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My Second Year MBBS Experience

10-13 minutes

First of all, let me thank all those people who read my

article ‘My First Year MBBS Experience’ and gave valuable
feedback as comments and mails. Their feedback and
constructive criticism make me feel more responsible and
have been the stimuli to write this article.

Our finals exams ended on 20th of December 2015. I went

to attend cousin's marriage after that. But surprisingly, the
result came after three days. That too at 1.30 am. I was
waiting for the result from 10.00 pm onwards. My whole
family woke up from deep sleep because of my laughter in
the sense of victory. This time also I got 70% marks. I
couldn't sleep properly that night because I didn't expect
that much even though I was forced to go to my bed. So
what I want to say is that, second professionals is
comparatively easy.

The 2nd year rather 2nd professionals actually last for 18

months even though the name says something else. Third,
fourth and fifth semesters are devoted to 4 non clinical
subjects which are pathology, microbiology, forensic
medicine and pharmacology. The hangover of first year
exams may predominate over the thirst to learn in this year
which happened with me of course. Since I had enough
time, I started watching English movies and it improved my
vocabulary. As we all know that third semester is known as
the honeymoon period because no one will open the book.
Unlike first year since the questions are much more
predictable this year we used to skip the portions which
were least important as far as exams are concerned. As

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usual the initial exams were tragedies like ‘Othello’ of

Shakespeare. Frankly speaking, I passed only the pre final
and final exams of forensic medicine.

Most chapters of pharmacology and pathology start with

relevant physiology. So to understand these subjects well,
you have to revisit your physiology textbooks. But
microbiology and Forensic medicine are totally new
subjects. Just like all the first year subjects, these subjects
also have some general topics which would be taken in the
first month of the course. It would be good to spend time to
read relevant physiology.

Pharmacology is easy in the sense it is very closely related

to physiology. But at the same time it is difficult because
names of drugs are not very easy to remember. It is
important to have an idea because your relatives who think
that you have become a great doctor will definitely ask you
about some drugs and it will be embarrassing if you
couldn’t say about that. General pharmacology is easy to
understand because it consists of some basic concepts and
some calculations and I am sure that all medical students in
India have solved very difficult numericals in order to crack
the pre medical test. It is very interesting also. But still the
examiners are very fond of asking questions from this part
especially based on pharmacokinetics. My pre final long
question was based on zero order kinetics. The diagrams of
all drug receptors are important especially the G-protein
coupled receptors. The book Katzung is a good book to
undertand the concepts of pharmacology.

All the approved regimens and guidelines are very

important. For example, direct question about different
regimens of tuberculosis and malaria can come as a long
answer question. You have to learn the dose of those drugs
which are included in standard regimens. Otherwise except
for emergency drugs, you don’t have to learn the dose of
each drug by heart. Initially it will be very difficult to
remember the names of drugs. I also faced the same issue,

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and same will be case with 99% of medical students. With

practice and time this problem will get solved. Whenever
you read a topic, study the prototype drug well because the
other drugs will be very similar to the prototype and
questions will be mostly based on the prototype drug.
Pharmacological treatment of TB, Migraine, Myasthenia
Gravis, Gout, Rheumatoid Arthritis, Malaria etc. can appear
in the question paper and make you Hemodynamically
unstable. Read TB and malaria from an Indian book
because most of the foreign authors have not given enough
importance to these diseases because these are not
endemic in their countries. I used K.D Tripathi for this.
Another important question will be about the therapeutic
status of a particular drug. We have faced questions like
‘Write a short note on the current therapeutic status of
Methotrexate in Rheumatoid arthritis and beta blockers in
hyper tension’. For this question, write whether that drug is
the first choice drug or not and why. Chemotherapy was
difficult for me. The best way to study it is to correlate it
with microbiology.

Pathology is a special subject for me because I passed in all

exams of pathology like biochemistry in first year. This
statement doesn’t mean pathology was a cake walk for me.
It is a vast subject. Any disease will come under this. It
forms the base of medicine. But questions from pathology
usually come from limited portions. So the fact that the
questions are highly predictable makes it easy to pass.
Robbins is the book for pathology. It is slightly lengthy but
the explanations are too good. The pictures make it easy for
you to understand. Unlike general anatomy, general
physiology etc. general pathology is extremely important.
The ten chapters of general pathology are equally
important. The first chapter cell injury is such a chapter in
which nothing can be left unread. If you study neoplasia
well in general pathology, you can use that knowledge
whenever you encounter a neoplasm in systemic pathology.
Read Robbins regularly because it will take only 12 hours to

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forget everything that you read yesterday.

From systemic pathology heart, liver, G.I tract, lung and

blood are the most important. Anemia, especially iron
deficiency anemia is unavoidable especially in a country like
India where it is very common. AML, ALL, CML, CLL, Multiple
Myeloma, Hodgkin’s Lymphoma and Burkett’s Lymphoma
are the important neoplasms to be learned from the blood
cells chapter. Peripheral smear findings of these are as
important as iron deficiency anemia. Morphological features
of the concerned pathology both macroscopic and
microscopic, is a must to write in the answer sheet. So give
enough time for that. The best way to remember
microscopic morphology is to correlate with slides that you
see during practical classes. Pathologists like diagrams as
much as anatomists do. So for every question, try to draw a
diagram. Rarely, they do ask about questions like markers
of myocardial injury. Differentiate between two entities will
definitely come for exams. We always had four to five such
questions for each exam. Apoptosis versus Necrosis, White
thrombi versus Red Thrombi are examples. Examination of
CSF and urine are asked in practical exams. The
appearance of both in different conditions is asked in viva.
Instruments used for different procedures will be kept for
spotting and you can expect 2 questions based on that for
practical. I used Harsh Mohan’s practical manual. It is a
book worth spending money on. A detailed description of all
important topics in pathology can be found in my article on
Must Know Exam Topics in Pathology.

Microbiology means the study of micro organisms. But don’t

think that it is very small. In fact this subject ias a stand out
example of how small organism can increase the mental
stress of a medical student. It is one of the most memory
consuming subject. General bacteriology is easy. Bacterial
growth curve, bacterial genetics and drug resistance are
usually asked from this portion. Immunology was my
favorite topic. It is interesting and easy to score also.

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Bacteriology is vast and very difficult to remember. For me,

it was difficult to remember the virulence factors of each
bacteia. Fortunately our long questions were clinically
oriented, so we were not asked about virulence factors
often. Small chapters can also trouble you. We had question
like Hide Potter’s disease in our pre finals. Learn well the
approach towards the diagnosis of pathogens in cases of
diarrhea, dysentery, abscess, sore throat etc. Remember,
lab diagnosis is the most important question in
microbiology. Everything is well given in AnanthaNarayan.
Virology, mycology and parasitology are comparatively
easy. Life cycle and hosts are must know in parasitology.
HIV, Hepatitis B, Influenza and TORCH organisms are the
possible questions. Genetic shift and drift of influenza is a
burning topic because of the pandemic of H1N1 that
consumed the lives of many all over the world. Common
names like liver fluke, pin worm, seat worm etc. can be
asked in the viva in parasitology. I used Baveja for
parasitology. K D Chattejee is another option. Opportunistic
infection is the most important topic in mycology.

Forensic medicine was the subject towards which I was

slightly ignorant and the reward was poor scores. You just
need to have some common sense to understand forensic
medicine. All I.P.C sections are important. This subject is
important to learn because if you don’t know the laws, you
may land up in legal troubles. Age and sex determination
using bones is an important topic. The exciting part of this
subject is postmortem examination. It is interesting to see
hanging and accident cases and do an autopsy. My teacher
told me once that if you don’t know the definition of rape,
then you will fail. That much is the importance of sexual
offences. Toxicology is another part of this subject which is
amazing. I used the book written by V V Pillay. It contains
so many stories related to the subject. My friends used
Reddy and Parek.Weapon examination comes in practical
exam. Mention the types of injuries possible whenever you
get a weapon to examine. Forensic medicine is easy but

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don’t ignore this subject like I did.

This is a wonderful year because you have ample time to

enjoy and relax. Since course is of 18 months, there are
enough opportunities to bunk classes. It is the best time to
develop co curricular skills. Clinical postings will go
simultaneously with the non clinical subjects. It will be
great if you correlate the knowledge you gained from these
four subjects with the case allotted to you in the hospital.
Watch serials like House M.D now because now you can
understand the pathologies and drugs stated in that. If you
have time, then read my Final Year MBBS Experience.

Feel free to contact me. doc.sarathrs@gmail.com

Do visit my blog in wordpress.

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