By Shivun Khosla
Part II Biological and Biomedical Sciences is a hugely varied subject which is formed of three components:
1. Your ‘Major’ Subject
2. Your ‘Minor’ Subject
3. Literature based Dissertation
The list of permissible combinations is available on the Part II NST website.
Major – Pathology Mechanisms of Disease (MOD)
The step from Part IB to Part II can be overwhelming regardless of what subject you take. MOD is less so as much of the work revolves around lecture material and textbook learning. Teaching is separated into two categories – lectures and case studies – and the learning onus from them differs but there is overlap.
The lectures go into depth about specialist topics. The content focuses on the pathogenesis of diseases which we don’t yet fully understand. The lecturers will try to introduce fundamental hypotheses regarding the disease they are lecturing about with supplementary experimental data. It is expected that you will then read up about the diseases in Robbins/Other detailed pathology book.
However, the textbook will only get you so far if you rote learn it as everyone does and you won’t stand out. By incorporating some of the new ideas with experimental support presented in the lectures (good for conclusions) alongside the mainstream hypothesis from Robbins you’ll be able to have a much more rounded and in depth knowledge of the diseases.
There is an annual debate between students about whether or not to read the references the lecturers provide and the resultant answer is usually a unanimous NO. The problem with using the references is that they are highly molecular and usually only apply to one disease. By the end of the year it will be incredibly difficult for you to have: a) read all the references for each lecture series in addition to the textbook work; b) remember it for your exam because the textbook work is more important; and c) try to find a way to incorporate it into your essays which are already time pressured enough as it is. The experimental information provided during the lectures is usually sufficient and there is no real point in going beyond that.
The case studies are there to provide the breadth of knowledge required in MOD. What is good about them is they are clinically orientated and thus more enjoyable and put you in a good position when it comes to Clinical School as it forms the basis of developing a differential diagnosis. They can be overwhelming as a LOT of ground can be covered in each one but take it back to basics and cover each disease mentioned. The diseases covered usually have known mechanisms of pathogenesis and are fairly straightforward to learn from the textbook.
1. Be diligent and cover the diseases in a systematic order. If you can, try and look at things not mentioned in the lecture but which you could put in a list as a differential diagnosis (good for Paper 2).
2. Don’t miss out parts of the information on a disease – make sure you cover:
• Epidemiology (Risk factors, incidence/prevalence, male:female ratio, at risk populations) – for essay introductions
• Pathogenesis (obviously)
• Some histology – especially pathognomonic features e.g. glomerulonephritides (it is used in Paper 2)
• Clinical Features and Consequences
• (Management – not usually necessary unless common sense e.g. radiotherapy, chemotherapy but having in your notes will help in the future)
3. Make a table of mutations for cancers and HLA associations for diseases – much easier to learn and good for Paper 4 as you can bang in a table if asked.
4. Flowcharting disease processes can be extremely useful for learning and understanding and is much quicker to draw in an exam to get your point across.
5. Order your essays logically – the examiners love subheadings it makes their job easier.
6. When discussing diseases always start with COMMON features e.g. murmur for Infective Endocarditis or start with ones you need to clinically rule out first e.g. in an essay on arthritis start with septic arthritis.
7. Paper 1 and 3 are Path heavy and they expect a lot of epidemiology and pathogenesis with less clinical features. The exception is if you can discuss the highly ‘clinicopathological correlations’ in which case it is worth discussing in more depth. Also try and cover as much ground as possible using tables and flowcharts for example tabulate a list of bacteria causing pneumonia which will give you the depth they want.
8. Paper 2 is about understanding disease progression over a period of time and how it relates to other diseases. None of the information given is coincidental and there is a way to link everything – but it isn’t expected of you. Understanding and discussing the histology, biochemistry and haematology in the context of the diagnosis will allow you to get higher marks.
9. Topics in Paper 4 are repeated and usually cover big groups of diseases not usually seen earlier in the week – make plans for the last few years for section A to save you time.
Minor – Pathology Biology of Parasitism
BOP is actually a good subject to take despite how dire the content is. The lecture handouts – although are full of text – contain everything you need to know for the exam. If you have a full set of handouts there is no need to attend the lectures as she doesn’t add any more information.
For the exam you do need to know the number of the proteins she mentions even though it is completely irrelevant information. The more facts you can get down, the higher your mark. It is literally that simple. You can afford to ditch 2 or three lecture series as long as you cover groups of parasites e.g. leave out trematodes but do all cestodes. It is even possible to bullet point vast sections of the essays – the examiner even says this.
Again the same sorts of questions come up year on year and there is only so much the Examiners can ask.
Literature Based Dissertation
This is the main place where Class I/IIi is decided and so being able to get 70-75 on it will help you out when it comes to the exam.
1. Choose a topic covered in the course – it means if it comes up in the essays you’ll already have something extra to put in.
2. Make sure you like the disease process and you have a genuine interest – remember you will be spending 3-6 weeks solid reading up and writing this dissertation.
3. Read recent reviews (within 2 years) to get a broad area you want to cover in the dissertation – Journals such as Nature Reviews, Current Opinion and Annual Reviews are good places to start. Use these to highlight fundamental papers in the field e.g. those from 1980s which you can use in your introduction and potential primary sources.
4. Collate your primary sources reading only the abstract initially. When you have 15-20 read them fully and identify further potential sources and repeat. While reading them it is a good idea to collate say a table which summarises each paper. This means when you get to the planning you can easily put papers into subheadings where you can use them.
5. By this point you should be able to have a general outline of what you want to write about and create a skeleton off which you can hang sources. At this point you should now collect your figures.
6. When analysing each figure IGNORE what it says in the text.
• Do you understand the method behind this figure?
• What does this figure mean to you?
• What basic trend is shown?
• What are the flaws in the method/statistical significance/n=?
• How does this figure relate to other figures in this/other papers?
7. Each figure should have a point you wish to argue – collecting multiple graphs/blots/etc. together into one figure and saying Blah et al. adapted is OK. It is best to do the legend at the same time as creating the figure.
8. Now you should start writing the dissertation section at a time. Once you have done that try to reorganise it so that sections might be linked and can flow logically creating your argument. For example Section A: Regulators of X, A.1 Heart Rate, A.2 Blood Pressure. You can then divide these subsections into sub-subsections but don’t go further than this.
9. When writing the text stick to PEE – point, example, explanation with the example being your figure. You can then make it slicker later when reediting. Make sure you use a programme for your references e.g. Endnote for Word.
10. Write your conclusion and create some of your own figures which draw together many points you have made in your dissertation.
11. Now read it all and critically cut out parts you think are unnecessary and don’t contribute to your conclusion. Try to link subsections together and sections together. Check all your figures and legends meticulously and scrutinise your analysis.
12. Re-draft and re-draft. It may take 10-15 drafts for you to get it right.
13. Finally write your introduction and abstract.
14. Redraft and create all auxiliary features – table of contents, table of figures, table of abbreviations etc.
15. Presentation is everything – make sure it looks pretty e.g. put boxes around figures, grade the importance of titles using font size.
16. Check all your references manually – it’s easy marks and is a waste if you lose them for this.
17. Print and read through hard copy identifying any typos or mistakes such as figures being cut off at bottom of pages then rectify.
18. Print final copy x1 and check again then if happy print another and bind.