Archive for September, 2006

MDCalc Has Gone International!

After a number of requests from the UK, Australia, and other English-speaking but more-standardized countries, I’ve finally (sorry!) updated my medical calculations website to be friendly to the rest of the world. Introducing MDCalc version 2.0, now with a quick way to select either US or SI units. Once I get a few volunteers that use SI units regularly to just triple-check my work (I’ve already double-checked it), the SI site will be come the new full-fledged site.

It’s been fun to create and update the site—I’ve received great suggestions and feedback from residents, med students, and docs from around the globe. Please send me your comments and feedback, either through the contact form or in this post!

Comments Snafu

Shoot, all your wonderful comments were getting marked as spam, and the email address I setup to get them from was working. I think we’re fixed again. Thanks for reading—and writing!

Graham’s Guide to Boards Prep

I just got some requests for information on how to prep for the Boards (Step 1), so I figured I’d supply this to all you new second- and first-years. (If you’re a first year and you’re already prepping for the Boards, you’re a gunner. But the Boards books are really useful for getting through second year Path, Pharm, Micro, and Phys, so I’d buy these before I start any of those classes.) A note of warning: these will definitely help you prepare for boards, and will also help you prepare for your classes, by helping organize information and provide mnemonics, but likely won’t be in-depth enough for you to ace your class’s final exam.

Your bible: First Aid for the USMLE Step 1. You will, essentially, compile all information from every other board review book into this one. (This one already has a ton of information.) You will study from this every day. You will memorize every word of every page of this book. And if you do, you will probably do okay on the Boards. It has some good mnemonics you won’t find elsewhere, and some people say if you start studying from it from day 1 of med school, you’ll be better off, but I didn’t really use it until I started studying for Boards. I’d hold out until 2nd year to buy it, as you can get the latest edition, which has been updated for what the authors have learned about the previous year’s board exam and its subject material. Expert tip: go to Kinko’s, get the binding cut off, three hole-punch it and throw it in a binder. Much easier to study with. Example pages with my chicken scratch everywhere: IMG_1754.jpg IMG_1753.jpg IMG_1752.jpg


10676205.gif 6303319.gifIf you buy any other review books, make them BRS Pathology and BRS Physiology. I don’t think I could have handled the sheer amount of information in med school without these two books. They’re essentially bullet points of every body system and disease. They help you organize the information in your head, and give you the really high-yield facts you’ve gotta know. I think most, if not all of our class owned a copy of each. They’re that good.

11686014.gifBecause Developmental Biology just sucks monkey balls, you’ll want a copy of High-Yield Embryology for yourself.

8711699.gif 10151776.gifThe rest of my suggestions, you can really just get used, or get a group of friends together and share. Pharm and Biochem were big challenges for me, and I really liked Lippincott’s for both of them—very complete, and very easy to read: Lippincott’s Illustrated Reviews Pharmacology and Lippincott’s Illustrated Reviews Biochemistry.

Finally, the rest of the High-Yield series are good short reviews, but not worth buying full price. Borrow from a friend or get them used.

And then there’s always the question of the dreaded, way-too-expensive Kaplan Q-Bank. I used it, probably everyone in my class used it. It’s not necessary, but I guess I have to recommend it. It gives you an insane number of questions, and does a number of things:

  • Forces you to practice taking computer tests.
  • Forces you to get used to not knowing the answer. (There are a ton of really random questions in Qbank that are totally minutae and worthless, but as a med student, it’s good to practice not freaking out when you have no freaking CLUE as to the answer to like 5 questions in a row.)
  • Helps you get really good at eliminating bad answers and guessing.
  • Gives you some feedback on what sections you are doing okay at and what sections you need more work on.
  • So there’s my little Boards talk.

    Oh, and one more thing: Make a calendar for yourself and stick to it! Give yourself breaks during the day, and reward yourself: “If I finish this section today, I’ll go get a Frappacino,” or “I’ll go to the gym,” or whatever you like doing. And give yourself the illusion of choice. Sure, you have to study for 10-12 hours a day for weeks on end, but ask yourself, “Hmm, do I want to study in the library today or the study lounge?” So many choices. It makes it more fun tolerable. Really.

Medicine’s Wrong Direction

We had a really nice brunch this morning for the Cardinal Free Clinics, which is an umbrella organization to support our two student-run free clinics. (We’re trying to recruit more physicians to get involved with our clinic and volunteer.) I’m a co-chair of CFC, so I gave a short little speech and we ended with our dean giving a talk, and one of his points really rang true.

He said that he felt like there had been something of a disconnect between medical advances and what people wanted from their doctors. That we’ve come incredibly far in the past 30 years in terms of medical progress—children with cancer used to mostly die, while now, they mostly live, for example. But seeing and communicating with the patient hasn’t advanced—if anything, it’s regressed. A patient wants a doctor that listens, one that cares, and one that sees the patient as the person, not the disease. But with all the financial and business changes that have come to medicine, we’re no longer really serving our patients the way they want to be served.

We can save and extend life in ways like never before, but our everyday interactions with patients have become dissatisfactory: rushed, pressured, and driven by the mighty dollar, not the needy patient.