Khan's Cases: Medical Ethics

Maryam Arshad and Sajid Khan present real-life ethical 

scenarios tested commonly on the boards.

We started a segment about illustrious Kemcolian authors, last year. Today, we review Khan's cases: Medical Ethics 101 which is co-authored by Maryam Arshad (Class of 2010)

This book charts ethical problems faced by a doctor in his daily life in a question and answer form. Throughout the book, authors Maryam Arshad and Sajid Khan pose usmle style questions and then provide thorough explanations backed with actual life incidents. The topics covered in the book include Autonomy, Beneficence, Substituted Judgment, Consent Issues, difference between major and minor in life threatening cases, abortion and other board-relevant medical ethics issues. 

The authors set out to give the students an easy-to-read book and as well as give him a USMLE experience with every question and in doing so they help a student come to grips with the common setbacks and mistakes of giving in to ticking an answer that ‘looks’ right instead of the one that ‘is’ right.

‘Khan’s Cases’ swiftly goes through essential topics in a very student-friendly style. After reading say, a 100 pages of the book, you retain what you went through due to the highly eloquent examples quoted in the explanations and yet do not feel the fatigue to cram. The rationale to the correct answers picks the problem at its root and with every question you find yourself recognizing the trick lines that confuse every student and that you can avoid only with practice.

Maryam Arshad is a graduate of King Edward Medical University, the top medical institute of Pakistan and Sajid Khan is a graduate of the university of Missouri-Kansas City and board certified in Emergency Medicine. Their tact in writing this book is commendable making it the first choice for a quick review of your understanding and concepts before the exam. The book became a rage on www.usmleforum.com soon after it hit the amazon market with threads containing comments “up-to-date”, “quicker than Conrad Fischer”, “very good for practice” and “cites recent court cases” repeatedly.  The book also officially became part of the curriculum if the UMKC School of Medicine in 2013.

The authors understand that staying up-to-date is the key to make a good guide book and so they have continued to make regular additions to the book with the changing style of USMLE questions seen on boards every year. Their style is a copy of Step 1, slightly more difficult to appropriately challenge what the student has learnt, and their content is extremely concise and to the point. 

At the end of the book, the authors provide what is called the ‘Key Ethical Principles’ which covers the very basic rules such as 

“a person can refuse ANY treatment for himself no matter how life threatening his condition may be provided he is not of danger to anybody else” and explains medical ethics terms.

Comparison With The Conrad Fishcer:

Because the book is very commonly compared to Conrad Fishcer’s Master the Boards USMLE Medical Ethics on usmle forums, it is only fair to merit the pros and cons of both together. There is no doubt that Conrad Fischer’s book remains the number 1 choice for a detailed and intellectual read and thorough understanding of medical ethics. However, many students debate on the wisdom of spending so much time on a field that makes a minor part of the real exam. In that case, Khan’s Cases takes just a day or less to be read and understood as it presents concise matter and aims on high yield topics. Also for those who have read Conrad Fischer initially, this is the best book for a fast review and application of knowledge before the exam. Apart from that, Khans Cases stays at the top of market because it’s a new book and has kept pace with the boards, its content matching the cases that students say are appearing on the exams currently.

USMLE World performance after a read of this book

I have been breezing through the medical ethics questions, after going through the book while doing the USMLE World random timed blocks. Though I have not taken the actual USMLE Step 1 exam yet, I feel confident in this subject after a read from Khan's. For me, this short and concise book has been fetching good returns for a little time investment.

For KEMU students..

For KEMU students who plan on doing residency abroad, this book is a must-read. I say a must-read because due to certain differences in legal and ethical aspects of Pak and US health system, it is imperative to have an understanding of this. 

Of course, the most obvious benefit is, a higher score in USMLE. Medical ethics is a part of Step 1, 2 CK, CS and even Step 3. A lot of our students who have not yet taken rotations in US hospitals will find these Questions tricky and they will find that its an area where minimal investment can pay huge dividends. In addition to this, during your clinical electives and/or observerships, you are bound to come across ethical issues.

Tete-a-Tete With the Writers

We had a question and answer session with the writers and here is what they had to say:

Sajid Khan is a graduate of the University of Missouri-Kansas City and board certified in Emergency Medicine











Maryam Arshad is a graduate of King Edward Medical University, the top medical institute of Pakistan





What prompted you to write the book?

Medical ethics is a subject that is heavily tested on the USMLE (both steps 1 and 2) and is something that will help even in the long term when we are practicing physicians. It is a subject that is not taught very well in medical school nor are there other books available. The Kaplan/Fisher book is horribly outdated and is not representative of what is on the exam at all. Our book, Medical Ethics 101: Khans Cases, fills that need. 

Being a Kemcolian what advice would you give to others preparing for Step 1?

I have a lot of advice to offer - with the Grace of God I scored 99 on both Step 1 and Step 2 CK and passed Step 2 CS (all first attempts). Since the 2 digit score is outdated now and is neither reported to the applicant nor the programs, it is more important to get a good 3-digit score. Aim for 250 plus. Many people told me I had to read everything at least two to three times - I did not do that as I feel like I can take my time and retain information rather than needing to re-read it over and over. But we all learn differently and you should do what is best for you. Do not take too long as your year of graduation has a huge impact on your chances for residency. If you have to choose between a 255 or 260, choose 255 and give the exam earlier. I like the Kaplan books (except pathology which is much better in Goljan), USMLE World Q bank, and of course Khans Cases. First Aid is good for a quick revision close to the exam. NBME exams are great predictors of the actual score. 

How did you pave your path to medicine?

After graduating at the top of my high school class, I got into King Edward on open merit and graduated from there as a silver medalist in 2011. During medical school and afterwards I did a bunch of US clinical electives. Try to do them at places which have a residency program, as you can work directly with the Program Director/APD/Clerkship Director and when they see that you are very knowledgeable, smart and hard working, it goes a long way. Currently I am interviewing for residency so staying very busy. Best of luck to everyone and remember there is a light at the end of the tunnel - all the hard work will pay off inshallah.