It’s that time of the year again. The air begins to cool and slip into a crisp autumn sweater. We have football on Sundays. Coffees and beers infused with the seasonal spices. And of course, thousands of premeds are transitioning from the easy going days of undergrad to the wake up call of medical school.
I seem to always preface these sorts of posts the same way, but I’ll do it again – I had no idea what was going on when I first entered medical school. I didn’t know what to study. I didn’t know where to study. I didn’t know how to study. I was a Florida boy experiencing my first northern winter. A small-town kid thrown into the big city. I was out of my element. I was lost and confused. So when I read posts from other first year medical students going through the same trials & tribulations, I can’t help but feel the urge to reach out and give advice.
So, if you’re a first year medical student overwhelmed with resources, studying day and night, and not getting the scores you’d hoped to achieve – take a deep breath. It’s alright. The first few months are getting for getting acclimated. If you feel like you’re putting in more time studying than you ever have in your life only to yield subpar results, this post is for you.
But before we begin, know that what works for one student may not work for another. We’re all different. You may be a cake person, while I prefer pie. You may enjoy studying with classmates and socializing, while I like sitting in my apartment by myself all day. Different strokes. I will give you a pretty detailed breakdown of how I study.
Why should you care what I have to say? I don’t know, honestly. I’m stupid. But I get good grades. And I haven’t felt a single ounce of stress about medical school exams since fall of my first year, because I know that this system works. Whether you want to use my study strategy word-for-word like a Bill Belichick playbook, or you simply find a few helpful bits of advice to take from it, this post will be full of actionable advice geared toward helping you learn more in less time, resulting in better grades.
For context: I scored average (maybe slightly above) on my first medical school block. During the second block, I changed things up a bit and scored in the top 10%. This was an anomaly, because during the third block of medical school, I nearly failed. I was disappointed with myself, discouraged, and angry. It was a much needed reality check. And it was evidence that I needed to find a better way to study. I explored the usuals – advice from upperclassmen, Reddit, Student Doctor Network, all of it. I’ve probably spent more hours researching how to study compared to actually studying than I should have, but I’m thankful, because with each and every passing block, my scores AND mastery of the material have improved. I’ve tried every resource and tinkered with my methods until I’ve reached the point where I know exactly what I need to do, and how much time I need to spend doing it, to get an A on an exam. Let us begin.
Stop Going to Class
This is the first bit of baseline advice I can give. Most US medical schools do not require mandatory attendance at every lecture, and this is a blessing. My golden rule is this: I can learn more in one hour by myself than I would learn in two hours in a lecture hall. Most schools stream lectures online like a Youtube video. There are two types of lectures: low yield lectures and high yield lectures. First, with your high yield lectures, such as pharmacology, where the lecturer is spouting of so much information every minute, it’s nearly impossible to keep up. So, instead of going to class, getting lost, leaving the lecture with about 15% of the material superficially floating in your brain, watch the lecture from your computer, pause when you need to, and rewind when you miss something. The second type of lectures are the low yield lectures. The “light science” stuff where the professor spends 10 minutes talking about a single slide. Don’t let these take up your precious study time – watch it on double speed, focus on the important points, and move on to the hard stuff. Repeat after me: Class is a waste of time.
First Pass & Anki
So, for your first pass of the material, you will be in a coffee shop, the library, at home, the bar, wherever – streaming the lecture from your computer. Understand this – the first time you are exposed to new material, you will not learn or remember everything. Imagine you were at the coffee shop and a cute blonde girl walked in – you covertly stared at her, tried to hear the name she gave to the barista, went home and thought about her all night. What do you remember? She was blonde. Medium height. Great. But what was she wearing? What brand were her shoes? Did she have earrings? Were they studs or dangling? She had a book in her hand, but what was the name of the book? What did she order? You don’t remember. And after a few days, you can’t even picture her face anymore. The more times you see that girl, the more you will know about her. This same concept applies to medical school.
During a given block, you need to see the information as many times as you can, especially when it starts to get detailed *ahem, immunology & micro*. Here’s what you won’t do: write handwritten notes. That’s right. Throw your notebooks in the trash. Save yourself ten bucks on all of the colorful pens. Writing out notes is a massive time sink, and exhausting. If you are doing this, stop – you’re wasting valuable time and making studying an arduous chore. You’re not a medieval monk scribing texts from Latin to German. You’re a medical student in 2017. Don’t make things harder on yourself.
So, here’s what you will do: Download Anki. Just google it if you’re not familiar – there are many guides on the internet. In short, Anki is a flashcard app that you can download onto your computer. What separates Anki from other flashcard services? Spaced repetition. Anki will show you cards that you struggle with/dont know frequently, while reminding you of cards you know well less frequently to make sure you still know it. Sure, you can waste time and watch the lectures or read power points 10 times over, but the best way to learn the material is to actively learn. Anki allows you to quiz yourself.
During your first pass, make Anki cards of everything. At first this will be time consuming, but just do it. After a block or two doing this, you can develop a sense for high yield material vs irrelevant bullshit and trim down the amount of cards you make. So if you have four lectures, stream them online, pause after each slide to make your Anki cards. Let’s say this will take you 6 hours to go through each lecture and make your cards. First pass = done. Plus, you have the added bonus of taking your time to go through each lecture, and type the information into your cards, which will help you learn as well. You start at 9 a.m. and you’re done at four (including an hour of break time). During the evening, do all of your cards until there’s none left. Repeat this each day.
If you didn’t know the answer, you’d click “Again (<1m)” on the bottom of the screen, and you’d see the card again in one minute. If you get it right the second time, one minute later, you click “good” and see the card again in ten minutes. If you get it right again, you click “easy” and see the card again in a day or two. So just like that, between watching the lecture, making the card, and doing it two or three times that day, you’ve already had at least four passes for that question. How could you get it wrong on the test? You can’t. You won’t forget it.
So let’s switch it up to something like histology. How do you use Anki to memorize histology? Simple, add images to your cards using Google images. For an easy example of a histology Anki card:
That’s an easy example, but you can make your questions a little harder, such as “where is this type of epithelium found in the body?” It is incredibly useful for anatomy as well, for instance, you can make a card such as, “name all the muscles innervated by the ulnar nerve” or “what nerve innervates the biceps muscle” or “which nerve is commonly damaged in fracture of the proximal radial head?”
If you do this, you’ll succeed. You’ll see these questions dozens of times before your exam, and you will never miss them. The important principle is that you do the cards every day. It takes way less time than going through each lecture again, and you’re actively challenging yourself and sparking brain synapses that are sleeping while you’re watching some boring professor ramble or torturing yourself by flipping through slides over and over again. Don’t be a masochist – make things easier on yourself.
What about concepts and pathways?
Anki is incredible for memorizing the details, the details that land you points on your exam. It would be nearly impossible to memorize all the details that you will need to know come test day without Anki. But don’t rely on Anki for everything. For example, what if you need to memorize the Kreb’s cycle, the brachial plexus, or the branches of the abdominal aorta? This is where you channel your inner artist.
Get yourself a binder, and 3 hole punch a stack of blank white paper. I emphasize blank, because fuck notebook paper with all those lines. Lined paper is for communists. On these blank white papers, draw out the glycolysis pathway, the brachial plexus, or the Circle of Willis in perfect, beautiful, detail. Look at them every day. After you look at them (this is one instance I suppose you could use notebook paper), draw them out. Crumble it up. Throw it in the trash. Do it again. And again. And again. Until you know it cold. If you do this, you will never forget which enzyme converts Glucose 6-Phosphate to Fructose 6-Phosphate. You will never forget which nerve roots contribute to the Musculocutaneous nerve.
I also highly recommend purchasing a white board and hang it above your study space. Draw out these schematics on the board and take a gander at it every time you sit down.
Exam Week & Crunch Time
By this point, you’ve watched every lecture, you’ve quizzed yourself on each important bit of information so many times that you could recite the answer while drunk at the bar, you know each step in the biochemical pathways so well that you could confidently tattoo them on your leg without worrying about getting something wrong. But before the exam, you still need to watch the lectures over again. There are inevitably points you missed, fuzzy concepts, or sometimes a professor will emphasize a point specifically that you didn’t catch. Watch them again on double speed. Don’t pause. Just do it. If you don’t have time to watch each lecture again, be sure to watch them in this ranking:
- Confusing concepts – you know some details but you still don’t get the big picture.
- Information dense lectures – you may have glossed over a few key points in lectures where you had to pause to make cards every 20 seconds.
- Early lectures – start from the beginning; you haven’t seen this material/lecture in a while
- Everything else
How well do you know it?
While doing multiple passes of information through lecture & Anki cards will ensure that you know all the details, you need to see the information weaved into question stems. If your school has practice quizzes, do them. Put Anki on cram mode and do 500 cards. Do the BRS questions. If you’re an M1, you don’t need to worry about getting a question bank, but look for practice in applying your knowledge anywhere you can find it. However, if you’re in a systems based curriculum, it’s not a bad idea to get USMLErx and work through the questions (on tutor mode) for the corresponding material.
Bonus: Outside Resources
I won’t go into immense detail here because I have covered essential medical student resources in this post: Essential Medical School Resources
Bottom line: Sometimes your professors will give shitty lectures. Sometimes they’ll talk about their research for 15 minutes. Sometimes they’ll go into incredibly useless detail that you’ll never need to remember. To know what IS important, get a copy of First Aid. Don’t annotate it or focus on memorizing every detail in the book – there is a time for that. But rather, as an M1, use first aid to see which points in a certain lecture are important. If your professor mentioned something and it’s in First Aid, know it. First Aid is a great guide for differentiating high yield from low yield, especially when you’re hit with so much information that you don’t know what to focus on.
As an addendum, sometimes your lectures are simply insufficient for learning hard material. If you’re in a systems-based curriculum and learning pathology for the given system, buy Pathoma. Watch the corresponding Pathoma video before the lecture and watch it again after the lecture to reinforce material, see what our savior Dr. Sattar thinks is important, and have things explained to you in a clear, concise way.
Now, Pathoma is only for pathology, so if you’re in a traditional curriculum it’ll be useless until second year. However, two weeks ago I purchased a subscription to a similar video service called Boards & Beyond, which is proclaimed as “Pathoma for everything else”. There’s a lot of truth to this statement and I cannot endorse it enough. As an M1, I think it’s a great idea to buy a Boards & Beyond subscription and watch the videos along with your classes. Dr. Jason Ryan is a fantastic teacher, probably better than the one your school assigns to teach. If you are struggling and frustrated with the quality of your lectures, I urge you to give Boards & Beyond a shot. You can email them for a 1 week free trail to see if you like it.
Have a Drink
If you follow this rough outline, you will succeed. I promise you. Here’s the Tldr version:
- Watch lectures from home
- Make Anki cards on all of the information
- Consistently do your Anki cards daily
- Supplement with outside resources (B&B, Pathoma)
- Make drawings and schematics of concepts and pathways; practice drawing them out until you know them cold
- Watch the tough lectures again on double speed before your exam
- Do Anki on cram mode
- Do practice quizzes and questions (school given, BRS, internet, possibly Q-banks)
- Kill exam
- Get drunk
- Feel minimal stress and enjoy your time as medical student
- Rinse & repeat
That is my formula for success. I promise it works. I promise that Anki deserves the hype. And I promise that you will know the information better and feel less stress if you adhere to this. The key is consistency. And afterwards, tweak your methods each and every block until you’re acing exams.
Being a medical student doesn’t have to a bad time in your life. It’s actually a pretty damn good time. Your only responsibility in life is to study. Embrace it. And understand that in the beginning, everyone’s stressed, no one knows what’s going on, and you’re simply adjusting. Stop being so hard on yourself. Study smart. And don’t forget to enjoy yourself when you can.
For more advice on success in medical school, stupid stories from my early days in medicine, and all kinds of other bullshit, check out the medical school section of blog and read more: Med School
And follow me on Twitter for updates on my latest posts: @JordanSoze
These are actually such good tips – especially how to learn complex pathways! Is Anki pretty much the same as Quizlet? 🙂
This was encouraging even though we here in India have a minimum attendance policy. I don’t really understand why it exists. But I think I’m going to use the flashcards… I used to use “cram” before but it got boring pretty quick…so I deleted that app.