Monday, December 18, 2006

If You Don't Think Studying Is Hard, You're Doing It Wrong

A disclaimer: I never said I had a fun or easy way to study, or even a particularly original one. I only said that it worked (for me).

When I decided I was going to try to get into medical school, I’d had thirteen years of grade school, three years of college, and two years of grad school. But the vast majority of this time was spent in classes in the arts, and the art I perfected was that of doing just enough to get an A- in anything. (The trick to that, if you’re interested, is: read the assigned material closely enough to get the gist of the ideas, show up to most of the classes (in particular the first three and the last three), write a paper that is slightly longer than the minimum assigned length, and string together coherent sentences for the midterm and final. So few people (no matter how fancy the school) manage to do all of those things that they’ll feel guilty marking you down much for simple crappiness (and believe me, I was guilty of much crappiness). There were a few classes that I got really into, but it seemed like even when I flayed myself open for a class, the T.A. wouldn’t care for my take on the subject and would give me an A- anyway.)

So let’s say I was a tad unprepared for premed classes. I had a heavy load of them, too, since I pretty much hadn’t done anything in college that counted as a science course, with the exception of Physics for Phreaks (where all I remember doing is going on a field trip to walk through a noise-canceling room while some poor grad student babbled about waves). I crammed into a two-semester period almost every required premed course, including labs. I read the books and got the gist; I showed up for class; and when I sat down for my first test—a physics quiz—I wasn’t too worried.

My attitude was rudely adjusted when the quiz came back with a big red “59” written in the top right corner. Thanks to the curve (a lovely device not often used in liberal arts courses), it worked out to something like a C, but holy shit—a 59??? I had blown 41 percent of the questions?? This wasn’t going to get me into med school. And I’d already quit my job.

OK, so it was firmly established that I was no Feynmann. I needed to get serious. Here’s the method I followed:
  • Realize that how painful something is to study is directly proportional to how much you need to study it.
  • Go to every class—and stay awake.
  • Read all of the material, painstakingly slowly, at least three times over.
  • The “gist” is useless; memorization is what counts.
  • After you think you’ve memorized something, try writing it all down on a blank sheet of paper. Hmm, maybe not as well memorized as you thought?
  • When you quiz yourself, which should be often, make sure you get all of the answers right three times in a row.
  • Beware the mnemonic. Mnemonics only work in very specific circumstances. For instance, “NAVY” is a handy mnemonic for remembering the order in which one encounters the important structures in the groin: Nerve, Artery, Vein, Ying-Yang. Most mnemonics, no matter how clever or bawdy, just inspire one to invention. Does that I in “PILES of POOP” stand for Ischemic? Infectious? Iatrogenic? Ipsilateral? Italian? Who the hell knows? I found that making up a memorable saying works much better. For instance, if you drink enough alcohol to affect your liver, there is a tell-tale pattern to the increase in the liver enzymes: the AST, aka the SGOT, is usually twice as high as the ALT, aka the SGPT. I remember this by saying “You AST for it, you SGOT it.” (I know it’s stupid. But it works—I remember not only the pattern, but that AST=SGOT.) Corny tricks like the ones for remembering someone’s name (you know, picturing Mr. Heinz as a giant ketchup bottle, for example) work well also.
  • You will never be hip again. Obviously.
  • Get enough sleep. Cramming all night the day before a test does not work for science classes.
  • Study similar things in proximity to each other. Calculus and physics go well together, for instance.
  • If studying something is making you fall asleep, take a power nap.
  • I said power nap. Do not let yourself sleep longer than 20 minutes.
  • Colorful highlighters and tabs and note cards are festive and helpful—up to a point. Past that point, they become time-sucking OCD rituals.
Hey, like I said, it’s not fun. But it worked for me. Despite my pathetic start, I went on to get the highest grade of anyone in that physics class, and I got an A+ average in my premed courses. I realize now that if I had used these kind of techniques in my liberal arts courses, I probably would have rocked them, too. Even when I worked hard, I neglected ever really to learn the material by heart.

In a few years I’m going to have to take my recertification test, so I’ll be hauling out these methods pretty soon. For now, I confess that I’m often getting by on the gist.


Anonymous said...

If I had followed these rules, I would have done far better at university (liberal arts, of course!) than I did. Unfortunately, I didn't really learn these rules until I started working and had to learn/solve work issues.

I remember being very fond of the festive highlighters and tabs. Didn't really help but it made the book look colourful.

I'm very sure that even if I applied every single one of these rules I'd never make it into medical school. You're obviously smart too.

Anonymous said...

Dear DM,

You've raised some interesting issues with your how-to-study guidelines. As a hard science undergrad student, I often struggled with (and wasted time thinking about) whether it was more important to be someone who "got it" as in the gist, or the concept, or someone who memorized everything and understood very little of the big picture.

For example, in studying the Kreb's cycle or organic chemistry in general, is it more helpful to just memorize all the minutia of certain processes first, and hope that your mind can make one big mental connection later, in the real world, after you've aced the test?

I did very poorly in the upper hard sciences (organic chem, differential calculus, advanced physics)in part because of this inner struggle. I wish I'd had an academic advisor just tell me, "Look, just memorize this shit and get the highest grades you can and worry about getting the gist later. You won't use half of this stuff in med school anyway." Or some such advice. Any thoughts on that, DM?

And last, with the advent of technology for storing and making accessible vast amounts of boring information (e.g. drug-drug interactions, polymerization equations), do you think med schools or vet schools or engineering schools are moving away from requiring students to memorizing volumes of facts ad nauseum and more toward students getting the big picture, the interconnectedness, the gist of how things work?

Thanks again for posting this--I didn't expect this until some time in 2007.

Digi Rebel said...

hi Doctor Mama
I'm an RN, big busy hospital, with
residents on our floor.(don't ya know we just luv em). Your site is great, I thoroughly enjoy it and always learn something new...Just wanted you to know I'm out here..

OMDG said...

Too many people worry that they're not "naturals" at science, and give up way too easily. Some concepts you'll get right away, and some you'll just have to grind out. This is true for everyone -- even the people who make you feel stupid by telling you how easy they found the subject. If I was struggling in a subject, I memorized it first (all the while memorizing my rationalizations for why the problem worked the way it did), and eventually I'd understand the big picture too. At that point the little details start filling themselves in.

Also, I highly recommend doing ALL of the practice problems in any class like Physics, Chemistry, or Ochem. Twice if you can. Including all the problems embedded within the chapter as you go through the reading for the first time. Also, try being prepared for an exam the week before you take it. It's not always possible, but it helps a lot.

Unknown said...

oh how i wish i had read these suggestions 6 years ago! as someone who graduated in the top 10 of her high school class just by showing up and getting the gist of things, i too had a very RUDE awakening in college. i gave up on *my* career in science, but now i advise undergraduate biology students. you better believe i'll be including these tips in my spring semester advising. thanks for another great post.

Jackie said...

Thanks DM, I was in Universty Science for two years before I pulled my head out of my butt and figured out that the "recommed readings" weren't actually recommedations, but "Get your ass to the libary and memorize every last word if you want to pass" readings.

Good advice!

DrSpouse said...

Interestingly, I did really poorly at science in my one year of a medical degree (this is an undergraduate course in the UK) but then started doing really well when I switched to a biology degree, and am now an academic in a science subject. The difference was the way things were taught - understanding versus memorisation.

Anonymous said...

Great tips! I am a doc too and your comments are soo true. It always seemed like my nonpremed friends had way more free time then I did and I spent hours upon hours studying for my hard core science classes. I love your site !

Anonymous said...

So true. I went for a graduate degree in chemical engineering after a liberal arts bachelors. I had the math but had to take undergrad science classes/labs, as well as the grad courses.

The upside to these killer classes was that results were usually directly proportional to the effort put in. Lots of studying = great grades.

In the working world, I would get lauded for things I had little control over, while projects I worked at for months often ended up as disasters.

And the best thing about engineering classes was there was always an answer to the problem. And you could usually tell if it was right. You would work all day on a problem and be like, "aha, its 15!" I never had that kind of certaintly with a job.

Ottoette said...

Thanks for reminding me why I don't return to school!
Exhausting just reading about it!

Sara said...

Heh wish I'd read this BEFORE six years of med school. I boned my way through undergrad and even a lot of med school. It shows though, especially on the real chemistry courses.

And yes - MEMORIZE. Fuck understanding. That one got me every time. At some point, you just can't make sense of it anymore.

Anonymous said...

My field of the liberal arts can be technical and so the gist often doesn't cut it. Still, I admit that you can't flunk everyone and so there is a fudge factor I do sneak in to save the slackers like your young self. The technical and the right/wrong answer is there in some other humanities fields as well but I admit that there's a reason they call them the hard sciences. For precision and the rest there is just no comparison. What you describe here sounds exhausting but also kind of exciting--I used to love the challenge of mastery in things like anatomy. Still, I never could have done what you did, I think.

The memorization didn't bother me in bio sciences but there was a basic misconnect on calculus and physics--very sad for me--I wanted to be good at everything. I hated being mediocre and that made it so hard to try. You had to have some genuine talent to do what you describe here.

What I also couldn't handle about sciences was the labs. The tedium and time indoors got to me. I felt trapped and the urge to take hour long bathroom/smoke breaks was irresistible. I would sneak outside and light a cigarette, open a book and be unable to get back in there.

Val said...

This is [another] great post DM! It actually gives me hope that I may pull my OWN head out of my butt; I can pull those dusty textbooks off the shelf & study for those board certification exams...

Anonymous said...

Anonymous again,
And thanks to old MD girl for her additional tips. Very helpful.

XE said...

For me, it's all about the cue cards. I put an open question on one side (list and describe all the types of anemia, including causes and treatment), and a very detailed answer on the back. I then make myself recall it from memory. I go through teh cards over and over until I can do them all without looking at the answers. It's time consuming, but it definitely pays off! If you make the questions too specific though, then it's too easy and it won't work.

Anonymous said...

Very timely advice as I just finished an intermediate accounting course (online, but still the real deal) and got a gentleman's (gentlewoman's) "B" even though I studied, by my sights, very hard. All of your tips were things I did almost, but not quite - hence the B (not an A or a C). Accounting is not rocket science, or even pre-med, but it is deceptive in that you read something through, think it's self-evident, and realize once you start the problem set (or the exam) that there are all sorts of details out there that you didn't quite pick up on. Hope some other ex-liberal arts person out there like me is taking your advice to heart. Signed Katy the Lurker

Peg said...

Your story is so close to mine...I cannot believe it. I was a Fine Art major for 3 years many moons ago. I always wanted to get into medical school, but never really thought of myself as "smart" enough. Well, I changed my mind and decided that I can do anything I set my mind to so now I am finishing my college degree in biology / premed. Switching to science from art is a whole different world, but I am, so far anyway, achieving straight A's. I agree with all of your tips and have been using them by instinct I guess since I went back to school so I can say for sure that they do work. Extreme effort goes a long way in obtaining one's goals.

Anonymous said...

I completely failed my first biochem test in med school because I thought I "had the gist of it" going into the exam. I ended up doodling on the pages and turning it in. I'm embarassed to this day about that.

I actually took a year off of med school after that, and I really thought agonizingly hard about whether I would go back--knowing that such a choice meant that I was going to have to memorize freighter-loads of facts whether or not I ever figured out the "gist."

Now, I'm with you--lots of gist in my day to day practice.

Anonymous said...

I was reading this and thinking "there's no way that someone would get an A- in my class with that attitude". But then again, I was teaching an upper division mathematics course this term. Clearly you're not accounting for your natural abilities either. I worked my ass off in the humanities courses I took to get my B+, or A- if I was lucky. Take it from me, a lot of college students cannot string together a coherent and logical sentence on the fly.

Mignon said...

If you had said this to me 15 years ago, I would've nodded, agreed, and continued to cram everything in the night before with my OCD highlighters and colored tabs. And cruised through with my C average. Because there's no med school after you get your BS in chemical engineering. Just work, and they don't really give a shit about your grades, or so I found.

But I'm planning a return to school when the baby turns 3, and then I'll care. Then I'll want to know the stuff I'm reading, instead of struggling to make space in my alcohol-and-hormone-rattled brain.

I look forward to the day I can and will want to use your brilliantly outlined study methods. Well done, DM.

Anonymous said...

Sigh. I know you weren't trying to make it sound fun, but oh, you did. What can I say--every few months I have to restrain myself from looking into med school...

Anonymous said...

Just popping by to wish you, TH and HB a very happy new year!

Fiona xo

Med-Source said...

Hi Dr. Mama,
I write a resource blog for medical students & I think your study plan is fabulous (if I could only stop procrastinating long enough to adopt it). Anyways, I have linked you post from my blog, but I was wondering If I could copy & paste the bulleted list part (citing you with a link of course)??? See my blog here & let me know.

Alyssa said...

Adding this to my favorites. I often laugh at myself over my moments of tantrum & depression on weekends about how I will never be able to be a normal college student and have a regular (read: party-filled) college life. It's a worthwhile sacrifice though. Thank you for the excellent post.

Anonymous said...

Hello doctor, I don't know if you have time to look at these comments or not, but how do you deal with a course or part of a course that is absolutely disinteresting. I am in engineering right now and I do well in engineering courses, but I dont like the math courses.

Unknown said...

Just found this post - awesome. I had the same experience in my first semester of college when I got a D on my calculus midterm. And then a A+ on the final.

I studied like one whackass mother on the LSAT (got into Top 10 school) and in law school. Currently in practice, it's a mix of gist and memorization. Tax law needs more than a gist. Marketing needs just the gist.