WILTIMS #161: Med School Strikes Back

If first year is the study of the normal body, second year is the study of everything that can go wrong and, if possible, how to treat it. We learn all of these topics first generally, and then organ system by organ system, as pathology/pathophysiology, microbiology/immunology, and pharmacology. ALL the -ologies!

It was surprisingly rough getting back into the swing of things today, even though we didn't learn much in the way of material yet. But as I dust of the mental cobwebs, I remember back to last year, and can barely believe how far I've come.

"Walk this way..."

Last week I helped out with the new first-years' orientation week. In between panels and walking lost students to their lockers, my classmates and I all agreed that it was so refreshing to see students before their spirits are broken by that first couple weeks of lecture - back when the biggest problems were deciding between buying or renting a microscope and finding the nearest grocery store. We quickly learned that these worries were easily drowned out by the flood of information we were being fed. And then we realized that that first test was a laugh compared to the second - and anatomy/histology was a cakewalk compared to even early physiology/biochemistry - and the cardio exam was at a whole 'nother level... and so on.

By the time summer rolled around we understood: med school never gets easier, it only changes form and/or gets harder. But every victory reassured us that we would survive the next challenge. Every "pass" on an exam showed that we had improved beyond our own wildest expectations from just a few months before.

So when today we heard that this would be the hardest semester yet (until the next, that is) and that all of this was a prelude to the ever looming USMLE Step 1 board exam at the end of the year, I could confidently shrug it off. Looking at the lost first-years in whose shoes we stood 12 months ago, I can't wait to see where we stand 10 months from now as we transition to clerkships. Bring it.

Today I Learned (TIL):

Stopping oral steroids cold turkey can be deadly due to adrenal insufficiency.

Hypertrophy is the abnormal growth of a tissue by increasing cell size, as compared to hyperplasia which is abnormal growth due to the production of additional cells. The term atrophy covers the opposite of both hypertrophy and hyperplasia. Metaplasia is the change from one cell type to another. When any sort of change leads to negative enough consequences, it can be called a dysplasia. Dysplasias are reversible, whereas carcinomas (cancers) are not.

Caseous necrosis is the type of cell death seen in tuberculosis. It is named for its morphologic similarity to cheese (latin: caseus = cheese).