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The following document is based on Georgetown Universitys First year guide.

This First -Aid was prepared by UTHSCSA Office of Academic Enhancement, with input from the Class of 2012. Some of the textbooks may not be used in your classes this year. While not all of the advice will help you personally, we think it will be a useful reference for your first year. Good luck!

FIRST-AID FOR THE SECOND YEAR


AN OVERALL LAYOUT FOR YOUR SECOND YEAR
Module 1 General concepts Module 2 Hematology Module 3 Respiratory Module 4 Renal & Male Reproductive Module 5 Cardiology Module 6 Dermatology & Musculoskeletal Module 7 Clinical Neuroscience Module 8 Endocrine & Female Reproductive Module 9 Gastroenterology

Jul General Concepts Hematology Respiratory Renal & Male repro Cardiology Derm & MSK Winter Break Clinical Neuro Endo & Fem. repro Spring Break Gastroenterology

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Course
Intro to Clinical Sciences I (ICS I) Intro to Clinical Sciences II (ICS II) Advanced Clinical Evaulation Skills (ACES) Pathology Pharmacology Psychopathology

Course Director
Mysti Schott, M.D. Nanette Clare, M.D. Kent Keeton, Ph.D. Brenda Talley, M.D. TOTAL

Contact hours

Credit hours
8.0 10.0 6.0 11.5 6.0 3.5 45

731

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OVERALL TIPS 1. Second year is quite a different experience from first year youll be spending a lot more time selflearning and a lot less time in class. 2. All the stuff youre learning this year is relevant to the Step 1 USMLE boards make sure to learn it! 3. A lot of times, professors will jump into a new module/organ system and expect you to know all the foundational stuff (ie. anatomy, normal physiology, etc). Spend some time going over first year material to remember the normal so that you can understand the abnormal. A good starting point is to read the pertinent section of BRS physiology or the relevant anatomy and physiology sections of First Aid. 4. If you havent already started during first year, make sure to make some annotations in First Aid with each module. Not only is it a good way to review high yield information for the module exam, itll also help you when you have to start studying for the Step.

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PATHOLOGY GENERAL DESCRIPTION Pathology is a course that you will be taking throughout the year. It will cover diseases, including the morphology and course of a disease. It is a very broad class, but you can do well by focusing on the syllabus and reading some supplemental material. Having a strong foundation in pathology will significantly help you on your Step 1 boards. Also, keep in mind that pathology counts for 11.5 credits for your second year while ICS is 18 total. BOOKS There are a plethora of books for pathology. While most students found the syllabus to be a good source of information, many supplemented their studies with various textbooks. Just like first year, youre going to have to figure out which is best for your studying style.
Robbins & Cotran Pathologic Basis of Disease (aka Big Robbins) Pocket Companion to Robbins and Cotran Pathologic Basis of Disease (aka Little Robbins) Robbins Review of Pathology (aka Robbins Question Book) general consensus is that this is an indispensable book for practice questions BRS Pathology Rapid Review Pathology (Goljan) - a lot of students recommend this review book for pathology, accompanied by the audio lectures (refer below)

First Aid for the Basic Science Organ Systems provides a good overview of embryo, physio, path, pharm, etc
and its all broken up by organ system.

First Aid for the USMLE

PROFESSORS Students especially liked Dr. Clares (heme) and Dr. Fowlers (endo & cancer) lectures. Other professors that students enjoyed included: Dr. Henry (neuro) gives a great review before the exam, Dr. Troyer, and Dr. Reddick (CV). OTHER RESOURCES Goljan audio ask around to find a bootleg version Webpath: http://library.med.utah.edu/WebPath/webpath.html Various items posted on blackboard STUDENT ADVICE
There were a lot of common themes with student advice; weve tried to distill them down to their essence (accompanied with some direct quotations for emphasis). Keep in mind, this is advice, and not hard and set rules to live by:

Dont put off studying don't put it off for the last minute,
on you!

Dont put it off till the last minute. KEEP UP!! It'll sneak up

Read & know the syllabus & powerpoints Know the syllabus and/or powerpoints before memorizing any review books. The syllabi are great; lectures will sometimes highlight what to focus on. Master the syllabus--this is what they will test you over. If you just stick to the syllabus you can get an A - but you won't understand anything b/c it is a lousy syllabus. So, other materials help you understand the info - esp the Goljian lectures. READ THE SYLLABUS know it backward and forward! ALWAYS look at the powerpoints too, there are at least a few questions that ONLY come from the ppts. Do the labs Go through the labs as you study for exams as well. images on the test only come from the path lab. Know your pictures! If you take the labs seriously when you have them, it'll make your life easier the night before the exam. Go to all the labs and do all the VJC questions--these are easy points that could mean the difference between letter grades at the end of the year. prepare for path lab, you will get much more out of it if you are already familiar with the info. Look at the labs the morning of or night before exam b/c one or two questions always comes from that You can learn a lot from path lab if you prepare ahead of time. DO NOT!! DO NOT be late to path lab if Dr. Clare is your room leader (this switches about every 2-3 labs). She will remember you coming in late...dont' be late. Don't forget to review the labs and do the Virtual Microscopy. Look at lots of pictures from different sources, but most of the pictures come from lab. Use extra resources use extra resources the see the same material written a different way. -3 FIRST-AID FOR SECOND YEAR
Follow along throughout

the year in BRS or Goljan and add your own notes to one of them as you do each module-- will save you lots of time at the end of the year. definitely do the practice questions on Robbins Review reading through Robbins helps, esp if the syllabus is not complete (respiratory, etc). Definitely get Robbins and read it along with the syllabus. Often, the syllabus is insufficient. Just be careful not to get too bogged down in the details of Robbins; that's when I used Goljan to see the "big picture." The beginning modules of pathology require you to read outside of the syllabus. I would use Robbins to answer path lab questions if you dont want to read all of the text. Goljan audio is helpful in certain modules. Listen to Goljan at the beginning and towards the end of each module. I recommend going

through First Aid for each test, so you will know the basics for sure, and then fill in the details with the syllabus and/or Robbins or Goljan.

Use the Robbins Questions Book to quiz yourself Start doing questions from the Robbins question book ealy. Don' wait until the end of the module to start. They really help in making sure you are getting the big picture. definitely use Robbins Question Book to quiz yourself. Do the Robbins Question Book!! It's good for usually 1-2 questions on the exam, plus will really help you see if you know the concepts well enough to perform on the test. Robbins question book is essential. Pathology shelf/final: The Path shelf/final is a large percentage of your grade, so the better you can do throughout the year, the better position you'll be in when shelf time comes. The shelf exam at the end is really really tough, and isn't curved. Don't think you'll ace it and get yourself an A. Make sure you look over Micro before you take the shelf.

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INTRODUCTION TO CLINICAL SCIENCES (ICS) GENERAL DESCRIPTION ICS, or Introduction to Clinical Sciences, is split into two sections. ICS I is the first semester course, and counts for 8 credits. ICS II is your second semester, which counts for 10 credits. Studying for ICS will consume most of your time second year - think of it as an all encompassing pathophysiology, differential diagnosis, clinical diagnosis, pathology, etc, etc, etc class. The difficulty lies in trying to determine what information is the most important for each disease and what the lecturer expects you to know. This is likely to be more similar to the hospital setting, where each teacher or doctor will have different expectations. The course is similar to pathology, in that you study disease, but ICS also focuses on how to diagnose and treat the disease. BOOKS Most students thought the syllabus (above all know the syllabus) was sufficient for this course, but also found other texts quite useful: Pathophysiology for the Boards and Wards quite a few students recommend this book as a supplement to the
syllabus

First Aid for the Basic Science Organ Systems provides a good overview of embryo, physio, path, pharm, etc
and its all broken up by organ system.

Rapid Review Pathology (Goljan) Goljans has lots of pathophysiology and is really helpful. Cecil Essentials of Medicine was helpful, but I mostly just used the syllabus. Pathophysiology of heart disease is MONEY for the cardio module. Pocket Medicine (Sabatine) was a helpful book to flip through when going through ICS lectures (you'll use it during 3rd
year).

First Aid for the USMLE was about all I used

PROFESSORS In this course, you will have a multitude of professors, based on their specialty, presenting a lecture. Dr. Adams (respiratory), Dr. Witz (OB-gyn), Dr. Plastino (gyn cardio), Dr. Fischbach (MSK), Dr. Nolan (renal) and Dr. Griffith (gyn) were especially liked by students Other professors that students enjoyed include Dr. Berggren (Infectious Disease), Dr. Moody (cardio) OTHER RESOURCES Professors will post relevant items on blackboard, so check it frequently STUDENT ADVICE
There were a lot of common themes with student advice; weve tried to distill them down to their essence (accompanied with some direct quotations for emphasis). Keep in mind, this is advice, and not hard and set rules to live by:

Go to lecture A good number of ICS professors tell you what their questions are during class. you could actually just listen to the lectures and take notes-- apparently people have had a lot of success with that. Attend lectures because sometimes they include information not printed in the syllabus. Go to lecture, some will tell you the questions; others have powerpoints that are completely different from the handout. In addition to reading the syllabus, go to class or listen to the podcasts or look at the powerpoints. A lot of the lectures give you big hints to their questions, so that helps narrow things down. go to lecture - You get an idea of what the lecturer focuses on esp if there is lots of material per lecture hour. reading first aid/pathophys for the boards and wards at the end each module helps to tie the main ideas/big picture Read the syllabus READ THE SYLLABUS and KNOW IT WELL. Know the syllabus, and always listen to the podcast, because professors will usually stress what to know for the test. Other:

Despite what you may initially think, you'll quickly find that ICS I and II are by far the most demanding classes in second year. Do NOT underestimate them. ICS is just hard cause all of the professors are different and want different things. Don't blow off the genetics CD. Questions on the test are random and you need to study. Find someone (a 4th year) to help point out what things are important and what things were on their tests. That is very hard to do as a student just learning... to be able to discern what is common to see in the hospital and what things will always be asked. Get that help from the beginning.

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Don't get too frustrated with some the lectureres. Many of them are clinicians and do a crappy job of teaching 2nd year medical students, so really pay attention to what they focus on and the stuff in the syllabus. Every module is different (some are really clear, others are awful) so it's had to give advice on any one. It was a big debate whether or not the lecturers actually write their own questions or whether they choose from a question bank. Some of the questions on tests are NEVER mentioned in class, which makes ICS the most frustrating class of the year. Dr. Kosub's practice questions are NOT indicative of test performance because each lecturer will write the questions for their particular lecture. Keep UP! try to read the lecture, even if you scan it, that same day after it's given. Utilize the podcast to supplement your learning, not as a total replacement for going to class (unless absolutely necessary) This seems like it's going to be an easy class at the beginning of the year but it's not, really. If you study path and try to relate it to ICS or study ICS and try to relate it to path, I think you'll have an easier time.

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PHARMACOLOGY GENERAL DESCRIPTION Pharmacology is one of the most well organized classes in your second year. Dr. Keeton does a great job of providing you with the important information on drugs, which is essentially all in the syllabus. He also gives relevant info during class including test questions. Many students made or used flashcards throughout the year, which was helpful, since repetition is key when learning about drugs. For this class, an A is an 85 or above, a B is a 75 or above, etc. and counts for 6 credits total. BOOKS Students found Dr. Keetons syllabus to be more than sufficient for this course. He will also provide a High Yield packet at the end of the year to study for his cumulative final. PROFESSORS Dr. Keeton is the course director and the main lecturer for the course. Most students found him to be a great lecturer. He does not allow his lectures to be podcast; go to his lectures theyre worth attending. Dr. Lewis lectures on antibiotics and infectious disease. Many students enjoyed his lecture and found him to be very knowledgeable. Dr. Jones lectures for the neuro module are highly recommended, since his exam questions can be quite challenging. OTHER RESOURCES Drug Charts from previous years (try to borrow someones MS2 study CD they may still be floating around) STUDENT ADVICE
There were a lot of common themes with student advice; weve tried to distill them down to their essence (accompanied with some direct quotations for emphasis). Keep in mind, this is advice, and not hard and set rules to live by:

Go to lecture and PAY ATTENTION!!! Keeton teaches about 90% of the lectures, and is well worth going to (especially because he doesn't podcast). Go to lecture and Dr. keeton will tell you what you need to know for the most part. Study what Dr. Keeton tells you to study. Mark the things he says will be on the exam. Go to ALL of Keetons classes. Go to class because he focuses your studying for the course. Go to class! Keeton is probably the best professor ever! He will explain things to you and tell you wacky, funny stories to help you remember drugs. He will also tell you what drugs he is going to ask about on the exams. Do not ever miss a class, because Dr. Keeton always gives out test questions, and his lectures are not podcast. You can believe everything he tells you will be on the test; no tricks, just what you need to know. Pay attention to his hints in class. Sometimes he is more subtle than other times, but he pretty much tells you what he thinks you should know about which drug. Use the charts from the study CD Use the study CD charts/make your own. The drug lists may vary from year to year, so be sure to double check. Use the charts from the study CD all year. Keep them for the final. Also studying the drugs on the drug list that Dr. Keeton provides is key. Also, the pharm review packet for the final is great. Make charts or use the ones on the study CD. It makes it a lot easier to learn the drugs. make or use drug charts from study CD, Making your own chart/note cards helps to study. Print the drug charts from the study CD. Make flashcards Work hard that first module, don't let it overwhelm you, and make note cards to quiz yourself. There is a list of drugs he sends out--make notes (just the essentials) by each drug. This will be a nice review sheet before the test. Notecards are highly useful too. Flashcards!!! Do well on the first exam Score well on the first exam, and you will be set for the remainder of the semester. Work hard that first module, don't let it overwhelm you, and make note cards to quiz yourself. Study hard for the first exam, it is worth a
lot. do good on the gen concept test and will make the rest of the year easier Do well on the first few exams so you don't have to stress as much about it the rest of the year.

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PSYCHOPATHOLOGY GENERAL DESCRIPTION Psychopathology covers mental illnesses, drug dependence, and treatments. This course is also well organized, with all test questions coming from the syllabus. Dr. Talley gives excellent reviews, but you must go to class to "earn" these reviews. Most students did very well in the course, and the topics that Dr. Talley reinforces will be very helpful for your boards. The class counts for 3.5 credits. BOOKS Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is the required textbook for this course, but most students did not buy it and found the syllabus to be a sufficient source of information. PROFESSORS Students especially enjoyed Dr. Talley. Other professors that students liked included: Dr. Matthews, Dr. Singh, and Dr. Shilerstrom. OTHER RESOURCES First Aid for the USMLE was a good resource. STUDENT ADVICE
There were a lot of common themes with student advice; weve tried to distill them down to their essence (accompanied with some direct quotations for emphasis). Keep in mind, this is advice, and not hard and set rules to live by:

Go to lecture Please attend class or else she'll be less generous in the reviews. The lectures are very interesting, and it's also a matter of respect... so you should definitely go to lectures. Dr. Talley gives a great review IF class attendance is decent throughout the year be sure to attend enough lectures, or else she might skimp out on the reviews. She never did this with us, but we have heard stories of the past. Go to Dr. Talley's lectures because she focuses your study for the course. This class is literally taught straight to the board exams, so Dr. Talley is not trying to waste your time, and she'll really help you understand what you need to do/know. go to class, when you go to class she points out what is important for the test and will give a good review. GO TO CLASS, dont be a bum, they usually have good videos, she gives reviews before each test that tell you whats on the test so study this the day before exam, but dont abuse this and not attend class. Go to class so she'll give you a good review. GO to LECTURE. Even if you study something else while sitting in class - it helps to hear it. She gives great reviews IF there is attendance. Go to class. You can absorb alot of information passively just by listening and not even taking notes. It really cuts down on the study time at the end. Also, if you go to class, she gives EXCELLENT reviews. Go to the lecture... they are entertaining and a good way to learn. Go to lecture. A lot of people stop going because of the reviews she gives at the end of the modules but if you just go to the lectures and halflisten you won't have to study at all for the tests. Also, the more people that go to lecture, the better her reviews are. Sit through the lectures to hear the material and view the videoclips (they really do help you to understand psychopath), and then go to the differential diagnois and review sessions! Go to the reviews Attend the reviews and differential diagnosis lectures for sure. Go to the Differential Diagnosis and Review at the end of each module. review sessions are very high yield for the test. Go to the End-of-Module Review!! Everything you need to know she gives you in the review, but you gotta go to class for her to give the review (plus you'll never open your syllabus unless you do go, so you might as well be exposed to it once already). 1. Go to her Differential Diagnosis 2. Go to her review. GO TO THE REVIEWS and know everything Dr. Talley says and you will make an A. Class helps a little, but the review is "money," as Dr. Talley herself will tell you.

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ADVANCED CLINICAL EVALUATION SKILLS (ACES) GENERAL DESCRIPTION This is the MS2 version of CAP. You will see patients with actual diseases this year, and the course is good practice for your 3rd year on the wards. Make sure you feel comfortable with eliciting a history and performing a physical exam, so that you will be more prepared to see real patients. BOOKS Case Studies to Accompany Bates' Guide to Physical Examination and History Taking is the accompaniment to the CAP text we have all grown to love. It is required for the course, but many students found that it was not needed for the course. Bates' Guide to Physical Examination and History Taking PROFESSORS Dr. Schott is the course director. [her] lecture at the beginning of the year on the oral and written report was helpful.
Do what she says and study what she says. Dr. Fischbach is awesome. Definitely go to class for the MSK module for ACES & ICS because he will ensure that you learn what is important for the step exam.

STUDENT ADVICE
There were a lot of common themes with student advice; weve tried to distill them down to their essence (accompanied with some direct quotations for emphasis). Keep in mind, this is advice, and not hard and set rules to live by:

On using Bates I already had Bates, but I really didn't use it. concentrate on the red text in the margins and the extra info sections at the end of the chapters. Bates is a sure bet though, especially the charts at the end of the chapter. look through the red print and the charts at the end of the chapter in Bates the night before the exam. It's not as intuitive as CAP. Although the information is usually covered in ICS, there are a few key terms that are tested that will never come up anywhere else except in the book. read bates to answer the test questions because they are really random. Reading Bates would be great. What you learn in path, pharm, and ICS will be very relevant to ACES. Read Bates and know the charts at the end of the chapters and you'll be fine. The test questions are easy. Just read the red text in Bates the weekend before the exam. On using the Bates Cases don't be fooled into getting the Cases book. You DON'T need it! You do not need the cases book Dr. Schott tells you to buy. I didn't buy it and never suffered at module cases. You do not need the cases book Dr. Schott tells you to buy. I didn't buy it and never suffered at module cases. You don't need the case guide, even though Dr. Schott acts like you do. DO NOT buy the case book to go with Bates. You are told that it is required for the ACES labs, but it is NEVER used! Don't waste your money! Study for ICS, it will prep you for ACES Sometimes, a lot of the ACES questions overlap with ICS, so I wouldn't stress so much, unless youre having trouble understanding techniques. Do the practice q's from Bates' Case book and from the syllabus. Study ICS and you'll know ACES. Don't read the Bates book except for cardio. Also, the charts in the back of the chapters were sometimes helpful in ICS and ACES. Most of the exam questions you can figure out from ICS and they discuss it during your labs. If you have the case discussions in addition to lab, be prepared for making extensive DDx lists. maybe read bates before that ACES cases so you dont look like a fool, other than that ICS covers all ACES material. The only exam I studied for Aces is the Cardio module. Every other module I could answer everything from ICS/Path studying. ICS will pretty much teach you all you need to know. study ICS and you'll do awesome in ACES. If you study for ICS, you should do great in ACES. Other:
Practice your clinical skillz and write out a set of questions for each high yield disease for each module-- this will come in handy for your cases 1st semester and for the OSCE 2nd semester. Ex-- if someone has shortness of breath, have a differential in mind that guides your questions.

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