Neuroscience – We're All Med Here

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!

Neuro Block 1

Hey guys!

I’ve had a lot of really exciting things happen in my life recently. But also some very stressful ones. Today’s post is going to be similar to my GI and endo/repro posts. Neuro is technically 5 weeks long, but it is spanned over 6 weeks as we have spring break woven in there.

I’m definitely feeling the buildup of stress and burnout this semester. I was able to do okay for most of the first semester except when it came to renal. Ya’ll already know how I feel about that renal course. If not, you can check that post out. But coming back this semester has been much harder to deal with that.

My current pitfalls:

Medical school is great at breaking down all of those protective barriers you’ve built for yourself. Those insecurities that you could somewhat deal with before? Those walls have been smashed down. That insecurity will find a way to bubble back up and hit you at some point. And it doesn’t matter what that insecurity is.

Like take mine: apparently mine is feeling inadequate or not good enough. This is something I’ve struggled with for a very long time. According to our on-campus counselor, I probably developed this back when I was a preschooler. So like, it’s not going anywhere. (Not like ya’ll really cared to know that.)

I was really good at not letting this get to me. I learned to build up my walls last year and learned so many different ways to cope and realistically look at life’s problems without it completely deteriorating how far I had come. But the stress from medical school (for me at least) has slowly started chipping away each layer of that wall. Brick by brick. They each chipped, cracked, and slowly crumbled.

Until the next thing I know, this insecurity is bubbling up into almost every aspect of my life and affecting every thing I do. Now, I’m not saying that my fortress is completely torn down. But, it’s pretty sad looking right now. Not very impressive.

God damn insecurities. I don’t have time for you.

But they don’t care. They do what they want.

So currently, life’s been a bit rough in that aspect for me. My grades feel like they have been slipping and I’m back at not being happy with most of my performances. I try to tell myself that passing is good, or doing close to the average or slightly above average is good; even if it isn’t what I personally want. But sometimes that can be difficult to accept within yourself.

And because of this, my brain isn’t interested in putting it in a box and shelving it away. It wants to think about it more frequently. And because of that, I personally am having a hard time getting motivated to do things. Or at least to make my study time productive.

Some positives:

I also know that my blog has been a bit on the negative side lately. I would apologize, but this is a real emotion that people deal with and then try to hide. Everyone pretends that everything is okay and picture perfect.

It’s not.

But! I have had some good news on my end. In case ya’ll didn’t know, I was lucky enough to become a Student Ambassador at my school earlier in the year. As a first year, most of the spots to tour and do lunch panels and help the school with their public face went to the second years. They had the experience. But now, with the second years getting ready to study for boards and going off to do other things for third year, this means more opportunities for me and my classmates!

If you have ever interviewed at KCU, you will have run into one of our many SA’s. We help give tours, do lunch panels, and answer all your burning questions. We are also the face of the school to our community. This entails more things, but overall the biggest time you see us is when we represent the school to new and incoming students.

I absolutely adored both of my SA’s when I interviewed. I also knew that if I went to KCU this was something I wanted to do. Not to mention, it reminds me of how far I’ve come (but just how actually recently it was) that I was in your shoes interviewing.

I also recently became our school’s MAOPS president. WOO!!!!! Cue the confetti and champagne! This club is the biggest student club on campus, and it is also tied to the MAOPS organization that represents all Missouri DO physicians at the state level. I’m pretty pumped to take over this year. Apparently I even get recognized at Capitol Hill? Will let you know how that goes.

Lastly, I’m looking to do a medical mission trip this summer. I’m terrified but excited all at the same time. I’m looking at either going though KCU or another program. So my two options currently are to Kenya or India. Not sure yet where I’m going or if it will come to fruition, but that is the hopes! I’m so nervous, but also excited to start using and working on my skills that I’ve learned in first year. Not to mention, I know the programs I might be participating in need the extra hands. Let’s see if this hope turns into a reality for this summer.

Pre-Neuro Test 1:

Okay ya’ll. They really like to mess with our schedule. Given how they took the concerns of last year’s students into play, they rearranged our first year schedules to give us more of a summer and try to cut back on some of the “free days” they had. However, it definitely isn’t working out they way they initially wanted. At least not from a student’s perspective. I do know that given how things went this year, they are changing things for next year again. It may not completely make sense to the incoming first years, but knowing where my class brought up our concerns, they are trying to make it more manageable. Especially since we’ve had more than one unit now that time was taken away and it did not work out to our benefit.

I do not however understand why they are re-arranging when some of the classes are. Ya’ll better get ready for a tough first semester next year. Well, who knows. Maybe with them rearranging things it’ll make it easier in the end.

And if you read my last post on endo/repro, you know they snuck in an OS CPA and midterm exam that took away from our studying for that block. This time, we have a PCM exam snuck into our schedule for tomorrow. We have our first neuro exam and practical this coming Friday. And I’m only bitching about that because our schedule so far has been pretty packed.

We had 14 neuro lectures in our first week (this past week), and had 3 days of packed afternoons filled with anatomy labs, OS lab, and a PCM lab. I think we had a PCM lecture as well stuffed in there, but really, that was a lot of neuro. I’m definitely not all caught up yet and I’m having to take a hot minute to try to learn all the PCM I’ve ignored all semester…

Oops.

We then get slapped with another 6 lectures next week. And just like last week, our Monday-Wednesday afternoons are packed with labs. Not really sure when we are supposed to learn all this information, or sleep. Or both. Because we definitely don’t have time to actually learn anything.

Here’s to hoping they re-arrange the schedule to add more time to neuro next year for the incoming first years. I feel like I’m not really learning or at least learning it well right now.

Just know that KCU has a reputation for having a hard curriculum. You will get your ass kicked at times. And right now, this is one of those times for us!

Will check in later. Maybe. We will see.

Post-Neuro Exam 1:

Welp.

I mean, I kind of just accepted my fate the night before. The feeling I was getting while on campus was that most students were in the same boat as I was feeling. Overall, the content wasn’t necessarily hard. If we had some more time to actually learn it, I think it would have been doable. However, since we had an entire head/neck course (which is what constituted our first Neuro exam) in less than 2 weeks, it really wasn’t that doable.

In all honesty; I failed.

And no, I’m not ashamed to admit that here. Why? Because like I said, most of the classmates that I spoke to also failed. Or just barely passed. We don’t have our averages back yet, but I’m pretty sure this average is going to be going down in the books.

And really I’m okay with that. I know I put everything into this test block that I could given the scheduling and hurdles that were thrown at me. At the end of the day, I was still gunna go home to a cat that mildly accepts me and gives me love, and a nice bottle of wine in my fridge.

The practical however I was hoping to do better. But just like with the written exam a few hours before, I didn’t have a good feeling about it. Who puts 10 some questions of embryo on an anatomy lab practical? Really?

Still a tad bit salty about that one. But ya know, I’m sure that average won’t be swimming either. So we will see.

Exam Breakdown:

So, out of 20 some lectures and 6 some anatomy labs, we ended up with 95 total written exam questions and 60 anatomy lab questions.

I’ll start with anatomy lab this time:

2 histology questions (Yes I punted these hard).
10 some embryo questions (I lost count honestly).
The rest were actual anatomy structures. Some were straight name this and some were slightly second order. The remainder of these were tagged either on bones, models, or the bodies.

The written exam this time around was mostly all anatomy. There was also embryo and histology on this exam.

71 anatomy questions
20 embryo questions
4 histology questions

And yeah. That’s about it.

Tid-Bits for this section:

You need to stay on top of the lecture material. Most people only had time for 1 pass. I chose to not actually look at all of the lectures (I think I didn’t look at 2 embryo and a histology lecture at all) so I could spend a bit more time learning all the dense anatomy on some of the other lectures. But just know, you won’t have time to get in 3 passes. You might get 2 at best on some of the material. Try your best. Make use of your time.
They will ask a lot of “if you get stabbed, puncture wound,” etc questions on this exam. There was also a fair amount of clinical questions, so make sure you look at your objectives to see what specific clinical diseases/scenarios they want you to know. They may put more in their slide set just because it’s “cool” or they really enjoy teaching it. But if it isn’t covered under an objective, it’s not fair game for a test question.
You need to use your lab time wisely. Part of that is making sure you’ve at least watched one of the lectures from that morning. The likelihood of you looking for structures in the body based off of what you’ve learned earlier in the day while in lab is high. Quiz each other while you are dissecting. Go to other bodies and start seeing what those structures look like. Use that time. You have 2 hours where you have to be there, which means 2 hours out of your studying time.
Blue link slides for testing your anatomy. Our professors did post several of this review links on blackboard for us. But, you also have access through KCU anyway I believe. If you have a different anatomy slide set that you’ve been using all year, use that. Stay on top of this anatomy.
Man, don’t punt embryo on this exam. I was okay with not knowing all of it for the written. But I’m annoyed at how much showed up on the practical. A lot of it happened to be pharyngeal arch derivatives and grooves. But there was definitely information pulled for all 4 of those embryo lectures given showed up.
The rest of the links that were recommended or sent to me involved some sort of anatomy resource off of the KCU intranet that we have access to. Acland’s, Thieme’s, and the Human Anatomy Resource link that KCU offers. I again didn’t have time for all of this, but if you have a chance to look at at least one resource to quiz yourself, do it.
If you like making Anki cards and can stay on top of them, here is a tip from a girl in my anatomy group: When previewing the night before, make your cards. Edit them while you are in class going over the material to make sure they are correct. Review them that night. As Anki builds with time, this pile can get a little overwhelming though. But if this is how you enjoy learning the material, this apparently worked well for her.
I used Teachmeanatomy.com for some high yield concepts at first. But honestly, I used a fair amount of youtube and Moore’s textbook itself to try to teach myself some of this material. A fair amount of content I didn’t quite get right away with just the slides and I personally needed to use our textbook to figure it out or look at a bigger version of a picture in the slides.

Lastly!

Roll with the punches on this one. It’s going to be rough. At the end of the day, you just have to hope for the best when walking in to take this exam. There really wasn’t a good way to prepare for this beast. If you are getting the feeling that everyone else in your class is struggling, don’t be upset if you are as well.

Something our class has had to remind ourselves with this block: they can’t fail all of us.

And in this case, it applies. It’s not that we wanted to do poorly, it is just how the cards seemed to land.

Update: Our class average for the written was 72% and a 73% for the practical. Which honestly, is better than I was expecting but not too far off from what E and I predicted.