Medical School MD + DO Mastery

A 4-year, board-aligned study system for medical school and licensing exams.

Walk the full Year 1–4 curriculum — foundational sciences, organ-system blocks, clinical clerkships and advanced practice — each with mastery checklists and linked learning resources, plus a dedicated review system for school exams, Shelf/COMAT, USMLE Step 1–3 and COMLEX-USA Levels 1–3.

PROCEDURES + RADIOLOGY + ANESTHESIA / PERIOPERATIVE

YEAR 4 | PAGE 34C - PERFORM SAFELY, INTERPRET SYSTEMATICALLY,

COMMUNICATE URGENTLY

PROCEDURAL PRINCIPLE Competence is not “I have seen this once.” For each procedure, know the indication, alternatives, contraindications, anatomy, equipment, consent/time-out, sterile technique, expected findings, complications, rescue plan and documentation - then perform only with the supervision your program allows.

G. PROCEDURE READINESS LOOP

BeforeDuringAfter
Confirm indication; review alternatives/contraindications; consent;Use aseptic technique; verbalize landmarks and safety steps; maintain patientConfirm success; check for immediate complications; obtain required
review anatomy/imaging; gather equipment; plan analgesia/sedation; position; time-out.communication; recognize loss of expected landmarks or instability and stop/escalate.post-procedure imaging/labs; document indication, technique, findings, complications and follow-up.

COMMON YEAR 4 EXPOSURE - SITE DEPENDENT

Skill familyLearning target
Vascular / blood samplingPeripheral IVs, phlebotomy, ABG/venipuncture; understand arterial/central line purpose and complications even when not independently performing them.
Tubes / drains / woundsUrinary catheter, NG/OG concepts, wound assessment, suturing/staple removal, drain/chest-tube observation depending on service.
UltrasoundProbe orientation, basic lung/cardiac/vascular/abdominal windows, procedural guidance concepts, image limitations.
Airway / anesthesia exposureBVM positioning, preoxygenation, airway adjunct concepts, laryngoscopy/intubation observation or supervised participation, sedation monitoring and rescue awareness.

H. RADIOLOGY - QUESTION -> IMAGE -> ACTION

  • Start with the clinical question: what are you trying to confirm, exclude, stage or guide?
  • Choose/justify the modality: radiation, contrast, renal/pregnancy considerations, urgency, portability and whether ultrasound/MRI/CT/plain film changes management.
  • Read systematically: patient/date/technique/quality -> structured search pattern -> comparison -> devices/lines -> actionable finding.
  • Communicate the urgent finding: do not let a critical image sit inside a note; confirm the supervising team knows and document closed-loop communication.

I. ANESTHESIA + PERIOPERATIVE MENTAL MODEL

PhaseWhat the Year 4 learner should understand
Pre-opProcedure + urgency, comorbid risk, airway, cardiopulmonary reserve, medications/anticoagulation, aspiration/NPO issues, pain plan and expected postoperative destination.
Intra-opAirway/ventilation, hemodynamics, fluids/blood, analgesia/sedation, temperature, positioning, monitoring and causes of sudden instability.
PACU / postopAirway obstruction/hypoventilation, pain/nausea, bleeding, hypotension, delirium, urinary retention and criteria for escalation/level of care.

I. ANESTHESIA + PERIOPERATIVE MENTAL MODEL — VIDEO-FIRST RESOURCES

Geeky Medics - Chest X-ray Interpretation: Structured Approach (~23 min) Stanford Medicine 25 - Intro to Scanning with Point-of-Care Ultrasound Stanford Medicine - Advanced Airway Management video portal SKILLS BOUNDARY Videos prepare you to recognize steps and complications; they do not confer procedural privilege. Real procedures, sedation, airway management and image-based decisions require direct supervision, institutional credentialing and local protocols. 2026/27 advanced-clinical expanded edition - verify school, supervision and institutional policies