Tomorrow is the first day of school for the Baylor medical students so I thought I’d write this to welcome everyone to the fold!  That goes for the rest of you at other medical schools as well – you are now part of the field of medicine and we’re glad you are here!

The classes you will have and the way you’ll have to study are completely different from what you experienced in college.  So I thought I’d share a little advice to expand on the rules of the road.

1.  It all matters.

Unlike college, you don’t get to choose your courses.  And, during the first year or two there are no electives  – they are all required.  So, the first big difference from college is that you don’t get to choose what is important.  There are a lot of people who have worked very hard to integrate your curriculum, so the good news is that a lot of it should be related (and therefore easier to learn).   One of the nice side effects of this system is that everyone in your class takes every course… so it’s a team effort!

2. Some of it doesn’t matter.

I know this sounds a little contradictory, but bear with me.  The first year of medical school is designed to teach you a new language. There is a huge vocabulary to master before you can move on to speaking this new language.  Some of the vocabulary is necessary to be fluent, but won’t be critical later when you start seeing patients.  Unfortunately, when you start, there is no way to distinguish which is which.  Probably the most important thing to take home from this idea is that you have to force yourself to make sure you have the concepts down before you set out to memorize a lot of details.

3. You just spent 4 years learning how to think and now you’ll have to memorize lists.

I think this is one of the hardest parts about transitioning to medical school.  It’s not that you won’t be asked to think (trust me!), but the first task is to teach you the language.  Unfortunately, that means a lot of memorization.  Until you understand the names of the muscles, enzymes, etc it’s hard to learn how they function and… more importantly, what happens when they don’t function the way they should.

4.  You have to “use” going to class to learn.

At Baylor (and I assume most medical schools), the basic science classes are video recorded and are available on line.  In addition, our students are given notes, slides, handouts, etc for each class.  That means that it’s possible to skip class and still have access to all the information.  You can learn this way, and do well, but it’s not optimal.   In college, most of the time, you heard new information for the first time in the classroom.  That was followed by assigned reading, note review, studying, etc to learn the material.   You can follow that paradigm in medical school and do well – but it’s not as efficient.

Here’s the ideal way (my opinion) to “use” going to class in medical school.

1.  The day before the class, read the notes and assigned reading.  You won’t know this material, so don’t get bogged down!  This is really more “skimming” that studying.  But – when you read, make sure it’s active, not passive. (no “in one ear and out the other”).  The best method I have found for active reading is the SQR3 method:

• Survey – Look through the notes (and any assigned reading) at the section titles, graphs and tables.
• Question – Go through a second time (again pretty superficially) but this time create questions that are likely to be answered in this material and write them down (this part is actually important, so take the time to write them down!).
• Read – Read with intention to answer the questions you generated and make some notes for later review.  Take the time to actually write the answers to the questions you generated if you found the answers.  If not, leave it blank to be answered in class the next day.
• Review – Look over (quickly and once) the notes you made and questions you answered.
• Recite – This is the one that seems stupid to most people, but it’s not.  Based on what is known about learning, reciting the things you really want to remember (out loud, not in your head) every time you review the material really helps with retention.  (better not to do this in Starbucks, though…J..)

2.  Go to class to hear the answers to your questions, make sure you get answers for any unanswered questions, and to create new questions you didn’t think of.  If there is something you don’t understand, or one of your questions wasn’t answered – ask!  I tell my classes all the time that there is no such thing as a stupid question.  If you are thinking it, chances are there are at least 10 other people wondering the same thing.  Ask out loud (to help the other 10 people) or, if you prefer, ask the professor after class. I also ask my students to email me questions they have or things that weren’t clear from my lecture. I post their questions (with the answer) on the first year class listserve (without their names) so everyone in the class benefits from the question.

3. In the afternoon or evening, after your classes are over, sit down with your notes, the handouts and any assigned reading.  Study it.  (The SQR3 method ) Then make a one page summary for each of the lectures – concentrate on the concepts and what you think is most important.   For anatomy, this might be a drawing rather than words. This will be the sheet you use to review before exams, so make sure it has the basic concepts as well as the important “vocabulary” (i.e. memorization) that you’ll need to know. Take the time to list what you think might be on an exam i.e. what questions you would ask if you were writing the exam. Force yourself to stick to one page. It’s how you process and condense your detailed notes into the overview and big points that you will need later in the clinics.

4. Review the material again the next day and a week later.  This review (which does not take long) is the most important step.  It truly is what makes the difference between learning the information and cramming before the test.

What this means, as an example, is that on Wednesday afternoon/night you will

1. Review all the lectures from Wednesday with the goal of making a single review sheet for each lecture (this is real studying)
2. Prepare for all the lectures on Thursday by actively skimming (note, this is not really studying) the notes and assigned reading for the lectures
3. Quickly review your notes from Tuesday’s lectures
4. Quickly review your notes from the lectures 1 week before

By the way – even though you will be working very hard, this is going to be a wonderful year!  Learning a foreign language is exhausting but exhilarating.  You have worked hard to get here, and you will do well.  Like everyone else who has gone through this, you will become fluent – and learn that it is a remarkably beautiful language.