First Year

First of all, Congratulations! Welcome to Sidney Kimmel Medical College!

The following is a guide to the first year courses and some tips on approaching these classes. Studying in medical college is different for each individual and we encourage you each to learn what works for you. The tips in this guide are things that have worked for us. Please remember that free tutoring is available through Jefferson's AOA Chapter, and we encourage you to contact us with any questions or concerns at [email protected].

Jefferson's first year curriculum is based on a block schedule. This means you can concentrate all of your studying on one course at a time-this is a very good thing. The year starts with three months of Anatomy, then three months of Molecular and Chemical Basis of Medicine, then The Systems (Physiology and Microanatomy), and finally Neuroanatomy. Interspersed throughout those courses will be Introduction to Clinical Medicine which is the class that will teach you how to be a doctor.

• Relax. Sleep. Eat well. Exercise. Get involved in other activities. Get to know your classmates.
• Now that you're a medical student, your actions are a reflection on our College and our profession. Please take this responsibility seriously and always be honest and professional.
• You can learn in class, at home, in study groups, from books, from lecture recordings, from models, by doing questions, and by making study guides. Learning in medical college is very different than learning in undergrad college. Just because a certain style worked for you in school does not mean it will work for you in medical college! Try different ways of studying and see what works for you.
• Students in the medical college traditionally help each other out by posting study materials and resources on the discussion boards. We hope you carry on this tradition.
• Do not feel obligated to go to class. If you don't learn in class, you don't have to go (unless it is required). If you can be disciplined enough to wake up early and study all day, that's fine. All lectures are recorded and can be accessed online. Remember that the system isn't perfect though and things occasionally don't get recorded. If you do learn in class and are the type of person who needs to ask questions during lecture, then go.
• Do not feel obligated to buy every required text. Some of them are required because they're the best books, but this is not always the case. For most classes during the first year, the syllabus you're provided with should be sufficient. Use the syllabus and lectures to guide your studying. If you feel you need material to supplement your learning, you can also use the copies in the library for the first week or two to see what is best without buying them as the bookstore often has a no return policy on review books.
• You can't learn everything. It is not possible to master every intricacy of human anatomy or biochemistry in three months. Don't get hung up on small points. Learn as much as you can in the time you have allotted to learn a section of material.
• It is also impossible to rewrite or make note cards of all of the information you are responsible for, so leave the flashcards for topics you are really struggling to memorize.
• Of course you need to get good grades and pass medical college, but don't forget that the primary goal is to learn. Your patients won't care that you got honors in every class if you can't diagnose and treat their problems! Do not cram for exams and then forget what you learned!
• Go to review sessions.
• Pre-read on the topics that will be taught each day. You don't need to memorize everything, but having a general impression of what is going on before you hear it from a lecturer will save you time in the long run.
• Try not to get behind! It can be very difficult to catch up when you have missed just a couple of days of lectures. Most of the material taught builds on understanding previous topics. Studying a little every day goes a long way.
• Never believe the 2nd, 3rd, and 4th years when they say a test or block is easy. If it was easy, that's because that student was well prepared.

Anatomy is the only class without a syllabus of the lectures, which makes preparing for anatomy exams different from what you will do for the remainder of the year. You will get a copy of all of the slides for all of the lectures and you should take good lecture notes on these. You can use Grant's anatomy textbook to study but the lecturers will be emphasizing the most important points, so pay attention. If you're not going to go to class, it is beneficial to listen to lectures online as most of the tested material comes straight from lecture. There is always a debate over which atlas to use. They will tell you that Grant's is better than Netter's (any maybe it is), but all of their slides will use the pictures out of Netter. Rohen's atlas is a book of cadaver photographs that can be very helpful in studying for practicals. If you are struggling to find a cadaver with certain structures well teased out, look at Rohen's! There are numerous other resources that you can use including the models in the learning resource center, online dissection videos, and atlases.

• Using the cadavers in the lab is an integral part of learning anatomy. Groups of eight students will be assigned to each cadaver, with two different lab sections so that there are four on one body at a time. 
• The most important advice we can offer is to study the anatomy before you go to the lab. If not, you'll be lost.
• Although they are multiple choice, the lab practicals are notoriously difficult. To do well you'll need to spend extra time in the lab. It is best to find a few students who you study well with, go to the lab outside of dissection times, and quiz each other. Larger groups will not be as helpful as things get too crowded.
• Some students find outlining the dissector to be a very helpful way to organize lab material, so reviewing for lab practicals can go smoothly. Outlining labs ensures that you pre-read and understood the material, and makes life easier closer to the exam. It also helps you to organize your notes, in a class where a syllabus is not provided.
• Keep the lab clean and the floors dry.
• Maintain your bodies (keep them moist). If there are a lot of good examples it will be easier to identify the structures.
• If a lab table has a good example of something, look at it because things look different on different cadavers. Try to keep a list of the lab table and the structure. Do not forget to examine the opposite gender body.
• Learn all of the structures in relation to each other. Learn the "Landmarks" and triangles.
• Study the radiographs and CTs. There are typically 10 scans on every practical (of fifty questions) so do not skimp!
• Do not purposely destroy structures. If the professors can't find it they have other bodies they can use or they can just choose a different, possibly harder, structure.
  
  
  • When you are learning the structures and studying for practicals answer the following questions:
  • Arteries and Veins: What is its origin, what are its branches, what organs/structures does it feed or drain, what is its relation to other structures, why is it clinically important
  • Muscles: What is its origin/insertion, what nerve innervates this muscle, what is the function of this muscle, what is its relation to other structures, why is it clinically important
  • Nerves: what is the nerve's origin, what does it innervate, what kind of fibers does it contain, why is it clinically important, what is its relation to other structures
  • Bones: what are the Tendons and Ligaments associated with the bone, what is its relation to other structures, what are the fractures associated with this bone and what injuries produce them
  • Organs: what is its blood supply, what is its innervation, what is its function, what is its relation to other structures.
• During Practicals:
  • Each station will have a card with a question on it. Read the card before you look at the structure.
  • Take each question one at a time. Do not let one question bother you. Just take notes about it on your answer sheet and try to think of the answer when you have extra time after an easier question.

This course is difficult for everyone, even if you majored in biochemistry. There is a syllabus of lecture notes that you will rely on. It is very thorough and the aim is generally to know everything in it. It can also be helpful to have another reference book for instances where you don't feel the syllabus explained a pathway well enough.

When studying for USMLE Step 1 at the end of second year, it will be good to already have a reference book that you are familiar with to study from. You really do need to know biochemical pathways for this block and you should be able to write them out, know what is happening in each step, and know what clinical situations arise if the pathway is altered.

While the exams are heavy with basic science material, do not forget about the clinical scenarios. They will be tested. Like anatomy, there are multiple choice exams every three to four weeks. The last exam is not cumulative.

Do not leave MEMORIZING to the week before the exam. Try to begin learning and even memorizing the material as you are learning it. This will make the week before the exam much less overwhelming.

The information presented in these lectures will make you a good clinician, and as long as you take it seriously, you can do very well in this class.

The format of this class changes every year. There will be ICM classes interspersed with other lectures. There will probably also be full days or weeks of ICM classes interspersed throughout the year that will cover some of the bigger topics like Child Development and Behavioral medicine. There is even a block on evidence based medicine. It can be difficult to find the motivation to study for these quizzes when they occur in the middle of a block, but don't blow them off, some of them are more challenging than people expect.

For the development and behavioral medicine sections, use the required book because some of the questions come directly from the reviews at the end of each chapter. The information from this class, especially 'ages and stages' will be on the boards (and actually a much larger component than anatomy) and will be very helpful during your rotations.

As part of ICM you will also be assigned to a small group that meets throughout the year and gives you the opportunity to role play patient interviews and to discuss controversies in medicine with your peers. Take advantage of these opportunities to learn how to take a good patient history.

These two courses run simultaneously but independently. You will get a grade for each one and a combined grade, but you have to pass both. Both come with syllabi that are very thorough.

Most students will see the Systems as a nice break after MCBM, but that doesn't mean it's easy (nothing is easy). Things will start to seem more clinically relevant at this point too. Like in other classes, make sure you don't fall behind. After Anatomy and MCBM, two very intense courses, many students don't take this class seriously enough.

The information from the Systems will be relevant for the boards and for clinical rotations. This is a class where learning the fundamentals well will come a long way towards helping you in your classes during the second year. When you study, ask yourself if you can really explain how a particular organ works. While the minutiae may be on the exams, an understanding of the general concepts will help you clinically.

You will also have labs for microanatomy but you won't actually learn how to use a microscope. The 'virtual' slide box is online and this is what you'll be going over during lab time. Make sure you can identify what is in the virtual slide box when you are given an appropriate context. If it helps you to learn it while there are doctors around to ask questions of, then lab will be very helpful. A lot of people just learn it on their own time, so going to the lab can be nice since it's usually not packed full of students. The teachers there are very helpful. It can also be very helpful to use some of the student generated study tools that are passed down from upper year students or made by your classmates.

Dr. Brainard is infinitely entertaining, making neuro a very fun class, but still a lot of work. It's a fast paced class so stay on top of the work. The syllabus is very good and the Nolte book is a necessity.

There are several weekly quizzes. These are a good way of forcing yourself to stay on top of the information. Everything you need to know is in the syllabus, but the textbook is very helpful for reinforcing concepts and providing good supplementary pictures. Many students report that if you only buy one textbook for the first two years, it should be this one. Even though there is no practical component, make sure you are familiar with neuroanatomy for the quizzes as there may be diagrams. The most important thing in neuroanatomy is knowing the pathways of neurons and the layout of the spinal cord at each level. You will need to know this for neuro, for the boards, and on rotations.

Dr. Brainard also does weekly "wind-sprint" reviews. They are on Friday afternoons, but absolutely worth attending. You'll get the most out of his reviews if you are already familiar with the material but even if you are behind, you should still go. In the past Dr. Brainard has not permitted these sessions to be recorded. Another great resource is the course website. Make sure you go over the quizzes from previous years. Certain questions tend to repeat themselves, and you don't want to miss them!

The neuro lab can be very advantageous if you read beforehand and elicit the help of a professor to go through each dissection with you. Seeing the whole brain and the sections will help you understand the 3D orientation of the brain. There will not be a practical until the end of the course; however, do not use this an excuse to skip lab. Neuroanatomy can be tough as everything is essentially the same color. The practice practical is typically similar to the actual exam, and if one is offered, it is in your best interest to attend.

The final exam consists of a lab practical, a cumulative written exam, and a clinical practical exam in which pictures of various abnormalities will be shown. Most students find the clinical practical straightforward. The written exam is more challenging than the quizzes, but if you stay on top of the work, you will be well prepared!