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The Write Stuff


The New Physician September 2004
Studying can be a dreadful and mind-numbing experience. And preparing for such tests as the United States Medical Licensing Examination (USMLE) can make reviewing for an anatomy quiz seem like a walk in the park.

For osteopathic students, there is another ring of Hades: the Comprehensive Osteopathic Medical Licensing Exam (COMLEX), a three-level test that’s similar to the USMLE but also includes material on osteopathic manipulative medicine. And what makes studying for the COMLEX difficult is the peculiar absence of COMLEX-specific review books. As a result, osteopathic students prepping for the exam have to make use of a variety of materials, says Naishadh Shah, a fourth-year at the New York College of Osteopathic Medicine (NYCOM) of the New York Institute of Technology (NYIT).

“[When we were studying], what we did was we mainly used books oriented for the USMLEs for the majority of the subjects from anatomy [to] microbiology…. Pretty much all of the subjects that are covered on the USMLE are 100 percent covered on the COMLEX as well,” he says. “So we used USMLE-oriented books for that, while for the [COMLEX] osteopathic manipulative medicine portions, we used whatever resources were available…. Some of them are geared toward the boards; some of them are just general review books of osteopathic manipulative medicine. We used those along with class notes.”

Of course, this isn’t the most convenient study method, but when Shah and fellow NYCOM fourth-year Rupen Modi were preparing for the COMLEX, there wasn’t a lot of time to do anything about it.

After completing the first step between their second and third years, though, they casually discussed the need for a COMLEX review book. “The idea started out as a joke,” Modi says.

However, that joke didn’t look so far-fetched after both students earned teaching fellowships at NYCOM. Shah teaches anatomy to first-, second- and third-years, while Modi gives them lessons on osteopathic manipulative medicine. And as fellows, they have delayed their graduation from 2004 to 2005.

But, really, what’s one more year for Shah and Modi, who entered NYIT’s seven-year Bachelor of Science/Doctor of Osteopathy program in 1997 and met while living in the dormitories on the Central Islip campus. Besides sharing many of the same classes, they discovered they also had a common cultural heritage. Shah was born in Gujurat, India, and moved to Queens, New York, at the age of 5, while Modi, who was born in Pennsylvania to Indian parents, lived in India for seven years before returning to the United States and graduating from high school in King of Prussia, Pennsylvania.

It was their ethnic backgrounds and interests that led them to their first undertaking. “If you go to [NYIT’s] Salten Center where all the club flags hang, you will see a banner for Ashram, an Indian cultural organization we started as sophomore undergrads,” Modi says. “Also, the very first NYIT date auction was our idea, part of a [student government association] and Ashram collaboration.”

While their auction dating efforts may leave the greatest mark on NYIT students, Shah and Modi decided to create a legacy, as well. “We were just talking [after earning the fellowships] about what can we do extra, what can we do more, what can we do different than the fellows that have been here in the past, and it started out as a joke, like, ‘Ah, we should write a book. It would be funny,’” Modi says.

Perhaps to test the limits of their senses of humor, Modi and Shah took the idea to a new audience: publishing companies. In March 2003, after a particularly tiring day on rotations, the two began writing. “We couldn’t think of anything better to do, so we said, ‘Let’s write a proposal and see [how] different publishing companies respond to our proposal,’” Modi says.

The three-page query outlined a simple concept: Write a COMLEX-focused review book. And apparently, the punch line was lost on book publishers, who jumped on the idea. “To our surprise, we actually got a very good response from several big-name publishers. It was like a joke gone too far,” Modi says.

In fact, Blackwell Publishing, which eventually won over the student-authors, saw a real business opportunity. “There’s a need in the market for a book like this, and the authors provided me with an impressive proposal that reviewed well with osteopathic students,” Nancy Duffy, a Blackwell acquisitions editor, said in a press release. She also said that the students’ professionalism, attention to detail and senses of humor have made them two of her favorite authors to work with.

And while some may view the authors’ status as students a liability, Blackwell didn’t. “The major advantage we had is that we were both students and teachers…, and the publishers really saw that to be the advantage that it is,” Shah says. “We are close enough to the students to relate to the issues that they are dealing with—what subjects they feel are not adequately covered or need further review before their exam and what format they like to study from—as well as being professors, to some degree…where we see firsthand the areas where students are having problems in and areas where students need clarification in.”

Their review book is set for release in spring 2005. And for two guys who had previously found the idea of being authors laughable, they seem to be making the adjustment well. “It is definitely challenging,” Shah says. “Though Rupen and I are well versed in our respective fellowship subjects, putting it all on paper is a different story.”

And the greatest challenge, as it turns out, is one that all medical students can relate to: finding the time to work on another project. “Writing a book requires a little vision, some planning and a lot of time. Anybody with these three can do it,” Modi says. “Our situation is the opposite. We had a tremendous vision, good planning, but we are always short on time. Between the workload from NYCOM, working on our MBAs, and all the other extracurricular activities we are involved in, time management is important.”

So several days each week, the student-authors dedicate three- to four-hour blocks to writing. “Usually, we will meet in the evening after our respective rotations are done. We will start work and take breaks for TV and dinner and still finish around 9 or 10 p.m.,” Shah says. “On weekends, we first finish our studying and weekly chores.… We usually meet in the late afternoon and work until the evening. In the back of our minds, we both know that once this project is over, we will be able to relax and enjoy some free time—which we have not had in many years. That motivation, in itself, is enough to keep us going and working hard.”

However, if past behavior is any indication, it is difficult to imagine either future osteopath resting on his laurels for too long. Maybe one of them will even think up another joke.
Scott T. Shepherd is an associate editor with The New Physician. E-mail your “Folk Tales” suggestions to