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Write short notes? Anki cards? Pages full of highlights? Read and re-read? Memorize?
- Always ask.. “Why?”
Throughout your journey at medical school, you will come across topics where nothing seems to make sense (in the beginning, at least). Traditionally, you'd then decide to spend more time on this section "later"... which eventually becomes a "day before the exam". This is when the average student panics, and in desperation gobbles up any content in front of them by memorizing, only to have it disappear out from the cerebrum into thin air on the day after exams! Sound familiar? Don't be disheartened, we've all been there.
What then, can be done? Ask "why?'. Glomerulonephritis presents with hypertension... "why?". An early diastolic murmur in aortic regurgitation... "why?". Weak bones in osteogenesis imperfecta... "why?". You get the gist.
You will find that asking “Why does this happen?” goes a long way as it helps in getting down to the nitty-gritty of content by understanding underlying disease mechanisms, and the reduced need for memorizing text after text, or word after word.
Caution; going for in-depth research into the "why" of various pathophysiology mechanisms may cost some time; so start early in the semester, and don't wait for that exam notice! Sometimes, the question leads down a rabbit hole of too much information (yes, there is such a thing). Once you get the hang of it, you'd know when to stop. We will discuss in detail about specific resources used (books, websites etc.) in a separate post.
- Think.. “How would a patient with this condition come to me (in real life)"?
Textbook patients are rare. What you will often find during rotations are variations of clinical manifestations within the scope of similar diagnoses (your differentials). Being a good doctor, therefore, would justly require not merely textbook knowledge, but also soft skills of fluent communication and critical thinking in order to extract as much information from your patient for an accurate diagnosis.
With every patient you come across, think about how the presentation varies from what you’ve read. I ask you to discuss with your peers about such uncommon presentations, and debate with yourself about possible differentials. Having all the textbook content committed to memory only takes you so far. Instead, learn actively by drawing up connections between the case studies in your text books, the laboratory mannequins, and your real life patients.
- Write, write and write more!
I'll keep this section short, as it almost needs not be said for medical students. Writing notes, and jotting down important points will help you retain and recall more! I've found this especially helpful during rounds, especially since I tend to forget the details of my patient in bed 1 when I reach bed 45 towards the latter part of the day. Don't be afraid to write on your text book. Write down words or phrases that connects a clinical finding in one chapter, to a differential in another. Expand your mind map by drawing images and scribbling artwork relating to your topic of study. The more metaphorical synapses you form within your textbook pages, the larger the number of actual neuronal synapses you will create within your brain (Ie: better memory circuits)!
- Discuss, debate and argue science!
Perhaps one of the most important tools we've evolved to possess within the animal kingdom is our ability for organized communication. Take maximum use of the proximal end opening of your GIT. Select a group of no more than 4-5 of your classmates (personally I feel any more is a crowd, and productivity tends to drop), and set aside an evening for medical discussions. It can be once a week, or once a month. Discussions could be anything from past question banks, topic based discussions, physical examination practice or brain teasers over a coffee. It doesn't need to be highly focused or goal oriented (at least until exam season begins). The knowledge you share, added with your colleague's experiences in similar clinical scenarios will help double down on concepts that would otherwise take you hours or days (of self-learning) to complete.
- Keep yourself updated.
We have only recently emerged- some of us shuffling, others crawling into an age where the many streams of medical science are often treated with doubt and hostility. Questionable as it should be, there is a cure for almost any disease on Google! It is therefore our role and responsibility as physicians to help educate our patients, for their own benefit and in the best interest of science. This requires that we have a firm grip on up-to-date and evidence-based medicine.
Almost all diseases have a combination of environmental and genetic components, those that are frequently changing and daringly expressive. Medical science will therefore always be a field of recurrent updates and continuous learning. It is crucial that you gain a deep understanding of the up-to-date and clear-cut concepts, and train your mind to question those unknown.
Gain knowledge for the sake of humanity, and not merely for passing your examinations. As Benjamin Franklin once said, "an investment in knowledge pays the best interest".
Good Luck!
Prashan Perera.
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