For those scoring high in preclinical years (top 10%), how do you study?

[PhillyMed777]

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I'll memorize F.A.

That won't get you the step score you want, unfortunately. FA is a guide; a list of facts. For a test that now examines understanding, isolated use of FA is foolish.

 

[Rekt]

Fuk it. My school's criteria for AOA is bullsh1t. I'm just gonna do the bare minimum to pass all my courses while focusing on Step 1. AOA is for the birds at my school, judging by the pansy-ass criteria. I'll memorize F.A. while these roodie-poos waste their time volunteering.... LOL

Your goal should be that anything you see in First Aid is a review. If you're learning anything or it's the first time seeing it for you, then you have baseline knowledge gaps. Learn the crap your school is teaching you, even if you think it is trash, then use FA later when it matters.

 

[NWwildcat2013]

I really like this advice.I was right at class average in M1 using the 'review the notes systematically and a lot of times' strategy. This year I've started anki and basically just putting in a **** ton of hours, lots of which are flashcards, and it seems to be working for me based on our first two tests. Really wanting to be even near your level for step 1 so I have a few questions if you don't mind...

Why different decks for anki? Did you keep up with each deck separately every day? And did you make your own FA deck even though bros is already out there? Do you use mnemonics with anki like sketchy/picmonic?

Also, just out of curiosity, did you drink coffee? I'm debating whether I should quit for the year just to have more consistent energy.

Smaller decks can be conquered more easily. If you have 2000 cards for one exam all from lecture, UW, FA etc. its just overwhelming and that is bad for when dedicated comes and you want to ditch the details of lecture in favor of FA. If you mixed it all together you won't know what is what. This also allows you to better focus on class stuff when it comes time for an in class exam or focus on specific topics that you are weak on.

Example:

Micro
-FA
--virus
--abx
--bacteria
--funghi/parasites
-UW
-Lecture
--1
--2
--3
--etc.

I just did as much as I could every day. Which is a lot. When cards are new you won't be able to clear every deck every day but as you gain momentum and some easy cards get pushed out to months you will be able to clear everything easily.

There are two reasons that I think I scored as high as I did on Step 1. I worked hard every day for two years including class and I MADE MY OWN ANKI DECKS. This is the first thing I usually tell people but nobody does it because its so hard. You will blast through your first pass if you made your own cards and you will retain them much more easily. Making them is like 50% of the value. Reading actively enough to generate a card from every testable fact, thinking about what is important, thinking about how to test yourself on it in card form, then writing it is often enough to remember something forever. I had plenty of cards that, on my first pass after making, I just knew and I always knew them and they very quickly got pushed out to months. That wouldn't happen with bros deck (I tried) or Firecracker.

I used SM but it is so powerful I found I didn't really need to make cards.

I drank **** ton of coffee and Red Bulls but I did that before med school and I still do.

 

[badasshairday]

Repitition like cray.

 

[Hangry]

I like what findmeonthelinks said about a scaffold. I was in the top 10% and used something called the memory palace, and part of the reason it works is because you build a framework in your mind to hang the information on. Then you use visuospatial learning to fast-track the new information into your long-term memory. It's an amazing technique and I swear by it, teach it to my students now in an online course. If you haven't ever heard of the memory palace technique, it's pretty fascinating stuff and it's at least worth finding out how it works.

I really don't think the classic memory palace type technique stuff is a good use of your time in medical school, at least by my limited understanding of memory palaces (which is primarily from reading moonwalking with einstein and wikipedia). It is like the ultimate memorization rather than understanding way to remember something. Even if you were able to get through medical school by pure memorization, you would be a poor clinician because the majority of important clinical decision making has no clear YES or NO answer that you could have memorized but is rather dependent on using your understanding of pathophysiology and how it applies to the situation in front of you.

On an unrelated note, lots of good advice mixed in with some not so good in this thread. I'll echo some prior users in saying that the most important ways to do well are

1. Never fall behind
2. Repetition (spaced!)
3. Study for understanding, not memorization
4. Better to know 1 resource well than 3 poorly
5. Study in a way that is effective for you, not anyone else. I would have rather gouged out my eyes than made thousands of flash cards or read textbooks cover to cover.
6. The best way to rock step one is do well in class and supplement with pathoma

 

[bananabreadhunter]

I really don't think the classic memory palace type technique stuff is a good use of your time in medical school, at least by my limited understanding of memory palaces (which is primarily from reading moonwalking with einstein and wikipedia). It is like the ultimate memorization rather than understanding way to remember something. Even if you were able to get through medical school by pure memorization, you would be a poor clinician because the majority of important clinical decision making has no clear YES or NO answer that you could have memorized but is rather dependent on using your understanding of pathophysiology and how it applies to the situation in front of you.

On an unrelated note, lots of good advice mixed in with some not so good in this thread. I'll echo some prior users in saying that the most important ways to do well are

1. Never fall behind
2. Repetition (spaced!)
3. Study for understanding, not memorization
4. Better to know 1 resource well than 3 poorly
5. Study in a way that is effective for you, not anyone else. I would have rather gouged out my eyes than made thousands of flash cards or read textbooks cover to cover.
6. The best way to rock step one is do well in class and supplement with pathoma

Great advice! Thank you. When to start supplementing with pathoma? I am a first year.

 

[NWwildcat2013]

I really don't think the classic memory palace type technique stuff is a good use of your time in medical school, at least by my limited understanding of memory palaces (which is primarily from reading moonwalking with einstein and wikipedia). It is like the ultimate memorization rather than understanding way to remember something. Even if you were able to get through medical school by pure memorization, you would be a poor clinician because the majority of important clinical decision making has no clear YES or NO answer that you could have memorized but is rather dependent on using your understanding of pathophysiology and how it applies to the situation in front of you.

On an unrelated note, lots of good advice mixed in with some not so good in this thread. I'll echo some prior users in saying that the most important ways to do well are

1. Never fall behind
2. Repetition (spaced!)
3. Study for understanding, not memorization
4. Better to know 1 resource well than 3 poorly
5. Study in a way that is effective for you, not anyone else. I would have rather gouged out my eyes than made thousands of flash cards or read textbooks cover to cover.
6. The best way to rock step one is do well in class and supplement with pathoma

I agree. CLASS CLASS CLASS.

Those who only study "high yield" sources and forgo class studying have a ceiling of about 250.

 

[psychhopefull2016]

I have never in my entire life pulled an all nighter to study. Start studying day 1 of a block. Either go to or listen to every single lecture. I actually can't stand Anki. I made about 500 (or more) paper flashcards per test and made a lot of paper diagrams. I learn absolutely nothing when I type but I learn a lot when I write things out. So I basically did the same thing people here are saying with anki but with paper cards.

 

[NWwildcat2013]

I have never in my entire life pulled an all nighter to study. Start studying day 1 of a block. Either go to or listen to every single lecture. I actually can't stand Anki. I made about 500 (or more) paper flashcards per test and made a lot of paper diagrams. I learn absolutely nothing when I type but I learn a lot when I write things out. So I basically did the same thing people here are saying with anki but with paper cards.

Yeah me neither.

If you need to stay up all night you're doing it wrong. I took the day off before my exams and two days off before Step 1.

 

[psychhopefull2016]

Yeah me neither.

If you need to stay up all night you're doing it wrong. I took the day off before my exams and two days off before Step 1.

I actually looked into moving my step 1 earlier because I was so sick of studying for it but it was $120 to move.

 

[Hangry]

Great advice! Thank you. When to start supplementing with pathoma? I am a first year.

As soon as you start learning material covered in pathoma. Remember, this is a supplement, not something you cover on top of or alongside your classes. You have a lecture on nephrotic syndrome? When you are done with your reps of class material for the day you breeze through the pathoma video on nephrotic syndrome at 2x.

 

[username456789]

Great advice! Thank you. When to start supplementing with pathoma? I am a first year.

Off topic, but when did people completely forget syntax and start asking questions incorrectly like this? I see it so often the past few years from the younger crowd. I have to assume it has something to do with the way people type in questions to search engines.

But do you actually walk up to someone on the street and say "how to find the subway station?"

It's fascinating to see how the Internet causes people to butcher the English language.

 

[bananabreadhunter]

Off topic, but when did people completely forget syntax and start asking questions incorrectly like this? I see it so often the past few years from the younger crowd. I have to assume it has something to do with the way people type in questions to search engines.

But do you actually walk up to someone on the street and say "how to find the subway station?"

It's fascinating to see how the Internet causes people to butcher the English language.

Since instant messaging services in middle school. 10 years in my case.

 

[username456789]

Since instant messaging services in middle school. 10 years in my case.

I was in middle school in the mid 90s. AIM didn't become much of a thing until I was a sophomore or junior in high school. It was what everyone used in college as well.

I still don't think the "asking questions as statements" issue is attributable so much to IM as it is simply to how common it is to use a search engine to solve a problem.

For instance, if I did not know how to change a flat tire, and wanted to learn online, it would make sense to type in "how to change a flat tire" which is not a question, but rather I am searching for an article with this statement as its title.

But if I am standing next to someone else and want to ask them how to change a flat tire, it would be idiotic to look at them and proclaim "how to change a flat tire".

 

[3characterslong]

Fuk it. My school's criteria for AOA is bullsh1t. I'm just gonna do the bare minimum to pass all my courses while focusing on Step 1. AOA is for the birds at my school, judging by the pansy-ass criteria. I'll memorize F.A. while these roodie-poos waste their time volunteering.... LOL

Where did you find your school's requirements? Also, if you don't mind me asking, what were the requirements that pissed you off so much? Be as ambiguous as you like, I'm just curious.

 

[Jabbed]

I understand why trying to emulate top scorers seems like it would make sense, but honestly you're far better off trying to develop your own sense of what you need to be doing. The single key to success in medical school is being able to objectively evaluate yourself and your study material. Always ask yourself:

• Did I understand and master the material? (not "did I get a good grade on the test?")
  
• Which of my study habits are working well? Which should I ditch? Which can be improved?
  
• Why am I using xx resource? Is xx resource working for me?
• What are my strengths? What are my weaknesses? What can I do to improve?

I scored at the top of the class following virtually none of the advice in this thread so far. I never attended class, I spent more time with outside resources than I did with class slides, and I made a compulsive habit of constantly reviewing information that I learned in previous classes through anki and other sources. It worked for me, and I can't imagine that I would've succeeded if I had shown up to class everyday and spent hundreds of hours pouring over powerpoint slides every week. With that said, I would not necessarily encourage everyone to follow my study routine.

 

[SandP]

I understand why trying to emulate top scorers seems like it would make sense, but honestly you're far better off trying to develop your own sense of what you need to be doing. The single key to success in medical school is being able to objectively evaluate yourself and your study material. Always ask yourself:

• Did I understand and master the material? (not "did I get a good grade on the test?")
  
• Which of my study habits are working well? Which should I ditch? Which can be improved?
  
• Why am I using xx resource? Is xx resource working for me?
• What are my strengths? What are my weaknesses? What can I do to improve?

I scored at the top of the class following virtually none of the advice in this thread so far. I never attended class, I spent more time with outside resources than I did with class slides, and I made a compulsive habit of constantly reviewing information that I learned in previous classes through anki and other sources. It worked for me, and I can't imagine that I would've succeeded if I had shown up to class everyday and spent hundreds of hours pouring over powerpoint slides every week. With that said, I would not necessarily encourage everyone to follow my study routine.

Thanks for your suggestion. I am also considering using outside sources. i.e. first aid and filling in gaps from wikipedia, internet. I am thinking of switching to this strategy once we start systems and get out of foundations. Do you think then that if I study other sources and fulfill the learning objectives I can still score well on school tests (without the powerpoints)?

 

[Jabbed]

Thanks for your suggestion. I am also considering using outside sources. i.e. first aid and filling in gaps from wikipedia, internet. I am thinking of switching to this strategy once we start systems and get out of foundations. Do you think then that if I study other sources and fulfill the learning objectives I can still score well on school tests (without the powerpoints)?

I would never recommend first aid or wikipedia as primary sources. My general strategy for M2 was Pathoma → Goljan RR → class lectures, which felt like "broad/logical overview" → "well-organized details" → "details, details, details". I brute-forced the relevant sections from the Brosencephalon deck after reading Goljan. Some subjects are truly important enough that it's worthwhile incorporating other resources: Lilly's pathophysiology of heart disease, West Pulmonary physiology, Sompayrac's How the Immune System Works, HY Neuroanatomy, Costanzo physiology.

 

[MelMcT2009]

Quizlet.

Every day after class (which I didn't go to, but did watch online) I would spend time going through each lecture from that day and then create a Quizlet deck for each lecture.

When going through the lecture I would make flow charts, diagrams, etc. The goal for the first pass of the lecture was to really UNDERSTAND the concepts well. A one hour lecture may take me 3-4 hours to go through. When I was done going through it I'd turn it into a Quizlet deck.

I did this for every lecture done that day. Usually after my first good pass of the lecture I would have the content down like 85%. By Friday afternoon you had the entire week done, and sat and Sunday were spent going over that weeks decks over and over. Would usually have the info 95-100% down after the weekend. Repeat each week. Last few days before exam were just spent touching up weak areas.

This is what I did for both years, although second year I spent a lot more time with flow charts and diagrams, as the info was more conceptual and less straight memorization. I still did make decks for every lecture though.

Also did a bunch of other stuff second year to incorporate board sources. This info can be found on my blog ([email protected]).

This really set the foundation though. Was able to get >250 0n my baseline nbme before dedicated, so studying then was a lot less stressful.

 

[sholamd]

I know of this technique. How did you make this process fast? i.e. did it take time to memorize fast? right now it's a challenge for me to make memorable pictures in my head.

The process becomes fast because it saves you so much time having to do repetition to memorize - it fast-tracks the information into your long-term memory.

It takes some practice but it feels good to flex your creativity in med school when you are usually doing so much pure science. The good thing is that you can "walk through" the memory palace in spare moments - when a lecturer is late to start, when you are on the bus to school, when you are having trouble falling asleep...

Also, if you adopt this technique you learn to make "memes" which make the process faster. For example, every time you see hyperkalemia, you have the same picture in your head (mine was Callie from Gray's Anatomy) so it gets faster that way too.

 

[Kaz]

Smaller decks can be conquered more easily. If you have 2000 cards for one exam all from lecture, UW, FA etc. its just overwhelming and that is bad for when dedicated comes and you want to ditch the details of lecture in favor of FA. If you mixed it all together you won't know what is what. This also allows you to better focus on class stuff when it comes time for an in class exam or focus on specific topics that you are weak on.

Example:

Micro
-FA
--virus
--abx
--bacteria
--funghi/parasites
-UW
-Lecture
--1
--2
--3
--etc.

I just did as much as I could every day. Which is a lot. When cards are new you won't be able to clear every deck every day but as you gain momentum and some easy cards get pushed out to months you will be able to clear everything easily.

There are two reasons that I think I scored as high as I did on Step 1. I worked hard every day for two years including class and I MADE MY OWN ANKI DECKS. This is the first thing I usually tell people but nobody does it because its so hard. You will blast through your first pass if you made your own cards and you will retain them much more easily. Making them is like 50% of the value. Reading actively enough to generate a card from every testable fact, thinking about what is important, thinking about how to test yourself on it in card form, then writing it is often enough to remember something forever. I had plenty of cards that, on my first pass after making, I just knew and I always knew them and they very quickly got pushed out to months. That wouldn't happen with bros deck (I tried) or Firecracker.

I used SM but it is so powerful I found I didn't really need to make cards.

I drank **** ton of coffee and Red Bulls but I did that before med school and I still do.

I find myself consistently forgetting to tag my cards, so that's probably a better way to do it...
Did you use first aid with your coursework from the get-go?

 

[NWwildcat2013]

I find myself consistently forgetting to tag my cards, so that's probably a better way to do it...
Did you use first aid with your coursework from the get-go?

Started in second year


Sent from my iPhone using SDN mobile

 

[Anicetus]

I've tried all of the above strategies at some point during the last 2.5 years of medical school and have still never been in the to 10%.

I'm gonna go out and say that a lot of it is natural smarts too.

 

[justkeepswimming]

As you can tell by this thread the study methods of successful students vary widely. I don't think that any one method is better than the other, but the best general advice I can give you is to make sure you're always doing something to actively help you process the information. The two biggest mistakes people make when studying are that they 1) try to passively absorb information and think that just being in the library or quietly reading is enough to make things stick, or 2) they get so caught up in the process of highlighting/color coding/making flashcards/whatever that they end up putting all their energy into making their study materials look pretty and forget to focus on the material itself. If you're listening to/attending lecture, take notes. If you're reading, take notes or make flashcards. If you're watching a video, write down key facts or pause it intermittently and try to re-explain what you just heard. If you're doing flashcards, make sure you're reviewing them in a mode that requires you to recall information yourself rather than just mindlessly flipping through them. If you find your brain drifting during any of your study activities, take a quick walk or facebook break and refresh, then come back to what you were doing. Doing well isn't about how many hours you put in, it's about what you put into those hours. Make whatever you are doing count.
The actual method I used to study varied by class and professor, but I always tried to study actively. I ended up in the top 5% of my class and the 95th/99th percentiles for USMLE/COMLEX, and to be honest I'm not that naturally smart, I just was careful about making my study time count so that I could sleep, play, and eat like a normal human.

 

[songl4a]

Any other tips justkeepswimming? Active studying is all well and good, but what about learning tiny details and minutae? Like after you understand the "big picture" how do you learn the 100s and enzymes and specifics?

 

[Dr.Forssmann]

Anki. Make every single thing into anki. Lecture, review books, UW questions, FA etc. and keep them organized. I literally knew everything for every exam that I had. Im not exaggerating or trying to impress anyone because anyone can do this with the appropriate use of Anki. I would walk out of an exam and know which questions would be thrown out due to inaccuracies or errors when everyone else was fretting about what the answer was. Thats how well I knew it because I had drilled every fact from every slide into my head. When it came time for Step 1 I had all of FA memorized because of Anki. You could open any page and ask me something and I'd know it. Same with UW explanations. Anki is incredible but people aren't willing to put in the time. It takes a ton of time but learning things to the level I'm talking about takes a ton of time with ANY method.

Study all day everyday but take tons of micro breaks and go to bed early. Many people don't like studying both Saturday and Sunday but if you do it leaves time for getting more sleep during the week and other inefficient but necessary things like going for a walk, zoning out before lecture to read you favorite internet garbage for 30 minutes, taking a long lunch just to think or call friends/family. I never advocate for filling those small break and lunch hours with studying. Fastest way to crash and burn IMO.

Be honest with yourself. Dont keep studying stuff you have down and don't ignore stuff you think is hard. Ask yourself "What would I not want to see on the exam?" and then go study that. Its hard to answer that truthfully and even harder to go to it, but its the key to success.

With those things I honored every course in MS1 and MS2 and killed Step 1. There is no secret other than working a ton and being smart enough to know when and how to recharge.

This is awesome. How do you make stuff into anki? Like do you turn it into a question with answer on the back? I can see the benefits if anki.


Sent from my iPhone using SDN mobile

 

[Mr Roboto]

Smaller decks can be conquered more easily. If you have 2000 cards for one exam all from lecture, UW, FA etc. its just overwhelming and that is bad for when dedicated comes and you want to ditch the details of lecture in favor of FA. If you mixed it all together you won't know what is what. This also allows you to better focus on class stuff when it comes time for an in class exam or focus on specific topics that you are weak on.

Example:

Micro
-FA
--virus
--abx
--bacteria
--funghi/parasites
-UW
-Lecture
--1
--2
--3
--etc.

I just did as much as I could every day. Which is a lot. When cards are new you won't be able to clear every deck every day but as you gain momentum and some easy cards get pushed out to months you will be able to clear everything easily.

There are two reasons that I think I scored as high as I did on Step 1. I worked hard every day for two years including class and I MADE MY OWN ANKI DECKS. This is the first thing I usually tell people but nobody does it because its so hard. You will blast through your first pass if you made your own cards and you will retain them much more easily. Making them is like 50% of the value. Reading actively enough to generate a card from every testable fact, thinking about what is important, thinking about how to test yourself on it in card form, then writing it is often enough to remember something forever. I had plenty of cards that, on my first pass after making, I just knew and I always knew them and they very quickly got pushed out to months. That wouldn't happen with bros deck (I tried) or Firecracker.

I used SM but it is so powerful I found I didn't really need to make cards.

I drank **** ton of coffee and Red Bulls but I did that before med school and I still do.

I'd be interested to learn more about your Anki workflow. The interface is a bit weird to me, and I haven't been able to find a groove with it.

 

[NWwildcat2013]

This is awesome. How do you make stuff into anki? Like do you turn it into a question with answer on the back? I can see the benefits if anki.


Sent from my iPhone using SDN mobile

I'd be interested to learn more about your Anki workflow. The interface is a bit weird to me, and I haven't been able to find a groove with it.

I get this question a lot on SDN and in real life. I dont mean to brush you both off but I say the following to most everyone:

What will work for you may not and likely is not how I made my cards. Additionally, my style evolved over the course of 2 year with regards to how many I made, how many items on the back vs front, cloze/standard/mixed, role of image occlusion, etc. Not only did it change over time, but it changed for each course I took and every resource I used.

My point is that you just have to start using it. Attempt it. Figure out what works for you. I never once asked anyone how to use Anki because I knew people used it so differently. Just start and if it isn't working then change your methods. How you define "not working" is up to you but my standard was that if I wasn't capable of remembering literally everything by the time of the exam I was doing it wrong.

Heres the key to Anki. If you wanna make it your #1 source its going to take ALL OF THE TIME. People like to s**t on Anki because it doesn't give you a complete picture or whatever. Thats false and if its true you are making lazy cards. You can make very excellent cards that force you to tease out nuances or understand high level concepts and connections between things. I can't tell you how to do this for everything, though. The material is too broad for me to explain how to best create cards because a good card is different in anatomy vs. physiology. Anatomy would be 1:1 question and answer or image occlusion. Physio might say, "What happens to ___ under this circumstances and why?" I'd have the answer and then an explanation, so it read more like a very short practice question with an explanation basically.

A good example would be that page in FA that talks about Ca, ALP, and phos in osteoporosis, Pagets, etc. Instead of just making 1:1 cards (also make those) make cards with key distinctions between them. Like "What is the main lab difference between 2 hyperpara and 1 hyperpara and why?" Answer: 1 hyperpara has high Ca and low phos while 2 hyperpara has opposite. Because in primary the excess PTH is the original problem and just goes about its business and isn't acting as compensation while in secondary the excess PTH is a response to the original problem of poor phos excretion by a messed up kidney. This high phos in addition to binding to and thus lowering Ca causes increased PTH release. So thats why PTH is high while Ca is low and phos is high.

In the above example I wouldn't actually make myself regurgitate that explanation each time but it was there in case I forgot and helpful while I was learning but I skipped over it when the cards were fresh. This is how you make anki cards that help you understand. Most people just say "What is Ca and phos in 2 hyperpara" and leave it at that. Thats where ppl go wrong with Anki. Im still using Anki in MS3. Just made a card yesterday asking "What do you need to do for dose of levo in a pregnant hypothyroid pt and why?" Answer: increase dose by ~30% because estrogen increases TBG and you basically need more hormone to saturate that and stay at the same levels. A non hypothyroid patient can bump production via feedback but a hypothyroid patient can't so increase levo. Reading about the explanation then writing it in a way I'd remember is enough that I won't have to do that when I answer the card but the act of understanding it enough in the first place was what helped me learn and its there for future reference. Also, in this way, my anki decks serve as notes since the decks are searchable.

 

[Musty perry]

I too stopped going to class around the same time and also watched every lecture at home for all honors in MS1+MS2. Doing this allows you to be much more efficient because you can structure your day best, eliminate commute time, and actually retain what you watch by repeating it, stopping it, having google handy for clarification etc. I could also pop over to my apartment complex gym to blow off some steam whenever I felt like it, was able to cook whenever, and could destress by sitting on my couch and just chilling.

Physically being in class is the stupidest requirement a med school can have.

So how were you able to get the class video? Silly question? Am sorry. Just trying to know how to be a smart reader.
Thanks

 

[NWwildcat2013]

So how were you able to get the class video? Silly question? Am sorry. Just trying to know how to be a smart reader.
Thanks

Clearly my school had podcasts available and recorded the lectures.

 

[Mr Roboto]

I get this question a lot on SDN and in real life. I dont mean to brush you both off but I say the following to most everyone:

What will work for you may not and likely is not how I made my cards. Additionally, my style evolved over the course of 2 year with regards to how many I made, how many items on the back vs front, cloze/standard/mixed, role of image occlusion, etc. Not only did it change over time, but it changed for each course I took and every resource I used.

My point is that you just have to start using it. Attempt it. Figure out what works for you. I never once asked anyone how to use Anki because I knew people used it so differently. Just start and if it isn't working then change your methods. How you define "not working" is up to you but my standard was that if I wasn't capable of remembering literally everything by the time of the exam I was doing it wrong.

Heres the key to Anki. If you wanna make it your #1 source its going to take ALL OF THE TIME. People like to s**t on Anki because it doesn't give you a complete picture or whatever. Thats false and if its true you are making lazy cards. You can make very excellent cards that force you to tease out nuances or understand high level concepts and connections between things. I can't tell you how to do this for everything, though. The material is too broad for me to explain how to best create cards because a good card is different in anatomy vs. physiology. Anatomy would be 1:1 question and answer or image occlusion. Physio might say, "What happens to ___ under this circumstances and why?" I'd have the answer and then an explanation, so it read more like a very short practice question with an explanation basically.

A good example would be that page in FA that talks about Ca, ALP, and phos in osteoporosis, Pagets, etc. Instead of just making 1:1 cards (also make those) make cards with key distinctions between them. Like "What is the main lab difference between 2 hyperpara and 1 hyperpara and why?" Answer: 1 hyperpara has high Ca and low phos while 2 hyperpara has opposite. Because in primary the excess PTH is the original problem and just goes about its business and isn't acting as compensation while in secondary the excess PTH is a response to the original problem of poor phos excretion by a messed up kidney. This high phos in addition to binding to and thus lowering Ca causes increased PTH release. So thats why PTH is high while Ca is low and phos is high.

In the above example I wouldn't actually make myself regurgitate that explanation each time but it was there in case I forgot and helpful while I was learning but I skipped over it when the cards were fresh. This is how you make anki cards that help you understand. Most people just say "What is Ca and phos in 2 hyperpara" and leave it at that. Thats where ppl go wrong with Anki. Im still using Anki in MS3. Just made a card yesterday asking "What do you need to do for dose of levo in a pregnant hypothyroid pt and why?" Answer: increase dose by ~30% because estrogen increases TBG and you basically need more hormone to saturate that and stay at the same levels. A non hypothyroid patient can bump production via feedback but a hypothyroid patient can't so increase levo. Reading about the explanation then writing it in a way I'd remember is enough that I won't have to do that when I answer the card but the act of understanding it enough in the first place was what helped me learn and its there for future reference. Also, in this way, my anki decks serve as notes since the decks are searchable.

Thanks for the response. That was really helpful. If you don't mind me asking, how were courses structured at your school? I've heard Anki is great for long term memory, but am wondering how it would work for fast results—we have exams weekly, often with only a day or two between the final lecture and the test. Is that enough time to add pertinent cards to the deck and memorize them?

 

[NWwildcat2013]

Thanks for the response. That was really helpful. If you don't mind me asking, how were courses structured at your school? I've heard Anki is great for long term memory, but am wondering how it would work for fast results—we have exams weekly, often with only a day or two between the final lecture and the test. Is that enough time to add pertinent cards to the deck and memorize them?

We had two weeks.

I think its doable. You are going to have less to memorize since your material is broken into smaller chunks. You just can't waste any time. You have to make the cards for the stuff on the day you get it and do a first pass and the next day do the same as well as reviews... repeat.

 

[deleted393595]

My top students do this, and:

They do NOT cram
They get adequate sleep the night before the exam

No matter how hard I try not to procrastinate, the above always happens 😀

 

[iDOliveinMD]

Hi, @NWwildcat2013 for my first few exams I have scored average which is something that I am not ok with. I have been using ANKI but I believe to my own detriment as I think that I've been using it inefficiently. I read your examples on how to make cards which make you truly think other than loads of cloze deletion cards. But I am still confused as to what exactly my approach should be. Part of my problem is that I'll have 3-4 lectures and create 150-300 cards which teach me some facts but apparently not enough and I can't find time to review them to the point where I am thinking out every card.

Example: I have 3 lectures to go through, should I...
A. Watch lectures at 1.6-2.0x speed pause when needed the 1st time through and add cards, repeat process for all 3 lectures and then review that day's and yesterdays cards.
B. Review yesterday's cards first, then watch each lecture at 1.6-2.0x speed twice, with the second time being when I add cards based on main ideas with discrete facts when appropriate.
C. Watch the lectures at 1.6-2.0x speed as many times as need until I have the concepts down pact while taking notes, transfer notes into cards

I've been doing more of A, wondering if I should try B. Or if you have better advice I'd be more than happy to hear it. Thanks

 

[osckey]

Honestly, I just learned to take it way more laid back. Do my work during the day as much as I can tolerate and call it a day by 6pm. Review all of your content at least 2 times over, minimize mindless memorization by trying to order things in logical steps (I'm looking at you Immunology), and commit your efforts to concepts that are counter-intuitive to you and that you struggle with. Also, try to read into your professor's teaching style as much as possible. If they spend 14 hrs. of lectures explaining one concept vs. 3 on another, then you can do the math on how much effort you should be putting into each when studying.

Pacing is another key issue. I just do enough each day to stay caught up that way I can enjoy my evenings. Otherwise, I burn out. Weekends are my days to review all the previous week's material and memorize. I personally REALLY enjoy reviewing material vs being presented new material. Given this, I tend to burn out if I try to memorize material before I understand it and as soon as it's presented to me. This is why weekends are key for me. Take the week and understand everything thrown at you each day, make sense of it, and make it intuitive. Then use the weekend to memorize and review.

Again, balancing my personal life has made me a waaaaayyyy better student than I was just 3 months ago neglecting my home and living in the library just because that's what I expected med school to be like. I definitely fell into the trap of feeling bad if I wasn't in the library all the time - a feeling that soon went away after my first exam when I began to realize what medical school was really like.

 

[heebeejeebies]

Reading this thread... some of you people need therapy. Or a drink. Or both. Jeeze.

 

[osckey]

Reading this thread... some of you people need therapy. Or a drink. Or both. Jeeze.

lol

 

[MelMcT2009]

Found an extension yesterday that converts quizlet notes to anki decks. I cannot begin to put my joy in words.

Yasssss. I didn't use anki until this year but I've also been using that to import decks

 

[kchan99]

I was a med student back in the day when all Macbooks had DVD drives...I did quite well in my preclinical courses, USMLE, and clinical rotations. Here are my words of advice:
-Studying is like voting in some places. Study early and often. Don't cram.
-How much to study during M1, except for anatomy, depends in part on your undergraduate course work. For instance, I took many cell biology courses during college so biochemistry, cell biology, and genetics were a breeze, but neuroscience and behavior were a little more challenging.
-I spent a considerable amount of time studying in anatomy, including reviewing lectures notes, reading a text, and dissections. I used to review atlases and the dissector guide before dissections to avoid making extra cuts into structures that I would want to find again while reviewing for exams. I suppose a Youtube video could be helpful for planning purposes like reviewing imaging before surgery.
-For histology, I used an out of print CD-ROM program.
-In M2, pathology and physiology ran concurrently. I started reading Ganong and Robbins early in the year, and basically read the books cover to cover. I also read many chapters from Katzung's pharmacology text.
-Don't skip class. I attended >90% of lectures.

 

[Willfrye027]

I started M1 in the bottom quarter of my class. The last exam I got the top score out of 215ishh classmates, and ive been consistently in the high 90's lately, so here's my thoughts FWIW.

There is no "one" magical method. Probably every one of the top 10 at your school has a different method.

For time management, I like to think in terms of what I do when I'm not studying. My default mode is to study, but what I do to rest/relax seems to be the key for feeling rejuvenated and studying with high intensity for the other 10-12 hours of the day (with lots of interspersed breaks of course). Do things to relax that are synergistic for studying (ie exercise). Avoid things that are detrimental (ie drink way too much on Friday and waste half of Saturday feeling like crap). Make sure you rest well.

In terms of "learning" (which does not=doing amazing in classes, btw), I have a little mantra- Conceptualize, memorize, practice. Each are a key component in mastering material, and each is conducive to many study methods. Practicing (see Qbanks...) is key because it shows you what you didn't conceptualize well or didn't actually memorize.

Each block, class, and professor will test differently. Find out who writes the tests and use that to guide how you study for the test.


Not that you should emulate this, but just to give an example, here is one aspect of my study strategy, the one thing that really pushed me into the top of the class. I realized that our tests have about 5-10% of questions that are just plain random. You would NEVER think to make an ANKI card for them and there is no way to conceptualize your way through it. Because the rest of the test is relatively straight forward, they have these questions in there to set the bell-curve. Basically to get these random questions/facts I just go through the powerppoints many, many times right before the test. Cramming, hardcore. I end up pulling stuff out of my a__ and getting the questions right, because I can visualize the slide it was on or remember the random fact. This process takes essentially a whole day or two of studying and is a HUGE WASTE OF TIME, except that it gets me those few points to get into the top. I'm not sure I will keep doing it like this, because it is a lot of time and energy that probably wont help me on step one. And since I started in the bottom, I blew my chances at AOA, so there is really no point in trying to kill these tests.

All that to say, try to be strategic and constantly improve your study methods. All other things being equal, I have found that STRATEGY is the key.

 

[Willfrye027]

Also I stopped going to class awhile ago. I get judged hardcore by my fellow students for this (especially the rule follower types), but in the end you have to do what works for you. Our school did a survey awhile back and there was no correlation between going to class and test scores. Do what works

 

[cbrons]

The thing you need to understand is that being in the "top 10%" for pre-clinicals might be a total waste of your time for the price of a lot of stress. Pre-clinical grades are not always counted in determining AOA.

 

[Username555]

Sounds good, but how did you have the time to make EVERYTHING into an anki card? I tried to get into anki earlier, but let's say just typing out every detail from lecture takes 30 minutes for the normal lectures and an hour for the longer ones. That's gonna be 2-3 hours a day wasted on just typing the cards.

Anki. Make every single thing into anki. Lecture, review books, UW questions, FA etc. and keep them organized. I literally knew everything for every exam that I had. Im not exaggerating or trying to impress anyone because anyone can do this with the appropriate use of Anki. I would walk out of an exam and know which questions would be thrown out due to inaccuracies or errors when everyone else was fretting about what the answer was. Thats how well I knew it because I had drilled every fact from every slide into my head. When it came time for Step 1 I had all of FA memorized because of Anki. You could open any page and ask me something and I'd know it. Same with UW explanations. Anki is incredible but people aren't willing to put in the time. It takes a ton of time but learning things to the level I'm talking about takes a ton of time with ANY method.

Study all day everyday but take tons of micro breaks and go to bed early. Many people don't like studying both Saturday and Sunday but if you do it leaves time for getting more sleep during the week and other inefficient but necessary things like going for a walk, zoning out before lecture to read you favorite internet garbage for 30 minutes, taking a long lunch just to think or call friends/family. I never advocate for filling those small break and lunch hours with studying. Fastest way to crash and burn IMO.

Be honest with yourself. Dont keep studying stuff you have down and don't ignore stuff you think is hard. Ask yourself "What would I not want to see on the exam?" and then go study that. Its hard to answer that truthfully and even harder to go to it, but its the key to success.

With those things I honored every course in MS1 and MS2 and killed Step 1. There is no secret other than working a ton and being smart enough to know when and how to recharge.

 

[Willfrye027]

That's why I just re-read the powerpoints a bunch of times. I did anki for awhile and it was just too much time to keep up. Plus, when you get tested on random a__ facts, its impossible to predict whats testable and you end up with test questions you didn't make cards for. And then a majority of your cards are actually pretty easy stuff you didn't need to make a card for in the first place and probably would have remembered just fine after a pass or two through the material. Anki works great for some people but has not worked for me.

I do still use anki when there are things that need to just be straight up memorized and don't have a conceptual basis or anything behind them (lots of pharm, sometimes cell surface receptors, etc). Basically if I find after going through a particular powerpoint like 4 times and I still don't have a particular fact or something down, Ill make a card for it. I end up with maybe 30-40 cards for the whole block, sometimes more depending on the block. But there are many ways to skin a cat..

 

[NWwildcat2013]

Sounds good, but how did you have the time to make EVERYTHING into an anki card? I tried to get into anki earlier, but let's say just typing out every detail from lecture takes 30 minutes for the normal lectures and an hour for the longer ones. That's gonna be 2-3 hours a day wasted on just typing the cards.

Its not wasted. Its like taking notes. You critically read and think about the material as you make cards. In fact, an hour long lecture should take like 2 hours to make cards. It did for me, because I had a textbook open and lots of googling to fully understand the material and make cards that really reinforced core concepts and the key differences between similar things.

It is a huge time investment up front. I compare it to a train. It takes awhile to get started and up to speed, but once it does then watch out.

 

[SunsFun]

I did quite well and looking back I would have probably done just as well had I been studying differently. I used different methods for different blocks as did many of my peers with not much impact on my eventual grades.

I think the difference comes down to 3 things: understanding the material, test-taking ability, and discipline. I did 2 passes at most but for most topics, but I made sure that I understood every piece of info and how it fits in with the rest for every slide/note before moving on. I absolutely felt burned out and ready/anxious to move on but I didn't until that was done. It all came down to personal discipline. Lastly, I approached the tests with a "ready to do my best and fail" mentality. I often was the last person to leave the room because, mentally, I was not going to give up on any of the questions that I didn't know until my time ran out. Many of my classmates taking 100+ question test after weeks of studying were mentally ready to be done so they often succumbed to the voice inside their heads to just "do better next time". "focus on boards instead", "kill the 3rd year clerkships", "write papers", etc... so those 5 questions separating good score from great score wouldn't get the necessary attention and proper effort.