Samin

Houshyar

Disclaimer: This is the method that worked for me and may or may not work for you. You should
amend it as you see fit and change your study methods and class attendance if something is not
working for you.

I actually never had a written plan. I realized that I was doing a lot of the things written below
automatically and naturally after a period of trial and error:

Approach to Organ Systems:

The order of knowledge should be as follows for a good understanding of principles in medicine:

1. Anatomy and Physiology

2. Pathophysiology
3. Pathology
4. Pharmacology

Sometimes you need a good comprehension of biochemistry, microbiology and immunology for
understanding certain diseases and therefore they should be studied as part of the
physiology/background knowledge if you haven’t studied them before. The issue with UQ’s system
is that you will go through 1-4 all in one week with your CBL cases.

On average each system is 4 weeks, with cardiology being 5 and neurology being 6. The latter two
are special because cardiac physiology is vast and neuroanatomy is essential for your understanding
in cardiology and neurology respectively. Here’s how I roughly went through each system on
average:

Week 1: Most of my focus was on knowing the basic anatomy and most of the system’s physiology.
Because UQ covers all four disciplines, I would know the basic pathophysiology and pharmacology
related to the diseases covered in the long case and short cases in week 1.

Week 2: By this time I’m pretty solid with physiology and am now mostly focused on the
pathophysiology. If I had enough time, I would start pathology by the end of the week. CBL cases are
now very easy because I know most of the anatomy, physiology and pathophysiology; I keep up
with the pharmacology relevant to that week’s cases.

Week 3: I focused on pathology mostly as it coincides with when most of the tutorials are held
(week 3 and 4)

Week 4: Continue with pathology and wrap things up with any pharmacological agent listed in First
Aid that was not covered by UQ. Start the physiology and anatomy of the next organ system.

By the end of the week, especially if the ‘theme’ was quite big I would generate a concept map for
myself and sometimes I would present it as a GIFT to CBL. Below I have an example of the summary
of all the factors affecting blood pressure, all the endogenous and exogenous (drugs) modifiers of it.

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Now here’s how my ‘average’ week looked like and how many times I saw the SAME material in a
single week:

Saturday, Sunday, Monday: Self study as above + CBL

Tuesday: Ochsner USMLE tutorials à 1st round of review +/- new topics introduced by tutors,
anatomy and histology tutorials (if applicable)

Wednesday: International USMLE à 2nd round of review +/- new topics introduced by tutors,
pathology tutorial (if applicable)

Thursday: Biochemistry/Microbiology Tutorials à I studied the topics announced beforehand if I

could so this would be more of a review but sometimes it was a first pass at the material for me.
Also, CBL was pretty easy now because of the number of times I’ve seen this material.

Friday: UQMS peer tutorials à 3rd round of review, UQSIG anatomy tutorials: at least my 2nd or 3rd
pass at the anatomy.

What I’m trying to convey here is that medicine is vast and I cannot say it enough but you need
multiple passes at this material.

I stopped attending lectures by the end of first semester and I was solely focused on learning using
the methods mentioned. I do recommend listening to the lectures at higher speed to save time and
looking at the slides before the exams. For the UQ exams 95% of my knowledge came from what I
had learned mostly on my own, and then 5% mostly slide-recall information.

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Approach to CBL:

You must attend these sessions prepared and ready to challenge your classmates (in a polite and
respectful manner) and yourself academically. There are a lot of questions that are unanswered in
medicine and science but it’s ok to ask them. Also try to answer as many questions as you can and
engage in a dialogue with your colleagues. In general, you need to get comfortable asking people for
help, which is difficult for a perfectionist medical student to do, but you need to ask for help your
whole career so if you still have some pride, put it aside and ask for help. For example, there was a
fellow student in my CBL last year that worked a radiology assistant, and I would ask him to walk
me through a chest X-ray or CT.

For your actual cases you really need to come to CBL prepared, whether you are presenting or not. I
always focused on mechanisms of disease and why things go wrong. Here’s an excerpt from one of
the cases and below you will have what’s going on in my head when I’m reading ahead and
preparing for this case:

Ok so there’s a lot to understand here, so I first check FA to make sure what is the minimum I need
to understand:

So here’s the questions being formed in my head and I go ahead and either search books for them or
if I’m desperate enough I just go straight online:

• How does NADPH oxidase deficiency lead to immunodeficiency?

o In my answer I draw the respiratory burst pathway and all the enzymes
• Why are they more susceptible to catalase positive organisms?
• What is dihyrorhodamine? Why is it abnormal?
• What is a NBT test?
o this diagram goes into my notes as part of the answer to that.

Now, as it turns out, in the course of my reading I realize there’s another immunodeficiency which
actually turns the NBT blue, and that’s myeloperoxidase deficiency. I check my diagram above
and YES IT MAKES SENSE because MPO is downstream of NADPH oxidase in my original pathway.

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Therefore this test is important because it can distinguish 2 defects in the same pathway. I bet test
makers would LOVE this.

Also make sure you can connect clinical signs and symptoms mentioned in the cases, one by one to
the patient’s disease. For example, does it make sense that a shock patient has a high heart rate?
What type of shock are they in if they have a low heart rate? Finally, make sure you can answer
every question in the CBL cases (this is where the short answer questions come from in the final
exam). Better yet, draw concept maps and diagrams.

Approach to Disciplines:

For each of the disciplines below I’m listing the resource that helped me most and how I used them.

• Anatomy:
o Don’t skip the tutorials, go there and find a tutor or a fellow student and ask them to
teach you something: ‘take me through all the foramina of the skull’
o Dr. Wragg’s notes are great especially if you don’t have any background in anatomy
o Supplement with ANKI cards
o Did the spotter exam that Dr. Omar prepared
o I got extra practice with Kenhub
o UQSIG peer tutoring
o Bob Acland’s videos
o Most Australian students have taken an anatomy course or two in their premed
which is not common for most Americans, so don’t get disappointed if others seem
to know more than you. Anatomy is easy and it’s all about repetition.

• Physiology
o Books:
§ Guyton and Hall
§ BRS Physiology
o Videos:
§ Dr. Najeeb’s lectures:
• I cannot emphasize how vital Dr. Najeeb’s lectures have been for me.
He’s a funny and engaging lecturer. Don’t watch his lectures
passively. Take notes and draw the diagrams! If you think he speaks
slowly get the Video Speed Controller extension on Chrome and
adjust the speed:
https://chrome.google.com/webstore/detail/video-speed-
controller/nffaoalbilbmmfgbnbgppjihopabppdk?hl=en

• Pathophysiology
o Books:
§ Pathophysiology of Disease (available on your school of medicine library)
o Videos:
§ Dr. Najeeb
§ Osmosis videos on YouTube

• Histology and Histopathology
o Read the tutorial sheets and answer the questions BEFORE going to the tutorial
o In the tutorials try to find the structures and ask the tutors to teach you

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o Books:
§ Ross and Pawlina
o Videos:
§ WashingtonDeceit on YouTube:
https://www.youtube.com/watch?v=IVQpqWYGdk8&list=PL6xLfAwtk_NJF
blis_fP2WozNgd5dMEwN
§ This guy is a funny and bitter pathologist and teaches both histology and
histopathology really well.

• Radiology
o Literally any video on YouTube is better than the UQ tutorials
§ StrongMedicine
§ MedCRAM

• Pathology
o Read the relevant sections of the BIG Robbins for your pathology tutorial. Take
notes on the tutorial sheet and go to the tutorial prepared. This is how your tutorial
sheet should look like, and then amend them as the tutor is teaching you. Also, this is
your chance to teach fellow students pathology. Don’t skip the histopathology or
zone out! They will be tested on your image exam.

o
o Pathoma is great but should serve as review at the end of the organ system to fill in
any missed information. Don’t use it as a primary source for understanding.

Now onto the trickier topics of immunology, microbiology, pharmacology and biochemistry: The
reason this is trickier for me to talk about is that I have a strong background in biological sciences
and I have tackled these topics in a different form than in medicine. The challenging part for me
here was the breadth, not the depth of the information. For example, I took a molecular
microbiology course where the emphasis of multiple lectures was on all the molecular aspects of AB
toxins and ADP-ribosylation. My professors never cared that I need to know that the toxins of C.

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diphtheriae, E. coli, … act through this mechanism but this is important to know for the USMLE, plus
the diseases that cause them and the drugs you need to treat them. With all these topics there will
be memorization but first you really need to understand some basic mechanisms before going
straight into memorization.

• Microbiology
o Attend the Ochsner tutorials
o Books:
§ Medical Review of Microbiology (available on the school of medicine library)
o Videos:
§ Dr. Najeeb has some good introductory lectures
§ SketchyMedicine is good but for review only
§ CanadaQbank on YouTube (concise and basic introductions)

• Biochemistry
o Attend the Ochsner tutorials
o Books:
§ BRS Biochemistry
§ Lippincott’s Biochemistry
o Videos:
§ Dr. Najeeb

• Pharmacology
o Books:
§ Katzung and Trevors
o Videos:
§ Speed Pharmacology on YouTube
• This is a new discovery so not sure how good he is just yet!

• Qbanks
o I started these in March of my 1st year. I do questions of a particular organ system at
the END of the module. Initially do them in tutor mode and learn from your mistakes,
by the end of the year do them in test mode.
o USMLERx
o Firecracker
o Becker

• Comprehensive Medicine
o Book: Harrison’s Principles of Internal Medicine
§ I use this to prepare my CBL cases and to look up important information,
especially in management and treatment. Don’t attempt to read this book
cover to cover since it’s 4000+ pages long.
o Video:
§ Paul Bolin on YouTube: he has really good review videos that go over mostly
the clinical aspects of a disease and management.

A note on First Aid: While First Aid is great for review; it’s not meant to substitute for your
understanding. So for example, if you feel like you’re falling down a rabbit hole trying to chase the
exact mechanism of some obscure drug (like I’m constantly doing), first check if the drug is even

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listed in FA, and if it’s not take a deep breath and move on. So use it as a reference but not
something to memorize or learn from.

Remember that at this point you need to build your fundamental knowledge of the basic sciences,
as you enter year 2 you will gradually shift from primary learning material, to primary review
material. Those review material are only helpful if you have done the work in your first year, and
they help you remember the important points about disease x or drug y.

There are also the Becker Integrated Cases that will start in a few weeks and I highly recommend
attending them and asking questions from Dr. Lionel Raymon, who will challenge you and teach a
lot. Don’t be intimidated by the long class hours; when he gives you the breaks, go eat and
decompress. Remember the USMLE is going to be 8+ hours long, you need to train your brain.

In general, the best thing for exam preparation, after you have done all your hard work is doing
questions. For the UQ exams I found a website called passmedicine.com (I believe to be based on
the UK medical schools) and did their year 1 level questions. Most of it is pure repetition but good
for UQ but not the USMLE. Other websites that you need to pay for are pastest.com and
OnExamination.com.

A quick note on other classes-- essentially my focus was on what’s the minimum I can do to pass
(with the exception of clinical practice described below) so I can spend more time on clinical
science:

• Research: just do the work and make sure you don’t miss the deadlines. Your easiest class!
• Ethics: I went through the formative questions and the slides multiple times before the
exams.
• Clinical Practice: Go to all the classes and PRACTICE. A lot of students just memorize the skit
and don’t know what or more importantly WHY they are looking for signs and symptoms.
The important thing here is to be able to correlate the signs and symptoms to various
diseases. For example, what is finger clubbing and what diseases cause it? What is the
mechanism of cyanosis?
o I recommend going to the SWIM practice sessions, which will be announced on
Facebook.

Last but not least, always ask questions especially from second years who have been through all of
this. I’m sure I missed some things, so if you still have questions, leave a comment in the Facebook
post or send me a private message.