The Patholgy Trifecta (Plus one)

2nd year medicine is mostly pathology. Pretty much every other subject during 2nd year revolves around the way stuff goes wrong. It’s the biggest topic on Step 1, yet despite its shear volume, is relatively straightforward. To do well in pathology, you need to nail the straightforward questions that make up the bulk of questions. Next, you need to nail the high yield, trigger word questions. You will probably not get tested on most of the ones your memorize, but these shouldn’t be missed either. Lastly are the questions that involve either complex pathogeneses or are just straight low yield nit-picky questions. The following was my approach to pathology 2nd year that kept me in the high 90’s in class and is reflected well on Q banks and NBMEs (and hopefully the real deal).

The trifecta of pathology is as follows:

  1. Pathoma
  2. Rapid Review Pathology
  3. Robbins Pathologic Basis of Disease
  4. (Bonus) your class notes


“For the sake of board examination purposes” will be repeated ad noisome. Dr. Sattar is a great lecturer that goes through high yield pathology and takes the time to integrate and explain the concepts. It helps to have seen the stuff before (he assumes this is a review by his tone). The book is a whopping 218 pages but his videos are gold. He goes through every word of the book, and his explanations add to the material and help bring it together. You can also speed up the videos, which is nice because I don’t think students ever listen to anything at 1x speed. Keep in mind that Pathoma is in no way comprehensive. I firmly believe that if you only knew Pathoma, you’d get about 50% of the questions right, maybe less on in-house exams. That said, if you know the topics covered in Pathoma, you should get a good base of questions right and not let easy points get away from you.

Rapid Review Patholgy

The gold standard review book for pathology. Dr. Goljan, papi, has crammed this book full of information. Between the outline format, tables, and high yield images, you should see almost every topic covered on Step 1. It’s tempting to just highlight everything, but I think the great benefit of this review book is the outline format which organizes everything more clearly than just trying to drink the information out of a fire hydrant. The first read through a chapter might not stick, or the 2nd or 3rd, but eventually the facts, and where they are on the page, will stick.

Robbins Pathologic Basis of Disease

The gold standard primary source. Others might use Rubin’s but I found Robbins a bit more readable, if that’s possible. The mistake students make is trying to read this thing. Don’t read it! When you get to a topic that doesn’t make sense, or you are particularly interested in (and have time) then read that section. But do not read the chapter! That said, I think this book is better than the smaller Basics of pathologic disease because after reading a tough topic in this big book, when you see the bullet points in Pathoma or RR, hopefully it is enriched by the in depth research you did in Robbins. Again though, do not read these chapters, you don’t have time, it won’t stick, and it causes undue anxiety.

Your lectures

I am the first to admit I did not attend a single pathology lecture. Our course director did audio reviews where he went through the lecturer’s notes and pointed out high yield topics, and since he, not the lecturer, wrote the questions, those reviews were better than going to lecture. I also can’t stand people at 1x. What I enjoyed was the PDF notes from some lecturers. I highlighted and annotated those while listening to the audio reviews. Each are saved in my Evernote account and I reference them sometimes when I know the information is there, clear and succinct, and I don’t have the energy to open Robbins. Because we were tested from class information and we are not pass/fail, I also made Anki cards from the notes. Max 20cards/lecture, usually less since we had 3-4 test questions per lecture. Our teacher also provided practice test questions which I always saved until right before the test.

My Pathology Schedule

During the 5-6 week term

  • Listen to Pathoma at 1.5 speed, highlighting and annotating
  • Listen to class audio reviews, making Anki cards; Review Anki cards on weekend
  • Read Rapid Review, highlighting and annotating
During the 4 day weekend before a test
  • Listen to Pathoma at 2x speed, just listening
  • Review term’s Anki cards each day
  • Do Robbin’s Review of Pathology questions (and realize they’re freaking hard)
  • Do in-house practice test questions

Final Thoughts

I don’t find First Aid‘s pathology sections comprehensive enough, and therefore never use them. Kaplan Medessentials has great tables and organization, but absolutely no explanation. It’s helpful for visually organizing things like renal pathologies where there are clear high yield trigger words. Both sources might be annotated from Q banks since they give page references, but in general I like using Rapid Review as my main pathology learning tool. That schedule is pretty idealistic, and I’ll be the first to admit most terms I couldn’t get through everything completely (or felt I needed to).

While I do still have all my Anki cards, I NEVER went back to them after a term. Firecracker is enough to keep me fresh on HY pathology topics, and I plan on a comprehensive review of each topic in Rapid Review before Step 1 anyways, so there’s no need to make each term progressively harder by continuing to do all the previous stuff.

As always, I hope this helps get you organized to tackle the mountain of information that is 2nd year pathology. I’m down to answer questions in the comments below.

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One comment on “The Patholgy Trifecta (Plus one)
  1. Mima says:

    very helpful site, thanks for allt he tips !!

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