JSMBS Unofficial Handbook

Once you’ve finished Anatomy and Fundamentals and enjoyed winter break, it is time to get back to the classroom. The courses in the second semester have more case-based learning and small group presentations than the first semester. For an overview of diseases and lab tests, Wikipedia is always a nice resource because it explains things in layman’s terms. Once you have grasped the general ideas and want more detailed information written by physicians, try UpToDate. UpToDate (http://www.uptodate.com) is easily accessible from any school computer or via Citrix. UpToDate is constantly being updated and is full of lots of detailed information. In addition, the library database, HubNet, has many valuable resources and is accessible from the Health Sciences Library’s website (http://hubnet.buffalo.edu/bin/static.cgi). It will take a little while at first to find what you are looking for, but you’ll get the hang of it quickly, and then it’s easy! Second semester will kick off with Fundamentals III, which covers microbiology, immunology, and hematology (two weeks of each subject). GI will be its own module in second semester, followed by Renal, and finally Musculoskeletal to end your first year of medical school------woo hoo!

 

Fundamentals III

    Fundamentals III was revamped two years ago: Dr. Alan Lesse took over as course director, and apparently some major changes were made to the course. Fundo III is essentially three classes crammed into one six week period: you’ll get a crash course in microbiology, immunology, and hematology. Exams are roughly bi-weekly, which means there is both less material on each individual exam, but also less time to catch up if you fall behind (Of course, reviewing the material ASAP is a good strategy for most classes, but Fundo III is a little bit less forgiving because of the frequency of the exams.) Be wary of the histo questions on the exams. Don’t panic, though: the exams are not particularly difficult if you put in the work, and the class tends to do very well as a whole in Fundo III. This year, most students did very well in Fundo III and it was a favorite with the Class of 2019 because of Professors Lesse, Lehman, Steinbrenner, and Heffner.  They present the material clearly and concisely: study the notes and you will have everything you need for the exam (as Dr. Lesse will remind you, ALWAYS remember what he puts in red).

 

Microbiology

    The first two weeks of Fundo III are devoted to microbiology. Dr. Lesse, an infectious disease specialist who is always amongst students’ favorite lecturers, teaches a large percentage of the microbiology section. His notes are amazingly clear, and his lectures are funny and entertaining. Microbiology may seem like a dry subject with a lot to memorize, but Dr. Lesse makes it as simple as possible. He pares the information down to a manageable level. Pay attention to the red highlighting in his notes: the red stuff is what he expects you to know for the exam. Look out for Dr. Lesse’s trademark suspenders and his Pseudomonas tie!

    You’ll also meet a few other lecturers in the Micro section, including Dr. John Crane, another infectious disease specialist. His trademark is his bow tie. Like Dr. Lesse, his notes are very straightforward, and his lectures are clear. You’ll probably get some basic pharmacology lectures as well. There are a few other infectious disease docs that come in to talk; again, their lectures are all pretty straightforward. The micro tests are very fair; there’s just a lot of information to learn. Stay on top of your studying, and you’ll do very well.

 

Immunology

    Immunology underwent some major changes this past year. The section is now based on a textbook, which we highly recommend that you purchase. It’s called “Basic Immunology,” and it’s very short and easy to read. Unlike most other lectures that you’ll have in med school, the immunology lectures are drawn directly from the textbook. Many students did get by without buying the textbook, but the book will definitely make life easier. Dr. Heather Lehman teaches most of the immuno lectures. Some students found her to be boring, but she goes very slowly and tries to elucidate key concepts as best as she can. She is also very willing to help students outside of class, and explain difficult concepts more than once. Read the book before going to their lectures: it will help. You’ll also get an introduction to pathology from Dr. Reid Heffner. He’s a great lecturer, and you’ll hear more about him in the Musculoskeletal section. Dr. Heffner will also give you some lectures on inflammation.

 

Hematology

 

Hematology is combined with immuno and micro to complete the Fundamentals III trifecta.  Anyone from our class would agree that having hematology before the other systems-based courses is incredibly helpful.  Hematology creeps its way into every organ system, and it’s nice to know a little bit about CBCs when reading a patient’s medical background in a case study.   

Dr. Amy Sands and Dr. Lynn Steinbrenner are both amazingly clear.   Dr. Sands teaches laboratory basics and the lymphoid disorders.   Be sure to keep her handout of laboratory reference values: it’ll come in handy for renal. Dr. Lynn Steinbrenner, an amazing clinician from the VA Hospital, is the course coordinator and teaches the bulk of the lectures. She won the Siegel Award for excellence in teaching and tells stories about her years on the wards- she definitely keeps lecture interesting!  Dr. Ettinger will be back to review “Hemoglobin The Magnificent” and blood coagulation.   Dr. Glomski will cover histology.   

The material in this part of the course is presented from almost an entirely clinical approach. Two hours of lecture per day are reinforced by two hours of small group work in which students present the information on a specific disease to their classmates.

The work on these presentations can seem a little tedious, especially when most of our brains are still on winter vacation, but the presentations actually work to the students’ advantage: the pro-active approach and built-in repetitiveness make it easier to study for the exams.

The exams are worth eighty percent of the final grade (the other twenty are for small group participation.) The exam also combines material from lecture and small group, as well as questions on histology (time to re-watch Dr. Glomski’s lecture), so it can be a little intimidating.   Although our class found Hematology to be well taught, the exam questions were still fairly challenging. When you get to the Glomski questions on the exam, be prepared to scratch your head and flex your “multiple-guess” skills.

Drs. Steinbrenner and Sands do a great job of organizing the course, and Hematology is the perfect way to start your organ-based study loads.

 

GI

 

GI is one of the longer modules of second semester (six weeks).  The course proceeds from the proximal to the distal end of the alimentary canal, while fitting in all of the fun “accessory” organs. The amount of material covered on each exam is significant, and there is absolutely no time to fall behind. With Fundamentals I and II, you only average about ten hours of lecture time per week: gross anatomy lecture and lab consume the other ten hours. Starting second semester, you only take one class at a time, so you have twenty hours of lecture per week, all pertaining to one course. So after two weeks, your exam covers forty hours of lecture! And you always have three to four hours of new lecture material that will be on the exam presented the Friday before your Monday exam. (Or, in the case of your final, you’ll have three to four hours of new material presented the day before your exam. Ouch.) GI has three exams: a “midterm,” a histo exam, and a cumulative final. Needless to say, the cumulative final exam is worth more than the midterm. Histo is only a small fraction of your grade, but you have to pass the Histo test to complete the module. Sorry! Don’t worry, though: Dr. Dlugos does an excellent job of teaching the GI histo, and most people did very well on the exam last year.

Dr. Michael Duffey, the module coordinator (along with Dr. Sitrin), teaches most of the
physiology. He is laid-back, quite entertaining, and easy to follow. He likes to talk about Iowa and being Irish. He’s also funny, and he’s a great lecturer. His notes consist mainly of diagrams from textbooks and a few odd sentences, so it’s wise to attend class and take good notes.  Attending lecture is a must: he often draws extra diagrams on the screen, and his notes have large gaps in them for which you will need his lecture to fill in.   If you miss something, it’s helpful to rewatch the lecture (preferably at double-speed) to fill in the details.   Some students found his exam questions to be quite difficult, but if you have a thorough grasp on the material, you’ll find them to be quite fair. If you like textbooks, Boron’s Medical Physiology is quite helpful (JUST as a reference: it’s very dense). Costanzo Physiology is also very good: it’s succinct and easy to read. You don’t need a text to do well, though.

Some  of  the  lecture  material  was  just  plain  weird.  Dr. Crane,  who  teaches microbiology  in Fundamentals II, returns to show disgusting slides of rotting flesh and masses of worms pulled from people’s rear ends. (Beware! This may include 5-6 pictures of a prolapsed rectum) His lectures on various bacteria and viruses require a lot of memorization. This past year, his questions had nothing to do with all those worms he lectured us on, so don’t kill yourself trying to memorize everything (you will probably end up not knowing what his questions on the exam are talking about anyways). Dr. Jan Novak presents material on pancreatitis. Dr. Michael Sitrin, the other course coordinator, gives a couple of lectures on micronutrients and small bowel syndrome. Dr. Sitrin’s lectures are boring, but his notes are very thorough, so don’t feel bad if you end up reading about useless garbage on Wikipedia during his lectures. (Of course, this editor would NEVER read Wikipedia during lecture.)

Dr. Thomas Mahl is another one of students’ favorite lecturers. He is easily the most hilarious professor that you’ll have first year. His jokes are pretty outlandish, but they’re pretty hilarious (as long as political incorrectness doesn’t bother you). He’ll give you some lectures on cirrhosis and hepatitis. He also reappears at the end of the module for a case presentation on Wilson’s disease. He and Dr. Duffey love to make fun of each other.

You’ll also get a couple of lectures on endoscopy, colonoscopy, and X-rays of the GI tract from some local doctors. You’ll get to see some pretty hilarious images of people’s GI tracts (we won’t ruin the surprises). Dr. O’Brian reappears to lecture on the genetics of colon cancer.  There are also several lecturers who only appear for one particular topic.   Some of them may not reappear next year, so we’ll spare mentioning them. For the most part, if lecturers only appear once, the test questions pertaining to their topics tend to be broad and relatively easy.  When studying, think big picture with these professors’ material.

Despite the stressful nature of this course, most students are excited to be learning about topics that are directly relevant to clinical medicine.  But by the time Spring Break comes, you’ll be ready for a vacation! And when you come back, nice and tan, you’ll be ready for Renal! Yeah!

 

Renal

 

This module is significantly shorter than the GI module.   You’ll get mixed responses as to the level of difficulty on the material.   It all depends on you and your grasp of the renal system.  So take rumors about renal being “really hard” with a grain of salt. Some people do find it difficult, but it is manageable. You’ll find that you have a lot more free time during renal, as compared to GI. The coordinators have arranged the schedule to include several hours of PBL each week, when, in reality, the PBL cases only take about thirty minutes per session.

The hardest part of the course is the physiology.   Dr. Mouhamed Awayda does his best to explain it, but it can still be quite mind boggling, and most students find it helpful to read up on renal physiology in an outside text. Again, Boron and Costanzo are great references.  You will spend most of your study time trying to grasp the equations and calculations necessary for the course.  It’s also helpful to rewatch Awayda’s lectures on double-speed. MAKE  SURE  YOU  DO  THE  PRACTICE QUESTIONS!!!!! (Hint: the practice questions are similar to what you’ll see on the exam!)

Dr. James Lohr, the module coordinator, covers the majority of the clinical information, as well as a couple

of the PBL cases.   Dr. Lohr is very easy-going, and although his lectures are on the dull side, he tells you exactly what you need to know for the exam. Pay close attention during the hyper/hyponatremia lecture.    It’s very confusing and takes a while to grasp, and he’ll do his best to explain it clearly. If you’re a textbook person, Rennke’s Renal Pathophysiology is helpful for Dr. Lohr’s material. By the end of renal, most students really liked Dr. Lohr; he even entertained us with a quick ten-minute slide presentation on his life story. Also, if you get the chance to interact with him outside of the class setting, do it. He is always willing to have a good time at the Steer. (he even bought this editor a couple beers after our final renal exam).  

Dr. Thomas Russo teaches the microbiology component of the module. He is an excellent lecturer with a great sense of humor, and his handouts are very clear. He will tell you everything you every wanted to know about UTIs (and even dispel a few myths).  Dr. Russo is a Red Sox fan, but according to Dr. Lohr he gave up following sports because he doesn’t have enough time to really focus on every trade- maybe you all can reignite his baseball fever.  

Dr. Lesse returns to teach the pharmacology portion of the module and will throw 100 slides at you in an hour and a half. Try not to let it overwhelm you (he usually asks about drug side effects and mechanisms of resistance) and  remember to look out for the red highlighting!

Dr. Heffner returns to teach a few lectures on renal pathology.   You may want to take a look at Robbins before the exam to see some pathology pictures that he may use for his exam questions. You’ll also have some path lectures from Dr. Edit Weber-Shrikant. There’s a lot of path in the second half of the module. The path material may seem overwhelming, but Dr. Heffner does his best to simplify it for you before the exam. It may be helpful to make charts to compare and contrast the different pathological findings in the diseases that are discussed.

Dr. Rocco Venuto, “the donor king,” comes in to talk about transplantation.   He is a very knowledgeable man, but not the greatest of lecturers.   His lectures are very boring and somewhat difficult to follow.   Also, he has no respect for time limits and loves to go over his allotted lecture time. Watch out for his exam questions: he likes minutiae., but should give you some hints during lecture about what his questions will address

 

Musculoskeletal

 

Dr. Reid “Hugh” Heffner, the module coordinator, is an excellent professor, and he’ll tell you everything you need to know if you attend his reviews. He is probably the most respectful and charismatic professor we’ve had. He’s very erudite, and loves to throw nerdy tidbits about history into his lectures. Did I mention that his reviews are critical?

The course begins with a quick, straightforward lecture on the epidemiology of musculoskeletal diseases.   You then jump into the histology of cartilage and bone. With a histology lecture always comes a histology lab with the entertaining Cotter videos.

There are many pathology lectures in the musculoskeletal module.  For the first exam, you’ll learn
about Paget’s (osteoclasts gone wild) and other interesting bone diseases from Drs. Heffner. There is also a pathology lab exercise on Paget’s disease.   These lectures are all pretty interesting, and the handouts are very
complete.  The pathology lectures are critical to passing this class (lots of matching of diseases with their characteristics).   Make a chart of the notes and lectures and commit it to memory early.   The last week of the module focuses mainly on dermatologic pathology.   These lectures were very rushed, and it is recommended that you use Robbins as a supplement.

Some familiar and lovable faces return to give lectures during this module, including Drs. Ettinger and Lesse.     For the aspiring orthopedic surgeons, there is a lecture on arthroscopic surgery done by the doctor from the UB Bulls.  Drs. Ablove and Heffner do a “duet” of lectures on practical orthopedics; it’s a really fun set of lectures, so make sure to attend! There’s also a “mystery case” presentation with Drs. Heffner and Brownie; attend so that you can see their outfits.

Dr. Glomski returns to teach a lecture on skin and hair.   There are pathology pictures on the exam, so pay close attention to the pictures that he puts up on his slides!

Musculoskeletal is not particularly difficult, but it is your last class before the summer, and you don’t want to end up having your plans ruined because you have to make up a class.  (Dr. Severin will send you a foreboding email before the class starts, warning you not to slack off.) The hardest part is staying focused and forcing yourself to study as the weather gets nicer.  This past year, we had one exam that was worth 90% of our grade. The other 10% of the grade was for showing up to small groups. Remember, though: you have to pass the test to pass the course (small groups can’t save you if you get a 69% on the exam).

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