Saturday, 1 August 2015

How to Study for Pre-Clinical Medicine at Medical School

Studying for pre-clinical medicine is not about finesse or being able to know intricate details, it's about keeping your head above the water while waves repeatedly crash at you. Your aim of studying is subsequently, to cover as much material as possible in a manner that maximises retention. This will vary in context depending on each medical school i.e. Barts has OSCEs in the first year.

You need to make a schedule that is realistic. I like to treat medical school as a nine to five job. You start work at 9am, have an hour lunch and finish at 5pm. This gives you a repetitive routine that can be altered for days out and impromptu social occasions.

It requires determination to stick to this because it is so easy to push things to the weekend, then the next week then months have flown by and the deadlines rear their ugly head.

Don't make To Do lists, schedule work. When are you going to do it? How much time does it need? This is much more effective then an ever growing list that you'll just ignore. Get a diary or use Google Calendar. Barts is kind enough to put all out timetables on Google Calendar so it helps to correlate your work.

The process I outline aims to have you review your lecture notes FIVE times in the space of the month, attempting to maximise retention without significant outlay of your time.

Preading (Pre reading)
You first two years of medical school will be lecture heavy. This means a lot of lecture notes and handouts. I use my iPad to directly write on PDFs of lecture notes however you may have a different method. The night before you should print/load/organise your handouts. This forces you to organise yourself for the day. It is also the beginning of the recall process. By investing 5-10 minutes of your time, skimming through the handouts for the next day, you are already familiarising yourself with the material. This means that the first time you see this lecture is not in the lecture. You have a general grasp of the context and ordering, which allows you to peg new knowledge to. It also highlights any areas that you don't understand at all.

This is 50-60 minutes of your time. I know they are dull, soulless events but lectures are the cheapest way for medical schools to teach us. You need to focus. You can't multitask effectively when learning so don't bother. This means no Facebook, Whatsapp or Snapchat. Put your phone down and pick up your pen/stylus. Make notes, draw diagrams and think of questions. If this is the only time you are going to look at this material, do it now. You are making a solid basis for all future retention, so don't fuck yourself over.

Evening Review
You need to review your notes within 24 hours. I time this with my preading for the next day. This helps to consolidate the knowledge the best and is significantly more effective than reviewing a few days later [source needed].

Go through the information, make sure you understand it and if you don't, find it out. Try to keep your source material in one place. If the lecture notes are adequate, then use them and cross out unnecessary information. If they useless (a common event) then make a mind-map. If you think you have enough time to rote learn medicine, then prepare to give up something else. Your brain will always remember visuals over text and relationships over random statements [source needed].

Weekend Review
At this point, you have review the information THREE times. This is your chance to truly learn the subject AKA study. It can be Saturday morning, Sunday night or a random free day in the week but you need to review on a regular basis to keep up. You should be relatively familiar with the subject matter so you'll be rushing through your notes to get outside.

How I Study
Rote memorisation is the toolbox of the traditional medical student. And it is very useful when you need to learn something and nothing else will do. However, I find that this method prevents you applying knowledge. You learn a list or a block of text and have no idea what it means, just the ability to repeat it if asked for definition.

Subsequently, I use very little writing after my initial note taking step in lectures. I know most of my fellow medical students like to re-write lecture notes, but I don't have time. I want to watch netflix and go out with my housemates, not keeping rewriting text hoping it will go in.

I will imagine that a fellow student is in front of me and I will talk them through the lecture as if I am teaching. The aim is to teach from memory and also talk in a way that shows I clearly understand it. This significantly helps my comprehension and ability to apply knowledge at a future date.

Talking to yourself can be weird but if you can't explain it with the notes in front of you, what luck do you have in the exam.

Month Review
A month is my preferred time, but this flexible for you. A fortnight or six weeks might be enough. This schedule forces you to review you knowledge and drag it up from the dregs of your memory. This is the final step to help transition it from short-term to long-term memory. At this point you have now reviewed the content FIVE times. You will have a good assessment of your strengths and weakness. Lectures that are not easy to recall can become focus points in your revision while you can ignore content that you are comfortable with.

Further Advice

  • Be realistic - Trying to cover three modules in a week isn't going to happen. Your timetable needs to be practical e.g. if you have to watch Game of Thrones every Monday then watch it, don't pretend to work. 
  • Pomodoro System - Wikipedia explains better, but basically, you work for 25 minutes, take a 5 minute break and repeat. I find it effective at forcing myself to study and a timer gives you a clock to beat. It can be addictive.
  • Block distractions - You've made the decision to study. Great! Now make sure it's efficient use of your time, otherwise you'll be there twice as long. Block social media, put your phone on airplane model and get going. 
  • Food and Water - Make sure you have water and some snacks within easy access. It's tiring work studying and I've happily convinced myself that I need to bake for three hours instead of studying, because there isn't any brownies in the house.

Medical school is hard, not because of the subject, but because it requires time management skills that we are never taught.