Exactly a year ago, I started Student Internship. Now, we are getting ready to welcome the new bunch as we prepare to take our leave from medical school – soon, soon. That first week of SI was so exhausting. I found myself studying for hours and still feeling useless.
One year later, and I’ve become convinced of one thing: you study differently for every rotation, and there are ways to study effectively without burning out. These are some of my methods and tips that tend to work when you actually use them (I’ll leave you to interpreting that).
Start at the your home base.
I’m pretty good at finding resources, but the best thing is to spend your first few days gathering resources from your own university. Why? Because you need something to use as comparison. So compile your notes in files (I sure hope you didn’t burn them after second year…) or even better, load them all onto your tablet. I can’t tell you the amount of times that I searched far and wide for study notes and only realised at the end that I should have started with some pretty good notes made by my own professors.
Technology is your friend. Free stuff is everywhere.
To be specific, I am referring to the LEGAL free stuff. I tend to share my flash cards, and I am working on uploading some of my summaries.
There are some great resources shared by universities and individuals. Examples:
- Internal Medicine Lecture Notes for House Officers (Ethiopia)
- High-Yield Shelf Notes (Surgery, Psychiatry, OBGYN, Medicine, Paediatrics) by Kim Young (for South African students: a shelf exam is like the end-of-block exam)
- Chemical Pathology Notes from University of Cape Town (they are known for their good chempath syllabus)
- Orthopaedics Notes from University of Stellenbosch
- Orthopaedics Workbook and Lectures from University of Nottingham (iTunes course)
You get the idea.
Twitter has also been a great help to me. One of my favourite accounts:
Youtube is GREAT, especially if you’re looking to brush up on anatomy. Yay for nerdy anatomy songs! And Figure 1. Get the app, it helped me through my surgical blocks SO MUCH.
Study in different ways
I have a problem: once I’ve read a chapter once, I’m bored with it and I struggle to study it again. You might not have the same problem to the same extent, but I do believe that using more ways of studying and therefore more ways of mental stimulation truly improves your memory retention. For example, I really struggled with pharmacology until I started using flashcards. This is as good a time as any to try some new things. When I really don’t feel like studying, I make mind-maps, because it makes me feel like I’m doing something creative.
Integrate public health, economics, or humanitarian work
This is a bit cryptic because I suck at thinking up good headings. So sue me (but please don’t). Anyway, what I mean to say is that there are ways of making medicine stick, if you combine it with another interest. For example, before psychiatry I downloaded WHO’s reports on mental health around the world. Similarly, if you were studying infectious diseases you could read some of Paul Farmer’s work. This is obviously a bit of a time-suck so I tend to do it only for subjects I need some help with and only in the first week of a rotation.
In Orthopaedics we had to take turns to present a journal article at morning meetings. We all disliked the idea, but it actually really put the discipline into perspective. For example, the first student spoke about Ponsetti vs. Surgery for Club Foot. Obviously none of us will go on to remember exact figures or surgical methods, but somehow it still made club foot more relevant to us. I did one of my presentations on the usefulness of ultrasound diagnosis (vs. Ortolani and Barlow manoeuvres) in developmental dysplasia of the hip and although nobody will really ask us that, in order to understand the article we had to get clued-up about DDH.
By the way, we had Ortho back in March/April… so the fact that I remember this is kind of a case in point.
Patient write ups
O. Em. Gee. I know a lot of people will kick me for saying this, but I don’t know why we don’t do more write-ups of patients.
Let me explain: the biggest challenge for me this year has been integrating my knowledge in such a way as to help a patient. So in these write-ups (which we have done for Internal Medicine and Psychiatry), you start with history, effect on ADLs and physical examination with special investigations. You then motivate your differential diagnosis and explain the steps that were followed to reach a final diagnosis.
Following that, you explain your management of the patient and you make a list of the indications, contraindications and side-effects of the different drugs used.
Finally, they ask you to describe normal physiology as well as the pathophysiology of the disease process, elaborate on the patient’s progression while in hospital, and to critically evaluate the patient management.
If you’re thinking that sounds like a lot of work, you’re right. And yeah, I left my write-ups to the last week and kinda hated myself for it. But I think if you do one write-up a week, of different disease processes of course, it would go SWIMMINGLY. As it stands, doing those write-ups, albeit three days before my Internal Med OSCE, made me feel more prepared for the exam than any of the other study methods I tried.
Be a little more annoying in the wards
I asked the physician if he would give me some advice for the coming exam-prep. He said that final years have a real excuse to be annoying in wards. Ask questions if you don’t know a drug. Walk around with one of your textbooks and read up if nobody is actively teaching you. Organise teachings among yourself and the juniors on your firm. You’re in the last stretch, you have a license to do this.
If you’re from my school, you’ve probably heard this one before.
I detest medical students who gather resources like squirrels preparing for hibernation and don’t share. DO YOU NOT WANT YOUR COLLEAGUES TO BE EFFICIENT ONE DAY?! Share and ask people to share. I can’t stress how important this is. Have a class DropBox or something similar on your university’s intranet. I truly believe that medical school will grow from strength to strength once we start looking out for one another. My friends and I sometimes do summary-exchanges – sometimes reading somebody else’s perspective makes the world of difference.
A burnt-out brain does not a diligent student make. But I’ll write more on this later this week.
If you use a method that works for you, feel free to share it here. If you have something you’d like me to tackle in a similar post, I’m open to suggestions!