"Histology For Retards"

As promised a few days ago, my histology notes are now available for download !

The first version of those notes was a small 15-page booklet, which I prepared during the last few days before my MDI progress test. It had no drawings and the text was limited to the bare essentials. The name, 'Histology for Retards', originated from a private joke and was meant to emphasize the over-simplified nature of the text.

One year later, while preparing for my MDII final exam, I decided to use that little booklet for revision, but it quickly became evident that it simply wasn't enough. Loads of information was missing, and the plain text didn't really make sense without images. So I borrowed some extra sets of notes and started making additions and corrections to the little booklet. The result was a -comparatively- massive 55-page 'second edition' , which I used to prepare for my exams and which I'm now sharing with you.

I hope you find it useful, and I'm looking forward to receiving your feedback !

ECG Tools

If you're like me, you probably think that the 'ECG Made Easy' book doesn't make things all too easy...

Thankfully, after a bit of googling I discovered that there are some nice people at a company called SkillStat, who have created an interesting series of flash-based applications that make things a bit easier :-D

Book-o-nomics

So... After asking around (and hopefully also reading my opinion), you've finally decided which books you want to buy. The question is, where should you buy them ?

Mireva is one of the staples of medical education in Malta and a kind of Alladin's cave for every even-slightly-nerdy medical student. The variety of medical titles offered is excellent and if you're looking for something über-obscure you can order it and they will have it within a month or so.

Agenda (on campus) offers a much smaller variety of books, and also seems to target the students in the intermediate years much more than those in the clinical ones. However, you will probably find most of the faculty-suggested books there, and the book prices are usually a bit lower than in Mireva.

Amazon might have excellent prices compared to UK bookstores, but is extremely expensive compared to the local ones (and that is way before postage costs are added !). Only recommended if you're really desperate for a specific book, and you can't wait a whole month for Mireva to get it for you .

Last, but certainly not least, we have the Internet !!! Sometimes you will find yourselves looking for a very specific piece of information in a book, and it's rather silly to invest Lm20 (or almost €50, as of 1/1/2008 :-P) in a book that you will only use once ! But worry not ! Google is your friend, and it can trawl through zillions of med student forums to discover links to .pdf versions of the book you desire :-)

What is a 'respectable quack' ?

To answer this question, we shall examine the example of Dr. Walter Freeman. This fine gentleman was a very prominent psychiatrist of the early-to-mid 20th century and a pioneer in the introduction of prefrontal lobotomy as a radical cure for mental disease.


When this procedure was introduced in the '40s it was considered as a panacea, and Dr. Freeman gained incredible popularity, performing the operation almost 3000 times, in an attempt to cure a wide spectrum of conditions ranging from schitzophrenia to sexual disorders. He was a very respectable gentleman. So respectable that even the Kennedy family entrusted him with the health of their daughter, Rosemary, whose alleged mood swings were treated with a lobotomy performed by Dr.Freeman.

Twenty years later, research data had started showing that prefrontal lobotomy wasn't the miracle cure that psychiatrists had believed it to be and the discovery of antipsychotic medicine accelerated the marginalisation of psychosurgery even more. Dr.Freeman, though, continued advocating and performing the procedure, and managed to lose his medical licence in the process. He no longer was respectable.

Fourty years later, lobotomy was outlawed in many US states and was widely considered by the public as one of the most barbaric treatments ever devised. A true shame for medical science. It was now clear that the ex-respectable Dr.Freeman (who had died in 1972) would finally remain in history as a most prominent quack.

The above example is very characteristic of a danger that no doctor (or, in our cases, future doctor) should ignore. We should never have too much faith in ourselves or our knowledge. Medicine is changing every day, new cures are discovered and old cures are rendered obsolete. We must be aware of this fact and constantly be on the lookout for signs that some of our miracle cures might not be so miraculous after all.

This is what 'respectable quack' means. A person who is a highly regarded professional, but still remains fully aware that his knowledge is both limited and mostly empirical, acting accordingly.

Books bloody books !!!

OK, a new academic year is starting and everyone is panicking about what textbook to choose... So allow me to give the intermediate MD students some advice :

First of all, every person is different and therefore has a different way of learning.

There are people who can learn endless pages by heart, and reproduce them perfectly without really understanding what the hell they're talking about. Those people can do really well in medicine (at least, the pre-clinical years), and there are some excellent books out there that they can use for memorisation.

I, on the other hand, belong to a less fortunate group of people who can't memorise for love or money, and always have to find a way to work things out, starting from the minimal amount of information that their little brain is able to hold. And this group of people always seeks a specific type of book : those that do away with endless text and use loads of pictures, diagrams and tables to help you understand what's going on.

The books I would suggest to the second group would be the following :

Anatomy Textbooks :

• Moore's Clinically Oriented Anatomy : a marvellous book, with well-written text, loads of clinical correlations and a large number of high-quality images, diagrams and tables. Its negative points are the large amount of small, insignificant details it contains (which can be overwhelming) and the fact that it only makes sense if you read a whole chapter at a time, from beginning to end. Therefore it's a book that requires time, and can't really be used for revision. But I still consider it the ultimate anatomy textbook that is currently available, and did use it for my study.
  

• Gray's Anatomy For Students : A very well thought-out book, that has excellent images and tables, but does away with the insignificant details of Moore's. Sometimes it seems too simplistic, but it has been proven to be more than enough for our exams, and really makes your life easier compared to Moore's. If I had to start the course over again, it would certainly be my choice.
  

Anatomy Atlases :

• Both Rohen's and McMinn's photographic atlases are great. The latter looks a bit more contemporary, but I would be happy to use any of the two (or both !). Photographic atlases are be much better than drawn ones for spotting test preparation, because it is done on real specimens, where the arteries aren't red, the veins aren't blue and the nerves are anything but yellow.

• Sobotta's and Netter's are the two great drawn atlases, which aren't very useful in the dissection lab but offer great help when the textbook's illustrations aren't clear enough. Small differences exist between them, and they're both on the expensive side (especially Sobotta), but they're worth it.

• Imaging Atlas of Human Anatomy : A book that is essential for the imaging part of the spot test, and which can also give you an excellent 3D perspective of the anatomical relations in the trunk, which are otherwise quite hard to understand.
  

Revision Books :

• Instant Anatomy : I don't know of anyone who doesn't have this book, and this says something. It doesn't make too much sense at the beginning of the year, but when you reach May it proves to be an indispensable revision tool.

• Anatomy At A Glance : The whole of anatomy, crammed into 170 pages, half of which are pictures ? Including clinical correlations ? This book is useless as a main textbook but a great last-minute read that can make the difference between passing and failing.

• MCQs In Anatomy (Lumley et al.) : I won't lie to you, saying that this book is good. In fact, I would normally not even touch it with a bargepole. You see, most of the questions in this book require you to know a ridiculous amount of completely pointless anatomical detail, which is completely useless for a medical student. BUT (and every sentence starting with a 'but' means trouble is on the way), one of the anatomy lecturers seems to be in love with it, and all the head and neck MCQs in the MDII final exam are usually taken straight from this book. So do get it, and make sure that you learn all the stupid details about the various insignificant foramina of the palate...
  

[MDII] Neuroanatomy :

• Fitzgerald's Clinical Neuroanatomy And Neuroscience : Huge book, with abundant useless detail, but it seems to make loads more sense than the textbook recommended by the lecturer. Use at your own risk, though, because neuroanatomy exam questions seem to be completely unrelated to both the book and the lectures... [UPDATE : More information and a set of notes are here !]
  

Histology :

• Ignore the textbooks and try to get your hands on a set of lecture notes. I will try and publish my notes on this blog in the near future. [UPDATE : The notes are here !]
  

Embryology and Cell Biology :

• Ignore the textbooks and use Prof.Cuschieri's lecture notes, which can be found on his website.

Physiology Textbooks :

• Pocock and Richards' Human Physiology : Short, simple and comprehensive. Far easier than Ganong's and far shorter than Guyton's, without lacking in content.

• Master Medicine Physiology : This book was recommended to me by a colleague and I found it ideal for the study of cardiorespiratory physiology, which seems to be quite long even in Pocock's.

• Use the lecturer's notes for endocrine physiology, they're short, simple and comprehensive.

• Ignore the Israels' Hematology book that is recommended by the hematology lecturer, because it's far too detailed and sometimes incomprehensible. Pocock covers the topic very well.
  

Biochemistry Textbooks :

• Lippincott's : Probably the simplest biochemistry book available that we can use.
  

• Avoid Stryer's at all costs, I know far too many people that bought it and never opened it.

• Also use the lecture notes provided by Prof. G. Hunter and Dr. T. Hunter. They're quite short and the exam questions are always out of them.
  

[MDII] Genetics :

• Most of the material covered in the lectures isn't available in medical genetics textbooks. Thankfully, lecture notes are provided and they're reasonably short and quite easily comprehensible.
  

[MDII] Neuroscience :

• Neuroscience (Purves et al.) : Excellent book but extremely long and detailed for the purposes of our course.

• The notes provided by one of the two lecturers are even longer and even more detailed (and not particularly well-written). Ignore them, for the sake of your sanity.

• Get your hands on past papers, and study very selectively from Purves.
  

[MDII] Pathology and Microbiology :

• Ignore the books and use the lecture notes.

• Make sure you get your hands on some past papers, because they are essential.
  

[MDII] Pharmacology :

• Again, ignore the books and use lecture notes.

• Past papers are easily available and should help you organise your study.