#9: Surviving Anatomy

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In this episode I will give you suggestions for learning anatomy and post an “Anatomy Tip Sheet” with the best resources I’ve found for surviving anatomy.  At the end I’ll answer a listener question about balancing lecture notes vs cadaver lab.

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  1. Learn to love Latin.  Well, not just Latin but all the nomenclature and etymology of medicine.  It’s impossible to learn all the prefixes, roots, and suffixes while you’re in medical school, but if you are struggling with remembering something, take the time to Google the etymology.  You may discover something that helps it stick, and it will probably come in helpful for other words as well.  Taenia means “ribbon” – and that helps you remember that the taenia coli is a ribbon around the colon, and that Taenia worms are ribbon-like.  Ampulla comes from the Greek for “bottle or jug” and you’ll see that again and again – Ampulla of Vater, in the duodenum, the ear – and always referring to a dilated portion of a tube, like a bottle or jug would be dilated.  Sometimes the etymology tells you exactly what a structure does.  For example, levator labii superioris alaeque nasi tells you that the muscle lifts the upper lip and nasal alae.
  2. Use repetition with variation.  You’ll probably have to go over something like the branches of the external carotid multiple times to memorize it, but to truly reinforce it you need to introduce variation into the memorization process.  Recite the branches backwards.  Use visual, auditory, and tactile learning.  Teach it to a friend.  Identify the structures that each branch supplies.  Draw it from scratch on a white board.
  3. Practice with a study group, on multiple cadavers.  Study groups are good for all areas of medicine, but with anatomy they can be especially good resources for mnemonics and clarifications of anatomical relationships you didn’t even realize you were confused about.  Studying on multiple cadavers teaches you to ignore normal variants and focus on the universal features of anatomical structures.
  4. Look at prosections, not just Netter’s.  In a real body, the arteries aren’t red and the veins aren’t blue, and when everything is a shade of brown the ID’s get much more difficult.  Seeing actual photographs of prosections will help you start to pay attention to things like the direction of muscle fibers and the relationships between structures.  Check the Anatomy Tip Sheet PDF for the best prosection site I’ve seen.
  5. Try to put anatomy into clinical context.  There is little straight anatomy on Step 1, and what appears is extremely high-yield and predictable (e.g. brachial plexus).  What IS tested is anatomy with clinical manifestations, like looking at a CT scan and understanding where the pathology is given a particular patient scenario.  Practice questions really help with this.  Check the bonus PDF for practice question resources. 
  6. Memorize mnemonics before lab.  This way you can use your time in anatomy, including down time you might have while someone else is actively dissecting, to be connecting your mnemonic with what you are seeing.  There are no end to mnemonics available online.  I will include one link in the bonus PDF but whatever long list of items you are struggling to remember, I would just Google it as you need it.
  7. Use other people’s flash cards.  This is the only time you will ever hear me say this.  I always preach that using someone else’s flash cards is dangerous, and a waste of your time.  Anatomy is the exception.  Check out the Anatomy Tip Sheet PDF for some flash card suggestions.
  8. Splurge.  Apps for your phone or iPad can go a long way, and can be used when you are on the bus or waiting in line at the cafeteria.  In the PDF I listed the five that seem to be the most popular and thorough, but I have to include the disclaimer that I haven’t used any of these myself.

Last, someone left a review (thank you so much!) asking for tips on “how to balance studying lecture notes vs cadaver vs netters diagrams.” 

The first step is to clarify your goals.  It’s wonderful to learn anatomy for its own sake, to be a better clinician.  But the fact is that you’ll forget most of it, and realistically you won’t need it anyway.  I’m going into dermatology, so the branches of the celiac artery, which I remember driving me nuts, are going to be pretty low-yield in my life.  Head and neck anatomy, on the other hand, will be essential.  In M1, you don’t really know what you’ll be going into, so let’s just forget about long-term utility and be honest.  You are trying to get the best grade you can get, and retain the most important info for Step 1.  Step 1, as I mentioned before, does not emphasize pure anatomy except for a few specific things, and you can refresh these as you go through your Qbank in the weeks before the exam.  So your goal should be to get the best grade in anatomy.

That said, the answer to balance depends on your school.  How much of the grade is based on lab practicals?  If that’s a lot, spend more time on cadavers and photographic flash cards.  Is the bulk of the grade a computerized test?  Then lecture notes are key, but be smart about prioritizing based on your professor’s preferences.  Do they lean towards dry questions, or do they try to use clinical scenarios – because that can guide your studying.  Some parts of anatomy are more clinically relevant than others.  

Last, as far as Netter’s is concerned, that should be low in the balance.  You will almost never have a question on an exam or boards that asks you to identify a structure on a Netter-type diagram.  Netter is used to clarify and reinforce your understanding of anatomical relationships.  Use it when you are struggling with a topic and need to see the material in a different way.  I knew some super gunners who would sit down and read Netter’s like you’d read a novel.  What a waste of time!  They didn’t do any better than I did in the class.  Netter’s is a reference for looking up info when you need it.

Ultimately, make sure you have a game plan.  Use the same 5-part study strategy that I recommend for all medical school courses (listen to Podcast #8 if you don’t know the five parts).  Identify the high-yield information, things that are easy to ask multiple-choice questions about.  Organize the information.  Anatomy is easy to organize, and picking out good mnemonics is part of organizing and preparing for “lecture” which includes cadaver lab.  Lab should be reinforcing the mnemonics and organization that you’ve done beforehand.  After lab or lecture, do practice questions, teach others, check your understanding of anatomical relationships by using multiple cadavers and not just your own.  

As you go, be willing to adjust the balance of lecture notes vs cadaver lab based on your own weaknesses and learning style.  This seems obvious, but many med students are stubborn and keep using study skills even when they don’t work, thinking that if they just do more that will mean better scores.  More of a bad study technique will give you more bad results.  Try something new!

Thanks for being with me today!  Visit sholamd.com to download the bonus PDF and join my email list.  I hope the podcast and PDF give you some good ideas and good resources for surviving anatomy.  If you have questions or suggestions, email me at info@sholamd.com.  See you next time!

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