Fourth semester was my favorite in Preclinical Sciences because, finally, we were talking about real medical disorders and their treatments. The most intimidating course for many students (including myself) was Pharmacology because there are so many drugs to learn. While it is still important to understand the mode of action of the drugs with respect to the diseases they treat, this is one class that you cannot escape memorization.  I have always had difficulty with rote memorization, but again, tables were very helpful for this class.  I separated drugs according to class and MOA and noticed patterns in names.  Once I learned the actions of a certain class of drugs, I assumed that any other drug that sounded like it also belonged to that same class and therefore had the same MOA. Lange PharmCards became invaluable for me because they made learning fun with mnemonics and cartoons.

I loved Pathology II. Our professor presented pathology to us in a systems-based approach. We learned about individual diseases as a whole, in addition to the pathologic findings. This was very helpful and integrative with the ICM classes, and between those two courses, we could finally see the big picture: a patient who presented with certain complaints, signs we see on a physical exam, findings on laboratory and microscopic testing, and finally treatment. I realize now that the ICM labs are so useful – from learning about SOCRATES and PAMHUGSFOSS for history taking, to noting the physical symptoms of Grave’s disease patient, to our professor chastising us for not completely examining a patient and missing a water-hammer pulse in Aortic Regurgitation. All these experiences were valuable, especially as I prepared for my clinical rotations and Step 2 CS.

I know that fourth semester is the last semester of Preclinical Sciences on the island, but I caution against neglecting these final courses. They provide a wealth of knowledge for Step 1. The shelf exams in fourth semester are also important in preparing you for USMLE type questions. The USMLE Step 1 has a good deal of pathology. Whether it directly asks for the pathologic findings or provides them and asks for something else – truly knowing the disease processes can mean the difference between failing, barely passing, and excelling on Step 1.

The ICM and Comprehensive shelf exams are similar to the format of Step 1 and can give you an idea of the amount of preparation you will need for Step 1: do not underestimate them. The white coat ceremony marks your final departure from the island, but it also signals that USMLE is the next great hurdle, and with adequate preparation, it will not be an obstacle.

by Jasmine Riviere Marcelin, Class of 2011