Underperforming in MS1 and need advice

[Tollats]

---

Members don't see this ad.

MS1 here, I'm posting this because I need some help with my approach to studying. My grades have been all over the place, from way above the class average to below average to in between. As I am not doing med school in the US, my pre-clerkship years are less focused on basic sciences and Step 1 material and more so on clinical medicine. I started off MS1 thinking I would be tested on the ins-and-outs of pathophysiology, microbiology, etc. but instead many of the questions on my exams are based around "which is the best next test to order?", "what treatment would you prescribe?", etc. This is not to say that I do not learn any of the pathophysiology - these concepts are usually covered briefly and followed by relevant diseases which take up the majority of the lecture, and some pathophys/pharmacology content are sprinkled into exams.

At the beginning of the year I tried making Anki cards but this was taking too long and I couldn't "see the big picture". For example, I would have a card asking about the best test for diagnosing Disease X before covering the presentation of that disease. I then switched my approach to making review outlines for the block - this helped put things into perspective (i.e. Etiology -> H&P -> Diagnosis, etc.), but I still feel that I haven't "fully" mastered the material walking into the exam. For example, when asked what the best next step in management is, I may be able to quickly recognize that the patient presents with COPD, but the next steps in management will be foggy in my brain. Or, I might know the management of cellulitis, but may forget how to differentiate this from DVT (as an example).

I suspect that the issue is I'm not getting enough "repetitions" in with the material, hence the knowledge gaps and difficulty i've had with retrieving/recalling information. My exams are typically monthly at the end of every block, and most of my time studying is spent watching and taking notes from lectures, reviewing the notes, and doing some limited practice questions - very passive. While I am not falling behind, I am having a hard time finding the time to go over material from previous weeks in a systematic way. Watching lectures -> taking notes -> making Anki cards for each lecture took me so much time that I started falling behind, so I switched to this "outlining" method which is also clearly not working. I'm not doing terrible, but I know that I can do much better and would really appreciate any suggestions.

 

[IMG69]

Can I know what country you're studying in? My schools exams are extremely clinical also with 20% of my year failing in our first year and 25% of the current first years failing their first 50% exam. Depending on what country you're in I may be able to point you in the right direction.

Cheers.

 

[Medical Muse]

I also had trouble adjusting to life as a MS1, but for different reasons. The important thing now is to find a way to connect the fundamental concepts to the underlying disease, to the patient in front of you, to the next test you will order. Honestly, those "which is the next best test to order" questions will always be a pain in the ass as there's a subjective element to them. Additionally, we rarely order a test in isolation but rather panels to ensure we cover all the items on our differential diagnosis.

The hard part to accept is that MS1 life is rough. For your situation, you are going to have to view your clinical experiences as the tip of the iceberg. After class, you will need to take the time to dive deeper into the underlying disease and treatments. Medicine is insanely complex and new knowledge is added to the field each day. There is no shortcut to mastering the material. As you start to fill in the pieces in your knowledge, you will see how the ideas connect and it will get easier. Keep pushing yourself and it will get better!

 

[esob]

I would suggest trying to do anki with a pre-made deck that has structured video content. Board and beyond and any version of the lightyear deck is a good example. You watch a video, unsuspend the related cards and repeat.

 

[Matthew9Thirtyfive]

MS1 here, I'm posting this because I need some help with my approach to studying. My grades have been all over the place, from way above the class average to below average to in between. As I am not doing med school in the US, my pre-clerkship years are less focused on basic sciences and Step 1 material and more so on clinical medicine. I started off MS1 thinking I would be tested on the ins-and-outs of pathophysiology, microbiology, etc. but instead many of the questions on my exams are based around "which is the best next test to order?", "what treatment would you prescribe?", etc. This is not to say that I do not learn any of the pathophysiology - these concepts are usually covered briefly and followed by relevant diseases which take up the majority of the lecture, and some pathophys/pharmacology content are sprinkled into exams.

At the beginning of the year I tried making Anki cards but this was taking too long and I couldn't "see the big picture". For example, I would have a card asking about the best test for diagnosing Disease X before covering the presentation of that disease. I then switched my approach to making review outlines for the block - this helped put things into perspective (i.e. Etiology -> H&P -> Diagnosis, etc.), but I still feel that I haven't "fully" mastered the material walking into the exam. For example, when asked what the best next step in management is, I may be able to quickly recognize that the patient presents with COPD, but the next steps in management will be foggy in my brain. Or, I might know the management of cellulitis, but may forget how to differentiate this from DVT (as an example).

I suspect that the issue is I'm not getting enough "repetitions" in with the material, hence the knowledge gaps and difficulty i've had with retrieving/recalling information. My exams are typically monthly at the end of every block, and most of my time studying is spent watching and taking notes from lectures, reviewing the notes, and doing some limited practice questions - very passive. While I am not falling behind, I am having a hard time finding the time to go over material from previous weeks in a systematic way. Watching lectures -> taking notes -> making Anki cards for each lecture took me so much time that I started falling behind, so I switched to this "outlining" method which is also clearly not working. I'm not doing terrible, but I know that I can do much better and would really appreciate any suggestions.

It sounds like you're not using your time effectively. You're doing a lot of passive stuff and not enough active stuff. You need to be doing cards and questions. Like @esob said above, get yourself a premade deck. That way the cards are already done for you. That will free up a lot of your time to go through them and do some practice questions. You can take notes directly into FA while watching BnB, then unsuspend the cards and rock them out. Then do AMBOSS or whatever question bank you like. Our exams are very clinical as well, and I find that doing a lot of reps on the cards and questions really helps, as does having small group study sessions where we talk out some sample cases to see everything in context.

 

[deleted915325]

I would recommend giving "Harrison's: principles of internal medicine" a shot. Its what all the hardcore clinicians use and it gives a very solid clinical understanding

 

[Tollats]

It sounds like you're not using your time effectively. You're doing a lot of passive stuff and not enough active stuff. You need to be doing cards and questions. Like @esob said above, get yourself a premade deck. That way the cards are already done for you. That will free up a lot of your time to go through them and do some practice questions. You can take notes directly into FA while watching BnB, then unsuspend the cards and rock them out. Then do AMBOSS or whatever question bank you like. Our exams are very clinical as well, and I find that doing a lot of reps on the cards and questions really helps, as does having small group study sessions where we talk out some sample cases to see everything in context.

So I looked into some of these resources (FA, BnB) and several pre-made decks and they don't seem to match up well with my lecture content 🙁 It looks like I would probably have to make my own cards if I continued on the Anki route. Are there any other strategies that may be helpful for memorizing this content (etiology, diagnosis, treatment, differentiating disease A from B) effectively without flashcards?

 

[deleted889094]

So I looked into some of these resources (FA, BnB) and several pre-made decks and they don't seem to match up well with my lecture content 🙁 It looks like I would probably have to make my own cards if I continued on the Anki route. Are there any other strategies that may be helpful for memorizing this content (etiology, diagnosis, treatment, differentiating disease A from B) effectively without flashcards?

I always think of things in terms of "How would I explain this to my relatives?" It helps you put things in the real world, use your own language to phrase it, and you don't really understand something if you can't explain it to someone else.

 

[esob]

Spaced repetition isn't the only, but it is the best way.

 

[Matthew9Thirtyfive]

Spaced repetition isn't the only, but it is the best way.

Spaced repetition is the way. Flashcards aren’t the only way to do spaced repetition, but whether you’re doing questions or drawing things out multiple times or what, you’re doing spaced repetition. Anki is just a way to automate the spaced part.

If you are creative with anki you can adapt it to your preference and to your curriculum. OP, if your curriculum doesn’t line up with BnB and zanki (do you not have a systems curriculum?), IMO it would be worth it to make anki flashcards based on your lecture material.

 

[Aurarice]

So I looked into some of these resources (FA, BnB) and several pre-made decks and they don't seem to match up well with my lecture content 🙁 It looks like I would probably have to make my own cards if I continued on the Anki route. Are there any other strategies that may be helpful for memorizing this content (etiology, diagnosis, treatment, differentiating disease A from B) effectively without flashcards?

Something of comparable workload to making cards yourself that I did during my first few blocks was to go through lectures, use the "Browse" function on Anki, and unsuspend/transfer relevant cards over. It was pretty rough at first, but once you start getting efficient at searching for keywords or conditions, everything starts to fall into place.

The only problem I've run into is greek letters and numbers. (eg. Is it written as alpha-1? alpha1? a1? α1? α-1? IL-2? Inteleukin-2? Interleukin 2? IL-{{c1::2}}?) etc. However, at that point, it's easier to just watch the relevant B&B/Sketchy videos.