My basic science is weak. How could I study more effectively?

[WanderingDave]

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I'm an older, nontraditional student with a strong humanities background, who has always succeeded academically by writing voluminous paragraphs of notes in class and then reading them. I did this all of MSI and II. My grades these years were nothing great, but nor was I a problem student, and I didn't fail any courses. Likewise, I passed my COMLEX Step 1 on the first try, but not by much. I just (would have) finished my first MSIII rotation, IM, today, except that I just failed the shelf exam. I've also been noticing that, compared to my classmates on rotation with me, my basic science is embarrassingly weak. They all seem to be very quick on the draw when it comes to minutiae of diagnosis and treatment. My old approach to learning clearly will take me no further.

I have no problem with the communication and humanitarian aspects of medicine. I take great histories and do thorough physicals. When I read, I understand at a very deep level the physiological processes underlying most common diseases. One of my greatest strengths is my ability to put these explanations into layman's terms for patients; I'm a very verbal thinker.

But what doesn't seem to stick in my memory are the minutiae and exacting guidelines for how to work up and treat specific diseases and complaints. This is what the exams want me to know. I've looked them up numerous times in my Pocket Medicine guide for writing progress notes on patients and cases for presentation. But they just don't stick in my memory.

What is the easiest and simplest way to fill this rather gaping hole in my doctoring abilities? I'm considering going through the exam review books we use, and making up a flashcard for each disease, with just the preferred diagnostic workup and the treatment for each, and then using these flashcards to study. Any other recommendations?

 

[xanthines]

My advice is to brute force it, if you can. I literally have notebooks filled with repetitive notes where I just wrote stuff down and diagrammed things out over and over again. No, it wasn't an efficient process but at least it was effective. If you really are a verbal type of person, you could try recording yourself some notes and just listen to them over and over again. If you do it right, iPods/iPhones can speed you up without sounding too much like a chipmunk.

 

[DaveinDallas]

Being an older, non-trad also (but coming from an engineering background), I feel your pain.....

For 3rd year -- go out and buy Case Files for each clerkship....that will give you the major basics of every disease process you can reasonably be expected to be tested over on shelf exams....then buy a good Qbank (like USMLEworld) and do those questions......do at least two hours of studying per night......once you hit the two hour cutoff, stop.

Now, I tried to get through case files once and my questions once...and I pulled B's on shelf exams with my highest being surgery, followed by IM.

Peruse pre-test since it does a fairly good job of coordinating basic science wth clinical science...see if it works for you....good study material for 5 to 10 minutes of downtime on wards....

you can do this...the first two years are the hardest.....

 

[McGillGrad]

Like Dave has mentioned, it is about applying the case-files type books to real life patients as you move through your rotations, ALONG with prereading review material for each rotation, every day. Just 30 minutes of reading about bread and butter cases will yield long term results.

For example, if you are on the cardiac service, read about ACS, CHF, CAD etc and then remember a patient that present with a history of each one. Should make it easier with your educational background.

 

[OveractiveBrain]

I am a great test taker. I rock Step exams and shelves. But I, like you, care more about doctoring than the numeric details and nonsense memorization that plagues the medical field. After all, why would I memorize something I could easily look up?

People who are able to memorize meaningless facts and regurgitate them on test day are rewarded over people who can synthesize information, process human emotion, and develop some strong differentials. The field is designed to reward the skilled multiple choice test taker, not the free thinker or innovator.

I was frustrated by this realization. If I were you I would continue your current course. You will likely be a better physician for it. But you must be able to finish those exams, pass those tests. I feel that the people who have responded so far miss your frustration; they think like multiple choice test takers. The "30 minutes a day" or the "10 minutes of downtime" method is touted by people who have already succeeded in the Multiple Choice world. I had to retrain my study habits so I could succeed on my tests, all the while not losing sight of the true goal; doctoring.

Here is my advice to you, for it sounds like you think as I do. You have the knowledge. You read it. You have to find a way of getting that knowledge back out of your head. WHen I read, I read for understanding. I enjoy the profoundity of knowledge, bridging everything together. Two days later, the wonder I felt remains, but the bridges have burned and the details are gone. The way I solve this is with repetition and memory triggers. This is painful, long, drawn out, leaving you very little time for anything else. But this is what I do. I read a thing, a book, an article, whatever you want. I read on one subject. Then I read that subject in First Aid. Then I reread the book, taking notes. Then I write a section of notes, well written with drawings and diagrams, in color (red for "bold" black for regular writing) that I could use to TEACH someone else the subject. Then I read First Aid again. Then I read the notes over and over. The images and red-bold words are my memory ques.

Ok. Thats unlikely to be for everyone. But the premise remains the same. Repetition and Memory Cues. The information has to stick some how. Writing it on a board or piece of paper, having some one quiz you over and over again, flash cards, something. There has to be some piece of studying you are missing. I think it is the forced repetition and the memory under stress you leave out of your study habits.

To simplify your quest I would recommend these two resources:
(1) First Aid for Step 2 or Step-Up to Medicine. Read one book 3-4 times
(2) Practice with a Qbank. USMLE World or, for Medicine, ACP for Medical Students.

Good Luck

 

[Styxx]

Overactive,
Great advice. I'm having the same problem. I know the info, get outstanding evals on my fund of knowledge, but on the shelf, I have a hard time accessing the info the based on the way the question is written. So I'll give it try, who cares if its labor intensive!

 

[Perrotfish]

How much time a week did you study for your exams?