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Help! I’m starting pathology tomorrow.

Posted Sep 03 2012 7:03pm

Tomorrow is the first day of school for a lot of medical, dental, nursing, physician assistant, medical technology, veterinary, and other allied health students. I hope I didn’t miss anyone. Most of you will be faced with the beginning of a pathology course tomorrow (or if not tomorrow, soon). And except for a couple scenes from CSI and X Files, most of you will have had little exposure to pathology before. What can you do to make some big-picture sense out of the fire-hose amount of minutae you’ll be faced with over the next weeks/months?

The short answer to pretty much any question you have about pathology is: Robbins.

The longer answer is: there are several formats of Robbins, and you should pick the one that’s the most useful for you. There are also a bunch of websites that can be very useful as you go through your course. Let’s take a look.

Robbins
Robbins and Cotran Pathologic Basis of Disease (now in its 8th edition) is the Bible of pathology. It’s used in pretty much every med school pathology course in the US, but it’s so good that pathology residents – and even staff pathologists – have it on the shelf and pull it down a lot. This version of Robbins is called “big Robbins”, and for good reason: 1464 pages, and you could use it to hold open a door on a windy day. It’s definitely complete and thorough – but the best thing about it is the way it’s written. Somehow the authors manage to take huge topics and distill them into a few really representative sentences or paragraphs. And the information is very current; with each edition, new and relevant research is added in (in a readable way, compared to the original papers). For most of you, this will be your reference throughout your course. If time was not an issue, I’d advise my students (and you) to read through each chapter as you’re covering it in class. For most students, that’s just not feasible – so you’ll likely end up just doing your best, reading in depth only on the things that are confusing from class, and looking up things you’ve forgotten.

There is also a great little summary book that most students call “baby Robbins.” The real name is Pocket Companion to Robbins & Cotran Pathologic Basis of Disease, 8th edition . It has 800 cute little pages and it wouldn’t hold any door open, though it works great to prop up your iPhone. If you’re a medical or dental student, this would be a great book to thumb through before (or at the beginning of) your pathology course just to give you an overview of everything. Also, if you can’t read big Robbins, you might just read through the part of baby Robbins that corresponds to what you’re doing in class. It’s very doable – just a few small pages on each system, and you’ll get a great overview of what you’ll be learning. If you’re an allied health student, and your path course is really short, this just might be enough of a reference for you.

Finally, there’s a third format of Robbins that doesn’t have a universally-accepted name (I’ve heard both “medium Robbins” and “teenage Robbins” but there are probably other names). The official name is Robbins Basic Pathology (which sounds confusingly similar to Robbins Pathologic Basis of Disease). This book is, as you’d expect, a medium-sized version of Robbins: 928 full-sized pages, written just as well as big Robbins, but with less information overall. This is the book we use in our dental student pathology course because big Robbins is way too big, and baby Robbins doesn’t have enough detail to cover what dental students need to know for boards. I don’t expect my students to read every word, but just to use it as they see fit. It seems they use it to look up stuff that doesn’t make sense, or to refer back to material we covered earlier. If you’re a medical student, you could use this book as a quick reference, but you’ll still need big Robbins. However, if you’re a dental, physician assistant, nursing or veterinary student, it’s an adequate source. It’s probably overkill for medical technology and allied health students.

There’s a couple ancillary Robbins products that I’ve used from time to time. I recently got a box of  Robbins flashcards , and I think they’re pretty good. They seem like they’d be helpful to flip through when you get sick of looking at your notes. There’s also a  Robbins flashcards app on iTunes which I don’t have but would assume to be similar to the paper version. There’s also a review book called, not surprisingly, Robbins and Cotran Review of Pathology . This book has a bunch of questions in it, and they’re vignette-style which is good to prepare you for boards. Finally, I just saw that there is a Robbins Pathology Atlas out now – I haven’t used this, and I don’t really think it would be necessary in most cases. Unless you’re way into pathology, big Robbins should show you everything you need to know visually.

Websites
There are a bunch of websites out there (besides Pathology Student !) that are good for students taking pathology courses. Here are my favorites:

1. Ed’s Pathology Notes (or The Pathology Guy) . Nice, detailed, easy to read information on pretty much anything you’d want to know about pathology. I’ve used this a lot, even as a resident. It’s basically a really, really complete set of medical student pathology notes.

2. Webpath . Tons of images (gross and microscopic), along with little clinical tidbits. There’s even a section on general pathology (e.g., infections, inflammation, immune diseases), which is something you don’t see in a lot of atlases.

3. Pathpedia . This website has a nice atlas (with info to go along with each image) and also a bunch of other resources.

4. Pathology outlines . Really encyclopedic (with journal references) but great if you can’t find something in your usual resources. The information is more in outline format (hence the name) than paragraph format – but sometimes that’s preferable.

Finally…
There are a couple things you might want to look at on Pathology Student . There are some posts that are good introductions to pathology: A quick review of cell injury (this is one of the first things you’ll cover, so you might want to read this now), What causes cancer (also a topic you’ll hit up early in your course), Melanoma, carcinoma, some kind of -noma (you’ll have to learn the language of pathology – and one of the first places this happens is with tumors), and  differentiation and anaplasia (more terms you’ll have to learn). I also have a list of resources you can use when you start studying for boards here , here and here ; you might find something useful in there.

You might also want to sign up for Path Bites (in the left hand column near the top of this page), which is a daily email I send out containing some little pathology tidbit, sometimes with a photo, sometimes just text. It’s kind of a nice way to review pathology and keep stuff fresh in your mind. You can also sign up to get our posts by email (also in the left hand column on this page).

If all else fails, feel free to email me (pathology@pathologystudent.com) with any questions you have as you get started. I hope you have a great course with some great teachers!

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