Monday, March 21, 2011

Study Strategies During Medical School

Studying in medical school is different than any other studying you have done before. This is just a fact. This is true because of the amount of information thrown at you each day. It has nothing to do with difficulty, in fact 98% of medical students are well prepared for the level of difficulty and its not a matter of trying to “understand” concepts. The difficult part is absorbing all the information and then retaining it. 4 to 5 lectures a day, each day with new info trying to get it all in and remembering what you learned the previous days is tough. Cramming almost everyday for monthly exams keeps you in “test mode” constantly.

Two learning scenarios in general that you deal with in medical school:

1) Lecture
In lecture, professors often try to turn it into an interactive process where they implement the Socratic method and ask questions to the class. They try to generate class discussion. Without getting into a grand description of this let me just say that this approach to a large group (>100 students) is not effective for most students. This concept comes from a Law school model that works well when discussing abstract philosophical thought and correlating it with the practice of law but it does not work well when trying to teach objective science. Personally I prefer a lecturer to merely stand and deliver the information. I find constant questioning to be a distraction and takes away from the delivery if info. However there are many students who prefer that method.
2) Small group
In small groups you and about 5 -10 students meet and discuss cases relevant to current lecture topics. This is an area where open discussion usually does help with the education process.

Ok let’s get back on point. This post is really about how to effectively study in medical school. Remember that this is merely my preferred study method. In my school, and many schools, they make use of the Podcasts. Podcasts are great because they allow you as a student to watch the actual overhead presentation of each lecture and hear all the audio. They usually get posted an hour or so after the lecture is completed (see podcast post below). I tried going to lecture for the first three months of Med school and did fine. I was getting 70% to 80% on exams and I was ok with that. The problem was that I was working my ass off and felt like I should be getting 90% for my effort. I began transitioning to podcasting and my first exam was a 95%. Overall I yielded a net gain of >10% on all exams with podcast. Dont ask how I figured those stats.

Studying for each lecture, you should have a strategic approach that you use with all of them. I would first skim over the lecture notes, which were pre printed by our school. I would focus on paragraph headings and try to think for a moment about each topic without reading the actual paragraphs, effectively brainstorming what I already knew about those areas. This would prepare my mind for that information. Once comfortable with the big picture I would begin back at the first paragraph and read through it quickly. Then again more methodically and try to pull out the big-ticket items. I would go on the each paragraph with the same approach. When done with the reading I would view the podcast and watch it diligently, pausing it almost every 2 minutes to effectively take notes. When done with each lectures’ reading and podcast I would complete the learning objectives, which our professors outline for each lecture. After completing them I would move on to the next lecture and do the very same thing until either I was starving or exhausted.

For those of you who aren’t furnished with preprinted notes and instead only have reading assignments from book chapters, it will be more time consuming but doable.

Unless you are uber smart and able to retain things that you see only once, you will have to maintain firm dedication to studying and never get lazy. When you are tired, yawning and your eyes are losing focus of the words, coffee will not help (Coffee only helps your brain when your brain is alert). At that point you should take a 15-minute power nap and get back to it. Seriously, this works well. I would lie on the hard floor with my legs on a chair and fall asleep. On the hard floor it takes about 15 minutes until pressure points cause you some pain and wake you up. This is your built in alarm clock. Get up, suck it up and get back to work.

I studied all day everyday, literally. That’s what it took for me to be as successful as I wanted to be. I would take a day of review each week and go back through only the learning objectives of previous lectures. I never used note cards because I didn’t learn that way. I merely read through the learning objectives and recited them out loud sometimes. As soon as I felt solid with the information I would meet a loyal study partner who had the same study strategy. We would both go through the learning objectives and talk about them, always learning new information from each other. With out my study partner I would have done significantly less well on my exams.

That’s it for now. Any specific questions pleas make a comment to this post and others can add their input as well.

Thursday, March 17, 2011

How do I begin the process of getting into Medical School

How to begin the process of “getting in to medical school”. For some PJ’s this will be easier than others. Those with their bachelor degree will only have to catch up on the pre-med courses and then go into MCAT prep. Those without a degree will have to gut it out and spend the time in college. Preferably at a major university. I wouldn't suggest finishing your degree at an online university. Either way here are some bullet points on the overall process:

• It doesn’t matter what your undergraduate degree is in. In fact, many medical schools are looking for non-science degrees such as philosophy or history. I suggest you major in something that you enjoy because this may be the last opportunity to learn something other than medicine.

• Make sure you work your ass off and get the best grades that you can. You do not need all A’s but the more the better.

• In addition to your undergraduate or as part of a minor you need at least: 2 semesters of physics, 2 semesters of general biology, 2 semesters of general chemistry and 2 semesters of organic chemistry. You need college algebra for all schools and some may require calculus but most don’t. Be sure to check the requirements of the schools you are applying to because some require other courses.

• You do not need to major in physiology, biology or to take a lot of science classes in addition to those noted above. That is what med school is for, to teach you the science that you need to know. They do not expect you to start off knowing it all. However there are some classes that would be helpful. If you have an extra semester or need filler classes I suggest that you take genetics, molecular biology, cellular biology, and statistics. But don’t stress if you don’t have them, they are not necessary for most schools.

• While you are taking the basic pre-med science classes noted above I highly recommend that you purchase the examkrackers study set and use the books religiously during your course work. This will start off your MCAT studying and will make that nightmare a little more palatable.

• During your last year of school (about 6-8 months before you apply to med school) start studying like crazy for the MCAT. Use the examkrackers books, make sure to get the Verbal reasoning books (plural) and use the online Kaplan resources. I tried the Kaplan classes and went to a few but found them to be utterly useless. I suggest using only the online resources.

• About 6 months before applying to med school begin requesting letters of recommendation from professors of your science classes and from some of the Doctors you have worked with in the past. MAKE SURE to establish sound relationships with your professors as you go through your undergrad. They will pay dividends. These guys will write you excellent letters and they will be a huge part of getting accepted to a med school.

• Also, during this time start writing your personal statement. Take this very seriously. Search the Internet for samples and spend as much time as you can to make yours perfect. We all have something that most med school applicants don’t have and that is our experience and training as PJ’s. Write about that. Make your opening statement exciting and fill it with drama. That’s what’s necessary to catch the reader’s attention. A great personal statement can almost single handily get you in the door, assuming that you have a reasonable MCAT score and grades.

• I said reasonable MCAT and grades, this means that you don’t need a 4.0 and a 35 to get accepted but it also doesn’t mean that you shouldn’t try to achieve those numbers. Give it every ounce of energy that you have and you will be successful.

• Make sure to utilize your University's pre-med/pre-health advisors. Most schools have dedicated staff that specializes in helping students get into med school. You need to make contact with them at the very beginning of your coursework so they can set you on the right path.

• The application process for med school is a huge ordeal and can be tedious. Email me with specific questions on that.

• For the most part if you follow the basics as I have laid them out you will be on the right track. There is obviously much more to it than I have noted above but the rest are primarily nuances that are usually different for each individual.

• Leave comments to this post and myself and others will be able to answer your questions. Also feel free to email us and we will get you set.

• Finally, take a look at the University of Arizona’s undergraduate program and its medical school. There have been two PJs who have went through those programs and another one just got accepted there. I expect to see another two or three get accepted within the next three years. We kind of started something over her in Tucson.

Thursday, March 10, 2011

New Lupus Drug

This is the first drug to come out in 50 years for treating Lupus. Although after reading this article I am a little skeptical of its efficacy, it does show that scientists are moving in the right direction. As I am sure everyone on this site is aware, Genetics is the wave of the future and the amount of impact Geneticist's are having within the field of medicine is astounding. More to follow...

Wednesday, March 9, 2011

Podcasting in Medical School

The following was written on the utility of Podcasting lectures in Medical School:

A student’s duty is to learn, and their first step is to determine how they learn. Albert Einstein once said: “Insanity is doing the same things over and over again and expecting the different results”. If a student determines that they are less able to learn from attending interactive lectures or case conferences time and again, they owe it to themselves to make a change. That change for many students at major Universities is the podcast. A podcast is in essence a take home lecture; a means to bring the lecture hall to a more suitable environment customized for each student. Ultimately it is a new learning tool offered to the student of today to ensure efficiency and optimize time management. In a technological world with so many new choices to assist a student in their education it is essential that every student identify the tools that work for them.

So what is the problem? If Podcasts were such an excellent educational tool that serves the needs of so many students why would it be necessary to write this treatise? The answer is simple. This new technology, like others, is not well understood by professors, and there are widely held misconceptions that cast podcasts in a bad light. Too many professors are reluctant to accept podcasts as positive because they firmly believe that students SHOULD be in class. Misunderstanding the podcasts has resulted in the assumption by many professors that the students who use them are lazy. This treatise intends to clarify exactly what a podcast is and explain how it is used. The ultimate goal is to express the concerns by students and attempt to explain this new technology with the hopes that the modern educator will understand and come to accept podcasts as a productive new learning tool.

Some professors disagree with the idea of podcasting because they believe students should be in class to ask questions and interact with their peers. While that may be true for some, it is not true for others and this presents one of the biggest hurdles for the podcast: overcoming this misconception. Many professors set up their lectures to be interactive in an attempt to make the environment more stimulating. Their goal of course is to attempt to make the experience of sitting through lecture as high yield as possible. This is a great strategy for those students who engage during lecture but it is of no benefit to those who don’t.

Many professors seem to think that the student should be required to attend lecture and therefore go out of their way to penalize those students who don’t attend. For example, many will refuse to use the podcast pointer or they will use the chalkboard rather than a power point presentation with the hope that if enough material is restricted to the classroom then the podcasters will feel pressured to attend. Forcing a student to attend lecture is not an effective means of educating. It will not accomplish anything besides filling a lecture hall, which is not synonymous with learning. Those students who do not learn while sitting in class will not suddenly be motivated to interact or ask questions. In fact, most of those students find the constant questions and interruptions in lecture to be more of a distraction than a benefit. Sitting in class is simply not conducive to learning for some students and pressuring students to attend only disrupts the learning process for them.

For those students who cannot fully benefit from attending lecture, podcasts are an important part of their individualized adult education. They allow the student to pause and think before moving on. The student can take comprehensive notes and understand them before they proceed to a new topic. This option is lost in the lecture hall as the student will only have time to rapidly jot down a quick note before the professor moves on, hindering thorough understanding of the topic or to even take proper notes. In the past this was the best option but still ineffective for many students. But we now have a new option, the podcast, which allows a much higher yield. A student can now take in information at his or her own pace and to process it effectively.
Here is an explanation of the benefits of the podcast as described by a student of the COM Class of 2012:
“Since I began using podcasts, my average test scores went up approximately 10 percentage points. In addition, because podcasts are a more effective use of my time, I spend less time per lecture than I previously did. For example: Prior to using podcasts, I was spending an additional three hours on top of each 50 min lecture I attended – a total of 4 hours per lecture. Given that on average we have 3-5 lectures per day, I was struggling to just stay caught up. With podcasts I go through each lecture slowly; I start and stop, replay, etc. Podcasts allow me to organize my thoughts and learn as I go. I am able to hang on every word the professor says and make sure I write it down. In class this is not an option. Even with this amount of detail my time per lecture is still reduced by podcasting – only two hours per lecture compared to the four I previously spent. In effect, I learn more of the material in about half the time.”

This statement demonstrates that some students find the podcasts not only more practical but as a valuable tool to better comprehend the material. Should a student be obligated to attend class when it is clear that their success would be diminished? If you ask the students who use the podcasts I am certain that the answers would be “no” across the board.

Another misconception seemingly held by many lecturers is that students are just plain lazy and use the podcasts as an excuse to not come to class. There is no doubt that there are lazy students but podcasts are not to blame for this. Those students will always find a way to remain lazy, irrespective of the availability of podcasts. In fact, the majority of the students who don’t attend class don’t even use the podcast. Many block directors have confirmed that before podcasts, there was an equal number of students present at lecture and the advent of the podcast has not significantly decreased the numbers of students in lecture.

Professors often think that a student just can’t understand the material presented if they aren’t in class, believing a student must be physically present in order to learn. As a student who has tried both, I can tell you that this belief is simply incorrect. One’s physical presence is not a measure of their attentiveness, determination or work ethic and most certainly does not equate to what they can learn. What professors don’t understand is that podcasters diligently watch the entire lecture, pausing it from time to time to jot down notes, and rewind to ensure a proper understanding of what the professor is teaching. This reflects the student’s enormous respect for the material that is being presented, and in effect, the time and effort put into a lecture by the professor is not lost on the podcast, but rather, amplified.

Lecturers should not ostracize students for utilizing different learning methods especially when those methods have proven to be successful. One of the greatest complaints by podcasters is being made to feel like less of a student, as if they do not work as hard for choosing to utilize podcasts. In every block (though not with every professor) podcasters must listen to comments directed at their absence. Some professors go out of their way to make it more difficult for podcasters to get the most out of lectures. For example, one professor said he preferred to use the laser pointer because he knew that podcasters could not see it; that there should be some reward for those who attend lecture. Nothing more acutely destroys a student’s motivation to learn than having to listen to comments from professors criticizing them for utilizing the podcasts. Ultimately, these comments demonstrate the lecturer’s ignorance of the system. Such unprofessional behavior further serves to divide the student body, often generating laughs from those students present in lecture and even causing arguments between podcasters and students who prefer lecture. Moreover, a student should not be denied access to lectures or any interaction based case conference by refusing to podcast them. This only hurts those students who find that attending group based conferences/lectures to be ineffective.

The modern age of technology offers us many new ways to make our lives more efficient and successful. The science behind education has always taken advantage of technology; from the chalkboard to the calculator to the computer and now the podcast. Education is not about how educators should teach as much as it is about how each student learns. With so many new learning tools available, the modern students are obligated to identify what works for them. They would be derelict in their duty if they did not take advantage of the learning tools that they individually deem to be most effective. Teachers, by the very creed of their profession, should be concerned with what has actually proven to help the student learn. Specifically, what the student has decided is the most effective means.

In the past, attending lecture was the only option so a student had to learn to adapt. Now we have many more learning tools, and it is the duty of every student to find the tool that works for them. We feel that it is important for faculty to support the students in their endeavor to not only be educated by others, but to educate themselves; our future profession requires it. The only way in which we as physicians will be able to meet the demands of the ever-evolving field of medicine is through self-education, and podcasts are an excellent means to achieve that. The take home message of this treatise is that a student should not be forced to learn in a particular manner, and the current obsession with attendance and pedagogic hand-holding by many professors has no place in adult education.

In ending I leave you with a quote from Kahlil Gibran: “The teacher who is indeed wise does not bid you to enter the house of his wisdom but rather leads you to the threshold of your mind.”

New to the blog

Hey all! I am looking forward to sharing my medical experiences with you all and taking a lot away from everything you guys have to contribute. This looks like a great site and it is refreshing to see more like minding people going into practicing medicine with a "non-traditional" background. Talk to you guys soon! Hooyah and R.L.T.W.