M1 Fall
Medicine & Society
Medicine and Society is a five-day crash course on the fundamental principles of epidemiology, preventive medicine, and evidence-based medicine. It covers basic statistical tests and clinical research design. The material is not difficult, but it can be a bit overwhelming for people who have not taken statistics previously. The bulk of the class is taught by Dr. Carl Li. Dr. Li tells a lot of bizarre anecdotes from his years in medical school and as a U.S. Public Health Service officer in Alaska. He’ll probably recount the story of the first leg amputation he observed. (“There’s nothing like the sound of the leg hitting the floor - THUD!”) His sarcastic sense of humor helps keep people’s attention, as the lecture material can be a bit dry. You don’t need to buy a textbook: the class notes are very thorough. Med and Society is your first class of the semester. It’s not a stressful class, but don’t let your guard down.
Gross Anatomy
Human Gross Anatomy is one of the most interesting and clinically relevant courses of the first year. This was, by far, the most intense course of first semester, but also a favorite among students.
You’ll be spending more time on anatomy than you will on any other course. There will be times when you’ll wonder how you can ever learn everything, but you will (and you’ll proceed to forget it just seconds after exiting the exam). This is the opportunity to remember back to that “certain something” that intrigued you about the human body and made you enter medicine.
YOU MUST TAKE THIS COURSE SERIOUSLY FROM DAY ONE. Students who don’t heed this advice fail the course; that’s not a warning, just a fact. Some students will not take the first block seriously because it’s worth fewer points than the latter two blocks. However, success in the first block sets you up for success in the second and dreaded third blocks. [Note from an editor on the “dreaded” third block: rumors always float around that third block is the most difficult. However, the third exam average is comparable to that of the other two exams. This editor performed better on the third block exam than she did on either of the first two exams. Do not let rumors about third block intimidate you.] You also must have a strategy for studying, or you might waste precious time studying in ways that aren’t conducive to memorizing the voluminous amounts of information. Reading through a hundred pages in your text will not allow you memorize anything in time. You also might be tempted to underestimate the difficulty of this course: when you go to your first lecture, you’re going to think that the course isn’t that bad. Then you realize that literally every word of each lecture is testable, and that you’re taking a short answer test. To get an idea of how much material that there is to learn, sit down once in the first week with your lab partner, and test each other on what you were just supposed to have learned in lecture and lab. You’ll be amazed at how much is in one lecture or lab presentation, and how long it will take you to master all of the material.
Here are three steps that you can take to do well in anatomy:
Step 1: Understand what’s on the exam. Most of the exam will consist of a pin in a structure (or a tag on an x-ray or bone etc), and follow-up questions related to the structure. Structures that are in the dissection instructions, in the presentation instructions, or in the assigned pages in the dissector are fair game to be pinned. Follow up questions will come from LECTURE, THE COURSE MANUAL, OR THE SPECIFICALLY ASSIGNED READING. For the record, as of this past year (2011), the only “assigned readings” for which you’re responsible (aside from the notes, of course) are clinical vignettes in Block Three. Dr. Hard assigns short readings (i.e. one to two pages) in Moore’s Clinical Anatomy. Usually, the readings are just clinical applications of the material that you’ve learned in class. All other “suggested readings” are optional, and you won’t be tested on anything that’s not in your manual (again, with the exception of what Dr. Hard tells you to read). Use Moore’s text as a reference, and only if you need it: reading Moore chapters in their entirety is extremely inefficient. Most students did not use Moore’s at all outside of third block.
Step 2: Plan how you’re going to memorize the information. You may want to memorize by area, lab presentation, lecture, or a combination thereof. Often, if you just try to memorize a lecture, you’ll memorize the subject in a way that might not make sense to you. To figure out how to study, you really have to understand what kind of learner you are. You might learn best in lab, with your hands on the structure (most people learn well in the lab), you might learn best from diagrams and pictures, or you might learn best from reading. Remember, everyone has a different learning style, and it’s OK! Just know how you learn best.
Step 3: MEMORIZE EVERYTHING!
Here are a few hints for lab. The anatomy lab will be the first time a number of students encounter an actual dead body. Some students will be grieving from a loss of their own, making the lab experience particularly trying in the face of their loss. Father Mike from the Newman Center is usually in the lab for the first couple of sessions. He is great to talk to about your concerns, and he also has been known to actually pick up a scalpel and help you dissect. At the end of the semester, there is a Gross Anatomy Memorial put on by your class to help you bring closure to the experience.
There are too many people assigned to each cadaver (usually eight) to work effectively at the same time, especially when you are all trying to dissect parts of the head. Some professionalism and interpersonal skills will go a long way: you’ll be spending a lot of time with the seven other people at your table. That said, don’t feel bad about leaving lab early when there simply is not enough room for you to work; your time is better spent elsewhere. But before you leave, talk to your tablemates to make plans for who will dissect when.
There is no perfectly pre-dissected body at which to look, other than what is given in the atlases. Keep in mind that many of the dissection instructions are modified from the instructions in Grant’s Dissector, so pay attention to your lab manual! Rohen’s Color Atlas of Anatomy is also a good book: it has pictures of actual professional dissections, so it’s a great way to study when you can’t be in the lab.
In addition to the professors who teach their respective sections, there are fourth year students TA-ing in the lab. The fourth year students are helpful most of the time, but do not count on them exclusively. Beware of some of the information provided by fourth years: some will quickly become infamous for providing incorrect info.
You will be required to present your dissections to other students at your table. Each table is split into four groups of two students each, and each group dissects different parts of the cadaver. You are responsible for teaching your classmates about the structures that you dissect. The idea is to have each duo teach the rest of the group about the area that they dissect. Many groups make models or prepare handouts with mnemonics, charts, or sketches, in addition to giving oral presentations. Good presentations are key to learning anatomy well! If you know the material completely when you present it to your table, you’ll remember it throughout the rest of the block. It is important to note that you should not rely on other groups’ presentations as the sole source of information. Some presentations are excellent, but some are poorly done, incomplete, or inaccurate. Bear in mind that everyone, even the instructors and TAs, will be wrong at some point, so if someone corrects you, don’t take it personally. At the same time, be respectful when others present, and when someone identifies a structure to you, take the motto,“trust but verify” to heart.
As of 2011, the faculty started evaluating the student presentations. (Don’t stress about being evaluated: it won’t affect your grade.) The faculty randomly evaluates two presentations each week. Usually, each table gets evaluated at least two or three times during the whole semester. As long as your presentation includes all of the elements required as outlined in the dissection instructions, you will be fine for the evaluation. The faculty will give you constructive feedback via email. Apparently, the evaluations are part of your “permanent record” through the OME, but again, as long as you do the work, you’ll be fine. Keep in mind that the entire group is expected to participate, not just the presenters! Everyone is expected to ask questions and take part in the presentation.
The lab is open at night and on weekends for extra study. Going to the lab is a great break from book studying. Be prepared to go into the lab on weekends. Some people go in every Friday and Saturday night (this is not an option for some people). You don’t have time during lab to study the material, so you have to make the trip back in, even if it means giving up your free time. Lab time is invaluable: this is when you solidify what you have learned (plus, it’s a lot more fun than just reading a book or looking at pictures). Actually, the lab time on a Saturday afternoon can be surprisingly entertaining. You might even find yourself looking forward to it, and then missing it when the class is over. This is both good and bad: don’t get too distracted by your classmates! Also, take time to look at the prepared exhibits and models on the sides of the lab, especially the cross-sections; these extra materials will be tested. In general, take the lab part of the course as seriously as the lecture, if not more. Study with your friends from other tables that are from other dissection groups. Look at a lot of cadavers, not just yours (different cadavers look completely different). Exams are structured to give you “textbook” specimens, but drawn pictures and real specimens look different! Remember, you are tested on YOUR CLASS’ dissections. So, if you have a crummy dissection, and your dissection appears as a question on the exam, everyone suffers. Since the anatomy practical is probably unlike any test you’ve ever taken, you’ll get a brief practice exam, organized by a few harried second-year students, right before your first exam.
Don’t wait until right before the exam to study in the lab! It gets VERY crowded and noisy. Try to go into lab after hours at least once a week throughout the block. It’s helpful to study when it’s quiet, and when there are fewer distractions in the lab. Bring a study buddy with you, or just go in by yourself and review some dissections. Even if you go into after hours for just an hour at a time once per week, you will find yourself to be much more confident in identifying structures. (Of course, you’ll be in the lab a lot more around exam time, but it helps to get a head start in the lab). If you can manage to form a four-person study group. one of you from each dissection group (ABCD), you will be able to clear up a lot of your questions together in lab. Try picking people from other anatomy tables so you can have the information presented differently than in you table discussions.
A few years ago, there was an incident when some medical students allegedly screwed up a dental student’s dissection. The course director went ballistic, treated us like guilty second graders, and closed down the lab for three days over a weekend. Barring any major concern at an anatomy table, just keep such incidents to oneself, so as not to ruin the lab hours of every student involved in anatomy. And, of course, respect other people’s dissections ! Just a thought (and, for the record, the ansa cervicalis was accidentally damaged by another member of the same dental table).
Take the rules of the lab VERY seriously. Do not, under any circumstance, take photos in the lab. Once you get into the lab, photography is completely forbidden, even if the photo is not of a cadaver. Incidents have occurred involving photography in the lab, and the faculty took them very seriously.
Here’s the lowdown on the course faculty. During your first day of lab, you will be abruptly introduced to Dr. Ray Dannenhoffer. He is there to scare you a little, and he sure does. Believe him when he tells you to study anatomy four hours a day. He might have a funny way of showing it, but Ray is in the med school for the students. He may like to bust people’s chops, but he is also a superb teacher and has a great sense of humor. Ray is very helpful, both in the lab and outside: he is also the director of the Office of Medical Computing. (Students in the past have warned others to be wary of asking Ray for help on dissections: he has a tendency to rip vital and delicate parts.) You want Ray on your side. Don’t piss him off. Just do your stuff, and return your bone box at the end of the semester.
Kevin and Tom are the caretakers of the lab. Kevin’s the young guy, and Tom’s the older one. They can become your best friends. They always keep the students’ best interests in mind and are very willing to help you, as long as you treat them with the respect they deserve. Heck, they’ve been here so long, they probably know anatomy better than the professors. However, they always act like they know nothing. Don’t let the façade fool you, and respect their years of knowledge and service. They also keep candy in their office if you need a break from a dissection or have some down time while someone else in dissecting the area you need access to (just remember to wash your hands first).
You will probably start the course with the axial skeleton and the muscles of the back, neck, shoulder, and arm. Dr. John Kolega teaches these sections. He knows his stuff and is a pretty good teacher. Some studetns found him to be a bit on the boring side, but his lectures are very thorough; at the end of the course, you’ll appreciate what a great instructor he is. He’s also the course coordinator, so he’s your go-to guy if you want to challenge any exam questions.
A word of advice about block I, the leg seems to be thrown at you in five seconds at the end of the course when you are handed a pre-dissected, dried out limb. Just because you don’t dissect the leg yourselves doesn’t mean it will not be heavily tested (oh and those dried muscles will be the same ones you have to identify, so get used to them).
Dr. Charles Severin is an amazing teacher. He has a knack for explaining complex stuff and having you remember it. He teaches the thorax and perineum. Dr. Severin spends a lot of time in the lab answering questions, and his patience and dedication are truly remarkable. His review sessions in the lab are the best: he’ll repeat his presentations over and over without complaining, even when it’s late at night. When he comes to your table, expect half the class to show up and watch, with the more adventurous ones standing on tables and stools to catch every word that he says. He’s known for giving analogies; sometimes they’ll make sense, and sometimes they won’t. Bottom line: if the analogies don’t make sense to you, don’t worry about what’s in “the basement,” and learn the material in any way that you can. (You’ll learn all about “the basement” in Dr. Severin’s perineum section during second block. Bet you can’t wait!)
Dr. Cynthia Dlugos covers the abdomen, as well as the autonomic nervous system. She loves teaching students, and is excellent at explaining difficult material. She always comes up with creative props for her lectures: towels, socks, metal rods, and vegetables from her own garden. She’ll be up to her elbows with guts as she helps you with your dissection, saying, “this is why they call it GROSS anatomy!” The thorax and abdomen sections can be more difficult than the musculoskeletal stuff, although they may not seem to be. Just remember not to blow off these sections, which include most of the internal organs: heart, lungs, GI tract, and the reproductive organs. Dr. Dlugos’s notes are heart-wrenchingly detailed, and, yup, you need to know it all. Dr. Dlugos loves helping students, so don’t hesitate to go to her office if you have a question. She will bend over backwards to help you. Just beware of her evaluations: they can be quite harsh. She means well, though.
(Note from one of your beloved 2012 OC members: I ran into Dr. Dlugos this past summer outside of her office in Sherman Hall. She inquired about my summer plans. When I told her that I was on the Orientation Committee, she replied, “Make sure that you tell them [the M1s] to study embryology!” I told her that I would put her words of wisdom in this handbook. Heed her advice. You have been warned.)
Drs. Frank Mendel and Robert Hard teach the head, neck, and cranial nerve sections. They are both excellent, and you can learn a lot from them if you show that you are putting some effort into the course. Dr. Hard gives off a tough appearance, but he’s a really nice and helpful guy deep down. He’ll tell you a lot about “suitcases” (you’ll see). The head and neck dissections are a bit harder, because the structures are smaller, and are often shielded by bone. Be sure to start learning the cranial nerves from the first day of the block! In this block, a book with text (Grant’s Clinical or Gray’s Anatomy of the Human Body) will come in handy: many of the structures in the head and neck can’t be visualized easily, but their location relative to other structures may be tested. It’s a guarantee that your head will be spinning after one of Dr. Mendel’s lectures or prosections, so try to read your notes before class. Dr. Mendel loves comparative anatomy, so be prepared to endure digressions into the world of primitive mammals. If you ask Dr. Mendel a question, he may not answer you directly, but you will gain a better understanding of embryology from his presentations.
Embryology is scattered through the various sections of the course, with some more discussion in the other classes. Embryology can be quite complex, but most exam questions pertaining to the topic are relatively straightforward and are always found in the class notes. (Exception: Dr. Dlugos likes embryology, and her embryology questions on the 2011 exam were very detailed. So make sure to study embryology well for her sections. See her advice above.)
First years can be smelled a mile away after leaving the lab. Some people avoid wearing their good sneakers into lab. Others always wore street clothes under their scrubs (long-sleeved T-shirts were popular). If you choose to wear clothes underneath your scrubs, don’t lean against the lab table, or grease will soak through your scrubs and onto your clothes. You’ll figure out what works for you. Wash your scrubs at least twice during the semester – please!!! You’ll get two sets of scrubs; it’s a good idea to wear each set for a week, and then wash both sets together every two weeks. (DON’T wash scrubs with your street clothes. Do a separate load!) Wash your hands well when you leave lab: eating a sandwich while your hands reek of formalin is pretty nauseating. It’s strange, though: you’d figure the last thing you’d want to do after lab is eat. However, formalin stimulates the appetite; you WILL walk out feeling ravenous (especially after the first few days in lab)!
One last note on books: picking an anatomy atlas is a very personal decision. Both Grant’s and Netter’s come with online access, and you can reference the diagrams that are in the course manual. You might also want to check out lwwanatomy.com (click on the free anatomy images link). Overall advice: don’t waste time looking for the perfect picture or book - just find one and start studying!
Try to stay excited and enthused. Come second semester, you’ll be likely to miss Gross. Enjoy the experience: few people will ever get to do what you will do!
Surviving the Dreaded Anatomy Exams (I’m including a little blurb here: the anatomy exams are very different from other med school exams, and they can be difficult for some students. Hope this helps.)
I despised anatomy exams; ordinarily, I’m a good test taker, but lab practicals have little in common with standardized tests, as I’ve learned. I really struggled with the first block exam, despite having studied very hard. However, I did much better on the second two exams, and I survived! Although my study strategies improved as well, I attribute my survival to learning how to get through an anatomy exam in one piece. Here are a few of my words of wisdom. (I’m not really that wise yet, so take my “wisdom” with a grain of salt.)
Anatomy practicals are very different from other exams. You will be answering these questions using a "fill in the blank" style on ExamSoft. The exam is split into two sections, a "wet" portion, taken in the anatomy lab, and a "dry" portion, taken in either Butler or Farber 144. For the "wet" portion, you are given three minutes at a station to identify tagged structures on a cadaver, and to answer follow-up questions about the tagged structures. Between stations, you’ll get a “rest stop,” so you’ll have three extra minutes to answer any questions that you don’t have time to finish. Since you’ll have time to answer follow-up questions at the rest stops, make sure that you have identified all of the structures that are pinned at a station! Once you’re sure that you’ve identified all of the structures correctly, then go back and work on the follow-up questions. However, sometimes the stem of a follow-up question will partially “give away” an identification. So it’s in your best interest to quickly read through all of the questions at a station before you look at the specimen. Even if you know the answer to a follow-up question right off the bat, identify the structures first: typing takes time! To sum up, here’s the strategy in a stepwise fashion:
1) Quickly read all of the questions at the station.
2) ID the tagged structures.
3) Answer the followup questions. If you don’t finish, take advantage of the rest stations.
The "dry" portion of the exam is also fill in the blank style. You will be given questions involving images of bones, clinical scenarios, photographs of actual cadaver specimens, etc.,. These questions really test how you can apply the anatomy you are identifying in the lab. Don't panic, answer questions as best as you can, and spell things as closely to the actual words as you can. Usually the professor's take multiple spellings/phrasings, as long as they don't have to try and decode your answer.
Important Note: Because this entire exam is taken on the computer, and you do not have access to your belongings during the exam, make sure your computers are FULLY charged before entering the exam. There are paper copies in case your computer does die, or if there is an unfortunate computer mishap, but this is not the norm--so be prepared with a fully charged battery.
If you come across a station and you have no idea what you’re looking at, don’t panic. If you panic, you’ll put yourself in a terrible state of mind, and you’ll be much more prone to making mistakes or to second-guessing yourself on easy questions. Dr. Severin likes to remind students not to change their answers unless they’re REALLY sure that they’ve made a mistake. He’s right; in fact, apparently he used to chop erasers off of students’ pencils so that they couldn’t change their answers without making a mess of their papers. If you’re not sure of an answer, go with your gut (no anatomy pun intended).
One student that I know likened an anatomy test to a golf game. Each station is like a golf hole, and the exam is like a round of golf. You’re likely to have at least one bad hole during every round that you play, but if you get upset after you double-bogey, you’ll choke on the next hole as well. (In case you don’t play golf, a double-bogey is a bad score.) However, if you keep a positive attitude, you’ll do just fine on the next hole. When you come across a hard station, just try your best to answer the questions, and do not panic. (Remember, each station is only worth a few points, and there are many stations. You’re given a large margin for error!) There’s a catchy British propaganda poster from World War II that reads “Keep Calm and Carry On.” There are no better words of advice for an anatomy test. If you find yourself starting to panic during the exam, close your eyes and take a few deep breaths while you’re at a rest station. Then grab a piece of candy from the faculty in the center of the room. You’ll feel much calmer if you spend a few seconds to take pause and relax during the test.
In summary: study hard, stay calm, go into the exams with a positive attitude, and do your best. If you put in the hours from the beginning of the course, it will pay off on the exams. If you don't do as well as you wanted to on the first exam, don't give up and TRY AGAIN. Anatomy is a challenging course for everyone, and you have the ability to make it through. Don't be discouraged--there have been many medical students before you and there will be many medical students after you who have conquered this course; you will be one of them!
Histology
Histology is not offered as a course in and of itself, but bits and pieces are scattered throughout the different course modules. During the first semester, you will learn to recognize basic structures in the cell, as well as general tissue types such as epithelium, fibroelastic connective tissue, muscular tissue, or nervous tissue. Most people found histology lectures in first semester to be horrible and boring. A mere mention of the word “histology” induces many a groan and rolling of the eyes.
In the first semester, you will learn most of your histology from a set of computer programs produced by
Dr. John Cotter. The navigation is a little odd but overall, the computer tutorials are very helpful, and they eliminate the need for TAs and microscopes. They also have quizzes built-in that are very good. It is often hard to concentrate on the programs during the assigned “lab time” in the mornings, so don’t feel bad if you want to use the time to prepare for other classes. (Attendance is optional.) You can always complete the programs at your own pace in your free time, either at the computer lab or at home via Citrix. (Study hint: review the computer applications more than once. It REALLY helps!)
Dr. Chester Glomski is funny and knows his stuff, although his lectures are hard to follow. He is a nice guy, and answers questions well. Have some pictures available when you go through his notes. His lectures are actually pretty good if you watch them later at double-speed.
When you start the organ-based modules in the second semester, you will actually work with real microscopes and slides. Dr. Dlugos reappears in the GI module and is awesome. She tells you what you need to know in an orderly manner. Her notes are very well organized, and much better than the textbook. She truly cares for students, and is always very helpful in the lab. Contact her early to schedule a review session: she will show you all of the required structures on the group microscopes. Attend the Saturday review session right before the exam, and your tummy may be rewarded with some of her homemade cookies.
To sum it up, histology is going to be hell at first, not because the material is difficult, but because Dr. Cotter teaches a little bit differently. His notes will seem ridiculously long, but his tests are fair. And don’t just memorize the program’s images, either. Learn the features of the cells that you’re looking for, and what differentiates them from cells that look similar, so that you won’t be fooled on the exam when different images come up. The key is to study this material hard: it is going to come back again in every module. The more histo that you learn in the beginning, the less you have to study later, and it is much easier to do it while your plate isn’t so full.
[Note from another editor: Dr. Cotter gets a bad rap, but he really knows his stuff. He may seem boring and standoffish, but he’s actually quite nice if you talk to him in person. He seems awful when you have him during first semester, but the material that he’s teaching is dry to begin with. He will seem much more interesting in the renal module. Give him a chance before you make a judgment for yourself.]
Fundamentals I
We will not lie to you - Fundamentals I is a very challenging course. It is challenging not because it is difficult, but because you are trying to keep your head above water in Gross Anatomy.
Our first lecture series came from Dr. Murray Ettinger, a scratchy-voiced, funny-looking guy whose entire
life seems to revolve around enzymes, proteins, COLLAGEN SUPERSTAR, and HEMOGLOBIN THE MAGNIFICENT. Learning Dr. Ettinger’s material (the nuts and bolts of biochemistry) is tedious, difficult and irrelevant to many clinicians that lack a research background. However, Dr. Ettinger is an excellent teacher, and he makes lectures funny and interesting.
Dr. Ettinger insists that students distinguish the “forest from the trees:” the big picture. However, his test questions can be quite specific. Never fear: the answers are found within the course notes in either verbal or pictorial format; the “really important stuff” will appear in both formats. Dr. Ettinger highlights key concepts in his notes with exclamations, such as “WOW!” or “NEATO.” Areas marked “FFT” stand for “forest from trees,” not “food for thought;” you must know and understand these pages in order to get the desired “H.” Sections labeled “FYI” will not be tested on the exams, but may come up indirectly. For example, you don’t need to memorize amino acid structures, but don’t kid yourself — you do need to know which amino acids are acidic, basic, etc. You MUST understand Dr. Ettinger’s material, not just memorize it. Pay attention in class, or his exams will hurt you. Go to Dr. Ettinger’s reviews!!! The information in the reviews is very high-yield for the exam! The reviews are well worth your time! Beware: the reviews are not always videotaped.
How does one succeed? First, go to class, and stay awake. Second, use the “Ramifications” handout as a
study guide. (Dr. Ettinger also gives you study guides that walk you through the highlights of his notes, page by page.) Third, take the time to do old test questions. And, fourth, as stated before, go to the reviews!
Lastly, if you find yourself struggling, follow the trail of papers to Dr. Ettinger’s office. Whether you need extra help, have a complaint/suggestion regarding the module, or just want to chat, his door is always open, but be prepared to stay for a while! Dr. Ettinger has been teaching at UB forever and truly cares about the students: do not hesitate to ask him for help!
During the second half of Fundamentals I, you’ll also meet Dr. Mark O’Brian, a molecular geneticist. Memorization simply will not ensure good results on his tests. Although the material may be familiar to folks who have taken genetics before in college, do not be fooled! You will notice that Dr. O’Brian likes trickier questions than Dr. Ettinger so it is a change of pace after finishing Dr. Ettinger's portion of the course. Dr. O’Brian gives skimpy, outline-form notes, so go to class, and take copious notes! He explains everything really clearly if you listen and take good notes. However, Dr. O’Brian’s lectures are generally very straightforward and to the point, and he tries to make class more interesting by starting each lecture with a “fact of the day.” To do well in this section, work on the practice problems in the back of his manual, and do so early: don’t wait until the night before the test to start. The practice problems are very similar to the real test so make sure to understand them all well! Try not to slack off on Fundo while studying for Anatomy!
Fundamentals II
Fundamentals II covers the principles of metabolism, genetics, and pharmacology. The material spans a wide array of disciplines. It is easy to fall behind in Fundamentals II, especially near the end of the semester when it coincides with the infamous head and neck block of gross anatomy. Most students agree that the best way to study is to read over a particular day’s lectures the very same day you attend the lecture.
The biochemistry component comprises metabolism, along with some nutrition. Dr. Alastair Brownie, the Scotsman and course coordinator, will proclaim the material “easy peasy lemon squeezy.” Not everyone agrees that the material is easy, but pay careful attention to Dr. Brownie’s notes, and you’ll be fine. Dr. Brownie tends to jump off on tangents during his lectures, so his explanations may be a bit hard to follow. However, his reviews and extra help sessions remain priceless. Dr. Brownie loves the Socratic Method, so do NOT tell him your name or you can be assured that you will be called on at least once daily. He loves to call on people at random to answer questions during lectures, and he has a knack for making people look unprepared in front of the entire class. Attend Dr. Brownie’s lectures and reviews. He will drill in the answers you need to know, even if it makes you feel bad about yourself. (Just in case, memorize what the recommended daily intakes of Vitamin B12 and folate are: they might show up on an exam.) Knowing his “Brownie Points” (no, unfortunately not extra credit) will do wonders for the first two Metabolism exams.
Dr. Te-Chung Lee teaches the fundamentals of carbohydrate metabolism, which means having to learn glycolysis and the Krebs cycle again. His notes are complete, and better organized than any textbook we’ve seen. It takes time to get used to his accent, so it is sometimes difficult to take notes during his lectures. Don’t worry, though: all of his test questions come from his typed notes. (They are challenging, however, so make sure you know the material inside and out.) Dr. Lee always interjects humor into each class. His jokes are actually funny, and he always seems to have a straight face when telling them. He is always available outside of class to answer questions and to clarify concepts. (You will understand why Godzilla can breathe fire.)
Dr. Peter Horvath comes in to give the class a couple of lectures on nutrition. He is a self-proclaimed hippie from Southern California. His lectures are great, but his exam questions sometimes seem to come out of left field. Study his notes carefully.
The genetics portion of the course is taught by Dr. Richard Erbe and Ms. Laura Fisher. It won’t be long until you realize that Dr. Erbe may be the most boring lecturer that the world has ever seen. He has a really soft soothing voice that makes it easy to fall asleep, you may need to watch him at double speed later on. However, Laura Fisher makes up for what Dr. Erbe lacks. She’s a genetic counselor who works with Dr. Erbe, and she’s a great lecturer. She takes the time to give lectures that are on your level, and she’s very clear and thorough. Her notes are also excellent, so you can go to class and just listen. In fact, if you have questions about Dr. Erbe’s material, ask her. She’ll almost certainly be able to answer your question, and she can give you a much better explanation than Dr. Erbe will. Fisher’s exam questions are very fair; however, it is very common for Dr. Erbe to test you on minute details in his notes. Your only real option is to study Erbe’s notes intensely, because he will ask some very difficult questions. (Erbe’s questions are so bad that they often end up getting thrown out, but take them seriously anyway!) There are a few guest lectures in the genetics module that are not taught super well, but be sure to pay attention to them because the questions can be nit-picky.
You will learn pharmacology from Dr. Jerrold Winter. Dr. Winter is intelligent - perhaps too intelligent, but he’ll leave you with some memorable comments. Here are some examples: “Potency is important. How many condoms do you want to swallow?” And, “I know your first choice for medical school was Hogwarts School of Witchcraft and Wizardry.” He has an interesting relationship with opiates which can be pretty humerous.
You will also learn about toxicology from Dr. Paul Kostyniak.
CPM
Clinical Practice of Medicine… oh boy! The course coordinator is Dr. Andy Symons. The relatively young Dr. Symons, a graduate of UB Med, has revamped the CPM module over the last few years. He is understanding of the time limitations in our schedule, and tries to focus on the most critical aspects of the clinical practice of medicine.
In CPM, you’ll learn how to interview and examine patients. It’s somewhat less stressful than the other classes and, chances are, you’ll actually have fun playing doctor at a local hospital or clinic. In the first semester, you get to practice giving injections on your peers at an injection workshop (it’s not mandatory, but everyone goes).
CPM is taught both semesters. You learn how to conduct interviews during first semester, and second semester is devoted to conducting the physical exam. The class is divided into two groups. After the one hour Monday lecture (which sometimes is absolutely pointless), one group attends a seminar led by a physician, while the other group goes to their clinical preceptors’ offices. To clarify, students who have preceptor can go anytime during that week when their preceptor is available. In the small seminar groups, led by local physicians, you will practice interviewing each other, as well as “standardized patients” - people from the community who agree to be interviewed and examined by students.
Each student will be assigned to a preceptor: a local physician who will help you refine your history taking and physical exam skills in a real clinic. Clinical sites range from small rural clinics to the large county hospital. Most preceptors are primary care physicians, but some practice other specialties. Facing a real patient may seem intimidating at first, but you’ll be surprised at how much easier it becomes as the semester progresses. The preceptors volunteer to work with first-year students, so they are generally enthusiastic about helping you develop clinical skills. You will have an assignment to do each week you’re at preceptor that has to be written up and handed in to your seminar leader. Some seminar leaders can be very strict with the degree of detail that needs to be in the write-up, so don’t slack off. After a few write-ups, you will get a feeling for how your seminar leader wants it done. CPM should not be a class that you should have to worry about too much, as long as you do the work.
The reading assignments, on the other hand, are annoying. Most students hated Mosby’s Guide to Physical Examination, the required text for the course. The book has long, convoluted explanations of the material. It’s a somewhat interesting read; unfortunately, though, most people don’t have the time to read the tiny print. Every week, Dr. Symons posts a quiz on UBLearns that is based on the reading. The quizzes are pretty straightforward, but can be time-consuming as you sift through all the information. On the bright side, questions for the mid-term and final are often based on some variation of the quiz questions. [Hint: you don’t have to read the full chapter; just look up the answers to the quiz questions.]
During first semester, the final exam consists of both a written test and a mock interview. The written test, if you go over quiz questions and lecture PowerPoints, is pretty painless. For the interviews, you’ll probably have to take a complete history or a problem-focused history from a patient. You will also be tested on taking blood pressure with a standardized patient. Don’t stress about the exams. CPM is much less stressful than Fundamentals or Gross Anatomy. By the time the final comes, you will have had so much practice interviewing patients, that it will seem relatively simple. Just remember your OLD CAARTS!
In the second semester of CPM, you will start to learn about the physical exam. You will learn to use the fancy medical tools that you just bought. Dr. Symons will tell you that you need to buy an otoscope and ophthalmoscope, but many students did not and got by without them. [You REALLY don’t need to buy them.] Reading assignments are more cumbersome, but come straight from Mosby’s. You’ll spend “hours” reading “hundreds” of pages on disease after disease after disease of organ systems not yet covered in other classes. Luckily, the exams are not focused on pathophysiology, so the diseases are mainly for your own edification (at this point). [Again, you DON’T need to read Mosby’s. Just look up the quiz answers. Don’t waste your time!] Study for the CPM second semester exam like you did in first semester, and there will be no surprises.
CPM is not a stressful class. Just get your assignments in and you’ll be fine. The exams are very easy. If you do the work, you’ll be rewarded with a good grade. Hopefully, you will enjoy CPM and have the chance to practice the skills you learn in class at preceptor. It is a good introduction to clinical practice, and with the basics under your belt, you will have plenty of time to hone your skills over the next few years.