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Sunday, November 20, 2011

Term 5 - SGU **updated**

Term 5. What to say about it.... it's both a relief, exciting, and incredibly stressful. I think we all have different opinions about it. Yes, its nice to know you're almost done with the first 2 years, but it's also a time where you have to make a personal decision to study. Honestly, there isn't too much new material. Learning Drugs everyday and what to use them for really is the bulk of it. The rest of your time is spent looking up/remembering all of your CPD skills (which you get to utilize in the hospital), remembering most of your biochem, histology, anatomy, physiology, (not so much neuro at all which is a relief), but also immunology and pathology. We breeze through the organ systems covering most of these modalities pretty quickly. The personal decision weighs in because some people do the bare minimum, and then again, a lot of people begin studying for the Step Exam.First Aid by their side at every moment, Question banks start flowing, talk about watching DIT and Kaplan videos, Kaplan lecture notes, Pathoma, reading BRS books and Goljan Rapid Review Pathology. I mean, everyone seems to be making an effort to really start boning up for the big National Exam. And then again, some don't. And that's because a lot of this effort is NOT neccessary to pass the term because so much of it is review. It really depends on how much attention you paid/and how much you learned in previous terms. So why do people bog themselves down with work? Fear probably. I don't know, but thats what it is.

So make your own decision about what and how much effort you want to put into this term, you'll most likely pass the courses, but how much you get out of them in preparation for the next big step is up to you.
In summary, this term really can be a HUGE vacation for you if you decide it to be. 

Okay, so what do you need for this term: 
  • Well, like I said, by now you really should probably get the latest edition of FIRST AID that lines up with the year you'll be taking the step I exam. Maybe also start thinking about how you plan to study for the step, review courses, books you'll plan to use later, etc, because you might as well get familiar with them this term because you're covering pretty much everything. Please visit the "usmle" tab above to see a list of resources that you could check out for the exam, and also the "bookstore" to see what other books you may have neglected to buy until now if you feel you need some. 
  • GET SOME FORMAL CLOTHES. you will be going to the hospital. If you don't have anything by now, go shopping. 
How to study:
  • I don't need to tell you anything here by now I'm sure. Just know that there are some GREAT summary files passed around that will help you review for the BSFCR quizzes/small groups on Fridays, one for each midterm. 
  • Use your first aid and start annotating everything in it. And DON'T LOSE IT!
  • Above all though, GET ORGANIZED. The schedule seems so rediculous at first, and there are LOTS of changes that happened during our term. I expect this happens a lot. You have Hospital once a week. You have a small group CPD session once a week. You have a pharmacology small group OR pathophysiology small group each week. And you have a BSFCR quiz/small group each week. Its a lot of small groups! And they all have different group numbers, and different group members and are in different locations/times each week. Just make sure you get the schedule and the details down, and know the times switch halfway through the course for BSFCR. 
  • I reccommend checking the schedule and sakai announcements often to make sure you take advantage of the inclass clicker sessions "clinical correlates" lectures that take place. 
For Pathophysiology **UPDATED**

  • I don't know if you'll feel the same, but the classes felt like review sessions (which was really good, incase you didn't learn things the first time around), however rarely bringing new information to the table. Also, they often added some clinical pearls for rotations, which was quite valuable. Worth going to class for if you have made time. 
  • There is no right way to study for the tests besides the notes (which I did go through), but but you should probably go beyond.
  •  I'd recommend starting to get your USMLE habits in place NOW. All the step information is worthy for your P-Fiz exams, as well as the USMLE. Dr. Uphadya has a good grasp of what is high yield and is a good one to pay attention to, both in Lab and in Class, and ESPECIALLY in the Clinical Correlation Lectures. The Clinical Correlations lectures helped me out tremendously as well and the questions he did frequently appeared in Question Bank questions. 
  • I recommend reviewing physiology all the way over again, system by system. Especially endocrine (First Aid really lets you down here, but DONT ignore the FA section!) A lot of endo questions are diagramatical, which FA doesn't include because they tend to be conceptual of the feedback mechanisms and what not. (up and down arrow questions, graphs, etc)
  • Get something to study for the step (for god sakes if you havent got First Aid yet...Smack yourself!) ...no seriously. smack yourself nice and hard. Get it together already!
  • Qbanks, Review classes, DIT, Kaplan online, Books, $pend whatever it takes, and annotate into First Aid. This will save you so much time in the coming months for your Test Prep, and it happens to also well prepare you for the P-Fiz examinations as well (bonus right?).
  • So study well, annotate into your Bible 2012, and review the Bible every night before you goto bed and especially before the exams! 
  • I try to keep personal opinion out of this blog, but personally, I studied each Body System covered in class as if I was studying for the USMLE. I almost completely ignored the class. And that was enough to pass. (read the next bullet point)
  • The fact that the class is 12 credits asks you to make a decision, because this is essentially the last contributor to your basic science GPA. This is the question: "Do you care more about your GPA at this point? or your USMLE score?" For me, the decision was easy, the USMLE. However, many students, you know who you are, at this point are on the cusp. This class really is a great opportunity for those of you to lift your GPA and get your act together. I'm sorry to say, those people I have less advice for, since my approach to this class was very different than your mission. My mission was to pass, and get the largest benefit towards the big test that I could in the time given, and not get the highest grade possible.
  • The exams are hard. Really hard, just like pathology. And you should be glad they are, this is the last time you get practice for the big one. Also, the curves can be big (and applied after the exam is taken, UNlike pathology with your pre-set "free 8 pts" curve). So, the tests make you think. But don't stress, they're not impossible. There are a lot of buzz words, just like pathology. And if you do Tons of questions (like you should be doing for the step), then you'll know what things to look for in the questions.  
  • Good luck. 

For Pharmacology:

Books: Not exactly necessary, but if you still want to get one, there are two that you should look at: The Katzung Pharmacology Board Review book is great for USMLE style questions for each chapter, and more for review, meaning less biochemistry and cell signalling type information. If you want the full exodous of pharmacology, you want the Katzung latest Edition Basic and Clinical Pharmacology Text.
  • Learn the mechanisms and biochemical pathways why we needs drugs first.. THEN learn the names. The names are just too similar to learn first. Cimetidine, Ranitidine, Famotidine, etc Learn the classes of drugs and what theyre used for, (aka H2 receptor responds to histamine increasing cAMP and increasing acid production by parietal cells in the stomach) then ask...(hmm wouldn't it be great to block this pathway in someone producing too much acid like an acid reflux patient?) wait... do we have a drug for that? (of course we usually do), then ask "whats the name of that drug?" -> (Cimetidine, Ranit....etc). Now you know a lot about that drug by the time you learn the name! You know the action, you know the receptor, you know what kind of patient needs it, and now you know the name. It is MUCH easier this way I've found. 
  • ******Make flash cards from the notes (written + powerpoint). 
  • The written notes are much more detailed and informative and I suggest them over the power points. 
  • Focus on unique characteristics about drugs. Kaplan lecture notes and videos will help you hone in on what these things are... or by doing QUESTIONS
  • FINALLY... READ THE POSTED ANSWERS TO THE SMALL GROUP SESSIONS. The info on those not only might be.. but i can bet you with much confidence and without doubt that THERE ARE enough questions from those on the exam that will earn you an Extra Letter Grade. Fight your stubbornness to not read them, I dare you. But I told you here first hopefully, and Dr. Dasso will remind you.. probably halfway through the term how important they are. 

Finally for Practical Purposes:
  • Make sure you prepare your flights for after the term is over early, flights run out quickly, especially in the December time. 
  • Prepare your vehicles and stuff you plan to sell... 
  • ***MAKE CERTAIN YOU SUBMIT YOUR STEP 1 REGISTRATION: *** GOTO http://www.ecfmg.org/ and fill out the application for a USMLE ID #. You will recieve an email with your ID # and a temporary password. Then you must fill out another form, and submit $780 (sorry, it sucks i know), to register. They will give you 2 forms to download, fill out and hand in to the registration office, one of which requires a Passport Photo. (For those that did the GSP program, i'll remind you may have some extra if you got a railway pass). 
  • This point brings up the issues of COST. Keep in mind a lot of this will cost you extra expenses you may not have prepared for. Step Preparation courses can be between $2000-8000, books can be a couple hundred $100, Question banks can be as much as $250-400/each for a short 3 month subscription, and the registration for the test is $780. My advice is to keep a few thousand dollars put away for your Step Preparation otherwise you may be eating top ramen noodles right up until the test and months afterwards until you get into clinicals, when you re-qualify for loans. 
  • FINALLY, HAVE FUN!!! Enjoy yourself and probably the last time you'll be living on a tropical island. Make the best of it. Cheers!


  1. Hi Ryan,
    I'm currently a 4th term student and I've been reading your blog since the beginning of the term. It's been very helpful, thank you so much. I just have a quick question: Which textbks for 5th term would you suggest buying (i.e. books that we'll actually use? like robbins for path, etc.)? I'm thinking about getting the lange flashcards. Anything else you would recommend? You can just reply to this comment or email me at ttan487@gmail.com Thanks a bunch and good luck with the rest of the term,


  2. I added some book recommendations to the Pharm section of the post, and also some extra posts about step review materials (for pathophys). Thank for your support!

  3. Hey Ryan,
    Thanks for the post! I'll def look into getting those books. Also, any textbk recommendations for pathophys? And for the intro to clinical med, are we required to get the textbk?

    Thanks again,

  4. there are some texts, but I cant in good faith recommend them because I never touched the ones i had access to. First Aid and the resources Kaplan provides are more than enough, including the notes you've taken since term 1, in order to review (along with the lecture notes) for the class. You really do go over the Histology, Biochem, Physio, Pathology, Immunology, Genetics...and Pharmacology of the different organ systems, so a large text might overwhelm you.

  5. Hey Ryan,
    I know you're probably studying hard for the boards but I just have a quick question about 5th term. You said a lot about pharm and preparing for the boards but can you tell me a little about how you studied for pathophys? The class is a bit frustrating for me even though it's review but I find the notes all over the place and hard to follow. I'm not exactly sure what to study, or if i should just study everything, because the objectives seem so vague. I have pathophys complete file, but I'm not sure if it's really enough. How would you suggest studying for this class and how were the exams? Were they as tough as pathology? How did you prepare and what resources did you use?

    Sorry to be taking up your time, no rush, just reply when you're taking a break. Thanks!!!


  6. I hope I was able to answer your questions Tanya. Thanks for being understanding. All the resources I used or tried to use are mentioned on the term 5 page and USMLE page.

  7. Hi Ryan,
    Thanks a lot, you answered all of them! By the way, one more quick question (sorry!), I was wondering how you studied for the cpd written midterm? Was just similar to 4th term's written cpd exams? I will probably just use cpd everything/gold/complete but just wondering if you had any else to say about it.

    Anyway, all the best to you on the step 1! Good luck!