The dreaded term 4. The weed out term. The most intense/hardest term.
Heading into term four, I felt super intimidated. I had only heard horror stories, about the workload, labs, material, professors, exams, etc. All any upper termer could say was that it was the most difficult term. We had just finished term three and started term four just a few days later. The material includes pharmacology, microbiology, and pathology. We were the first term to have all those integrated instead of separated. That means that for a given system — say Cardio and renal — we would learn all the bacteria that could cause infections pertaining to the heart, the pathology of the heart and kidneys, and lastly all the drugs pertaining to those systems (treatment for hypertension, heart failure, etc.). Overall, I actually really enjoyed this term, and while you have to have commitment (you have to that every term lol) this was by far my favorite term, and my highest scoring term!
So, were the upper termers right? Sure, it was a lot. But one thing other upper termers also advised was going to Dr. Oke’s sessions, and that advice was invaluable. The path slides from SGU lacked detail and order (in my opinion). When you think about the pathology of a disease, I find it to be most helpful thinking about it an organized way — what is the etiology, risk factors, pathogenesis, investigations, and complications/outcomes. During pathology small groups, SGU suggests that students prepare slides that way. Unfortunately, it’s not presented in that manner in class (maybe its a time thing?). Anyways, thank gawddd for Dr. OKe. This man changed my life. I was in his “large session” that was held on Wednesdays and Saturdays. I had no idea what to expect going into his session, but I brought my laptop and was eager to see how it was going to go. Basically, he went through each disease we were taught and explained the disease in an organized way. For example for Minimal Change Disease affecting the glomeruli in the kidney, he would explain the etiology, risk factor, pathogenesis, investigations/findings, complications. When he talks, I do my best to type every single word he says, because it is gold. After each session I would edit my notes, and add in pictures from the lab (they love using these images) and add in lecture pictures. Because I had his notes and added in the pictures, I never had to study the pathology department slides. I 110% recommend attending Dr. Oke’s session. He also goes through questions that he writes himself, and they are fireeeeee. In his questions, he writes how the patient will present, their investigations, and then for the answer choices, it will be either Risk factors of said disease (which you have to figure out), etiologies, or pathogenesis of 5 different disease. The questions require you to know the diseases inside out and SGU loves risk factors and complications, so they really solidify your knowledge. Even while doing USMLE RX questions, I would recognize a disease based on what Dr. Oke had taught us. Basically, what he teaches is important, not only for SGU tests, but also for STEP (the most important test of our young doctor lives lol). I’ve heard people knock Dr. Oke, but honestly he changed the way I think about medicine and disease processes, and really helped me understanding of the material from term four. Below are some pictures of the notes I got from Dr. Oke’s sessions
So what is a week like in term four? We had class Monday – Friday from 8-10 am. Then throughout the week we would have various pharmacology, pathology, microbiology, and CPD labs at either 1 pm or 3 pm or BOTH 1 AND 3 PM, AND afternoon IMCQs about 1-2 per week. I often felt like I couldn’t do any studying til after 5 pm, because of all the getting up and going to this and that.
Path labs — Basically your small group would be responsible for presenting 1-2 slides a piece to each other. So say I have a gross image of the myocardial infarct, I would have to go through and explain the findings of the image, etiologies, risk factors, pathogenesis, complications, outcomes, investigations. Depending on your small group, this could be super helpful. Since, I went to Dr. Oke I felt that I already had most of the information from his sessions. But I did try to listen, and make sure I knew what each member was talking about. After each slide was presented, the presenter would write their own question and we would have to guess what the answer was.
Micro labs — the most time consuming lab ever. They require you to do a presentation over a microbe. This includes a “decision tree” (I actually never included this lol), presentation, biology, epidemiology, etc. They also want you to use as few text/words as possible. So, you place pictures on a powerpoint and explain the microbe to your small group members. As much as I hated these labs/time commitments, there were times I could recall what fellow small group members said and get answers right on the test, so it does help.
Pharm Labs –– these usually take the least amount of time to finish. I always got something out of these labs, so it’s worth going to for sure. They usually involved 3-4 cases where we would go through and discuss treatment options for patients, and what we would be worried about in terms of adverse effects. To prepare for these labs, I would try to review the pharm lectures to get the most out of the cases. Approaching Pharm — A lot of people used sketchy, but I liked whiteboarding better. I can make review sheets and recall better, so I did that. Whatever works for you, just stick to it!
CPD labs — We started with History taking, which is actually very important for getting to the most correct diagnosis. We would all take turns doing the various physical exams, and on certain days, it would be a simulation lab where we would all have specific tasks and then write a soap note afterwards. This stuff is on the OSCEs and the STEP, sooo its important. I liked these labs, and it felt like we were actually practicing to be doctors. It is a nice break from the books/cubicles.
PATHOMA — I liked to use pathoma as a pre-read for Dr. Oke sessions. I would listen along and take notes, and after attending Dr. Oke’s sessions, it really solidified my knowledge of the material. This guy explains each pathology really well, so I found it to be a very useful resource.
CK MED+ — This guy used to go to SGU, and he makes powerpoints with really important and useful information. He also explains the material really well with cool ways to remember it. Some of the micro slides from SGU are really detailed, which I liked, while others had very little information on them, so I would watch him after the lectures and then study from his slides and SGUs combined.
My advice — Antibacterials, learn them ASAP, Attend Dr. Oke’s sessions (sign up in term 2 to secure a spot, I will post the link at the bottom of the page to his facebook page), Know the lab slides, CK MED, and whatever has worked up to this point, keep doing you! If you can make it through this term, grinding it out, you will be sitting pretty for term 5, where you can start studying for boards!!