Medicine From The Trenches

Experiences from medical school, residency and beyond.

Study Skills (Part VI)

Introduction

When sitting down for study, one has to have a plan for getting the best results most efficiently. This post is designed to assist any student in getting the best results for their study time in the most efficient manner. In professional school, it is vitally important for a student to obtain a strong knowledge base and continue adding to that knowledge base and refining that knowledge base for the rest of their career. In 2013, when there is so much information practically at one’s fingertips, it is still vital for a modern medical professional to have a strong and refined knowledge base.

Set goals and objectives for your study session

Don’t sit down at that table in the library without having a study plan. It is best to set some goals (and time frames) to accomplish for that particular session. For example, I would plan on studying at least two hours for every hour spent in lecture and 1/2 hour for every hour spent in lab. Depending on the subject matter, I would list the specific items that I planned to study in each session. Next to each of those items, I would place the amount of time, based on my time frame and the amount of time that the lecturer had spent on those items next to each of the times. When I had had completed an item, I would cross it off my list. If I needed more time, I would move that item to the end of the list and add more time before I crossed the item off my list. In short, I always had a study plan. An example: Plan for studying gross anatomy.

  • Review the previous lecture items – 30 minutes
  • Review the present lecture and organize it – 10 minutes
  • Lecture item – 20 minutes
  • Break- 10 minutes
  • Lecture item-20 minutes
  • Lecture item – 30 minutes
  • Break- 10 minutes

On my breaks, I could walk around, get something to drink or go up and down a flight of stairs so that my circulation could get moving. If something crept into my thoughts, I would jot it down in a piece of paper and think about it on my next break while I was moving around.

Reading

I always made sure that I covered the assigned reading in my textbook before attending lectures. By doing this, I knew what was important in the next lecture and I had an idea of what might be covered. Sometimes, textbook reading is the only way something would be covered that needed to be in my knowledge base. The textbooks would generally put items into perspective that I needed to learn to become a good physician. This meant that I was adding to my knowledge base as well as organizing the materials to be studied. In general, I used 1/2 of my study time on weekends to get ahead in my reading.

When I became a resident physician, I read at least 30 minutes per day (no matter how tired I was) and a minimum of 3 hours each weekend. I kept a running list of the articles that I read from journals and the subjects that I covered in my surgical textbook. By the end of 6 months, I had completely finished Sabiston Textbook of Surgery and had kept up with my journals. I always had something printed out to read over lunch or while I was waiting to begin a case. I kept notes on cards and summaries of articles that were pertinent to my rotations/practice goals. When I completed my surgical textbook, I re-read the sections that I felt were most important for my practice so that my knowledge gained from the textbook could be incorporated into my long-term memory.  I also covered any topics in the textbook that were covered in conferences and grand rounds.

Journal Reading

It is important as a physician for one to keep up with the literature of one’s practice. This habit started in medical school when a medicine professor challenged us to read the New England Journal of Medicine each week. I started with the case of the week and moved to the review articles and then the original research articles. At first I understood very little of what I was reading but in a few weeks, I was used to most of the language of medicine. I kept a medical dictionary on my desk and looked up words that I didn’t understand. Not only did I start to understand upcoming changes but I started to learn which journals were important to my future medical practice.

I had completed graduate school before medical school and knew the importance of learning the literature of one’s subject area. I soon came to love and appreciate Nature Medicine (lot’s of basic science here) and Physiological Reviews (very dense review articles but great reading).  If you are at the undergraduate level, get used to knowing how to read and understand original research in the journals of medicine and your field. It is vitally important that even before attending medical school, one has to be able to read and critique journal articles. One also has to become comfortable with evidence based practice which should begin long before medical school with reading and critiquing the literature of your particular field of study. If you are a non-science major, you should force yourself to read and assimilate some of the journals of basic science (biology, chemistry or public health).  I am always puzzled with a medical student will be sitting in my office offering being a “non-science major” as an excuse for not knowing how to read and evaluate the literature of medicine. Once you walk through the door of medical school, you have to become familiar with the language, science and art of medicine no matter what you studied as an undergraduate.

Weekends

The best part of the weekend is that generally you have a bit of extra time to review and refine your daily study habits. In medical school, I used the weekend to plan my next week’s work. I also used some of my weekend time to review the materials from the previous week. This meant that I was on my third pass of materials that I had previously studied in the week before. Yes, my studies might cut into my relaxation time but in medical school (and any school for that matter), one gets one “shot” at not “screwing up”. I still had plenty of time to shop, explore and party  but these things were not the purpose of my weekends. Even today, since quite a bit of my time is spent preparing lectures and curriculum for my students, the weekends are still used to review and refine materials from the week before.

I generally kept the same sleep/wake schedule on the weekend as I utilized during the week. It becomes highly disrupting to keep changing a sleep/wake schedule. This generally means that if I go out for a late night party, I still have to continue with my weekend schedule. On my vacations, I might “sleep in” a couple of hours but I utilize my early morning hours on vacation to read books and enjoy a movie whereas during work time, those early morning hours are used working or keeping up with my professional reading.

Social Media, Television and so forth…

It’s great to have Twitter, Facebook and other social media sites to keep up with friends but these sites can’t become major distractions during your study time. If you have to keep up with Facebook on a regular basis, then utilize one of your study breaks (the10-minute ones) to post and catch up. If social media is more important than your schoolwork, then you might want to consider changing to a vocation that doesn’t require as much reading and study as medicine. There is plenty of time to do things on social media, as I am proving now as I take the time to write this post, if you plan the other things in your day accordingly.

Having a recorder on my telly has been wonderful. I simply look at the log for the upcoming week and decide what I want to watch so that I can set the DVR to record it. If there is a football game that I want to watch, I simply have my I-Pad with me so that I can multi-task. I have always been able to answer correspondence and read while enjoying a sporting event. Needless to say, I don’t get to too many live games (unless I am one of the physicians on the side lines) and instant replay is one of my best friends.  Once I started undergraduate work, my telly watching become a very secondary entertainment event. Even today, I usually end up erasing shows that I just can’t get around to watching but everything comes up on Netflix or Hulu at some time in the future so I don’t think I am missing many things.

Meetings

Meetings can cut into your study and reading times but I have learned to treat most meetings like conferences. In administrative meetings, I look at the agenda and listen to the things that are of greatest importance to me or my division and let my mind go to my I-Pad (substitute any tablet, smart phone or paper) when things do not concern me directly. When I am conducting a meeting, I set strict time limits and stick with them. I don’t like my time being wasted and I respect the time of others. Sometimes, I have to decline meetings that are just not a useful way to spend my precious time.

If you have to have a meeting, try to schedule them over breakfast or lunch so that one can eat and meet if necessary. Having a meal also helps to keep a meeting from running off the “rails”. I find that administrative academic meetings can quickly affect my clinical time. I have to make sure that my administrative colleagues understand that I have to keep my clinical hours, my office hours and my practice (OR) hours. This means that I am often leaving meeting early and usually can’t go overtime. Learn to conduct a concise and informative meeting and learn to say “no” to things that interfere with your professional/personal life.  In short, one has to learn to set priorities.

When things come undone

When your can’t keep up with your schedule, within reason, it is time to look at your priorities. A schedule can’t be so rigid that adherence starts to cause stress. If things are so stressful, take a look at what you can do to unload some of the demands. You still have to schedule in some reasonable relaxation time. If you are not getting some relaxation/recreation, you become less efficient and more prone to interruptions that take you off course. If you have too much recreation/relaxation, you can’t get things accomplished. In short, refine and revise as you go along.  You have to realize that emergencies will happen and have a means to get back on track once the emergency has passed. Again, weekends are good for “catching-up” if this needs to happen. If something gets you behind during the week, go to where you need to be and catch up on the weekend. If you stay a bit ahead, an emergency need not completely derail you and your schedule.

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24 August, 2013 - Posted by | academics, study skills

1 Comment »

  1. As always great advice 🙂

    Comment by S | 25 August, 2013 | Reply


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