An Informal Guide to the Second Year
Autumn Quarter
Pharmacology
This is a course that is worth the time invested. Introductory Pharmacology focuses on concepts using relatively few (but important) drug classes as examples. Some students consider the lectures a bit too general and a little heavy on calculations, with lots of details given on a few major classes of drugs. You will need to learn the rest of the drugs on your own. The course direction will be changing so ask for more info about this class after we complete it. The text by Goodman and Gilman comes out in new edition this August and is a good reference which is worth owning. It is also on reserve in Crerar. Lippincott’s is a much better buy but many people found "Pharm Cards" to be helpful, especially in the spring (although they do not cover all of the material on the Boards).
Microbiology
Microbiology covers bacteriology, virology, and parasitology. Make good charts or notecards during the course, as they will be very helpful for both the in class exams and on the Boards. The lectures are generally excellent and lab is pretty laid back and fun. If you have had microbiology lab before, this one is pretty basic and can be unproductive. The lab practicals aren’t too stressful (open book in groups of four), but the written components are tough. Medical Microbiology and Immunology ,which has excellent charts and great summaries for quick reviews, is strongly recommended. Clinical Microbiology Made Ridiculously Simple is also a good text. The NMS Microbiology textbook can be a good resource as well.
Cell and General Pathology
This is more or less a preview of the Clinical Pathophysiology (CPP) course in the winter quarter. It consists of histopathology (i.e. all the disease parts of histology), as well as the causes and mechanisms of several diseases. Dr. Meredith, Dr. Wong, and several other professors are excellent, and the course is well taught. Be prepared for long lectures and labs. Know the stuff well, for it will return in CPP and the Boards. Pathologic Basis of Disease by Robbins is a must and will remain useful for years to come. Pocket Robbins is also handy. Coffee, juice, and doughnuts are served during the morning exams!
lmmunobiology
You can learn a lot in this course, which covers basic immunology and, since this is U of C, basic research. Due to the fast pace of research in this field, a lot of the materials presented in lectures can’t be found in textbooks, which can make co-op notes helpful. Don’t get overwhelmed by the material, since it is very important and will be on the Boards. A good overview of the material is available in the Medical Microbiology and Immunology.
Winter Quarter
Clinical Pathophysiology (CPP )
This is one of the best courses you will encounter in the first two years of medical school at Pritzker. It is brutal, but extremely rewarding. The course meets MWF with two lectures and a lab in the morning and two lectures and a lab in the afternoon. The key to surviving this class is to keep up with the material and stay sane. The essence of this course is to integrate all that you have learned so far, and make some sense out of it. Labs are case-based, quite long, and full of histopathology. Robbins’ Pathologic Basis of Disease, baby Robbins’, Cecil or Harrison’s baby version, as well as the BRS & NMS Pathology are recommended. But be choosy, you don’t need all these books. This is the time when a lot of students invest in either Cecil’s or Harrison’s medical textbooks. They are not essential for this quarter, but will be a key to your third year clinical rotations. New computer-aided learning for lecture and lab are of great help, particularly the casebook web-site. This web-site contains an old exam, as well as answers and slides from the labs. Lectures are given by a wide variety of clinicians and tend to be very good.
Physical Diagnosis
During winter quarter, you will learn how to perform physical examinations on your partners, use your medical instruments properly, and how to present your patients to the attending. In the spring quarter, you will actually perform these exams on real patients. It is an exciting course, but individual experience depends a lot on the attending, resident, and fourth year students to whom you are assigned. Try not to miss too many lectures as your absence will be noticed! Small group sessions are scheduled to help teach specialized exams (e.g., cardiac, orthopedic). Special training sessions with model patients and professional guidance are set up for the female pelvis, male prostate, and rectal exams. These are time-consuming but excellent experiences. This is also a good time to learn about reading hospital charts and interpreting medical abbreviations. It is helpful to read up on the patient’s disease after seeing him/her, since this will be beneficial to you in CPP as well. The final exam in the spring quarter is based on standardized patients, so if you practice on patients during the quarter, you should be well-prepared. Additionally, there is a practice session with the same models half way through the course-so there are no surprises on the final "head to toe" exam. The recommended book is Swartz’s Textbook of Physical Diagnosis. It is a good book and can be very helpful in leaming certain techniques, but often requires lots of hard-to-come-by reading hours. It is definitely not essential in order to learn how to perform a great physical.
Spring Quarter
Clinical Pharmacology: Introduction to Therapeutics
This is a good preparatory course for the Boards and clinical rotations. Study hard throughout the quarter so you will need minimum supplements to prepare for the Boards. It covers general categories of drugs, their usage, and adverse effects. The psychiatric drugs may not be adequately covered but are nonetheless important, so read up on your own. Handouts are generally pretty good. The final is Boards-style shelf exam and a good practice for multiple choice test taking. Students found Lippincott’s Pharmacology and Pharm Cards to be extremely helpful. Drug classes, specific agents, mechanisms, side effects, and clinical indications are all pertinent to the Boards. This is a good course to use to help review some pathology and microbiology.
Electives
You have 100 units worth of elective course. You may want to consider a class that will help you review for the Boards.
Review for the Boards
United States Medical Licensensing Exam. Step I
Chance favors the prepared mind
-Louis Pasteur
The first step of the newly revised, three part United States Medical Licensing Exam (USMLE) is administered to second year medical students in June (or whenever, between May and September, the OME schedules it with the USMLE). Step 1, a day-long examination of approximately 350 items, is designed as a broadly based, integrated examination. There are seven, one-hour sections comprised of anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology, as well as interdisciplinary topics such as nutrition, genetics, and aging. The examination is written to test the scientific principles and basic medical knowledge that a student should understand for subsequent educational experiences and for his or her career as a physician. The exam became a computer-based test in 1999. The OME provides a thorough orientation to its format and scheduling during MSII.
For Step I (and II), the standard score scale is such that a standard score of 200 represents the mean of the original 1991 anchor group. In general almost all the Step I (and Step II) scores will fall between 120 and 260 on the standard scale. A score of 179 or better is required to pass Step I and a score of 170 or better is required for passing Step II. A second two-digit score will be provided to each examinee. This score only has relevance to the Federation of State Licensing Boards in each state at the time you are applying for licensure. Students who record a passing score may not retake the exam to better their scores.
You should strive to do well on the Boards. Some residency programs, especially in the competitive career fields, emphasize Board scores significantly in their evaluation of potential candidates. However, do keep in mind that not all programs emphasize Boards, and passing is your first priority.
With regard to study preparation, it is important to remember that students have been successful with various study preparation techniques. You should simply choose the one that you believe will work best for you. Do not spend time worrying about how others are preparing, it will only stress you out.
There are two main kinds of preparatory books on the market: review books and pre-test books. The review books are generally a combination of review outlines/texts on the topic plus end-of-the-chapter questions. The pre-test books simply provide hundreds of questions in National Board format on a specific topic, with associated detailed answers. No general summary or outline material is provided.
Essentially everyone uses First Aid for the Boards as a guide for which books to buy. The back of this book has a student-ranked listing of review books in every subject. In addition, this book contains sections with high-yield facts and study advice. The Board Review Series (BRS) is also popular, presenting information in an intelligent outline format.
With regard to the pre-test books, the McGraw-Hill Series is probably better than the Medical Exam Review Series because the descriptive answers are more complete. In general, it is a good idea to read the entire descriptive answer even if you get it correct. Don’t go too crazy, as your time to read and learn all of this material is limited. Also keep in mind that many pretest book questions are based on the old format of the exam, so they are often very detailed and more difficult than the actual Board questions.
You can spend a small fortune on these review and pre-test books, so look for bargains on them. Many of the books can be obtained from the Senior Class Book Sale or junior students. Also, many students buy books as small study groups and thus defray some of the cost by spreading it around.
Most students recommend beginning study review early in the spring quarter. Begin before then if you are really worried, but remember, you’ll have your hands (and brains) full with CPP and Physical Diagnosis.
Also keep in mind that the OME facilitates students’ ability to take NBME Subject Exams in some topics (i.e., Path, Pharm, and the Comprehensive Basic Science Examination). These exams often point out weak points in a student’s knowledge base or test-taking strategy.
The suggestions above are not hard-and-fast rules, but merely a compilation of many students’ recommendations. Different strokes for different folks. You know best what works for you.
The curriculum has been rearranged so that the quarter ends about 5 weeks early leaving "free-time" to study for the Boards. Some electives may continue through the entire quarter so be choosy.
Remember, 55-60% correct will earn you a passing grade. Don’t flip out. Think of yourself as being fully capable of scoring well if you have prepared. Put yourself in a position to demonstrate this. Do not sabotage yourself. Do not begin to prepare the week before the exam. Remember to get lots of rest and to eat well.
A Personal Overview of the Second Year
Previous second years have reflected:
It is a wonderful feeling to wake up one day and know that you have learned as much about medicine as the doctors who teach you; in fact, by the time the Boards arrive, you will have more trivial medical knowledge than most attendings. So you see, second year is filled with excitement, saturating information, and very little sleep. I actually had a terrific time second year, and you can too. It’s all in the attitude. The exhilarating feeling you get from accomplishing and tackling second year is really indescribable and wonderful. Once it’s all over, you feel a wave of relief and then sudden panic when you realize that soon third year will begin. So enjoy your last few months in class and revel in your ignorance for a little while longer while you can still use it as an excuse for not knowing all the answers. If you ever feel completely overwhelmed, overworked, and overcharged for this education, just remember these are NORMAL responses and will gradually lessen as the year moves on. Time passes faster than the mind can tell, and soon the year will be over and you won’t believe that you’ve come through it alive. We have all been there and understand your position so come to us for support, advice, or a shoulder to lean on, that’s what we’re here for. GOOD LUCK, KEEP SMILING, AND ENJOY EVERY WONDERFUL MOMENT!!