptoms you would experience when you remove part of a tract. A sizable chunk of our 2nd exam questions were based on this. There were actually some questions on our 3rd exam that went over 2nd exam material. And honestly, that was a low blow to do. But, there were also similar style questions on the 3rd exam tracts. Looking back they were very very heavy on the tract questions during the second exam though.

Practical:

Just like the rest of your practicals, it will be 60 questions. And because we didn’t have a practical on the same day as our second exam, everything from the second and third exam was fair game for the last practical.

Not all of our brains were viable either. (I mean our cadaver brains, but I guess you could say the same thing about med student brains here…) Because of that, there were less real brains we could use to learn with, they were harder to handle just because picking them up often ended up melting the myelin (it is fat based), and most of our brains were sliced.

On the practical you will see slices (both paper and real slices), tags on actual brain tissue, models, pictures, all of it. Everything was pretty much fair game, and there were unfortunately a wide range of things they could pull to test us on. I think they gave us a 12 page list or something ridiculous like that.

In general, my class did not have a good time with this practical. Our labs were not structured and they didn’t teach anything this time around. We basically showed up and had to try to find all of the structures on our own. Most students didn’t bother going to lab because we had no direction and it was incredibly anxiety inducing. I was one of them. Why bother wasting my time trying to find something if I can’t even tell if its right? When I could go learn a lecture, and try to get a base understanding of a lecture? I’m really really hoping that the fellows next year are more hands on with teaching this topic, and the course directors structure lab differently so it facilitates learning.

I suggest you go to anatomy tutoring for this. One of the second years who was a head tutor, single handedly taught us all neuro. If it wasn’t for him, none of us would have gotten the scores we did on that practical. I’m not sure how they will go about doing it this year. I’m not sure if the anatomy fellows for this next year will help with this or if one of the tutors will be taking this on. Either way, our head tutor was the only reason both our class and the class of 2021 got any sort of a decent score on our practicals.

This was the site he recommended by the way: http://courses.biology.utah.edu/nielsen/5315_lecturepresentations.html

This website works best in internet explorer. If you don’t have it, you can download a similar version of internet explore through an app on your iPad. This was recommended by our tutor to help pick out some structures. I can’t remember which lecture specifically it was but I’m sure you can play around on the website and find it. If not, I’m sure there are other websites similar to this you can use.

There is also an Anki deck link lower down in this post of just brain slices. The 2021 class only needed this to do fantastic on their final practical. Ours was not that easy or straightforward. BUT, it can help you learn where some structures are for both lab and lecture.

How I studied:

The biggest thing that is going to help here is learning the anatomy first. You don’t need to go crazy in-depth right away. But get oriented. Know a few big structures at first and you can zoom in a little at a time. As of right now, you do not need to know every single tiny minute anatomy structure. But having an idea of the order and where things are relative to one another will help.
Then learn the tracts. Draw, draw, draw. If you can draw them and explain where they cross and what areas they are going to and what synapses where, you are golden.
Once you are fairly comfortable with the above, you can start going through and figuring out if there is a lesion here and what happens. Or better yet, they are going to give you symptoms and a timeline and ask you where the lesion is. This is how they are going to test you on this knowledge. I know, not fair, but this is apparently what they ask on boards as well.

Start on the smaller chunks of things, and then you can go back in and add in more detail based on the slides.

Honestly, I used a similar approach for blood vessels as well. I drew out the Circle of Willis first. I then went in and added where the cranial nerves were at/what was sandwiched or ran with what blood vessels. You are going to want to know that if blood supply on one vessel gets knocked out, what cranial nerve(s) may get affected. The same thing goes for parts of the brain. But truthfully, if you are comfortable with general anatomy, you can either go back in and fill in the details or be able to generally guess.

Then I went back and learned how each of the branches off the Circle of Willis worked. And how knocking out certain areas will affect what parts of the brain.

The books:

Okay. So. When it comes to resources they give you a ton. A TON PEOPLE. You do not need to use all of them. In fact, they give you so many, or at least recommend so many, that it frankly is very overwhelming.

The first one: “Neuroanatomy in clinical context” by Haines. The very first time, and honestly probably a few times after that too when you open this book, you will get overwhelmed. There is a lot of brain anatomy and imaging here. And not a lot of supportive text. Quite frankly, it feels like they only added text to call it a textbook instead of one giant picture book…

The way I handled this was first learning a bit of the anatomy off the slides or from a secondary resource. One that I knew I could easily follow so I didn’t feel entirely lost. I partially used my powerpoint from class (although they flew through a lot of information as well) and youtube for this section. Get your feet wet a bit with where you are at.

Then I went back to look at specific brain slices, etc in this book. If it is easier for you to understand/orient yourself, look at more of the hand-drawn figures. Again, orient yourself. If you are feeling overwhelmed step away from this book and consult the good ol’ internet with a source you feel you can comfortably learn more from. Then get back to this. They will test you based off of images and slices in this book.

Note: They don’t give brain slices on the written exams. Just on the practicals. However, you do have to have a good base understanding of where certain structures lie in different areas of the brain to know where the tracts are running through or to/from.

When you feel like you know the anatomy better or can orient yourself to be able to tell what slice of brain you are in, start looking at the actual slices and imaging they have. They take a chunk of images out of this book and slap it into their lecture slides. But there are WAY more images in the textbook that they could pull from on the test or in your future anatomy lab practical. They also had an extra book that they kept in the lab that had a ton of photos. It couldn’t leave the lab, but I’m assuming they also took some slides from that book as well.

In the future, you can use this knowledge to look at real brain slices in the lab.

I have an Anki deck that was handed down from previous years that is just brain slices. This was all a previous year needed to know to pass the final neuroanatomy practical, but I found it helpful in me just learning structures for this section. Our practical was way harder than what these slices had.

Brain Slices Anki Deck: Download From Here

Physio books:

Well. I didn’t really use any physiology books this time around. The recommended one was “Neuroscience” by Purves. We have it at home, I just didn’t pick it up much. I attempted to use it for one of the exams, but there is a lot of text. I didn’t personally get a ton of useful information out of it. But I sure as hell tried.

Dr. Karius will also have her iBooks for some of her lectures on blackboard. Her iBooks repeat what she says in lecture basically. If you prefer the text, use her iBook. If you prefer to just listen to her lecture and dissect that, then use that.

Also, Dr. Karius loves her compare/contrast tables. She would briefly show us the filled in tables during lecture but leave them blank for you to fill in. If you are watching the lectures, you can just pause and take a photo or write the information down. If you are in lecture, I suggest you take a picture then.

Why?

You’ll need it to help you quick study. But it’ll also help you know what she wanted after you attempt to fill in the charts yourself and want to compare it to what she had.

Helpful recommended sources for tracts:

– If you like a general overview I first started with Handwritten tutorials on youtube. On their actual website they have PDF’s drawn out for you. If you want to add those to your iPad and draw all over them/follow along, this is helpful. It isn’t quite the in-depth that you will need for the test, but it is a start. You may need to actually go to their website and click on the ‘videos’ header to pull up this information (specifically for tracts) because sometimes their youtube page won’t have all of the videos.

-I then jumped into Ninja Nerd Science’s videos. They were way, WAY more in-depth. In fact, probably more in-depth than you actually need for certain aspects. But close to what you need for others. He talks about specific pain fibers in a lot of these pathways, but his videos are longer. If you are already getting a good gist of how the tract is running then great! It is sticking. If you find his videos too long, then no big deal.

*Protip: On Youtube you can increase the speed. So just bump up the speed if you don’t have time to sit and watch 30-60 minutes of his video. Or you are just used to increased speed due to watching med school lectures.*

-Another channel that I have used for some information and some of my classmates have used: Armando Hasudungan. Personally, some of his videos are really helpful. Other times I felt his information wasn’t up to par since it was slightly different from what we were taught. Which I was concerned might screw me up. But if you like the way he teaches, he’s pretty in-depth too. Also, he’s great artist.

-Dirty USMLE. LOVE this channel. Pretty high yield stuff as well.

-You could also use USMLE STEP 1. They might be able to concisely teach you some high yield topics. But they will not go into detail.

-Neuroscientifically challenged is another great neuroscience channel. His are very brief, so it is a good place to get an overview of/review for boards. I think all of the videos are 2 minutes or less. Which means not great for in-depth understanding, but a good place to start and then go back and build.

Pray to whomever you pray to. Ya’ll gunna need it.

Notecard material:

I’m currently using Quizlet as I can download the same app onto my phone after I make the notecards on my computer. That way, I can pull it up while I’m in line at the grocery store or waiting for food or whatever and not feel guilty.

There are some Anki cards that former second years have made. I do have the Brain Slice one (up earlier in the post) that was posted on the classes facebook page (I don’t have a facebook so someone will kindly send them to me). Again, I use Anki on my computer because it is free that way. There may have been other decks that I simply didn’t get access to.

I will notecard material such as herniations, lesions, and most of the physiology lecture material. That way, I can quickly get in the information that is more high yield for testing. I have tried note-carding other material, but honestly I couldn’t figure out a good way to notecard some of it. Oh well.

I hope some of this helps ya’ll in neuro. This was not a good course for our class and we hoped we expressed this enough to our professors and administration about changing it for years to come.

Good luck. Cheers!

What I did this Summer!

Hello MedHatters!

How is everyone? This will be posted incredibly late. But you know what? I don’t care. I will probably need a reminder to be grateful by the time this comes out. Or conversely, I’ll be sad that I’m not still doing these things. So, don’t judge me.

Anywho, we are the first class (or at least the first in a very long time) that we got 8 weeks of summer. The classes before us only had 4. Which really, doesn’t seem fair to them. And yes, a lot of the now third years (a class above me) were not very happy to know we got an extended summer. But I gotta say, having an extra month was G-L-O-R-I-O-U-S.

The goal for this, apparently, was so we would have additional time to do research. It is very hard to convince someone to take you on in their lab when you only have 4 weeks available to participate. I mean, it’s pretty hard to get much accomplished in 4 weeks in a lab. Unless you join an intensive research opportunity (which usually involves an application). And you really won’t have a ton of time to continue doing research once school starts again.

There are some students who will start working in the labs of professors on the KC campus over the summer (or from COB) and try to continue working during medical school. More power to you. I don’t care enough to do that.

BUT!

Most of us are definitely not using that time to do research. Some of us are trying to buff up our CV during the summer with other opportunities, but a lot of us really just want to relax.

And currently while on summer break, it is fantastic to have this much time off! We did have to suffer a bit during the year because we still learned the same amount of material, just in less time on some courses. Despite what they told us (which is that they took stuff out), I’m pretty sure they didn’t. I’m hoping they’ve taken our feedback about this and truly did look at the curriculum and changed it more accordingly to the new time limit. I guess ya’ll next year will find out if they did or didn’t.

Okay, back to what I was saying. Because we have a bit more time, this means I was able to fill up my summer with additional fun things outside of just chilling and doing nothing at home.

Which was great. I did have a few moments that after chilling in my apartment doing mostly sleeping and cleaning with my cat. There were times where it got a bit lonely. But, I definitely had plenty to do this summer!

First week off:

I’m not going to lie, it took a few days, actually almost an entire week, for me to accept that I didn’t have to study. I was constantly freaking out thinking I should be studying something. It took a week + to actually come down off of my almost 10 month streak of constant stress as well. I literally had panic attacks because I wasn’t studying.

On the flip side, it was pleasant to be able to hangout with my significant other for an entire week without interruptions. No stress from school, looming exams, having obligations in our schedule, none of it. It was simply amazing to basically date him all over again and spend time with him uninterrupted for a week.

Why a week? Well, that was all I could get E to agree on staying past our final exam before he went home for the summer. Maybe I can bargain for longer next summer lol.

Our goal was to try to be active at least every other day that first week. The reason being is one, we like hiking. We haven’t really been able to hike or explore much since school started. Two, for the most part it is cheap to do! Minus the gas money to get somewhere, it was a relatively cheap activity that we spent a couple of hours doing. It was great to be outdoors for both the mind and body, doing some exercise. And three, well we are really out of shape from basically sitting on our butts all year studying. So we wanted to ease into it!

I have so many photos. It’s going to be hard to choose some of my favorites to add here.

Places we went:

Lake Bella Vista/Bentonville, AR. They had a massive track around a lake which was flat, but they also had some bike trails in a more wooded area/hilly area. We definitely decided to go on the bike trails because they were more interesting. Totally got my ass kicked as I hadn’t done anything in a while. The flat track was a nice ending to the hike though!
Us on part of the bike trail path.
Also found a random 10 commandments chained to a tree at the end of our walk?
Springfield, MO. We visited the Nathanael Greene Park which had a small botanical garden area. There were also many other parks within that park. We were rushed out by the rain after
Some finds during a brief walk through the botanical gardens.

only being there 20 or so minutes. But! We did get to see some cute bunnies nomming on plants and a ton of beautiful flowers!
We also visited the Wonders of Wildlife National Museum & Aquarium while in town. We wanted to continue to explore/walk but wanted to get out of the downpour that occurred while at the botanical gardens. Great aquarium actually! There was much more there than I expected. Some lull areas, but overall really fascinating with a lot of different exhibits. E even had a standoff with a giant octopus (it didn’t like that another large red thing was in it’s space!).
A beautiful jelly in the aquarium
We did explore a bit in downtown Springfield after all of this, but we decided to grab a bite to eat and head home just because we were exhausted from all the walking. We will have to come back next year and explore more!
The last hiking spot we fit in was actually here in town in Joplin. We initially went to check out Grand Falls (a smaller waterfall) but there wasn’t much hiking over there. Looks like a great place to hang out though while hot.
Octopus standoff!
Instead we went to Shoal Creek (formerly Wildcat Glades Conservation). There is a large hiking trail that tracks along the river. The same river you can float down from Grand Falls. It was, incredibly long… I was not expecting the hike to be that long. My feet definitely hurt. As an FYI, there are only 2 spots to cross the river. If you don’t feel like doing the entire trail/oval, make sure you don’t cross the river. Otherwise, you will have to walk the entire length OR grab an uber to get back to the center. There were also two spots out on the trail as they are redoing a bridge. We started in the afternoon but finished in the early evening (after construction crews usually go home) so we just walked along the torn up trail anyways. I don’t recommend doing this while they are doing construction though.

View from our walk on the Shoal Creek Trail. We even got to a see a beautiful eagle!

Hanging with my BFF’s:

I really didn’t get to spend as much time up in KC my first year as I had hoped. I tried to make an effort during part of first semester of first year. I really did. But stress and life happened. The goal was to hang out with my besties as much as I could since they were all staying here and I moved to Joplin.

But because life never goes as planned, I tried to spend as much time up here in KC with one of my besties over the summer. Practically every weekend I would drive up on Friday afternoon/Saturday morning and stay until Sunday night/Monday morning. There were a couple of times where I came mid-week, usually because I had to come to KC for something else. But it was fantastic to get to hang out with her as much as I did.

One of my amazing BFF’s. Also, can we just appreciate how tan I look in this photo? In a race between a ghost, a sheet of paper, and myself, I usually win in how pale I am…

Most of my medical school friends were not in town as they all went home, travelled abroad, etc. I definitely enjoyed being able to just chill by the pool with friends this past summer and chat it out. Or drink. Or both. In general, it was nice to catch up with some of my friends either on campus (again, I have really shitty internet) or bumping into them outside in the community too!

Prepping for kenya:

Honestly, this took up most of my time. There was a fair amount of prepping and shopping that needed to happen before this trip. This trip was expensive to begin with (to cover costs of flight, lodging, food, and travel while we are there), but there was a fair amount that needed to be done and paid for outside of that. Mostly including immunizations and obtaining things on my packing list that I did not have, thought would be good to bring, or in order to take care of my cat while I’m gone.

It was all very expensive. Lots of shopping. Lots of traveling. Lots of packing!

I will be starting a Kenya series that goes over all of this after I come back from my trip. Stay tuned!

How I filled the rest of my time:

Well, one this blog. lol. I finally got the writing bug! There was a time last year where I was writing because I wanted to document and put things out. However, in doing so it almost burnt me out more. I took a brief break from it and thought that as soon as summer hit I’d be motivated again.

Wrong.

I wasn’t motivated until about a week before I left for Kenya. And in all honesty, that might have been just because I was super excited to go to Kenya. But thankfully I had a lot of great ideas that I had stashed away last year and never wrote about. So I’m going to try to write as much as I can before school starts, so I can just focus on school when it gets here.

I played so.much.sims. OMG. I haven’t played this game in forever and I forgot how much I enjoyed it? My computer that was gifted to me in a previous relationship does not have a CD rom drive unfortunately. But E was kind enough to leave his laptop home so I could use his to play! I had a lot of fun just doing this for hours. I know, sad. But I needed a way to veg out seeing as I don’t play video games.

For most of the summer I didn’t read. I wanted nothing to do with a book. My brain didn’t want to think, and for some reason it thought that if I read fiction I was all of a sudden going to have to use my brain…

I know. Doesn’t make sense. I’m realizing that now.

I did bring two books to Kenya with me though. They are the last two in a murder mystery series that I started last summer and just couldn’t get around too. I was pretty positive I wasn’t going to ever actually pick them up. I brought them as a just in case, but low and behold when you are stuck in a car for 6+ hours for a few days, music gets a bit old. So I picked one back up and we will see if I can finish it before school starts!

I did however do some light reviewing. But honestly, I mean super light. If you can call it that. I wanted to relook at some basic skills before going to Kenya. We had a bit of a refresher course while there, but I wasn’t positive that would happen before leaving stateside. I did not however, review anything in first aid OR pre-read for class. This lady wanted all the time not related to school as she could get.

Another thing that took up a large chunk of time was cleaning. Oh Lord Jesus I did so much cleaning. You don’t realize how dirty your apartment is when you are constantly focused on studying. And you also don’t realize how much your cat sheds in the summer until you are actually home and it is on literally everything.

I mean everything. How does she even expend that much energy to shed that much?

Aside from being slightly annoyed by the cat hair, I actually enjoy cleaning. I’m a stress cleaner and I grew up with a mother who was pretty strict about keeping the house clean. So it is nice to have a thoroughly cleaned apartment. That way I can start on a clean slate.

The surprising thing this summer that I was involved with included the mass amount of dealings with my school club. I honestly didn’t think I would have to be this involved this summer. It’s not a bad thing, I will enjoy the fruits of my labor next year. But really, there were quite a few things that boiled over from the year prior. I guess that’s what happen when you run the largest club on Joplin’s campus?

The last thing that I really enjoyed filling my time with this past summer is not characteristic of me at all. I made banana bread. I made it from scratch for the first time ever. I won’t call myself a baker, mostly because I really can’t do much without a recipe in my hand that someone else gruelingly made so I can easily follow it. But I was pretty happy at how well it turned out.

It was very delicious by the way. And very filling.

Much dense. Very banana.

What to do the summer before 1st year:

If you are reading this before starting medical school, I do have some advice on what to do or what not to do. You will likely hear all of this from several current students or former students. But the common theme is this: Enjoy yourself. The summer before is when you will be the most excited about what is ahead in your journey.

DON’T prep. You will have no idea what you will need to know. Even talking to prior years, they change the curriculum so often at KCU that even though we just went through it, it likely isn’t the same anymore. So, enjoy your last summer before the craziness begins.
DO do whatever it is you want. Cross off things on your bucket list. Hangout by the pool all summer. Go on adventures. Travel. Read leisurely. Do all those crazy crafty things you’ve always wanted to try. Whatever it is you’ve wanted to try or haven’t had time to do, now is the time to do it. You likely won’t have time to do it in school.
Eat all the delicious food you want. Because why not? You will definitely stress eat. A lot of us gained weight our first year. We sit most of the day, stressed out and studying. We eat I would say a fair amount because we use our brains so much, but a fair amount of us just don’t have time to go to the gym or are so stressed out that we can’t balance the weight we gain with our current lifestyles. And honestly, when you are stressed you don’t crave great food. It’s usually crappy stuff you want that is comforting while eating it but not good for you later. That’s okay. Enjoy the guilt free eating or all the delicious food now. LOL.

Thanks for sticking around! If you like what you read feel free to leave a comment, send me an email with questions, or share on social media.