the medical chronicles

The Step 1 Study Post

What I used & how I used it:

-UWorld: As some of you guys know, I used UWorld throughout the second year in pathology, pharmacology, pathophysiology, and behavioral science. On day 1 of my dedicated study period, I reset UWorld (you’re allowed to do this once) and started from the top with random, timed blocks. I did 2-3 blocks per day, reviewed them, annotated FA with any gems of knowledge until I finished the bank one time through. As I went, if I got a question right but didn’t feel confident about the subject, I would “mark” this question with the little flagging option. I finished this a week or ten days out from the test. From here, I started doing blocks of previously incorrect questions. If you get it right, UWorld moves it out of your incorrect bank. So I continued to do this (actually switched to tutor mode for this because it was faster) until there were no more questions left in the incorrect bank. I also sharply increased my questions per day to about 6-7 blocks. Once this was over, I did the “marked” banks, again until all of the questions were out of the bank. By this point, I had accumulated more in the incorrect bank and did these questions, yet again, until they were all gone. 

The self-assessments were also so key. Unlike the NBME exams, you can review the entire test, with explanations. It gives you a score estimate and people debate about the accuracy of these scores, but mine weren’t too far off from my NBME scores. More on this below.

The key with UWorld is reviewing the questions. The diagrams, charts, and explanations given in UWorld are second to none. They’re incredible. I would say that it was hands down the greatest source of my learning during M2 year and during dedicated study. 10/10 highly recommend.

-First Aid: Added gems from UWorld, sketchy, and pathoma as needed. This is regarded as the Step Bible, and I agree. It’s your go-to for everything. If I got a question wrong in UWorld, the first thing I would do is open up to the FA section and ask myself if I had memorized everything about this concept that’s in FA, would I have gotten the question right? A lot of the time, yes. Of course UWorld goes above and beyond on some topics and I would be sure to add any extra information into FA. I divided FA up based on each of the chapters and had a specific “topic of the day” that I would study once I was done with my UWorld blocks. In retrospect, I wish I would’ve spent 3 days on neuro and only 1 day on behavioral science, but I think it ended up working out okay. 

-Pathoma: I started off watching the videos associated with each section, but eventually ended up just reading the book instead. I had already watched them all at least twice during the school year. This is an absolute key resource for learning pathology. Our professors recommended Robins, but I just couldn’t. I read Goljan Rapid Review throughout the year if I felt like I needed more exposure to a certain topic. I didn’t end up using Goljan during the dedicated study period, mainly because I felt pretty strong in pathology and needed to focus more on relearning M1 material and other subjects. 

-Sketchy micro: I spent the first 3 days of dedicated rewatching every sketchy micro video available. I would’ve done the same with pharm, but sketchy pharm was not out during my second year so it felt like a huge burden to start sketchy pharm during dedicated. I loved sketchy micro during second year and loved it again during dedicated. I think I would’ve bombed micro without it… 

-NBME forms 16, 17, and 18: These were $60/test. Worth it though. 

-School-provided CBSE x3 For those of you that don’t know, the CBSE is the Comprehensive Basic Science Exam aka just a practice step 1 but shorter. My school gave three of these to us. 

My original schedule: Wake up, exercise, and eat breakfast before starting the day. 9:30am-10pm study every day and Sundays off. I planned on doing 2-3 UWorld blocks/day, and studying the topic of the day.

What actually happened: A couple weeks into dedicated, I started meeting a friend on campus around 7:30-8a to get started. How long we stayed varied/depended on the day, sometimes before dinner and sometimes until 9p. I actually ended up not exercising as much as I should’ve. Having someone else to talk to that actually understood what I was going through may have saved me though. I actually didn’t end up taking an entire day off either. Instead, I usually worked every morning and would sometimes take an afternoon or evening off if I needed it. 

I basically would start the day with a UWorld block and review. I made a powerpoint of all my incorrect questions (which ended up being a huge power point LOL). Study topic of day. Eat. Another UWorld block + review. Study topic of day. Eat dinner. Possibility of another UWorld block. Sleeps. Wake up, repeat. For 6 weeks.  

What I wish I had done more of: exercising, taken more breaks, not go completely nanerz towards the end, worried less about what everyone else was doing, etc. 

Since I don’t want to post actual scores, I’ll describe my practice exams in terms of my “goal score.”

CBSE 1 & 2: Goal score - 45 points… *cries* Yes, the exact same score on both of these tests despite them being a couple months apart. 

CBSE 3: Goal score - 20 points- better! At least I’m improving. This was the start of my dedicated study period. 

UWorld Assessment 2: Goal score dead on. Wut. Probably overestimated. Five weeks out.

NBME 16: Goal score + 5…. okay guuuuurrrlll you got dis. Four weeks out.

NBME 18: Goal score - 6… rude. *FORGOT SNACKS, HANGRY BY BLOCK 3* Three weeks out.

UWorld Assessment 1: Goal score + 7 !!!!! Two weeks out.

NBME 17: Goal score + 7 !!!!! One week out. 

So I felt pretty good going into the test. I actually was not nervous at all before or during the test which is VERY STRANGE for me. I’m normally anxious, but I was so calm. It was weird. Anyways, that’s how I studied for Step 1! If you guys have any questions, feel free to ask! :D 

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Manchester Evening Chronicle Household Medical Advisor a complete popular-science work of reference how to avoid illness, and how to prescribe for and treat all classes of ailments & diseasescompiled from the most recent recognised system of prevention and cure by H Muller MD - no date c1900

cover design with the artists initials AW

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The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York, written by Deborah Blum, is a non-fiction account about the development of forensic toxicology as we know it today. In 1918, New York City appointed a chief pathologist as its first scientifically trained medical examiner. The book chronicles his life’s work and the work of the city’s first toxicologist as it related to the deaths caused by poisoning at the time. Their lead ensured that new forensic standards were set for the rest of the United States.

The author wrote the book because she was always interested in poison and “wanted to write about the mystery about why poisons kill us”. It’s a critically acclaimed work that was optioned for TV and featured in an episode of American Experience back in 2014. It can be approached as a collection of short stories (one poisoning case per chapter) and the backdrop of the Prohibition is said to make for a particularly engaging read!

in july of 1518, in full view of her neighbors, frau troffea began to violently dance in the streets of the city of strasbourg, france. there was no music and her face betrayed no expression of joy. she appeared unable to stop herself from her frenzy.

had this remained an isolated incident, the city elders may have put it down to madness or demonic possession, but soon after troffea began her dancing, a neighbor joined in. and then another. by the end of a week more than 30 people were dancing night and day on the streets of the city. and it didn’t stop there. by the time a month had passed, at least 400 citizens of strasbourg were swept up in the phenomenon.

medical and civic authorities were called in once some of the dancers began dying from heart attacks, exhaustion, or strokes. for some inexplicable reason, these men believed that the cure for the dancing was more dancing, so they erected a wooden stage for the dancers and musicians were called in.

this all sounds like some archaic bit of folklore, but the dancing plague of 1518 is clearly chronicled in medical, civic, and religious notes of the time. modern researchers pore over those notes to develop theories as to what caused this bizarre incident.

one of those theories postulates that the dancers were the victims of mass hysteria: instances when more than one person believes they are afflicted by an identical malady — often during times of extreme stress within the affected community. the strasbourg incident occurred during a time of rampant famine and malnutrition and subsequent deaths. but 400 people? a well-known recent incident generally seen as an example of mass hysteria is 1962′s “the tanganyika laughter epidemic” which affected only 95 people.

a second theory is in the realm of agriculture. the condition called ergotism occurs when grains of rye are attacked by a specific mold. eating the infected rye can lead to seizures, although the movements of strasbourg’s afflicted looked much more like traditional dancing than seizures of any sort.

a final school of thought states that the dancing was in result of some kind of religious ecstasy caused by veneration of saint vitus, the patron saint of epilepsy.

none of the theories completely explain the 1518 dancing.

bit by bit the dancers stopped, and the dancing would end as mysteriously as it began.

http://en.wikipedia.org/wiki/Dancing_plague

Justice

Hello dear Tumblerers and Medblrs,

I know I had promised a print issue for the 2 in 1, but due to technical difficulties and other stuff, it seems The Medical Chronicles had a one year print break.

BUT (and I pinky promise this time, so you know it’s true), the print issue for Summer 2015 will be out in July/August. And this issue is special because we’ll be hitting on a hot topic in medicine the last few months - Justice. With the #whitecoatsforblacklives and the CIA files, justice and humanity in medicine was brought to the surface for a while - but we can’t let it disappear again.

So I need you to submit your articles, pictures, opinions, art, and any piece you like, on the theme of justice for our next issue (we’ll also take bits of comic relief too).

Deadline: Saturday July 18, 2015.

Looking forward to all of us making this issue big, so hit that submit link or send that email to themedicalchronicles@gmail.com!