How do I fix this?

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ciestar

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Long story short: either I greatly suck at time management or I am hugely inefficient at studying (probably both..). But I can't seem to get out of my own way. I know to be behind (or feel this is the case) is normal, but I really feel like I never catch up and the week before an exam is killer. I pull a ton of late nights and I don't get far as my exam scores suck. I am passing (pass/fail curriculum) but i feel like I am putting way more in than I am getting out of studying. That, and fail an exam you feel more pressure and anxiety to not let that happen again. Biochem seems to be my kryptonite, thankfully I just need to pass the final to pass the class, so I survived. I just cannot let this continue. Any suggestions? I cannot stay up until 4 am constantly, it isn't helping. I am a regular with tutors and in instructors' offices trying to sort this stuff out...but maybe I get severe test anxiety on top of being exhausted and it's killing me. I also definitely dwell too much on small details and get hung up on these.

Also, before suggesting getting psychological help, I am already there. This is more for maximizing the efficiency of studying.

EDIT: I always go to class to avoid getting completely behind as much as possible. But even when I do, I still spend too much time on reviewing lectures later...so if I have four lectures in a day, I can generally get through one before it gets to be too late in the day. I treat attending lecture as forced discipline as I struggle keeping up with lecture if I don't go. Would previewing lectures help this at all? What's the best way to preview/review lectures (especially when you're given a 10-20 page handout per lecture..)
 
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Long story short: either I greatly suck at time management or I am hugely inefficient at studying (probably both..). But I can't seem to get out of my own way. I know to be behind (or feel this is the case) is normal, but I really feel like I never catch up and the week before an exam is killer. I pull a ton of late nights and I don't get far as my exam scores suck. I am passing (pass/fail curriculum) but i feel like I am putting way more in than I am getting out of studying. That, and fail an exam you feel more pressure and anxiety to not let that happen again. Biochem seems to be my kryptonite, thankfully I just need to pass the final to pass the class, so I survived. I just cannot let this continue. Any suggestions? I cannot stay up until 4 am constantly, it isn't helping. I am a regular with tutors and in instructors' offices trying to sort this stuff out...but maybe I get severe test anxiety on top of being exhausted and it's killing me. I also definitely dwell too much on small details and get hung up on these.

Also, before suggesting getting psychological help, I am already there. This is more for maximizing the efficiency of studying.

EDIT: I always go to class to avoid getting completely behind as much as possible. But even when I do, I still spend too much time on reviewing lectures later...so if I have four lectures in a day, I can generally get through one before it gets to be too late in the day. I treat attending lecture as forced discipline as I struggle keeping up with lecture if I don't go. Would previewing lectures help this at all? What's the best way to preview/review lectures (especially when you're given a 10-20 page handout per lecture..)
Please provide more details on study environment, study habits, daily routine.
 
In a nutshell - you are likely spending too much time trying to master material on the first pass. Unlike many other disciplines, medicine yields more easily to repetition. It ultimately means you will turn pages on material you barely know with the understanding that you'll be coming back to it again soon.
 
Please provide more details on study environment, study habits, daily routine.

I have no real set routine as it revolves around whatever the class schedule is for the day. I do most of my studying at the school, though. Since we don't really have class the few days before the exam, I generally do that from home. Habits are basically what I attempted to give insight to. I attend lecture, and maybe @operaman is right, I probably am spending too much time trying to master everything on first pass. Because of this, I spend entirely too much time on it and I repetition isn't much of a thing...some lectures I never see a second time but I never once thought of it like that. So would a better strategy just to read through the notes and not really sit and dwell on any details? How many passes should I ideally have for each lecture?

My lack of a real routine could be an issue. But usually I am up at 730, at the school around 8 and usually stay there until around 6ish and I am usually done with studying by then unless I have a tutoring session that evening. Bedtime extremely varies.
 
You know my standard answer...seek out your school's learning or education center and get help, especially with the time mgt aspect.

Start reviewing class material before going to class! My successful students always do so, even with a quick read through of the PPTs.

And read my post on med student success.

Long story short: either I greatly suck at time management or I am hugely inefficient at studying (probably both..). But I can't seem to get out of my own way. I know to be behind (or feel this is the case) is normal, but I really feel like I never catch up and the week before an exam is killer. I pull a ton of late nights and I don't get far as my exam scores suck. I am passing (pass/fail curriculum) but i feel like I am putting way more in than I am getting out of studying. That, and fail an exam you feel more pressure and anxiety to not let that happen again. Biochem seems to be my kryptonite, thankfully I just need to pass the final to pass the class, so I survived. I just cannot let this continue. Any suggestions? I cannot stay up until 4 am constantly, it isn't helping. I am a regular with tutors and in instructors' offices trying to sort this stuff out...but maybe I get severe test anxiety on top of being exhausted and it's killing me. I also definitely dwell too much on small details and get hung up on these.

Also, before suggesting getting psychological help, I am already there. This is more for maximizing the efficiency of studying.

EDIT: I always go to class to avoid getting completely behind as much as possible. But even when I do, I still spend too much time on reviewing lectures later...so if I have four lectures in a day, I can generally get through one before it gets to be too late in the day. I treat attending lecture as forced discipline as I struggle keeping up with lecture if I don't go. Would previewing lectures help this at all? What's the best way to preview/review lectures (especially when you're given a 10-20 page handout per lecture..)
 
I have no real set routine as it revolves around whatever the class schedule is for the day. I do most of my studying at the school, though. Since we don't really have class the few days before the exam, I generally do that from home. Habits are basically what I attempted to give insight to. I attend lecture, and maybe @operaman is right, I probably am spending too much time trying to master everything on first pass. Because of this, I spend entirely too much time on it and I repetition isn't much of a thing...some lectures I never see a second time but I never once thought of it like that. So would a better strategy just to read through the notes and not really sit and dwell on any details? How many passes should I ideally have for each lecture?

My lack of a real routine could be an issue. But usually I am up at 730, at the school around 8 and usually stay there until around 6ish and I am usually done with studying by then unless I have a tutoring session that evening. Bedtime extremely varies.

Repetition is key. One pass through a lecture is definitely not enough for most people. Most people I know do at least three passes per lecture. I personally do 4-5. I watch the lecture, then review it again later that night, then again the next night, then again on Saturday, and, if necessary, again on Sunday (we have weekly Monday exams).


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I had somewhat similar issues during the first 2 years, and unfortunately I didn’t figure out what worked best until the end of 2nd year. This is what worked really well for me, and if I had the chance to re-do pre-clinical years this is probably what I would do from day 1:

Sunday and Monday - Watch the current week’s lectures from last year on 2x (or higher if manageable) while taking notes (…and pausing to do so, as needed…) on whatever was provided for notes/handout/PowerPoint/etc. It was pretty rare that lectures/lecturers/material changed from year to year.

Later on Monday, but no later than Tuesday - Go over relevant sections in board review material (Pathoma, pharm in FA, etc.). Usually I could just add a few notes from what profs. presented on, but if I found that a school lecture was super minutiae heavy or not covered well in board review material I just made a note to actually review those lecture notes instead; for a given block this was usually < 5 lectures. This is the material I then used to study/review.

After annotating board review material and for the rest of the week - All of the lecture material should be condescend into an easy review format at this point, so just review ad nauseam, do as many quality practice questions as possible (e.g., Guyton and Hall review, UMich, Robbins Review, etc.) attend mandatory crap, and adjust as needed.

Once I committed to this approach there was a notable increase in my exam scores and decrease in the amount of time I spent studying. I realize this may not work for every curriculum or individual, but hopefully its helpful.
 
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Long story short: either I greatly suck at time management or I am hugely inefficient at studying (probably both..). But I can't seem to get out of my own way. I know to be behind (or feel this is the case) is normal, but I really feel like I never catch up and the week before an exam is killer. I pull a ton of late nights and I don't get far as my exam scores suck. I am passing (pass/fail curriculum) but i feel like I am putting way more in than I am getting out of studying. That, and fail an exam you feel more pressure and anxiety to not let that happen again. Biochem seems to be my kryptonite, thankfully I just need to pass the final to pass the class, so I survived. I just cannot let this continue. Any suggestions? I cannot stay up until 4 am constantly, it isn't helping. I am a regular with tutors and in instructors' offices trying to sort this stuff out...but maybe I get severe test anxiety on top of being exhausted and it's killing me. I also definitely dwell too much on small details and get hung up on these.

Also, before suggesting getting psychological help, I am already there. This is more for maximizing the efficiency of studying.

EDIT: I always go to class to avoid getting completely behind as much as possible. But even when I do, I still spend too much time on reviewing lectures later...so if I have four lectures in a day, I can generally get through one before it gets to be too late in the day. I treat attending lecture as forced discipline as I struggle keeping up with lecture if I don't go. Would previewing lectures help this at all? What's the best way to preview/review lectures (especially when you're given a 10-20 page handout per lecture..)
Hey! I'm sorry to hear that you're struggling. Take any of my advice with a huge grain of salt because I'm also an M1. I don't think that you should ever be staying up until 4 AM, even if you are behind in studying. At that point, you're probably not retaining a great deal of the information you're studying and you're hurting yourself for the next day of studying. This is something I've had to adjust to, because I often have to force myself to go to sleep even when I don't feel "done" with studying (although I suppose that goes along with the feeling of always being behind!)

I can tell you that what I do is make Anki cards during lectures (I go to about half and stream about half depending on the day's schedule), tag them with the relevant information, and add them to my block's Anki deck. So basically each day consists of adding cards to the Anki deck, going through the Anki deck to completion, and doing as many practice problems as possible. I figure that if I can go through all of the assigned flashcards everyday, I make sure that I am doing several passes of each lecture before the test.

Also, huge congratulations on passing all of your classes! P=MD.
 
I'm thinking that you are going way too far "in the weeds" with your studying. If you're putting in that kind of time, you should be seeing results. Do you have friends that you study with? If so, how are they performing on tests? The best advice i can offer is to sit down for a weekend and have a classmate that is performing well show you their study habits.

I second what has been mentioned above - find something to guide your studying. I used Firecracker and first aid. These were my "weedwackers" per say. If the material covered didn't find itself into either of those then I deemed it "in the weeds." What I mean by that is I would spend less time focusing on that material and more time focusing on the higher yield stuff. This may seem ridiculous but I found this to be a really important skill that I developed. This method worked well for me because my school used NBME exams for preclerkship.
 
I'm thinking that you are going way too far "in the weeds" with your studying. If you're putting in that kind of time, you should be seeing results. Do you have friends that you study with? If so, how are they performing on tests? The best advice i can offer is to sit down for a weekend and have a classmate that is performing well show you their study habits.

I second what has been mentioned above - find something to guide your studying. I used Firecracker and first aid. These were my "weedwackers" per say. If the material covered didn't find itself into either of those then I deemed it "in the weeds." What I mean by that is I would spend less time focusing on that material and more time focusing on the higher yield stuff. This may seem ridiculous but I found this to be a really important skill that I developed. This method worked well for me because my school used NBME exams for preclerkship.

My genetics instructor used those EXACT words! She said I definitely am too far in the weeds with bascially everything, which explains a lot of why I get so hung up on small details and take a while to finish a lot of the material. I do not study with friends, so I cannot comment on that. Certain classes whatever I am doing works fine, as I am getting good scores in these courses (histology and nutrition).

I definitely think having something to guide me would be helpful. I've never actually heard of Firecracker. I have a couple of the BRS books. Unfortunately, I don't get to as many practice problems as much as I'd like due to above mentioned issues, which I think is especially hurting me in physiology. Anatomy, I have a tutor for the practical portion and saw a dramatic change in my practical score, not so much the written portion.

So, guided studying...so far mentioned has been BRS, Firecrack and First Aid? Any other ones out there that are helpful?

And @Goro, I plan on going back to academic services, again, after winter break, so I do have that in the works, at least.
 
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Hey! I'm sorry to hear that you're struggling. Take any of my advice with a huge grain of salt because I'm also an M1. I don't think that you should ever be staying up until 4 AM, even if you are behind in studying. At that point, you're probably not retaining a great deal of the information you're studying and you're hurting yourself for the next day of studying. This is something I've had to adjust to, because I often have to force myself to go to sleep even when I don't feel "done" with studying (although I suppose that goes along with the feeling of always being behind!)

I can tell you that what I do is make Anki cards during lectures (I go to about half and stream about half depending on the day's schedule), tag them with the relevant information, and add them to my block's Anki deck. So basically each day consists of adding cards to the Anki deck, going through the Anki deck to completion, and doing as many practice problems as possible. I figure that if I can go through all of the assigned flashcards everyday, I make sure that I am doing several passes of each lecture before the test.

Also, huge congratulations on passing all of your classes! P=MD.

I hear about Anki all the times, but how do you use it? I think I have some sort of bias and think of it nothing more as making flashcards? I know doing simply that wouldn't help me, but perhaps I am way close minded towards and wouldn't mind some further insight into it!
 
I had somewhat similar issues during the first 2 years, and unfortunately I didn’t figure out what worked best until the end of 2nd year. This is what worked really well for me, and if I had the chance to re-do pre-clinical years this is probably what I would do from day 1:

Sunday and Monday - Watch the current week’s lectures from last year on 2x (or higher if manageable) while taking notes (…and pausing to do so, as needed…) on whatever was provided for notes/handout/PowerPoint/etc. It was pretty rare that lectures/lecturers/material changed from year to year.

Later on Monday, but no later than Tuesday - Go over relevant sections in board review material (Pathoma, pharm in FA, etc.). Usually I could just add a few notes from what profs. presented on, but if I found that a school lecture was super minutiae heavy or not covered well in board review material I just made a note to actually review those lecture notes instead; for a given block this was usually < 5 lectures. This is the material I then used to study/review.

After annotating board review material and for the rest of the week - All of the lecture material should be condescend into an easy review format at this point, so just review ad nauseam, do as many quality practice questions as possible (e.g., Guyton and Hall review, UMich, Robbins Review, etc.) attend mandatory crap, and adjust as needed.

Once I committed to this approach there was a notable increase in my exam scores and decrease in the amount of time I spent studying. I realize this may not work for every curriculum or individual, but hopefully its helpful.

Thank you! Yes! I definitely need a way to condense material as much as possible as well. I do not do well with lectures on 2x speed, I find my mind wanders or I miss what is said and find myself having to rewind to hear what I missed. My physio instructor swears by Guyton and Hall, and I had the book of problems for the last exam but didn't actually get to use it.... But i definitely noticed that BRS has a much condensed version of the lectures I am given. Did you just study from the books themselves after putting your own notes in there?
 
Repetition is key. One pass through a lecture is definitely not enough for most people. Most people I know do at least three passes per lecture. I personally do 4-5. I watch the lecture, then review it again later that night, then again the next night, then again on Saturday, and, if necessary, again on Sunday (we have weekly Monday exams).


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Our exams are about every 3-4 weeks, but even so, this is helpful since it just makes sense to review lectures from that week in this way. I definitely agree that one pass usually isn't enough for most lectures/subjects, and this has hurt me in the past. Thanks for the advice!
 
I hear about Anki all the times, but how do you use it? I think I have some sort of bias and think of it nothing more as making flashcards? I know doing simply that wouldn't help me, but perhaps I am way close minded towards and wouldn't mind some further insight into it!
It's funny you say that because I felt the exact same way going into medical school. In college I don't think I made a single flashcard. I thought they were pointless. That being said, I think that medical school is far more amenable to flashcard learning because a great deal of it is just memorizing discrete facts that on their own are not that complicated--it's the sheer volume of them that causes issues.

The way I do it is I will basically add everything from one lecture onto my Anki deck for the unit. Some of it is just simply recalling information, like "What is the innervation of the pectoralis major?" Some of it is more time-intensive, like "Draw and describe the Wiggers diagram." But the bottom line is that if I can do the cards, then I should know pretty much everything that is presented to me.

There are a few reasons why I like Anki. First of all, there's a lot of research that supports its efficacy. Second of all, it keeps me honest. I know that if, at the bare minimum, I can get through all of my assigned Anki cards, I'm up to speed with the material. I also think that it has a lot of neat features like image occlusion, which is nothing short of a godsend for anatomy.

I also consult other resources like Costanzo's Physiology, SUNY Downstate/UMich websites, etc. if I'm really not getting something. But Anki is definitely the foundation to my studying. Again, though, this is what works for me! I'm sure you'll find your own studying strategy. I'm definitely still experimenting a lot.
 
It's funny you say that because I felt the exact same way going into medical school. In college I don't think I made a single flashcard. I thought they were pointless. That being said, I think that medical school is far more amenable to flashcard learning because a great deal of it is just memorizing discrete facts that on their own are not that complicated--it's the sheer volume of them that causes issues.

The way I do it is I will basically add everything from one lecture onto my Anki deck for the unit. Some of it is just simply recalling information, like "What is the innervation of the pectoralis major?" Some of it is more time-intensive, like "Draw and describe the Wiggers diagram." But the bottom line is that if I can do the cards, then I should know pretty much everything that is presented to me.

There are a few reasons why I like Anki. First of all, there's a lot of research that supports its efficacy. Second of all, it keeps me honest. I know that if, at the bare minimum, I can get through all of my assigned Anki cards, I'm up to speed with the material. I also think that it has a lot of neat features like image occlusion, which is nothing short of a godsend for anatomy.

I also consult other resources like Costanzo's Physiology, SUNY Downstate/UMich websites, etc. if I'm really not getting something. But Anki is definitely the foundation to my studying. Again, though, this is what works for me! I'm sure you'll find your own studying strategy. I'm definitely still experimenting a lot.

And with your Wigger's diagram question, do you literally redraw the entire thing when that card comes up or draw it out while creating the card?
 
And with your Wigger's diagram question, do you literally redraw the entire thing when that card comes up or draw it out while creating the card?
I literally redraw the entire thing. I'm not sure how familiar you are with the program, but after you see a question you basically rank it on how difficult it was for you. If you have absolutely no idea, you'll have it reappear in less than one minute. If you sort of knew it but you're not confident, you might have it come back after ten minutes. If you're really confident, you press the "easy" button and it won't come back for a few days. The older the card is, the longer the lengths of time become. So say I've done the Wiggers diagram question card three times. By now, I probably know it pretty well. The card comes up and I might have an option of sending the card away for like 15 days. So the principle behind it is that I will focus more on the concepts that are difficult to me and less on the ones that are easy. If I know something cold, the card will appear much less in circulation.
 
Every piece of advice in this thread can be really helpful if catered to the way you learn. The two pieces of advice that I would heavily emphasize to any student is to not get intimidated by studying. Posters have already mentioned this, but don't get too bogged down with material and expect to know it cold after one pass. Also, if your exams are every 3-4 weeks (and systems based like mine), coming back and reviewing week 1 material in later weeks makes A LOT more sense because of context.

Secondly, you should really harp early on in the study period to understand things at a conceptual level--specifically anything path related or physio related. Knowing how an organ system works is key to identifying pathology and understanding why certain signs/sx occur is the name of the game for path and a huge part of board exams. Don't stress too much over not having a pharm lecture completely memorized in one pass. If you have the physio and the path down, then the pharm is just alphabet soup with some side effect situations.

And you should never stay up till 4 and pull those kind of hours. My worst exam (by 10%) so far in med school came when I slept two hours the night before an exam. I would honestly rather go over material 1-2 times and sleep 8 hours rather than see material 3 times but pull an all-nighter.

If memorizing some enzymes, genes, or drugs is difficult by your third pass through material, just write it on a sheet of paper and refer back to it on the days leading to your exam. If you're understanding material on a conceptual level, then a single sheet or two will be ample and can be looked over several times to hammer in those last few facts before an exam.

Lastly, you're never going to walk into an exam and expect a 100. At least at my school (US allopathic), where the averages are in the high 70s or low 80s on exams, you just have to walk in being comfortable with the material, after a good night's sleep, and expect to be able to reason your way through any question they give you. If you could spend more time with step resources, it would be ideal but not paramount, especially if you're at a school with a traditional curriculum.

This is advice from someone that scores above average (top quartile? Idk our school doesn't release averages or ranking), and I don't seem to stress at as much or study as much as some of my peers. Again, learning conceptually, not psyching yourself out, and sleeping regularly will do wonders for you and any student. Good luck!
 
Every piece of advice in this thread can be really helpful if catered to the way you learn. The two pieces of advice that I would heavily emphasize to any student is to not get intimidated by studying. Posters have already mentioned this, but don't get too bogged down with material and expect to know it cold after one pass. Also, if your exams are every 3-4 weeks (and systems based like mine), coming back and reviewing week 1 material in later weeks makes A LOT more sense because of context.

Secondly, you should really harp early on in the study period to understand things at a conceptual level--specifically anything path related or physio related. Knowing how an organ system works is key to identifying pathology and understanding why certain signs/sx occur is the name of the game for path and a huge part of board exams. Don't stress too much over not having a pharm lecture completely memorized in one pass. If you have the physio and the path down, then the pharm is just alphabet soup with some side effect situations.

And you should never stay up till 4 and pull those kind of hours. My worst exam (by 10%) so far in med school came when I slept two hours the night before an exam. I would honestly rather go over material 1-2 times and sleep 8 hours rather than see material 3 times but pull an all-nighter.

If memorizing some enzymes, genes, or drugs is difficult by your third pass through material, just write it on a sheet of paper and refer back to it on the days leading to your exam. If you're understanding material on a conceptual level, then a single sheet or two will be ample and can be looked over several times to hammer in those last few facts before an exam.

Lastly, you're never going to walk into an exam and expect a 100. At least at my school (US allopathic), where the averages are in the high 70s or low 80s on exams, you just have to walk in being comfortable with the material, after a good night's sleep, and expect to be able to reason your way through any question they give you. If you could spend more time with step resources, it would be ideal but not paramount, especially if you're at a school with a traditional curriculum.

This is advice from someone that scores above average (top quartile? Idk our school doesn't release averages or ranking), and I don't seem to stress at as much or study as much as some of my peers. Again, learning conceptually, not psyching yourself out, and sleeping regularly will do wonders for you and any student. Good luck!

Lol I definitely do all of the above. I rarely get much sleep before any exam, which I know isn't good but I swear my anxiety over "not knowing anything" basically gives me an adrenaline rush the entire night. I definitely psych myself out, I know I do and that's one of my biggest problems.

Sleep has been a problem my entire life, and even now, I have been up all night. Basically story of my life.

Our averages (mostly around an 80 for most courses, some of the "easier" exams are an 85) are always released plus the standard deviations. I am consistently under this, but in general, within one standard deviation of the mean, but that doesn't make me feel better. I am somehow allowing a self fulfilling prophecy to continue, that I am now convinced I just cannot do better than I am doing (destined to be mediocre tends to be one of the statements I use). I definitely struggle with the attempting to know everything cold on the first pass, but I just can't seem to really wrap my head around not getting bogged down and how to really study subsequent reviews of the same material.

Just as an FYI, my next exam at the very end of january/early february covers physiology (respiratory/GI), immuno (basically a comprehensive exam of the entire course..so covers basic complement, inflammation, innate immunity, cytokines, through stuff like organ rejection, hypersensitivity, and autoimmunity), nutrition (Vitamins A, D, K, Iron, Calcium, Phosphorus, and other nutritional states during various pathologies), Histology (Respiratory and GI), and a new class we're starting which is statistics (basically).
 
Thank you! Yes! I definitely need a way to condense material as much as possible as well. I do not do well with lectures on 2x speed, I find my mind wanders or I miss what is said and find myself having to rewind to hear what I missed. My physio instructor swears by Guyton and Hall, and I had the book of problems for the last exam but didn't actually get to use it.... But i definitely noticed that BRS has a much condensed version of the lectures I am given.
It took me a good part of 1st year to get use to watching lectures at 2x+ for similar reasons; it just takes persistence and you should be able to adjust. I noticed that the majority of the time I zoned out for a bit and had to rewind the lecturer was usually just reading straight from his/her PowerPoint. The Guyton and Hall review book is solid. You should be doing practice questions along with regular studying and not waiting until just before an exam to start practice questions. This will help you assess your strengths and weaknesses early on, and can help guide you as to what is important and what is minutiae. Obviously this goes for any subject, not just phys.

Did you just study from the books themselves after putting your own notes in there?
Once I got my system down that's pretty much what I did. The big exceptions being:
Biochem - finished before I adopted this system of studying, also this method wouldn't be conducive to the way biochem was taught at my school (lots of things in board review material that we didn't cover in lecture and vice versa).

Embryology - we were pretty much only tested on minutiae that came from the latest research and not what is needed for boards.

Neuro - our neuro lecturers actually put together solid handouts that are better than any commercially available sources I've seen.
 
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I'm going to PM you my study troubleshooting guide, a checklist of things to watch for. I think you have to be systematic about what is working and not working.
 
Something else to consider: spend less time on SDN until you feel more comfortable academically. This will hopefully give you more time to de-stress and rest, which will help you focus better when you do hit the books. Other things to consider to boost study efficiency is to minimize distractions (Facebook, phone apps / updates, etc.).

Apart from that, as others have mentioned, getting better sleep hygiene is key (chronic sleep-deprivation isn't doing you any favors), and focusing more on constant repetition rather than trying to know everything on first pass should make your life a bit easier -- the things that are important to know will continue to pop up with time. Good luck!
 
Another broader conceptual thing is this:

Spend less time asking "why?" And more time asking "how will this be tested?"

There is a time and a place for digging in and learning concepts thoroughly, but there is also a time to let that go a bit and focus on how it will be tested. You will come back to many of these concepts repeatedly through your schooling and training, and each time you will pick up new things and gain a deeper understanding.

For any lecture, there is a finite set of possible exam questions. There are an infinite number of ways to dress these up, but you can always boil them back down to one of those original few. Try to figure out what these are as you study and do your repetitions and it may help keep you from wandering too far into the weeds.
 
time management.... inefficient ... I can't seem to get out of my own way.... I pull a ton of late nights ... I am putting way more in than I am getting out of studying. maybe I get severe test anxiety on top of being exhausted and it's killing me.

1. Time management is a learned skill. I am talking from experience that people who waste their time are one of the possibly most annoying persons. The lack of respect that comes from this poorly developed skill is incredibly big.
Now I know how this sounds : " Take me easier, will ya ? " - NO. Believe it or not, this time management problem starts out as a problem that only affects you - your time, your loss, right ? Just that in time, you won't be able to pull yourself together and that will affect other people's lives also. We do not live on an island, we are all connected to each other, and in Medicine especially we are enchained to each other and the weakest link is the one that everyone starts to resent sooner or later. Not being able to manage your time is going to come back to bite you in more ways than you can imagine.

2. Inefficient studying techniques are understandable at the beginning, but with increased experience, inefficiency has to decrease : you have to find the proper strategies and methods for studying, you have to find out your limits, and you have to become a functional lifelong student, who knows more and more about himself. But do not think that this comes automatically : you do have to wake up and start knowing yourself. There are persons who are still incredibly inefficient even as residents, others will be the ones who will sacrifice their physical and mental health because they will not be able to keep up with the tempo, and so on. These are lost causes in the majority of the cases, because you will notice that Medicine is the field in which you do not want to sleep your life away and fall off the wagon, because getting back on track is not possible after a certain point.

3. It's interesting that you wrote " I can't seem to get out of my own way. " - If you can recognize that actually this is a problem, then you will be able to develop a flexible attitude toward your career and this is a very helpful personality trait to have. You have to actually listen to that voice inside your head that often times whispers what's actually wrong, so in order to get out of your own way, you first have to be honest with yourself about where you are screwing up.
Surprisingly, many people know their bad habits, inefficient studying techniques, lack of discipline, etc. - yet they do nothing about them. So if you think recognition is enough to get out of your own way, think again : you are well aware that you have poor time management skills, poor sleeping habits, poor studying techniques, yet you haven't done anything to correct that. You have the possibility to fix the problem, because you see it, but you don't do it - Why ? Delusional perception that " Some day things will change " ? Self-defeating behavior because of a past bad experience ? Success barriers ? Negligence ?

4. " I pull a ton of late night " - You know that lack of sleep causes brain damage, right ? No need to say more. Some persons can function on little sleep, but you aren't one of them , so it is pointless to force it.

5. " I am putting way more in than I am getting out of studying " - Maybe you put a lot of quantity, but not enough quality. I have classmates who study the most and they have the worst studying methods also. You can't even explain to them that probably they don't study in the best way, because they would look at you with big eyes : " But I study all day ! How you dare to judge me ?! "

6. " I get severe test anxiety on top of being exhausted and it's killing me " - Just like one of my classmates. She is one of the best students, but she is a mess and she admitted it herself. The thing that you have to realize early on is that going through ANY type of process in such a mental state is not worth it. You have to find a way to maintain your balance or you will collapse sooner or later. People think that a mental disease is something you can neglect, because it cannot affect you, but it is exactly like a broken bone or a stomach ulcer - if it goes untreated, your condition will only get worse. Neglecting it is not bravery - it is foolishness.
 
I'm going to PM you my study troubleshooting guide, a checklist of things to watch for. I think you have to be systematic about what is working and not working.
I am M1 and Struggling with my school work. Can you please forward to me your study troubleshooting guide, A checklist of things to watch for? Many thanks
 
Repetition is key. One pass through a lecture is definitely not enough for most people. Most people I know do at least three passes per lecture. I personally do 4-5. I watch the lecture, then review it again later that night, then again the next night, then again on Saturday, and, if necessary, again on Sunday (we have weekly Monday exams).


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How do you have time for this? It usually takes me a couple of hours to get through 1 lecture (watching, pausing, making anki cards). Do you just watch your lectures without pausing them? Teach me your ways
 
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