Hustle culture and busy work. These are huge problems these days whether you are in the medical field or anywhere else.
You get rewarded for being busy rather than being productive and get graded for memorization rather than understanding.
Unfortunately, our outdated education and medical education system still promotes these things. Med school and life in general is busy. There is a lot to learn and seemingly not enough hours in the day.
There are certain levels and strategies to studying that make your efforts more fruitful and worthwhile.
This isn’t going to be about motivating yourself to study or any of that. We already have posts about that. This is more about the mechanics and technicalities of what you actually need to do.
First Pass- Understand Foundations
The first time you see information you need to focus on genuinely understanding the foundational concepts. A lot of med students, including me the past, start off on the wrong foot by thinking about the exam and tailoring their studying towards it.
Most blocks are 4-6 weeks. The exam does not matter right now. You are in medical school to actually learn the information then apply it to real people down the road. Exams are just a necessary evil that are important to pass, but they don’t actually reflect understanding.
Being a good test taker is a game and can be easily manipulated. Actually understanding the information is where the value is.
So during your first pass of information, the priority is not the exam, it is understanding the foundations. For example; the types of heart failure and their causes.
You need to first understand how the heart works normally, then how the causes prevent it from working normally and drawing the connection between them. Understand the WHY. I personally learn best through videos for this kind of thing. YouTube is full of great information, so is Online Med Ed so use those (at 2x speed of course) to understand foundations.
The school won’t praise you for doing this, it might not even help you on the exam. At the beginning, before you get efficient, you might find yourself spending more time studying than others.
But again, you are here to learn how to be a doctor. When you get a 3am call as a resident for a patient in heart failure, you have to rely on your understanding of foundations to make decisions, not a flashcard you memorized to pass an exam.
A lot of people start coasting when they get into medical school since most are pass/fail. They just want to pass the exam and don’t care about much else. This leads to a lot of stress and poor performance later as a clerk and resident.
So again, I would use YouTube/Online Med Ed/Ninja Nerd to understand the foundations.
As you go through make flashcards on Anki (my preference) or notes about the important points so you can keep reinforcing that understanding over time.
The exams are pretty garbage. And we’ll talk about them. But you need to take it in your own hands to make the effort to understand foundations.
Second Pass- Memorize/Flashcards
Now we move to the next phase which should start going much faster because you already have a strong grasp of the foundations.
Most med school exams are not great at testing what you actually know. They are a game that is played more through test-taking strategy and so part of your studying does have to revolve around them.
Watch our other videos to see why didn’t go to class and how we studied (structure wise).
But the long and short of it is that at this stage, you need to use the school specific resources (in combination with something like Online MedEd or a resource of your choice that is quite frankly better at teaching medicine than med schools are).
Now you will go through the lectures/videos/notes and make your flashcards/notes on the facts that you need to know for the exam and in general practice.
This is something like using Lasix, Beta Blockers, Ace Inhibitors in heart failure. In stage 1, you understood WHY we use these medications and HOW they help us in a situation with heart failure. Good for you.
In this stage, it is about memorizing which medications we use, their contraindications etc. This is tailored towards not only the exam, but real life as well as you may not always have textbook answers available to you in real life.
This is things like memorizing the various causes of a disease, diagnostic tests, lab results you may expect to find, physical exam findings you may expect to find. All of these things are being memorized, but underlying that, because you understand your foundations so well, they should all be making sense to you. If they are not, go back and review your foundations.
For example: You may memorize that Jugular Venous Distention is a hallmark in right sided heart failure. Great. But you should understand for real life, based on your foundations, that it intuitively makes sense. If the heart is failing on the right side, where it normally receives venous return from the body, it makes sense that the blood would back up and pool away from the heart as it can’t get into the heart. No fancy medical language, just complete understanding of the concept.
This makes memorization much easier because you aren’t memorizing random facts, they are all things within the narrative of what you are learning.
Third Pass- Cheat Sheet
Now you have a strong foundation and understanding of the material for real life, and probably enough to pass the exam. At this point, there is a week or two left before the exam. Now it is about continuing to do your due Anki cards or reviewing your notes, so your foundations stay strong.
But anything new that we do is going to be focused on playing the school’s game and doing what they are asking of us for the exam specifically.
This is small details like dosages, bolded text from your slides, random facts etc. Stuff that really isn’t that important from a conceptual level because in real life it can easily be Googled or referenced elsewhere.
But right now you are at the test taking stage, so make a cheat sheet of these random things, or stuff that just requires rote memorization, or things that for whatever reason you are having trouble remembering.
Write the exam. Delete this garbage from your brain. Move on.
However, keep your foundations, you’ll need them later. And they’ll be there because you learned it the right way.
Again check out other videos for how to be productive and set up your day correctly to execute the above. But this should really help you guys. I truly wish someone had told me this the first day of med school.