Advice for Term 4 at SGU
My boys with me for the last late nights of Term 4
As expected, this was the most challenging term so far. It lived up to the hype. Though it wasn’t unbearable. There were times when I wished it was impossible because that would have. been a good excuse to say I’m not cut out for it.
In 17 or so weeks, we went over everything learned in the first year plus pathology and pharmacology (except Neuro & MSK which are done in T5). In retrospect, I see the line of thought here. We learned the properly working body in the first year. The second-year requires that knowledge plus what goes wrong and how to fix it. I look back to first-year content and was envious of that level of challenge. Even though at the time, I thought I was overwhelmed.
However, now that I know I passed and I’m moving on I can look more fondly on Term 4. Because I have to be proud of what I made it through. I mean I used my knowledge to pick out the right allergy medicine for me at Costco the other day. That’s worth the pain, right?
My Study Process
Disclaimer: These are my personal study habits that probably won’t work for everyone and in no way diminishes the importance of school lectures. That being said, I’m still not a lecture person. I get too distracted too easily. At this point, everything needs to be said in 2x speed for me to recognize its English. I used outside resources for both learning and review.
My rhythm was morning: Anki + SG + Self-care —> Lunch —> Lectures + POST-reads —> Prep for next day lectures and SG.
Post-reads consist of watching the Sketchy and annotating and/or pathoma. I started the term by continuing my one-page summaries, but by CPR I was just annotating Stella/MedBakery’s notes or cumulative charts.
OUTSIDE RESOURCES:
Path = Pathoma > Sketchy Path
Pharm = Sketchy Pharm > Pixorize > Physeo
BnB for some leftover topics, but the videos were often too long for me to integrate
Review
Anki M1M2 deck (***most of the cards will now come from Zanki and you have to manually move them over)
Clicker + ITI cumulative documents: I used these documents from past terms as a workbook to review and check which knowledge I was able to keep
USMLE-Rx: SGU will give this to you in T5, but I didn’t know that and bought a subscription for Black Friday. Their Express Videos were awesome for topics I needed to be hammered in. I loved their Bricks which are like small textbook-style snippets.
They also have workbooks that walk you through First Aid!
Amboss Qbank: I love their wiki pages. Made SG easy when I needed more information. You can test on certain topics which are cool.
Kaplan Qbank: My throwaway qbank to get more practice in, but I’ll be saving USMLE-Rx Qbank for T5 and Uworld
Term 4 content
FTMC was the diving board between Term 3 and Term 4. From up here, we’re still looking at the big picture but you can still make out the little details that we’ll be diving into later. It’s the first taste of pharm, but they start with something familiar but not comforting: autonomic drugs. Grace’s Firehouse Med Prep/Fries & Redbull schedule is very helpful to use as a template or to identify what resources are most popularly used. So of course Sketchy has become my lifeline for pharm and some path topics, especially later in the term. For pathology, Pathoma was amazing at teaching me all the important things. This module feels overwhelming but it was a good gut check for me to see if my study habits were going to work. Spoiler alert, had to make some serious changes to increase efficiency like stop writing my own notes and prioritizing qbanks/anki even at the cost of other things.
CRS, well if FTMC is the diving board then CRS is when you hit the water belly first because someone pushed you in. The distinction between what’s micro, path, and pharm are way more clear. This being said the first week has a little bit of room as they wind up. I would advise reviewing normal physiology and anatomy in 1-2 videos or notes to preface your brain for what’s about to come. There is an expectation that you mastered that information and can use it to understand the disease and treatment. Summary charts are your friend!
RHS, someone told me CRS is the hardest, and then it gets better. I think that’s an oversimplification because it’s all hard. CRS is a shocker like “I didn’t know life could be this hard”, but RHS’ difficulty is like “Really? 1 + 2 isn’t 3 but X(*1)^2 + 2”. What I’m trying to say is RHS gets complicated. The lecture structure especially in the beginning feels chaotic because the different disciplines of Micro, Path, and Pharm will teach the same concept. Don’t let your guard down because they’re slightly different and that’s where it matters. It’s like we’re all looking at the same thing, but they tell you to want they see and expect you to put the pieces together.
DERS, everyone is ready to be done. The content follows Pathoma and Sketchy pretty well until reproductive pharm then no one seems to care to make content for that. I would say my routine was the best here. Consolidating and practicing knowledge recall and reasoning over everything. Watching Sketchy more than once was quite helpful. The warning I would give is that don’t forget OCEX/OSPE is at the end and you’ll want to chunk out some time for it. However, its point worth is considerably lower than the unit exam.
Clinical Content
There are a handful of lectures and a ton of small groups emphasizing actually working with a patient. Remembering that these books and vignettes lead somewhere. Though, it wasn’t super helpful to listen to a lecture on things that are so visual. Dr. James McGill’s youtube channel and Amboss have some great videos. Amboss even has practice clinical cases. SGU also gave us iHuman access. I actually found timing my fake conversation with this virtual patient was helpful to create a groove. At least online, it was easy to get in a habit of reading off assignment sheets but during the OCEX we did the whole patient encounter, PE, and closure including diagnosis in one sitting!
Unfortunately, this content often took a backseat to lectures and to the many pathology small groups. I was able to find some time to prepare for the OCEX closer to the date, but if I could go back I’d make more effort to learn the techniques beforehand. I hated that reading the PE techniques always landed on me during the term, but I appreciated it when I was prepping for the OCEX.
As far as the OCEX, it is a step more challenging than what we did in a small group just because our work was always divided with our peers. In the OCEX, it’s you and back-to-back patients. We signed into our Zoom and they did the most nerve-wracking virtual shakedown for security purposes. We got ~ 17 minutes once we read the door note with vitals and chief compliant, then we had to take the history, list out the techniques of the physical exams we would do, and then talk to the patient right away to close out with our diagnosis and plan. I’m 120000% sure I didn’t get the first diagnosis correct because I totally blanked, but my patient was so kind and I suppose I got the procedures and SOAP note correct enough because I got a decent score.
Other stuff
Another reason Term 2 was difficult was all the opportunities to be distracted. You could start research, be in club executive boards, or tutor through DES or AEP. None are required, but SGU alumni have recommended starting to do extracurriculars for residency apps. I also know people who did none of these and focused on Term 2. I wouldn’t say it’s super essential. I overcompensated and committed too much very early. A mistake.
TL;DR
The volume is intense. The content is intense. So make sure you have a study system in place!
Take a break. Take as many as you can. In the middle of one of the modules, I took a couple of days off. Went home and relaxed. Came back ready to tag back into the fight.
Efficiency, time is the biggest limitation. Especially adding the 55 Small Groups we had.
Outside Resources: This is the term where they’ll come into play so get to know them as soon as possible so you know if they’re for you.
Exams are hard. Most questions will be 3rd order (but they seem like 12th order to me)
Closing
Term 4 is awful, but it’s not invincible! I couldn’t believe that so many people endured this but it was inspiring to remember that.