20142015
MS-1 SARC Manual
1
Jennifer Cipullo, Rajan Manmohan, Erika Yih
Class of 2017
INTRODUCTION ................................................................................................................................................. 3
Fundamentals of Basic Science Block ................................................................................................................ 8
Medical Anatomy ................................................................................................................................................................................................................ 8
Fuel Metabolism ............................................................................................................................................................................................................... 13
Genetics ................................................................................................................................................................................................................................ 16
Cellular and Pathological Basis for Disease ....................................................................................................................................................... 19
Immunology in Health and Disease ....................................................................................................................................................................... 23
Medical Microbiology .................................................................................................................................................................................................... 26
Organ System and Pathophysiology Block ...................................................................................................... 29
Neuroscience ..................................................................................................................................................................................................................... 29
Introduction to Psychiatry.......................................................................................................................................................................................... 33
Introduction to Patient Care Block .................................................................................................................. 36
Medical Interviewing ..................................................................................................................................................................................................... 36
Introduction to Physical Examination .................................................................................................................................................................. 38
Advanced Physical Examination I ........................................................................................................................................................................... 40
Clinical Experience I ....................................................................................................................................................................................................... 40
Patient Physician and Society Block ................................................................................................................ 42
Introduction to Being a Physician........................................................................................................................................................................... 42
Ethics, Law, and Professionalism ............................................................................................................................................................................ 43
Behavioral Medicine ...................................................................................................................................................................................................... 45
Scientific Reasoning in Medicine Block ........................................................................................................... 48
Introduction to Medical Decision Making........................................................................................................................................................... 48
Methods & Logic in Medicine 1 ................................................................................................................................................................................ 50
Summer After First Year .................................................................................................................................. 53
Acknowledgements......................................................................................................................................... 57
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INTRODUCTION
Overview
Congratulations and welcome to the University of Pittsburgh School of Medicine! All of your hard work has
finally paid off, so enjoy your matriculation to medical school. Studying in medical school will be drastically
different from what you are used to, but there are multiple resources to help ensure that the transition is as
smooth and successful as possible. One of them is this guide, the SARC Manual. We, the Student Academic Resource
Consortium, have compiled feedback from the class of 2017 to provide you with an insight into the first-year
experience. Our goal is to provide you with an idea of the first-year curriculum and to give you advice on what
books to buy, the most important lectures to go to, and how to study.
The manual is organized by block and by course. Contained herein are the opinions of over 60 members of
the 2017 class. While you may be overwhelmed with information now, you can skim the manual at the beginning of
the year to get a sense for what is in store. As you prepare for each course, you can revisit each section for more
detail.
Good luck and have a great year!
Anatomy of the SARC manual
The information in the SARC manual comes largely from surveys of the class of 2017 and inherited survey
results from SARC manuals past. Our surveys asked for both quantitative data on how people studied and
qualitative information on what they thought helped or would have helped (AKA advice).
Advice is contained in the last section of each chapter. Note that people sometimes provided differing or even
contradictory advice, because people are, well, different. To help clarify, we have in many cases noted in
parentheses how many students gave a particular piece of advice.
Data is contained in the second section of each chapter, and is summarized into charts like the ones below (which
also contain general data not specific to any class. Our hope in providing this is to accurately reflect the diversity of
approaches that worked for our class and help you to place your efforts somewhere in the middle of our
continuum.
Summaries at the beginning of each chapter aim to synthesize the survey information and other wisdom into a
narrative that will give you perspective and peace of mind as you tackle a new class.
General Study Tips
A good recommendation is to start with your current study habits. However, be aware that the volume of
material is greater and coming at a faster pace than in an undergraduate curriculum. Those who have been out of
school for a few years or that are coming from a non‐science background may want to pay more attention to
developing new study habits. Below are outlined the most common strategies employed by PittMed students. It’s
best to experiment and find out what methods seem to work for you.
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Highlighting and rereading the syllabus. At the start of each course, you will receive a syllabus
containing all of the lecture notes. Since tests are for the most part built around these syllabi, this is the
most popular and highest-yield strategy.
Pre-reading the syllabus. Having seen the material once already makes a big difference when you are
listening to the lecture. You get more out of the lecture, do not get lost as easily, and can pay more attention
to the details than just the big picture.
Condensing syllabus notes. Condensing the material into your own words forces you to digest and
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understand the material.
Focusing on the learning objectives. The syllabi will have learning objectives for each lecture. The
learning objectives tell you what the instructors expect you to understand. By answering the objectives,
you can focus your studies on the important concepts that are tested and not waste your time on
extraneous details.
Highlighting and rereading the Powerpoint slides. For some courses, the slides are more informative
than the syllabus.
Using flashcards. This is a popular and effective strategy for anatomy and microbiology. Netter’s Anatomy
Flash Cards and Lippincott’s Microcards are popular published sets. It is far more effective to make your
own, though, if you have the time. You can only include the information you need, and making the card is
part of the memorization process.
Making study groups. Being able to teach a concept means that you know it really well, and you can use
your classmates to shore up the parts where you are weak. Good study groups provide accountability, not
chat time.
Doing practice questions. Practice questions are available in the syllabus or online for most classes, and
are usually similar to exam questions.
Re-listening to podcasts. Some students are aural learners and benefit from listening to lectures again at
faster speeds.
You will figure out the right combination for yourself. Generally students drift into one of the following categories:
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Getting the Most For their Money: Attends lecture religiously, pre-reads, seeks out instructors for help
Married to the Syllabus: pre-reads, post-reads, post-post-reads, highlights with a codified system
Speedy Gonzalez: Chipmunks sound slow to him after he spends all day listening to Dr. Schumann at 2x on
his computer.
Social Butterfly: Not found studying alone. Needs communal suffering for motivation.
Just Confused: Has yet to nail down what works. Likely to change gears between or within courses.
Lecture Attendance
Attending lecture is largely an individual preference. Some people learn best by reading on their own and
searching for answers, while others need a dynamic environment that can yield immediate responses to questions.
Some favored lecture as a chance to actually hear the information, and thus reinforce what they had previously
read. Many students have commented that attending lectures is only valuable if you take the time to pre-read so
you are not overwhelmed by the lecturer’s pace.
All lectures are recorded with the PowerPoint synced to audio and subsequently posted online. Podcasts of
the lectures are also available, but with audio only. Most people found this to be a great resource to review lectures
or to view information missed due to illness or travels. Some students skip lecture completely, using the recordings
alone. They cite the efficiency of being able to speed up/slow down/pause the lecture.
Yet, overall, students agreed that recordings should not be used as a complete substitute for attendance.
Some lectures are not recorded, either by accident or design, often causing podcast-learners to miss important
information. Some people note that many second-years with the lowest practice board scores happened to be
regular lecture-skippers. Also, one study found an inverse correlation between medical school performance and
frequency of accessing online video lectures. 1 Please remember that lecturers have many other obligations (mainly
1
McNulty JA et al., An analysis of lecture video utilization in undergraduate medical education: associations with performance in the
courses. BMC Med Educ 2009, 9: 6
4
clinical and research responsibilities). If they notice that attendance is minimal they will be less inclined to put
together a compelling presentation. We urge you to consider these factors when deciding whether or not to attend
class.
Note for Mac users:
Use the Navidile player on Google Chrome.
Textbooks
Perhaps the greatest asset of this manual is to give some guidance on what books to buy and what you
might not want to waste your time on. Some books were universally accepted as essential (i.e. Netters) and others
tended to vary upon personal preference. Books purchased at the health bookstore are nonreturnable. Consult this
guide or check out a copy of the book in the Book Room (M219, immediately on the right after the double doors on
your way to free coffee in the Alumni Office). Other cheap options for acquiring texts include: half.com, SOMADS
email list, and a student organized book sale held intermittently throughout the year.
Below is a list of books that had a consensus verdict from the class of 2015.
“Buy! Buy! Buy!”:
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Netter’s Atlas of Human Anatomy
Abbas’s Basic Immunology
Haines’s Neuroanatomy
Rao’s Rational Medical Decision Making
“Don’t Waste your Money!”:
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Klippel’s Primer on the Rheumatic Diseases
Albert’s Molecular Biology of the Cell
You will have to decide whether you want to buy the others. Use the data from the polls in this manual
(grouped by course) and take a look at your friend’s copy before you put down your money.
General Advice
The first year will be great. We promise. However, that doesn’t mean there won’t be challenges and
obstacles along the way. Real life doesn’t stop just because you are busy for an anatomy test. Thankfully, PittMed
provides numerous resources to help you weather the added stress of being a medical student. Many people
stumble at some point during the year, so don’t be afraid to seek out help. The worst thing to do in this situation is
to do nothing. Finally, remember you are not a studying robot. The school and the city have many options for being
involved beyond medical school. A sane and healthy student is a well-performing student. Below you will find
advice from the current second year class. Please keep in mind that this advice comes from a variety or individuals
and may or may not prove best for you. As with any advice, take what works for you and don’t get stressed out by
the rest.
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How would you rank the difficulty of the basic science classes?
(1 is the hardest)
40
35
1
30
2
25
3
20
4
15
5
10
6
5
7
0
Anatomy
Fuel
Genetics
Path
Pharmacology
Immuno
Micro
Note: Pharm has been removed from the MS-1 curriculum for the Class of 2018.
How long did you prepare for an average
PBL?
4%
9%
12%
Up to 30 min
30 min < t ≤ 1 hr
1 hr < t ≤ 2 hr
24%
2 hrs < t ≤ 3 hrs
36%
t > 3 hrs
Advice from the Class of 20152:
 Just relax. You're a smart person. You'll do just fine.
 Don't study on Friday evenings.
 Make sure to take time for relaxation. You can't study all hours of the day!
 Don't fall behind. It's easy to get caught up in life and say you will just make up work the next day. Just
spend 2 hours a day, everyday, studying to ensure you keep up with the material. When test time comes
around you will be happy that you don't have to study 6-8 hours a day like your peers.
 Set up a schedule that you can adhere to and a pace that you can maintain throughout the year. Don't
procrastinate. Keep up your hobbies because you can't study all the time and relaxing is always important.
 Lecture is not for everyone. Don't feel obligated to go if you feel like you can study more efficiently by
spending your time in the library instead. Realize this early, and you can save yourself a lot of time!
2
We did not poll the class of 2017 for general advice. Advice from the class of 2015 still applies to you!
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Don't put off studying until the last minute! You can't cram like you did for college! Pre-reading, going to
lecture, post-reading is the best! Make sure to take breaks - you'll go insane if you just study all the time!
Study groups make studying fun!
Schedule breaks! Occasionally, your brain will take a break whether you want it to or not. When this
happens, step away from the syllabus and refuse to study for a set amount of time. Otherwise, you'll end up
half-relaxing and half-studying but doing a poor job at both.
Find what works for you! I had to completely change how I studied upon coming to med school. Your study
style may also be different for each course. Don't be afraid to try new things or to get advice.
Have confidence in yourself. You are here for a reason. You are just as smart and work about as hard as
everyone else here. Do your best and, when it comes to be the night before the exam, let it go--rest easy and
go in with confidence. Anxiety will only hurt you.
If you're still in college mode of staying up until 3am studying and then sleeping until 10am, the sooner you
break the habit the better.
Take time off and don’t apologize for it!
Find a mentor/project for MLM and DSRP during November/December.
Pre-read. Lecture is a waste without it. Sequester yourself in the library early and often. Once you do this
you realize you can actually get studying done. Facebook is the devil.
Don't worry about what everyone else is doing to study or how much time everyone spends studying.
Everyone develops their own methods.
Stay on top of the material! Repetition and discussion are great memory devices.
Everyone has an individual style of learning, set of interests, and opinions. When anyone tells you a class or
test is easy or hard, remember it’s just that ONE person's opinion. If someone says anatomy is the toughest
(or easiest) class ever, just keep the perspective.
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Fundamentals of Basic Science Block
Medical Anatomy
Dates: August 22 – October 11, 2014
Course director: Jack Schumann, Ph.D.
Block: 100% of FBS Section #1
Exams: 2 written examinations (20%), 3 laboratory practicals (30%), and 1 written comprehensive final
(50%)
Overview
Anatomy is exciting and difficult, both in its own right and because it is the introduction to medical school.
It will be a lot of work, and it’s important to figure out early what is expected of you and what it takes for you
personally to keep up. Much of the quantitative and qualitative survey information below focuses on how to divide
your time, both between the many different sources of information that are available and between the lecture and
laboratory aspects of the course. You’ll find your own strategies for what and how to study, but we hope the survey
results below will show you what worked for our class. Whatever methods you use, you should aim to memorize
both the names and the spatial arrangement of the structures mentioned in the syllabus.
Lecture
Lectures usually consist of Dr. Schumann going over the material in the syllabus systematically, pointing
out the structures on blown-up Netter's illustrations. Most students attended most lectures, and several
commented positively regarding Dr. Schumann’s organization and teaching.
Laboratory
In the laboratory sessions of the course your team of six will be following the instructions in a book called
Grant's Dissector on how to dissect and locate the structures for the day. Your group will have to keep up with the
day’s scheduled dissection, but lab time is also a chance to practice identifying structures in your and other teams’
cadavers and to ask the surgeons on hand to clarify structures you can’t find or don’t understand. To facilitate this
and to ease the time burden of lab, most lab groups divided up so that on a given day only some members were
actually dissecting. You can also visit the lab on your own at any time. It is very important to look at all of the
cadavers, since they can look very different from your own and the practical exam will involve every cadaver.
Textbooks and Syllabus
Netter's Atlas of Human Anatomy is the standard text for all medical schools and one that you will use
throughout your medical education. This and the syllabus, which extremely well organized, are the essentials for
this course. Many students also bought Grant's Dissector, which guides you in the lab. However there are many
copies available in the laboratory and you could probably get away with sharing with a friend or using a copy from
the book room. Rohen's Color Atlas shows labeled photographs of dissected cadavers. Many students never looked
at it, while some say it is better to study Rohen’s than to go to lab. Finally, Dr. Schumann recommends Moore’s
Clinically Oriented Anatomy which, as a standard textbook, covers much of the information from the syllabus in a
very different format. Few students used this resource.
Changes
Medical Anatomy is already regarded as a very well-constructed and well-taught class. Dr. Schumann says
that this year more time will be spent on ultrasound experiences and on Head & Neck (the time spent on this
region was cut very short last year due to a scheduling mishap).
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Other Resources
-Anatomy videos. These highly-useful videos should be available on the course website. They consist of Dr.
Schumann presenting a difficult section of the body in the lab.
-University of Michigan medical school website. Has practice questions, lab images, and dissection videos.
http://anatomy.med.umich.edu
-Suny Downstate has a website with gross anatomy structures and quizzes.
http://ect.downstate.edu/courseware/haonline/index.htm
-Pretest Anatomy. This book has a lot of clinically-oriented practice questions
-Models in the anatomy lab. The plastic models and preserved dissections are excellent and sometimes used on the
practicals, so make sure to get acquainted with them too.
Survey results from the Class of 2017
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Some Internet Resources
AnatLine http://anatline.nlm.nih.gov/Anatline/index.html
Digital Anatomist http://www9.biostr.washington.edu/da.html
Gray’s Anatomy http://www.bartleby.com/107/
Instant Anatomy http://www.instantanatomy.net/
LUMEN Structure of the Human Body http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/ Mascagni
Images from Anatomia Universa http://www.lib.uiowa.edu/hardin/mascagni/index.html
Neuroanatomy Lab Resource http://courses.temple.edu/neuroanatomy/lab/index.htm
University of Michigan http://anatomy.med.umich.edu/
University of Michigan Visible Human Project http://vhp.med.umich.edu/
University of Utah Neuroanatomy Atlas http://library.med.utah.edu/WebPath/HISTHTML/HISTO.html
University of Utah Visible Human
http://library.med.utah.edu/WebPath/HISTHTML/ANATOMY/ANATOMY.html
Cardiac MRI Anatomical Atlas http://www.scmr.org/education/atlas/intro/index.html
Emory Radiologic Anatomy http://www.emory.edu/ANATOMY/Radiology/Home.Page.MENU.HTML
LUMEN Cross Section Tutorial http://www.lumen.luc.edu/lumen/meded/grossanatomy/x_sec/mainx_sec.htm
McGill Radiologic Anatomy http://sprojects.mmi.mcgill.ca/radiology/
Wayne State Radiologic Anatomy http://www.med.wayne.edu/diagRadiology/Anatomy_Modules/Page1.html
Whole Brain Atlas http://www.med.harvard.edu/AANLIB/home.html
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Qualitative anatomy advice from the Class of 2017
*summarized from 38 total responses
Studying
Go to lecture (5) or don’t (2).
Preread (2)
Focus on memorizing the syllabus (6), and clinical correlations (1).
Draw structures out multiple times (1).
Postread (3).
Use practice questions (2), particularly BRS Questions (1).
It’s all about repetition (2).
Resources
Make sure to use…
Rohen’s (5)
experiment with Firecracker to see if it helps you. (2)
Moore’s (1)
use online dissection videos- esp. SUNY Downstate’s (1)
look at museum specimens before dissection (1)
ask for a tutor (2)
Lab
Focus on/go to lab (10).
Alternatively, scheduled lab is not as useful as using Rohen’s or going in on your own (2).
Look at other tables’ bodies (3).
Learn the anatomy before you go into lab (2)
Follow Schumann or the surgeons when you are not dissecting (2).
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Fuel Metabolism
Dates: October 13 – 29, 2014
Course director: Martin Schmidt, PhD
Block: 25% of FBS Section 2
Exams: 1 written examination.
Overview
This will be Martin Schmidt’s second year as course director for Fuel Metabolism. He doesn’t anticipate any
major changes to the course, so the advice from our class should be applicable, although Dr. Schmidt is continuing
to make improvements to the syllabus and overall course. One addition for the class of 2018 will be an optional
simulation session at the Wiser Center.
Here’s what we can tell you: Fuel metabolism feels like a semester-long biochemistry course crammed into a
few weeks. We memorized metabolic pathways and cycles and learned how they interact to maintain homeostasis.
Just as we had to memorize specific nomenclature in anatomy, we needed to know specific (particularly the
regulatory) steps of metabolic pathways. This level of detail is what makes fuel metabolism challenging.
Most of our classmates ranked fuel metabolism as in the middle of the pack in terms of difficulty (easier than
Anatomy). If you look at the qualitative comments, however, you’ll notice warnings against taking the class too
lightly at first. It can be tempting after anatomy to relax through the beginning of fuel metabolism, but in a short
and front-loaded course getting even a little behind can be a serious problem.
The good news is that studying for Fuel Metabolism is fairly straightforward. Most students read the syllabus
and other textbooks, wrote out pathways over and over and over, and focused on learning objectives, which were a
good representation of what was on the test.
Attending Lecture
Attendance at lectures dropped drastically between Anatomy and Fuel Metabolism as people settled into
their studying routines, which for some (the majority of) people meant studying from home for this course. You
will figure out for yourself how your time is best spent. However, if you decide to study from home, make sure it
does not mean taking the first few days any easier. Dr. Schmidt schedules PBLs so that the topics coordinate with
current lecture topics, so keeping up is important.
Textbook and Syllabus
Some of the class used Lippincott’s Illustrated Reviews: Biochemistry, and when they did they described it as
helpful. However, most of the class did not use it.
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Survey results from the Class of
2017
How useful was Lipincott's for studying
biochemistry?
2%
Worth buying
11%
Worth borrowing
15%
Not worth the time
or money
72%
No opinion - I never
looked at it
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Qualitative Fuel Metabolism advice from the Class of 2017
Attitude
Don’t take a mental (or physical) break after anatomy (8).
The course is short, quick, and front-loaded (3).
Studying
Textbooks and outside sources are useful (9).
Focus on Learning Objectives (7).
Studying on your own may be more useful than lecture (7).
Memorize the pathways (5). Draw them out over and over (2) using a whiteboard (1).
Study disease processes, not just pathways (1).
Start studying early (1).
Pre-read and post-read (1).
Use flashcards to organize material into categories (1).
Do practice questions (1).
Resources
Be sure to use…
the syllabus (3).
other texts (9) – BRS (2); First Aid (2); Lipincott (1).
Anki flashcards (1).
completed learning objectives from the previous year’s class (1).
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Genetics
Dates: October 30 – November 25, 2014
Course director: Paula Monaghan-Nichols, PhD.
Block: 34% of FBS Section #2
Exams: 1 written exam (65%) and 4 TBLs (35%)
Overview
Good news! Most students considered genetics to be among the easiest basic science courses, and several of
our classmates mentioned how much they enjoyed course director, Dr. Monaghan-Nichols. After ten weeks of
Anatomy and Fuel Metabolism, Genetics can feel like a breath of fresh air. Most of genetics is formatted similar to
previous classes. There are a lot of lectures, patient conferences that feel similar to those in Intro to Being a
Physician, case presentations and “Team Based Learning” (TBL) sessions.
Team Based Learning
Like PBLs, TBLs are a novel and increasingly popular style of learning. The format is a little complicated, but
Dr. Monaghan‐Nichols will describe it in depth on the first day of the class. The goal of these sessions is to
encourage you to learn the material and cooperatively apply your knowledge in a team setting. A book chapter or a
paper will be assigned for you to read and there will be a short quiz at the beginning of class that counts toward
your final grade. You will then separate into small groups where you will take the same quiz again as a group,
discussing the questions and coming to a consensus. You will then be given a group grade for the quiz as well.
Then, your group will be assigned several medically relevant problems to work through (not for a grade). Open
discussion with the faculty member running the session will follow each quiz. The hope is that everyone will bring
different strengths and knowledge bases to the group that will enhance everyone in the group’s understanding of
the material.
Relax!
Genetics is a real course, and does require studying, but most students find that it is not a very
stressful experience. When students do get frustrated, the source is often TBL, which can present a very
different experience depending on your own learning style, your group, and how bothered you are by an
ambiguous question that loses you a few points. As you’ll see under qualitative advice, several of our
classmates suggest not stressing too much over TBL points. If you aren’t worrying about grades you may
find yourself more open to the unique, positive features of the course, which presents at times both the
patient-centered and cutting-edge aspects of genetics.
Survey results from the Class of
2017
How long did you prepare for
TBLs?
1%
13%
Up to 30 min
14%
30 min < t ≤ 1 hr
1 hr < t ≤ 2 hr
36%
36%
2 hrs < t ≤ 3 hrs
t > 3 hrs
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How useful was Genetics in
Medicine?
0%
Worth buying
5%
13%
Worth borrowing
Not worth the time or
money
No opinion - I never looked
at it Class of 2017
Qualitative anatomy advice from the
82%
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Attitude and background
The workload is lighter than in anatomy/fuel (4) but it is still possible to fall behind if you are too
lax (3).
If you haven’t seen much genetics before, ask for help (1) or use extra materials (1).
If you took genetics in undergrad, it might be easy (1) but not necessarily (1).
Dr. Monaghan-Nichols is nice (1) and helpful (1).
Studying and resources
Use boards questions because the exam is NBME (3).
You might not find lecture helpful (3)
or the lecture and the syllabus might be all you need (1).
The clinical presentations are worthwhile and help solidify material (4).
The shelf-style exam doesn’t reflect the course material (4).
In particular, it is heavy on clinical details (1) and diseases (4).
Embryology is difficult (1) and visual – make sure to go to these lectures.
Use learning objectives (1).
The book is helpful (1).
You’ll have to make big-picture connections between lectures for yourself (1).
TBL
Don’t stress over TBL (5), but do prepare (2).
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Cellular and Pathological Basis for Disease
Dates: December 1, 2014 – January 27, 2015
Course directors: Marie DeFrances, MD PhD, Don DeFranco, PhD, Cynthia Lance-Jones PhD
Block: 50% of FBS Section # 2
Exams: 2 TBLs, Pharm workshop, 2 exams (equally weighted)
*note: exact percentage weight of each component of the course was not provided by directors
Overview
Like every course in your first year, Cellular and Pathological Basis of Disease (CPBD) will cover a lot of
information quickly. What may be different is that some of the course material will be familiar to students with
extensive backgrounds in biology. The course is divided into two sections which are separated by the winter
recess. Before the break, cell biology, cell signaling, and pharmacology will be covered and tested; after the break,
histology and pathology will be covered and tested. The significant change from last year is that for the class of 2017,
pharmacology was its own, separate, one week course that was taught in late winter/early spring. This year, the
pharmacology course is combined into this Cell/Path course. Although the two sections can feel like separate courses
their main uniting feature, unique in your first year, is their strong emphasis on cell and tissue slides. Like
Anatomy, Cell Bio and Path requires you to balance this sort of visual learning with memorizing terms.
CPBD has many components: lecture, histology lab, histology workshops, pathology sessions and a pharmacology
workshop. Make sure to refer to your schedule so you know what’s coming up. The basics of each section are
outlined below.
Lecture
This class includes many lecturers for this class and they all have very different styles, so it’s often hard to
decide which lectures to attend and how to approach them. Most of the 2017ers agree that you should study lots of
images from the lectures, especially in the pathology section of the course. They can be frustrating at first, but after
you look at more and more images, clarity should arise.
Lab
The histology labs constitute a major portion of the course. TAs and faculty wander around the lab, available
for questions, and your classmates will also be there, available for group studying. After the first few labs you will
know whether they help you to learn. You could also go in on your own time or find images online. Regardless of
whether you continue to go to lab sessions, however, make sure to emphasize reading slides in your personal
studies. There was pretty strong consensus among the class of 2016 that knowing how to read a slide is the key to
CPBD.
Pharmacology Workshop
This activity functions like group-presentation-PBL, in which groups of three must teach their classmates
about a particular example of cell signaling. Unlike PBLs you’ll be assigned a topic with a specific set of questions. It
will be up to your group to coordinate and prepare a sound presentation.
Histology and Pathology Workshops
These workshops are more akin to the histology lab sessions than to the pharmacology workshop. TAs and
faculty walk you through several histology images and help you to see aspects you may have missed on your own.
This is a good way to quiz yourself, see what you know, and ask questions.
Textbooks and Syllabus
As you will see in the data below, most students prepared for CPBD by studying from the syllabus, as
19
opposed to using supplementary materials. The course directors do strongly suggest reading from Albert’s
Molecular Biology of the Cell for the first half of the course and one of two Robbins books, Pathologic Basis of
Disease and Basic Pathology (sometimes called Baby Robbins) for the second. Copies of Robbins are available online
through the library.
Survey results from the Class of 2017
20
21
Qualitative CPBD advice from the Class of 2017
*Summarized from 26 responses
Studying
Study lots of histological images (5)
Go to lab (3), although the graduate student TA’s might not know everything, if not, go to Dr. Duker
for help (1).
Go to lecture (8), especially the histology lectures and Dr. Duker’s (2).
Memorize answers to the learning objectives (1).
Don’t cram (3).
Resources
The syllabus is a sufficient resource (1).
The syllabus is sometimes confusing (2)
Study using …
Robbins (2).
22
Immunology in Health and Disease
Dates: January 29 – February 23, 2015
Course directors: Christine Milcarek, PhD, Chester Oddis, MD, and Per Basse, MD, PhD.
Block: 48% of FBS Section #3
Exams: 1 written exam (90%). (PBL was 10%)
Overview
The course feels divided into two parts: basic science and clinical applications. The first week of the course
covers the basics of innate and adaptive immunity, specifically focusing on the components of cell-mediated and
humoral immunity—everything you ever wanted to know about B-cells and T-cells. For this part of the course,
many students found the Abbas text helpful to fill in gaps and see the big picture. After setting this foundation, the
lecturers provide introductions to immunologic tolerance, immunodeficiency syndromes, and rheumatic diseases
(the clinical application part).
We had one multiple-choice exam. There was a review session and mock exam a few days prior to the exam,
as well as additional practice questions online.
Lecture
By the time you get to immunology, some people will be lecture people, and others will not. Especially for the
first half of the course, many feel they can get by using Abbas, the syllabus, and lecture recordings, although others
feel that lectures keep them involved and motivated, and at times the instructors will point blank tell you what
material they will test you on.
The clinical applications section of the course is harder to get by without attendance, mostly because it isn’t
covered by Abbas or any text in the way that the basic science section of Immunology is.
Textbooks/Syllabus
Our class came to a strong consensus that Abbas’s Basic Immunology is useful for this class. It is clearly
written and illustrated, easy to read, and a good tool for enhancing your understanding of the material presented in
the lectures and syllabus. In fact, many of the lecturers will use figures from this text in their Powerpoint
presentations, or refer to specific sections in the syllabus.
The rheumatology section of the course claimed Klippel’s Primer on Rheumatic Diseases as its text. However,
the majority of the class of 2017 didn’t use it.
Study Tips
One of the challenges in the first part of the course is to note the different surface markers on important cells
and remember which cytokines are involved in each response. Nail down these basics early – the class can be
tough to cram for because of its two very different sections.
For the rheumatology portion: It is important to fully grasp the differences between the different rheumatic
diseases, as some found this to be a large concept on the exam. Many in our class found it useful to devise tables
comparing the different rheumatic diseases causes, epidemiology, symptoms, etc. The exam included some details
from the syllabus that were not emphasized in class.
23
Survey results from the Class of 2017
Abbas
How useful did you find the following books?
Primer on Rheumatic Disease
2%
Worth buying
Worth buying
8%
23%
Worth borrowing
Worth borrowing
Not worth the time
or money
Not worth the
time or money
2%
16%
59%
90%
No opinion - I never
looked at it
24
No opinion - I
never looked at it
Qualitative Cell Biology and Pathology advice from the Class of 2016
Attitude
Good class (1) but don’t fall behind (2).
Make sure your understanding is complete, and don’t underestimate the material (1).
Studying
Make sure to get a solid foundation of the basic science part of the course (1).
Make sure you can distinguish between the different rheumatic diseases (1).
Do practice questions (2).
Pre-read and post-read (1).
Pay attention to learning objectives (1).
Resources and Lectures
It is essential to use textbooks (22) such as Abbas’s (20), which may be even more useful than the
syllabus (9) or lecture (6) in the first half of the course.
Do spend time on the syllabus (3), particularly for the clinical applications part of the course.
Clinical lectures are really helpful (1).
Supplement with …
Primer on Rheumatic Disease (1).
BRS (1).
Armando Hasudungan’s immunology YouTube videos (1).
25
Medical Microbiology
Dates: February 24 – March 27, 2015
Course director: Peter Veldkamp, M.D., Bruce McClane, Ph.D.
Block: 52% of FBS Section #3
Exams: 1 multiple-choice examination
Overview
Microbiology is, undoubtedly, one of the most difficult courses of first year. For many it is at least on par
with Anatomy for volume and difficulty of material. While the material may seem overwhelming, maintaining a
strict daily study schedule makes the class manageable. Many students find this to be one of their favorite first year
courses. Micro obviously has a very strong clinical focus and wide utility for any specialty of medicine and is pretty
high yield for the boards, so hard work in this course will likely pay off in the future. The course is divided up by
concept (pathogen biology, infectious cycle, etc.) and not by individual pathogen, so it might be worthwhile to use a
textbook that organizes it by pathogens, or many students created charts to keep the material organized. Ours and
previous classes really liked “Clinical Microbiology Made Ridiculously Simple”, which provided great mnemonics
and memory aids for the multiple drugs and bugs. Other students opted for the flashcard approach (homemade or
buying MicroCards) and found that to be useful for conquering the material. Whatever method(s) you choose, it’s
crucial to get organized from the start and keep on top of things. The course is front‐loaded with information (i.e.
the antibiotic lectures). Don’t fret, this eases up as the course moves on and is designed to give you ample time to
commit the harder material to memory. Take advantage of this and do your best to keep up!
Lecture
After anatomy, lecture attendance tends to drop off in the following classes, but we saw a large resurgence
during micro. Most of us felt the lectures were of quality and worth attending. Some of the lecturers are among the
most inspiring during the first year. Also, the returning course directors are great and are very present throughout
the course. In addition, there are weekly, optional quizzes that are not podcasted or posted online. Many students
felt this was a good way to test their knowledge and get a feel for what the exam might be like.
Textbooks/Syllabus
Most of us didn’t use the recommended textbooks. The syllabus is well organized and contains everything
you need to know. Many people found “Clinical Microbiology Made Ridiculously Simple” to be a good investment. It
organizes the material by pathogen (different approach from the syllabus) and contains lots of cheesy memory
aids.
Lab
There is a required lab portion which links with what you do in PBL. In the lab you will learn some common
microbiology techniques with the help of your TAs (who will be current micro grad. students). You’ll be required to
wear a lab coat, so make sure you are prepared. Overall, the lab is well-run with clear instructions and competent
TAs. The material from lab and PBL will be on the exam, so you should have an idea on how to perform and
interpret the different tests.
Study tips
You will be expected to know the defining characteristics of pathogens and other details covered in the
syllabus. Everything you need to know is in the syllabus, so you shouldn’t need to rely heavily on any outside
materials, aside from clarification. Know lab stuff, as there are always a couple questions that should be easy points
provided you paid attention. There are lots of practice questions online and in the syllabus, plus the weekly
quizzes, if you went.
26
Survey results from the Class of 2017:
How useful was Clinical Microbiology
Made Ridiculously Simple:
Worth buying
34%
39%
Worth borrowing
Not worth the time or money
5%
22%
No opinion - I never looked at it
27
Qualitative microbiology advice from the Class of 2017:
Attitude
The toughest class first year (2).
Don’t fall behind in this class (9)
Interesting class but a lot of information (2)
Course is front-loaded. Very dense at first, but tapers off after the first 2ish weeks.
Studying
I didn't find much use going to class, so I made sure to podcast that day's lectures immediately after
class got out.
This is probably the class that being in lecture definitely helps. Nowalk’s was good.
Start memorizing antibiotics and drugs early (9), it'll make sense at the end of the course why.
Don't fall behind in this class; it goes at the speed of light.
For each organism you encounter (especially bacteria), you want to always memorize its
characteristics, virulence factors, transmission, geographic/population distribution, diagnosis, and
treatment (15). Constantly make tables, notecards, or whatever your comfortable with to organize
the material, for example the organisms and drugs.
This is NOT as easily crammable. You don't have to study everyday, but do try to keep up somewhat
- studying at least 2 days a week should be sufficient for you hardcore crammers.
It would have been more helpful to group/learn bugs by diseases they most commonly cause.
The exam questions are extremely detailed, so beware!
Pre-reading would have helped since each lecture was so dense in material.
Resources
Clinical Microbio Made Ridiculously Simple was also very helpful (4).
Board study materials like First Aid
FirstAid Microbiology is 100% ESSENTIAL.
Lab
Review lab material more.
28
Organ System and Pathophysiology Block
Neuroscience
Dates: April 6 – May 15, 2015
Course director: Cynthia Lance-Jones, PhD
Block: 80% of OPS Section #1
Exams: 2 written examinations each worth 50% of total grade (multiple choice, identify the structure)
Overview
You are (hopefully) relaxed and refreshed from spring break, and ready to start the Organ Systems block.
Last year the course consisted of lectures, optional laboratories in which you grossly dissect and examine the
brains of the cadavers you collected during anatomy, optional online simulation exercises, one PBL, clinical
conferences and radiology sessions.
A big change from last year is that the laboratories will be replaced by workshops, which Dr. Lance-Jones
hopes will better teach you the brain anatomy and pathways.
Lecture
While the quality of the lecturers vary for Neuroscience, it is probably best to attempt to attend each
lecture as this year there were many which were not podcasted due to the presentations containing private patient
information. More importantly, the podcast availability was not always known beforehand, so people who did not
attend would learn only after the lecture that it was not recorded.
Study tips
This course is heavily front-loaded, and the material at the beginning (anatomy) is foundational for the
remainder. So study hard the first two weeks. The neuroanatomy can be challenging, especially for those who have
not taken a neuroscience course before. You will eventually get a feel for looking at sections and CT scans. Test
yourself repetitively on the images provided online and those in Haines. Last year there was a significant visual
portion to the exam, where you were asked to identify structures or what would result clinically from damage to
certain areas on brainstem and brain sections and CT/MRI images.
After the first two weeks, the course becomes much more manageable. “Find the lesion” questions will
certainly appear on your exams, so focus on the sensory/motor pathways.
Textbook and Syllabus
The syllabus is fairly well-organized, but is extremely dense and not always highly cogent across lecturers.
There are three textbooks for this course. Netter's you already have. Haines is indispensable, as the laboratory
exercises refer to it constantly, and its images are part of the pool for exam questions. Blumenfeld is much more of
a traditional textbook. It has illustrations and CT/MR images with a clear narration. In addition, it has sample cases
that can be useful for lesion practice.
29
Survey results from the Class of 2017:
30
31
Qualitative neuroscience advice from the Class of 2017:
*summarized from a total of 23 responses
Studying
Go to lecture (some were not podcasted last year as they contained patient videos) (1), especially
the radiology consults (1)
Read Blumenfeld for the first half, attend lecture for the second half of the course (1)
Pre-read (1)
Memorize the brain pathways and anatomy early (3)
Resources
Make sure to use…
Haines for brainstem loci (1) …or….don’t waste your money on Haines (2)
Blumenfield (4)
Board questions, especially in the beginning (1)
32
Introduction to Psychiatry
Dates: May 18 – May 29, 2015
Course director: Jody Glance, M.D.
Block: 20% of OPS Section #1
Exams: 1 written examination (multiple choice plus a written mental status exam)
Overview
The end is in sight! Intro to Psych is definitely less intense than the previous courses; however, some
students find it easy to slack off and get behind at this time of the year, making the course harder than it should be.
Hang in there and stay on top of the work for the final two weeks before summer “freedom”. The course does have
a lot of scheduled class time, with many required small group sessions, patient conferences, and lectures. You also
learn the details of a mental status exam and write-up not only through lecture, but also through completing a
practice write-up assignment based on a YouTube video. Dr. Rosenstock provides great feedback on this practice
write-up to prepare you for the mental status exam write-up based on a video during the exam.
Lecture
By now you should certainly know your lecture preferences. Most of our class found the lectures
worthwhile, and Dr. Rosenstock enjoys group discussions and class input. He even tried to implement a Twitter
feed for the class to use to ask him questions and leave feedback! Dr. Tew’s psychopharmacology lectures involved
chalkboard diagrams and tables, which do not translate to the podcasts. The 2017ers who attended Dr. Tew’s
lectures highly recommend them.
Small Groups
These mandatory sessions usually involve discussing a patient interview that was shown in class or a
clinical vignette presented in the syllabus. Thus, make sure you attend the screening in LR4 or you’ll be lost and/or
useless for the discussion. Consider using the mental status exam checklist in the syllabus to take notes while
watching these videos. These videos become good practice for the write-up you’ll turn in before the exam, and the
second one you’ll do during the exam. Writing a MSE is fairly easy once you know what to look for.
Textbook/Syllabus
No need to spend any money on a text for this class. Dr. Rosenstock has clearly put a lot of effort into
making the syllabus well organized and thorough. You shouldn’t need an outside text, and if you find yourself
interested in more information or clarification, the library reserves or online resources should be sufficient.
33
Survey results from the Class of 2017:
How useful was Adreasen for
studying psychiatry?
2%
Worth buying
Worth borrowing
Not worth the time
or money
No opinion - I never
looked at it
98%
34
On average, how much time did you
spend preparing for small-group?
On average, how much time did you
spend working on the practice
psychiatry exam write-up?
5%
3% 3%
<1 hr
0-0.5 hrs
26%
32%
36%
1 hr
68%
1-1.5 hrs
2-2.5 hrs
2 hrs
>2 hrs
27%
3-4 hrs
Qualitative psychiatry advice from the Class of 2017:
Attitude
Fun course (3) but don’t underestimate it, as exam questions can be tricky (1).
Patient sessions are informative/interesting (3).
Studying
Go to lecture (6).
In particular, attend the sessions with clinical cases/patient interviews (3), Dr. Tew’s lectures (1),
and the lecture on prescription drugs (1).
Know the medications and treatments for various disorders (2).
Or… don’t go to lecture (2) and just podcast (2) and/or read the syllabus instead (2).
Work hard on the mental status exam write-up to help prepare for the final exam (2).
Attending lecture makes post-reading easier since syllabus is long-winded (1).
Pre-read the syllabus (1).
Resources
Use First Aid or BRS in addition to the syllabus (1).
35
Introduction to Patient Care Block
Medical Interviewing
Dates: September 4 – October 23, 2014
Course director: Reed Van Deusen, MD
Block: 50% of IPC Section #1
Exams: 1 interview session
Overview
Medical Interviewing is your chance to get started with one of the most essential clinical skills. This is a
wonderful opportunity to practice interviewing in a “risk-free” environment, with a standardized patient. Do not
assume that you will be good at interviewing because you are good with people, outgoing, or whatever.
Interviewing can be difficult for everyone, and takes a lot of practice. The course mostly consists of small-group
sessions discussed below, plus a large-group discussion and demonstration. At the end of the course there will also
be a “clinical interviewing assessment”. You will do a full interview with a standardized patient (SP) with only your
facilitator watching, and receive detailed feedback on both your strengths and weaknesses as an interviewer.
The grading for this course is extraordinarily subjective. Don't worry about your grade – you will not fail.
Just relax, be yourself, and have fun!
Small-group
This course only meets once a week and your group will likely split into two. Each person gets a turn on the
“hot seat,” interviewing the standardized patient, while your peers watch. This can be intimidating, but don't
worry. You will soon realize that everyone makes mistakes, and nobody knows what they are doing at first. You are
given a chance to call “time out” if you feel stuck, and this option is used pretty often! During a “time out” you are
able to collect your thoughts, ask for help, or rewind to start the interview over again. And remember, no matter
what happens, your classmates are required to compliment you afterwards (seriously). All comments are strictly
limited to positive reinforcement, which is a great self-esteem booster.
The session will focus on one aspect of the patient's history. Each student will get a turn to talk to the SP,
with the option to pick up where the previous interviewer left off, or to start afresh. It is strongly recommended to
volunteer to go first or second in the hot seat. If you wait until the end, you may feel as if you're just going over
things your peers have already covered. Do not take this as a clinical exercise or try to figure out what your patient
has – this course is just about learning how to do the interview.
Some students expressed annoyance at the political-correctness of the class. For instance, you will be
required to give only positive feedback to your peers. Don't let this get to you. You will definitely get some
constructive criticism from the facilitators. No matter how “touchy-feely” the class gets, you will definitely get a lot
out of it if you participate.
Textbook/syllabus
Most members of the class of 2017 did not find it necessary to purchase the textbook for this class, but it
does provided useful incite to the art of interviewing.
Advice from previous classes:
• Have fun!
• It's really awkward to do the interviews in front of people but you'll get used to it.
• Very facilitator dependent. Helps to read ahead of time so you know how to move through an interview
then use the class to pick up subtle points and learn your weaknesses.
36
•
•
•
•
•
•
Most of the people who complained that there were unclear expectations didn’t do the assigned reading.
I never prepared for medical interviewing, and I did just fine. Just take it easy and don't be nervous. It may
be a bit of a drag to have MI right after exams, but just consider that it's good to just get it out of the way.
If you're looking for honors, focus less on trying to get actual information from your standardized patient
that attending to their emotional wellbeing and trying to get them to cry.
It's going to seem awkward but it actually gets better. And in the end you'll realize your interview skills
actually did get better.
Make the most of it. Pitt has a great clinical piece to their curriculum, and while it does add a significant
amount of time to your week, it is a skill that should be practiced early on.
Read the textbook and cite it in class to get Honors. It's online, so there's no reason not to! Plus, this course
will change your life! I talk to people differently now!
Survey Results from the Class of 2015:
How useful was the Medical Interviewing
textbook?
Indispensable
(definitely buy)
6%
47%
39%
8%
Occasionally useful
(use the library
copy)
Not worth the time
or money
No opinion, I never
looked at it
37
Introduction to Physical Examination
Dates: October 27 – December 19, 2014
Course director: Melissa McNeil, MD
Block: 50% of IPC Section #1
Exams: 1 standardized patient exam
Overview
Now for the fun stuff that drove you to med school! This class introduces you to the technique of physical
exam in a totally relaxed atmosphere. You’ll learn how to use your stethoscope and how to look at retinas without
butting heads/locking lips with your patient. The goal is to master the general flow and mechanics of a physical
exam. No worries—you aren’t going to be reamed if you can’t identify another student’s murmur or get a precise
jugular venous pressure. Your goal should be to learn the basics and feel comfortable with the choreography of the
classic physical exam. However, do not mistake the relaxed nature of this course as an indication that the skills are
unimportant. They are important, and in a short time (i.e., in February) you will perform these techniques in a
hospital with real patients.
The course consists of lectures by faculty and small groups led by MS-4s. At the end of the course you
perform complete physical exams on standardized patients. The first attempt is for practice; you get valuable
feedback from the standardized patient (who is well versed in the aspects of the physical examination). Then you’ll
perform one last physical examination, about a week later, for a grade.
Have fun and practice, practice, practice. These skills don’t come naturally. The more you practice on
classmates, friends, and family, the easier (and less awkward) your physical exam experience will be later on.
Lecture
Lecture is usually once a week, and Dr. McNeil gives almost all of them. Lectures are broken down by organ
system, and they include slides, videos, references to Bates (an important text), and clinical pearls. Again, a lot of
the information may seem like too much to handle, but remember the focus is on the how for now; the what and
why will come later, with additional courses and experience.
Small Group
Small group is typically facilitated by two MS-4s. This is your opportunity to practice examination skills on
each other. Groups are broken down by gender to minimize potential awkwardness (though one of your
standardized patients will be of the opposite sex). You’ll get up close and personal with your classmates, but this is
an excellent chance to gain competency with your examination skills—with input and practical advice from the
4th-years. Use this time to gain insights and tricks of the trade from the 4th year medical students. They are a great
reference and often give the most useful advice on how to easily operate your instruments.
One challenge with this course: You learn lots of physical exam techniques, you practice them in small
groups, but you perform only some of them during your final exam. The important parts for the final exam are
clearly laid out in a list—make sure you know that list, and practice physical exams that follow the list. Many
students find it useful to spend time outside of class practicing on friends, roommates, family, or any willing
volunteer. The more you practice, the more confident you will be for your final exam.
Textbook
It is said that by the end of second year you will know Bates from cover to cover. At this point it is not
imperative that you master Bates, but it is a valuable resource to have handy while learning the physical
examination. Most of our class found it to be a worthy investment even at this early stage.
Special Note on Equipment
Dr. McNeil asked that we tell you two important tips about the equipment you will need for physical exam:
38
1. Buy the necessary equipment before the class starts. You will hit the ground running in this
class and it’s important you come prepared your first day.
2. BUY QUALITY EQUPIMENT. Obviously everyone has a different budget, but it’s a good idea to
buy the best quality equipment you can afford, it will save you money in the long run. If you
have questions about what to purchase or what brands, you can contact Dr. McNeil. Also, there
is a sale held before the course starts that is sponsored by AMSA that will outline and provide
order forms for what you will need to buy.
Advice from previous years:
• Great class. Felt like I was actually learning practical skills.
• This is helpful because the fourth years give you practical tips, knowledge, and good lines for doing the
physical exam.
• Practice, practice, practice. You'll thank yourself later.
• You can find good equipment for cheaper than the school sale. Check out Amazon.
• Lots of fun. There is a checklist in your syllabus of the full physical exam you'll need to do with a
Standardized Patient for your final exam. Memorize this! Practice it often until you can run through it
without even thinking and you'll breeze past the final exam.
• Pay attention! You need to know this stuff! Also, get a nice stethoscope - you will need it forever and ever!
• The lectures are helpful. You really have to prepare for this class for it to be useful - especially for the small
groups. It truly is what you make of it - if you want to slack off, you can, and vice versa.
• The MS4s really want to see you succeed, so don't hesitate to ask them if you need extra help
Survey results from the Class of 2015:
How much did you spend on your equipment
(stethoscope, otoscope, etc.)?
2% 2%
10%
How useful was Bate's Guide to Physical
Examination?
$0-$200
$201-$400
24%
0%
$401-$600
16%
$601-$800
31%
31%
16%
68%
$801-$1000
$1000+
39
Indispensable
(definitely buy)
Occasionally useful (use
the library copy)
Not worth the time or
money
No opinion, I never
looked at it
Advanced Physical Examination I
Dates: January 5 – May 22, 2015
Course director: Scott R. Herrle, MD, Kishore Vellody, MD, Andrew McCormick, MD
Block: 43% of IPC Section #2
Exams: None until second year, grade based on facilitator evaluations
Overview
Advanced Physical Exam 1 (APE1) is your first opportunity to perform the skills you learned from IPE on
real patients! No more classmates or actors. The scheduling may appear complicated for this course, but the fullgroup session on the first day will help clarify the details. Essentially, during a month when you have PE scheduled
you’ll perform physical exams, write H&P’s, and possibly present patients to your fellow group members. You’ll be
in a small group (typically with 3 other students) with one faculty member. A great deal of effort is put into
identifying a patient for each student, but sometimes a patient will decline, in which case you’ll end up tag-teaming
a physical exam. Some preceptors will migrate in and out of rooms to provide feedback and advice to students. If
you think you found some interesting pathology be sure to tell your facilitator. It’s never too early to start listening
for murmurs or various lung sounds. It’s also helpful to make your own list of what to do/ask for in the history and
physical exam. Don’t feel like you have to do everything from memory (as was the case for your IPE ‘final
physical’). Use example H&Ps as a template, and be willing to accept constructive criticism from classmates and
facilitators.
In addition to interviewing and examining patients, you will have two larger sessions pertaining to
Ophthalmology and ENT. Additionally, during the Neuroscience and Psychiatry courses you will have neurological
and psychiatric exam/interviewing sessions pertaining to the current coursework.
Remember
This is the only time when you will have the opportunity to take 1‐2 hours on doing a complete history and
physical. Take your time, ask for help and suggestions from your facilitator, and try not to feel too embarrassed in
front of the patients. Most of them understand you are only a first-year, and are surprisingly willing to help.
Learning Logs
Fill out your learning log right after the session so that you don't forget anything, Learning logs only take a
few minutes to complete so don’t let them pile up. If you do, it will be difficult to remember all your patient
interactions at the end of the semester, so save yourself the headache and complete them as soon as you get home.
Advice from previous classes:
Don't get frustrated with the lack of consistency among facilitators/groups. Just use every opportunity to
learn from interacting with patients. That's what you came to school for! Stop worrying about your basic science
coursework and enjoy your clinical time!
Textbooks
Many students found Maxwell Quick Medical Reference to be very useful. It’s small enough to fit in your
white coat, and inexpensive. As mentioned for IPE, Bates is also a valuable resource for the History and Physical.
40
Clinical Experience I
Dates: January 5 – May 22, 2014
Course director: Asher Tulsky, MD, Laura Panko, MD
Block: 43% of IPC Section #2
Exams: None until second year, grade based on facilitator evaluations
Overview
CE1 and CE2 are similar to APE in that you go out for some real patient contact one afternoon a week. Both
are very similar to shadowing. CE1 is with primary care, and CE2 is with a specialty you pick. In general, they are
more laid back, with no requirement except that you observe. CE3 requires you to do 4 sessions at a community
site of your choice – they range from a walk-in clinic to a soup kitchen. You will have an introductory lecture at the
beginning of the semester to attempt to explain the confusing logistics of the course. If you feel confused after the
first session, don’t worry. You will receive a personalized schedule in your mailbox that will outline where you
need to be for each of your CE sessions.
Learning Logs
These work the same way as the learning logs for APE.
Tips
Make the most of this opportunity to interact with patients. Every preceptor is different, so ask questions
and volunteer to help when you can. The physicians are very receptive to first-year medical students, and your
time will be much more enjoyable if you are inquisitive and remain interested in all the patient cases. For CE1 and
CE2, remember to bring the evaluation form to the last session, and have the preceptor fill it out in front of you and
give it back so that you can hand it in. This is much easier than counting on the preceptor to fax it in on his/her
own.
You can fulfill your CE3 requirements at any time, not just in the assigned month. Definitely take advantage
of this – you can do your sessions over the summer or strategically at times of lower workload. This gives you one
month with an extra afternoon off.
41
Patient Physician and Society Block
Introduction to Being a Physician
Dates: August 18 – August 22, 2014
Course director: Shanta Zimmer, MD
Block: 20% of PPS Block Section #1
Exams: 0, grade is based on participation in small group activities
Overview
This is a weeklong introductory course that does just what the name suggests – it gives you a taste of what
it means to be a physician, with emphasis on how doctors communicate with a range of patients and interface with
larger public health issues. The course is essentially effortless and, moreover, lots of fun. You just need to show up
to some small groups, attend some panels and patient presentations, and go to a session with a service
organization in an underserved community in the Mon Valley. The course is essentially an extension of orientation,
with no books and no grades. This week serves as an opportunity to just relax before Anatomy gets underway.
Lecture
You will be attending some lectures and panels with physicians and public health people. You’ll also attend
some patient conferences, during which patients with chronic diseases will describe their experiences with their
physicians and the health care system.
Small Groups
You will have some mandatory-attendance small group activities.
Textbook/Syllabus
There is a small syllabus that will provide readings that complement the lectures and small group sessions.
42
Ethics, Law, and Professionalism
Dates: August 27 – December 17, 2014
Course directors: Charissa Pacella, M.D, Melissa McNeil, M.D., MPH
Block: 100% of PPS Section #1
Exams: 1
Overview
ELP is another important non-basic science course, where you discuss the hot legal and ethical issues in
medicine. The course consists of weekly lectures by experts in the field of ethics and law, many of which are
followed by a small-group session. For the class of 2017, the grade was based on attendance at small-group
sessions, satisfactory completion of a series of online modules, and satisfactory completion of an essay. In previous
years, there was a final exam in addition to a midterm paper. For the class of 2018, the course directors have
decided to return to the format of administering a final exam at the conclusion of the course. For this reason, in
addition to survey results from the class of 2017, we have included survey results and advice from the class of
2016 – the last class to have an exam in ELP. Their advice may be more relevant for next year’s course.
This, like MDM, is a class that could be extremely useful for the rest of your career. The legal aspects of
issues such as end-of-life care and abortion are essential for any physician. The ethical discussions in small-group
sessions are well worthwhile – they will be interesting and you will certainly get a deeper appreciation for the
subject. If you are attentive and put effort into this course, you will be sure to get a lot out of the small group
discussions.
Textbook/Syllabus
The syllabus contains reading assignments drawn that should be completed before each week's class.
Study Tips
The lectures are podcasted, but course directors encourage lecture attendance. Most of the lecturers are
knowledgeable and enthusiastic, particularly Professor Meisel and Dr. Arnold. They will keep you engaged, so you
will learn a lot of important lessons for the rest of your career just by showing up.
The small group sessions usually involve discussing a hand-out with several ethical dilemmas. These can be
great experiences if the group members speak up and express themselves respectfully. Often, after listening to
others, you will find yourself questioning your own previous values, and refining your stance on the issue.
Survey results from the Class of 2017:
Use podcasts:
Percent of lectures attended:
0-24%
16%
6%
only for missed
lectures
16%
instead of live lectures
25-49%
16%
13%
65%
50-74%
for review after
attending lectures
66%
not at all
75-100%
2%
Survey results from the Class of 2016:
43
What methods did you find useful for mastering ELP?
Boards Practice Questions
Flashcards
Learning Objectives
Another Text
Postreading
Prereading
0
10
20
30
40
50
How often did you attend
class?
60
70
80
90
100
It is best to use ELP podcasts
34%
33%
39%
57%
15%
17%
13%
4%
0-24%
25-49%
50-74%
75-100%
Only for missed lectures
Instead of live lectures
For review
Not at all
Qualitative ELP advice from the Class of 2016:
• Go to class every now and then. It's actually pretty entertaining!
• It is very tempting to skip this class because of how intense anatomy is. I say give in to your temptations
(but do learn the material at some point).
• Go to lectures if you think they're interesting. If not, stay home and read the syllabus.
• The exam had a surprising amount of detailed quiz questions. I recommend attending lectures, since they
are fairly interesting, and then just studying right before the exam. No need to study tons during the course.
The readings are worthwhile if you have time.
• A lot of it may seem self-explanatory, but there's random information that is actually quite useful that you
may not have known before.
• Seems simple and common sense, but the test is more detailed than the common-sense knowledge.
44
Behavioral Medicine
Dates: January 14 – May 13, 2015
Course director: Jason Rosenstock, M.D.
Block: 100% of PPS Section #2
Exams: 1; 2 assignments
Overview
Behavioral Medicine casts a wide net. In contrast to the science courses, it is one of the few courses that
examines non-biological factors that influence a patient’s health. It emphasizes social and psychological
components of health and disease and sets its eye particularly upon subjects that traditionally frustrate doctors:
patient non-adherence, obesity, substance abuse, and the like. If you liked your social science courses in college,
you’ll probably like this course.
Remember
It’s easy to blow off this course (and any other course taught on Wednesday morning), and it’s no secret
that we devote the bulk of our time and energy to the science courses. (Our schedule is set up that way, after all.)
However, courses like Behavioral Medicine put your learning into a larger context and bring up vital issues that
might not surface again until you’re dealing with patients during clinical rotations—and then you’ll be even busier.
If you miss these points now, you may miss out on something important for a long time.
Lecture and Assignments
Dr. Rosenstock gives some of the lectures, and he finds quality guest lecturers for the others. He takes into
account our exam schedule, and the Wednesday before an exam usually does not have class. Experts in relevant
fields lead the small group sessions and the sessions often begin with a pre-written case. In addition to small
groups, this course included two graded assignments:
•
A Behavioral Modification Project, in which you choose to either improve something in your life. Options
include diet change, exercise plan, flossing, taking vitamins, and similar things. You then try to make this
change for a month and keep track of your progress. At the end of this time, you do a write-up and present
your results to your small group. This is a great project for future physicians to identify how hard it is to
change lifestyle habits. It gives you the opportunity to put yourself in the patient role as you try to live a
healthier lifestyle.
•
A Pain Interview, in which you interview someone who has experienced “clinically significant” pain and
then write a short paper about it. Dr. Rosenstock provides you with detailed instructions on how to
accomplish this project and how it will be graded, as well as example pain interviews, so it should be
straightforward.
Syllabus
The syllabus for this course is fairly well organized. However, because lecture styles vary dramatically, the
information in the syllabus ranges from detailed descriptions to copies of Powerpoint presentations. Pre-reading
was not necessary. However, much of the multiple-choice portion of the exam was taken from the syllabus.
Exam
The exam is straightforward; if you study a couple hours for it, you should be fine—especially if you
attended lectures. Make sure to attend Dr. Rosentstock’s review lecture.
45
Survey results from the Class of 2017:
How much time did you spend on
the Pain interview?
How much time did you spend on
the Behavioral Mod.?
40
30
% 20
10
0
60
40
%
20
0
Up to 1 hr 1 < t ≤ 2
hrs
2<t≤4
hrs
4<t≤8
hrs
Up to 1 hr 1 < t ≤ 2
hrs
t > 8 hrs
46
2<t≤4
hrs
4<t≤8
hrs
t > 8 hrs
Qualitative advice from the Class of 2017:
Attitude
 Probably one of the chillest classes first year. Enjoy, and learn for the sake of learning!
Studying
 Try to do a little as you go alone so it's not to overwhelming at the end of the course
 Don't bother going to lecture. Just do the learning objectives and read the syllabus you'll be fine!
 Not as important to attend lectures.
 Minimal studying required if you keep up with the class.
 Focus on the learning objectives.
 Be sure you know when specific projects are due.
Exam






The exam is straight from the syllabus, and the lectures and syllabus don't really match up that well,
so just go the lectures you think will be interesting and study the learning objectives before the
exam.
Don't go to class or read syllabus, can easily prepare for final the night before
The test was not really that easy, so take it seriously and if possible spread the studying out over 23 nights
The exam is more difficult than would be expected of such a laid back course.
Read the syllabus and do all the practice questions. Some of them show up again on the test
verbatim.
I think lectures were more informative than the syllabus but the test is based on the syllabus
47
Scientific Reasoning in Medicine Block
Introduction to Medical Decision Making
Dates: August 27 – December 17, 2014
Course director: Margaret Hsieh, MD, Aaron Brown MD
Block: 100% of SRM Section #1
Exams: 1 multiple-choice exam (75%), small group attendance (15%), case write-up (10%); must have a total
grade above 65% to pass the course
Overview
MDM intends to teach you how to evaluate experimental design and wade through the numbers in
scientific papers. The course is actually exceedingly important. Not only will you be able to use the terms “odds
ratio” and “relative risk” fluently, but you will be able to judge the worthiness of articles you come across in your
career. Unfortunately, the lectures take place at 8:00 am every Wednesday, which resulted in minimal attendance
past years. This year, therefore there will be a major change. There will be no more lectures, except for an
introductory and final review. Instead, you will be required to complete online modules; Dr. Hsieh will be available
during what normally would have been lecture time for questions. Keep in mind, however that they are also
mandatory small groups for this course. Last year the grade consisted of: 75% from a multiple-choice final exam,
15% comes from participation in small groups, and 10% from a 30-minute presentation about an article for PBL
group. This year, the article presentation will instead be replaced by a case write-up.
Textbook/Syllabus
The syllabus does not have course notes, just the articles and exercises for the small group sessions. The
textbook is written by Dr. Rao. A good portion of the people in our class ignored the lectures and learned
everything from the book. The book uses simple language and does not assume you have a background in math.
Study Tips
Most students would strongly recommend learning the material in the textbook on pace with the course,
attending lecture to supplement your understanding. Other students found it easy to wait until the end of the
course to learn all the material. However, if you keep up with the class, you can get help from your PBL facilitators.
Usually there is plenty of time to review the course material in each PBL.
48
Advice from Previous Years:




Don't freak out about this class. If you are spending more than 30 mins on PBLs, stop. Your
facilitators will give you all the answers anyway, and you're not graded. Just study from the
Rao book for a couple of hours the two weeks before the exam and go to the review an older
student gives (but take what he says with a grain of salt, covers a lot of unnecessary
material).
Practice doing basic math without a calculator if you're a bit rusty at it. You are not allowed
a calculator on the exam, and you'll be required to do some calculations in your head.
As stated last year: “Make sure to buy Dr. Rao's book. Also, don't get carried away with the
statistical calculations, this course is more focused on the big idea and use of these
statistical tests.”
The exam can easily be studied for the weekend before the test, but it'd be helpful to stay
abreast of the material so you don't feel like an ignoramus in your small group sessions
49
Methods & Logic in Medicine 1
Dates: January 14 – May 27, 2014
Course director: Rachel J. Givelber, M.D., Peter Drain, Ph.D.
Block: 100% of SRM Section #2
Exams: 0 (grade based on oral presentations and written user guides)
Overview
Following winter break, Methods and Logic in Medicine (MLM) replaces Medical Decision Making in the
Wednesday morning time slot. The good news for those who love their sleep is MLM isn’t scheduled for every
week.
The MLM course follows a two-part format: MLM A and MLM B. MLM A is designed to get you thinking
about your scholarly project (yes, already). In this half of the course, you invent a research project that you could
feasibly perform while in medical school, and you present this idea to your small group. For most students, this is a
chance to present and receive feedback on their Dean’s Summer Research Project presentation. (However, don’t be
concerned if you have other plans for the summer and are not planning to submit an SRP; you get a chance to
invent a purely hypothetical project, which might be more fun.) After presenting your project, you get feedback
from both a student in your small group and the course facilitators; at the end of the course, you submit a final plan
for your project incorporating these comments. Last year, this was due following the deadline for SRP, so students
just submitted the same proposal twice.
For MLM B, the course directors provide you with neuroscience clinical vignettes, and you conduct a
literature search to identify an article relevant to the patient’s condition. You submit the draft of your PowerPoint
to your facilitator the Monday prior to your presentation. Students have to submit a user guide on one of the
papers presented that week from a template that is available on the course website. When Wednesday rolls
around, you present the article (with trusty PowerPoint) as classmates and faculty raise comments and questions
about the scientific method of the paper. If you’re confused about the process, don’t worry; the course directors
outline it in plenty of detail. This class is very simple and most students did not have any real difficulties with it.
Textbooks
There are no textbooks for MLM.
•
•
•
Hints and tips
Our class found MLM to be somewhat disorganized, and at times the requirements for presentations and responses
to articles were unclear. The course is completely run through the Learning Portfolios (LPs) site on The Zone,
which can be a bit confusing at first. There are three different hierarchies to the LPs (see below). Small group
discussions and the dissemination of general course information occur through discussion boards on the LPs, and
the default setting is to send you an email letting you know someone has posted a new discussion, but without the
content of the message itself. It would be worth spending a few minutes familiarizing yourself with the Learning
Portfolios site:
Methods & Logic in Medicine: This is the main site for the entire course. Course announcements are posted here,
as are course documents (including those with the course schedule and descriptions of the different tasks), articles
for MLM A, and clinical vignettes for MLM B.
Small Group #: This site is for your small group. It is where you self-assign roles for each week. Presentations and
evaluations from small group members are to be posted to the documents section prior to each class.
YOUR NAME—Learning Portfolio: This is your individual learning portfolio. You can post presentations,
documents, and article responses and correspond with your facilitators in a site that is open to you and course
faculty only.
Throughout MLM, you play various roles. One week, you may have to present an article, while the next you only
critique a classmate’s article. Signing up for your role early using your small group LP will allow you to get your
50
pick of article, small group role and the date on which you present, which may help manage your workload if you
know you will be gone certain weekends or especially busy with exams. Although articles were only released a
week ahead of time for MLM A, individual small groups usually pre-assigned roles and dates for the entire course
during the first small group meeting. This helped with planning and coordinating so that we all met the role
requirements.
Survey results from the Class of 2017:
51
On average, how much time did you
spend working on your presentation?
On average, how much time did you
spend working on a user’s guide?
3%
3%
9%
20%
1-1.5 hrs
14%
2-2.5 hrs
32%
3-3.5 hrs
4-4.5 hrs
17%
5-6 hrs
37%
•
•
•
•
•
•
>6 hrs
0-0.5 hrs
9%
56%
0.75-1
hr
2-2.5 hrs
>3 hrs
Other Advice from Previous Years:
Prepare your presentation early! There are a lot of requirements for article presentations, so if it is your turn to
present, make sure you start early.
Do not forget about the training modules. The syllabus hardly makes mention of them, but there will be several
mandatory training modules that you must complete online. Most people are able to test out of them without
actually going through the module.
Don't expect organization or consistency from the course directors, and despite what they say, don't feel like you
need to have a definite scholarly project by the end of first year.
Double check when you’re supposed to turn things in. It’s not always well-publicized.
If you love research, you'll love MLM and MDM. If not, you won't.
As with many of the non-core science courses (and the science courses, for that matter), you get out of this course
what you put into it.
52
Summer After First Year
Popular activities: Research, volunteering, shadowing, traveling, relaxing
Overview
Many people wonder what to do for the summer after first year. It is the last real summer break we will
ever have. Should you relax and travel? Should you do research? With the way the administration offers lunch talks
about summer research projects, many feel pressured to do that and to start searching extremely early for a
research mentor. Many also feel that they do not know what field of medicine they want to enter, so how should
they know what research to pick? Relax. Breathe. No matter what you choose to do in the summer, you will be
okay. Always keep in mind that it is your last big chunk of time to do whatever you want for a while. Go home, see
family and friends, go on vacation, or whatever you need to do to recharge for second year.
Summer Research
The Dean’s Summer Research Program and its affiliated opportunities is the most popular activity students
have chosen to do. After finding a mentor and a project to do, you write a 2-page proposal and apply in March. If
your proposal is accepted, you will do 8 weeks of research during the summer, and you will be funded by the Dean.
You make just enough for living expenses. During the summer, you attend 2-3 research workshops. At the end of
the summer, you must submit an abstract of your research project, and in September, you must do a poster
presentation. The “affiliated opportunities” are programs such as T35 NIH Training grants and other funding
opportunities in more specific areas of medicine. There are also independent sources of funding. Many people stay
in Pittsburgh, but you can do research somewhere else as long as you find a mentor there and a mentor here at Pitt.
If you do your homework, you will be funded for research in any area of medicine anywhere. For more detail about
summer research programs, go to the Zone>Research> Summer Research Programs.
Travel/Research Abroad
Another popular choice for the summer is to go abroad for research and/or travel. Our school has many
connections to international institutions. For global health information, go to the Zone>Enrichment>Global Health
SOM Programs. To see a list of past international research projects, go to the Zone>Student
Groups>AMSA>Research Abroad Database (on the left side under Lists).
Maine Experience
Mount Desert Biological Laboratory, Maine
Intensive Laboratory Research Experience
The ILRE is a one-week experience in bench research generally held during the last week of May, and the
trip is fully funded. The faculty consists of MDs and PhDs from Pitt and frequently from Yale. The week is
comprised of three lab rotations; each student selects these from 4-5 rotation options. The proximity of the Park
permits a work-hard / play-hard approach to enjoying what the lab and island have to offer. Each rotation lasts
two days: 1.5 days lab work and 0.5 days of recreation on Mount Desert Island (Climbing, Biking, and Sea
Kayaking). During each rotation, students will have the opportunity to plan experiments, collect data, interpret
findings with the faculty, prepare a report and present the data and conclusions to the entire group. Deadline for
application is at the beginning of March. For more information, go to the Zone>Research>Maine Experience.
Volunteering
Some students choose to do Bridging the Gap, Pittsburgh Schweitzer Fellows Program, UPCI Summer
Academy, and more. For a list of volunteer opportunities, go to the Zone>Enrichment>Community Service
Learning.
53
Shadowing
Many students use their free time to shadow physicians. Shadowing your mentor is easy and convenient,
and you can ask your mentor for their recommendations for which of their colleagues to shadow. This experience
is especially important if you are worried about not knowing what you want to do. There is also the Western
Pennsylvania Health Preceptorship Program, an official shadowing opportunity.
Survey results from the Class of 2017:
What are your summer plans?
Dean's SRP
Other Research
Volunteering
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
When did you begin contacting potential
mentors?
40%
35%
30%
25%
20%
15%
10%
5%
0%
August
September
October
November December
54
January
February
March
April
When did you finalize summer plans?
40%
35%
30%
25%
20%
15%
10%
5%
0%
October
November
December
January
February
March
April
May
How many potential mentors did you contact?
60%
50%
40%
30%
20%
10%
0%
1-2
3-5
6-8
55
9-10
>10
Qualitative advice for finding a mentor from the Class of 2017:
Resources
 Department websites are good.
 FAST advisors can be helpful.
 Ask upperclassmen.
 Ask your advisory dean; if you know what field you want to go into/explore, try to find
something there.
 Use the database of scholarly project mentors.
 Ask everyone around you for suggestions on who to talk to. The grapevine is the way to go.
 Talk to your small group facilitators. Likely they know people if you are interested in a
similar field as them.
 Go to networking events, you can meet someone and talk about their research then you
don't have to send a bunch of cold emails
How to find a mentor
 It helps to start searching earlier but regardless it will work out.
 Have a back up plan if you don't get DSRP
 Cast your net wide initially because most people will not respond to your first email. Send a
second email if you're really interested if you don't hear back after a couple weeks.
 The requirements for the scholarly project are....unique. Having a mentor who has worked
with it before and knows what to expect is a huge plus.
 Find mentor w/ pre-approved IRB project. The IRB process is FOREVER.
 Pick something you like and someone who you are compatible with personality wise.
 It's more important to find a great mentor than to find someone in any particular field or
topic
 Evaluate how much time and effort the mentor is willing to put into you and your project.
 Stick to what you are passionate about and find a mentor who's project sounds interesting
to you
 I found it helpful to set up meetings with people I didn't specifically want to do research
with, but who I thought could give me a list of names of people to contact. That made the
research part a lot easier because I just contacted people that other faculty recommended.
 Contact as many people as possible to learn about all potential areas of research.
 Genetics has a relatively lighter workload. It might be a good idea to use this time to find a
mentor.
 Look broadly. Don't be scared to contact anyone, and don't be scared to tell a mentor no.
 Get an idea of what you want to do before you go talk to potential mentors. Meet with the
department contacts first, they can be very helpful
 Go with the vibes. Trust your instincts on who you'll get along with, and who will be a good
mentor.
 If you're deciding between research in different specialties, pick the more competitive one,
since it is easier to scale back from competitive research than pick up your effort last
minute...Find a mentor that is willing to help you through the process, and find a project that
is already underway and something you will perhaps be able to publish from.
56
Acknowledgements
We would like to thank the class of 2016, and especially 2017 for their input in creating this document.
Also, we thank the previous SARC coordinators, James Bohnhoff, Neeti Patel, and Kayllie Wang.
57