Course Syllabus

Course Goals

The goal of the MCBM course is to prepare you for your years of clinical training and for the USMLE Step 1 exam by teaching you molecular biology, cell biology, genetics, biochemistry, and cell physiology.

As a practicing physician, you will have to be able to explain to your patients, in simple terms, various diagnostic procedures, diseases, and treatments.  You will be required to keep up with the medical literature and follow clinical research presentations.  Now is your one-time-chance to learn the necessary basic science; later on, you will neither hear this nor have time for this.  Lecturers in upcoming first- and second-year courses will expect that you are familiar with the material that is presented in the first year of medical school.  When you prepare for the USMLE step 1 exam, you will have only about 3 days to review the material that is presented in MCBM.  Later, clinical faculty will expect that you can apply principles of basic science to the care of patients.

We want to provide you with a foundation in cell biology, cell physiology, molecular biology, genetics, metabolism, and nutrition so that you will have an understanding of the molecular bases of disease.  We will give you the basic skills to use laboratory values for diagnostic purposes, and we will offer you opportunities to solve problems that relate to clinical practice.

Our course goals largely derive from, or are guided by, the JMC Learning Objectives.  These learning objectives are excerpted below according to their relevance to this course.

 

Professionalism

By the time of graduation, all students must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.  This includes:

3.   A commitment to honesty and integrity in all aspects of professional life (clinical, decision making, scientific pursuits, and interpersonal interactions).

 

 

Medical Knowledge

By the time of graduation, all students must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.  This includes:

1.   Knowledge of the normal structure and function of the body (as an intact organism) and each of its major organ systems.

2.   Knowledge of the molecular, cellular, biochemical, and physiologic processes that are important in maintaining the body’s homeostasis.

3.   Knowledge of the multiple causes (e.g. genetic, developmental, metabolic, toxic, microbiologic, autoimmune, neoplastic, degenerative, psychogenic, and traumatic) of maladies and the ways in which they affect the body (pathogenesis).

4.   Knowledge of the altered structure and function (pathology and pathophysiology) of the body and its major organ systems that are seen in various diseases and conditions.

5.   An understanding of the power of the scientific method in establishing the cause of disease, and in evaluating the efficacies of traditional and nontraditional therapies.

7.   Knowledge of the natural history and epidemiology of common/important illnesses within defined populations, and the individual and systematic strategies for health promotion and disease prevention.

8.   The knowledge and ability to identify factors that place individuals at risk for disease or injury, to select appropriate tests for detecting patients at risk for specific diseases or in the early stage of disease, and to determine strategies for responding appropriately.

9.   Knowledge of the process and value of research in the basic and clinical sciences.

 

 

Patient Care

By the time of graduation, all students must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.  This includes:

4.   The ability to appropriately select and interpret diagnostic tests used for screening and diagnosis of common/important illnesses, taking into account the cost, availability and limitations of these tests.

5.   The ability to reason deductively in solving clinical problems.

 

 

Interpersonal and Communication Skills

By the time of graduation, all students must demonstrate interpersonal and communication skills that result in the effective exchange of information and facilitate collaboration. These include:

1.   The ability to communicate effectively, both orally and in writing, with patients, patients' families, colleagues, and others with whom physicians interact in the professional setting.

3.   The ability to work within a patient care team to provide safe and effective patient care.

6.   The ability to effectively teach patients, families, colleagues and other health professionals.

 

 

Lifelong Learning

Medical school is the first formal step in the lifelong process of medical education.  To build and sustain professional competence, by the time of graduation, all students must have:

1.   The capacity to recognize limitations in one’s own knowledge and clinical skills, to seek advice and to use constructive feedback to improve performance.

2.   The capacity to recognize one’s own attitudes, including personal strengths, limitations, and vulnerabilities, to employ appropriate coping strategies and seek assistance when needed.

3.   An understanding of the need to be continuously setting personal learning and achievement goals and to engage in lifelong learning to stay abreast of relevant advances in medical care.

 

Besides  the JMC Learning Objectives, our course goals are also guided by recently developed competencies in biochemistry, that subserve the ACGME core competencies for physicians at the end of residency training and the AAMC “Recommendations for Clinical Skills Curricula for Undergraduate Medical Education”.  The following biochemistry core competencies were adopted by the Association of Biochemistry Course Directors at their 2011 meeting:

 

 

Competency Domain	Proposed biochemistry competency	Sample learning objective
Medical Knowledge	Apply and integrate   molecular and metabolic knowledge of conditions and disease states for   clinical problem solving (e.g.,   metabolic syndrome, diabetes,   carcinogenesis, tissue regeneration, mental illness, amyloid diseases).	Explain the biochemical basis of (disease).
	Apply molecular and   metabolic reasoning to evaluate clinical and translational research.	Describe how the development of effective therapies is based   on an understanding of the molecular or metabolic nature of (disease).
Patient Care   Sub-Domain: Clinical Testing	Select, justify, and interpret the   results of clinical tests in order to identify likely molecular and metabolic   causes of disease states.   (e.g., PCR, flow cytometry, mass spectrometry, immunologically based tests,   complete blood count, comprehensive metabolic panel, hemoglobin   electrophoresis, serum iron studies, uric acid, lipid panel).	Predict the results of (specific lab tests)   for a patient with (specific disease/condition).
Patient Care   Sub-Domain: Diagnosis	Based on patient history, physical exam, medical record,   and/or laboratory test results, develop differential diagnoses for molecular   and metabolic causes of disease states (e.g., genetically inherited   causes of dyslipidemia, metabolic acidosis, hyperbilirubinemia, hypoglycemia,   hyperammonemia, hemolysis).	Prioritize   and justify diagnoses that explain a (presenting symptom, physical exam   finding, lab test).
Patient Care   Sub-Domain: Clinical Intervention	Select and apply   preventive, curative, and/or palliative strategies for the management of   conditions or disease states with a molecular or metabolic basis (e.g., aging,   pregnancy,diabetes, hypercholesterolemia,   hereditary breast cancer, Lynch syndrome, hemoglobinopathies, galactosemia,   glucose 6-phosphate dehydrogenase deficiency, mitochondrial diseases,   glycogen storage diseases, urea cycle disorders, lysosomal storage diseases,   gout , fatty acid oxidation deficiencies, PKU, alcoholism, poisoning).	Explain the biochemical basis of the use of (specific   clinical intervention) in the treatment of (specific disease/condition).
	Predict the effectiveness of, and   possible adverse effects associated with, interventions for conditions or   diseases based on knowledge of molecular, genetic and cellular regulatory   mechanisms (e.g., reduction of   dietary trans fats for dyslipidemia, increased exercise for insulin   resistance, insulin analogs for hyperglycemia, allopurinol for hyperuricemia,   statins for hypercholesterolemia, Imatinib for CML or GIST, ATRA for APL).	Explain the   biochemical basis of (specific toxicities) seen with (specific clinical   intervention).
Practice-Based Learning and   Improvement	Evaluate the molecular and metabolic   plausibility of claims made in the medical and lay public literature based on   appraisal of scientific evidence and biochemical reasoning.	Produce a written or oral evaluation of   an advertisement for a (drug, nutritional supplement, etc), citing current   literature.
	Demonstrate curiosity about the   molecular and biochemical basis for the maintenance of health and the   causation of disease.	Formulate a question the answer to which   could improve diagnosis and/or treatment of patients.
	Demonstrate knowledge and appropriate   use of information literacy for the clinical diagnosis, testing, and   understanding of biochemistry-based conditions.	Conduct a   literature search and identify the most relevant articles or other forms of   information regarding (disease).
	Based on assessment data and feedback   related to biochemistry, reflect on one’s own performance to identify   strengths and challenges, set learning and improvement goals, and engage in   appropriate learning activities to meet those goals.	Document evidence of reflection on progress toward learning   goals.
Interpersonal   and Communication Skills	Effectively explain to   patients from a variety of backgrounds the molecular and metabolic basis of   conditions and disease states and how lifestyle and/or therapeutic   interventions can alter their manifestations.	Explain   the molecular basis of (disease) to a standardized patient.
	Communicate   biochemical reasoning effectively with peers, medical school staff and   faculty, and other members of the health care team.	Teach a peer about (biochemical process) and   ensure that the peer meets the relevant learning objectives.
	Communicate enthusiasm for   knowledge to patients and professional colleagues.	Ask thoughtful questions regarding how we know   what we know, and how we can learn more.

 

 

Professionalism	Demonstrate empathy and   respect towards patients regardless of the biochemical nature of their   disease and with sensitivity to diversity (e.g., obesity, cancer, depression, alcoholism).	Reflect about your personal biases regarding the   causes of (disease).
	Demonstrate respect,   accountability, and reliability in interactions with patients, families,   peers, and other healthcare professionals.	Arrive on time to required   sessions and meet deadlines without reminders.
	Demonstrate ethical behavior   and integrity in one’s work (e.g., cite sources, appropriately attribute   ideas, acknowledge gaps in knowledge or skills and seek help when needed).	Cite resources   appropriately.
Systems-Based Practice	Demonstrate effective use of   nutrition, lifestyle and genetic counseling referral services.	Identify when to consult a dietitian or genetics   counselor.
	Contain healthcare   costs by selecting and justifying diagnostic measures and treatments.	Prioritize and justify the use of   (specific diagnostic test) for patients with (specific signs and symptoms).

 

 

The ABCD also developed a large set of learning objectives, as well as topics that should be taught, that guide students towards the desired competencies.  Some of these learning objectives, often slightly modified, can be found in some of the notes for this course.

 

 

 

Course Directors

 

Dr. Peter Ronner is the director of the Molecular and Cellular Basis of Medicine course.  Office: 250 BLSB.  E -mail: peter.ronner@jefferson.edu.  Phone: (215) 503-5190.

 

Dr. Sue Menko (571 JAH, Sue.Menko@jefferson.edu) and Dr. Jan Hoek (269 JAH, Jan.Hoek@jefferson.edu) are the co-directors for cell biology.

 

Dr. Mark Fortini (830 BLSB, Mark.Fortini@jefferson.edu) is the co-director for genetics.

 

Dr. Thomas Butler (445 JAH, Tom.Butler@jefferson.edu) is the co-director for cell physiology.

 

 

 

Team-Teaching

 

We are faculty members of several departments who team-teach the MCBM course.  Most of us carry out both research and teaching. 

 

We worked hard to integrate the many different contributions of the various lecturers into a coherent picture. 

 

We encourage you to get to know at least some of the faculty on a personal basis.

 

 

 

Course Web Site

 

It is crucial that you have access to the course web site (please log in via http://pulse.jefferson.edu).  If you do not yet have access to this site, please inform the course director immediately.

 

You are expected to check the course web site for announcements daily.

 

 

 

New In This Year's Course

 

In response to last year's student evaluations, we made the following changes:

• Every lecturer received the personal suggestions for improvements from last year's students.
• We gave several lectures a major overhaul and improved others as well, though less noticeably.
• We added a problem-solving session on blood labs, heme metabolism, and iron homeostasis.
• We condensed the cytogenetics sessions from 5 to 3.

 

In addition, we made the following changes:

• We scheduled related topics in closer sequence.
• We are increasing further our emphasis on testing you with USMLE Step 1-type exam questions.
• We added a lecture on personalized medicine
• Dr. Walker is newly teaching Cell-Cell Junctions and Cell Biology of Cell Division (previously taught by Dr. Menko)
• M.D./Ph.D. students who went through 2 years of medical school atJeffersonwill hold review sessions a few days before exams.

 

New In Last Year's Course

 

In response to last year's student evaluations, we made the following changes:

• Every lecturer received the personal suggestions for improvements from last year's students.
• We gave several lectures a major overhaul and improved others as well, though less noticeably.
• We will do better with posting preliminary files of lecture slides by the evening before class.

 

In addition, we made the following changes:

• We lost two lecturers (Drs. Taraschi, and Williams) and we gained two new ones: Dr. Mark Fortini, and Dr. Andrzej Fertala).  Dr. Fortini is also the new co-director for the genetics section of MCBM.
• We added a problem-solving session on Protein Structure at the end of the first week.
• We added a Team-Based Learning (TBL) session at the end of the third week to review some of the material that will be on the first exam.
• We are increasing further our emphasis on preparation for the Step 1 USMLE exam.
• We will offer a few optional review sessions to see whether students find these helpful.

 

 

 

Books to Consider

 

• The MCBM course integrates molecular biology, cell biology, genetics, metabolism, and cell physiology.

 

• We are not aware of a single book that covers all of the areas of the MCBM course adequately.  Hence, please consider the following:

-          As we did with your predecessors, we provide you with lecture notes that should contain most of the important information.  Previous students have used these notes as their main study tool.

-          While we do not require that you read a book, we recommend that you use some of your study time to do this.  Your time with books is most likely best spent looking at USMLE Step 1 practice questions.  Research has shown that solving problems or exam questions is a very effective way of learning.

-          At the end of the second year you will have to pass the national USMLE step 1 exam.  At most, you will have a few weeks to prepare for this exam by reviewing all of the first- and second-year courses.  It will be advantageous to you to have all of the necessary information in a familiar place and format.  Furthermore, early in the MCBM course, you should familiarize yourself with the style of board exam questions so that you are optimally prepared for the exam.

-          Everyone has their own style of learning and their own preferences.  You should choose books that you like to work with and that you will like to use as references in years to come.

-          If you have books from your undergraduate courses you will probably continue to use them.

-          You might want to share books with friends, roommates, study-mates, etc.

 

 

• For the cell biology topics in MCBM, we recommend that you consider the following book, which will also help you with the molecular biology topics (our instruction is at a much more basic level, though):

 

B Alberts et al., Molecular Biology of the Cell, 5^th edition, Garland Science, 2007, 1392 pages, hardcover, about $155.  eBook purchase (2010 prices): $106.00; 1 year e-rental: $91.00; 180 day e-rental: $76.00.  This book is written more for graduate students, but a lot of medical students like to use it once in a while.

Link: http://www.garlandscience.com/textbooks/0815341059.asp

 

(5 chapters of this book are not printed but included on a CD as pdf files)

 

Please note that a 2002 edition of this book is also available on line in the Books section of the PubMed website:  http://www.ncbi.nlm.nih.gov/sites/entrez?db=Books.  Books are listed alphabetically by title.  Click on the title.  To see any book content, you have to search for something.  What you get in return is very limited.  This online resource is a low-quality band-aid.  If you want to study the material from this book seriously, you will need to use a hardcopy.

B Alberts et al., Essential Cell Biology, 3rd edition, Garland Science, 2009, 860 pages, ISBN-13: 978-0-8153-4129-1.  Hardback: about $144.  eBook purchase (2010 prices): $97.00; 1 year e-rental: $83.00; 180 day e-rental: $69.00.  Some faculty (Dr. Winter, Dr. Johnson) feel that this book covers fairly well the molecular biology you need to know; others (e.g., Dr. Menko) say that this book does not cover cell biology in sufficient detail.

Link: http://www.garlandscience.com/textbooks/0815341296.asp?type=ebook

 

 

N Chandar,S Viselli:  Lippincott’s Illustrated Reviews:  Cell and Molecular Biology, 248 p., 2010, about $46.50; ISBN-10: 0-7817-9210-X; ISBN-13: 978-0-7817-9210-3.  Faculty have widely different opinions of this new book, probably because the chapters are of unequal quality.  DNA coverage is excellent, but the coverage of transcription is too brief and not well explained.  The description of translation is okay, but the cell biology is described in a very simplistic manner.

http://www.lww.com/product/?978-0-7817-9210-3

 

 

• For the genetics portion we recommend that you consider one of the following three books:

 

BR Korf, Human Genetics and Genomics, 3^rd edition, 2006, 288 p., about $73.  This book contains both molecular biology and genetics at an intermediate level of detail.

Link: http://www.blackwellpublishing.com/book.asp?ref=9780632046560&site=1

 

JA Westman, Medical Genetics for the Modern Clinician, 1^st edition, Lippincott Williams & Wilkins, 2005, 256 p., about $51.  This book is very concise and the author emphasizes clinical genetics.

Link:  http://www.lww.com/product/?978-0-7817-5760-7

 

T Strachan and AP Read, Human Molecular Genetics, 4th edition, Garland Science, 2010, 781 pages.  About $147.  This book is very comprehensive; it is for the student who wants to get in-depth information about genetics.

Link: http://www.garlandscience.co.uk/textbooks/0815341822.asp

 

The 1999 / 2^nd edition of this book is available for free at PubMed:

http://www.ncbi.nlm.nih.gov/books/NBK7580/

• For the topics in metabolism we have never seen a book that we faculty truly like.  In the past, the most popular book with our students has been "Lippincott's Biochemistry" (see below).  Most students buy this book for its diagrams.  

 

RA Harvey, and DR Ferrier, Lippincott's Illustrated Reviews: Biochemistry, 5^th edition, Lippincott, 2010, 528 pages, about $67.  (The 4^th or 3^rd edition are also acceptable.)

Link: http://www.lww.com/product/Lippincotts-Illustrated-Reviews-Biochemistry/?978-1-60831-412-6

 

The nationwide bestseller among biochemistry books for medical students is Marks’ Basic Medical Biochemistry; A Clinical Approach by MA Lieberman and A Marks, Lippincott, 3^rd ed., 2008, 1024 p., about $74 as an e-book (print version is out of stock).  This book has some clinical correlations that many other books lack.  However, many readers object to the naming of patients in clinical correlations.

Link: http://www.lww.com/product/?978-0-7817-7022-4

 

There is an abbreviated, 580-page version of the above book; it is Marks’ Essential Medical Biochemistry by MA Lieberman, A Marks, and CW Smith, Lippincott, 2006, 584 p., about $60.  This is a cheaper alternative to the full edition; you still get about the same information.  A new edition is likely to come out very soon.

Link:  http://www.lww.com/product/?978-0-7817-9340-7

 

 

Another fairly popular book is:

RK Murray et al., Harper’s Illustrated Biochemistry, 28e, McGraw-Hill Publishers, 2009, 693 p., ISBN 0071500928 / 9780071500920, about $61.

Link:  http://www.mhprofessional.com/product.php?cat=116&isbn=0071625917

Note: This book is available on Jeffline as an e-Book.

 

 

If you never had Biochemistry, and if biochemistry seems foreign to you, you might benefit from reading an older edition of L Stryer’s Biochemistry (4^th edition or older).  (The 5^th edition by JM Berg et al. is very disorganized.)  You can also use the latest, 7^th edition by JM Berg, JL Tymoczko, and L Stryer, WH Freeman, 2012, 1120 p., about $178.  ISBN-10: 1-4292-2936-5 ; ISBN-13: 978-1-4292-2936-4.  This book is particularly well suited to learning the material on DNA that Dr. Winter presents.

Link: http://www.whfreeman.com/Catalog/product/biochemistry-seventhedition-berg

 

 

The 2002 edition of L. Stryer’s Biochemistry is available for free at the PubMed website http://www.ncbi.nlm.nih.gov/books/NBK21154/.  In order to view the book's content, you have to log in and search for something, which is a pain.

 

 

Some of you may like Lehninger Principles of Biochemistry, 5^th edition, by DL Nelson and MM Cox, W.H. Freeman Publishers, 2009, 1100 p., about $189.

Link:  http://www.whfreeman.com/newcatalog.aspx?disc=Biochemistry&course=Introduction%2Bto%2BBiochemistry&isbn=071677108X

Please also use other biochemistry books that you own or that are in the library's collection.

 

 

• For the cell physiology portion we do not specifically recommend a book.  If you would like to have a suggestion tailored to your needs, then please ask Dr. Thomas Butler (Thomas.Butler@jefferson.edu).

 

 

• We would like to suggest that you start practicing for the USMLE step 1 now.  You can use as many books as you like.  The following books are some of the better ones:

 

RW Dudek: BRS Genetics, 352 p., 2009, about $44; ISBN-10: 0-7817-9994-5; ISBN-13: 978-0-7817-9994-2.  This book has lots of illustrations.

http://www.lww.com/product/?978-0-7817-9994-2

 

 

GN Wilson, Biochemistry and Genetics PreTest Self-Assessment and Review, 4^th edition, McGraw-Hill Publishers, 2010, 528 p., ISBN 0071623485 / 9780071623483, about $32.

Link: http://www.mhprofessional.com/product.php?cat=116&isbn=0071471839&cat=116

 

 

TA Swanson, SI Kim, MJ Glucksman: BRS Biochemistry, Molecular Biology, and Genetics, 432 p., 2010; about $46; ISBN-10: 0-7817-9875-2; ISBN-13: 978-0-7817-9875-4.  The questions in this book tend to be a little bit weird.

http://www.lww.com/product/?978-0-7817-9875-4

 

 

MA Lieberman, R Ricer: Lippincott’s Illustrated Q&A Review of Biochemistry, 224 p, 2009, about $44; ISBN-10: 1-60547-302-2; ISBN-13: 978-1-60547-302-4.  The questions are good!  Dr. Lieberman has also written questions for the NBME.

http://www.lww.com/product/?978-1-60547-302-4

 

 

MW King: Lange Q&A USMLE Step 1, Sixth Edition, 528 p., 2008, about $47; ISBN-10: 0071492194, ISBN-13: 9780071492195.  This book has 128 questions on biochemistry.

http://www.mhprofessional.com/product.php?cat=108&isbn=0071492194

 

 

T Le: First Aid Cases for the USMLE Step 1, 3e, 512 p., 2012; about $45; ISBN-10: 007160135X;  ISBN-13:  9780071601351.  This book has 19 cases in biochemistry; many are uncommon (e.g., Hurler syndrome). http://www.mhprofessional.com/product.php?cat=108&isbn=007160135X     T Le, V Bhushan, J Tolles: First Aid for the USMLE Step 1 2011, 623 p., 2010; about $45; ISBN-10: 0071742301; ISBN-13: 9780071742306.  Some of the pages are a review of biochemistry. http://www.mhprofessional.com/product.php?isbn=0071742301 RM Klein: Anatomy, histology and cell biology: PreTest self-assessment and review, 3e, 2007, available online (Jeffline).  The questions seem to require a lot of memorization and little reasoning.  The question stems are much longer than those on USMLE shelf exams.  

 

GH Sack, USMLE Road Map: Genetics. McGraw-Hill Publishing, 2008.  Available online (Jeffline) as an e-book.  The questions in this book require more experience and knowledge than we can convey in MCBM.  The answers often seem much more diverse than those in a typical USMLE question. 

 

 

• A medical dictionary is highly recommended, not so much for the molecular biology, genetics, cell biology, and biochemistry proper, but to look up the meaning of medical terms.  You will keep using this dictionary during your practice of medicine too. 

An excellent choice is Dorland’s Illustrated Medical Dictionary, 32^nd edition, Elsevier, 2011, 2176 p., about $52.  Link: http://www.elsevier.com/wps/find/bookdescription.cws_home/724999/description#description

 

(Please note that while Stedman's Medical Dictionary for the Health Professions and Nursing is a beautiful book, the explanations of many terms in biochemistry are atrociously wrong.) 

 

 

 

Resources for the Expert and Life-Long Learner

• Databases, such asPubMed,MDConsult, UpToDate.
• Scriver CR et al., “The Metabolic and Molecular Bases of Inherited Disease”, 4 volumes, 2001.  Scott Library: WD 205 M587 2001.  Now, this book is updated and published only on-line, butJeffersonno longer subscribes to it. 
• Professional journals, such as New England Journal of Medicine, JAMA.

 

 

 

Books and DVDs that are on Reserve at the Circulation Desk in the Library for the Duration of MCBM

These books are available at the Circulation desk for 2 hours at a time.  If access is a major problem, please let the course director know so that extra copies can be made available.

 

QU 450 G46 2003  Gene Technology (DVD)

QH 581.2 M718 2008  B Alberts et al., Molecular Biology of the Cell, 5^th edition, Garland Science, 2008.

 

N Chandar,S Viselli:  Lippincott’s Illustrated Reviews:  Cell and Molecular Biology

QH 581.2 E78 2009  Alberts Essential Cell Biology, 3rd edition, Garland Science, 2009.

 

QZ 50 K84h 2007  BR Korf, Human Genetics and Genomics, 3^rd edition, Blackwell Science, 2007.

 

QZ 50 K84H 2000   BR Korf, Human Genetics, A Problem-Based Approach, 2^nd edition, Blackwell Science, 2000.

 

QZ 50 W516m 2006  JA Westman, Medical Genetics for the Modern Clinician, 1^st edition, Lippincott Williams & Wilkins, 2006.

 

QH 442 S894h 2004  T Strachan and AP Read, Human Molecular Genetics, 3^rd edition, Garland Science, 2004.

 

QH 431 T473g 2007  RL Nussbaum et al., Thompson and Thompson's Genetics in Medicine, 7^th edition, Elsevier, 2007.

 

QU 18 C451b 2008  PC Champe, RA Harvey, and DR Ferrier, Lippincott's Illustrated Reviews: Biochemistry, 4^th edition, Lippincott, 2008. 

 

QU 4 M346b 2005  Marks’ Basic Medical Biochemistry by CW Smith, A Marks, and MA Lieberman, Lippincott, 2005.

 

QU 4 R454b 2009  Harper's Illustrated Biochemistry by RK Murray, Lange Medical Books, 2009.

(also available on Jeffline as an e-Book)

 

QU 4 S928B 2007  JM Berg et al., Biochemistry, 6^th edition, 2007.

 

QU 4 S928B 1995  L Stryer, Biochemistry, 4th ed., 1995.

 

QU 4 L523p 2008  Lehninger Principles of Biochemistry, 5^th edition, by DL Nelson and MM Cox, W.H. Freeman Publishers, 2008.

 

QU 4 L523p 2005  Lehninger Principles of Biochemistry, 4^th edition, by DL Nelson and MM Cox, W.H. Freeman Publishers, 2005.

 

QU 18.2 B6155 2007  Biochemistry and genetics : PreTest self-assessment and review, 3^rd edition, by G Wilson.

 

 

 

 

Suggestions for Studying

 

The following are some suggestions from previous students:

 

• In the beginning, I should have completed every lecture from the day that evening.  I started doing this in the January portion and it helped a lot.  I would definitely recommend to the incoming class to make sure they go over the day’s material that day and complete it.  Repetition is key.
• The study groups helped me a lot.  ...  I took a little while to figure this out, but the advice I have is: always preread (even only for 15 minutes helps), listen and highlight/take notes on the lecture notes, read over lecture notes and summarize concisely in your own words.
• I have been studying in a group since the first day of medical school. Although I studied individually during my undergraduate years, I have found group studying in medical school extremely helpful. It provides a source for questions, but perhaps most importantly, companionship during the long studying hours.

 

Everyone has their own preexisting knowledge, talents, interests, ways of learning, and social network.  The following is written mostly for those students who would like to consider another person’s ideas.  If you feel that your own techniques do not provide you with the expected results, please do try some of these ideas.

• Key ingredients for success are organization, motivation, efficiency, and a social network with classmates.
• Being well-organized is incredibly important.  Maintain a calendar that contains the course schedule, appointments, your daily study plan, and other important items.  Know, where your books, papers and files are.  Create and maintain an environment that is conducive to learning.
• Time is limited.  You have approximately 4 hours per lecture to preread, attend lecture, study the material, do homework problems, commit concepts and words to memory, and have a discussion with other students.  Try to be super efficient in your use of time.
• Figure out how and when you get the highest return for your study time.  Plan your studies accordingly.  Complete undemanding tasks when you are tired.
• Prereading the notes for a lecture for about 5 minutes helps you know where the lecturer will lead you, how concepts might look, and at which point you have to pay special attention.  If prereading takes you more than about 20 minutes per lecture, consider asking an experienced colleague to give you a quick preview.
• While attending a lecture, figure out where the lecturer puts the emphasis.  Make notes about this in the syllabus so that you know what the most important ideas are and what constitutes a negligible detail.  If a lecturer spends 10 seconds on an issue, this topic is much less important than the one the lecturer talks about for 10 minutes.
• You may want to prepare a 1-page summary of each lecture, show this to a colleague (Is it reasonably complete?  Is it accurate?), and by the time the exam comes up be able to reproduce it from memory.  A recent paper (JD Karpicke and JR Blunt, Science 331: 772-5, 2011:  Retrieval practice produces more learning than elaborative studying with concept mapping) seems to support the notion that frequently telling yourself (or a colleague) how something works is a highly efficient way of learning science. Variation of this theme: VARK-learn.com suggests reducing lecture notes 3:1..
• You need to commit material to long-term memory.  You will probably have to jog your memory several times, initially within 24 hours of the lecture, then, perhaps every 1-3 days, and finally maybe once a week.
• When reviewing material, deal with the most important concepts first.  Do not read what you know already; instead, figure out your deficiencies and then correct them.  Strive to be able to teach a concept knowledgeably.
• Solving problems helps you be prepared for exams and clinical practice, and it also enhances long-term retention of the material (i.e., many students learn by doing).
• If you are in the habit of rewriting every lecture, please consider using a more efficient approach to learning, such as writing a 1-page summary and practice re-creating it from memory (see above).
• When studying, take occasional breaks and reflect on what you have been doing.  Are you using your time in the best possible way?  Are you getting lost on a tangent?  Was something you did especially helpful?  What is most important for you to do next?
• Allow yourself plenty of time before exams to understand all concepts.  Last-minute cramming is almost impossible.  Also, be aware that to solve many of the problem in our exams requires that you prepare more thoroughly than you would if we just asked for cued recall of facts.  You have to be able to teach the outlines of every major topic or concept in 1-3 minutes.
• In their book, How to Succeed at Medical School (see below), D Evans and J Brown write the following about cramming (p. 19): “You might in the past have crammed for exams, and your memory might be such that you can memorise a whole lot of facts and hold them in your memory for a week or two.  There are three problems with doing this in medicine.  First, the volume of facts will become too great to hold; at some point you will not be able to manage, and at that point you will realise that you are actually years behind in your knowledge.  Second, you will not be asked to just regurgitate facts, instead you will be asked to apply knowledge: you need a deep level of understanding to be able to do this, and cramming doesn’t give you that kind of level.  Finally, and most importantly, you are not studying to pass exams, you are studying to be a doctor.  Cramming information in your head just before an exam and forgetting it shortly after will not help you care for patients, regardless of whether you passed.”
• It is very helpful to discuss the course material with colleagues.  You may have to try out several study groups until you find a good match.  In the past, some successful study groups met daily in a dorm room for an hour at the conclusion of a day’s study efforts.  This approach motivates you to get the day’s work done and attend group meetings, even when you do not feel 100% prepared.  If your grades are not what you expected, and if you are not a member of a study group, please try out a study group for at least one exam cycle.  You may want to teach each other from memory (not from notes), exchange 1-page summaries, check out each other’s attainment of learning objectives or ask each other questions.  Many students say that a group that is all business is preferable over a group of friends.
• The following suggestions about group work come from the book by Evans and Brown (please see the reference below):  They say the fact that the whole is greater than the sum of its parts may be a good selling point for you to start a group.  They suggest that you start with clearly stated objectives for which everyone can prepare.  They also write that the members of the study group do not have to be your friends - they have to be colleagues whom you can work with.  Finally, they warn that every group goes through a rocky phase, soon after being formed, but that this usually leads to a more successful group.  For more ideas about study groups, please see "External Links" on the course website.
• At exam time, you are expected to apply scientific rigor to figure out which answers are wrong and which answer is right.  Hence, when you present material to a colleague, ask her/him to be very critical of you to make sure that you understand the underlying concepts well and talk about concepts in the correct terms.
• Stay informed about what is going on in the course (read the announcements, talk to colleagues).
• Find out what the exams will be like.  Attend the mock exam.  Check out the online exam (perhaps early in the block so you know the target, but certainly well before the exam).  Make sure that you can answer all practice questions correctly; do not just use the practice exam as an indicator of your likely exam grade.
• Do not neglect MCBM because of pressure from ICM-1 (or vice versa).  At the end of each week, be up-to-date with your studies.
• Get enough sleep to be mentally alert and stay healthy.
• If you have not yet had a course related to MCBM and do not have a science background, you will need to devote more time to the course than your colleagues who have a science background.
• If you need help understanding a concept, please feel free to ask the faculty.
• Should you be in trouble academically, please seek the advice of faculty and student deans right away.
• If you have exam anxiety, please consider some proven methods.  You can try relaxation or take a course in yoga.  In a recent experiment it was found that high-school students handled exam stress better, if they wrote a 10-minute essay about their stress right before the exam.
• Keep in mind the relevance of cell biology, molecular biology, genetics, physiology, and biochemistry.  If you learn these fields this time, you will not have to restudy them as much when you cram for the board exams, or when you are in your busy clinical years.
• If you wonder about balancing your time (work and pleasure) optimally, you might like to read Stephen Covey’s “The 7 Habits of Highly Effective People”.  This book is available in every bookstore in the self-help section, and it is an easy read.
• The following is a book that is aimed at medical students in general: D Evans and J Brown: How to succeed at medical school; an essential guide to learning; Wiley-Blackwell, 179 pages, 2009.  ISBN: 978-1-4051-5139-9.  TJU library call number: W 18 E922h 2009.

 

 

 

 

Study Detractors

If you experience a major illness or any problem that keeps you from studying, you are strongly encouraged to talk to a physician in Student Health and/or your dean of student affairs before your grades are affected negatively.  Sometimes, it is possible to make an exam accommodation.  However, once a poor exam grade exists, the grade can not be changed or deleted.

 

 

 

Help Available

 

Every lecturer will be available for questions.  Please contact the instructor via e-mail, and/or make an appointment before going to a lecturer’s office.

 

Every student has her/his own strengths and weaknesses, and teamwork helps everyone learn the material.  A few weeks into the course, we will set up a “Buddy” program in which students who excel are paired with students who are having difficulty with the course.  Both “buddies” commit to an initial and a follow-up meeting, in which they might discuss how best to study and how to prepare for an exam, as well as practice teaching the core material.  Thereafter, further meetings are entirely up to the “buddies”.

 

A list of tutors will be available from the course director.  In our experience, it is uncommon that a student truly needs a tutor.

 

Students who score less than about 70 in an exam will receive a personal e-mail invitation to talk individually with the course director as well as their student dean.

 

 

Course Evaluations

 

Evaluations will be carried out online on an ongoing basis and finished after each examination.  You will be assigned to evaluate one portion (i.e., one third) of the course.

Your evaluations are tremendously important to us.  We want to learn from you what worked well in this course, and what needs improvement.  Similarly, individual faculty are interested in learning about ways to improve their syllabi and lectures.  Thank you very much in advance for your invaluable help and suggestions!

Student representatives to the Committee on Curriculum have repeatedly expressed the view that one of the duties of being a medical student is to fill in course evaluations.  A course evaluation can only be considered representative, if at least about 80% of the assigned students have filled in an evaluation.  For this reason, exam grades will be released only after 80% of assigned students have submitted a course evaluation.

Your evaluations are part of a systematic evaluation of teaching at JeffersonMedicalCollege.  The course director will evaluate the teaching of each instructor, and your evaluations will be an important part of this document.  For each faculty member, the course director will then report to the appropriate chairperson a summary evaluation of "highly effective", "effective", or "needs improvement".  If a faculty member receives a rating of "needs improvement", the course director may provide the department chair verbatim with several of your comments.  Dr. Rattner (Senior Associate Dean of Undergraduate Medical Education) will review your evaluations of the course and course director, as well as the faculty's evaluations of the course director.

Based on your evaluations, the MCBM course liaisons will present a summary of concerns and suggested improvements to the First-Year Taskforce, which consists of the Dean of Undergraduate Medical Education (Dr. Rattner), all first-year student liaisons, and all first-year course directors, and which will be attended by the Chair of the Committee on Curriculum (Dr. Isenberg).  A summary of these deliberations, as well as a plan of action will then be presented to the full Committee on Curriculum.

A summary of changes made to the MCBM course as a result of last year's evaluations is provided elsewhere in these introductory pages.

 

 

 

Exams and Grades:

 

We expect that you will be able to use the information we presented to you to solve medically relevant problems.  In exams, many problems will be intended to be totally new to you, and you will be expected to solve them with only the knowledge we provided to you in the course.

 

The exam questions will largely be written in the style of the step 1 national board exams (see http://www.nbme.org/publications/item-writing-manual.html; however, we use only multiple choice/one best answer items.

 

We urge you to learn primarily for your own benefit as a future practicing physician, rather than to pass our exams.

 

Grades for the first two years of medical school are not all-important.  In the exams, not all of you will get 90s; the average score will likely be 77-85.  Your final Dean’s letter for your residency application will summarize your performance during the first two years in just one short paragraph.

 

The exams are designed to ensure that the students who have a passing score (³70) can adequately deal with questions related to cell biology, cell physiology, molecular biology, genetics, or biochemistry.

 

The exams may involve material from the following sources: all materials handed out or posted on the website, all assigned readings, and all classes held.  Questions in the second and third exams may relate to important concepts presented in earlier parts of the course.

 

We will provide you with online sample exam questions.

 

The exam questions are the property exclusively of the faculty who write them.

 

It is a breech of the professional code of conduct for anyone to retain, remove, collect, reconstruct, copy, distribute, or study any question(s) of exams from 1998 onward that have not been specifically made available by the course director.  For all exams since 1998, short answer statements were handed out, and their use in exam preparation is acceptable. For study purposes, the use of Biochemistry 100 back-exams from 1997 and before is also acceptable.

 

If you need any kind of special accommodation for a disability, please let the course director know as soon as possible, but at least by 12 noon on the day before the exam (e-mail is most convenient).

 

JMC exam rules will be in effect.  Thus, during an exam, the use of calculators, computers, phones, cameras or any other electronic equipment is not allowed.  You are also not allowed to use any notes during an exam.

 

For exams, we expect you to arrive on time.  If you arrive late, you will not be given extra time.  If you arrive after the first half of the exam time, you will not be seated and receive a grade of zero.  Exceptions will be granted if you bear the consequence of an incident that was completely out of your control (e.g., a 2-hour interruption of train service during a good-weather day, not a 10-minute lateness of a SEPTA train).  After the exam, you may have to provide proof of the unusual circumstance that led to your lateness.  Even though you were allowed to sit for the exam, your exam grade could be revoked, if it turns out that the initial accommodation was not justified.

 

Exemption from an exam:  According to the Student Handbook, students are excused from scheduled class examinations “only for the most extraordinary of circumstances, such as acute debilitating illness or unanticipated family emergencies”.  However, in practice, accommodations are made for instance if you have not been able to study for a few days because of illness or a family emergency.  If you are not sure whether you qualify, please get in touch with your student dean, with Student Health, or with the course director.

If you feel that you cannot attend a regularly scheduled exam, you have to get permission from the course director, who works closely with the student deans.  If you have an illness, you must provide your student dean with a note from the Student Health Service.  If you have an acute family emergency or if you have an ongoing major problem (other than illness) that prevents you from studying, you must communicate this also with your student dean.  The student dean will then communicate with the course director with an appropriate measure of confidentiality.  Please note that you must inform the course director in a timely manner before the exam, or else as soon as possible around the time of the exam.  The course director’s phone number is 215-503-5190 (you can leave a message) and his e-mail is peter.ronner@jefferson.edu.

If you are worried about infecting other students or disturbing other students with your coughing, please ask the course director to take the exam in a separate room.

 

If you have been exempted from attending a scheduled exam, you have to make up the exam as soon as possible, generally within a few days of the scheduled exam.  Your student dean and the course director will have the final say about the time and date of a make-up exam.  They will attempt to be as fair as possible, taking your situation into account.  If by February 10, 2012 you still have not taken all exams, you will receive an Incomplete.  The Committee on Student Promotion will then determine how you have to rectify this grade.  At the discretion of the course director, your make-up exam may be shorter than the regular exam was.  The Incomplete should be rectified well before the officially scheduled reexam for students who failed the course. 

 

We want to give you a chance to learn from your mistakes on the exam, and have a voice if you feel that a test item was graded unfairly.  We want to resolve all differences of opinion in a professional and courteous atmosphere.

 

After the examination, two opportunities are offered for a second look at the exam booklet (time and place are listed in the course schedule).  During these times, the course director may be available for questions.  You must adhere to the policy on exam questions that is printed on the front page of each exam booklet; this means, for instance, that computers, phones, and note-taking are not allowed during these sessions.  Please bring a printed grade report to the second-look session; do not look up your grade report on your phone.

 

If you have a question about a test item (e.g., why is answer .. incorrect?  why is answer .. not the best choice?), or if you feel that a question is graded unfairly, please send an e-mail to your class liaisons.  Before you send off your request for regrading, please consider that you are asked to select the best answer; ideally, all answers can be ordered on a scale of least correct to most correct, and there is a reasonable difference between the most correct and the second most correct answer. 

 

Appeals to exam questions must be made to the liaisons via e-mail by the dates printed in the schedule.  The course liaisons will compile the appeals, remove personal identifiers, and forward the final list to the course director. 

 

Once a test has taken place, the syllabus and the course website constitute the gold standard.  We will not give credit for wrong answers, simply because there is a contradictory statement in a book, in a journal article, or on a website (errors abound!).  An exception to this rule is that we will give credit for an answer that can reasonably be viewed as correct by today's scientific knowledge.

 

The course director will make the final decision on the grading of test items.  The course director reserves the right to exclude flawed test items from the calculation of the exam grade.  Compiled answers to appeals will be posted on the course website.

 

Your grade will be reported to you electronically.

 

The final course grade will be made up of the following grades:

 

            Exam 1:                                   counts for 5% of the final grade

            Exam 2:                                   counts for 29% of the final grade

            Pedigree problem:                    counts for 2% of the final grade (see part 2 of Syllabus)

            Exam 3:                                   counts for 4% of the final grade

            Exam 4:                                   counts for 24% of the final grade

            Exam 5:                                   counts for 5% of the final grade

            Exam 6:                                   counts for 31% of the final grade

 

The exams are set up such that each question is worth about the same towards the final course grade.  We think that frequent testing makes your final course grade more accurate.  To take into account your level of preparation, the odd-numbered (short) exams will have easier questions than the even-numbered (long) exams.

 

In accordance with JMC rules, medical students with a course average of ³90 will get honors.  Please recognize that assessments are not perfect.  Nonetheless, they are the agreed-upon yardstick.  If you have an 89.4 average, please don't pester us about honors.  You are obviously borderline for honors, and neither you nor we can decide with certainty whether your performance deserves honors.  (Besides, if you had an 89.6 average that is rounded up to 90, you would probably just consider yourself lucky to receive honors and not complain either.)

 

The students who perform among the top 5% will automatically get a letter of recommendation deposited in their file.  However, the course director is always willing to write a letter of recommendation for any student (e.g., for a summer internship).

 

Note that every exam will feel a bit different.  For the most part, each lecturer writes her/his own exam questions.  None of the exams are expressly cumulative.  However, we expect that you know the essentials of all the material that was presented in the course.  For instance, autosomal dominant inheritance and dominant negative effects are discussed in November, and we expect you to understand these terms also at the December and January exams.

 

Historically, many students have a bit of a problem knowing what to expect on the first exam.  The mock exam should help you know what we expect from you with regard to week 1.  Please make sure you take the mock exam.  Likewise, please also complete the practice exams that are posted on the course website.  In the past, some students felt that the exam in December is especially tricky.  The mean class grade is usually lowest on the final exam, in part, because there is a lot to learn.  By achieving an average grade of >75 in November, you can avoid a lot of anxiety later on.