I can’t believe I’m saying this but: today is  my first day of third year! I took USMLE 1 a month ago weeks ago. It is such a relief to be beyond that exam. Since then, I’ve done a bit of traveling and I’ve tried to stop panicking about my impending score. In the future, I’ll share with y’all my strategies to study for the exam and to stay sane and motivated throughout my dedicated study period. In this post, I want to continue to chat about how I tackled second year coursework. It’s probably a good idea to first read the post about how I studied throughout the year.

Second Year at TUSOM: Second year begins in May with the inflammation (pathology, immunology, & clinical diagnosis) block. That block is followed by two months of well-deserved summer and then followed by the following blocks: microbiology (microbiology and immunology), hematology/oncology (microbiology, pathology, pharmacology, & clinical diagnosis), cardiology (microbiology, pathology, pharmacology, & clinical diagnosis), renal (microbiology, pathology, pharmacology, & clinical diagnosis), pulmonary (microbiology, pathology, pharmacology, & clinical diagnosis), gastrointestinal (microbiology, pathology, pharmacology, & clinical diagnosis), neurology (microbiology, pathology, pharmacology, & clinical diagnosis), reproduction/endocrine (microbiology, pathology, pharmacology, & clinical diagnosis), and psychiatry (pathology & pharmacology).

Immunology is technically recognized as a first year course at Tulane but it is taught in the first two blocks of second year.

General Strategy for Mechanisms of Disease: Mechanisms of Disease (MOD) is the pathology course at Tulane. As you probably expected, it’s the most time consuming course and so it was the course I prioritized throughout the year. There are a lot of resources out there to make pathology more manageable and some individuals find it more efficient to ignore lecture material in favor of outside resources. You definitely have to figure out what works best for you (which could take a block or two).

• Lecture: I actually attended lecture this year. I know! The complete opposite of my life first year. I made Anki cards while I was in class and made an effort to get through these cards 2-3x before the examination. I also charts and diagrams from lecture material that I looked at exclusively 1-3 days prior to exams.
• Textbook: I compared quite a few textbooks and found Rapid Review Pathology to be my favorite. It’s written in outline form which makes it easy to breeze through the material. On the margins of each page are high yield points. I made an effort to read Rapid Review Pathology sections related to lectures at least one day beforehand; this really helped me to zero in on what material from lecture was most likely to be tested.
• Pathoma: Rapid Review Pathology isn’t really going to explain pathological findings. I often looked at a stream of symptoms like !?!?!? why are these affiliated; what is causing this? That’s where Pathoma came into play for me. Sattar explains pathological findings. I found that listening to relevant Pathoma sections a day before corresponding lectures or at the end of the block (as a review) to be extremely efficient. I know some people blast through Pathoma at the beginning of the block but that didn’t work super well for me.
• Questions: Questions are a must. My goal for each block was to make my way through at least 200 practice questions. I worked my way from easier question sets to the more challenging question sets: 1. Lippincott’s Q&A, 2. Robbins and Cotran Review of Pathology, 3. Osmosis, 4. webPATH, and finally 5. USMLE Rx.
  • USMLE Rx: Amazing question bank that I used throughout the year and in my dedicated step study period. I usually completed all but 40 questions per organ system. I wanted to save a few questions for dedicated step study period in order to assess what I didn’t remember from First Aid.
  • Robbins and Cotran Review of Pathology: Extremely challenging questions that are worth completing. The question stems are extremely lab value heavy so it’s helpful to keep a set of normal values handy.
  • Lippincott’s Illustrated Q&A of Pathology : I’m partial to the Lippincott’s Illustrated Q&A series. Those of y’all who read my first year posts know that I find Lippincott’s Q&A questions to be a great teaching tool re: concepts and image practice.
  • Osmosis: This question bank is extremely quirky. If you use my referral link, you can get a free month to Osmosis. Majority of the questions are  multiple choice but there are a handful of true/false questions. The questions definitely touched on topics I had never heard about in lecture and was never asked about on Tulane examinations but these topics definitely popped up on UWORLD. I think it’s worth checking out but the question bank may not be for everyone.
  • WebPATH: 25-55 quality questions on each organ system. Not crucial to work through but if you have time for extra practice, it’s worthwhile.
• Occasional Use:
  • First Aid: I started using First Aid to prepare for my block exams around Thanksgiving. I think that it’s important to familiarize yourself with First Aid prior to the start of your dedicated period.
  • Dr. Willbe Anki Deck: I used this deck sometimes to cover material in Robbins (especially because I didn’t have the patience to read Robbins).
  • Pathophysiology of Heart Disease:  I used this book during the cardiology block. I found it to be an extremely stressful read; it’s extremely detailed and I was unsure of why (but really, why?) anyone would read it cover-to-cover. I skimmed through most of it but I found the arrhythmia chapter to be extremely high-yield.
  • Renal Pathophysiology: I read this book cover-to-cover and I loved it. If renal is not your jam, consider working you way through this book.
  • Pathology: The Big Picture: This book (like others in the series) is a short and sweet description of pathology. There are some pretty great tables and charts that I found beneficial.
  • Robbins & Cotran Pathologic Basis of Disease: Robbins comes in three sizes (Little Robbins, Medium Robbins, and Big Robbins) and I tried to read Medium Robbins in addition to Rapid Review Pathology. I didn’t find this to be necessary. Robbins is such a time suck so if it’s not working for you, STOP.

How to make mechanisms of disease less painful: Review relevant physiology prior to the start of the block! I used Firecracker to quickly remind myself of pertinent equations and etc. I know that some people re-read BRS Physiology. I did that for one block but I found Firecracker to be the best way for me to remind myself of first year material.

General Strategy for Introduction to Infectious Disease: Introduction to Infectious Disease (IID) starts off with an introduction block where we had an overview of majority of the microbes that we’d encounter later in the organ systems. IID is easily one of the most organized courses at TUSOM and I found that lecture material did not need to be supplemented too heavily in order to be successful.

• Lecture: As in the case with MOD, I made Anki cards in lecture. I made a LOT of diagrams.
• Textbook: Rapid Review Microbiology and Immunology is an amazing textbook and I used it throughout the year. I sometimes took a peek into Lippincott’s Microbiology if I needed some clarification.
• Sketchy Micro: I talked about Sketchy in my second year overview post but this resources is worth chatting about again. There’s no simpler way to draw connections between the different critters.
• Questions:
  • USMLE Rx
  • Osmosis
  • Lippincott’s Illustrated Q&A of Microbiology and Immunology
  • BRS Microbiology and Immunology

How to make introduction to infectious disease less painful: I made diagrams with classifications of each of the microbes and I included informations from sketchy micro and Firecracker re: characteristics and toxins. Also if you’re looking for a fun way to review material, Microbe Invader is the way to go.

General Strategy for Pharmacology: So pharmacology is one of the easier courses. It’s quite a bit of information but it’s thankfully cram-able.

• Lecture: I did NOT attend these lectures but I did listen to them afterwards (2X) just to catch any additional information that may not have been on pharmwiki.
• PharmWiki: This is the  to success in pharmacology. All information in red text or bolded is what you should focus on. I made little pharmwiki charts (small enough that they can fit in my white coat pocket) throughout the year that I used to study.
• Questions:
  • USMLE Rx
  • Osmosis
  • PharmWiki Quizzes: The PharmWiki quizzes do a good job of highlighting topics that are most likely to show up on the examination. I think it’s important to work through the quizzes at least two times before the exam.

How to make pharmacology less painful: Try not to fall too far behind. For certain blocks (e.g. cardiology and neurology) there are a lot of drugs and it’s extremely stressful to try and cram all that information at the end of the block.

General Strategy for Clinical Diagnosis: Clinical Diagnosis and Foundations in Medicine are two classes that are highly intertwined. We had a handful of clinical diagnosis lectures throughout the year and a few questions would pop up on exams. There’s honestly not too much that I can say — it’s pretty intuitive information so don’t worry too much.

General Strategy for Immunology: I mentioned earlier that immunology is technically a first year course at TUSOM. It’s a pretty straightforward course and so I used lecture as my primary source of information.

• Lecture: Every slide is testable. So learn it all. Luckily, concepts are repeated time and time again but seriously, know every single slide.
• Textbook: There’s a lot out on the internet about which immunology textbook is the best. I found Lippincott’s Immunology to be simple yet thorough enough to give me a really good background on immunology. I supplemented this textbook with the first four chapters of Rapid Review Microbiology and Immunology.
• Questions:
  • USMLE Rx
  • Osmosis
  • Lippincott’s Illustrated Q&A of Microbiology and Immunology
  • BRS Microbiology and Immunology

How to make immunology less painful: Review the material regularly and look through the corresponding unit in First Aid. This course is cumulative so it’s important to review information from the first block prior to the second / final immunology block exam.