Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Excellence right from the start!

Now that most medical schools are either underway or starting to get underway with classes, I wanted to take a moment to emphasize a few things to help students get off to a strong start. At this point, orientation is over and the business of getting your day-to-day work begins in earnest. This is the time to make small adjustments (definitely nothing major) to make the most of your study time and to keep yourself on a strong path to excellence in scholarship. Here are some things to consider:

  • Make a daily schedule that is not so tight that you don’t have room for those “little things” that creep up and eat into your study time.
  • Be sure to take 30 minutes out for some physical activity. If nothing else, walk up a couple of flights of stairs on your study breaks but don’t sit for hours without moving. Do three 10-minute sessions if you can’t do 30 in one session.
  • Don’t use your meal times to study. At least for the time that you are eating, relax and take in your atmosphere (even if it’s the hospital cafeteria) so that your digestion will thank you.
  • Snack on cut vegetables and fresh fruit while you study. Drink water for hydration. Junk food slows down your brain and leads to weight gain that you don’t want. Trust me on this one, snack on the vegetables instead of chips and soda.
  • Try to limit your coffee (cut back if needed) to one cup with caffeine per day as coffee/tea and other caffeinated drinks are very dehydrating. Dehydrating leads to being tired and less efficient.
  • Divide your study periods into 50 minutes of study with 10 minutes of break time (good time to get up and move). When you return to your studies, your brain will be ready to work again. You can also surf the net, do Facebook and other things on your 10-minute break so that you are not wasting study time with the social media.
  • Limit your study group to 4 people or less who have the same study habits as yourself. More than 4 people is too social and less efficient.
  • Change your study location often. If you love the library, move to a classroom once a week. If you are on campus, go to a Starbucks or something just for a different background.
  • Remember that the school administration is there for your success. At the first sign of trouble, illness or anything that takes your from your studies, meet with your faculty adviser (or dean of students) so that you can get the problems taken care of immediately. Waiting around to attempt to “gut it out” is a poor decision because your classwork is going to move very rapidly and you don’t want to get behind under any circumstances.
  • If you find yourself behind, go to where the class is currently and do your “catch-up” on the weekend. I can’t emphasize more that medical school goes so rapidly that even slacking one day during the week can put you behind quickly.

Try NOT to listen to what others in your class are doing or not doing since  you have to take care of your needs and you have to be very selfish with your time.What others do or do not “do” is meaningless unless you are directly affected by their actions.  If there are troubles at home, you are going to have a minimum of time to get personally involved with things that may be largely beyond your control. You can lend your support verbally but essentially, you have one shot not to “screw-up” your medical school coursework. In today’s world of high tuition and heavy investment, you have to be selfish with your time and energy. Putting your time and energy into your coursework will pay off later on when you are trying to get into residency. Again, there is very little room to make mistakes at this point in your career.

If you have home demands, again, seek help early rather than later. If you have a spouse (or significant other) that appears to be demanding more and more of your time, you must have a long conversation with that person. You just don’t have the luxury of being able to make every child’s soccer game or even “date-night” if the exams are coming fast and furious. This means that on your vacations, you will have the time to play and enjoy the relaxation but when classes are in session, your time is largely going to be involved in mastering a curriculum that can seem endless. If you haven’t started school, make sure that your spouse/SO/children know that you will need some time to adjust to the pace of your studies which means that you may not be around very much. This doesn’t mean that you don’t love them but it means that your studies are more demanding than ever before.

The faculty coordinator for any of your courses is the first person that you should see if you are having problems. The faculties are experts in terms of the mastery of the curriculum thus, you should “tap” that expertise as needed. Don’t make the mistake of “killing” your career because you are “too proud” to ask for help. I always went to office hours just to do a periodic “check” of my understanding of the material as presented. This is a very good practice to get into long before the exams come up. If you have taken an exam, and scored lower than you expected, then you NEED to spend more than a small amount of “quality time” with the course instructor. Again, you essentially have one shot at learning everything that you can master as quickly and efficiently as you can get the job done.

Do not ever attend any class/lab unprepared. You have a course schedule and you have a course syllabus. You should be “pre-viewing” every lecture before you attend it without question. The more you are exposed to the material that you must master, the more efficient you will become with the mastery. I always previewed for the upcoming lecture right after I completed my study and mastery of the current lecture. On the weekend, I reviewed the previous week’s materials as if the test would be on the following Monday. In short, the weekends were my best friends because there would be no lectures on Saturdays and Sundays.

Keeping a well-balanced and well-rounded schedule is vitally important in medical school. If you have shorter lecture days, this means that you have longer study periods. Just because you are not sitting in lecture, does not indicate that you have “nothing” to do for the rest of the day. Again, shorter lectures and labs mean that the mastery of the curriculum materials is more dependent on your ability to “teach yourself” the materials. A shorter lecture day does allow you to get those 30 minutes of physical activity done during the daylight hours which is wonderful but get to your studies as soon as you can and check off tasks on your daily schedule as you complete them.

I would make a weekly schedule on the weekend before the “work week” began. I would make a daily schedule from my weekly schedule making sure that I put things in like ” 2 weeks until exam week” or 2 days to cardio drug quiz”. I made sure that I kept up with my reading before the lecture and not after the lecture. For me, the textbook was my key to recognizing the key components of the upcoming lecture. I would put my textbook pages on my daily schedule along with a check box so that I could check off as I completed my readings .

My other system was to take notes on the left side of a loose-leaf binder. I would divide the page into 1/3rd for a margin and 2/3rd to take notes from the actual lecture. The margin was to list the key terms/concepts/things from the text that were related to the notes. When I studied, I filled in the right side of the loose-leaf page with summaries of what was on the left sheet. When I did my weekly review, I essentially studied from the right summary sheets only with annotations from the textbook as needed. Since I had already completed my readings in the text, I knew what I needed to have in my notes versus what was already in the book. I was also able to write my own test questions and insert them in my small loose-leaf binder right near my lectures/handouts/notes. If there were other important hints that I garnered from my meetings with the instructor, I would put these on “Post-It” notes and stick them on my study pages.

My other system was to head to Kinkos and allow them to cut the bindings from my textbooks which allowed me to punch holes in the pages and insert them into my binder I had my textbook pages, my notes from reading and my notes from lecture all in one place. I also kept three colors of pen (blue, black and red) for hand-written notes plus my four colors of highlighters that I used to circle things and make arrows in the margins for key concepts. The highlighters were a study tactic learned from a friend who had a type of dyslexia that made visual cues vitally important for her. I utilized the highlighters in much the same manner and found that on test days, I could recall the materials that I had circles and highlighter with the varying colors more easily. If you type your notes using word processing software, you can use the same system but you must format your pages. See Photo below.

These are just some suggestions to help get you off to a good start. Consider them or use them but make sure that you get moving fast.


10 August, 2011 - Posted by | academics, medical school, medical school coursework


  1. Hello Dr. NJBMD,

    Your post is extremely helpful. Thanks for taking the time to create this post. I have been researching how to improve my study skills ever since I did poorly in medical school. So you do leave the left 1/3 margin for your notes from the textbook and the rest of the 2/3s of the page for the notes from lecture?

    Also how long do you spend taking notes on the textbook readings? My biggest problem is that I am a slow reader and it takes me a long time to read through the textbook and take notes. So I am always anxious about falling behind in my courses. Do you have any advice or suggestions for me?

    Thanks a lot!

    Comment by Tom | 14 December, 2011 | Reply

    • To Tom:
      The left 1/3rd is for summary, short explanations or anything that helps me remember what is on the other 2/3rds of the page. I generally didn’t take too many notes from the text but used the text reading for anything that needed clarification or a deeper explanation. If I couldn’t understand something after the lecture and reviewing it in the text, that meant that I would be spending some quality time with the lecturer during office hours for deeper understanding. I actually would meet regularly with my lecturers to check my understanding of the more difficult concepts.

      Comment by drnjbmd | 14 December, 2011 | Reply

      • Thanks Dr. NJBMD!

        How long did it usually take you to do the textbook readings before class? Did you spend a lot of time reading the text to understand the content well before lecture or did you just read through it quickly so you had a general idea of what the professor’s lecture would be on, so you could better follow the lecture?

        Comment by Tom | 15 December, 2011

      • To Tom:
        I am a fast reader with excellent comprehension (comes from reading all of those books as a child). I read my textbook to understand and pick out the major concepts so that I could check my understanding in lecture. If the lecture didn’t enhance my reading, I spent some time with the lecturer during office hours. I didn’t memorize the book but I had a good understanding of what the lecture would entail.

        Comment by drnjbmd | 15 December, 2011

  2. This is great! Having spent ~2 weeks in med school before my medical leave, I was constantly stressed about my studying habits. And overwhelmed. Hello med school. I’m excited to tackle it again next year when I’m better (!!), and I feel that I’ll have less anxiety after reading your (very helpful and practical) tips.

    Comment by a | 17 October, 2011 | Reply

  3. I found out about your blog in an attempt to a rondom search for medical schools. I finished my Ph.D last year in biotechnology. I am teaching at a community college part time now. I always wanted to go to medical school and I cannot seem to forget about it. I always find myself searching about medical schools, syllabus, etc. anything related to being in a medical school. But the problem is I am 35 which is not much of a problem but I have 15 months old daughter and my husband and I want to have more kids. This means I might be able to enter the medical school in my late 30s or early 40s. From your blog and other friends and searches trough the internet I can grasp how hard to be in the medical school. Even working part time, I feel guilty leaving my baby at the babysitter but at the same time I really want to go to medical school. I am really struggling about what to do. I fell like going to medical school will be a choise in between family or school since I am guessing I will not be able to spend much time with my family because of the heavy load of classes etc. I know I have to sit and decide myself but I was wondering about your opinion. Do you have your own kids? if so was it hard to do it with kids? Thank you very much in advance.

    Comment by emel | 27 September, 2011 | Reply

    • To Emel:
      Medical school is very, very demanding on people who do not have a family to care for. Plenty of people with children are able to get through school with much support from their spouse or family (extended or otherwise). Age isn’t a barrier but having the energy and stamina to keep up with your studies and take care of your family is a huge consideration. Many people have waited until children are older (school aged) in order to enter medical school but keep in mind that even if you get into medical school and get through first and second year, there are going to be third-year rotations where you will be expected to take overnight call. Residency is another 3-7years of training (and overnight call) thus you may want to make sure that you have made provisions for the care of your children (children get sick and have many needs) and that you have a spouse/extended family that can be there to help you with meeting your children’s needs. Medical school isn’t a choice between family or school but it does take a strong support network in order to meet the demands of family and school. Any career (restaurant chef, business owner etc) can demand long hours away from family and require a strong support system if children are involved. Good luck.

      Comment by drnjbmd | 1 October, 2011 | Reply

  4. Thanks a lot, i hve gained a lot from this, because am about to get into medical school this year. Thanks a lot as we expect to get more from u.

    Comment by Martin | 19 August, 2011 | Reply

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