A Detailed Study guide for 4th year By Kanza Afzal

A Detailed Study guide for 4th year

By Kanza Afzal

(Batch 2012-2017)

So, now that the Third professional exam is finally over for our batch; and we set foot into final year *gasp*, we can proudly welcome the new 4th year or should I say officially 4th year? ;) Almost a month has passed already since classes began for you guys and this guide is a teensy bit late, but you know what they say – it’s better late than never. Let’s get started then!


The mantra of how we get along in pathology. B)

1.     *Pathoma!!!*  The MLE people might already be familiar with this one. I can’t add enough exclamation marks to emphasize the importance of this book. Don’t let the small, compact size of this book deceive you; because the smaller the better. Only a week ago I heard a junior exclaim in the common room how she hated Pathoma and despised the book in its entirety; all the while I smiled internally and thought about the not-so-distant future when the same girl would be appearing for her 3rd professional and would be relying heavily (if not solely) on Pathoma to pass pathology. Yes, it is that great a book! May Allah bless Sir Sattar with the best. :’) (Ameen)
·        Take your time to get the hang of the book. It may seem that this book has extremely limited information, but actually all of it is very high-yield. Read a chapter (or even 3 pages at a time) whenever you feel like it. Then combine it with videos.
·        Start watching Pathoma videos from the get-go. You can buy a CD if available, or borrow the videos from a senior/friend or if  you are an extreme book nerd with no social interactions whatsoever, you could always go to https://thepiratebay.asia/search/Pathoma/0/99/0  and download the videos chapter wise. ;)
·        Watch the videos at the normal rate the first time, you can always switch to x1.5 speeds the next time(s). Make it a habit to get atleast 2-3 hours worth of videos done at the weekend. (Trust me, you can always binge-watch your favourite seasons afterwards as a reward.)
·        Don’t forget to annotate your book with material from the video. While you may not do it the first time around, always pause and write whatever mnemonics, fun-facts or important questions he tells you the second time around. This saves you the need of going through the videos a third or a fourth time.
·        Some of the extremely important topics that you shouldn’t waste your time on Robbins with are: Kidney (all hail Pathoma for this one),  Female genital (the ovarian tumors, trust me when I say that this is a list of never-ending names that has been extremely simplified for us in Pathoma), Blood (don’t forget the poor platelets here, they are in the hemostasis section), CVS (congenital anomalies and the vasculitides), Endo and Liver.
Note: I’m not saying you shouldn’t do all of Pathoma (go ahead by all means), but the above-mentioned should definitely be done from Pathoma  first.

2.     Robbins:  So the question arises: “To big, or not to big?”  Well this one is tough, but after the whole arduous experience of prof, let me say that seniors are always right. When they tell you to do selected topics from Big Robbins, do only those selected ones.
·        The selected topics include:  Blood (only Hodgkin’s lymphoma and the WHO/ Fab classification tables given for AML etc; all the rest can be covered from pathoma/medium), Male genital (Bph and prostate CA), Female genital (esp Cervix and ovarian tumors), Breast (whole ch), Heart (Infective endocarditis and Rheumatic fever, pericarditis). Staging of cancers if not present in Medium. All of the other topics from these chapters and all the remaining chs should be done from Medium.
·        For the enthusiastic ones who hold a highlighter, ready to smear it across the whole page the first time they’re reading it, please don’t do it. Until now, you had been reading comparatively smaller *coughs* books like B.D, Katzung or Nra. I know each one of you studies differently, yet as you step into clinical years, you realize that one can’t simply read all the material for the final exam. So before you grab that highlighter, make sure you have read that topic atleast 3 times. Cut out unnecessary intros and epidemiology with a pencil/pen and highlight only the most important of the points, so that at the end if you read only the highlighted stuff, you get done quickly with the topic. (Disclaimer: my friends often made fun of me being able to read a kora-kaghaz sort of a book without any underlining/highlighting. xD)

An example of my highlighting xD

·        An efficient method that some of my friends adopted was to annotate pathoma onto Robbins or vice-versa. You can always do this if you are good with sticky notes and things; it saves you a lot of time. ;)

3.     Goljan: 
  Haven’t read this book so can’t give an honest opinion. I think it will suffice to say that Pathoma and Robbins are good to go, unless you really love pathology and want a distinction maybe? :P I only ever read the sensitivity and specificity topic from the pdf version; explained well here. Will help in c-med too. ;D


By now all of you must have bought Concepts in Community Medicine or Naveed Alam. However, if anyone of you hasn’t; feel free to take these books from your seniors. In addition to these 2, you need to buy/borrow “Research methodology and basic biostatistics” by Dr. Saira Afzal and buy/download the pdf version of High-yield biostats.
·        While most of you won’t feel like studying cmed at all, make sure to have perused your copy of Concepts in cmed/ Naveed Alam (aka NA) atleast once in the summer vacations. Don’t leave it till profs, it gets difficult to get the hang of the books especially if you haven’t had class tests the whole year.
·        The one you should make time to actively study is High-Yield Biostats. Biostats is not taught in detail here at K.E, so it is better you get the concepts earlier on, as it also helps you understand of what is actually going on in your research. Read chapters1, 2, 7(sensitivity and specificity), 8(Measurement of risk onwards, especially how to interpret odds ratio and relative risk) and the first few pages of ch 3 at the very least. If you are good at math, you can do this in a matter of days. ;) Otherwise take your time to get a good grasp of this portion, it is heavily tested in the final viva.
·        Next do the research types, sampling and ethics from the small Research book. Biostats can also be reviewed from here after you are done with high-yield. In short chapters 3 through 6 and ch 11should be done thoroughly from this book.
      P.S. listening to kaplan's behavorial sciences lecture 1 and 2 helps a lot in cmed
And you won't need high yield after that just kaplan and annotate the points in maam book not in kaplan


Moving on to the clinical side; this one should definitely be concentrated upon in ward time. The only recommended book is Dhingra; it is sufficient, no need to hassle yourself with foreign authors. (The only change you need to make is the one about the clot removal in Tonsillectomy, don’t worry – the teachers will mention this numerous times, all you have to do is listen :P) Make sure to revise the topic taught in the morning during the ward month, and you won’t need to open Dhingra the rest of the year.
·        First and foremost, get important topics marked by seniors. The whole book does not need to be read.
·        The lectures cover Ear, pharynx and esophagus mainly. Try to go through the sections of nose and larynx in the summers or in the ward by yourself thoroughly.
·        Nobody mentions instruments and/or methods especially in unit 2 (though with the new professor, things might have changed). And na├»ve people like me had no idea that these were important parts of the final viva right until the prof. >.< So press on your teachers during your ward rotation to set up a separate class for instruments and methods. Or you can request your Professors to arrange such a class during your morning lectures.
(Note: O.T wale aik uncle kafi achay instruments krwa detay hain, you just have to bargain a little. :p you can see also a video of his demonstration on the Kemunited youtube channel or borrow videos from your seniors.)


Again, most of ophthalmology is learnt actively during your ward rotation. The problem is the choice of books. In my opinion the combination of 2 books, as suggested by previous seniors, is the most suitable.
·        Jatoi, the smallest in size, is a must-have. In the times that you need to pass a ward test by studying a single night, this is the book to refer to. It has adequately summarized topics in the form of points.
·        Next you have to make a choice between Saleem Akhtar and Jogi. From what I’ve heard both books are almost the same in content and structure apart from a few minor things here and there (I had Saleem). And one of these detailed books is necessary as we saw numerous mcqs come from Saleem this prof. Some of the topics like cataract, glaucoma and lid operations are covered in better detail in these books. Jogi is also available in pdf form ;)
·        Instruments are usually covered during your ward time and are given at the end of Jatoi and Jogi too. However some, such as the entropion clamp,  are never shown at all (except in unit 1) while the external resorts to asking which lid of which eye the clamp belongs to and how would you position it. :/ So, set aside some time to see videos for such instruments or ask your professors to give demonstrations for these as well.
·        Last but not the least, the dark room methods. These weren’t taught to us the whole year (except maybe a few lucky batches?), yet every single one of us was handed an ophthalmoscope or a retinoscope in the Prof and asked about its functions and merits/demerits. Please ask your professors to arrange a morning lecture for this so that the whole class benefits. Or else you can watch some really good youtube videos like the ones here to get an idea: https://www.youtube.com/user/216gilani/videos (except the chronicles one though xD)

Woah, that got really long. :D Hope you had a happy read and wishing earnestly 
that you make the best out of this year. Remember me in your prayers. :’) Till then, Ciao! 


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