How to Not Fail Anatomy: The Quick, Cheap, Dirty Guide

I would like to first preface this guide with the following: When you first arrive to the island you are going to hear lots of different advice coming from all over the place whether it was solicited or not. Everyone’s got an opinion and many people feel inclined to provide you with their thoughts on certain subjects, teachers, and tests and as a first semester student, you will come to realize that a lot of it is contradictory and a lot is pretty subjective to the individual. Each student comes from a different educational background and there will be subjects they are excellent in and others that they will struggle with. For example, since I was a Biology major at BC and took MCB and Genetics, I don’t find MCB difficult. I allocate little time to it and I still do just fine. Because of this background I may be inclined to tell you MCB isn't bad, and to spend more of your study time on anatomy. You may follow my advice and do well in anatomy, but then fail the first block exam in MCB. So please be wary of everyone's advice and try to put what they are saying in perspective by asking about their backgrounds. With all the chatter that went on in my first semester about this class, or that particular exam, the single most simple and true piece of advice I received was to study for every class like its your worst subject. If you do poorly in an exam it's solely because you didn't study hard enough for it. And it's true. AUC gives you all the tools and support needed to pass all your classes and as long as you put in your study hours, you will do well.

With all that being said, let's get to anatomy!

As a student who had no background in anatomy, I was fairly intimidated by the new language and material for the first month of school. I hated anatomy lab (I still do actually), did very little dissecting and didn't spend any extra hours in lab. It was a rough first block which culminated in an exam grade so terrible, that it kept me in failing range for pretty much 1/2 of the semester. I adjusted my study habits and I would like to share with all of you what I did to go from 60s to 80s.

The Only Books you will ever need:

1. BRS Gross Anatomy

2. Netter's Atlas of Human Anatomy

3. Rohen's Color Atlas of Anatomy: A Photographic Study of the Human Body

What I came to realize as I struggled through first semester anatomy:

1. Read BRS anatomy and forget the class notes. Other than Dr. New Zealand's slides, all the other anatomy professors' slides are pretty useless and do not stand up well on their own when it comes to studying for block exams. Whichever part of the body you are doing, I recommend reading the corresponding chapter in BRS that week and write down notes. Star the clinical points (pink boxes) in the book that are mentioned in class or are in the class notes since that is what will be tested on. 

2. When you do a new part of the body spend the first day or two memorizing the bones and muscles of that section. Open up Netter's and just stare at the page and memorize all the muscle names. It will take a couple hours but learning them in the beginning will be good for later in the week when the professors reference back to these muscles. I sometimes had a hard time staring at Netter's because there are just so many goddamn names so I used winkingskull.com to quiz myself. You can click on labels to hide or reveal them. After I thought I got everything memorized I would do the quiz to make sure I was 100% on the names. Winking skull is free to register and you have access to the more important slides so I highly recommend using this site when memorizing muscles. 

3. After learning the names and locations of the bones and muscles, you MUST LEARN BLOOD SUPPLY AND NERVES.  Use Netter's to learn where the nerves and arteries travel and how they branch because the pictures are great for it. And then use BRS to learn which structures the neurovasculature is associated with. If you break the medial epicondyle of the elbow you will have to know that it can affect the ulnar nerve because it passes posterior to it. 

4. DO QUESTIONS!!!! This is what saved me for my exams!! BRS questions are awesome. Do them at the end of each chapter and read all the explanations whether you get the question right or wrong since they completely explain why one answer is right and the others wrong. In addition to these questions go to the UMich anatomy site for even more questions that tend to be easier, but are an excellent source for learning what is most important.

5. Block Week after-hours lab time! The Lab Practical exam accounts for half your anatomy grade and tends to be the half that everyone does better in. To be honest, I never paid attention to a single thing in lab. The first half hour while the professors lectured, I zoned out.  I dissected from time to time but had no idea what I was ever cutting into. When I was not dissecting I spent most of the two hours talking with my tablemates about anything and everything that had nothing to do with anatomy. So how is it I started scoring 83s in the Lab Practical? I would go to the lab with a group of my knowledgable friends 3 or 4 nights during block week. I would stay for an hour and half and we would run through all the structures in the body. We did it again and again each night for that last week and that is what saved me. I figured why try learning the structures during the first couple weeks when everything was just going to look different at the end of the block? This is a terrible attitude to have by the way. You should pay attention in lab and try to actively learn what you are seeing in the bodies. The point of my revealing little story is to emphasize the importance of going to after hours lab during block week because that is your shot to see the structures that will be tagged after the weekend.

6. When you aren't in lab, use the Rohen's book to see actual cadaver images with all labels. Netter's is nice but it is all cartoons showing everything in the most perfect way. For the actual practical exam, Rohen's is amazing. The book has full color, labeled photographs of all the structures one might encounter during dissection. This book is particularly important for the weekend before block exams because you aren't allowed back into the lab after 8 am on Friday. Also very important: Do the practice practical images on Angel! Dr. New Zealand will upload a bunch of pdf files containing photos of tagged and labeled structures that are high yield for the actual block exam so definitely go over those pictures a couple of times before taking the exam! For even more practice with identifying tagged structures on the cadaver, Umich has tons of questions covering the material.

A word on Mock exams: I didn't go to a single one. I can't tell you anything about them but they are pretty popular with most of the class. It usually takes a couple hours, but I rather spend my time studying in LH4. For first block it may be a good idea to go just to see what the actual exam is like. You get one minute to answer the question of the tagged structure and when you hear the "next" you walk over to the next question. The Mock exam is headed by the anatomy TAs so they don't really know what will be tagged on the exam, but they manage to get a few tagged structures that appear in the real thing. 

And there you have it! It may seem like a lot now, but I started doing all these things by block 3 and my grade definitely jumped up. I wish you guys the best!

Done with Anatomy Lab FOREVER

I know I said I wouldn't be posting again till after finals, but here is just one quick picture.  Each semester the "firsties" pose for a group picture once completing anatomy lab.  Here is ours:

And here are a couple of mine:

Thank god its over. Yay for the January 2011 class!

Saturday Morning and an Anatomy Update

Image via Wikipedia

Oh Oh Oh To Touch And Feel Very Green Vegetables and Herbs ;)

I just got a good study session in this morning. When I drink the night before, I usually wake up pretty early the following morning so I was up, dressed, and out by 8:30.  Right by Note Services in the main AUC building there are a bunch of picnic tables stationed with awesome views of the lagoon, so I decided to sit there and do work. I wish I had my camera at the time. For the two hours I was up there, I went over most of my MCB stuff from this past week and now I have to worry about anatomy for the next few hours.

Speaking of anatomy, the start of this block is significantly better than the start of first. I actually know what's going on in class, which was not the case for the first couple weeks of school, and now I've learned to use the UMich site for extra questions and for going over things I don't quite understand. This block we are focusing on the head and neck of the body. I've heard from a few student that this is may be the hardest block because you have to remember so many details about the nerves and blood vessels, like what foramen they exit out of, what muscles they innervate/supply blood to, the clinical significance if a nerve or artery is cut or impinged upon, etc. So I've been staying on top of my work, I've got the general cranial nerves down thanks to the help of a somewhat dirty pneumonic (not the one in the brain caption) and now I just need to memorize all the bones and muscles of the head and face. Not so bad, right? I've been using a site that's been great for naming all the external and internal structures of the body called winkingskull. You can click to hide or reveal the name of a particular bone/muscle/nerve/artery/vein and after you think you've got the hang of all the names you can take the quizzes. If you want to use this site, it's free, but you will have to register your email address. 

In addition to lecture, my lab experience has also been better. For whatever reason, the smell has not been as pronounced and I want to say it's because I've gotten used to it, but I think it's because we are only working with the head right now (small exposed surface area) and we've been covering up the rest of the body. I don't even want to think about what's growing in our body's thorax right now. Since I haven't been having issues with the smell, I actually did some dissecting on Thursday! Shocking right? I feel like I outdid myself since I couldn't even handle the back, but I somehow managed to go ahead and dissect my cadaver's FACE. On one half of the face, the guys at my table were digging for nerves and on my side I was trying to clear the fat off to expose the muscles. We had a couple of awesome TAs at our table helping out with the parotid gland and clearing off fat, thanks Khyati and Qinshi! And also a shout out to one of our Head TAs Josh who was helping me out with the muscle half of the face, and showing off some finesse with the scissors and probes.

Block I Exams and Post-Show Festivities

They are done. 

Finally. 

And just when I think I have a moment to catch my breath, the force feeding begins again. Block II has officially kicked off with the usual round of classes this morning and lab in the afternoon. I also already have the results for my exams, but I think I'm getting a little ahead of myself here, so let's take a moment and backtrack.

At AUC, each semester is divided into 4 blocks. At the end of each block, everyone takes 3 or 4 exams pretty much back-to-back. As a first semester student, I took:

--Anatomy Lab exam, 40 questions, one hour beginning at 9:15 a.m. For this exam, the anatomy professors tag different arteries, veins, muscles, and nerves of the cadavers and you have to identify the structure or state what that tagged structure is associated with, or even apply it to a clinical situation. There's also another room (the dry lab) where x-rays/CT scans are displayed, as well as bones and you have to identify the structures. Each student is stationed at one question and we rotate around the room every 30 seconds or so. I suppose this is an efficient way of doing things, but once you pass a question you are done with it. There were some tags that I knew within 5 seconds and others where I wished I had more time (BPS of the lungs!!)

I was out at 10:15 and spent the next few hours reviewing histo, MCB and anatomy. The next round of exams started 1:00 and they were suppose to go till 4:00, but the thing I *really* liked here is that you could take whatever exam you wanted and spend as long as you liked on it within those three hours. The professors allocate an hour to complete each exam, but the thing is if you finish Histology in 30 minutes like I did, you use that extra half hour for the MCB exam. Roll over minutes at their greatest.

-- Histology exam, 50 questions, 1:00-1:30. I felt like this was going to be my easiest exam so I decided to take this one first and man did I burn right through those questions! I felt like I knew every answer and that never really happens to me during exams.

--Molecular Cell Biology I exam, 40 questions, 1:30-2:15. I took a little longer on this one. I felt fine throughout, but not like how I felt during histo. I could see which questions I was missing and I felt like I could have done better if it weren't for my laziness with detail in DNA replication. I saw what special enzymes and proteins I had to memorize the day before and decided I didn't feel like exerting the extra effort. No bueno

--Anatomy written exam, 40 questions, 2:15-3:00. Anatomy is my achilles heel and I knew if I took this one first I would probably lose a lot of my confidence going into the exams. I felt lost throughout this exam. I was frustrated because I felt I knew about the structures and subjects that were most stressed in class and lab, but for whatever reason there weren't many questions on what the professors spoke most of! For example, Dr. G spent the most time of any of his other slides discussing the Tetralogy of Fallot during his heart lecture. NOT ONE SINGLE exam question about it.  Because there were 3 professors teaching this block, each got to write at least 12 questions. I was so frustrated towards the end of the exam I think I was just blindly choosing C for every question I skipped over and preying I got a few hits. All I wanted was to just get out of there and enjoy a few hours without having to worry about studying. I thought to myself that tomorrow would be a new day, a new block, and I'd have to implement new studying techniques.

RESULTS:

Histology- seems like Histo is everyones favorite subject since we all did pretty well in it 

Class Average: 84%

Me: 92%

MCB I- Another good average for our class, but it kills me to think that if I had studied a little better I could have gotten somewhere in the 90s. 

Class Average: 80%

Me: 80%

Anatomy- a 69.5% and above is what's considered passing at AUC and I'll tell you right now, the average of our class was a failing grade at 68% (the written and lab are averaged together) The professors decided to throw out a couple of the questions in attempt to raise the average, which now stands at 74.5%. With that being said, I scored below the minimum passing grade for this exam and *gulp* I failed. Yes folks, I failed with a 65%. I needed an additional three or four questions to pass, but there you go. You know what this means? Study regiment overhaul. I need to actually follow my own rules I've already put forth on this blog and then sprinkle a little UMich every night with a heavy dose of BRS anatomy.  From this moment on, I vow to do this every single day. Failing is simply unacceptable. 

Lastly, when you're done with blocks please go all out Monday night. I went to Tantra with a bunch of my fellow first semesters/second semesters and I had a fantastic night. A little craziness is essential for the preservation of sanity. 

Related articles

• Block II Hits and Misses (medschoolcaribstyle.com)
• Goodbye Block III (Good Riddance) (medschoolcaribstyle.com)
• First Semester Done and I've Passed All my Classes! (medschoolcaribstyle.com)
• Semester 2: Block I  (medschoolcaribstyle.com)

Gross Anatomy Lab

In anatomy lab, this is what your cadaver looks like after you get through dissecting parts of the thorax, back and face. Haha well...at least this is what it looks like to me. And that may be part of the reason why I hate anatomy lab. I'm not a huge fan of being near dead things, because I'm not entirely sure they won't come back to life. I heard from a second semester student that last semester, the power went out during after-hours lab time and the ten seconds it takes the generators to kick in, the hand of her cadaver grasped her wrist. Duh duh duh. Yes, anatomy lab at night is something out of a horror movie. That's why you will never catch me dead (pun INtended) using the lab after 4:00 pm even though it is pretty much open 24 hours a day.

All joking aside, I'm definitely in the minority when it comes to lab. Most people absolutely *love* getting in those bodies, cutting things up, and pulling organs out. Yesterday I held a real life (well, dead) human heart in my hands. I enjoyed it for a few minutes and was equally happy to pass it on to the next person. I spent most of my lab time yesterday digging out the branches of  a very juicy left lung. I'm hoping it will get tagged for the first round of block exams on Monday since that will be the only thing I may be able to identify! Lab really isn't as bad as I make it out to be, but the one thing that really makes the experience particularly unpleasant is the smell emanating from the cadavers. The formaldehyde stings my eyes and nose when I'm close for too long and I hear this is when the bodies smell best. After the third or fourth month dissecting the same bodies, I can only imagine how repugnant things get. 

It begins

You walk into class 5 minutes before it starts and take a seat by the aisle. You look around and see some of the familiar faces of your classmates talking, smiling, all and all having a good time. The professor is in the front of the class setting up his computer and clipping the microphone to his Tommy Bahama shirt. Now that's how you know you're at a Caribbean med school, you think.

The professor begins speaking to silence the class and dims the light so everyone can see the powerpoint slides projected onto the screen. The professor introduces himself and goes into where he's from, where he studied, what he has done with his research and life... and then he starts lecturing.

You stare at him for a moment. He's speaking, but it can't be English. No, no this is definitely not in English. You're in the wrong class. You don't have a clue what he's saying. Is it his accent that you're having a hard time with? No, no that can't be it because you can recognize some words like, "the" and "and". The pictures projected on the screen look somewhat familiar but all the text written is unintelligible. Is this all in Chinese, you wonder. You continue to stare dumbly at the professor who's gesturing, pointing, and speaking animatedly of what's on the slides, but you can't make sense of what he's trying to say. His words mean nothing to you, his whole sentences mean nothing to you. Someone raises a hand and asks a question using the same strange language. You don't even know what the question was. Everyone else is scribbling notes or typing furiously and you look down at your empty piece of paper. After 50 minutes of this nonsense, class ends and you are able to understand the people around you again. Most are discussing what's next, what to study, their hunger, their sleepiness, etc and the few... the few just like you, are pale with that look of horror on their face, thinking exactly what you are thinking.

"How the hell am I going to pass anatomy?"

AUC First Semester Classes

I apologize for not posting on the subject of classes sooner, but I simply couldn't based on the fact I only had MCB on Wednesday, Thursday, and Friday of last week. I just had my first classes in anatomy and histology today and I'm about to leave for anatomy lab in the next twenty minutes. I'll be more than happy to write a detailed account of what's up in a few hours. Until then, ciao.

***

Some of you may be wondering what a typical day at AUC is like and I'm willing to comply. Let me first highlight that the following schedule is only for first semester students at AUC and this schedule may be very different at other Caribbean schools.  Alright then, from Monday to Friday I've got the following: 

8:00-9:20     Molecular Cell Biology I Lecture

9:30-10:20   Anatomy Lecture

10:30-11:20 Histology Lecture

BREAK

2:00-4:00     Anatomy Lab (No lab on Fridays)

DONE/Study Time

Doesn't seem so bad, right? I've only had my first full day yesterday (sorry, I posted this later than I intended) so I would have to agree with the presumption there, but I'm definitely going to revisit this question in a couple months. I've got a sneaking suspicion that I won't be thinking the same thing at that point in my medical education.

The way classes are organized here are by blocks. There are four blocks in a semester and at the end of each block you take back-to-back exams in each of the classes listed above. Exams are always on a Monday. Then the rest of the week is spent learning material for the next block. With this structure, you can have different professors coming in to teach different blocks. While AUC has many professors that are here permanently, the school also lures professors from the US/Canada by allowing them to come to St. Maarten for 3 weeks with their families, all expenses paid, to teach a section of the course that they specialize in whether it be genetics, anatomy of the brain, or cell biology. Many of these visiting professors who do come here to teach a block or a semester are usually from US medical schools, but what they all have in common is their love for teaching. Professors at AUC aren't focusing or concerning themselves with research and writing papers... their sole purpose of being here is to purely TEACH.

Today, we had a visiting professor from Columbia University (Dr. A) teaching the anatomy of the brain and spinal cord. He was an excellent and knowledgeable speaker, and I know I'm going to have my hands full when I start going over what we did in class today. The anatomy department overall is set up a different way from the other classes. There are 5 different professors who will be teaching anatomy this semester, switching off different days to lecture on the area they know best. At first I was afraid of redundancy and confusion among the professors, but I realized today that all the professors sit in each other's lectures to be sure they aren't repeating covered material and they sometimes refer back to a lecture of another professor from the day before (this was the case today). For the last 4 lectures Dr. N had been teaching our class and he is from Nigeria. He spent 15- or so years dissecting and teaching anatomy in his country before he was brought to AUC to work as a professor. At first, I had problems understanding his accent, but once I moved closer to the front of the class, I've had much better luck comprehending him.

MCB will be taught by three different professors switching off at each block and so far I'm really enjoying the professors we had/have. Dr. M is from Scotland and he taught three classes last week about genetics... he will be returning for a full block at the end of the semester. One of the other students mentioned that he reminded her of a Ricky Gervais and I added he was a of a cross with Sean Connery... haha yup. Not only is he an avid Ravens fan, but he does have a dry wit that I think the class really enjoys to break up the monotony of the 80 minute lecture. The professor we will be having for the rest of this first block is Dr. V and he is from the Netherlands. He got his degree and doctorate from the Utrecht University (this university dates back to the middle ages!) and got one of his post-doctorates at Temple University in Pennsylvania (I know all about his education because he spent a good 20 minutes of lecture yesterday discussing his research and education haha).

Histology will be taught by a visiting professor Dr. Al for this first block. He is a professor from Dalhousie University in Nova Scotia and I've enjoyed his lectures, and perhaps this is due to the fact that he's been covering material I already know and I don't feel quite so overwhelmed right now (as opposed to anatomy). He's friendly, knowledgable, and I'm really liking his pace for lecture, not slow, but not flying through slides like some other professors (cough anatomy profs cough).

I think this post is long enough for now. I can cover anatomy lab some other time. I need to spend ample time on anatomy because I've never taken it before. Right now I feel a bit lost and overwhelmed with the material. I spent my time looking over lecture stuff yesterday and I'm going to have to do lots of it this upcoming weekend. Block 1 exams are fast approaching...