Friday, July 15, 2011

Pre-Clerkship Advice Series: Academics

"Be careful whose advice you buy, but, be patient with those who supply it.
Advice is a form of nostalgia; dispensing it is a way of fishing the past from the disposal, wiping it off, painting over the ugly parts, and recycling it for more than it's worth."


8000.  That's my estimate of the number of hours I've spent in the last 2 years devoted to medicine.  Along the way, I've learned a trick or two that I wish I'd known back in September of year 1.  So for all the incoming medical students, I humbly present to you my first blog series:

Red Frisbee's Guide to Surviving BEING AWESOME! in Pre-Clerkship:

ACADEMICS
Medical school is a full-time job (sometimes it feels more like 2). 

A lot of my peers started medical school fresh from an undergrad degree.  In fact, one of the girls I'd pseudo-dated, like many of the other young'uns in my class, hadn't even finished her bachelor degree yet (she was legal...I'm pretty sure).  I, on the other hand, had spent my a couple of years prior to med school being the opposite of studious - being a hobo, working for "the man", and living a nomadic backpacker life. 

Although those years away from school effortlessly stripped away many of the tactics I'd learn in my undergrad years, I'm not sure I was necessarily at a "study skills" disadvantage.  Med school, after all, proved to be a different ballgame for everyone.  There were so many times where it felt like I was trying to drink from a firehose. 

After serving my first 2 years in medical jail school, studying effectively has become easier.  My best suggestion is do what works for you, but here are my study tips to doing well and getting through to the next semester.

1. Hit the ground running
It's still surprising that I managed to survive 1st year considering I crammed like nobody's business.  I did fine on the exams, but retained far less that I should have.

In 2nd year, everyone that I have talked to said year 2 was far more difficult (likely dependent on which school you're at).  I did far better and found it much more manageable because I actually kept on top of things right from the start line.  Still, I've had countless moments of "why don't I even remotely remember this topic?" everytime I looked back at what was taught a month ago.  Unless you're blessed with one of those "hear it once, know if forever" memories like some of the folks in my class, give yourself plenty of time to learn it several times through the block/semester.  Cramming in med school and keeping your sanity are mutually exclusive.  Start reviewing right from week 1.

2. At the end of the day, if you try to know it all, you will kill yourself
Nobody can know it all.  You won't.  The keener at the front won't.  Your doctor won't. 

There have been few exams where I don't recall people at the "high end of the spectrum" in my class feeling like they are going to fail an exam.  Yes, you absolutely need to know the details but it's pointless to stress over not knowing all of them. 

I learned to keep calm by appreciating that the feeling of "not doing great" is inevitable.   Never forget that at the end of the day, your chances of failing (even if you absolutely believe it) are very low.  And even if you do, it's not the end of the world (no one in my class has "failed" out of med school - they get kicked out for far dumber reasons like being cracked out while on duty).



3. Learning Resources
Accept that you will have to build a library
Here's a moment of extreme nerdiness.  I discovered this year that I have a huge crush on books (or if you prefer a "book boner").  I think I purchased 4 or 5 textbooks max in my undergrad years.  Unfortunately, medicine has SO much crap that you absolutely cannot get away without having an effective collection of resources.  Your classroom powerpoints will not cover everything you need to know.  Google and wikipedia will not cut it.  Neither will MD Consult/Access Medicine.  Nor Uptodate.com (these are all great resource by the way). 

Be selective when you do
My personal library is still scant compared to my friends' collections, but that's because I'm selective.  It's easy to become over-resourced once you hear Joe Blow describe how good a book is, or how Susie McSmartass gleams over her new set of antibiotic flashcards.  Over-resourced = overwhelmed = not effective studying.  Take a good look at what you think IS useful and buy those, especially if you can use it throughout the years.  I suggest just start with a good anatomy book and atlas, Toronto's Notes (so concise!), and a clinical skills book (Bates!).  If you have those 4 essential things, you've got a solid foundation and you can add to those PRN.

Pick books that are clear-cut (usually you can get recommendations from friends).  And get PDF's of those that you won't use much.  An Uptodate.com subscription is great but is more useful for the clerkship years.


4. Class
To go or not to go - that is the question
"Wow, I gained absolutely nothing by coming to class today.  I'll still have to go home and spend another 2 hours going through each lecture I sat through."  That's the thought I had in 90% of my days in year 1.  By year two, I smartened up and quit going to class.  That doesn't mean I was sleeping in or out playin' hookey Ok, I went snowboarding more than I should have.  But, nearly every class I wasn't in, I was in the library or at my desk learning the material being taught to my sucker classmates at that very moment .

I was able to go through new material, make my own notes, and most importantly - understand it!  Lecturers zoom through lectures super fast and my feeble brain ain't capable of keeping up.  I ended up saving a lot of time by skipping lectures and knew the material far better by the end of each week.  If you have a small group (see point 5) to chat about the material with, that's even better.  Provided you haven't tried to sabotage your classmates, they'll let you know when is something important mentioned in class you missed (which is about 0.1% of the time).


5. Study group
"I'd love to play poker tonight guys, but I'm meeting with my study buddies tonight." *Snorts and pushes nerd glasses up*
Maybe a study group was your saving grace during undergrad.  Maybe you were the Abercrombie douchebag who laughed at the thought of it.  I was never a firm believer of these until med school, but they definitely saved my ass more than once.  Set a designated time and day of each week to go through what was covered during the week.  Once routine kicks in, they aren't a drag.  It's amazing how different 4 or 5 brains can come up with far more perverted mnemonics than just 1.  And it's comforting knowing that others are going through the exact same excruciating pain as you.  Throw in a beer at the end of the session and life is suddenly a whole lot sweeter.

I also found that going through our Clinical Skills weekly made me a superstar in the clinics as well.  I never took clinical skills seriously during my first year but lemme tell ya - OSCEs are a bitch if you don't practice regularly.  I'm writing this while I'm on a Family Practice rotation right now and my preceptors have been very happy with my patient examinations.  And, again, a glass of wine during clin skills practice sessions are nice too.



6. Get Your Money's Worth!
A lot of my peers were hesitant to get help from the profs and doctors.  I never understood this.  They are being paid by the public and my 20K tuition a year to do their job...teach!  Email them nicely with your questions and they are generally super friendly and willing to help you out.  If you're hesitant just remember...you paid for it - milk it for all it's worth!


7. Lather, Rinse, Repeat
Go through things again.  Then again.  Then again.  Most of clinical practice is common sense, but a lot of the science behind it is not.  Do whatever practice questions you can to help yourself.  Then go through things....again.

Good luck everyone.  Remember - the idiot that everyone knows about in the year above you made it through.  You will too.

1 comment:

  1. awesome blog, keep up the good work! glad you liked my site www.medaholic.com

    Best of luck in your clerkship!

    ReplyDelete