Studying effectively is important in a medical career. First and foremost, having an effective way of learning is key to complete medical school. Secondly, medicine and surgery are careers requiring constant learning, changes come thick and fast and it’s important to be able to integrate new findings into your practice. Thirdly setting up efficient learning structures while at medical school will benefit you when it comes to sitting membership exams, where you need to study around your clinical commitments.
Studying effectively depends upon what type of things you’re studying and how you learn. Broadly, types of studying can be broken down into “Book Work” and “Practical” work. As a medical student this effectively means “Written papers” and “Clinical Exams” respectively, though there is often significant overlap in both.
Irrespective of what you’re studying, the first thing to do is to plan. A solid plan and timetable of how to attack an exam is critical, there are many ways of doing this. The start of this step requires knowing when your exam/test date is, then working back and seeing exactly how long you have to prepare. The preparation time for different people will be entirely dependent on how you study for exams. Similarly, knowing the format of your exams will be very helpful to allow you to prepare effectively.
Some like to dedicate specific days of the week or times of day to certain things (“I’ll learn anatomy on Tuesday afternoons”) or to block time out for things to be learnt (“I’ll learn anatomy in week three”), a mixture of the two is probably the best approach, with a solid block to get the basics established, followed by consolidation periods where you can go over things (“I’ll learn anatomy in week three, then go over and make sure it’s all clear on Tuesday afternoons”).
For big topics, it’s often much easier and more time efficient to try and establish early a pattern of learning that involves regular, small chunks of work. An hour per day of learning over a year allows you to learn vast amounts for relatively little outlay and significantly less stress than cramming!
Chunking is effectively breaking a larger topic down into smaller component parts. Depending on the topic, it may be appropriate to break it down in different ways, for example anatomy may be broken down by location (face/upper limb etc) while operative procedures may be broken down by specialty. Emergencies may be divided according to where in the ABCDE structure they’re likely to fall, or how a patient may present. Chunking allows you to move between topics and make links. Links between different topics or ideas consolidates them within your mind and will allow you to learn more easily.
It’s not unusual to see medical students with the faithful “cheese and onion” (Oxford Handbook of Clinical Medicine) on the wards – this is great if, during a ward round, something is mentioned and you’d like to read a little more about it during a quiet moment. The smart phone has this capability, and while this opportunistic type learning is fantastic, it may also be worth carrying some notes with you. Often this can just be a folded piece of paper with didactic points you have to learn (i.e. not “understand” but just must “know” such as drug doses). This allows you to look at them in gaps and consolidate your learning around clinical commitments.
There is a wide range of techniques people use for their learning including:
- Studying in different or new places
- Working in groups – each person learns about a different disease or problem and then comes back and each teaches to the group. Teaching others can be a highly effective way of consolidating your own learning
- Learning in bed – this can be very effective, especially for didactic knowledge points. Ideally, make it the last thing you see before you fall asleep, and the first thing you see on waking!
- Spider diagrams – for visual learners, these can be very effective for remembering “understanding” type problems.
- Stick Men – A simple outline of a stick man can be used and arrows to the various signs and symptoms of diseases can be added. These can aid pattern recognition associated with making diagnoses.
- Flash Cards – These can be made to cover systems/diseases or specific questions, these can be easily carried around and can be used either on your own or as part of a group.
- Post-it notes/On the wall – Around exam time, some people post their notes onto the walls, the idea being that repetition is education and education is repetition.
Ensure you have a good batch of resources, including past papers. Past papers are best used early to gauge where you’re at, and then once you’ve covered most things to identify areas of weakness. Online test services have exploded in recent years, and now enable you to test your knowledge by domain and even by question type (such as extended matching questions and single best answers, which each require different technique).
Make sure that the books and websites you’re using are up to date. Certainly most medical students use online resources as much, if not more, than book-based resources now. A number of useful online resources have been developed by medical students and doctors to assist in revision and learning.
If you’re on twitter, following the #FOAMEd hashtag can be a great way to find content (FOAMEd = Free Open Access Medical Education), though it can be very diverse, and may well be at a higher level than you need for your exams.
The practical components of medical school exams require a slightly different approach to the written exams. That said, they exist symbiotically, such that a solid basis from your book work will set you up really well for practicals. The key to learning for practical exams (this includes communication skills, long cases, short cases, clinical examination and practical procedures) is knowing the format for your exam, and practice.
Planning how to approach your examinations is critical. Know what you’re expected to know, and how you’re going to be assessed on it. The best way to pass practical exams is to have actually done what they’re expecting you to be able to do for real. For example, if your first time placing a cannula is the week before your exam, you’re unlikely to be as confident as someone doing five a week throughout the year. In the lead up to exams, sketch out a structure of what you need to practice, and how you’re going to do it. It really helps to have a senior colleague who can practice with you – observing and advising as you go.
>Practical skills – this is all practice based, watch an expert doing it, or access online resources explaining how to do it, then practice practice practice. Also practice your exam chat, often in stations for practical procedures you’re expected to talk to the plastic arm like it’s a patient, so get used to it.
>Communication skills – there are a number of books (the best and most appropriate to use are those written for PACES preparation). The key here is knowing the structures, key facts and practice. Practice with friends going through the scenarios. For history stations, ensure that you have a good structure for your history and key headings in your mind for different histories.
>Clinical skills – these need to be practiced with close observation by someone who examines finals or has recently done finals/membership examinations. Ideally, set it up so you have short, regular sessions so you can develop your technique. Practice needs to be in the time you have allocated, on real patients, with real signs, and with a following presentation/viva as appropriate. A grilling after each examination regarding presentation, diagnosis, investigation and management can really set you up for any tricky questions that come up at finals. Around this dedicated practice time, you should be examining every major organ system at least once a week in the build up to finals, and ideally once a month when you’re on firms (though this is firm dependent).
>Looking after yourself
You can’t perform well if you’re not fit. For many people, the stress of exam time can lead to major amounts of caffeine and not enough sleep. Sleep is key for revision and being sleep deprived will not allow you to perform at your best on the day. Keep eating, drinking and exercising as you would outside of exam times, maybe with a few extra treats to keep you going! Ensure that your work time is broken up by things to look forward to – this might be seeing friends for a coffee (around exam time, non-medical friends may be preferable), going for a run, or catching up on the latest episode of Game of Thrones. Either way, whatever it is, ensure that you have regular breaks, for some people working for 20 minutes at a time is far better than a three hour slog. By the time you get through your first year at medical school, you should know what works for you, and don’t be dissuaded by the people putting in 17 hour days without breaks! What works for some is disastrous for others!
Finally, if you’re feeling really stressed, talk to someone about it. Chances are there are lots of others feeling the same way as you, and you just need to make sure that you have a good support structure to deal with the exams. Family members, friends and loved ones can be a first port of call. The welfare office at your students union or at the university can often offer help also, and may advise on services you can access.
Either way, if you put the work in, you will pass your exams and have a great summer after! The important things are to plan, to know what your exam format is, practice, know how you learn effectively, practice, practice some more and get some rest! Good luck!