Pathoma, Sketchy, Question Banks, oh my!

Third-party resources are used by most medical students to supplement preclinical learning, according to a study led by two OUWB students that also suggests such material would be “well-received” if “formally integrated” into the OUWB curriculum.   

“Use of third-party resources to supplement pre-clinical education: a single institution experience” is the title of a poster based on research by Ryan Ko and Nicholas Ludka, both M3s.

The research recently was presented at the Association of American Medical Colleges 2022 Group of Student Affairs, Careers in Medicine, Organization of Student Representatives National Meeting in Denver.

The study found that 97% of OUWB students who responded to a survey supplement learning with the use of third-party resources such as Pathoma, Boards & Beyond, and Sketchy. The study suggests the resources “would be well-received as a formally integrated supplement to non-redundant, in-house lectures.”

“A lot of people are using these (third-party) resources…they’ve become somewhat standardized for the common U.S. medical student,” says Ko. “We’re just shining a light on what are some of the best resources for students…and Student Affairs can take it from there.”

Berkley Browne, Ph.D., associate dean, Student Affairs, was the sponsor of the study.

Overall, she says it’s useful to have such insight into what supplemental resources are being used by students.

“Insight not only for those of us who are doing student support or academic support work, but (for) some of our faculty…if course directors and other faculty have insight into resources students are using, can that be useful for informing how some courses are designed?” says Browne.

Use is ‘notably growing’

The third-party resources in question generally are marketed as aids to help students perform better on board exams. Ko says that historically, most medical students have used third-party resources on their own, and to supplement material presented by faculty, whom he stressed “have the utmost knowledge of the topic at hand.”

For example, Ko says prior to lectures from OUWB faculty, he might watch a video from Boards & Beyond on the pressures of the heart, and what causes heart failure or embryological diseases.

“There might be three to four hours of lectures from our faculty, but I’ll get a really quick glimpse from the third-party resource first,” he says.

Each resource is unique. Pathoma, for example, is a video lecture series (supplemented by a 218-page textbook) that bills itself as the highest-yield resource on pathology. In a December 2021 piece called “The Grind of Medical Training Makes Us Better Physicians,” Shirlene Obuobi, M.D., currently a cardiology fellow, called Pathoma “still one of the best medical resources in existence.”

As part of their research, Ko and Ludka surveyed all current students at OUWB and about half responded. They found “a high prevalence of use of (third-party resources) at OUWB.”

Per the responses, the most popular third-party resources used by OUWB medical students are (in order) Pathoma, Sketchy, Question Banks, Boards & Beyond, and First Aid.

The subjects where the resources were identified as being “most helpful” were pharmacology, pathology, and microbiology.

“Many OUWB students have utilized third-party resources…to supplement their learning,” the poster states. “The use of (third-party resources) is notably growing.”

But Browne says it’s important to note that just because some resources are more popular — and backed by big marketing campaigns and incentives — that doesn’t mean they are always the best for helping students learn.

That’s why, she says, OUWB uses an endorsement system for third-party resources. With the exception of one of the Question Banks, the most popular resources identified in the study by Ko and Ludka currently aren’t endorsed.

“We prioritize what is going to help the student master the material, not what’s going to be the easiest to get them through a test,” she says.

Issues with supplemental material

Despite their widespread use, Ko says students face some issues with third-party resources.

Cost is the biggest. Accessing just one of the resources can cost hundreds of dollars. Boards & Beyond, for example, offers subscriptions ranging from $24 for one week of access to $399 for two years.

“About a quarter of our current student body has spent at least $500 on these resources,” says Ko.

Not everyone can afford the extra out-of-pocket expenses, he says.

“If we formally recognize and support the use of these resources, it would be more equitable for students who come from less-advantaged backgrounds,” says Ko.

Browne says OUWB provides assistance in securing student access to the resources it endorses.

“We are obviously very concerned about equity,” says Browne. “Between Student Affairs, Medical Education, and Preclinical Education, we pay for or subsidize the resources that we recommend. Some of the resources that came out in this study are not necessarily things we endorse, so that’s why we don’t pay for them.”

Endorsed resources also can help students avoid paying a lot — sometimes thousands — for material they might not need, says Browne. That’s because a team of OUWB faculty and staff reviews resources “inside and out” to ensure a good fit for students.

Further, she says the school annually conducts a thorough review of its library resources to ensure students have access to everything they need to be successful.

“Some of the work we do is helping them maximize the things that are available to them already for free,” says Browne.

Ko says another problem with the third-party resources can be information overload.

That’s because there can be redundancy amongst various sources. He says having third-party resources incorporated into the curriculum could work to the advantage of students.

“If we reduce some of the redundancy, they we can focus on learning to an even greater depth,” he says.

Looking ahead

Despite the challenges, it appears students aren’t going to stop using the third-party resources.

Ko, recently elected to the AAMC Organization of Student Representatives Administrative Board and serving as a national delegate, says the poster was “very positively received” at the conference in Denver.

“Several students…and student affairs faculty came up and asked me questions about (the study),” he says. “Several people were taking photos of it with plans to take the data back to their own institutions.”

Ko says there currently aren’t any specific plans to take the research further, but he’s hopeful it will help medical school officials everywhere “really see how popular they are.”

At the very least, he says, it helps stress the point that medical students are extremely resourceful and can learn on their own successfully.

“(Medical students) are self-directing their learning in more ways than every before,” he says. “It’s almost essential that, from a national standpoint, faculty realize that we’re adult learners. We are more capable of covering this material than you may think, and we want to get into the clinic earlier so we can become better clinicians.”