Everything You Always Wanted to Know About OMS II But Were Afraid To Ask

This is meant to be a sort of walk through of my impression of the courses of second year, how I
studied for them and what worked for me. While my first year was very good, my performance
second year was better on all fronts and hopefully knowing a little bit about the courses might
help y’all too, I dunno. I was going to put the grades I got for each course to “verify” my take on
each class but that seemed like a dick move. A lot of this info comes from notes I left on my
phone at varying points throughout the year.

Second year in general

Remember neuro? Well, pretty much ALL your classes this year are going to require that kind of
work ethic (at least the major classes). While the material isn’t inherently harder, there is more
of it, and most of it will be all new. So buckle in and all that—but also pace yourselves.

Pathology
Recommended resources:
- Pathoma (see following for caveat), the Grey Book, Dirty USMLE videos on Anemia,
genetic disorders.
- Sketchy path exists but I found it…not awesome. Definitely worth a shot if other
sketchies are your jam though.
Course Overview: This class is a rough one. 80% of my USMLE, approximately, involved
pathology, and probably 30-40% of those questions had histological images. Knowing histo is
HUGE, and keeping up is also important, as you have tests very frequently, and sometimes with
not a lot of time to prepare. ABSOLUTELY GET THE GREY ROBBINS QUESTION BOOK, AS UP TO
20 QUESTIONS WERE TAKEN DIRECTLY FROM IT ON ONE EXAM. Pathoma is another great
resource, however, I didn’t use it at all during the year as I felt it too shallow and it just slowed
me down; certain professors (Dr. Devine in particular) will write questions that intentionally
include information Pathoma omits, so don’t use it as your only source. With that said, it is
GREAT at providing an overview to build from and Pathoma Guy (Dr. Sattar? I dunno, I call him
Pathoma guy) is brilliant. When it comes to the boards, Pathoma can be enough to brush up on
all the path you really really need, in my opinion. It’s also very high yield, examiners LOVE to
cover stuff in there. Finally, Dr. Tullot is the MAN, and if you’re struggling, don’t hesitate to go
to his office hours, as he’ll help outline exactly what you need to know. Subsequently, if I hear
anyone talking shit about Dr. Tullot I’ll drive up to Phoenix and smack you. Another thing worth
mentioning is that the course includes a lot of good physio, biochem and anatomy review—
normals are rarely tested, but it is a nice context (and also nice board prep)
First Quarter: The first exam is broad but fairly superficial, don’t let it freak you out too much—
same with the ~400 slide long cancer lecture for exam 3, it’s basically the whole test. I found
the final to be the hardest because it was combined heart/lung, but I don’t know if they’ll do
that mess again. BE SURE to do the grey book for the cancer exam.
Second Quarter: The WBCs unit is tough, but you have Thanksgiving break to cover it—use it
wisely, hit the WBC dyscrasias and leukemias hard. The anemia material is also tough, but the
Dirty USMLE video helps, and Dr. Tullot’s slides are great. Find good ways to learn this now and
remember how you made it work come board study.
Third Quarter: Probably (see: definitely) the most challenging (although GI from unit 2 is a
toughie as well) quarter for path. Renal can be confusing, but just find efficient ways to
categorize things and then go from there. If you dig tables, use tables—and pay attention to Dr.
Tullot’s lectures, he’ll point out the stuff he’s bound to test on (Devine as well, to a lesser
extent). The CNS, repro and genetics units are really, really, really, really important for boards
which is why they’re In this quarter. Really focus on them here, know them to Devine’s level of
detail and you’ll only need to brush up on them and hit some practice Q’s for boards.
Studying: Just keep up with it and get good at categorizing and organizing diseases fast, then
pick out the strange things and outliers. If you’re struggling, See Big T and do the practice
questions. Some units have insane amounts of slides, but…welcome to Path.

Pharmacology:
Recommended Resources: Katsung (the text) has some decent practice questions, but really
you don’t need other stuff here. Sketchy pharm exists and is useful for some, but again, I wasn’t
a fan. Dirty USMLE has some excellent board review tidbits.
Course Overview: Pharm has a nasty reputation and, if you’re bad at straight memorization, I
get why. Past the first exam, it really just comes down to how well you can hammer facts and
associations into your head. Knowing mechanisms and biochemistry helps but not enough to
bypass the sheer amount of crap you have to fit in your head. I’m going to break down the class
not by quarter but by professor. As far as exam prep, use the front pages of the drug lecture
handouts to organize them and then just annotate, memorize, repeat. Use flashcards,
mnemonics, whatever. This class is meant to be harder than most board questions, and while
some might disagree, I definitely agree. Know it how they teach it and it will take you a long
way. Also take advantage of the physio review throughout the course.
Potter: She handles ANS, psychopharm and the viral/cancer drugs—and these will probably be
your favorite units because she is among the most straightforward testers you get Second year.
Use her HANDOUTS—not the slides—and focus on bolded things. My tactic was to go to her
lectures (or watch at home if you aren’t a lecturegoing type) and add extraneous material from
her slides to the handout. Knowing all the bolded material will get you a solid pass, but if you
wanna really kill it, you’ve gotta have a solid mastery of some non-bolded facts and indications
as well (or just be a good guesser/test taker). Like Dr. Tullot, she’s awesome.
Kerecsen: The other infamous pharm faculty. Absolutely brilliant when It comes to drugs, but
he tests you in a hard and roundabout way. His unit one material will require you to go over his
slides, handouts AND what he says in lecture—as they all have different things that he’ll test—
and get em down. This is especially true for his toxicology lecture (unit one), his anti-arrhythmia
medication lecture and heart failure lectures (unit 3). The rest of the time, his slides alone are
sufficient (but giving the handouts a once-over helps). By the time you finish the year and take
the board(s), you’ll probably hear him telling you “the boards are coming” in your head.
Caul: He does endocrine, and it’s a WILDLY dense unit, but his slides alone are sufficient to ace
the exam. Spend extra time on the diabetes drugs, they’re a beast, and also know indications
and uses for the sex hormone drugs. Beyond that, just put in the work.
The rest: Dr. Jones (not from neuro) and Dr. Korsch (I probably spelled that wrong) handle a
couple oddball lectures here and there—just use the lecture slides and you’ll be golden.
Studying: the first exam is nothing like the rest—so if you do super well, great, but be wary of
the next exam(s) which are less watered-down biochem and more drugs. Lots more drugs. If
you don’t do so hot, don’t stress. It’s one final grade which means you can totally eat one or
two exams and come out on top.
Pharm Final: It sucks. There are a million ways to study for it, but this is what I did: start 3ish
weeks out, spend the first week going through a unit or two a day, re-annotating the KEY facts
(seriously like one or two things) and major mechanisms/class adverse effects on the front
pages for each drug. If you already did this, cool…do it again. Then spend two weeks drilling
them, making tables, flashcards, whatever, just actively studying them. The exam is big picture
for the most part—it doesn’t ask nitty gritty comparisons about drugs in the same class, but it
will expect you to know BIG things about the drugs and distinguishing between two classes. It’s
harder than any pharm question I got on any board exam, so prep for this, do well, and then
just light review to your board date.

Microbiology
Recommended Resources: Lippincott’s Illustrated Microbiology/Immunology Review (Look for
the one with “Jensen” in the by-line), sketchy micro
Course Outline: In a lot of ways, micro is like pharm in that the first exam is based heavily in
principles and the rest are straight memorization (with some exception). Fortunately, it’s only
two quarters, and the first quarter is far and away more intense. Generally, the first two exams
are BIG—work hard to hammer them down and give yourself a solid buffer going forward. The
second exam is 20-21 lectures long and covers a shitload of high yield things, so its worth trying
to get down as best you can, but you really don’t have much time after the first exam to do so.
Just be smart and keep It a high priority and you’ll do fine—there’s a lot of material but the
questions are straightforward if you know your stuff. Another caveat I have is that Sketchy is
the bomb, but, like pathoma, I didn’t use it during the course. I found it infinitely more helpful
for board review after you’ve (theoretically) learned it all once. Plus, it doesn’t go as in-depth
into virulence factors as some lecturers (Katsif) will expect. With that said, I’m definitely in the
minority of people that didn’t find it helpful during the class, so give it a try and see if you dig it.
Also, attend the guest lectures for those big ol bonus points.
Jensen: Do your best to attend all of his lectures because he’s a) hilarious, b) awesome, c) will
tell you exactly what and what image he’ll test on. His presentations are almost always >100
slides but have >30 images and many repeats. Furthermore, he handles parasites mostly, which
is a notoriously(?) weak portion of sketchy micro, in my mind.
Katsif: Just know everything—he’ll test details as often as he’ll test big-picture things, and he
loves virulence factors. His lectures on pneumonia are great though, and important going
forward.
Kokjohn: Another hilarious and very straightforward lecturer. He has handouts and slides both,
but his slides are usually sufficient—if anything, read over his handouts just to be sure and see
if he places any emphasis on other things. There are things he explains in detail in lecture that
aren’t well explained on slides—they aren’t often tested for him, but are the sort of thing it
pays to know.
Hnida: Another straightforward lecturer—he’ll highlight things he really wants you to know and
his test questions are usually right off that material. One or two of them will make you think
pretty hard, but it just comes down to knowing his material.

Clinical Medicine
Recommended Resources: Any and all good vibes you can get.
Course Outline/Studying/Description: So, ICM is basically still ICM in that it covers a
hodgepodge of material that, in theory, follows your major pre-clinical coursework. The big
difference between ICM in year one vs. year two is that you have to treat it like a real class
now. If you studied hard for it year one, keep it up and the adjustment will be much less—but if
you just kind of whipped out some miracle prep-work in the night or two before the exam, you
can’t really do that here. There’s just too much material and the tests always seem to pop up at
the worst times (rivaled only by OCCAs for that). Keep up with it, review the case documents
like lecture notes and go by the objectives and you’ll be okay. I’ll post my own review
documents if those were helpful for you last year, but, like I said, they probably aren’t enough
on their own. Anki is good, Pathoma videos are probably helpful for some of the pathology
portions, but a lot of it comes from just taking the class seriously and putting in a little work
most days. Watch out for the 250-something slide neuro review two days before the class final
in the Spring (even though It’s very board-relevant neuro and very easy neuro), and the
midterm for the spring quarter was one of the most ludicrous exams I think I’ve taken ever.
Hopefully with the new year there will be some revisions, but, prepare hard for that one
because it’s the most difficult exam of the course far and away. When it comes to your group
assignments, find a way to get it done and then get it done. My group used a community google
doc. Others met up and discussed stuff. Whatever works for y’all.

OMM: I’ll keep it short—OMM is largely unchanged, but much of it is geared towards board
stuff and more “advanced” takes on things covered in first year with a renewed focus on clinical
elements. The exams might be a titch harder, but not by a mile. Just study for it, practice for the
OCCAs and you’ll be just fine.
Recommended Resources: Savarese—no, really, you need that book.

Psychopathology:
Recommended Resources: Dr. Potter’s Psychopharmacology notes, Sketchy pharm for the
psych shit if you liked it, Fadem maybe (some people used it).
Course Outline: Psych is back, kind of with a vengeance. It’s a whirlwind 5-week, two-hour-per-
Friday crash course on how to treat most of the crap learned in first year. All things considered,
it’s not a bad course, it’s just difficult to really study for. The grade is determined by a 25 point
midterm and an equivocal final. There will be very few questions about straight diagnosis—
instead you’ll have to identify and then treat based on the diagnosis you come up with. Drug
side effects are also tested, so for this reason, here’s how I’d recommend studying: first, going
to the lectures helps (they aren’t recorded, I think, and their slides are about as helpful as first
year), annotate extra things mentioned, especially the stuff said but not written from first year’s
course. Then, go back and review the psychopharm notes from Winter Quarter pharm—if you
did well on this unit or two, great! If not, now’s your time to redeem yourself and also hammer
it home for the pharm final while you’re at it. If you’re able to sort of coalesce the big takeaway
points from both into a single review document and work from that, you’re in good shape—
that’s what I did and walked out having aced both exams, which was mostly luck accounting for
weird recall of a couple good guesses and remembering random things that were mentioned
but not written. The lectures are early and long, but they’re worth going to if you’re tryna get
everything you can from the class.

Radiology:
Recommended Resources: Radiopedia, Google, Essential Clinical Radiology (I literally just
discovered this book in my attending’s office two weeks ago and it would have helped so
much), that study guide that will probably circulate to y’all eventually.
Course outline: This class is immensely frustrating. I don’t know how much will have changed
by the time y’all take it, but I hope a lot. The takeaway is basically study the big picture things
from the slides, use radiopedia to make sense of the stuff that isn’t explained, and don’t stress
over a lot of the random “extra” info thrown in there. The quizzes (at least the ones given by
the primary lecturer) aren’t a reflection of the exam, so don’t stress—just google away until you
can get the correct answer so you have that buffer in your grade. Try to make a habit of
wrapping them up the week of the lecture so they aren’t hanging over your head. Some of the
neuroimaging, interventional radiology and CT questions came right from the quizzes as well
(the questions that actually pertained to lecture material). This is another 5-week course in
Spring term, so just grin and bear it. There isn’t much advice I have to offer for this class
because I studied a bunch of different ways and I know people who studied harder that fared
worse than me on the final—there’s no real logic to it, just know that Dr. Finch is right when he
said they aren’t gonna try to fail anyone.

Patient Care Experiences/OSCEs:

Basics: These just happen at bad times, but above that, they aren’t bad. You get a document
outlining the case you’re expected to see and work up a DDx for, which makes it very
streamlined. Spend a little time beforehand working out a flow for your history and physical,
practice whatever techniques you have to, and then rock it. It’s less about a correct diagnosis
and more about interaction, so just keep that in mind. Also, always try to at least bring up
OMM. Even if it’s not hella relevant or if you have twenty seconds yet—bring it up, especially if
it’s an observed OSCE.

Board Prep:
Resources I Used: USMLE-Rx, Kaplan Qbank, Combank, Uworld, Pathoma, Sketchy Micro, Dirty
USMLE, First Aid for the USMLE Step One, Savarese
Everyone is going to study differently, and there isn’t a “right” way to do it (as long as you
actually do it), so im just going to outline what I did. I don’t want to list my scores, but my
USMLE ended up being well above 250 and my COMLEX was above 650, so I dunno, worked for
me.
STUDY FOR YOUR CLASSES. Really. Really really. It is board studying, and if you get a solid
foundation, it’s less to try to cram in during dedicated.
Planning: If you’re taking both, I would recommend taking the USMLE before the COMLEX; it’s
shorter and, honestly, better to just have done (at least that was my logic). However, do what
works for you, and if you aren’t ready by X date, push it off a little. Go into it feeling confident
and ready (or as ready as you can).
I started with the Kaplan Bank and USMLE-Rx a little before Thanksgiving, which might have
been a little early considering how much you still haven’t learned by then, but I also did maybe
10 questions from each, most days. If I got something wrong, I looked it up, made a couple
notes, kept going. If I got it right, I read a little blurb solidifying why the right answer was right,
and I kept going. Again, early on, the focus in my mind was class (and it stayed that way
throughout the year). I ended up starting UWorld I think the second week of Spring quarter,
doing anywhere from 25-40 questions a day depending on work load, and during the weeks
where you have two big exams or three exams, I cut back significantly. By this point I had
maybe 300 questions of USMLE-Rx left and I just let those wait until dedicated. The five week
classes end and it’s supposed to give you more free time to do board things, but really, between
having an elective (even though it was a minimal one) and tutoring and Path getting intense, I
really didn’t feel like I had a lot more time. It’s also worth mentioning that the school plans
several workshops during Tuesdays and Fridays where you once had class, which does eat up
time.
Dedicated Study: Questions, reading, videos, repeat. If you’re doing super well and know
someone who isn’t, try working with them—or if you’re not doing so well and need help, try
finding a buddy, it helped keep me sane and also made me test my own comprehension of
material. I tried to make it through pathoma once and sketchy micro once (if not twice for the
viruses and bacteria) while adding notes to first aid or something like that. If you got USMLE-Rx,
the videos they have for biochem, psych and phys as well as EBM materials made a world of
difference as opposed to trying to just read First Aid like a book (even if it’s basically just having
people read it at you with occasional lame jokes and diagrams).
Above all, do what works for you. I ended up going through UWorld twice and the other banks
once, as well as doing all four of the Savarese practice exams and doing videos/reviewing with
friends to solidify weak points. I didn’t do any of the NBME assessments which probably was a
bad move but it worked out. Don’t sleep on OMM (try to do some combank questions daily,
even if they aren’t OMM questions, they’ll often include OMM findings to keep you thinking
about it) and also take some time to rest and do shit with friends. Yeah it’s dedicated study, but
you’re gonna need breaks, I promise. My typical day meant questions/work starting around 8-
8:30 and finishing around 8, with maybe an afternoon per week doing something unrelated to
studying and maybe a couple 15-20 minute breaks during the day—but by the time I took my
COMLEX there was no way I could have done another day of that routine, so pace yourself.
Most of all, try and enjoy it. This material is pretty cool and is the bread and butter of being
able to communicate effectively with peers in the medical field. At least I read that somewhere
I think.