July 5, 2021

The Art of Studying Medicine

In the spirit of a very popular new socials tag line - tell me you’re preparing for medical exams, without telling me your preparing for medical exams. Alright, here we go. Completely reversing your day/night cycle, so that your body no longer realizes what circadian rhythm is. Long luxurious bubble baths, that are in no way relaxing, because you’re glued to an iPad as you cram last-minute (pointless) lectures. Endless coffee runs, even if you hate the stuff. Blowing up histology slides and air playing it to your Apple TV. Serious procrastination via the use of Facebook medical meme groups, or the newest episode of Love Island, or a little of both. And, the slow spiral of insanity that is SWOTVAC (exam study week for those non-medical readers). Just about sums it up, right? 

For some of us (like me), medical school was a little while ago. But just because I’m not a freshie, doesn’t mean I don’t remember how brutal exam weeks were. And more importantly, the exams don’t stop there, they just get more arduous. I recollect my first year of medical school, I tried quite a few versions of “study”.. almost none being sufficient for their intended purpose. 

No two people are the same when it comes to learning. We all learn at different paces, implementing different techniques that work. That being said, you might not know that most study methods embraced worldwide are passive. Passive learning is like a one-way road. You start walking down it, gradually picking up things as you go but you never deviate from the set path and you rely on absorbing knowledge without much commitment to it. So, this would be study styles like textbook reading and online lectures. You aren’t testing yourself in this mode, and therefore probably not retaining all that much either. Active learning is the type of learning which demands some form of engagement from you. That is, you actually have to do something. While you interact, your brain is critically thinking, allowing you to make associations that will stick long-term. Active styles of study include peer discussions, hands-on work like getting up at the whiteboard to jot down everything you know, and teaching someone else.

I found for the longest time, I was a passive learner. It would take multiple re-reads of the same pages, to retain even a quarter of the information. Not only is this majorly tilting, but it’s also ineffective and a terrible time sink. So, I started doing some research and concluded that I needed to revamp my study technique. If you’d like to read more about re-inventing the wheel, keep reading. 

Schedule everything 
It might seem like an ironic waste of time to set up a detailed schedule, but what it allows for is understanding the time you have available so that you can best employ it. Find a planner or calendar that suits your needs and start to pencil in the basics like sleep, exercise, personal care, and family or partner time. These are all essential activities that should not be relinquished. Ensure you add any classes, practicals, and assessment due dates as well. Once you have penned all of this in, it’s time to examine the time you have free and size up the extent of study you need to do. For example, if you know that you are sitting four major exams in your exam period, try splitting your time studying for these solely based on the weight of the exam and how confident you are with the content before commencing study. I wouldn’t normally split the workload by four equally, because some exams are harder than others and you may have a wider knowledge base for some exams over others. When you know what time you have available and how you’d like to split it up, make sure you write it all down and keep it handy. 

Begin with the passive study
You can’t begin to study if you don’t know the content. So, the passive study is the necessary foundation that you will build on down the track. If you write notes yourself, read over them a few times. If you prefer a textbook, read that. It’s really up to you which resource you utilize. I found that textbooks are full of long walls of text, and you tend to get dazed and zone out quite quickly. Succinct, well-prepared study content is the best choice for passive study because you want to know the pertinent facts straight up. Given how much I have synthesized textbook content in the past, I’ve recently opened an online store that specializes in one-page medical study resources. You can navigate to my store from this blog site if you are interested in taking a look. The plan is to add a few new study sheets every week, for the foreseeable future. Even with the concise notes, you may want to make smaller notes on the side explaining concepts that you may not fully understand. This will serve as a reminder every time you read the study sheet. I also find it helps to read out loud. A technique I learned is the Pomodoro Technique, which is where you set a timer and focus on solid, uninterrupted, productive study for 25 minutes and then when the timer is up, take a break for 5 minutes. So set a timer, knuckle down, and read that information like your life depends on it. Then take your break. This works absolute gold and keeps you concentrated for much longer periods of time. 

Transition to active study 
When you have read through the relevant content a few times, it’s time to promote active study of the concepts you’ve just read about. My favorite way to test your knowledge is on the whiteboard. Grab a marker, and say to yourself “okay, I’m going to jot down everything I know about X topic”. Fill the whiteboard with as much content as you can, as fast as you can. Andrea Tooley is an MD Graduate (now Oculoplastics Surgeon in the US) who I have been watching for many years; she loves using this method as well. I've linked here if you'd like to take a look at her content on Youtube. Sometimes setting a timer can help keep you on track. Anything you don’t remember well, leave blank. When the time is up, take your note sheet and match up your work. What did you not remember so well? Fill it in on the whiteboard, saying it out loud as you go. What did you ace? Praise yourself for recalling all that you did. You may still not understand a certain concept, and that’s why you didn’t remember enough to write it down. If that’s the case, google a YouTube video on it and take a listen. This can serve as the next phase of the passive study. Another option is to adopt the “see one, do one, teach one” principle. If you can describe and teach a topic to someone else in a logical way (especially if they’re non-medical), then it’s likely you already know the content quite well. Pull your bestie aside, your mother, or even your pet cat; you’d be surprised how much you know when it comes to crunch time. And from here it’s pretty much a rinse and repeat situation, for every topic that you need to know.

You’re probably thinking, “well if it were that easy wouldn’t everyone be doing it?”. And you’re right. They would be. The truth is it’s not simple at first. It’s a fairly detailed process, and if you have huge exams filled with every topic known to man - it can be very challenging. That’s why I would recommend the following tips to refine your study sessions even more. 

  • Pre-written notes. There is no possible way you can write your notes exam week, while simultaneously studying the content of them. And if you can, you wouldn't be likely to retain much. I recommend making sure your notes are ready to go before study week. As a general rule of thumb, I used to have all of my notes completed before I was halfway into a semester. Most of the time, I would even start the note writing in the final week of the inter-semester break to give myself a head start. I highly recommend this, because if the notes are ready early on - you can start your study routine well before the dreaded cram week. Encoding memory over a longer period will assist with subject recall, and you will find those study weeks serve more as a "brush up" rather than seeing content for the first time. Remember: the study sheets should be concise (preferably single-page) items that you can carry around the house and revise. Try collating the sheet with a few different resources, that while the sheet itself is concise, it is summarising a broad range of sources. 
  • Use videos to round out your knowledge when passively studying. I love a good educational video, and nowadays the internet is littered with them. Find something quick, comprehensive, and easy to understand. When I was feeling particularly exhausted, I would watch videos to round out my knowledge and reinforce principles. I'd recommend trying Armando Hasudungan on Youtube. Khan Academy is also excellent.  
  • Test yourself. While getting up on the whiteboard to write down content and teaching others are remarkably valuable active study techniques, sitting down in a mock exam setting will also do wonders. Quizzing yourself quite literally shows you what you don't know (ie: you'll get those questions wrong). If the test is categorized by topic (for example the cardiovascular physiology section of the exam) and you get all of these wrong or right, then this will tell you how much you need to work on your understanding of the topic. Quizzing yourself early on in the study process will inform your study goals. Try using AMBOSS, ANKI decks, and past exam papers floating around. 
  • Mnemonics are your friend. Before starting medical school, I didn't believe in the power of a good mnemonic. I've since realized that they are vital, especially when you need to learn a list. Everywhere you turn, there will be one for you to memorize. My suggestion would be to ensure you can personalize the mnemonic, otherwise, it tends to get lost in your memory bank. 
  • Colour coding works. As an additional memory aid, you can colour code topics to assist with recall later down the track. 
  • Do not pull all-nighters, it will do more harm than good. There is no point in staying up all night, and then forcing your sleep-deprived study to sit an exam the next day. It is a recipe for disaster. You will have botched your chance of converting short-term to long-term memory during REM sleep. And you have also tired yourself out to the point where driving would nearly be as dangerous as drink-driving - because your senses and reflexes are severely diminished. You will find that a night of restful sleep, and the opportunity to turn a new leaf, will help you see clearer and stay more focused and on task throughout the day. 
  • Cramming is pointless. Similar to the premise of the all-nighter, last-minute cramming is pointless. Aside from maybe one brief fact, or a statistic, cramming won't save you. If you don't know the content minutes before entering the exam, then it is fair to say you probably just don't know it. 

I take my proverbial hat off to anyone who chooses to study medicine. It is a massive commitment that will weigh heavily on your shoulders and will often dictate how you spend your time. That's why I strongly believe that learning to study efficiently, and not mindlessly, is so important. If you can do something twice as well in half the time, why wouldn't you? You will find that your study time becomes more enjoyable if you feel on top of your workload, and if you can see tangible differences reflected in your quiz marks and final exam results. 

Until next time! 

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