Studying in Medical School – Making it Relevant

One of my rules of the road for Medical School applies to studying:  “You can learn to drink from a fire hydrant but you have to learn how.”

(this image is from the online Palm Beach Fire Department coloring book)

There are three issues you have to come to grips with as you start medical school (i.e. the things that are different from college)

  1. You are going to have a volume to study that is overwhelming
  2. You have to memorize a good portion of this overwhelming material because you are learning a new (foreign) language
  3. Most of the information you will be given is actually important  (i.e. there’s not much you can blow off)

It’s hard at first to distinguish between the things that you need to know on a permanent basis (all of the cranial nerves) and what you need to know for the tests (foramina of the skull… unless you end up a neurosurgeon).  At first you just have to assume it’s all important, but, as time goes on (particularly after you are in the clinics), you will become more adept at compartmentalizing things into permanent memory, retrievable memory and “look it up” memory.

“A man should keep his little brain-attic stocked with all the furniture that he is likely to use, and the rest he can put away in the lumber-room of his library, where he can get it if he wants it.”  Sir Arthur Conan Doyle

It’s easy for anyone to study the night (or week) before the test.  The pressure is on, and the deadline that looms tends to make you efficient and driven.  But there is no question that this is not the way to go for things you really want to learn.  You don’t want to be the kind of doctor who treats a seizure based on what they “crammed” for a test… you want the concepts of treatment in your memory, accurate and retrievable. (The details are another thing… that’s what the internet, drug formularies and books are for.)

How to drink from a fire hydrant, lesson 1:  The core of adult education is relevance.

I remember the drudgery of learning cardiac physiology my first year of medical school.  Hour after hour of the physics of contraction, the list of receptors, the details of the cellular organization.  I tried to memorize it over and over, but this was really boring stuff.

One day a classmate dragged me along to a “noon conference”.  I’d like to say it’s because we were really motivated, but actually it was because there were free sandwiches.  But a funny thing happened…. It was fascinating – a discussion of how patients with heart failure present, how to treat them and why it was important.  And all of it was based on the physiology I had been studying!  I actually understood what they were talking about!  When I went back to look at what had previously been boring, I now understood why it was important.  It was relevant and, therefore, it was easier to learn.

Every medical school has a long list of conferences open to anyone in the medical school.  Many of them happen in the early morning, the late afternoon or at lunchtime and, therefore, they fit in to the schedule of basic science students.  Check out the calendar on your school’s web site. Start with the departmental grand rounds (weekly lectures given to teach the entire department from the medical students to the full professors).  Don’t limit yourself to medicine and pediatrics.  Go to the grand rounds given by orthopedic surgery, rehabilitation medicine, psychiatry.  Ask clinical students you know if there are interesting lectures that you might be able to attend.  Look on the medical school web site for visiting professors or special lectures.  This is not only a good way to make studying more relevant, but you may find something so interesting that it could end up being your future career.

There are other ways to make it relevant.  Spend a minute on PubMed or UpToDate (both of which should be free to you through your medical school) to find clinical information that makes the topic interesting.  If you are studying the rotator cuff in anatomy, look up rotator cuff tears and how to treat them for 5 minutes before you start studying.  If you are learning about peristalsis in the GI tract, find a review article on abnormalities of peristalsis.  But – Don’t get bogged down.  You won’t understand much of it to start with (which is normal!).  Don’t try to be a “gunner” (the slang at Baylor for the students who sit in the front row and try to get every question right) and try to learn the clinical information.  That’s not your job in basic sciences!  Just use it to motivate you – to undertand that there is a context for this new language you are being asked to learn.

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