How to Survive Medical School: Histology & Physiology

I’ve begrudgingly realized that vacation is coming to a close. In a little over two weeks, I’ll be back in class (okay…at home) . Many of you are soon to start your first year of medical school and I would be surprised if you aren’t a bit nervous. My greatest concerns, I’ll admit, were academic in nature. I found it difficult to find legitimate advice about first year courses. In far too many blogs, MS1s compared medical school to drinking out of a firehose.

Okay sure, they aren’t wrong. Okay sure, I’ve said that myself. Yet, I found those blog posts  to be anything but helpful.

In a previous post, I shared some advice about five first-year courses: anatomy, biochemistry, embryology, genetics, and neuroscience. In this post, I’ll share my study-strategies for histology and physiology. If you have questions or advice, feel free to leave them in the comment box.

Histology: upperclassmen told me to take histology seriously. They mentioned that it is very easy to treat histology as a low-priority course (I agree, it is) but that a good foundation in histology is invaluable when pathology rolls around. 

Histology at TUSOM: We take histology alongside genetics, biochemistry, and physiology — these courses are taught in blocks divided by organ systems. In our last block, endocrine & reproduction, the histology and physiology department tag-teamed lectures. That was hands-down my least favorite block (content-wise) but the block in which I understood the material the best. We have a lab component and PBL component in our histology course (is that standard? I’m not sure) and we also had some professionalism questions thrown into our histology examinations — these questions were the bane of my existence.

Study Strategy: I will admit that it took me time to figure out how to best learn histology material. In most courses (as you can see in my previous post), I use lecture material as my primary resource. I tried to do that for histology but, that was not enough for me to do as well as I wanted in the course. So, after a few blocks, I switched things up.

  • Primary resourcesRoss & Pawlina became my bible. Did I read it cover-to-cover? Yes. Did that help? Yes, for sure! For each block (once I realized that histology lectures were not for me), I would read the corresponding Ross & Pawlina chapters twice. I would try to make my first pass through Ross & Pawlina before the histology lab session and my second pass just a few days before the exam.
  • Lab: Our anatomy tanks were reunited for histology lab. Each lab session, we were instructed to find specific structures and answer a series of questions — it was sort of a mini-PBL (problem based learning). I found The Big Picture: Histology to be a great reference text in lab and a good review of the material in case I wasn’t able to get through Ross & Pawlina before the lab session.
  • Images: You definitely need to study images. I used the Tulane images as my primary set of images and I supplemented with images from Yale and Dartmouth. Another neat way to get familiar with images is to watch Shotgun Histology videos that correspond with your block’s material.
  • Questions: Definitely do practice questions. I made sure to do the questions (5 per chapter) in The Big Picture: Histology. The questions in Pretest: Anatomy, Histology, & Cell Biology are pretty difficult (and demoralizing) but worth doing, if you have time. I found Lippincott Illustrated Q&A Review of Histology to be a great learning tool — hands down one of my favorite histology resources.
  • Shelf examination: The histology and physiology shelf examinations were our 7th and 8th exam in a period of two weeks. As you can imagine, I was extremely tired by that point. A month out from the histology shelf exam, I started to slowly work my way through High Yield Histology. I tried to read BRS Cell Biology & Histology but I definitely ran out of steam; instead, I worked through the questions in BRS Cell Biology & Histology and called it a day. I went through a set of ‘high yield’ histology shelf facts — this was actually pretty helpful.

If I Could Do-Over?:  I would have made an effort to further integrate my histology and physiology studies. Although we have ‘integrated’ curriculum, the only time I really felt a true connection between histology and physiology was our final block. As I mentioned, that was the block in which histology really made sense. Everyone made a big deal about Blue Histology. That was not particularly helpful for me and it took far too long for me to cut it out to my examination preparation.

Physiology: I was afraid of physiology at first. Everyone gripes about physiology; everyone compares physiology to physics. I hated physics in high school and in college. I found physiology to be enjoyable.

Physiology at TUSOM: We take physiology alongside genetics, histology, and biochemistry — these courses are taught in blocks divided by organ systems. Our professor has some course synopses for us which were pretty helpful.

Study Strategy: At first, I read the required textbook (which was terrible — I do not recommend slogging through Berne & Levy) and took notes on lecture material that corresponded with the course objectives. That was terrible. I performed well comparatively (I guess it was a rough block for all of us) but it was just a terrible test-taking experience. I found that physiology is not a course in which I can learn via objectives. I need to think about the big picture — the why. I need the details and thorough explanations and so I heavily supplemented lectures.

  • Primary resource: I found listening to the lectures and ‘translating’ the lecture material into handwritten synopses (terrible drawings included) to be more instructive than reading the provided course synopses 2-3x. I re-listened to physiology lectures a week out from the examination. For pulmonary physiology, we were taught by Dr. Levitzky who wrote Pulmonary Physiology. That book was not for me but his lectures were phenomenal. If you need a resource for pulmonary, check out his handouts.
  • Textbooks: Like I mentioned, I wanted explanations for physiology. I needed more detail than was provided in lecture so that I could really understand the processes. I used a series of three textbooks:
    • Netter’s Essential Physiology: I read the corresponding chapter(s) before I started to listen to the physiology lectures for the block. The images are fantastic. The descriptions / explanations are easy to understand. This book was such a game-changer for me.
    • The Big Picture: Physiology: I read this about a week out from the examination.
    • Constanzo’s Physiology: I read this the weekend before the examination. Anything that was new to me (yikes!) I would draw out / incorporate into my handwritten synopses. This book is gold. Seriously. This is a book you should probably just buy now.
  • Questions: I made sure to work through the questions in Netter’s Essential Physiology and The Big Picture: Physiology at the bare minimum. For most blocks: I also did the questions in Lippincott Illustrated Reviews: Physiology, Physiology – An Illustrated Review, and BRS Physiology.
  • Shelf examination: One month out from the examination, I started to read through BRS Physiology and USMLE Roadmap Physiology. I did the corresponding questions in those two books. I went through the Lippincott Illustrated Reviews Flash Cards: Physiology but this was not that essential. The best resource (for me) was Guyton & Hall Physiology Review — amazing (and very difficult) questions. Get it! Seriously!

If I Could Do-Over?:  I know that people love Pretest: Physiology. I didn’t. I slowly came to realize that the Pretest series is not for me. I could handle it for histology but outside of that…I wasn’t a fan. I didn’t think it was the best way for me to reinforce high-yield facts. If something isn’t working for you — drop it as soon as possible!

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