Dr. Daniel Paull received his medical degree from the University of Miami Miller School of Medicine and is currently an orthopedic surgery resident at the University of Toledo Medical Center. He is the author of So You Got into Medical School… Now What?, a book meant to help students with the transition to medical school. I was sent a free copy by the author and have agreed to write an honest review.
I started reading So You Got into Medical School… Now What? when I began my clinical rotations. Reflecting on how my own experience has been over the past several years, I can say that this book is an insightful read for anyone who is about to embark on the long and difficult journey that is medical school. From your very first lecture, to preparing for Step 1, to applying for residency, this book serves as a guide to your four years as a medical student.
One of the major challenges when first starting medical school is not necessarily the difficulty of the subject material, but rather the volume of material that you’re expected to know. This is where the first several (and perhaps the most important) chapters of the book come in handy- by addressing how to adjust to the medical school workload and how to efficiently study. Here, Dr. Paull provides examples using actual topics you will encounter in your pre-clinical years and shows you different ways to approach learning them. Personally, I wish I had gotten this book as an M1 because it would have saved me a lot of time and trouble.
Each chapter addresses a major medical school hurdle by starting off with an anecdote. I have to admit that the stories are incredibly accurate and I found myself thinking, “Yep, that’s exactly how I felt” many times throughout the book. I chuckled when I was reading through the Clerkships chapter. Part of the vignette in this section describes a scenario where a newly minted M3 is suddenly asked a question about asthma classification and treatments by the attending:
It takes ten seconds before the asthma treatment chart arises from your memory. For your attending that is ten seconds too many. She proceeds to lecture “everyone” about the specifics of asthma treatment, without ever giving you a chance to show that you do know the answer, you just needed a moment…Before finishing, your attending says, “I want you to prepare a five-minute presentation on this topic for tomorrow.” Great. Just what I wanted to do with all the free time I don’t have, you think.
Having been told to make topic presentations myself, I immediately could relate to this vignette. These stories are what make the book engaging and fun to read.
In addition to the stories provided at the start of each chapter, the author includes a plethora of advice for that specific time during your medical school career. So far, I have found the Clerkships chapter to be very insightful. Although at first I anticipated most of the advice for this chapter to be common sense (i.e. be professional, be on time, etc.), what I didn’t expect was how much information there would be on things that I had no idea about. For example, the shelf exams and their scoring, studying during M3 year and how it differs from studying during the pre-clinical years, and how to make the most of subjective evaluation gradings are all things that play a large role in third year clerkship success, however, I’ve never really been given solid advice about those topics until I read this particular chapter. It is this kind of information that makes this book so useful.
Overall, I highly recommend this book to prospective and current medical students. My advice would be to get a copy of it prior to starting medical school and reading the first couple chapters before starting classes. Then, before embarking on each of the medical school hurdles, to read the relevant chapter. It will definitely help make medical school seem less nebulous and intimidating. I look forward to revisiting The Residency Interview chapter when the time comes.
(Review published November 2015)
Notability (iPad app): The best note-taking app in my opinion. You can import PDFs and highlight, write notes, and type annotations directly onto the PDF. The flexibility of the app is what makes is great. Highly recommended if you only receive a PDF version of class notes and would rather not print out a 100+ page packet.
Acland’s Video Atlas of Human Anatomy: This helped me a ton for the anatomy lab practicals. You can choose what part of the body to study and watch the video for that corresponding section. The dissections are amazingly clean and fresh- it looks like the person died maybe a couple minutes ago. They’re really good with showing you the relationships between muscles, nerves, and blood vessels.
How the Immune System Works: Short and sweet book that breaks down the immune system for easier understanding and if you have time to read it. It does not go into nearly as much detail as class, but it’s a good starting point and may help with understanding complicated topics in a more conceptual way. Recommended, however do not use this as a replacement of the notes!
Picmonic/Sketchy Micro: I used Picmonic with our Micro I and II classes and I attribute it as the reason why I did well on the bact/viro/parasitology sections. I personally did not use Sketchy, but I briefly used a friend’s account later on and liked it better since the pictures they use are more intuitive, whereas Picmonic’s seem to be a random mash of things. Some might argue that the randomness of Picmonic is what makes it so memorable in the first place, but to each his own. The major advantage that Picmonic has over Sketchy (at least when I used it) is that it had a huge amount of pharmacology. This was immensely helpful when I had to go back to my Picmonic playlists and re-study pharm for boards.
Pathoma: From what I remember, this book costs only $80, and includes access to all the errata, updates, and online video lectures. It’s a great bargain and well worth the price. I used Pathoma during M2 year as we moved through the systems. The easy-to-follow book along with how Dr. Sattar explains seemingly complicated pathological concepts really helped with understanding lecture material and gave me a good baseline for boards.
COMLEX Level 1/ USMLE Step 1:
First Aid for the USMLE: Obviously, the bible. I recommend flipping through an older edition just to familiarize yourself with some content until you can get a copy of the newest edition, which usually comes out in January of every year. As you go through a class, look through that corresponding section in First Aid. By the time the class is over you should already be pretty familiar with that section. You will get the most use out of the book during your second year of medical school when you start getting into systems. MEMORIZE THIS BOOK. A lot of people also annotate into it. I personally took it to a Kinkos and had the binding removed (make sure the person working doesn’t cut off too much of the margin!). Then I got it 3-hole punched so I could put it into a binder. I was then able to add loose-leaf notes filled with diagrams, mnemonics, and drawings. Basically, if there was anything that helped with making the information in First Aid easier to digest (it’s pretty info dense), it went in the binder.
Goljian Rapid Review: This is a much more intense version of Pathoma, without the videos. If you ask an upperclassman they might have the audio for it, which is outdated. If you use this (which I don’t necessarily recommend), you should start it very early in your board prep because it is a massive book with huge amounts of material. Pathoma > Goljian RR.
USMLE Step 1 Secrets: Pretty neat book to flip through if you’ve got some down time. This is supplemental material, and by no means do I recommend it if you’re short on time. If you’re going to use it, I recommend getting it early on in board prep and just going through a couple cases a day.
Kaplan USMLE Step 1 Notes and Audio: This is recommended more to FMGs who may be out of school for a while, or for Caribbean students that have months and months to study for boards. It is essentially a huge volume of videos and accompanying notes, divided by subject. I used these for my weak points: mostly biochem, embryo, and pulm. I’m not going to lie- it was a huge time sinker but man did it help clarify and conceptualize some things. If you’re short on time, I do not recommend this. If anything, they might be good to use while going through classes during M1 and M2 year.
Savarese OMT: Most commonly used resource for people taking any of the COMLEX exams. I think it has something like 19 chapters, which are pretty easy to go through. During dedicated you can probably fly through this book in 3 days. For those that take both the USMLE and the COMLEX, it is recommended that you take the USMLE first, and then cram this book in before sitting for the COMLEX several days later. It’s definitely a good idea to get this book to brush up on important OMT concepts.
Doctors In Training (DIT): NSU-COM gives this resource to students as part of their board prep. It is incredibly pricey if you decide to buy it for yourself. It comes with a workbook and a series of videos. IMO, DIT is something that should be used before dedicated time. It covers only the basics with the help of some mnemonics and repetition. If you’re really struggling with the basics, then DIT might be an okay place to start assuming you have the time to invest it in. Even during dedicated study, there are only so many videos you can watch. Not to mention that you also need to stop the videos to fill out things in the workbook, and then actually take more time to really dedicate what you just watched to long-term memory. I don’t really recommend this resource otherwise.
USMLE World: This is a must, especially if you’re planning on taking the USMLE. If you’re planning on only taking COMLEX, it’s up to you if you want to invest the extra time/money into an additional question bank. However, UW is undoubtedly a major learning resource. Don’t get bummed out with the percentages. I started in the 40s% and worked my way up to 80s%. The important thing is that you see progress. If you’re plateauing, then that’s a problem. Take your time with each question and really understand the teaching point. You should not be flying through the explanations- that defeats the whole purpose of the Qbank. There’s a lot of debate as to when people should start UW. Personally I think it should be started late in the second half of M2 year, after most of the systems have been covered in class and after other less important question banks have been exhausted. UW is so good with interweaving different subject material from multiple systems that to use it early in your prep is kind of a waste. Just my two cents.
Rx Qbank: One of the first Qbanks that should be used. It basically asks questions straight from FA, and the nice thing is that it’ll show you exactly what page in FA the answer is. It is not a difficult question bank to get through. I recommend going through it with class.
Kaplan Qbank: I did not use this question bank since I just didn’t have the time. It’s supposedly very nitpicky with detail but other than that the questions are supposed to be better than Rx. Again, I didn’t use it, so I can’t really comment.
ComQuest/ComBank: For Level 1, most people use ComQuest. The questions aren’t as good as UW, but they’ll help expose you to the question types that are on COMLEX. Since the questions are not as complicated as UW, they don’t take that long to get through and review. Even if you’re taking the USMLE, I still recommend doing some ComBank/Quest questions just to get used to the way the COMLEX is.
Firecracker: This is a resource that must be started as an M1. It takes a ton of dedication to really commit. You basically flag topics and it gives you flashcards to go through every day. If you miss a day they really start to pile up, so it’s important that you’re committed daily. If you can invest the time into it, then it’ll pay off with memorizing all those annoying details needed for boards.
Anki: This is a flashcard app where you make your own decks and can quiz yourself. You can alternatively download cards that others have made- Broencephalon’s deck is the most popular in terms of board prep. Like Firecracker, you have to invest time into reviewing cards every day.
CramFighter: Not a bad app. You enter your resources and when your test is and it spits out a daily schedule for your board prep. The problem is that it doesn’t “weigh” different resources. It treats each resource as equal, when in reality you might prefer to finish UW before your test than the DIT videos. Other than that, it’s a useful app.
NBMEs: These are the practice exams that you can buy for the USMLE. I highly recommend running through some of these during your prep to make sure your score is improving.
COMSAE phase 1: These are practice exams for the COMLEX. I think most people find these less accurate than the NBMEs, so you should especially take these with a grain of salt. If you’re scoring 450 or less, I highly suggest pushing back your test, as you’re in danger of failing the real deal. There’s too much uncertainty with the COMSAEs to really know if you’re in your target range, so it’s a good idea to use the NBME’s as well. I alternated between the two every week.
Useful for Rotations:
Success on the Wards- 250 Rules for Clerkship Success
- Has some general advice and tips for every rotation you go through
- Shows you what the notes for each rotation should look like
- Explains how to present patients depending what service you’re on
- Advice for residency applications for each field
White Coat Clipboards
- Keep all your papers together in one place so you’re not fishing around your pockets
- Provides a hard surface so you can take notes on it while standing
- It has basic lab values on them which is nice to reference to in the beginning of rotations
- Super sturdy and fits in white coat pocket
- All medical students need to have this, it’s really the most useful thing ever
Maxwell- Quick Medical Reference
- Good to reference when you’re first starting rotations
- Helps a lot when you get sent to interview new admits
- Has a ruler on the back to measure lesions (used this more than I thought I would)
- Also great when you need to do a neuro exam
Pocket Medicine by Sabatine (AKA the purple book)
- Extremely useful during inpatient IM, but I found myself using it on other rotations too
- All the interns/residents use this book, so if you’re thinking about going into IM it might be a good book to buy anyway
Shelf (COMAT) Exams:
- AAFP questions: Students can become members of the AAFP for free and access over 1,000 practice questions. Some of the questions are really detailed and IMO are beyond what an M3 should know. I would recommend doing these after you’ve exhausted the qbank questions.
- COMBANK for Shelfs: In my opinion, the most helpful- more so than the AAFP questions. The FM shelf is a very broad exam and I thought this did an okay job at hitting the big testing topics. Since it’s so broad, I would have also done the Level 2 questions from COMBANK.
- Case Files: This book has 60 FM cases that may be similar to patients that you’ve encountered on your FM clerkship. Each case is followed by a couple questions and then a discussion. I actually liked the book a lot. It is a decently large book though, so if you want to really get through all of it you should aim to start it on Day 1.
- Step Up to Medicine, Ambulatory Chapter: A good quick review to look through a couple days leading up to the COMAT. My only issue with the chapter is that it doesn’t seem to go into that much detail/depth, but that’s why we have questions, right?
- Step Up to Medicine: I really liked this book. I thought it was easy to read and everything made sense. It breaks the diseases down by diagnoses, PE findings, treatment, etc. It serves as a good “textbook” for the shelf
- Master The Boards 2: I liked this book less than Step Up. I felt like it was missing a lot of information. I was told by a resident that this better serves Level 2/Step 2 rather than shelf exams, so it might be better not to use it at all.
- COMBANK for Shelfs: I did all the IM questions and thoroughly reviewed them. They mimicked the shelf exam questions well.
- COMBANK for Level 2: After I finished all the IM Shelf questions from COMBANK, I moved onto this qbank. I felt like this covered a larger variety of questions and was a little bit more reflective of what was on the actual shelf in terms of subject matter.
- Pocket Medicine: I referenced this throughout my rotation and felt pretty comfortable using it. I used it occasionally during shelf studying to remind myself of some important criteria.
- Up To Date: Obviously a great resource. I used Up To Date whenever I saw conflicting information in books or question explanations.
- First Aid 2015: Once in a while I had to go back to FA to brush up on some Level 1 concepts. Hopefully you didn’t set it ablaze after you took Step 1.
- Case Files: I really liked the Case Files for OBgyn. It hit a lot of the most testable topics and gave thorough explanations for differentials and what to do next.
- COMBANK for shelfs: I thought some of these questions were too easy and not reflective of the exam. I still think it’s a good idea to do them though since it will drill the differential diagnoses into your brain.
- COMBANK for Level 2: Moved on to this question bank after I finished all the questions for the shelf. Provides a broader coverage of OB/gyn topics.
- Blueprints: I used this as a textbook and to read about topics that I was unsure of or unfamiliar with. It’s pretty big so it might be kind of difficult to read it cover to cover. I recommend just reading relevant topics that you encounter on your question bank that you need further explanation of.
- Case Files: Skimmed through the book whenever I had some down time on my rotations. I liked the charts and tables that they had in the book so I would reference those a lot when I was studying for the shelf. This book was basically the ‘textbook’ that I used to study for the shelf since it has a lot of information.
- Up To Date: Used occasionally to look up things.
- COMBANK for Shelfs: Went through the Peds questions. I thought it was pretty reflective of what I saw on the shelf.
- First Aid Psychiatry: Make sure you get the most updated one with DSM-V. There’s a whole section in the back with all the drugs which helped a lot.
- COMBANK for Shelfs: Useful. I thought the explanations were really important from this qbank because they pointed out how to differentiate between diagnoses that seem very similar.
- First Aid 2015: I used this to refer back to some of the old mnemonics
- Up To Date: Good to reference when you’re reading up about your patient’s and why they’re having the surgery. Sometimes I would randomly get pimped on the epidemiology and UpToDate was helpful for that.
- Schwartz: This is a huge book and I do not recommend reading this whole thing, but it has a lot of good information to refer back to before going into the case. Also a good resource if the attending likes to ask “What landmark are we looking for?”, “How far down would I bovie?”, “Now what is the next step?”
- Access Surgery: I used this during the rotation. They have illustrations of a lot of the cases that you would see and explain each step so it’s easy to follow along when you’re in the OR. Also useful for pimp questions.
- COMBANK for Shelfs: Mostly general surgery-focused questions. I would also supplement this qbank with the Level 2 COMBANK questions.
- Pestanas Surgery: A lot of people rave about this book, but I thought it was just okay. There’s also an audio that goes with it that you can also listen along as you go through the book but I felt like I was doing more work/wasting time since the audio doesn’t match up with the text. I ended up just reading through the book 1.5x while doing the questions in the back. I think it helped to learn more about topics that weren’t as emphasized in COMBANK.
COMLEX Level 2 PE
COMLEX Level 2-PE Review Guide (JB Review): Pretty much the only resource you need. Make sure to run though the cases timed with a friend. Have any mnemonics down cold, and keep a list of OMT treatments you can use for specific complaints. *Be nice to the SPs*. Despite what people may say, you actually need to study for this test. I recommend taking the test before fourth year starts to get it out of the way.
COMLEX Level 2 CE/USMLE Step 2 CK:
Master the Boards (MTB) for USMLE Step 2 CK: This was essentially my bible. Some people don’t like it, some people do. Just depends on the person. I treated like how I treated First Aid, except I didn’t take it apart and add extra notes. I used it to annotate things into it. IMO, it’s a good book because it’s well organized. Sometimes I felt like it was missing information, but the book itself is kind of bare bones- it only tells you what you need to know to answer the question. If you want extra information, you’ll have to look into other resources.
Step Up To Medicine: If MTB didn’t have what I was looking for, I would go into this book. This book is super info dense, but it’s a good supplement to MTB, at least in my opinion. It also has a decent ambulatory chapter in the back that I felt MTB was lacking in. By the time you’re studying for boards, you should have already at least looked at Step Up, since many people use it during their IM rotations.
First Aid for the USMLE: Sometimes I would have to go back and refer to some things in First Aid. It’s not really necessary, but it was convenient.
USMLE World: Still an excellent Qbank for Step 2/Level 2. If you’re only taking COMLEX, you might be able to get away with not using UW, but it’s still a great learning tool and if you have the time I would recommend going through it. Like before, don’t worry about the percentages. Just make sure you’re learning.
ComBank: For Level 1, most people go with ComQuest. For Level 2, people go with ComBank. I actually had several questions on the exam that were verbatim to questions I’d done in ComBank. That being said, I wish that they would make some more challenging questions. A lot of theirs seems to be relatively straight forward.
NBMEs: Same thing with Step 1. I would take one every week, or every other week if you’re also taking the COMSAE.
COMSAE phase 2: These are practice exams for the COMLEX Level 2. These, like the ones for Level 1, are not that accurate, so I would recommend supplementing with the NBMEs to make sure you’re well above the passing threshold.