How to study in Medical School?

[leviathan]

TN is a good primer before clerkships. I just read all of OB+GYN and knew it cold before starting that rotation and did very well. I also did case files which is a good review series. Once in the rotation itself you are mostly fine-tuning and learning from guidelines and journal articles. A dense rotation like IM is way different; there's too much material to just read Toronto notes or some review book.

[Nixon]

Totally untrue. Shortcut: past exams - can't speak to every school, but I know UofT, UBC and Calgary all have their own pools floating around. Most people study a lot but don't have the rigour to go through more than maybe 0.5-1 past exam. I do the opposite - blaze my way through as many past exams as I can.

 

Even if you don't know ANYTHING, pure repetition will clue you in to enough right answers to pass. This doesn't mean you will understand what's going on - then again, 90% of what I learned in preclerkship meant nothing in clerkship sooo...

 

As for clerkship, all that really matters is ward evaluations, so learn the common stuff that gets asked about (e.g. which cytochrome is upregulated by which drug under which conditions is a classic scumbag exam question, but a poor "ward clinical teaching point"). If you are half-paying attention, the clerkship exams will be straightforward, UNLESS the exams are out of left field - in which case, hopefully someone in an upper year will have warned you beforehand so you can study appropriately.

 

Like, amount of ENT anatomy I learned in ENT -> there is an outer ear, middle ear and inner ear, plus a lot of sinuses all over. Amount of ENT anatomy on ENT exam -> specific to which section of which turbinate should be surgically fixed for X condition. Result = "wtf?!" on the exam if you weren't warned beforehand.

 

Its not only about passing exams but learning how to treat human beings.

[psychoswim]

Its not only about passing exams but learning how to treat human beings.

 

Agreed. And you could also happen to be the first year where the exam is completely different from the 10 previous ones! Speaking from experience hehe.

[goleafsgochris]

Its not only about passing exams but learning how to treat human beings.

 

wow good point I bet she didnt think of that

[estairella]

Its not only about passing exams but learning how to treat human beings.

 

Spoken like a true pre-clerk. I often know 3-4 ways to 'treat' many common conditions

 

1) the way you're taught in pre-clerkship, usually based on old guidelines or that specific presenter's personal quirks (useful for passing the exam)

2) the latest guideline/evidence-based way (useful for when you're being pimped)

3) the way most people do it at your base hospital based on available medications/traditions/etc. (useful for not getting the nurses angry or confused)

4) the way your primary supervisor likes to do it (usually same as #3, but if it's different, do it that way if you want a good evaluation)

 

Once again, most of what you learned in pre-clerkship is crap when it comes to diagnosis, workup and treatment on the wards. Pathophysiology / anatomy / etc. is useful information to know, but it's the diagnosis, workup and treatment part that actually helps patients, and you won't learn that until you're seeing how doctors do it in real life, not in a textbook.

[PhoenixFlare500]

Spoken like a true pre-clerk. I often know 3-4 ways to 'treat' many common conditions

 

1) the way you're taught in pre-clerkship, usually based on old guidelines or that specific presenter's personal quirks (useful for passing the exam)

2) the latest guideline/evidence-based way (useful for when you're being pimped)

3) the way most people do it at your base hospital based on available medications/traditions/etc. (useful for not getting the nurses angry or confused)

4) the way your primary supervisor likes to do it (usually same as #3, but if it's different, do it that way if you want a good evaluation)

 

Once again, most of what you learned in pre-clerkship is crap when it comes to diagnosis, workup and treatment on the wards. Pathophysiology / anatomy / etc. is useful information to know, but it's the diagnosis, workup and treatment part that actually helps patients, and you won't learn that until you're seeing how doctors do it in real life, not in a textbook.

 

I think Nixon meant learning to be polite and courteous and caring towards the people you serve as a physician and caregiver, not how to treat their disease.

[estairella]

I think Nixon meant learning to be polite and courteous and caring towards the people you serve as a physician and caregiver, not how to treat their disease.

 

If that's what Nixon meant, why did he quote my post on how to take a shortcut on passing exams? Because, if it isn't obvious, medical school exams don't test your caring, courteousness or politeness. And for the record, neither do OSCEs - OSCEs test your professionalism (which is a very different concept).

 

And if it isn't FURTHER obvious, this is a "how to study in medical school" thread, not a "how can I be a more humanistic physician?" thread - once again, there is no amount of textbook studying that will make you less of a douchebag.

[thebouque]

Esteralia is right. Also you can learn a lot from past exams.

[Nixon]

Wow.. I did not mean to turn this thread into a who's-right-who's-wrong fight. Go back and read your post estairella. From what you wrote, what I understand is that you seem to care more about passing an exam than actually learning something that could be useful later. I don't agree when you say that 90% of pre-clerkship is bull****. If it were then pre-clerk woulnd exist and i guess we'd learn from clerkship experience from the beginning. That being said, I dont blame you for using exam banks. Theyre quite useful and I use them a lot too but i don't stick solely to that. Last year ive seen too many people studying in such a manner and then forgetting 95% of the info afterwards. To me thats not an efficient way to educate yourself. Id rather finish a class with a B and having learned s/thing out of it than with an A+ and having to work my *ss off later on because i cant recall what ive studied a few months ago.

 

I didnt mean to bash you around with my post, nor did i mean to act like a douche bag. I'm very sorry it turned out this way.

[rogerroger]

This is so true. Can't say I agree with all estairella's comments on this thread but they hit the nail on the head on this last one. Very good point and something which definitely contributes to the new "challenges" of clerkship.

 

Look at old exams! I have been caught on not doing this and it sucks. Read them, seriously! It will tell you which 1-4 they are looking for on the exam...

 

Spoken like a true pre-clerk. I often know 3-4 ways to 'treat' many common conditions

 

1) the way you're taught in pre-clerkship, usually based on old guidelines or that specific presenter's personal quirks (useful for passing the exam)

2) the latest guideline/evidence-based way (useful for when you're being pimped)

3) the way most people do it at your base hospital based on available medications/traditions/etc. (useful for not getting the nurses angry or confused)

4) the way your primary supervisor likes to do it (usually same as #3, but if it's different, do it that way if you want a good evaluation)

 

Once again, most of what you learned in pre-clerkship is crap when it comes to diagnosis, workup and treatment on the wards. Pathophysiology / anatomy / etc. is useful information to know, but it's the diagnosis, workup and treatment part that actually helps patients, and you won't learn that until you're seeing how doctors do it in real life, not in a textbook.

[estairella]

I didnt mean to bash you around with my post, nor did i mean to act like a douche bag. I'm very sorry it turned out this way.

 

No worries Nixon, you weren't being a douchebag, just maybe too idealistic.

 

(Paraphrasing) Pre-clerkship education is important and you shouldn't take shortcuts just to pass exams

 

I would argue that pre-clerkship education, just like having 3-4 years of undergrad before entering medical school, is more about tradition than learning. Of course some foundational knowledge is important, but:

- in many countries people enter medical school directly after high school with comparable health outcomes (Quebec: CEGEP -> 1 year of university before medical school)

- in McMaster and Calgary, medical school only lasts 3 years - if you look at their curriculum, the 'traditional preclerkship' part is significantly cut, with clinical electives starting in the summer of 1st year

 

So even if preclerkship is 90% BS is extreme (even though that's what I put it at), the fact that Calgary and McMaster exist - and continues to place students in plastic surgery, radiology, dermatology and other very competitive specialities who only take exceptional students, shows that it is at the very least 50% BS (assuming Calgary and McMaster have 100% optimized their education).

[thebouque]

It depends on your point of view. For me preclerkship was just as important as clerkship. However it is the tendency to put less emphasis on basic sciences and more on clinical medicine very early in the program. Maybe the future generations of doctors will apply recipes and algorithms without a real understanding of they are doing. Physicians will then be closer to technicians than actual doctors. We are in an era where optimization is at the forefront and where we need to be efficient. Nowadays, embryology, histology, histopathology, physiology, biochemistry etc are considered a waste of precious time.

[leviathan]

One of the few things that separates physicians from midlevels is our deeper understanding of medicine. Getting rid of basic science knowledge for guidelines and 'cookbook medicine' is probably not a good idea, unless it is accompanied by explaining why things are done the way they are.

[DOC_Ma]

This is true. Medicine is adopting a more corporate posture with "turnaround time" and "volume" being the prime metrics of success.

 

As it stands family doctors don't need to know anything about medicine as long as they have the guidelines available.

 

The system is flawed. In particular Fee for service encourages "high volume" because quality is not measured with monetary means. However even though it's not perfect, nothing much better can replace it in the near future.