How do you learn/understand in medical school and not memorize?

[Girlygirl2020]

I can understand that a good chunk of medical school is pure rote memorization, and there are tons of tried and true methods to get concepts cemented in your brain (SRS, mind maps, e.t.c). However, I don't really read much about techniques and ways to truly understand what you're learning in medical school. Like I don't want to memorize the symptoms of diabetes, I want to understand WHY those symptoms occur (and then later of course, remember it). While I know this takes a longer time to master, I feel it would help me in the long run (especially for step 1). A few techniques I've read about include teaching others, phrasing things in your own way, e.t.c. Does anyone have any input?

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[Newyawk]

I can understand that a good chunk of medical school is pure rote memorization, and there are tons of tried and true methods to get concepts cemented in your brain (SRS, mind maps, e.t.c). However, I don't really read much about techniques and ways to truly understand what you're learning in medical school. Like I don't want to memorize the symptoms of diabetes, I want to understand WHY those symptoms occur (and then later of course, remember it). While I know this takes a longer time to master, I feel it would help me in the long run (especially for step 1). A few techniques I've read about include teaching others, phrasing things in your own way, e.t.c. Does anyone have any input?

Teaching others and phrasing things your own way are useless if youre not working with the physio and pathophysio.
When people say learn and dont just memorize, they are referring to the mechanisms behind the manifestations. Anyone can memorize that peripheral neuropathy and kidney disease are sequelae of DM. When you get to step 1 and the clinic they will expect you all to know that. However, if you understand WHY kidney disease occurs (vascular damage yada yada) you will not only remember the info better but will have a better understanding of it. This will translate to better communication between team members and patients. It will also allow you to score well on exams that penalize students who just try to memorize facts.

The way to do this is to use sources that TEACH you WHY, and dont just tell you THAT it happens. This is why first aid can be really hurt students who try to use it as their ultimate source.

A great way to do this is to always be proactive in your learning. When a book tells you a symptom that doesnt make sense to you look into it. Uptodate, wiki, whatever

 

[Girlygirl2020]

What are some resources that teach you why and don't just tell you?

 

[bahdahboom]

I can understand that a good chunk of medical school is pure rote memorization, and there are tons of tried and true methods to get concepts cemented in your brain (SRS, mind maps, e.t.c). However, I don't really read much about techniques and ways to truly understand what you're learning in medical school. Like I don't want to memorize the symptoms of diabetes, I want to understand WHY those symptoms occur (and then later of course, remember it). While I know this takes a longer time to master, I feel it would help me in the long run (especially for step 1). A few techniques I've read about include teaching others, phrasing things in your own way, e.t.c. Does anyone have any input?

It’s a balance. Some things you memorize, a lot of things you try to understand so you don’t have to memorize. I constantly ask myself why and how while studying.

 

[CleverAdvisor]

What are some resources that teach you why and don't just tell you?

Med school.

If you decided to read something like pathoma or FA without learning the material first it will be difficult because there is no context

 

[Girlygirl2020]

Med school.

If you decided to read something like pathoma or FA without learning the material first it will be difficult because there is no context

Why is that I read so many times on this forum that their medical school curriculum isn't high yield?

 

[Aerus]

Why is that I read so many times on this forum that their medical school curriculum isn't high yield?

Because of any or multiple of the following reasons:

1) Professors are teaching their own research
2) Courses go into more depth about certain topics than what is covered in Step 1 resources
3) Curriculum tries to integrate too many "clinical" applications that go beyond Step 1
4) Curriculum tries to integrate topics that aren't on Step 1 into the curriculum, like Health Policy, Sociology, etc.
5) Students like to complain that the slides aren't going line by line through First Aid.

Some of the above is understandably frustrating on the student's part whereas others are just complaining. The majority of the time, the curriculum does just fine covering Step 1 material, but there is a lot of information that must be self-learned, since no curriculum can cover everything.

If schools JUST taught from First Aid, sure it would be the most high yield curriculum, but that essentially means you let NBME dictate and completely control what medical education should be like.

 

[Girlygirl2020]

So basically focus on what your professors are teaching. Are there resources outside of lecture that teach you this? Just in case your professor are part of the % that don't

 

[GadRads]

Some things just have to be memorized. Some lend themselves to understanding. And some to a combination of these.

 

[Newyawk]

So basically focus on what your professors are teaching. Are there resources outside of lecture that teach you this? Just in case your professor are part of the % that don't

No, you have to pick and choose what you think is important, especially if your professors are lecturing about their own research (that might not even be that well respected, btw) or from a giant textbook. Thats where a review book comes in - it will tell you what is important and not important. The issue is most review books do a poor job at fully explaining things (bc thats not the point of them). So you have to do your due diligence and look things up and annotate your review books.

 

[Girlygirl2020]

No, you have to pick and choose what you think is important, especially if your professors are lecturing about their own research (that might not even be that well respected, btw) or from a giant textbook. Thats where a review book comes in - it will tell you what is important and not important. The issue is most review books do a poor job at fully explaining things (bc thats not the point of them). So you have to do your due diligence and look things up and annotate your review books.

OHHHHHHH okay I got it. Thank you so much 🙂

 

[seekere]

I'm an incoming M1, but I just took an upper level course on memory and cognition. There are so many techniques such as different types of mnemonics, mindmaps, loci techniques, but it's all personal. The biggest universal takeaway is that testing oneself is by far the best way to memorize and learn. Also testing practice should be interweaved rather than blocked (if you are learning A, B,C,D, don't practice AAAAABBBBCCCCDDD but instaed ABCDCBCABC etc)

 

[Goro]

I can understand that a good chunk of medical school is pure rote memorization, and there are tons of tried and true methods to get concepts cemented in your brain (SRS, mind maps, e.t.c). However, I don't really read much about techniques and ways to truly understand what you're learning in medical school. Like I don't want to memorize the symptoms of diabetes, I want to understand WHY those symptoms occur (and then later of course, remember it). While I know this takes a longer time to master, I feel it would help me in the long run (especially for step 1). A few techniques I've read about include teaching others, phrasing things in your own way, e.t.c. Does anyone have any input?

You know, this is what an UG education is for. To learn HOW to learn.

Many SDNers have commented that the intellectual rigor of med schools isn't that strenuous, it's the volume that's challenging. Although some of the material taught here (like Pharm) makes brain melt and leak out of my ears!

A Hem/Onc colleague of mine once told me that "Medicine is knowing more and more about less and less"

 

[Girlygirl2020]

You know, this is what an UG education is for. To learn HOW to learn.

Many SDNers have commented that the intellectual rigor of med schools isn't that strenuous, it's the volume that's challenging. Although some of the material taught here (like Pharm) makes brain melt and leak out of my ears!

A Hem/Onc colleague of mine once told me that "Medicine is knowing more and more about less and less"

I get that, but I hear a lot of people tell me the way I studied/learned in undergrad isn't going to cut it in medical school. So I was wondering what others were doing.

 

[mistafab]

I honestly feel bad that some people think their school curriculum doesn’t prepare you for step one. Maybe theirs doesn’t! But there definitely was way more coverage total on lectures than on my review material. I would not write off lectures as some waste of time unless it really is in your school - my school did an excellent job. There were things point blank from lectures that were on my step exam that were nowhere at all in FA or pathoma.

Plus - for people like you who have to UNDERSTAND things in order to memorize it (like me), I found lectures to be absolutely KEY to understanding what the heck was going on. I usually would pre-read the textbook chapter (just to get familiar with stuff) and then when lecture rolled around I could really hear what they were saying. If you don’t pre-read then lectures can seem like random facts being thrown around.

 

[Goro]

I get that, but I hear a lot of people tell me the way I studied/learned in undergrad isn't going to cut it in medical school. So I was wondering what others were doing.

What they're talking about is relating to the sheer volume for the most part.

 

[ZotZotter]

I think case files are a good way to get some utility out of concepts that would otherwise be pure memorization. I'm not calling it big picture "understanding" or anything like that but it definitely shows you how to apply an otherwise random body of facts.

 

[bahdahboom]

I'm an incoming M1, but I just took an upper level course on memory and cognition. There are so many techniques such as different types of mnemonics, mindmaps, loci techniques, but it's all personal. The biggest universal takeaway is that testing oneself is by far the best way to memorize and learn. Also testing practice should be interweaved rather than blocked (if you are learning A, B,C,D, don't practice AAAAABBBBCCCCDDD but instaed ABCDCBCABC etc)

In all reality, in med school, you'll most likely be doing AAAAABBBBCCCCDDDAAAAABBBBCCCCDDDAAAAABBBBCCCCDDD etc.. It takes a few repetitions of focusing on a specific topic to get a moderate comfortability with it. Hence why med school is so time-consuming.

 

[AnatomyGrey12]

Like I don't want to memorize the symptoms of diabetes, I want to understand WHY those symptoms occur (and then later of course, remember it)

Oh don’t worry, you’ll be memorizing that too.

Medicine is memorization. If you memorize enough tiny details they eventually come together to make the picture. This is why Anki is king

 

[Girlygirl2020]

I honestly feel bad that some people think their school curriculum doesn’t prepare you for step one. Maybe theirs doesn’t! But there definitely was way more coverage total on lectures than on my review material. I would not write off lectures as some waste of time unless it really is in your school - my school did an excellent job. There were things point blank from lectures that were on my step exam that were nowhere at all in FA or pathoma.

Plus - for people like you who have to UNDERSTAND things in order to memorize it (like me), I found lectures to be absolutely KEY to understanding what the heck was going on. I usually would pre-read the textbook chapter (just to get familiar with stuff) and then when lecture rolled around I could really hear what they were saying. If you don’t pre-read then lectures can seem like random facts being thrown around.

I definitely can't memorize without understanding! Unfortunately

Oh don’t worry, you’ll be memorizing that too.

Medicine is memorization. If you memorize enough tiny details they eventually come together to make the picture. This is why Anki is king

But wouldn’t I be better off learning what causes diabetes and what diabetes does to the body...eliminating the need to memorize the symptoms?

 

[AnatomyGrey12]

But wouldn’t I be better off learning what causes diabetes and what diabetes does to the body...eliminating the need to memorize the symptoms?

Nope. How do you suppose you’re going to learn those things?

 

[libertyyne]

I have found the weirdest thing happen in medical school. You memorize minutiae first, and then bam one day it all clicks together and you understand what the minutiae is about. Think of it like this: the concept is a building. The little factoids are the bricks that make up that building. You can try looking at the building and you may get glimpses of it, but if you dont have all the bricks in place you will not retain it or keep the view focused long enough to answer the questions about the contours of the building and architectural flourishes.

 

[Girlygirl2020]

Nope. How do you suppose you’re going to learn those things?

Hopefully from my professors and lectures?

 

[Girlygirl2020]

I have found the weirdest thing happen in medical school. You memorize minutiae first, and then bam one day it all clicks together and you understand what the minutiae is about. Think of it like this: the concept is a building. The little factoids are the bricks that make up that building. You can try looking at the building and you may get glimpses of it, but if you dont have all the bricks in place you will not retain it or keep the view focused long enough to answer the questions about the contours of the building and architectural flourishes.

But it just feels so much more work memorizing a bunch of facts and then hoping it ends up working out in the end? Wouldn’t it be better to build the foundation of the house before adding all the fixtures vs the other way around?

 

[libertyyne]

But it just feels so much more work memorizing a bunch of facts and then hoping it ends up working out in the end? Wouldn’t it be better to build the foundation of the house before adding all the fixtures vs the other way around?

You need the bricks to build up the walls. I am just telling you my experience. You can try the other method ND see if it works for you.

I used to think like you that I need understanding to remember something. I found out I only need 3 passes. There is also something to be said of the ease of access to facts. It takes a long time to reason through a question. Even the The answer choices all sound famiar and you can't reason your way out of a question. And by the time you are done reasoning the person next to you has answered four straight recall questions And moved on to the next one.

And in this analogy the foundation is your undergrad training and the skills you practiced to do well on the MCAT.

 

[AnatomyGrey12]

I have found the weirdest thing happen in medical school. You memorize minutiae first, and then bam one day it all clicks together and you understand what the minutiae is about. Think of it like this: the concept is a building. The little factoids are the bricks that make up that building. You can try looking at the building and you may get glimpses of it, but if you dont have all the bricks in place you will not retain it or keep the view focused long enough to answer the questions about the contours of the building and architectural flourishes.

This.

Hopefully from my professors and lectures?

🤣

But it just feels so much more work memorizing a bunch of facts and then hoping it ends up working out in the end? Wouldn’t it be better to build the foundation of the house before adding all the fixtures vs the other way around?

That’s why you start by memorizing physiology, then pathophysiology, and then finally pathology.

 

[Girlygirl2020]

This.



🤣



That’s why you start by memorizing physiology, then pathophysiology, and then finally pathology.

But that’s what people have been saying on this thread, that you’ll learn all of the concepts from your lectures? So now I’m just confused AF

 

[libertyyne]

But that’s what people have been saying on this thread, that you’ll learn all of the concepts from your lectures? So now I’m just confused AF

Lecturers on average are pretty bad.
You will not be tested on concepts alone. You will be tested on detail. Unless you go to school without multiple choice questions.

 

[Giovanotto]

You guys are hilarious, it's all memorization.

 

[Girlygirl2020]

You guys are hilarious, it's all memorization.

If it’s all memorization why don’t we just have computers do the job? They’re better at memorizing than we are.

 

[Giovanotto]

If it’s all memorization why don’t we just have computers do the job? They’re better at memorizing than we are.

Correct, however, medicine, as I'm sure we'll both come to realize further down our training, is just as much an art-form as it is a science. And if it's not, then things will be bleak, because AI isn't merciful.

 

[Newyawk]

The pathway is this:
Topic --> mechanism (if one exists) --> symptoms/signs/management/etc

Just trust me on this @Girlygirl2020. These kids havent even taken step 1 yet let alone been in the hospital where they have to explain their reasoning to residents and attendings (who are much more impressed with logical thought processes than spitback).

 

[Vkserop]

Memorize is the basis, but more importantly, how to understand them

 

[libertyyne]

The pathway is this:
Topic --> mechanism (if one exists) --> symptoms/signs/management/etc

Just trust me on this @Girlygirl2020. These kids havent even taken step 1 yet let alone been in the hospital where they have to explain their reasoning to residents and attendings (who are much more impressed with logical thought processes than spitback).

I don't think we were implying step one or clinical rotations were a brute memorization. But are you seriously going tell this girl that she can make it through and do well in preclinical just by understanding biochem, anatomy, histology, and neuroscience?

 

[AnatomyGrey12]

I don't think we were implying step one or clinical rotations were a brute memorization. But are you seriously going tell this girl that she can make it through and do well in preclinical just by understanding biochem, anatomy, histology, and neuroscience?

In my experience when people say “instead of memorizing I’ll really go for understanding” they really are just using it as a cop out for actually memorizing what they need to memorize.

 

[Newyawk]

Youre not teaching her anything by telling her that she has to memorize things. Memorization is part of learning anything. Everyone knows that. Technically you have to "memorize" concepts too. You have to "memorize" anything you learn. But its much easier to memorize the TCA cycle if you first know why it even exists.

 

[AnatomyGrey12]

Youre not teaching her anything by telling her that she has to memorize things. Memorization is part of learning anything. Everyone knows that. Technically you have to "memorize" concepts too. You have to "memorize" anything you learn. But its much easier to memorize the TCA cycle if you first know why it even exists.

Medicine is not a hard concept. Understanding why something exists is pretty straightforward and takes a few minutes, after that it’s all about memorization. I’m strictly talking pre-clinical.

 

[Gurby]

Youre not teaching her anything by telling her that she has to memorize things. Memorization is part of learning anything. Everyone knows that. Technically you have to "memorize" concepts too. You have to "memorize" anything you learn. But its much easier to memorize the TCA cycle if you first know why it even exists.

Much easier to memorize the TCA cycle once you've already memorized a bunch of other pathways that feed into / out of it

 

[Girlygirl2020]

Literally you guys my first sentence of this post is me acknowledging the importance of memorization....but I want to go a step further than that. I don’t think med school is all about memorization, it’s a good chunk, but not all of it. And I also know (by reading **** tons of books about memorization) that memorization is SO much easier when you understand things. I just want another tool in my belt when it comes to medical school.

Everybody and their mother studies hard in med school and memorized a **** ton of things. So in the end, what separates those who do really well on step 1 and clinical vs those who don’t? Its not like none of us study and don’t know the Kreb Cycle. You have to master the subjects, and the only way to do that is to understand, not just memorize. Right?

 

[TheIllusionist]

Rate limiting step in reaction for success in preclinical education and STEP1 is your diligence and memorization ability. The critical thinking in preclinical education is oversold.

I asked a couple Deans what the most common major for failouts was...

The few I asked all said engineering. I was expecting something like psych.

Yes thinking is important, but it serves an extremely ancillary role. But people get bent out of shape hearing this. They want to believe that they are doing more prestigious forms of learning that require the depth of understanding seen in rocket science or highly quantitative econ. In reality, analytic skills don't make much of a difference. It is the reason why the MCAT STEP1 correlation is so weak. It is why the specialty with the highest average MCAT scores, as per AAMC, is neurosurgery with a 33 on the old MCAT. A 33 is a good but not stellar score on the aptitude heavy test like the MCAT.

Now, you are beyond a lot of the academic aptitude testing for your life. What is important now is assimilating tons of information into your brain and obtaining tons of crystallized intelligence. Crystalized intelligence is correlated with fluid intelligence, more of the IQ type, but not perfectly whatsoever. A lot of med school is a rereading and space repetition contest. It's not about struggling there with a deeply complex problem for hours and having eureka moments. those happen but are not commonplace.

Attendings now and practicing good medicine does require a lot of thinking, if one wants to be good and choose to employ it.

Being a student is about being OCD about reading and rereading high yield facts and testing it you remembered all the nuances with questions. Physiology can sometimes be an exception but that's only one subject and again only sometimes.

 

[AnatomyGrey12]

Literally you guys my first sentence of this post is me acknowledging the importance of memorization....but I want to go a step further than that. I don’t think med school is all about memorization, it’s a good chunk, but not all of it. And I also know (by reading **** tons of books about memorization) that memorization is SO much easier when you understand things. I just want another tool in my belt when it comes to medical school.

Everybody and their mother studies hard in med school and memorized a **** ton of things. So in the end, what separates those who do really well on step 1 and clinical vs those who don’t? Its not like none of us study and don’t know the Kreb Cycle. You have to master the subjects, and the only way to do that is to understand, not just memorize. Right?

No. Preclinical is a race to memorize the most details. I have already done ~1000 Step 1 practice questions. If you memorize every little detail you can get almost every single one of them right. Step is not the MCAT, which was a heavy critical thinking exam.

Rate limiting step in reaction for success in preclinical education and STEP1 is your diligence and memorization ability. The critical thinking in preclinical education is oversold.

I asked a couple Deans what the most common major for failouts was...

The few I asked all said engineering. I was expecting something like psych.

Yes thinking is important, but it serves an extremely ancillary role. But people get bent out of shape hearing this. They want to believe that they are doing more prestigious forms of learning that require the depth of understanding seen in rocket science or highly quantitative econ. In reality, analytic skills don't make much of a difference. It is the reason why the MCAT STEP1 correlation is so weak. It is why the specialty with the highest average MCAT scores, as per AAMC, is neurosurgery with a 33 on the old MCAT. A 33 is a good but not stellar score on the aptitude heavy test like the MCAT.

Now, you are beyond a lot of the academic aptitude testing for your life. What is important now is assimilating tons of information into your brain and obtaining tons of crystallized intelligence. Crystalized intelligence is correlated with fluid intelligence, more of the IQ type, but not perfectly whatsoever. A lot of med school is a rereading and space repetition contest. It's not about struggling there with a deeply complex problem for hours and having eureka moments. those happen but are not commonplace.

Attendings now and practicing good medicine does require a lot of thinking, if one wants to be good and choose to employ it.

Being a student is about being OCD about reading and rereading high yield facts and testing it you remembered all the nuances with questions. Physiology can sometimes be an exception but that's only one subject and again only sometimes.

This.

 

[USMLEHeadache]

I try to write test questions to see how well I understand the material.

 

[Redpancreas]

I honestly feel bad that some people think their school curriculum doesn’t prepare you for step one. Maybe theirs doesn’t! But there definitely was way more coverage total on lectures than on my review material. I would not write off lectures as some waste of time unless it really is in your school - my school did an excellent job. There were things point blank from lectures that were on my step exam that were nowhere at all in FA or pathoma.

Plus - for people like you who have to UNDERSTAND things in order to memorize it (like me), I found lectures to be absolutely KEY to understanding what the heck was going on. I usually would pre-read the textbook chapter (just to get familiar with stuff) and then when lecture rolled around I could really hear what they were saying. If you don’t pre-read then lectures can seem like random facts being thrown around.

This so much. There are too many above average people on here with loud voices on here who lots of people listen to because they post 270+ who give terrible advice (ignore your curriculum, etc.) and for the average person with ambitious goals, it’s the wrong strategy. University of FAP can’t mimick a 2 year curriculum.

 

[Girlygirl2020]

So it's literally just who can memorize the most?

 

[Newyawk]

So it's literally just who can memorize the most?

If learning and being able to apply previous knowledge to new questions youve never seen before (ie at least 20% of step 1) is spitback then sure its about who can memorize the most. I personally dont consider that spitback. As somebody who did thousands of questions and worked his butt off throughout preclinicals and STILL walked out of step 1 like wtf was that why were there so many random Qs, i can tell you firsthand that thats nonsense.
If it was just memorization, whats separating the 270s from the people who study for months and momths and still barely pass? Is it just how much volume they can memorize?... or is it the ability to integrate info?

 

[Girlygirl2020]

If learning and being able to apply previous knowledge to new questions youve never seen before (ie at least 20% of step 1) is spitback then sure its about who can memorize the most. I personally dont consider that spitback. As somebody who did thousands of questions and worked his butt off throughout preclinicals and STILL walked out of step 1 like wtf was that why were there so many random Qs, i can tell you firsthand that thats nonsense.
If it was just memorization, whats separating the 270s from the people who study for months and momths and still barely pass? Is it just how much volume they can memorize?... or is it the ability to integrate info?

I agree with you. I don't think it's just memorization, but it's so weird that a handful of people are saying it just it. I don't expect to do crazy analysis or have to think hard about medicine like the person mentioning engineers...but there has to be something more to it all

 

[deleted765155]

This so much. There are too many above average people on here with loud voices on here who lots of people listen to because they post 270+ who give terrible advice (ignore your curriculum, etc.) and for the average person with ambitious goals, it’s the wrong strategy. University of FAP can’t mimick a 2 year curriculum.

I seriously don't understand the constant belief that if someone chooses to disregard their school's lectures that they suddenly only use UFAP for an entire two years straight. This is the one argument I always see from people on SDN and administrators at my school and it drives me insane. Pretty much every student I know that ignores their school's curriculum uses Boards and Beyond or another super comprehensive lecture series, Pathoma, Sketchy Micro, Sketchy Pharm, Firecracker/Zanki, USMLERx, Kaplan, U-World, +/- FA, +/- Goljan.

But people argue that in order to succeed as a third year medical student that you must watch a live lecture from a physician (or PhD), who very well might not have rehearsed what they are about to teach, wing it on the spot and flip through 80 slides in under an hour. What do these lecturers at your schools teach you in class that every other resource willingly chooses to ignore, that the NBME chooses to ignore?

 

[Vrachika]

I'm all about understanding everything I can to do as little memorization as possible, you sound a lot like me. Even though I'm good with memorization, I absolutely hate doing it.

To make this happen, I do this crazy thing where I listen to lectures and follow my school's curriculum. Lol. I didn't read most of this thread so what I'm saying may be super redundant.

It's true that not all lectures/lecturers are great (and sometimes are downright bad) and sometimes the curriculum misses things, but I really don't get how people can just do UFAP, etc and have a deep understanding of stuff. Don't get me wrong, some boards resources are absolute gold, but I personally feel they should be used as intended, for high yield review.

For me, I listen to lecture, then use resources like Pathoma, FA, Sketchy, and the occasional textbook/google search, then just one more pass through lecture material. That way I'm not ignoring the curriculum, I'm getting in those high yield (amazing) board resources, and not spending insane amounts of time studying/memorizing. My grades are good, and my long term retention is decent because I focused on understanding. I absolutely miss a handful of questions on every test on some "details", but it's just not worth that 3rd pass of lecture material for me, and I know it's stuff I'll forget before boards anyway (if its even important for boards).

 

[Vrachika]

Also, if you don't like memorizing, sketchy is amazing for memorizing stuff because they make it fun and they make it into "understanding". Yeah, you might be "understanding" a completely fictional fantasy land fairy tail, but you will remember all those details forever because it was told to you in a story that makes sense of all the memorization details.

 

[Redpancreas]

I seriously don't understand the constant belief that if someone chooses to disregard their school's lectures that they suddenly only use UFAP for an entire two years straight. This is the one argument I always see from people on SDN and administrators at my school and it drives me insane. Pretty much every student I know that ignores their school's curriculum uses Boards and Beyond or another super comprehensive lecture series, Pathoma, Sketchy Micro, Sketchy Pharm, Firecracker/Zanki, USMLERx, Kaplan, U-World, +/- FA, +/- Goljan.

But people argue that in order to succeed as a third year medical student that you must watch a live lecture from a physician (or PhD), who very well might not have rehearsed what they are about to teach, wing it on the spot and flip through 80 slides in under an hour. What do these lecturers at your schools teach you in class that every other resource willingly chooses to ignore, that the NBME chooses to ignore?

These are very good points. You can use most of these on top of the curriculum and still be comfortably free. In terms of professors winging it, they may, but the written material usually isn’t. Beyond the Boards/Goljian are probably the most comprehensive on there. Also, it isn’t necessarily what they teach that’s different but how they’re assessed. Teaching something and then forcing you to study for it or else you fail out is a strong teacher. I remember details nowhere in review sources (again these are reactionary) on the real thing. In reality they were in probably some source, but my curriculum made it more memorable. Also you are underestimating (maybe only slightly) some of these people. They have access to lots of NBME material and how USMLE makes questions and many of them are given money to travel to conferences where this is discussed. Overall, I pretty much agree with what you’re saying by the way when you give Step 1 Advice. It’s just the way we start that seems different.