The Secret to Medical School is Practice

The first official event for new students at Baylor College of Medicine is Convocation.  One of the highlights of the ceremony is when a rising fourth year medical student is named as the DeBakey Scholar. The DeBakey Scholar Award was conceived by the Baylor College of Medicine faculty in 1973, as a tribute to Dr. Michael E. DeBakey, one of the founders of the Texas Medical Center and a medical icon, who was revered throughout the world as the most famous surgeon of the 20th century.  It is awarded by a select committee of faculty at the college’s Convocation Ceremony to a currently enrolled medical student, who has completed all but their last year of medical education. The recipient is considered to be “living model of excellence” in residence for the incoming freshman class and the other underclass students and is chosen because of demonstrated excellence in scholarship, integrity, academic leadership and service.

This year’s award winner, Nader Zamani, delivered an inspiring talk to the entering class which he called “ The Secret to Medical School is Practice”. I asked his permission to share the text of his speech with you here.

 

I’ve been asked to speak with you briefly this morning to tell you what I wish I had been told during my own orientation. Though I am hardly in a position to impart any advice, I can definitely tell you about my experiences over the last 3 years and what has been beneficial for me. And let me be among the first to acknowledge that the emotions of excitement, anxiety, intimidation, and even fear that you may be experiencing right now are normal.

They are normal because you know that medical school will not be easy. Yes, you will be pushed. You will experience physical and emotional challenges. And at times, your patience, and even your compassion may be tested.

However, through it all, you will thrive. And when you succeed, not only will you appreciate the journey that much more, but you will also realize how much you have accomplished.

Given the challenges of medical school, you are here because you deserve this opportunity. Though I completely understand that this in itself may be intimidating to know that you are now among a class of incredibly bright and driven students, this is actually one of the best parts of medical school. And to help calm some of your anxiety, please recognize that doing your best does not mean that you have to be the best in any one subject. Doing your best is simply an obligation to yourself to set realistic goals, to ignore the external concept of ranking, and to realize that it is acceptable to say “I don’t know.” In fact, this is only in this way that you will continue to learn and to adapt to the challenges that you may encounter.

Over the next few weeks, you will receive great advice from upperclassman and our wonderful faculty about how to do well. And over the next few months, you will develop study habits that allow you to digest and process the material that you are being taught. You’ll learn how to seek out opportunities that supplement your interests, and to collaborate with faculty mentors to develop a balance in your lives that not only fulfills the demanding aspects of medical school, but also caters to your own health. As I quickly realized, taking care of yourself is one of the most important aspects of medical school, and as you will see, we are lucky to be in an environment that not only realizes that, but makes it a priority.

I have heard many times throughout the course of medical school that to be successful as an academic physician, one needs to devote 1/3 of their day to reading, 1/3 to writing, and 1/3 to thinking. And most recently at the Department of Surgery’s Inaugural Research Day, Dr. Malcolm Brock of Johns Hopkins University told us that it is the thinking part of this formula that ultimately results in the quality research and discovery that has the potential to impact our practice of medicine.

The formula for medical school, however, has to be a little bit different. From my experiences, the 3 factors that would have to be in the formula are:

1) Studying – which includes actively keeping up with the material, asking questions, reviewing, really thinking about what you are learning, and trying to apply these concepts to a clinical setting.

2) Taking care of yourself – which includes eating well, exercising, trying to get enough sleep, and maintaining your social support systems.

3) And one of the most important factors — Service.

Similar to the thinking part of the equation of a physician’s day, the service part of the student’s formula can easily be deferred, especially considering our academic priorities. But I want to use this opportunity to urge you that this is the part of the formula that ultimately makes the difference. Taking time to reach out to others has provided me with the motivation to continue through this journey when it is easy to get bogged down by the stress associated with being in medical school. Whether service to you means working at a clinic, spending time at a shelter, tutoring, or helping your classmates, each one of us can serve our school and community by volunteering our time.

But as with anything else in medical school, you don’t have to do it yourself. By learning to work together with the amazingly talented people around you, you will grow as not only individuals, but also as a class. You will become a community with a sense of obligation toward each other, which is essentially a responsibility to help one another manage the trials that lie ahead. Ultimately, our life experiences may shape our practices, but it is our interaction with others and our service for our community that molds our profession.

I’m lucky to have attended DeBakey High School, because it was while I was there that I first became impressed by Baylor’s community outreach initiatives. Whether Baylor is working to eradicate disease on an international stage, supporting its relationships with undergraduate institutions throughout the state, or enhancing education throughout our local community, it is clear that many of our paths have led us here because of Baylor’s very own outreach programs.

It is in this very sense of community that I urge you to give back as well. You’ll be surprised at not only the inspiration, but also the perspective that you will receive as a result of your efforts. You will realize why you are spending so many hours studying, and you will begin to reevaluate what is truly important to you. In fact, your defining moments in medical school may very well be those in which you actually take a break from studying to reconnect with others.

It’s that very kindness and compassion required in medicine that truly makes our profession an art, one that requires a lifetime of practice. And it is this PRACTICE of medicine that demands so much of us. If there is a secret to doing well in medical school, it is to always keep practicing – practice your studying; practice asking thought-provoking questions; practice your self-care; practice your kindness; practice your service.

The Irish poet John O’Donohue wrote that with inspiration, we are able “To enter each day with a generous heart. To serve the call of courage and love.” We are all truly lucky and fortunate that we are here. We have been given an opportunity to learn not only how to help, but also how to heal. Despite the challenges that lie ahead for all of us, please remember that the road we are on is a privilege…so take advantage of it!

Congratulations, good luck, and we are all excited for you and for what is to come on your journeys here!

Residency Interviews Part 2: The Flights

Unfortunately, the big airlines haven’t caught on to the market of residency applicants, so they don’t issue month passes or an equivalent (any airlines out there paying attention?).

Airline travel is by far the most expensive and most complicated part of arranging your interviews.  As a medical student embarking on the 2-3 month tour of somewhere between 8 and 20 programs, you are probably most concerned about saving money while keeping as much flexibility as possible.  Here’s some strategies and ideas to help:

Strategy 1:  If you live in ahub city, consider whether the long-term payoff for gathering miles on one airline will be worth it.  Right now it might cost more, but if it may make a difference a few years from now. If you get the credit card associated with the airline, there may be other benefits.  But, on the downside – the tickets will usually be more expensive. The other big downside to using most of the “hub” airlines is the relative lack of flexibility.  If you need to change tickets at the last minute, you’ll have a change fee that varies from $75 to $300.

 Strategy 2:  Go with the cheapest possible ticket through one of the third party providers like TravelocityExpediaKayak , or Orbitz.  When you are booking these tickets, remember a lot of big cities have more than one airport.  When you do the math, a much cheaper ticket plus a rental car to drive an hour may put you ahead. Make sure you read the fine print on these “deals”.  This is probably best for the last minute ticket – there isn’t much flexibility if you have to change your flight.

Strategy 3:  Fly Southwest Airlines.

A plane sitting on the tarmac at an airport

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I try not to endorse specific companies, but it is really clear to me, after talking to a lot of students, that there are some real advantages to flying Southwest Airlines for your residency interviews.  The biggest is that there are no change fees.  This means that you can book SW Airlines, check for dramatically cheaper fares elsewhere and then cancel the flight with no fees.  Since SW Airlines lets you keep a “bank” for these unused tickets, you can just apply it to the next trip (or to the well earned vacation at the end of the interview trail).  Check out their flight routesto see the cities they serve.

Try to organize your interviews geographically

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This isn’t always possible, but when it is, it will really save time and money.   On the East coast,don’t forget that the train is a good optionto get from city to city.  If you have more time and less money (and are interested in a great story you can tell) you might think about taking a bus between cities.

There are a lot of myths about early vs. late interviews.  In my experience, it doesn’t really matter.  Most programs take the time to pick the best candidates for their program, and they know that the last person they interview may be the perfect person for their program.

Despite what you wanted originally, you may find that you have been “forced” to book back to back interviews on opposite sides of the country.  There is nothing wrong with politely calling the program coordinators to explain the situation and ask if there might be any flexibility to move you to another date or put on you a waiting list.   Don’t push – remember, being rude to people who aren’t in charge is considered a huge red flag by most program directors. (Not to mention that it’s just not right.)

Build in flexibility for weather

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Residency interviews happen during the winter months.  If you are flying through or to the northern states, there is a real risk of flights being delayed or cancelled.   Don’t book tight connections and last minute arrivals.   Many programs have a social event the night before the actual interview day.  This is really important to attend (more on that later).  In order to make sure you arrive in time, try to book flights early in the day.  If there are weather delays, you will usually still have some options that let you get there in time.  If you make the early flight and arrive early – enjoy a new city that might be your home for the next 3-7 years!  Find a good museum, have a great lunch, go for a walk in a local park.

Avoid red-eye flights

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Yes, they are cheaper.  But – you will arrive crumpled, tired and not at your best.  This is not the time to cut corners.  Take a flight that gets you there rested, in time and able to be ready.

Other advice (from poormd.com, flyertalk.com, businessinsider.com)

  • Shop Tuesday at 3pm Eastern for the best prices
  • Prices stay low Tuesday, Wednesday and Thursday
  • Sale prices are removed from websites on late Thursday
  • Some flights are discounted at night, so check in the early morning
  • Airlines start discounting tickets 3.5 months before departure
  • Airline ticket prices dramatically increase 14 days before departure
  • Tuesday, Wednesday and Saturday are the cheapest days to travel
  • Monday, Friday and Sunday are the most expensive days to travel
  • Sign up for every frequent flier, frequent driver (rental car) and frequent sleeper program (hotels) you can
  • Follow airline Twitter accounts for last-minute deals
  • The first flight of the day is often the cheapest

Getting Ready to Start Medical School

It’s one of the most common questions asked by soon to be medical students…. “What should I do to get ready to start medical school?

Set up your environment

The amount of material you will be asked to master in your first year of medical school is more than you’ve ever been asked to master before.  You have to approach it with a different strategy than you used in college.  One critical component of this strategy will be to keep up with the material – starting from the first day.

If you try to hook up your cable, organize your electricity and straighten out parking at your apartment during the first week, you will fall behind.  Take the time to come explore your new environment and get settled in at least a week before classes start.  A week doesn’t sound like much to miss, but it’s a significant amount of information in medical school! One of the important tasks to check off the list during the week you are settling in is to set up your study area.  Make sure you have a computer that meets all your needs and an area to study that is pleasant, ergonomic and comfortable.  Most students find a dual screen to be very helpful as you are moving through notes and slides to study.

You’ll be spending 1-2 hours studying (at a minimum) for every hour of class.  Given the number of hours you’ll spend studying, you might want to think about an “active” desk that lets you stand, walk, or pedal as your study.

Develop (or strengthen) an exercise habit

Use this summer to develop a daily exercise routine that you can take into your new (and crazy) schedule.  Your goal for the summer should be to develop a balanced exercise program (cardio, strength training and flexibility) that works for you.  If you’ve never done any strength training, hire a trainer and learn about it. If you develop a balanced exercise routine this summer, it will be much, much easier to continue this once you start medical school or your internship. Commit to doing at least 30 minutes of exercise a day this summer and it will be a lot easier to continue once the pressure of school really kicks in.

Link to a Beginner’s Guide to Running

Running is one of the best (and most convenient) cardio exercises for medical students and residents (because it’s cheap, efficient and effective)  Use this summer to become a runner. If you hate running, find another good cardio exercise habit to develop instead – but pick one!

Link to 9 Ways To Make Bike Commuting Easier

If you don’t own a bicycle, think about getting one.  There will be places to ride for fun when you have time off.  You can also use your bike to commute to school which is a great way to sneak in exercise and save money.

Link to Learn to Love Cooking (and Save!!

If you don’t know how to cook, learn.

Good nutrition is an important part of doing well academically.  It’s hard to concentrate and learn if you are eating junk. There is one simple trick to eat well during medical school: Learn to cook.  This is a skill that will become progressively more important as you enter your clinical work in medical school and then move on to your residency training.

Learn some basic skills to cook simple things.  If you have good cooks in your family, have them teach you.  If you don’t have family members who can teach you, find cooking classes near you and sign up.  Many high end grocery stores and gourmet stores offer classes for beginners – look on line for classes near you.

Why Doing Nothing Is One of the Most Important Things You Can Do

Come to medical school rested.

Do not study. Seriously.  We will give you what you need and nothing you can do this summer will make it any easier.  It’s far more important to arrive rested and ready to go than to try to learn material that may or may not be relevant. Take a real vacation (or two). Visit family and friends – take a road trip and connect with people you haven’t seen in a while  Hang out on a beach, go for some great hikes, read some great novels.  Sleep in late, eat well, and just rest!

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The Best of Wellness Rounds 2011

HAPPY NEW YEAR TO EVERYONE!

Advice for interns

Why I hardly ever drink diet drinks

How to choose your specialty

What to do on your day off

Studying basic sciences – strategies for success

Studying clinical medicine

Getting (and staying) motivated to exercise

How to succeed on clinical rotations

Gifts for medical students and residents

Why I’m spending more time on Twitter

How not to have sore feet after a day in the hospital

This Week’s Highlights from @drmlb

Twitter has become a wonderful way for me to send out a variety of ideas and links that I think are helpful (and/or interesting).  Here are this week’s highlights!  If you are new to Twitter RT means Retweet (just “forwarding” it as is) and MT means Modified Tweet (“forwarding” it with a comment).

  • “This is definitely a 15 minute video every medical student should see.” The art of the physical exam bit.ly/nnmaTN @drmlb
  • Comments one makes to colleagues: as important as the interview. Professionalism = doing the right thing when no one’s watching. RT @MedPedsDoctor
  • Beginner’s mind in medicine. How to keep what we do exciting! MT@KevinMD bit.ly/qle7SJ
  • One flight of stairs = 16 calories burned. One day on call = ?10 flights ?20 ?30)..it adds up! @drmlb
  • Epidemiologist with humor?!? This is a great talk about drug development. bit.ly/ovkPyS @drmlb
  • “…small things often adds up to produce a far greater impact than any of us realize.” Surgery through different eyes bit.ly/q5XUkh  @drmlb
  • “..those of us who spend our emotions at work are not the kind to view our work as “just a job.” MT@Kevin MD bit.ly/pRAbmm  @drmlb

Thoughts From the White Coat Pocket – Part 2

Last week was the White Coat Ceremony at Baylor College of Medicine.  As part of the ceremony, several upper classmen are asked to address the entering class, speeches that we call “Thoughts from the White Coat Pocket”.

Good evening ladies and gentlemen. Dear colleagues, let me introduce to you: your first white coat. Brand new, tailored for your size, just came out the plastic bag – it is a pretty cool object to own.  Let me assure you it is far more than that.  This inanimate, fairly non-complex thing will soon become an integral part of you. It will determine greatly how you see the world and how the world sees you, even when you are not actually wearing the white coat.

First of all it is a symbol. It is a symbol of relying on scientific evidence for patient treatment, symbol of honesty and respect, symbol of healing, of trust, of being non-judgmental and accepting. Whatever specialty you choose, everyday you will be dealing with people. Many of those who will come to seek your help will do it on the worst days of their lives. Yes, they will be angry, upset, confused, tearful and cranky and from this day on, you no longer get to turn and walk away or let them figure it out on their own. They will be there to see you, not you as a person, but as someone who wears the white coat, thus capable of making things better…

Because you white coat is also a shining armor that was strengthened by the reputation and effort of multiple generations. This armor will make you stronger than disease, often, but not always stronger than death.  You can hide your fear behind the white coat, it is ok. You’ll learn how to ask uncomfortable questions and how to deliver terrifying news. And you will have many opportunities to be scared: your first day of rotations, your first delivery, the first: “Doctor, what do you want to do?” from a nurse. And, believe me, you will hear these words much earlier than you expect…

And, of course, the white coat is a magic cape. It makes hearts beat faster, it suddenly makes it ok for people to discuss most personal things with you, they will believe in your superpowers, because I don’t know how otherwise explain the call from my former co-worker with a request to cure his dog’s arthritis.

Some may say that this white coat is short, because our knowledge is not so impressive yet. Perhaps, but I view it as foundation. We have not build a house yet, but the moment this white coat touches your shoulders – you’ve started. And when you see your first patient at your preceptors office, remember that although you don’t have the letters MD after your name yet, you, just like, your preceptor, have an obligation to be respectful, empathic and knowledgeable.

So, do you feel those butterflies in the stomach? It is a great feeling, so hold on to it. It is similar to falling in love. You are starting a relationship that is going to last a life time. It is going to have ups and downs, routine, exasperation    and fatigue, but stay determined and work for it. Stay motivated, true and inspired. You are in one of the most exciting professional fields. And I know you have dreamt about it for a very long time. Today, finally, it is official. Congratulations!

Katya Jordan, MS3

Thoughts From the White Coat Pocket

Last week was the White Coat Ceremony at Baylor College of Medicine.  As part of the ceremony, several upper classmen are asked to address the entering class, speeches that we call “Thoughts from the White Coat Pocket”.

When I think back about my white coat ceremony 4 years ago, I remember being really worried about what outfit I was going to wear that day. I went through every tie and shirt combination at least 10 times. Eventually I just decided this occasion was too big of a deal and went out and bought a brand new outfit…which I never wore again. I must have taken a million pictures in it…I mean I needed just the right lighting, a smile that said “I’m a professional young doctor with a great bedside manner but could also be an extra on a daytime soap opera,” and if I cropped the picture just right you couldn’t even tell it was a short white coat. Admittedly, it was my Facebook picture for almost a year, marking the beginning of a great journey. Little did I know that both the pristine, little white coat and I would never be the same.

See the funny thing about the white coat is that it changes just as much as you do during medical school. I remember the first day of preceptor for PPS1. I was so proud to wear it. To my shock and horror, that same day a 15 year old boy with a bad stomach bug would defile my coat. I scrubbed it, took it to the dry cleaners, and yes even sent it to my mother. The coat was clean, but something felt different about it…the coat had changed…I had changed. It no longer represented the promise of clinics. It had seen it’s first battle with disease and survived, and a part of me was proud of that.

My little white coat would not see battle again until my second year during my first day of clinics. I woke up that morning and had my best friend take once again a million pictures for Facebook. It was that year that the coat and I transformed again. It was no longer a symbol but rather a tool that I could not live without. During my internal medicine rotation, it held my books, my stethoscope, my penlight, and my history and physicals as I anxiously waited to present. During surgery it held my trauma sheers, bandages, and my granola bar to get me through heart transplants. During psych, it distinguished me from the patients so they didn’t put me away! I couldn’t live without it and a part of me didn’t want to think of a world where I didn’t have 4 massive pockets. True story – I once put a Venti iced coffee in the pocket of my white coat and walked from BCM to Ben Taub with no spillage….these coats are indestructible!

Then something happened this year. I started my sub-intern month on the brink of being an MS4 and decided to leave my coat in the team room. These were MY patients, I was the acting intern and I needed to go into battle without my security blanket. The white coat and I grew apart…and I started needing it less and less. This trend continued as I began my fourth year and started taking more responsibility for my patients. Suddenly the coat felt too small, it could hold my stethoscope and my books, but it could not hold all the responsibilities I was going to face next year.

I will always be grateful to my short white coat. This is a very important day for all of you, take care of your coats and remember what they stand for. When you wear them you are representing BCM and all the generations of amazing physicians this school has produced. And when you get to your fourth year and feel those pockets getting heavier, when your coat feels small and you are ready to take on the challenges and joys of being a first year doctor…that’s when you know you are ready for the long coat.

Welcome to the family BCM class of 2015 and Congratulations!

Tony Pastor, MS4

How To Succeed In Medical School

Yesterday was the first day of orientation for the new medical students at Baylor.  One of our traditions is to announce the winner of the DeBakey Scholar Award at the beginning of orientation.  The DeBakey Scholar award is one of the most prestigious awards given at Baylor; it is awarded to the rising senior whose academic success and character best emulates Michael E. DeBakey.  This year’s award winner, J. Mason Depasse, was asked to give some advice to the new class of medical students.  His remarks were so exceptional I asked his permission to post them here.

Welcome and congratulations on your admission to Baylor College of Medicine. My name is Mason, and I spoke to many of you during your interview day and second look weekend, when I told you why I loved Baylor. I hope that, after your retreat, you are already beginning to love it here as well. You made an excellent choice, and you will appreciate that more and more as you progress. I could go on and on about what makes Baylor great, but today I’m not here to talk about that. Today, I’m here to talk to you about how to succeed in medical school.

I remember my first day of orientation, and I know the mix of anxiety and excitement you are all feeling. I’m sure you have been told about the flood of information coming your way, and many of you may already be bracing yourself for the impact, particularly those who have had time away from biology or those who have an eye for a highly competitive specialty. While nervousness is perfectly natural, I want to stress that, when the material starts building up – and if you remember nothing else from this talk, remember this – you should not panic. Don’t freak out. People from all manner of academic backgrounds do it every year, and no matter what you’ve been doing or studying for the past four or ten years, you will get through it. It might take a little elbow grease, but you’ll make it.

To help you get started on the right foot, I’ve compiled a short list of things to keep in mind as you begin the basic science curriculum.

First and foremost, try to keep up. This is far harder to do than it may sound, but try your best not to procrastinate. The easiest and most reliable way to successfully tackle any seemingly overwhelming task is to break it into stages, and absorbing the enormous volume of information in basic science is no exception. In college, most of the testing in the sciences focuses on concepts, particularly for upperclassmen. You studied a set of rules for how to calculate electric fields and… something about nucleophiles, and you demonstrated that you could apply those rules. You all have the aptitude and the study skills to succeed in those courses, or you wouldn’t have gotten into medical school. Unfortunately, these skills will not be as effective here because you can’t outsmart basic science. You can’t do it. It’s a whole world of knowledge, and as our professors told us, you just “gotta know it.” You have to put in the hours, and keeping up with the material by regular studying makes this manageable. Get into a routine, and try to stick to it. And when you get a bit behind, and we all get behind at times, catch up as soon as you can.

Second, find a way to study that works for you. This may sound obvious, but I’ve seen students become concerned that they are not in a study group, or aren’t making flash cards, etc. But study groups and flash cards may not work for everyone. There is no “wrong” way to study; if it works, then you’re doing it right.  Your PRN leaders can give you all manner of suggestions for study tips and tricks, and you should feel free to try them out. You have a practice diagnostic exam before your first set of real exams, and you should use it to determine whether your method is working. But even when you find a strategy you like, your study method may not always work. Medical school is a long haul, and there are a lot of different challenges to face. Keep in mind that succeeding here is about adapting and persevering in the long-term. I wasn’t always happy with my performance, I was frustrated at times, but I found that it’s not worth beating yourself up about it. Adjust and prepare for next time.

Third, use your resources. Your professors will provide you with documents and powerpoints of their lectures, and these will sufficiently cover the material. However, you may find it helpful to supplement your reading with outside sources. Don’t overwhelm yourself, but there are all manner of texts and reviews available. Even looking over a topic in First Aid, the Bible of USMLE Step 1, can be helpful for solidifying your knowledge. Furthermore, don’t be afraid to ask for help. Baylor has a culture of cooperativity. Your classmates, your PRN leaders, upperclassmen, and professors are all here for you and will be happy to provide advice and support.

Fourth, stay balanced. Medical school can be very demanding, and it is easy to burn out if you don’t take care of yourself. Go out with your friends. Join IM sports. Go to the gym. If you’re applying to orthopedics, go to the gym again. Whatever you do, take a break. Two productive hours of studying are far more effective than four hours of staring blankly at the same page. Believe me, I know. There will be weeks along the way during which you will work a ridiculous amount of hours and balance isn’t really feasible, and when those come along I recommend trying to make it up afterwards.

Finally, once you’ve gotten settled into a routine, be aggressive. You’re here because you want to be physicians, and you’re paying through the nose for it – though not quite so much at Baylor. Thankfully, you chose an institution with just about every opportunity for research, service, and clinical experience that you can imagine. Seize them. Join student groups. Email professors you want to shadow or work with in the lab. Go to Ben Taub and learn how to start IVs and suture. When you’re on clinics in what feels like forever from now, I want you to remember that you are the only member of your team who is paying to be there. So get your money’s worth. Know your patients, and I mean really know them, and imagine that you are making all of the decisions. Think of your own treatment plans, and ask questions if yours differs from the final one. Medical school shouldn’t be four years you just have to get through in order to become a physician. Don’t let medical school just happen to you. Medical school is your chance to sample the spectrum of clinical medicine and gain the experiences necessary to begin forming more concrete career goals. So once you’ve got your rhythm going and you’re comfortable with your routine, I strongly encourage you to get out there and explore.

J. Mason Depasse, MS4

 

Starting Medical School: Strategies for Studying

Today is the first day of medical school at Baylor College of Medicine!  Welcome to our students, and to new medical students starting at other schools in the United States (and the world!).  The following is a guide on how to study for new medical students written by senior medical students and faculty for our Transition to Medical School course.  I thought it was exceptional – and worth sharing.

Your goals

  1. Learn material for long term retention
  2. Pass exams
  3. Develop skills for lifelong education & studying (nope, it never stops but it can get faster!)

1. The Basics

  • No magic formula for studying except for diligence and consistency
  • Goal is to learn and apply pertinent material – NOT perfection
  • Efficiency is a skill developed through practice, persistence, and reflection – not the result of drinking more caffeine or a genetic trait that skipped your generation
  • Studying is not a competitive sport – some student take (much) less time to learn than you will, but some take (much) MORE time than you…that’s life! Good news – in the end, we are all doctors.
  • Be gracious.  To yourself and your peers as you pass through the basic science crucible that brings out some less than pleasant coping mechanisms.  It’s normal and will pass.
  • You will succeed!  Don’t believe us some days?  Ask any of the thousands of physicians, professors and mentors around you – we’ll be glad to remind you!

2. The Specifics

  • Choose one way to study and stick with it for at at least 1 week
    • Switching study methods costs more time than it saves and there is a learning curve to all of them
  • Start with the first lecture and go sequentially to be sure you don’t miss topics
  • For all study techniques
    • Study reps: 45-50 min “on”, 10-15 min “off” (see below)
    • Skim before lecture (assigned readings, ppts, syllabus, etc)
      • SKIM to familiarize yourself with how to spell new words and the general outline/concept of the lecture – this is not learning time
    • Attend > stream lecture and actively listen by taking notes, drawing pics, writing qs, etc.
    • Take a lunch break after lectures to get good nutrition, socialization and to recharge
  • Techniques for LEARNING
    • Mind maps
    • Review notes with ppts, syllabi and text book and create a condensed 1 page review
    • Rewatch the lecture while condensing notes and focusing on main points
    • Flash cards of high yield material
    • Single page flow chart of material
  • Techniques for REVIEW
    • Practice questions (online, review BRS books)
    • Small group discussion, lecture by lecture (max 4 ppl)
    • Small group quizzing of lecture material
    • Peer or upperclassman tutoring

Study Reps: 45-50 min “on”, 10-15 min “off”

  • “ON”
    • Close email, g-chat, FB, other distractions, put phone on vibrate/silent
    • Set an alarm and STOP studying when it goes off
    • Write down other tasks that come to mind on a sticky note but do NOT stop studying to do them (ex: reply to email, wash dishes, make a snack, look-up question from another lecture, chat with nearby friends, etc.)
      • These tasks can be done during your “off” period
      • You will be amazed at what distracts you and feels “urgent” while studying, but there is almost NOTHING that can’t be put off for <45 min, including perez hilton
    • Don’t be frustrated if the first 15-20 min (or more) feel “wasted” bc you can’t focus – this is NORMAL and the time from sitting to focused productivity will decrease as you adjust to a daily routine (the same as exercising)
  • “OFF”
    • Set an alarm
    • Reward time! NO STUDY RELATED ACTIVITIES!
    • Grab a snack, read a NYT article, catch up on the FB developments (OMG, so much happened in 45 min!!!), chat with a friend, send off a quick email, check off the list you made during  your “ON” period
    • Get up and stretch, walk around for a couple min – it’ll wake you up, get you out of your “study zone” (wherever  you are working)
    • Congratulate yourself on sticking to your study schedule and breaks
    • Relax and don’t worry about how much time you have/not spent studying, let the alarm clock guide you rather than checking your watch constantly

3. The Refinement

  • What works for others may or may not work for you – don’t be discouraged!
  • Study methods evolve as you discover what sticks best in your own head
  • New topics/blocks may require different approaches
  • At the end of the week or block, reflect on what worked well (timing, setting, method)
    • Adjust study methods to what works best for you – but remember, DILIGENCE and CONSISTENCY are king & queen
  • Exam results not reflective of your efforts?  Ask for help! Professors, upperclassmen, mentors and strong peers can enhance your study skills.
  • STUDYING is STUDYING – it is never wasted.

4. The Balance

  • All work and no play makes a miserable and burned out student, resident and physician
  • Set aside at least 1 hour as sacred for meeting your personal needs (NOT chores)
    • Examples: exercise, cooking a nice meal, calling friends and family, reading a great book, prayer or meditation
  • Sleep on a schedule: go to bed and get 7-9 hrs of sleep every night, your brain needs that time to literally build memory
  • Eat well: again, your brain and body need good protein to build synapses for memory, carbohydrates for fuel to burn while studying, and plenty of water to keep you going in the Houston heat
  • Break up your week: take Sat. afternoon/evening off for fun activities with friends/family (movies, restaurants, dancing, bars, parties…), sleep in Sunday morning and have time for yourself and your personal development (reading, writing/journaling, church, chats with significant other)
  • Schedule it: if we write it, we do it.  Use your gmail calendar, phone app, planner, etc. and plot out your week including your studying, exercise, family/friends and other activities.  It will give you a sense of control over your life as you plan your days, rather than your days ruling you.

5. The Non-Science Major

  • You’re not alone – great physicians come from a variety of backgrounds!
  • You may play catch-up at first, but you undoubtedly can succeed
  • Writing and theoretical dissection of literature/theory/philosophy/art will be applicable in medicine – but basic sciences throws you back to the forgotten days of multiple choice exams and memorization.  Dusting off those skills and learning to study for regurgitation/application rather than creation may take some time, so don’t despair if you are spending longer in the library than the Bio-E major.
  • Link up with a science-major classmate who is good at identifying high-yield material AND explaining it.
  • Contact the upperclassmen study tutors – many of us had limited science exposure starting med school (“Wait, is it 2 livers or 2 kidneys – I’m not really sure?” – General Surgery Bound MS 4) and more than succeeded — but we’d love to make that transition easier for you!

Starting Medical School: Rules of the Road

In the next few weeks 17,000 college graduates will start the process of becoming lifelong students of medicine.   Medical school is a wonderful, but at times difficult experience.  Here are five “rules” that I hope will help with this exciting transition.

 

1. You can drink from a fire hydrant, but you’ll need to learn how.

The amount of information you are going to be exposed to in medical school is logarithmically more than you had to learn in college.  At Baylor (where I teach) we calculate that the first year of medical school is the undergraduate equivalent of 22 hours of course work per semester.  It really is like being asked to drink from a fire hydrant.   You are going to have to study more, study better and actually use the time in class to learn.  The first year or two of medical school may, at times, seem like an obstacle course you have to “get through” to get to the “real stuff”.  But these first two years are important; You are learning a new vocabulary… a new language.  If you don’t learn the breadth and depth of this new language, when it comes time to apply it to patient care you won’t be “fluent”.   By the way, sometime during the first month or two of medical school you will think that a) everyone here is smarter than I am, b) the admissions committee must have made a mistake and I’m not really supposed to be here and c) there is absolutely no way to read all of this material.  But, like everyone who has done this before you, will discover that a) you are just as smart as everyone else (sometimes in different ways, but equally effective) b) nobody made a mistake – you really are supposed to be here and c) you have to change the way you study, but you really can learn this much material.

 

2. Make your bed.

You wanted to become a doctor for a myriad of reasons, but one of them was surely because service to others is important for you.   Therefore, you are already primed to sacrifice a lot of your needs for other people.  Sacrifice is part of the culture of medicine.  But, it’s like a Starling curve… a little sacrifice makes you better, but too much makes you ineffective.  “Make your bed” is a simple rule (and action) which helps you remember that you need to take care of your environment, your fitness, your nutrition and your spiritual wellbeing as you are learning how to become a physician.

 

3. Act like a doctor – starting now.

We (all practicing physicians) see you as a doctor already.  I know this is a really hard concept for first year medical students, but it’s absolutely true.  You have started your apprenticeship and, unless you are one of the very, very few who change their mind, you will have an MD after your name in 4 years.  With all of the joys and privileges that come with this role, there are a few responsibilities to start thinking about as well.  Start thinking about your decisions, words and actions and how they might be interpreted by patients or colleagues.  It’s no longer acceptable to put anything you want on YouTube, Facebook, Twitter or other social media.  How you dress and act when you are in professional settings will be important.  You’ll learn more specific details about professional behavior from your professors and colleagues as your training progresses, but the core values of medical professionalism start when you enter the profession, which is now.

 

4. Kindness matters.

It is remarkable how our paths in medicine cross over and over again.  The person sitting next to you on the first day of medical school may be someone who will be an intern with you in 4 years or who will refer you patients 10 years from now.  You and your classmates will be going through classes together (like you did in college), but this is different.  You are starting your professional life together as well.  The camaraderie that results is a gift and is also very important personally and professionally.  Don’t blow off the class events.  Don’t stay home to study instead of going to class.  Go out of your way to meet everyone in your class and really get to know them.  Cultivate and nurture these important friendships.

 

5. Enjoy the journey

You are about to embark on a life changing (and fulfilling) journey.  This journey is a privilege and it is very, very special.  Take a few minutes everyday to write down the events of the day.  The first time you hear a murmur in a heart will be just that – the first time.  Take a minute to record what that was like.  You are going to have a lot to process as you start studying anatomy – more than just the names of the structure.  “Talking” about it in a journal is a great way to make the transition we all make in the anatomy lab.   There are also going to be some hilarious stories and events that you’ll forget if you don’t write them down.  When you look at them later, you’ll be glad you recorded them with words, photos, or drawings.

 

“Our study is man, as the subject of accidents or disease. Were he always, inside and outside, cast in the same mould, instead of differing from his fellow man as much in constitution and in his reaction to stimulus as in feature, we should ere this have reached some settled principles in our art.”

William Osler, from Teacher and Student, in Aequanimitas.