First half of MSK

Hello!

Welcome back to this fabulous world of crazy.

courtesy of giphy.com

MSK is 6 weeks. Which is 3 weeks longer than biochem was. This time we don’t have any quizzes to help boost our grade, and we have anatomy practicals on the same day as our written tests. Testing in general is much longer (due to more questions), and as it is anatomy, it’s harder to logic your way through something as it is mostly straight memorization. I’m writing this after my midterm, thus I still have 3 more weeks to go until this section is completed.

I struggled hard with this section (so far, let’s hope I can make a comeback).

Exam Breakdown for our Midterm:

There were two tests that I took on the same day for my midterm. The written portion and the anatomy lab practical portion.

Anatomy questions: 64

Embryo questions: 24

Histology questions: 4

Total: 92 for our written exam.

Exam practical: 50 questions (mostly identify what the structure is).

Some were bones. Some were muscle bellies or tendons of muscles. Some were arteries, nerves, or veins. Some were radiographs. We even had a couple embryo questions in our anatomy practical (soooo not happy about that one). What I’m getting at is there was a wide range that was tagged for this practical.

Studying for the first half:

Yo, I need to figure out my shit for this next half. That rule of 3 from biochem? Yea I found it hard to do that. I was lucky if I got through one pass this time. Needless to say there were a lot of things I’m finding I should have done differently.

Lectures:

  • Some lectures I benefited from actually attending. Some I did not. Depending on the lecturer and if they read off their slides, it was easier to just go through the slides myself. If I was unable to attend lecture, I would try to watch it at home. Other lecturers however it was greatly beneficial to show up because they would discuss things that were not explicitly noted on their slides.
  • Again, either looking at the slides, going to lecture, or watching your lecture should be your first pass. I had trouble getting through one pass this time, and a lot of the material I tried to punt but choose wrongly. I know better now.
  • We had mostly embryo and anatomy lectures this time around. We had one histology lecture and no CIS cases (or clinical integrated scenarios). And man, ligaments and embryo were my for sure downfall this test.
  • For the second half I will definitely be looking at Dr. Anderson’s lectures from my COB days. He was pretty encompassing and for chunks of his lectures (not all), they were organized very well and pretty easy to understand. Although I definitely have my favorite and not so favorite lecturers in medical school, there is a lot of information that is not necessarily given to you in the slides that you need to know. So I will be turning to his lectures for more information to help me learn!

Lab:

  • We have required lab about 3 times a week. What you have time to do in lab does not encompass  enough time for you to get it done. In fact, what our fellows would tell us to do in lab would not be the level we needed our bodies to be at by the time we got to the practical. Lots of extra had to be done that was not apparent to me (or it didn’t click in my brain anyways) until about 2 weeks in…
  • Be prepared to spend some extra time in lab getting at and looking at the structures you need to see.
  • I personally didn’t feel actual lab time was helpful. Sure, slicing/dicing/chopping/stabbing, whatever adjective you want to use was fun, especially when I was not in a good mood. But getting to the structures was not helpful for me. Once were were there and I could actually see it, it all of a sudden became helpful.
  • I did put in some extra time in lab studying or going in to pick at structures, but I needed more. I did go to additional small group lab tutoring which greatly helped, but I didn’t spend enough time going in and just identifying structures on my time off. I also didn’t know the material super well before lab tutoring or going into lab, so I didn’t absorb as much as I would have liked.
  • What I should have additionally done was go to separate bodies with a friend or by myself and try to identify different structures. Our body isn’t going to look like other bodies. Anatomy has a similar pattern overall, but is not always that concrete pattern that you learn from your textbook. Going and looking at other bodies would have been helpful in identifying different structures, and ultimately, lead to less of a shock come practical time.
  • Atlases also greatly help you learn the structure and start to learn the orientation. However it is not 3D. Once you get your body in the position to where you can start to identify structures, this is where the atlas stops helping and the body becomes helpful. Unfortunately there is no guide though…

Bone Boxes:

  • We were given bone boxes at the beginning of the year (during orientation) to use during MSK. They are there as in lab you spend most of your time picking away at fat and fascia to see the structures. Since there is a lot in there, it’s hard to actually see the bones. You use the bones given to you to learn the bones themselves.
  • Definitely should have spent more time on this, but identifying structures on bones was a much easier portion on my practical that I thought. Thank you Dr. Anderson for making me learn all this last year!

Schedule:

Here is what my week 2 looked like:

Sorry that it’s all the same color, but my personal notes to study certain things were placed on top of my actual schedule as posted by the school. There was a lot. For some of my frustrations and experiences, visit this post: “8 things I learned (so far) in medical school.” Particularly the long days section.

Additionally on Tuesday, I had anatomy lab tutoring from 8:30-10pm which you cannot see on the schedule, because my screen isn’t big enough!! But I promise it’s there.

My week 1 was just as hectic which I won’t post. My week 3 was a little less hectic class wise, but very hectic in trying to catch up on all the studying I was unable to fit in before hand. I won’t bore you with another schedule screenshot here.

Helpful Areas for Studying:

Okay. I should have definitely listened to my tutors on this, but failed to do so. Here were the areas they told us to focus on/tips to help us succeed, and whoa yea I didn’t take it as seriously:

-Moore’s clinical blue boxes. One of our textbooks, Moore Clinically Oriented Anatomy is super lengthy in text but has these blue “boxes” with clinical correlation. In reality they are like half a page to an entire page but I digress. There were a fair amount of blue box material as exam questions and I chose to not look at it much.

-Using Gray’s Anatomy Review questions. I did do some of these, but not enough. They also recommended integrating in some questions during study sessions instead of doing it all at once. Well, I decided to do all 200 questions per section in one sit down and really didn’t get that far. Then realized I had a lot to still learn. But the stuff I knew I knew well!

These questions are tough, and are usually second order. There are first order questions in here, but if you can answer these questions fairly well, you will do well on the similar types of questions they dole out to you on the exam. Just, actually break them up like it was suggested. Because there are a TON of questions. But, don’t be too hard on yourself if you don’t get a super good score overall on them. Most of the second years used them to figure out where to focus their studying on, and I’d have to agree on that. Again, I just did this too late.

-Stay on top of this. No joke. There is a lot of information in general in each block, but as anatomy/musculoskeletal is pretty much all memorization, there is not great way to really get a handle on it unless you are regularly going over your material. You won’t be able to get every nitty gritty detail down; I mean you are a human after all, not a robot.

-If embryo is integrated like mine is during our learning (meaning there are lectures in each section pertaining to that topic, not just one block for it) DON’T PUNT THIS INFORMATION. It’s hard. Everyone knows it’s hard, and no one likes studying it. Hell, even our professor knows we don’t super enjoy studying it and that it is difficult to understand. But don’t just assume you will be able to kinda sorta guess on those questions because embryo is it’s own language. Also, nothing in this makes logical sense (to me anyways). Spend some time on it.

-I tried to do this, but failed miserably in actually sitting down and doing this (again, I keep saying this for a reason SO YOU LEARN FROM MY MISTAKES HERE PEOPLE). If it’s super overwhelming for you, then go joint by joint or section by section. Do one layer of back at a time. Then focus on shoulder. Then focus on arm/brachium, etc. This way, you can break it up into manageable chunks and can then string all the information together.

-I tried using KenHub quizzes as a last resort. It was great for identifying information, but not super helpful in the degree I needed to be at unless all your quizzes were on level 4. Even then, there were things that they were quizzing you on that you may not need (there was plenty that I did not need during that level, but it gave me the types of questions I was more likely to encounter). So using this was very hit or miss for me.

In general, anatomy atlas/apps are great at helping you learn to identify structures or start learning where you should see them, but they will not get you to the level you need for medical school. It is a great way to help you start to identify the muscles/nerves/tendons/etc to orient yourself, but you will need to go way beyond that to actually pass your test.

Compared to COB: you really just needed to be able to identify the muscle and know the origin/insertion/action/innervation. Which if you knew where it was, you were able to identify it. In medical school, you need to know all of that, but also the relationships it has with the rest of the body in that area…

What I would have liked to have done differently:

I hinted at a chunk of this already. But some additional things I wish I would have done include drawing more, and writing out my notes more. I was able to write a lot of my notes out for biochem and a large chunk stuck. It also helped me organize my notes/thoughts better for me. This time around I simply just couldn’t bring myself to study as much, and thus this portion of my studying suffered.

And well it’s anatomy. Your drawings don’t have to be Picasso, but drawing it will help you with relations. If you can visualize where something is supposed to attach and insert onto, then you can get a pretty damn good idea of what the function is. If you know the area where it is residing, you can also get a damn good idea about the innervation and blood supply (particularly muscles).

Real Talk:

courtesy of giphy.com

No joke. I’m not even afraid to tell the world this. I cried so.damn.much. during this section. I had a really hard time rebounding from biochem, and then had an OS CPA (meaning I had to show I was competent in my osteopathic skills which was a test) the following week after our biochem final. So early that first week I had a hard time snapping back into reality, and then spent the rest of the week trying to learn OS because I hadn’t spent as much time on it previously.

I know, sob story. But you will have times like this to. I basically couldn’t bring myself to snap out of being burnt out to get my butt in gear for this first midterm for MSK. But hey, it’s whatever. It’s one test and technically I didn’t fail, so at least I don’t have to remediate.

What this did teach me: again, it’s okay to not get an A. It also taught me that I took some time to do not so great, so now I need to get my ass back in gear for the second half of this section. It also taught me that being a perfectionist isn’t something I will achieve every single time. As a former competitive dancer and ballerina, this is extremely hard to accept.

So yea, there is my experience from the first half of MSK. Hopefully when I do the second half of this post after the final exam, it will be a more positive situation!

 

Let me know in the comments below what you liked about his post and what you would like to hear more of on the blog!