Being a First Year Student
The curriculum is divided into five blocks. Although you will hear many of the upperclassmen refer to the classes as blocks, the school is on a semester system. Much like college, the first year goes from August to December, then you get two weeks off and then you are in class again from January to May. The summer after your first year is your last summer off and you can use this time to rest, work, do research, shadow or travel abroad. When you return in the fall, you will again be in the classroom where you will be learning systems pathophysiology until February. The first two years cover the basic sciences in integrated blocks. Your third and fourth involve clerkships in various in- and out-patient settings. The last few weeks before graduation serve to integrate the previous four blocks and bring the class back together after two years of rotations.
As you would expect, there will be plenty of lectures to attend, but mixed in with these will be labs, small group discussions, review sessions, and also a good amount of time for individual study. The first twelve weeks (Block I) will be devoted to Human Structure and Development (i.e. Anatomy, Development and Histology); while the next fourteen weeks of your first year (Block II) will be devoted to Cellular and Subcellular Concepts (i.e. Biochemistry, Immunology and Genetics). It will be important to get to class and lab on time, if not early. It is important in lecture because now there is limited space in your classroom and seating will be tight. Also, Dr. Johnson will emphasize how important it will be to get to lab early. Keep in mind Dr. Johnson has a tendency to emphasize everything, so do not get too caught up in everything he says. The schedule has changed since last year, so lab may not be the first activity in the morning. Regardless, it will be important for you to arrive on time.
Throughout HS&D (and every other block) you will have tests every three weeks or so. At the end of HS&D there will be a week of PE midterms (really easy, so no worries) and the HS&D final. This is followed by your first week long Community Practice Experience (CPE). CPE comprises 4 weeks in which you will be in a primary care setting and will have the chance to put your interviewing and physical diagnosis skills into practice. For the CPE, you are required to attend 1 week at the end of Block 1, 2 weeks during May, and 1 week the following Fall. Each week you attend, you will have more knowledge from your studies and you should be able to understand and contribute more to your mentor. The dates for CPE are relatively flexible for your two week session in May. If you have a known conflict months in advance, talk to the people in the medical education office and they should be able to accommodate your needs. Karen Vaden is the primary contact for CPE.
After your first CPE you will have your DPR midterm (a video-taped session of you interviewing a standardized patient). At the end of CS&P you will have your first SPA exam. This exam tests your ability to take a complete history and perform a complete physical. After the last block of first year (Neuroanatomy and Dermatology) you will take the second part of SPA. This exam will test your ability to diagnose a patient and learn as much about an illness as you can using the resources available to you. After the SPA exam you will go on your 2nd CPE which should last 2 weeks.
Block II will integrate the topics of physiology, pharmacology, microbiology, infectious diseases and pathology with the following systems: nervous, musculoskeletal, gastrointestinal, renal, cardiovascular, pulmonary, integumentary, endocrine/reproductive, and heme/lymphatic, in addition to continuing the small groups and some labs from Block I.
As you would expect, there will be plenty of lectures to attend, but mixed in with these will be labs, small group discussions, review sessions, and also a good amount of time for individual study. The first twelve weeks (Block I) will be devoted to Human Structure and Development (i.e. Anatomy, Development and Histology); while the next fourteen weeks of your first year (Block II) will be devoted to Cellular and Subcellular Concepts (i.e. Biochemistry, Immunology and Genetics). It will be important to get to class and lab on time, if not early. It is important in lecture because now there is limited space in your classroom and seating will be tight. Also, Dr. Johnson will emphasize how important it will be to get to lab early. Keep in mind Dr. Johnson has a tendency to emphasize everything, so do not get too caught up in everything he says. The schedule has changed since last year, so lab may not be the first activity in the morning. Regardless, it will be important for you to arrive on time.
Throughout HS&D (and every other block) you will have tests every three weeks or so. At the end of HS&D there will be a week of PE midterms (really easy, so no worries) and the HS&D final. This is followed by your first week long Community Practice Experience (CPE). CPE comprises 4 weeks in which you will be in a primary care setting and will have the chance to put your interviewing and physical diagnosis skills into practice. For the CPE, you are required to attend 1 week at the end of Block 1, 2 weeks during May, and 1 week the following Fall. Each week you attend, you will have more knowledge from your studies and you should be able to understand and contribute more to your mentor. The dates for CPE are relatively flexible for your two week session in May. If you have a known conflict months in advance, talk to the people in the medical education office and they should be able to accommodate your needs. Karen Vaden is the primary contact for CPE.
After your first CPE you will have your DPR midterm (a video-taped session of you interviewing a standardized patient). At the end of CS&P you will have your first SPA exam. This exam tests your ability to take a complete history and perform a complete physical. After the last block of first year (Neuroanatomy and Dermatology) you will take the second part of SPA. This exam will test your ability to diagnose a patient and learn as much about an illness as you can using the resources available to you. After the SPA exam you will go on your 2nd CPE which should last 2 weeks.
Block II will integrate the topics of physiology, pharmacology, microbiology, infectious diseases and pathology with the following systems: nervous, musculoskeletal, gastrointestinal, renal, cardiovascular, pulmonary, integumentary, endocrine/reproductive, and heme/lymphatic, in addition to continuing the small groups and some labs from Block I.
Block 1 -- Human Structure and Development
The first twelve weeks of class (Block I) introduce the concepts of structure and development of the human body. Human structure (anatomy) is a visual science, of course, so expect to spend more time in laboratory than in lecture. An integrated approach to instruction has been designed so that Gross, Microscopic, and embryology of organs and organ systems are seen as a whole. Neuroanatomy is threaded throughout the entire twelve weeks so as to connect the brain and spinal cord with the structures they control. Each 3-week section has a theme for instruction. The theme is reinforced by a weekly series of clinical cases in small groups. There will also be a Radiographic Anatomy Lab in which radiology residents will be able to go around the G-floor labs and help the individual groups go through CT and MRI images of their body. Occasionally there will be anatomy clinics which are scheduled throughout the block to assist in the integration of anatomy and clinical applications. **Note that you will need to put in a lot of extra time during Anatomy. The amount that you get out of the course is directly correlated to how much time that you put in. It is important to treat each test as if it is the most important test of the block. The exams will increase in difficulty as the course continues but decrease in the overall percentage that they contribute to your final grade.
The gross anatomy lab features “down draft” tables that allow the air to be pulled down through the table, which decreases your ability to smell the bodies. Each group will engage in ILS (integrated learning station) during lab. For anatomy, you are placed in groups of 6-7 and within these groups you will be split into groups of 2-3 individuals. Two groups will be at the body at any given time while the third group is at the ILS stations participating in activities directly related to that day’s dissection. These assignments are meant to give you a better understanding of the system with which you will be studying. You may be asked to read sections in the text, look at cross-section, CT, MRIs, etc. These are tested on the exams and are very useful in understanding the material.
Your class may want to consider setting up informal practice practicals on the weekends before tests so that you can practice identifying structures. These are helpful in that it can help you to be in the right mindset for the practicals, but it is important to realize that these practicals are set up by students and not professors. It would be a good idea for your class to seek out MSIIs to help you set up the practicals because they have already been through this and may have more knowledge as to how to tag and what to tag. Usually you will need about 10 or so of your classmates to volunteer to devote their Saturday morning (or weekday afternoon) to setting up the practical. They will usually choose times for students to come in and try to identify structures and then check their answers. Please remember to be kind and grateful to the student volunteers because without them there would be no practice practicals. Don’t wait until after the first exam to start reviewing structures in the gross lab! Try to keep up with the work in the gross lab because all of the other topics (developmental, neuro, micro, etc.) depend on your knowledge of the gross material. GO TO THE PRACTICALS. Also, make sure that you have the cadavers well hydrated at the end of the practical, you don’t want to ruin another person’s cadaver. Also, remember that if you are going to the lab after hours do not leave someone else’s body out to dry. Drying out the bodies makes it much harder to work with them. The more you understand Anatomy, the easier the other courses will be. THEY ARE HIGHLY INTERTWINED (even though at times they may not seem to be). For example, you can memorize development and anatomy facts separately, but if you completely understand the concepts behind how the anatomy develops, then anatomy falls in line very easily and you can truly remember the anatomy and how it develops, rather than just memorize it. Also, many students have found it useful to form informal study groups – this can be a very helpful way to learn. Make sure that in your study group each person is adding something to the review. Frequently, you will comprehend something completely wrong (either from class, lab, or meeting) and not know it until you discuss it with someone else!
In anatomy, exams are given after each three-week block and a cumulative exam during the final exam week. All exams will be integrative and will consist of both written (maybe on the computer) and laboratory questions (lab practical questions.) The class will be split in half and while the first group takes the multiple choice section the other group will be upstairs doing the practical. You will have exactly 2 hours to complete the multiple choice sections and 70 minutes for the practical. Each and every body will have 2 tags, no more and no less. The rest of the 70 questions of the practical will be cross sections, radiology, osteology, etc. The exam questions are supposed to be linked closely to the stated objectives of each lecture, lab, or small group activity, and some are clinically based. The exams go as following: the first one covers the back and thorax, the second covers abdomen and pelvis, the third one covers head and neck and the 4th exam covers the extremities. THERE IS NO PRACTICAL FOR THE FINAL EXAM. One of your best resources is your big sib (a student mentor from the Class of 2012). Be sure to ask him/her (or any other second-year student) for tips on how to approach the work for Block 1A.
After each exam, analyze your performance for strengths and weaknesses so that you can plan effective means to improve your study skills, comprehension, and integrative thinking. Don’t wait too long to seek help if you are having difficulty. The faculty is very willing to help you, and they can offer some tips on how to approach the material. If on any exam you achieve a grade of less than satisfactory or fail you will be asked to meet with one of the course directors as well as one of the deans. Don’t worry, these meetings are just to see how you are doing and the professors will offer words of advice and encouragement.
Interact with your professors. They are very accessible and are available to help you understand the material. Some of them will spend weekends and nights with groups of students. Take advantage of this. Professors are on your side and are very willing to help. Don’t ever feel that you have a stupid question – they are always willing to answer anything, usually in more depth than necessary. If you do have a stupid question they will make a joke and everyone will laugh and the class will have comic relief for that lecture. Don’t wait too long to ask for help.
Textbooks with a clinical perspective have been chosen in most cases so that you can see the immediate relevance of the basic anatomy you are learning and apply it to development of your clinical skills and reasoning. ***Make sure to look at the recommended book list below.*** The new dissection manual for gross anatomy lab will get too smelly and greasy to be used for study at home, so your group WILL want to buy a manual to keep in the lab and you should probably take it to Kinkos and have it bound. Combine reading of lecture notes, learning objectives, lab guides, and textbooks to organize your learning. Don’t confuse browsing through an anatomy atlas with knowing the real structures in the laboratory. Also, make sure you solicit help from the instructors including the lab directors and technicians. There is no point in memorizing structures improperly.
In general, you will find that for many of your classes, while there is a recommended textbook, it is NOT tested directly from and serves more as a supplement and reference to the class notes. Therefore, you are free to choose the text or review book that best fills in the gaps in your knowledge. With all the choices out there this can sometimes be overwhelming. Below are some of the books that previous classes have found useful for each block.
Block 1- Human Structure and Development – Useful Textbooks
Netter’s Atlas of Anatomy – This is by far the most commonly purchased book. Some folks also purchase the Netter’s flash cards as they serve as a great study resource that you can take on the go.
Gross Anatomy (Board Review Series) – These books serve as a good additional resource in anatomy and are good at telling you what is really important for the long run; distilled down into need-to-know information. Helpful practice questions at the end of each section.
Moore’s Clinical Anatomy – This book is helpful for correlating the anatomy with clinical syndromes and their symptoms. There are copies available in the Anatomy lab which can be used there, though they are an older edition. Try to get by using the lab copies before purchasing.
Blumenfeld’s Neuroanatomy through Clinical Cases – This book is good for the head and neck section and it is also used as the text for Phase 2C, so you kill two birds with one stone.
High Yield Anatomy and Neuroanatomy – These are also helpful at distilling the information down into need to know facts that are good for the few days before the test.
Rohen’s Color Atlas of Anatomy- Great Book! If you have trouble translating the cartoon images in Netter’s into real life, then take a look at this. It has actual labeled photographs and is great to study for the identification/practical portion of the exams from.
Block 2 -- Cellular and Subcellular Processes
There will be a huge difference in time distribution from Block I to Block II. You will have significantly more time out of the classroom in Block II. This can be good or bad, some students will procrastinate and others will study more.
The goal of Block II is to establish a foundation of cell and molecular biology for understanding mechanisms of acquired and inherited human disease and it spans 14 weeks ending right before you leave for spring break. The lecture material combines courses in Biochemistry, Pathology, Molecular Biology/Medical Genetics, Pharmacology, and Introductory Microbiology and Immunology. The presentation is allied to weekly case conferences in which clinical scenarios are used to apply basic science topics. The aims of the biochemistry components of Block II are to engender an appreciation for the importance of inter-organ metabolism and metabolic regulation in human health. The block is separated by 4 exam topics. To set the stage for this course, the first exam includes a basic groundwork in immunology with Dr. Mizel and Dr. Grayson. Dr. Mizel and Dr. Grayson, the immunology professors, are always willing to have small group sessions to review concepts--you just have to ask. The key with immunology is to remember that it is one of the most rapidly changing fields you’ll study. If material in a text differs from lecture, know the lecture material. The first exam will also have some material from Dr. Smith on cellular signals and pathways. The second exam will intertwine protein structure, enzyme mechanisms, bioenergetics and extracellular mechanisms and this is led primarily by Dr. Smith. Realize that while you are covering all of this material you will also be taking class in pathology and pharmacology relating to your topic of discussion.
The third exam will have a foundation in Molecular Biology as well as Medical Genetics and this section will be taught primarily by Dr. Wang. The very last topic to be discussed will be Microbiology. This section is headed up by Dr. Reid and it is very important to stay current with the information because there is a lot to know concerning the pharmacology, disease and microorganisms. Introductory pathology will present the cell and tissue damage that occurs in autoimmune injury, inflammation and neoplasia. These topics will comprise about 55% of class time with the remaining hours spent in FCM, BAP, and Population Epidemiology.
The order in which the topics are presented allows the subject matter to build upon the previous week’s material. Expect to correlate topics from biochemistry and molecular biology with immunology and topics from immunology with pathology. In biochemistry, you’ll see that Dr. Smith does a great job in conveying the facts and making biochemistry entertaining. Pay particular attention when he tells you to listen.
Dr. Smith is an organized and enthusiastic lecturer. It is necessary to pay attention in his lectures, as he often displays IMPORTANT diagrams, and then explains them to the class. Warning: the explanations aren’t always written out! Take the formative exams (which you will be able to find online) to check your study progress while preparing for the exam! The formative examinations are usually helpful. They are a good way to judge your current knowledge base, and sometimes the same questions are actually seen on the real tests! Our class found that some of the formative exams were several years old and did not align perfectly with what was taught and emphasized in lecture. Supposedly, that will have been taken care of for you guys.
Dr. Wang will be heading up the Molecular Biology portion of the course. Most in our class thought she was a terrific teacher. If you have questions, don’t hesitate to ask. Also, she is willing to have help sessions and she had excellent lecture outlines. Again, take the formative exam while studying for the test! The second test statistically is the lowest of the entire first year, followed closely by the microbiology test. For the second exam, DO NOT NEGLECT the clinical lectures about in vitro, genetic testing, etc. They can be painful but the questions from this section make up a very large portion of the test and your knowledge of the “hard science” will not be able to make up for partially studying the clinical lecture material.
Immunology questions can be very difficult because few students have a solid background in the field. Using Tegrity after the class may be very useful in understanding the lecture material at your own pace. The board review book, High Yield Immunology and the book How the Immune System Works (by Lauren Sompayrac) are very good, and can often explain difficult concepts in elementary terms as well as provide the big picture. The most important thing with immunology is that you understand ALL of the mechanisms behind the processes. Immunology questions will frequently have examination questions that require you to know several discrete facts in order to get the questions right.
It is important to stay caught up, as the information in these courses builds on itself throughout the semester. Nevertheless, most of the class seemed to agree that Block II is the most manageable time during the first year! There is a bunch of “down time,” but don’t get too far behind! This is important to remember – if you can get ahead and master the material during your down time, this will make studying for the test that much easier.
Block 2- Cellular and Subcellular Processes – Useful Textbooks
Lippincott’s Biochemistry (Board Review)
Lippincott’s Pharmacology (Board Review)
Robbins’ Pathologic Basis of Disease (Textbook) This book covers material that you will need for the rest of your career in medicine. You can use it for pathology during IB, but it will become even more useful in future sections. There is an electronic version available through the library’s Electronic Textbooks for free use by students. All of these are available in the libarary.
Pathology “Red Book” (Board Review Series) – This is a good book for studying for boards and for getting the important info from this section.
High-Yield Immunology by Johnson – This is a helpful book if you are having trouble getting the whole picture.
Immunobiology by Janeway – Most didn’t get the book as it goes into much more detail than you will need, but found using the CD helpful for pictures and for the Quicktime movies. There is also a version of it available free online through the library’s Electronic Textbooks.
Clinical Microbiology made Ridiculously Simple – Amazing book! It may sound silly from the title, but this is by far the most purchased book for micro concepts and is a great board review book. Great mnemonics for trying to memorize all those bugs and drugs!
First AID for the USMLE STEP 1: This book does a great job of listing the important facts of biochemistry, immunology, genetics, and microbiology you may miss with the large amount of lecture material.
How the Immune System Works: Lauren Sompayrac
The goal of Block II is to establish a foundation of cell and molecular biology for understanding mechanisms of acquired and inherited human disease and it spans 14 weeks ending right before you leave for spring break. The lecture material combines courses in Biochemistry, Pathology, Molecular Biology/Medical Genetics, Pharmacology, and Introductory Microbiology and Immunology. The presentation is allied to weekly case conferences in which clinical scenarios are used to apply basic science topics. The aims of the biochemistry components of Block II are to engender an appreciation for the importance of inter-organ metabolism and metabolic regulation in human health. The block is separated by 4 exam topics. To set the stage for this course, the first exam includes a basic groundwork in immunology with Dr. Mizel and Dr. Grayson. Dr. Mizel and Dr. Grayson, the immunology professors, are always willing to have small group sessions to review concepts--you just have to ask. The key with immunology is to remember that it is one of the most rapidly changing fields you’ll study. If material in a text differs from lecture, know the lecture material. The first exam will also have some material from Dr. Smith on cellular signals and pathways. The second exam will intertwine protein structure, enzyme mechanisms, bioenergetics and extracellular mechanisms and this is led primarily by Dr. Smith. Realize that while you are covering all of this material you will also be taking class in pathology and pharmacology relating to your topic of discussion.
The third exam will have a foundation in Molecular Biology as well as Medical Genetics and this section will be taught primarily by Dr. Wang. The very last topic to be discussed will be Microbiology. This section is headed up by Dr. Reid and it is very important to stay current with the information because there is a lot to know concerning the pharmacology, disease and microorganisms. Introductory pathology will present the cell and tissue damage that occurs in autoimmune injury, inflammation and neoplasia. These topics will comprise about 55% of class time with the remaining hours spent in FCM, BAP, and Population Epidemiology.
The order in which the topics are presented allows the subject matter to build upon the previous week’s material. Expect to correlate topics from biochemistry and molecular biology with immunology and topics from immunology with pathology. In biochemistry, you’ll see that Dr. Smith does a great job in conveying the facts and making biochemistry entertaining. Pay particular attention when he tells you to listen.
Dr. Smith is an organized and enthusiastic lecturer. It is necessary to pay attention in his lectures, as he often displays IMPORTANT diagrams, and then explains them to the class. Warning: the explanations aren’t always written out! Take the formative exams (which you will be able to find online) to check your study progress while preparing for the exam! The formative examinations are usually helpful. They are a good way to judge your current knowledge base, and sometimes the same questions are actually seen on the real tests! Our class found that some of the formative exams were several years old and did not align perfectly with what was taught and emphasized in lecture. Supposedly, that will have been taken care of for you guys.
Dr. Wang will be heading up the Molecular Biology portion of the course. Most in our class thought she was a terrific teacher. If you have questions, don’t hesitate to ask. Also, she is willing to have help sessions and she had excellent lecture outlines. Again, take the formative exam while studying for the test! The second test statistically is the lowest of the entire first year, followed closely by the microbiology test. For the second exam, DO NOT NEGLECT the clinical lectures about in vitro, genetic testing, etc. They can be painful but the questions from this section make up a very large portion of the test and your knowledge of the “hard science” will not be able to make up for partially studying the clinical lecture material.
Immunology questions can be very difficult because few students have a solid background in the field. Using Tegrity after the class may be very useful in understanding the lecture material at your own pace. The board review book, High Yield Immunology and the book How the Immune System Works (by Lauren Sompayrac) are very good, and can often explain difficult concepts in elementary terms as well as provide the big picture. The most important thing with immunology is that you understand ALL of the mechanisms behind the processes. Immunology questions will frequently have examination questions that require you to know several discrete facts in order to get the questions right.
It is important to stay caught up, as the information in these courses builds on itself throughout the semester. Nevertheless, most of the class seemed to agree that Block II is the most manageable time during the first year! There is a bunch of “down time,” but don’t get too far behind! This is important to remember – if you can get ahead and master the material during your down time, this will make studying for the test that much easier.
Block 2- Cellular and Subcellular Processes – Useful Textbooks
Lippincott’s Biochemistry (Board Review)
Lippincott’s Pharmacology (Board Review)
Robbins’ Pathologic Basis of Disease (Textbook) This book covers material that you will need for the rest of your career in medicine. You can use it for pathology during IB, but it will become even more useful in future sections. There is an electronic version available through the library’s Electronic Textbooks for free use by students. All of these are available in the libarary.
Pathology “Red Book” (Board Review Series) – This is a good book for studying for boards and for getting the important info from this section.
High-Yield Immunology by Johnson – This is a helpful book if you are having trouble getting the whole picture.
Immunobiology by Janeway – Most didn’t get the book as it goes into much more detail than you will need, but found using the CD helpful for pictures and for the Quicktime movies. There is also a version of it available free online through the library’s Electronic Textbooks.
Clinical Microbiology made Ridiculously Simple – Amazing book! It may sound silly from the title, but this is by far the most purchased book for micro concepts and is a great board review book. Great mnemonics for trying to memorize all those bugs and drugs!
First AID for the USMLE STEP 1: This book does a great job of listing the important facts of biochemistry, immunology, genetics, and microbiology you may miss with the large amount of lecture material.
How the Immune System Works: Lauren Sompayrac
Block 3 -- Neuroscience, Psychiatry, and Dermatology
This block will be 7 weeks long and it will have 3 tests. The first exam and second exam will cover the basics in neuroanatomy, neurophysiology and neuropathology. A large emphasis is placed on the mechanisms behind neurologic diseases (i.e. Parkinsons, Alzheimers, etc). Psychiatry and pharmacology of the nervous system will also be covered. There will also be a lab component for this exam, where in anatomy you had histology and radiology lab you will now have neuroanatomy lab. A common remark of second years who have just taken Step One is to not ignore the psychiatry lectures. Make an effort to understand this field that many of your classmates will refer to as too “subjective.”
The last week of this block will be devoted to dermatology and this is headed up by Dr. McMichael. This section occurs over a span of 4 days and you will have the opportunity to spend one afternoon in the dermatology clinic where you go from room to room and see patients in groups for 4-5. This is great because now you are able to see a lot of the diseases you have discussed as well as treatments for these diseases. Even though the block is very short do not get complacent with your study efforts, take the block seriously and the exam will be fine.
Useful Textbooks
High Yield Neuroanatomy
Neuroanatomy through Clinical Cases (Blumenfeld)- the required text. This is one of the few classes that you will actually need the specific book that is recommended- you will have to have your own copy to get through the labs, which reference it. But, it isn’t that painful as this is one of the best written textbooks around.
Clinical Neuroanatomy Made Ridiculously Simple- NOT a substitute for the text, but great if you need to see an overview before you delve into the details of the lectures/textbook.
Pharmacology (Lippincott’s)
First AID for the USMLE STEP 1
Other Courses During First Year
FOUNDATIONS OF CLINICAL MEDICINE (FCM)
This class will last throughout Block I and will meet once per week (Tuesday or Thursday afternoon). It covers the two basics of clinical medicine: the patient interview and the physical exam. Interview and physical exam will alternate.
Doctor-Patient Relationship (DPR)
Dr. Celestino is in charge of the interview component of the class which will meet for 12 sessions. During this part of FCM, you will learn step by step how to do a patient interview. You will be in a group with 4-5 of your classmates and two faculty advisors. There will be reading assignments about varying topics of the patient interview to be completed before each class. During class, after a discussion of the readings, you will have a chance to practice what you have learned as you go onto one of the hospital wards and interview patients. Some classes that involve sensitive topics will involve role playing with classmates instead of the interview. Be prepared to give and receive lots of feedback on interview style and content. You will be evaluated based on two taped interviews (a midterm and a final) that you will turn in to your advisors along with a summary of the interview and a self-assessment. This class can be intimidating at first, but you'll enjoy it once you have had a few sessions to practice.
Physical Exam (PE)
Dr. Jackson will be in charge of the physical exam (PE) component of FCM. This class will give you an introduction to the basic techniques of the physical exam. The class will begin with a short lecture by Dr. Jackson (or a specialist) about a particular portion of the physical exam. This will be followed by time to practice what you learned on fellow students. You will practice in groups of 2 or 3, with a second-year student to review technique and answer questions. The only way to really learn this is to practice, practice, practice. For this class, you will need, at minimum, a stethoscope - but a penlight, reflex hammer, and a 256 Hz tuning fork will be useful (and you’ll need them later anyway). You may also want to purchase a diagnostic kit to help you at home, but the practice rooms at school come furnished with them. DO NOT!!!! BUY THE DIAGNOSTIC KIT OR STETHOSCOPE AT THE BOOKSTORE. A REPRESENTATIVE WILL COME IN AUGUST TO SELL THEM AT A DISCOUNTED PRICE!!! Many students also feel that it is not necessary to buy the diagnostic kit at this stage of your medical career. However, the stethoscope is a must. Information about what kind of stethoscope is needed will be given early in the block.
Useful Textbooks – few buy these
Mosby’s Guide to Physical Examination (Seidel, Ball, Dains, & Benedict)
Bate’s Guide to Physical Examination and History Taking (or the pocket version)
For this class Dr. Jackson will recommend that you reference either of the above texts- NOT both. The library already buys an electronic subscription to the video version of Bate’s, which allows you to see videos of the physical examination being done. This is sufficient, but if you want more explanation, then look at one of the above texts.
SPA (Standardized Patient Assessment)
You will have an information session several weeks before each Standardized Patient Assessment (SPA), which take place during each exam week. For the first SPA in Block I, you will get a standardized patient (actor) with a complaint and you will be expected to conduct an interview and physical exam in a specified amount of time. This is all accomplished in an exam room with a one-way mirror and video camera. You will receive feedback from your evaluator on the content and technique of your performance. For those portions of the physical exam that cannot be simulated, i.e. elevated blood pressure, carotid bruits, etc., you will be given cards with results (provided that you actually performed that portion of the physical exam).
For the Block III SPA you are actually given a patient write-up (no standardized patient) and have 48 hours to prepare a two hour basic science and clinical learning issue presentation for two faculty members. During this SPA, you can actually order tests and get results on the intranet to help you form hypotheses about what is going on with the patient.
Typically, the first SPA is worth very little (grade-wise) while later ones will carry more weight. The SPA will be used to determine a portion of your FCM final grade.
Population Epidemiology/Evidence-Based Medicine
One of the major goals of this course (abbreviated “Pop-Epi”) is to learn how to interpret medical literature. It focuses on study designs, epidemiology terms, validity, reliability, bias, basic statistics, and outcomes analysis. It also focuses on using the literature to make evidence based clinical decisions. The course then continues on to other public health topics.
Pop-Epi is an ever evolving course, so our experience will probably be different from yours. For us, Pop-Epi started in block 2. We had 2 weeks of Pop-Epi every Monday and Friday afternoon for 2 hours and then had our final exam the week of Thanksgiving. After winter break, Pop-Epi continued on Thursdays. We had a Pop-Epi lecture every other Thursday, which discussed particular topics in public health. On each test we had 3 questions relating to the Pop-Epi lecture.
Many students did not find it necessary to purchase the recommended book. The problem sets are due before the Friday session and are graded. They ask important questions you should think about when approaching an article. The rest of the course grade is determined a multiple-choice final exam and the three or so questions on each exam after winter break.
BAP (Being a Physician)
Required readings are selected by Drs. Ober and Lambros. These patient-centered readings address how a physician might deal with the emotionally-overwhelmed events of medical practice, model excellence in the doctor-patient relationship, illustrate physician behaviors that are detrimental to patient well-being, or touch on other aspects of professionalism.
Whole class discussions center on professionalism issues identified in the required readings, general conversations with Drs. Ober and Lambros, Assistant Dean for Education, on issues of professionalism in general, discussions of problematic physician and student behaviors as they arise throughout the year and development of strategies for maintaining professional values under conditions of stress.
The format of BAP may be changing for the upcoming year into a more small-group experience.
CPE (Community Practice Experience)
The object of this course is to 1) provide students with an opportunity to practice the clinical skills and apply the basic science knowledge that they will be learning in Block I; and 2) introduce students to public health and community medicine.
Students will spend a total of four weeks in primary care practices throughout North Carolina. This includes two, week-long sessions during each of the first two years and a two-week rotation the summer between first and second years. Students can request certain areas of the state. Since many area medical schools attempt to place students and students typically request the same locations, input on placement will be limited. The school and AHEC will provide housing for you, if needed.
The exact amount of time students will spend in the clinics will vary. You will be given an assignment detailing your schedule and activities. Our class was required to spend eight half days in the clinic during the the two week-long sessions and 16 half days during the summer CPE. Of course, the time actually spent in clinic will also vary depending of the preceptor. The remaining non-clinic time was spent writing patient notes, researching learning issues, analyzing the community.
Students come back to school reporting a wide variety of experiences. The student/preceptor relationship is quite variable. Some students are immediately thrown into action while others begin through observation.
If you have questions or it’s clear from your first week-long rotation that your preceptor and/or setup aren’t going to work, give Dr. Clinch, the course director a call. They really want people to have good experiences.
This class will last throughout Block I and will meet once per week (Tuesday or Thursday afternoon). It covers the two basics of clinical medicine: the patient interview and the physical exam. Interview and physical exam will alternate.
Doctor-Patient Relationship (DPR)
Dr. Celestino is in charge of the interview component of the class which will meet for 12 sessions. During this part of FCM, you will learn step by step how to do a patient interview. You will be in a group with 4-5 of your classmates and two faculty advisors. There will be reading assignments about varying topics of the patient interview to be completed before each class. During class, after a discussion of the readings, you will have a chance to practice what you have learned as you go onto one of the hospital wards and interview patients. Some classes that involve sensitive topics will involve role playing with classmates instead of the interview. Be prepared to give and receive lots of feedback on interview style and content. You will be evaluated based on two taped interviews (a midterm and a final) that you will turn in to your advisors along with a summary of the interview and a self-assessment. This class can be intimidating at first, but you'll enjoy it once you have had a few sessions to practice.
Physical Exam (PE)
Dr. Jackson will be in charge of the physical exam (PE) component of FCM. This class will give you an introduction to the basic techniques of the physical exam. The class will begin with a short lecture by Dr. Jackson (or a specialist) about a particular portion of the physical exam. This will be followed by time to practice what you learned on fellow students. You will practice in groups of 2 or 3, with a second-year student to review technique and answer questions. The only way to really learn this is to practice, practice, practice. For this class, you will need, at minimum, a stethoscope - but a penlight, reflex hammer, and a 256 Hz tuning fork will be useful (and you’ll need them later anyway). You may also want to purchase a diagnostic kit to help you at home, but the practice rooms at school come furnished with them. DO NOT!!!! BUY THE DIAGNOSTIC KIT OR STETHOSCOPE AT THE BOOKSTORE. A REPRESENTATIVE WILL COME IN AUGUST TO SELL THEM AT A DISCOUNTED PRICE!!! Many students also feel that it is not necessary to buy the diagnostic kit at this stage of your medical career. However, the stethoscope is a must. Information about what kind of stethoscope is needed will be given early in the block.
Useful Textbooks – few buy these
Mosby’s Guide to Physical Examination (Seidel, Ball, Dains, & Benedict)
Bate’s Guide to Physical Examination and History Taking (or the pocket version)
For this class Dr. Jackson will recommend that you reference either of the above texts- NOT both. The library already buys an electronic subscription to the video version of Bate’s, which allows you to see videos of the physical examination being done. This is sufficient, but if you want more explanation, then look at one of the above texts.
SPA (Standardized Patient Assessment)
You will have an information session several weeks before each Standardized Patient Assessment (SPA), which take place during each exam week. For the first SPA in Block I, you will get a standardized patient (actor) with a complaint and you will be expected to conduct an interview and physical exam in a specified amount of time. This is all accomplished in an exam room with a one-way mirror and video camera. You will receive feedback from your evaluator on the content and technique of your performance. For those portions of the physical exam that cannot be simulated, i.e. elevated blood pressure, carotid bruits, etc., you will be given cards with results (provided that you actually performed that portion of the physical exam).
For the Block III SPA you are actually given a patient write-up (no standardized patient) and have 48 hours to prepare a two hour basic science and clinical learning issue presentation for two faculty members. During this SPA, you can actually order tests and get results on the intranet to help you form hypotheses about what is going on with the patient.
Typically, the first SPA is worth very little (grade-wise) while later ones will carry more weight. The SPA will be used to determine a portion of your FCM final grade.
Population Epidemiology/Evidence-Based Medicine
One of the major goals of this course (abbreviated “Pop-Epi”) is to learn how to interpret medical literature. It focuses on study designs, epidemiology terms, validity, reliability, bias, basic statistics, and outcomes analysis. It also focuses on using the literature to make evidence based clinical decisions. The course then continues on to other public health topics.
Pop-Epi is an ever evolving course, so our experience will probably be different from yours. For us, Pop-Epi started in block 2. We had 2 weeks of Pop-Epi every Monday and Friday afternoon for 2 hours and then had our final exam the week of Thanksgiving. After winter break, Pop-Epi continued on Thursdays. We had a Pop-Epi lecture every other Thursday, which discussed particular topics in public health. On each test we had 3 questions relating to the Pop-Epi lecture.
Many students did not find it necessary to purchase the recommended book. The problem sets are due before the Friday session and are graded. They ask important questions you should think about when approaching an article. The rest of the course grade is determined a multiple-choice final exam and the three or so questions on each exam after winter break.
BAP (Being a Physician)
Required readings are selected by Drs. Ober and Lambros. These patient-centered readings address how a physician might deal with the emotionally-overwhelmed events of medical practice, model excellence in the doctor-patient relationship, illustrate physician behaviors that are detrimental to patient well-being, or touch on other aspects of professionalism.
Whole class discussions center on professionalism issues identified in the required readings, general conversations with Drs. Ober and Lambros, Assistant Dean for Education, on issues of professionalism in general, discussions of problematic physician and student behaviors as they arise throughout the year and development of strategies for maintaining professional values under conditions of stress.
The format of BAP may be changing for the upcoming year into a more small-group experience.
CPE (Community Practice Experience)
The object of this course is to 1) provide students with an opportunity to practice the clinical skills and apply the basic science knowledge that they will be learning in Block I; and 2) introduce students to public health and community medicine.
Students will spend a total of four weeks in primary care practices throughout North Carolina. This includes two, week-long sessions during each of the first two years and a two-week rotation the summer between first and second years. Students can request certain areas of the state. Since many area medical schools attempt to place students and students typically request the same locations, input on placement will be limited. The school and AHEC will provide housing for you, if needed.
The exact amount of time students will spend in the clinics will vary. You will be given an assignment detailing your schedule and activities. Our class was required to spend eight half days in the clinic during the the two week-long sessions and 16 half days during the summer CPE. Of course, the time actually spent in clinic will also vary depending of the preceptor. The remaining non-clinic time was spent writing patient notes, researching learning issues, analyzing the community.
Students come back to school reporting a wide variety of experiences. The student/preceptor relationship is quite variable. Some students are immediately thrown into action while others begin through observation.
If you have questions or it’s clear from your first week-long rotation that your preceptor and/or setup aren’t going to work, give Dr. Clinch, the course director a call. They really want people to have good experiences.
First Year Course Hints
- Go to the first few lectures of each block to decide if your learning style would benefit more from going to class or not.
- Try asking professors what is the most important material for the test (but everything you're tested on will be in the lectures)
- Determine whether you learn and study better from home or class
- Human development block
- Embryology
- Awesome site for animations if you are confused http://www.indiana.edu/~anat550/embryo_main/
- Anatomy (For some it’s unpleasant, others love it-- either way it’s really a great opportunity to learn and it’s really a good idea to stay on schedule or ahead). The SRS questions are there to help you think as a group through problems).
- Netters Atlas (or Grant’s)
- Color atlas- real pictures not like the sketches in Netter’s (there are practice sessions you can attend where upper classmen set up practice ID sessions- those can be really helpful), but things can get a little crowded. Don’t worry about the crowd, just go to them and take it in.
- They’ll tell you don’t spend too much time in the lab, it’s a balancing act. Try to learn while in the lab if you can.
- Be courteous and allow shorter students to see. Share the dissection process. (there is a memorial service at the end of anatomy, which is really thoughtful-- if you can participate, don’t be shy!).
- Cell/subcell block
- Immunology-
- Know everything
- Go to lectures unless you’ve taken immunology in undergrad! This topic can be a real doozie, and is arguably one of the most important topics of all of medical school to help understand a LOT!
- Biochem
- Take the time to make your own study guides and draw out the pathways. It’s time-consuming but a good way to combine and synthesize info that is presented in pieces.
- Know everything
- Also very useful to know well to devise treatment plans; helps understand disease processes
- Microbiology
- Clinical Microbiology Made Ridiculously Simple (this might be one of the best, easiest-to-read texts you’ll buy all year, totally worth it)
- Know the lectures, even the weird obscure stuff.
- Genetics
- See above- 1st AID has good explanations of things
- Neuro block
- Texts: Blumenfeld is a MUST
- Practice labeling and focus on lesion localization
- Statistics
- Calculators are allowed
- 1st AID section is brief overview
- Is on USMLE (no surprise)
- Lectures
- Dermatology
- Not a hard block if you get the lectures down you’ll ace this exam.
- You get to spend a few hours in the derm clinic seeing some of the diseases you learned... awesome experience