How to Survive Medical School: Anatomy, Biochemistry, Embryology, Genetics, & Neuroscience

It’s official: I am not longer a first year medical student. Two weeks ago, I completed my third neuroscience examination and with that, my first year curriculum at TUSOM. I’m giddy albeit apprehensive. The end of first year does not, unfortunately, mark the beginning of summer. Here at TUSOM, we complete first year with neuroscience (this is a six week course that terminates early May) and swiftly plunge into second year material. Next week marks the end of the immunology/inflammation block and our brief introduction to pharmacology and pathology. And that is why I am both excited but terrified. The immunology/inflammation block concludes with an examination on May 29th (my birthday–huzzah!?) and then I am free until the first week of August. I. cannot. wait. for. summer.

Now that I have survived my first year of medical school (I still can’t believe it!), I figure it is as good as time as any to share pearls of wisdom in regard to the first year curriculum at TUSOM: anatomy, biochemistry, embryology, genetics, neuroscience, and physiology. Some readers have emailed me / tweeted me / messaged me about the academic nature of medical school and I’ve been working my way through those responses. I realized that other readers / future readers may have the same questions; thus, here begins a series of blog posts: How to Survive Medical School. I found that many inquiries have been about anatomy. In an earlier post, I shared the personal aspects of my experience in anatomy lab. Although I vaguely mentioned / vented about anatomy coursework on both this blog and the Twitterverse, I have not really shared specifics about the academic aspect of the course. I know, I know — better late than never, right?

In this post I will (1) preface with some information about my personal learning style (just so you can better understand the perspective from which I give my advice), (2) provide some general resources for first year, and (3) describe how I studied for each particular course. Please keep in mind that not all the advice may apply to your particular learning style or institution; nonetheless, I hope that some of this proves helpful!

I would call myself primarily an auditory learner. And so, a quality lecturer is my best friend. Listening to a lecture 2x is a much more efficient way for me to study than other means. Of course, not all lectures are delivered in the way that I would prefer and in those cases, I fall to my backup learning style: read & write. In such cases, I transcribe lecture slides in my own words and I use a textbook to supplement the information. I rather not read textbooks but a well-organized textbook is much better (in my opinion) than a set of muddled lectures. I use flashcards to master the information that I need to simply memorize / quickly drill.

General Resources for First Year of Medical School

Anki: I. adore. flashcards. You’ll come to realize quickly that for each exam / block you’ll have tons of material to drill down. I am one of the unfortunate souls who writes painstakingly slow which is a bit incompatible with the pace of medical school. Anki has been a saving grace for me. Anki is a spaced repetition flashcard program that is quite powerful. It is easy to add images (or lecture slides) to each card. There is an image occlusion function which makes it possible to block out labels on images (shout out to my friend Nick for introducing that function to me) which is particularly useful during neuroanatomy, anatomy, and histology. It is possible to add audio to the cards, which is really neat. There is a mobile app (unfortunately this is not free, although the desktop program is free) which means you can study Anki on the go!

Firecracker: The first week at medical school, I asked a couple of second years if there was a resource they stumbled upon last year that they wished that had used from the beginning. Firecracker was one of the resources oft mentioned. I used Firecracker primarily for the anatomy & embryology units but I found it to be a really neat way to study high-yield information.

Wunderlist: I find that to-do lists keep me from wigging out about all I have to do. My favorite program for to-do lists (I’ve tried quite a few) is Wunderlist. I’ve talked about my love of Wunderlist before; to be honest, I have to attribute my sanity to Wunderlist. There is also a (free) mobile app.

Anatomy: imagine that you are given the opportunity to interact with a completed 1000 piece puzzle. Over the course of the term, you closely study each quadrant and every single puzzle piece. And then you are expected to identify (during examinations) significant or less significant / memorable pieces placed in odd / zany orientations. As a non-visual learner, anatomy was by far one of the most challenging courses for me as a first year student.

Anatomy at TUSOM: TUSOM handles anatomy in a unique manner. Here at TUSOM, we take anatomy and embryology concurrently over a period of ten weeks. Yep, that’s it…just anatomy and embryology. Pretty unique, huh? The course is divided into three blocks: (1) Back, Upper Limb, and Lower Limb, (2) Thorax, Abdomen, Pelvis, and (3) Head and Neck.

Study Strategy: I switched up my study regimen each block but I’ll share just a few quick resources and strategies that I found invaluable.

• Primary resources: In order to tackle the ‘lecture’ component of the course, I heavily utilized lecture material. I made sure to attend lectures (I was a naive medical student at this time, I actually sat through 90% of the lectures) and re-listen to the lectures to clarify any points of confusion. Prior to dissection, I made sure to read through Grant’s Dissector so as to get a grasp on the dissection procedure and to see diagrams of exclusively high-yield structures.
• Atlas: You’re going to need an atlas, but the atlas you choose depends on which atlas best suits your needs. A very popular atlas is Rohen’s; the strengths of this atlas is that actual cadaver dissections are included. I found the Rohen’s atlas (countless tagged structures that are unlabeled – no thanks) to be unnecessarily stressful. I learned structures best when I went into the anatomy lab (either alone or with a small group) to review on the donor-cadaver my tank dissected and other donor-cadavers of which I was less familiar. And so, I was more than happy with the Netter’s atlas.
• Text: I found that a textbook was not essential but I did utilize Gray’s Anatomy upon occasion.
• Kenhub: I fell in love with Kenhub and I convinced a sizable proportion of my class to make accounts. It was a really neat way to learn structures and I found it to be invaluable to learn blood supply. I found Kenhub to be infinitely better (for me) than the Netter’s flashcards or Rohen’s flashcards.
• Questions: It is incredibly easy to underestimate the benefit of practice questions. Questions are a phenomenal way to assess whether you have retained the necessary information. The University of Michigan questions (under ‘practice quiz’ and ‘practice practical’) are a great way to drill down high yield facts. As phenomenal as this resource is, it is definitely not sufficient. I found Lippincott’s Illustrated Q&A Review of Anatomy & Embryology and BRS Gross Anatomy to be fantastic.
• Shelf examination: By the time the shelf examination rolled around, I was exhausted. Our shelf exam was a few days after our block three examination, and I made no effort to study for the shelf examination during the third block. An attempt to review everything in such a short amount of time was…impossible. Upperclassman created and shared a presentation with us that included the most high yield information — this was incredibly useful!

If I Could Do-Over?: This is not a course that I would want to repeat — it certainly has not been my favorite course — but I could do-over, I would have put more effort into my shelf preparation. I stumbled upon USMLE Road Map Gross Anatomy which would have been extremely useful if I used it earlier in the game, but maybe I can use it for USMLE 1? Also, Gray’s Anatomy Review is a question book comprised of difficult and comprehensive questions. I started to use this in my last block of anatomy and I could have sworn I saw almost identical questions on my exam!

Biochemistry: I know this is an unpopular opinion, but I loved biochemistry. I enjoyed biochemistry in college (my college friends can attest to this); I loved biochemistry so much that I joined my biochemistry professor’s lab. To cut it short: I love biochemistry.

Biochemistry at TUSOM: We take biochemistry alongside genetics, histology, and physiology — these courses are taught in blocks divided by organ systems. Our professor has a lot of resources for us: course synopses (essentially a mini-textbook tailored for our course), recordings of the course synopses (I really pity the person who had to do these readings), lectures, and a question bank.

Study Strategy:

• Primary resource: I solely used course synopses. I read through them 2-3x and the most ‘confusing’ synopses I read 4-5x. I attended only one biochemistry lecture over the course of the year; I listened to perhaps 3 lectures; I found drawing out pathways and reading the provided synopses to be all I needed to succeed.
• Questions: I used the course question bank in addition to BRS Biochemistry, Molecular Biology, & Genetics and Lippincott’s Illustrated Q&A Review of Biochemistry.
• Shelf examination: I learned my lesson with the anatomy shelf exam, I made sure to prepare. One month out from the shelf exam, I started to work through High Yield Biochemistry and the Lippincott’s Illustrated Reviews Flash Cards. I made a map of the important reactions reviewed in the course. One week out from the exam, I re-worked through all the questions in BRS and Lippincott’s. Two days prior to the exam, I reviewed the biochemistry section in First Aid 3x.

If I Could Do-Over?: I heard a lot of hype about biochemistry in medical school and I wish that I could have told Ajibike from months prior to calm down. Biochemistry is a do-able course; it’s heavily memorization based but it is do-able. So if you are worried (as I was), don’t worry! You’ll get through it. It won’t be fun (all the time) but you’ll survive!

Embryology: I find the subject material fascinating — truly! — so I wish that I spent more time on the material.

Embryology at TUSOM: As I mentioned earlier, we take anatomy and embryology concurrently over a period of ten weeks. Embryology is often the forgotten course during that period of time (as there is far less material in embryology).

Study Strategy: Full disclosure — I did not take embryology as seriously as I should. To be honest I remember very, very, very little besides Tetralogy of Fallot. Embryology involves a lot of folding and strange antics — it can be a nightmare for a non-visual learner.

• Primary resources: I attended most of the lectures and I made sure to listen to at all of the lectures. Our course director provided handouts for each lecture — I made sure to ‘translate’ these handouts into a language I best understood. I drew accompanying figures which were particularly helpful for me.
• Youtube: If you find yourself confused about the twisting and the turning of the cell groups, find a Youtube series that explains it well.
• Firecracker: I found Firecracker to be an invaluable resource for embryology. Firecracker is a really neat way to review First Aid principles and since I was only focused on really learning the basics, Firecracker was a good way for me to do so.
• Questions: I used Lippincott’s Illustrated Q&A Review of Anatomy & Embryology to supplement the questions on Firecracker.
• Shelf examination: Just to re-interate what I said before about the anatomy shelf examination — by the time the shelf examination rolled around, I was exhausted. I attended a review session for the block examination and that was the way in which I prepared for the embryology portion of the examination.

If I Could Do-Over?: I would have made my ‘translated handouts’ from the the jump — I started making these second block and I found this method to be invaluable.

Genetics

Genetics at TUSOM: We take genetics alongside biochemistry, histology, and physiology — these courses are taught in blocks divided by organ systems.

Study Strategy:

• Primary resources: Lecture material. I listened to every lecture at least 1x and made lists to memorize symptoms of diseases.
• Questions: I completed the practice tests provided by the professor; otherwise I did not do very many questions for genetics material.
• Shelf examination: In order to prepare for the shelf examination I completed the genetics sections in BRS Biochemistry, Molecular Biology, & Genetics and Lippincott’s Illustrated Q&A Review of Biochemistry. I also read through the corresponding sections in First Aid 2-3x.

Neuroscience: I first found neuroscience intimidating. It’s a whole new language. Gyri and sulci and fiber tracts; I never studied neuroscience in college so I was first startled. The subject matter is really cool (do I say that about everything) and extremely important so I recommend really making an effort to learn neuroscience well.

Neuroscience at TUSOM: We call neuroscience neurocation. No, the subject matter is not simple but since we take neuroscience as an independent course (over a period of six weeks), the workload was far less than our integrated curriculum. Neuroanatomy laboratory sessions were optional so…I basically never went to school. It was phenomenal.

Study Strategy:

• Primary resources: Lecture. Lecture. Lecture. As you’ve probably noticed, I use lecture material (from the comfort of my own home) as my primary source of material. I made sure to make Anki cards for the lecture material which I used to review the most testable information in the lecture slides.
• Text: I found that the organization of our course did not necessarily make sense to me. I did use outside resources quite frequently for neuroscience. I found Lippincott’s Illustrated Review of Neuroscience and High Yield Neuroanatomy to be fantastic. Lippincott’s featured more detail than we covered in class, which I needed to piece the information together. High Yield was perfect to get the overall picture and to quickly skim through before an exam.
• Atlas: Nolte’s atlas is phenomenal. Just trust me. I used Nolte’s and our image bank to review for the ‘practical’ portions on the examination. Seriously, Nolte’s is gold.
• Powerpoint: I stumbled upon an absolute gem — an amazing powerpoint (extremely large file) that details fiber tracts and high-yield disorders. Seriously, check it out. You won’t regret it! Make sure to view the powerpoint in ‘slideshow’ mode. Otherwise…it’s not particularly useful.

Where is the advice for physiology and histology? Don’t worry — I’ll be sharing that with all of you in the very near future! I hope that at least some of that was helpful. I remember how much I panicked before courses and I hope this helps you feel just a little bit more calm before launching into your first year at medical school. Feel free to comment if you have questions or want some clarification!



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