How to be awesome

[mint22]

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...in medical school?

I'm an M2 and love medicine--clinical medicine especially, which is starting to seem like my forte. However I am still amazed at how smart and brilliant some of my classmates appear (as verified by the high scores on our exams). How can I be like them? What's their secret to medical knowledge/acumen? Anyone at the top or maybe even top half of their class willing to share what they do? Obviously grades during the pre-clinical years are not the be-all-end-all of who's going to be a great doctor--but it would certainly be nice to do better!

Please be practical if possible. (As an M2 I've already read/seen a lot of the vague, e.g. "Make a summary sheet" or "Use Anki" or "Read Robbins" or "You have to see what works for you"--I'm looking for some concrete advice to really prove--primarily to myself--that I can be awesome and know things!).

So this question is more specific--it's for those who are getting thru and doing very well and have concrete ways of studying or learning or being efficient with their time, especially now that boards are approaching. What are you doing that other students might not have thought to do?

I'd appreciate any/all advice as I have found the material thus far challenging but I am ready to do what it takes to feel confident in my knowledge--and hopefully down the line do well on Step 1, so that many specialties can still be an option.

Sorry for the length, and thank you so much in advance! Looking forward to hearing your wisdom!

 

[David Hasselhof]

Some people are just smart. That's really all there is to it.

I do think with extreme dedication and hard work it is possible for anyone to do very well on Step 1, so don't lose hope. Preclinical grades aren't a huge deal.

 

[happygilmore]

Yeah, natural intelligence helps.

I know people who didn't study that hard and broke 260.

After that it's just daily discipline and speed/efficiency.

 

[Stellar Clouds]

Repetition, repetition, repetition.

 

[Anastomoses]

I'm not sure there's a trick to it once you're at a sufficient level. I think some people just retain things faster and longer. Even stupid things. Some people are more socially intelligent than others...they pick up "natural" cues that are more difficult for certain people to put together (think mild aspergers variety).

In your specific case, the only thing I can think of is looking at your own exams and seeing where you drop the ball. Are you skipping small details? Missing the bigger picture sometimes? Look for the holes in your own patterns.

 

[mint22]

Thanks everyone! And true, natural intelligence helps. But everyone is smart in medical school, and hopefully by having been admitted, has the baseline intelligence needed to succeed. Can you be more specific about things like hard work and daily discipline? To what extent are these individuals studying? What are their daily habits? What do they do on a day-to-day basis? I wish there was a scholarly article about this topic LOL... if only I could just shadow the outliers for a day!

 

[Little Soldier]

i think its the cumulation of tiny little different thinking styles the "smarter" people have picked up. I dont know if you play a musical instrument or not, but when reading sheet music, people often read the lines and say ok this quaver is supposed to be a c, this note on the piano is a c and so i need to press that key. rather the ones who learn quicker skip the middle ground and just go this note represents this key.
if you try and translate that to say anatomy, students are often ok there is a bone here which conencts the body of the vertebrae to a transverse process and its called a pedicle, rather than skipping the middle ground and just saying "thats the pedicle"

there are heaps of little things like that, im not sure if i explained it correctly, but doing that makes memorising anything a million million times easier. you dont reognise some person name alice by looking at them and saying they have brown eyes, brown here, big nose, huger forehead and ear hairs, you just see them and know what it is straight away.

 

[Anastomoses]

there are heaps of little things like that, im not sure if i explained it correctly, but doing that makes memorising anything a million million times easier. you dont reognise some person name alice by looking at them and saying they have brown eyes, brown here, big nose, huger forehead and ear hairs, you just see them and know what it is straight away.

Actually you explained that very well.

And also, some people really do have to go...that's brown eyes, big nose, bigger forehead...alice!" We all range in different degrees of that in fact. Even very bright people - we're all on a spectrum.

 

[chronicidal]

Repetition, repetition, repetition.

Spaced repetition, retrieval practice, visual mnemonics, practice questions.

 

[Akali]

. But everyone is smart in medical school...

Yeah, I don't know about that. In my first year, I lived with three other fellow first years. Two of them were not what I would call particularly smart, at least they definitely didn't come off as such. These two had to work harder and spend more time to understand concepts and then commit that information to memory. They would ask me and the other roommate how we were able to get things so fast without working as hard. It's basically just that natural intelligence. Some people are just naturally able to make associations quicker, to understand complex subjects quicker, to recognize what details are more important to know, to more immediately arrange information in a logical way that makes it easier to understand, and etc.

I've always seen academic success, at any level, as being the product of two things: This innate "intelligence" and the dedication and discipline to spend your time studying. The former is harder to improve while the latter is easier to improve. One can compensate for lacking in one factor by improving the other factor.

 

[Brain Bucket]

Spaced repetition, retrieval practice, visual mnemonics, practice questions.

Str8 up. Man's droppin' pearls here.

Yeah, I don't know about that. In my first year, I lived with three other fellow first years. Two of them were not what I would call particularly smart, at least they definitely didn't come off as such. These two had to work harder and spend more time to understand concepts and then commit that information to memory. They would ask me and the other roommate how we were able to get things so fast without working as hard. It's basically just that natural intelligence. Some people are just naturally able to make associations quicker, to understand complex subjects quicker, to recognize what details are more important to know, to more immediately arrange information in a logical way that makes it easier to understand, and etc.

I've always seen academic success, at any level, as being the product of two things: This innate "intelligence" and the dedication and discipline to spend your time studying. The former is harder to improve while the latter is easier to improve. One can compensate for lacking in one factor by improving the other factor.

Mostly agreed. But - you cannot compensate for hard work with intelligence in Medical school (certain minimum amount of intelligence, however, is required).

 

[Anastomoses]

Yeah, I don't know about that. In my first year, I lived with three other fellow first years. Two of them were not what I would call particularly smart, at least they definitely didn't come off as such. Some people are just naturally able to make associations quicker, to understand complex subjects quicker, to recognize what details are more important to know, to more immediately arrange information in a logical way that makes it easier to understand, and etc.

I've always seen academic success, at any level, as being the product of two things: This innate "intelligence" and the dedication and discipline to spend your time studying. The former is harder to improve while the latter is easier to improve. One can compensate for lacking in one factor by improving the other factor.

Pretty much.

I've met med students who were almost drop dead dumb, even. Not relative to the general population...but still, not that smart.

In my cousin's MBA literature they learn how some people innately have an eye for detail while others often see the big picture. It's fairly uncommon to be exceptional at both. I bet there are a million little things like this which account for "intelligence" and retention speed.

 

[eefen]

Spaced repetition, retrieval practice, visual mnemonics, practice questions.

+ 1 million

 

[studocplsignore]

Spaced repetition, retrieval practice, visual mnemonics, practice questions.

I'm pretty sure I know what most of those are about, but can anyone give me examples on how to use them, what exactly they are, etc?

 

[chronicidal]

I'm pretty sure I know what most of those are about, but can anyone give me examples on how to use them, what exactly they are, etc?

retrieval practice - as you are learning (from books, lecture), constantly ask questions of yourself about what you are learning and try to produce answers from memory (i.e. not multiple choice, but open response). this is active learning. it can be facilitated through flashcards

spaced repetition - cramming is the key to maximally efficient performance on once-off small-scale exams, spaced repetition is the key to long term retention and doing well on later big exams (step 1) and surprise exams (e.g. getting pimped by your attending, having to apply knowledge to a patient you see). search these forums for 'anki', a free spaced repetition system / flashcard software. also search for Firecracker, previously known as Gunner Training, which offers a step 1 preparation product that operates on spaced repetition delivery of questions. maybe also Osmosis.

visual mnemonics - mnemonics are memory aids. we remember things that are 'elaborately encoded' - facts that are infused with meaning and make connections to existing things in our memory. unfortunately there are some things in medicine that are relatively isolated, especially when we first learn them. a useful way to memorize some things, e.g. a list of key signs/symptoms in a genetic syndrome or characteristics of a certain pathogen is to construct a visual depiction of the words using words/items/names that you already know (e.g. metronidazole = a knight riding the Metro train), create a story or a sentence that relates the disparate elements, and then practice the reconstruction of that image from memory (retrieval practice). search for Picmonic.

practice questions - the key to doing well on exams is doing questions. doing questions not only prepares you for the style and content of questions on the exam, but doing questions aids your learning process in general. forcing yourself to answer questions, particularly high quality / well constructed / challenging questions that require multi-step reasoning/application and have thorough answer explanations/feedback, is a form of retrieval practice and helps solidify your memories. invest in a question bank (USMLE World > Kaplan Q bank > USMLE Rx) or question books (many, including First Aid Q&A, robbins and cotran review of pathology), do old exams from your school if you have access to them

combine them:
you learn something, via a book or lecture. you ask yourself what you just learned. you mentally organize concepts in a manner that makes sense to you. you make some mnemonics where necessary, preferably visual if possible, you tie it into your previous knowledge where applicable. only for the most high yield facts (rule of thumb: what's in First Aid for the USMLE Step 1), you formulate that knowledge into anki cards or bank the relevant questions in firecracker. you do those flashcards when the program tells you to do them, repeatedly over longer and longer intervals, repeating just at the point when you're about to forget them. at this stage it's just recall, the lowest form of knowledge but also the foundation for everything. then you do step 1 style questions that require a higher level of thinking - application of that recall, combined with some data interpretation or multi-step associations. then you win at life.

 

[Brain Bucket]

then you win at life.

If only. *Sigh*

 

[studocplsignore]

Thanks for the explanation chronicidal, I'm glad you took your time to explain all that for me!

I do use Anki for studying of material, because I find it easier to help remember things (at least, I think it helps me). It also has me thinking about the material that I'm going over - what do I put into the flashcard. Essentially I'm creating a test of the material and so I need to understand it and also how it relates to other material around it.

One thing I do want to ask is - does this mean I should keep up with my old Anki cards even after the test is finished? We have a test nearly every week, so I accumulate quite a bit of cards, should I be reviewing those as well to keep the information in my brain? Or should I make a cut-down version of them, maybe referencing First Aid to see what's important and move/create those cards instead?

Thanks for all the help.

 

[chronicidal]

Or should I make a cut-down version of them, maybe referencing First Aid to see what's important and move/create those cards instead?

that sounds like a good idea. something slightly even better would be to separate those cards to begin with when you're making them. then after your test is done you can suspend all the non-important cards easily.

 

[Brain Bucket]

Thanks for the explanation chronicidal, I'm glad you took your time to explain all that for me!

I do use Anki for studying of material, because I find it easier to help remember things (at least, I think it helps me). It also has me thinking about the material that I'm going over - what do I put into the flashcard. Essentially I'm creating a test of the material and so I need to understand it and also how it relates to other material around it.

One thing I do want to ask is - does this mean I should keep up with my old Anki cards even after the test is finished? We have a test nearly every week, so I accumulate quite a bit of cards, should I be reviewing those as well to keep the information in my brain? Or should I make a cut-down version of them, maybe referencing First Aid to see what's important and move/create those cards instead?

Thanks for all the help.

Tags. Filter. Win.

 

[mdtobe249]

Spaced repetition is crucial. I was able to do well in medical school finally after struggling a lot in undergraduate by finally learning how to be an effective student - and a lot of it is just starting early, having a plan of attack and sticking to it. Talk to successful upperclassman before any new block and find out what the keys to success in those areas are.

 

[phonyreal98]

I'm not sure there's a trick to it once you're at a sufficient level. I think some people just retain things faster and longer. Even stupid things. Some people are more socially intelligent than others...they pick up "natural" cues that are more difficult for certain people to put together (think mild aspergers variety).

In your specific case, the only thing I can think of is looking at your own exams and seeing where you drop the ball. Are you skipping small details? Missing the bigger picture sometimes? Look for the holes in your own patterns.

Asperger's doesn't exist anymore! 😛

 

[cartoondoc]

To me, the most important thing was practice questions. Otherwise, nothing stuck.

 

[DCBFan]

Getting a sixth sense for what's "high yield" is an often-overlooked aspect of doing well in preclinical grades. Even if you aren't super smart just knowing what you can ignore will take you a long way. My study group plays a game called "guess the exam question that will come from this lecture" and some people are scary good at it. Meanwhile 60% of a lecture is needless fluff (epidemiological statistics, redundant risk factors that are risk factors for everything, etc.). I know some people who take "notes" that are essentially a transcription of what the lecturer says. If you aren't expending the mental energy to paraphrase the material in your own words, you aren't actually learning. And your notes will be impossible to efficiently review anyway.

Also practice questions.

 

[Anastomoses]

Asperger's doesn't exist anymore! 😛

wha...I saw her just yesterday.

 

[11MD2B]

Speak with confidence. It is that easy. Most of you know roughly the same amount of material but those who speak with conviction appear the most intelligent. It's a good skill to develop and will help you stand out during third year and beyond. Conviction bordering, but not breaching, arrogance is how you to be awesome at this game.

 

[mcloaf]

Speak with confidence. It is that easy. Most of you know roughly the same amount of material but those who speak with conviction appear the most intelligent. It's a good skill to develop and will help you stand out during third year and beyond. Conviction bordering, but not breaching, arrogance is how you to be awesome at this game.

Maybe. I know some people like this who are annoying because even when they don't have a ****ing clue what they're talking about they are sure that they do, so rather than just listening they have to waste 15 minutes arguing about it before they shut up and let somebody who knows what they're talking about speak. It's a waste of everybody's time and it worries me a little that they'll be making decisions about patient care.

 

[Kahreek]

the secret is cocaine.

 

[Kahreek]

I had this preceptor who once told me, "ehh you are still worrying about grades? Grades wont help you from now on, it takes more than that" Grades get you a spot , but to be awesome, that is a whole new level.

 

[Venko]

Some ideas… (mainly clinical stuff)

1. Know your patients cold, come up with your own plans of management and offer them with confidence but accept changes to your plan. Attendings deal with lots of students who are like data gatherers…take a history and physical but then fail to synthesize anything. Providing some synthesis will not only stand out from a crowd but also work to solidify the practice of medicine for you and increase the longevity of the lessons learned.

2. Take advantage of opportunities. If someone asks if you want to do something mundane but you want to go to lunch or go home or whatever, do the mundane thing and ask, "is there anything else that you are going to do that I can learn from," immediately afterwards. People are likely to appreciate your interest in seemingly uninteresting things and extend you offers for more cool things.

3. Anticipate what you want to get from the rotation and tell your residents / attendings ahead of time. I used to make a list of topics I wanted to master, types of patients I wanted to see, and procedures I wanted to do while on the service and emailed them to everyone on the first day of the rotation. Inevitably, people sought me out for these opportunities when they came. It not only shows initiative but also builds your knowledge base and thus over time, makes you, "awesome."

4. Know people's names. Everyone. students, residents, attendings, nurses, janitors, technicians, everyone and use them.

5. Study your patients. Research your patient's conditions in board review books, then in textbooks and journals. Study the mysterious things that come up on rounds and then present ideas the next day when time permits.

6. Make life easier for your team whenever possible. This frees up their minds and bodies to teach you. Know what size sterile gloves your resident needs and go get them before they ask for it..stuff like that.

7. Sleep at every opportunity at home, eat well, get some physical activity.

8. Out work everyone. Get to work earlier than everyone, stay longer than everyone. Don't hinder others just outwork them.

9. Help your colleagues succeed. It is better to graduate 10th in a class of all-stars than first in a class of terrible students. Also, if you help everyone else learn, more often than not people will be there to help you.

10. Lastly, at the end of the rotation, I suggest creating a summary document of the highlights of the rotation, the areas you think could be improved, interesting cases you worked on, the top teachers you had, the most memorable occurrences, and sign it and give it to the rotation director. Also provide people that you think could write you letters of recommendation with a new USB drive, your CV, and a copy of this summary, and ask them to write a letter of recommendation for whatever specialty you think you'll go into at the time and let them know you'll let them know where to send it and they should just keep it on the drive until the time comes. This way the content will be extremely detailed and fresh when interview season does arrive. Be sure to write thank you cards immediately afterwards, and again when you apply for residency and again after you match telling them where you are going and what you are doing.


These are my very dorky, very intuitive ideas on how to be an awesome medical student.

 

[gregoryhouse]

I keep seeing practice questions and I definitely agree, but where are you guys getting these practice questions from? Are you making them up on your own? Class resources?

 

[Kahreek]

Some ideas… (mainly clinical stuff)

1. Know your patients cold, come up with your own plans of management and offer them with confidence but accept changes to your plan. Attendings deal with lots of students who are like data gatherers…take a history and physical but then fail to synthesize anything. Providing some synthesis will not only stand out from a crowd but also work to solidify the practice of medicine for you and increase the longevity of the lessons learned.

2. Take advantage of opportunities. If someone asks if you want to do something mundane but you want to go to lunch or go home or whatever, do the mundane thing and ask, "is there anything else that you are going to do that I can learn from," immediately afterwards. People are likely to appreciate your interest in seemingly uninteresting things and extend you offers for more cool things.

3. Anticipate what you want to get from the rotation and tell your residents / attendings ahead of time. I used to make a list of topics I wanted to master, types of patients I wanted to see, and procedures I wanted to do while on the service and emailed them to everyone on the first day of the rotation. Inevitably, people sought me out for these opportunities when they came. It not only shows initiative but also builds your knowledge base and thus over time, makes you, "awesome."

4. Know people's names. Everyone. students, residents, attendings, nurses, janitors, technicians, everyone and use them.

5. Study your patients. Research your patient's conditions in board review books, then in textbooks and journals. Study the mysterious things that come up on rounds and then present ideas the next day when time permits.

6. Make life easier for your team whenever possible. This frees up their minds and bodies to teach you. Know what size sterile gloves your resident needs and go get them before they ask for it..stuff like that.

7. Sleep at every opportunity at home, eat well, get some physical activity.

8. Out work everyone. Get to work earlier than everyone, stay longer than everyone. Don't hinder others just outwork them.

9. Help your colleagues succeed. It is better to graduate 10th in a class of all-stars than first in a class of terrible students. Also, if you help everyone else learn, more often than not people will be there to help you.

10. Lastly, at the end of the rotation, I suggest creating a summary document of the highlights of the rotation, the areas you think could be improved, interesting cases you worked on, the top teachers you had, the most memorable occurrences, and sign it and give it to the rotation director. Also provide people that you think could write you letters of recommendation with a new USB drive, your CV, and a copy of this summary, and ask them to write a letter of recommendation for whatever specialty you think you'll go into at the time and let them know you'll let them know where to send it and they should just keep it on the drive until the time comes. This way the content will be extremely detailed and fresh when interview season does arrive. Be sure to write thank you cards immediately afterwards, and again when you apply for residency and again after you match telling them where you are going and what you are doing.


These are my very dorky, very intuitive ideas on how to be an awesome medical student.

Awesome way to drive oneself nuts, and the anastomoses "like" just validates my point.

 

[Venko]

Awesome way to drive oneself nuts, and the anastomoses "like" just validates my point.

Certainly your prerogative not to use my advice. I can just tell you what worked for me, what I would like to see as a part of a residency leadership group of a major teaching institution. In my opinion, "awesomeness," takes work and planning, but again its just my opinion.

 

[Brain Bucket]

Some ideas… (mainly clinical stuff)

1. Know your patients cold, come up with your own plans of management and offer them with confidence but accept changes to your plan. Attendings deal with lots of students who are like data gatherers…take a history and physical but then fail to synthesize anything. Providing some synthesis will not only stand out from a crowd but also work to solidify the practice of medicine for you and increase the longevity of the lessons learned.

2. Take advantage of opportunities. If someone asks if you want to do something mundane but you want to go to lunch or go home or whatever, do the mundane thing and ask, "is there anything else that you are going to do that I can learn from," immediately afterwards. People are likely to appreciate your interest in seemingly uninteresting things and extend you offers for more cool things.

3. Anticipate what you want to get from the rotation and tell your residents / attendings ahead of time. I used to make a list of topics I wanted to master, types of patients I wanted to see, and procedures I wanted to do while on the service and emailed them to everyone on the first day of the rotation. Inevitably, people sought me out for these opportunities when they came. It not only shows initiative but also builds your knowledge base and thus over time, makes you, "awesome."

4. Know people's names. Everyone. students, residents, attendings, nurses, janitors, technicians, everyone and use them.

5. Study your patients. Research your patient's conditions in board review books, then in textbooks and journals. Study the mysterious things that come up on rounds and then present ideas the next day when time permits.

6. Make life easier for your team whenever possible. This frees up their minds and bodies to teach you. Know what size sterile gloves your resident needs and go get them before they ask for it..stuff like that.

7. Sleep at every opportunity at home, eat well, get some physical activity.

8. Out work everyone. Get to work earlier than everyone, stay longer than everyone. Don't hinder others just outwork them.

9. Help your colleagues succeed. It is better to graduate 10th in a class of all-stars than first in a class of terrible students. Also, if you help everyone else learn, more often than not people will be there to help you.

10. Lastly, at the end of the rotation, I suggest creating a summary document of the highlights of the rotation, the areas you think could be improved, interesting cases you worked on, the top teachers you had, the most memorable occurrences, and sign it and give it to the rotation director. Also provide people that you think could write you letters of recommendation with a new USB drive, your CV, and a copy of this summary, and ask them to write a letter of recommendation for whatever specialty you think you'll go into at the time and let them know you'll let them know where to send it and they should just keep it on the drive until the time comes. This way the content will be extremely detailed and fresh when interview season does arrive. Be sure to write thank you cards immediately afterwards, and again when you apply for residency and again after you match telling them where you are going and what you are doing.


These are my very dorky, very intuitive ideas on how to be an awesome medical student.

Thanks for the fantastic write-up.