Pathophysiology (FCP)

Last Updated Sept 2011

This class has been frustrating for a lot of M2 students. The problem is that it's taught and coordinated by attendings who haven't been where we're at for a long time. Asking them to know what's appropriate knowledge for M2s is like playing, 'Are You Smarter than a Fifth Grader.' Unfortunately, this means some of the lectures will be difficult to follow (though others are outstanding) and many of the test questions will be above your level. Sorry to tell you, but there are tests that 33% of the class has failed 2 years in a row. The good news is that there is also one easier test so that almost (yes, almost) everyone passes the course.

Because the tests are asking you questions that are beyond your level, it's hard to know how to prepare. This is advice from one student who got an O in pathophys in 2010-2011:

1) Do practice questions. If you use Kaplan Q-Bank or UWorld through the year, their pathophysiology questions are fairly good preparation for the exams, and they fill in the gaps for stuff that you're not getting in this class but you need for step 1. If you don't want to do a Step 1 Q-bank, you can also do MKSAP practice questions (these are developed by the ACP for the Internal Medicine clerkship). These are M3 level, but they are probably the best practice available for the exams in this class. I cannot overemphasize practice questions here.

2) Use a review book for the M3 medicine clerkship. The official textbook has no correlation to the exams whatsoever, and the textbook in the course coordinator's mind (Harrison's) is longer than the Bible and impossible to tackle without neglecting your other classes and aspects of your life like eating and sleeping. I recommend "Step-Up to Medicine," which is sort of the Goljan of internal medicine, or First Aid for the Medicine Clerkship, which is less dense than Step-Up making it faster to read but less comprehensive. Though these are M3 books, they cover more of what is tested in this class than your textbook or many of the lectures. As an added bonus, studying these now will give you a leg up on next year.

3) Most of the guest lecturers will write their own questions. Whether they test you on material that was clearly taught varies from teacher to teacher, but it's still a good idea to review their lecture slides for the test.

Finally, keep complaining - each year it gets harder for the administration to blame the fallout from Pathophysiology on having a, "whiny M2 class this year."

UPDATE from 2011-2012 class: Our class was very vocal about the problems with this class and a few things changed for the better. It seems Dr. Holley is now more careful to choose exam questions that correlated with class instruction (although it still wasn't perfect by any means). Dr. Holley was willing to do exam reviews with us to go over the exam questiosns which reinforced learning a ton. If she is willing to continue this, then definitely take her up on it. During these sessions, she often realized just how bad a question was, and she saw the frustrations we were having. She didn't appear directly sympathetic, but behind the scenes she made adjustments to improve things.

People always ask about what resource(s) to use. Here are some of the resoruces used by the 2011-12 class:

1) Pathophysiology for Boards and Wards

2) Underground Clinical Vignettes Series

3) Harrisons' Principles of Internal Medicine (this may be overkill, but a few students really liked it)

4) Step Up to Medicine (covers most, but not all, relevant topics; a few topics were lacking in detail/depth)