Episode 104: Dr. Dan answers a listener question about how to scramble up an effective study approach during the first semester of medical school.

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Getting Board Certified

Hi, this is Dr. Dan here with both the Medical School Podcast. I am sorry, it has been awhile since I have issued a podcast. I finished residency and am now board certified in Psychiatry by the American Board of Psychiatry and Neurology. It’s a bit of an interesting podcast in that we’ve had over a million downloads total. I started off in Emergency Medicine and video and audio log an entire transition of burnout in that field. Having a bad malignant residency experience, transitioning over to Psychiatry and doing a lot of self searching, and did that somewhat publicly for at least a private audience of the medical school podcasts.

MMC Mobile Listener Question

Today I’m going to cover a listener question. I’m going to read his question and reply to it. Here we go. This was written to me by a student several months ago so he was in his first semester of medical school. He says that he’s listened to many of my podcasts in the past but doesn’t recall if or when this particular question has ever been covered. In fact, it hasn’t.

Question

He says, “When we had our first block of exams finished a few weeks ago, I scored in the 50s range for anatomy, physiology, and biochemistry. Histology was the only exam that I passed. As time progresses more closely to exams, I grow more and more anxious which becomes extremely distracting. I limit all other distractions such as phone, computer, and noises but I’m still left with my worst distraction, my mind. I begin to think about irrelevant things in my life and get too anxious as I try harder to concentrate on material.” This leads to depression, even trying medication to help him regain focus and care for things again to try to get motivated. However, he feels that his issues lie in his inability to keep pace with the curriculum because for him to learn something he has to really go slow to digest it. Which of course is not something that the standard curriculum permits.
His father is a physician and suggests that he speak with Student Affairs to see if he can go into the five year program offered by his medical school, though he’s reluctant to spend any more time than necessary in medical school. He’s having a second biochemistry exam tomorrow which he doesn’t feel any more prepared for than the first one, but he will meet with Student Affairs afterwards. As far as his study techniques, he says, I use a timer and try to push myself to go faster. But I always slow down and never get everything done on my schedule. I’ve reviewed study habits exhaustively and attempt to be an active learner, but those habits take me too long and I fall behind. I suppose I am not all too sure what to ask you but I guess I could ask if there’s any active study method that doesn’t take a long time to do.”

Answer

That is the question, I’ll keep it anonymous, of course. I keep questions anonymous. I don’t say who is emailing me but this one sort of hit me between the eyes because, the truth is, that I taught a lot on study techniques. I have nine videos in the Medical Mastermind Community about study techniques. Even a speed reading course is in there. I even break down all the different classes you take in medical school and which study techniques for each one of those is the most likely to be beneficial. I have to admit, I’ve been doing the Mastermind Community and these podcasts for eight years now. I’ve always said that, based on my own experience, that it takes so long to learn different kinds of study techniques, that you don’t want that kind of distraction while you’re in medical school.
If you come across the Medical Mastermind Community and you’re already in medical school, at least in the first year, it’s too late, you just hold on by the seat of your pants. Now, in hindsight, I see that that’s disappointing for the first year medical students. I suppose I was motivated because I didn’t want to cause harm or be telling medical students in their first semester to try all these different study techniques which distract them. Maybe they could blame me if it doesn’t go well. I just speak from personal experience and say that if I tried to do my speed reading course and practice those techniques that I would have been too distracted and more worried about the process of studying than the material itself.
In fairness though, I was speaking specifically about speed reading itself because I listened to about a 30 hour course on how to do it. There’s no way you got time to do that in medical school. Today I’m going to cover a brief, adapted, speed reading and study technique method that you can use while you are in medical school, even during that first semester. What you’re going to want to do is log on to mmc.works. That’s at the Medical Mastermind Community. The speed reading program for members there … Go to the video, I believe it’s number four, that shows the matrix of different study techniques compared to, side by side, the different types of study material.
What you want to do is just go over to the right side and look at the different study techniques. Be honest with yourself as you read down that list and say,”Which one of these study techniques have I not tried? Which ones am I averse to?” What I’m going to ask you to do is challenge yourself and try to use one of those study techniques that you have not used before. Now, what you don’t want to do is, if your test is in three weeks try a study technique for the next three weeks and then see how you do on the exam. Of course, that video series teaches in detail about how to master the exam cycle. If you have three weeks until the next exam you might try a new study technique for about four or five days and then do some practice tests.
Whether that’s out of some question book, High Yield or BRS or some data bank or something like that, you want to test yourself and see if you think your percentages are going up of if somehow you’re learning the material faster or better before you decide. You don’t want to wait until the test to decide if your study technique is working or not, that’s the wrong thing. You want to be emailing Dr. Dan saying, “Hey, this was a bad idea.” I don’t claim that any particular one of them is a secret but there are a dozen of them and you need to apply different ones in different situations.
In fairness to the student that wrote this question and sent me this long email, the fact that he’s trying different study techniques tells me he’s on the right track. In fact, the good news is later we emailed each other and he said he was doing better so I’m so happy for that. I don’t think he was going to have to go to the fifth Pathway Program after all but that great let down after the first round of tests in medical school, it’s no surprise at all that someone would think they have to re-think their whole life. It’s just a feeling, it’s not true. Everybody feels that way. They’re used to making A’s in college and then you get socked with a D on your first round of tests in medical school. It’s a sucker punch and the medical schools know they’re doing it.
I think there’s an undercurrent that they know that they’re going to make it hard for you. Some people are going to drop out right away too fast. Those aren’t the kind of people you want to be doctors. You want people that can get it out. Sometimes right at the most opportune time, one of the later exams is somehow a little bit easier. They don’t announce that or tell you that but you want to hang in there if you can. Definitely talk to your dean and your Student Affairs Offices so that you don’t wind up with a bunch of fails on your record.
If you have to go to a fifth pathway that takes five years and basically splits the first year of medical school curriculum into two separate years so you can get into the habit of studying at that medical school level, then go ahead and do that if you have to. Just follow the local rules there. You don’t want to override what your school is saying just because you heard it on a podcast. Go talk to the source, talk to the people who know the rules, but give yourself a fair chance to.
I will give an example here of a study technique that you might apply because it’s the most under utilized study technique that can be the most highly effective one out of the dozen that I teach in the Medical Mastermind Community. I’m going to give it away right here on the podcast today. That is audio recordings. Let me teach you briefly how to do that. These days you can use a phone or you could even buy an audio device or directly speak into your computer. What you want to do is read the material that you’re having to study, whether that’s a syllabus, a text book, the notes or Power Points. Whatever your de facto goal standard material is that they’re going to be drawing the questions from the test from, you need to read through that two or three times.
The first time you read it try not to do a lot of highlighting and underlining unless a professor has said something in particular was going to be on a test. The first time you’re reading it, it’s all highlighted, it’s all new so the whole thing will be covered in different colors. That’s not as helpful as if you use my method, because on the second time you go through it you want to highlight stuff that you don’t already know. Remember, you always focus on what you don’t know. Medical school is a world of feeling uncomfortable, and that does change when you get out, by the way. Now that I’m done I can speak with authority on that. I don’t stay in a world of uncomfortable, that’s unsafe for my patients. I need to stay abreast of current changes in medicine but I need to stay within my safe zone of practice because I practice on real people.
Medical school is a place to teach you what your limits and boundaries are. If you lack a particular topic, guess what, you’re not going to be able to spend much time on it. Because if you like it, it’s probably going to go into your long term memory quickly. Therefore, you need to be focusing on what you don’t know. Each successive time you read the material, what you want to do is highlight only the things that you know are important but you also know that you don’t know yet. You don’t have them memorized. You never want to highlight anything that you already know, that makes no sense. Because the highlighting is to draw your attention to say, “Hey Dan, you need to look at this again before the exam.” Only highlight it if you really feel like you need to look at it again before the exam, not because it’s important. It doesn’t matter if it’s important. What matters is if you already know it. It has to be both important and something you don’t already know.
You might use a yellow highlighter the second time through and then a red pen the third time. On the third time some of that stuff, because you’ve gone to more lectures, you’ve done practice questions, you might have looked at other resources, other books. Some of the stuff you really will have learned and it’s a confidence booster, by the way, to see that you don’t have to keep highlighting the same stuff over and over. Some of the stuff you highlighted in yellow. Now the third time you’re reading it, you don’t have to underline it in red pen because you already know it. There you go, you have visual proof you are learning some things. That’s a confidence booster!
That’s not to say that on the exam when they twist the questions and the material all around, that they couldn’t trip you up. They can but you are learning. That’s a confidence booster and it should resolve some anxiety. After you’ve gone through the material as many times as time will allow in your exam cycle, to make sure you are assessing your study technique well in advance of the test with practice questions. Whatever time you have, what you want to do is grab an audio recorder of some sort. When you make the audio recording, only read the red ink or whatever it was you used the last time you went through it. Don’t read the entire highlighted thing. You don’t have time to read the whole thing or even what you highlighted the second time through. Just focus on that third time you read through it, what did you underline and find important there?
You shouldn’t have that many notes. For a particular exam, you might have an hour or two worth of audio, something like that. You want to filter it down and practice doing that. There are many other techniques we don’t have time for here today, but I just wanted to encourage you that there are dozens study techniques I teach on mmc.works. If you choose to join the Medical Mastermind Community those will be there for you. That is all I have for today. If you think teleconferences would be beneficial, you can go to mmc.works and email me and see if you guys want to revive that or not. Otherwise, I’ll be waiting more questions. Just email me if you have questions about medical school, getting into medical school, how to survive and thrive. My background is doing about half of a … 17 months of an Emergency Medicine Residency and having a horrible educational experience with a bunch of mostly poor mentors and bad leaders.
Leaving in disgust, spending a couple years outside of medicine before re-discovering my passion for the military and Psychiatry, and publishing a book on military PTSD. It’s called “Combat PTSD in America Toward a Permanent Solution”. You can look that up real soon. That’s fun to find my passion finally, and finally grow up and get a big boy job. You’ve heard me podcasting for several years probably and I’ve noticed that I was figuring it out myself. Now I figured it out for me and I can help you do the same thing, discover your passion. Modern medicine in the medical education system are kind of broken. I published a paper in the Journal of Unscrewing and Alternative Education which is a major criticism paper of modern medical education.
They do the best they can. When I get out, away from an academic center where I am now, I can tell that all I learned about ethics and professionalism were very helpful because many people don’t have that at all. I got a good education but there are many things that are broken. There are many leaders and mentors, program directors, that don’t know how to figure out what is going to make a person happy in a career and what their gift is. They just have a box and they want you to fit in it and, “Can you show up and do that, yes or no?” If no, they don’t often take the time to develop you and teach you so that you can mature in a profession, they just kick you out. Those malignant programs are still out there because human beings are still out there. Some are good, some are bad, some are ugly, and I know I’m a bit of all three. Anyway, it’s a pleasure to get back on the Mastermind Community Podcast and you have a good day. Godspeed on your next exam.

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