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How to prepare for the exams/tests?

IgorSun

Lurker
Hello ladies and gentlemen,


I want to raise a very important topic for me:

How do you prepare for your tests and exams?

What techniques do you use to memorize information (schemas, terminology, pictures, exact data etc.)?


In two words: how do you memorize information?
 

frootloop

Doctor
Moderator
To be fair, medical school requires a substantial amount of memorising... There are plenty of things which don't really take much by understanding or clinical reasoning that you just need to 'know'. And exams, especially earlier on, just *love* to test how many of the weirder little details you've managed to memorise.
 

chinaski

Regular Member
To be fair, medical school requires a substantial amount of memorising... There are plenty of things which don't really take much by understanding or clinical reasoning that you just need to 'know'. And exams, especially earlier on, just *love* to test how many of the weirder little details you've managed to memorise.

Are you in medical school to pass exams, or to become a competent doctor? Passing an exam by memorising lists won't make you the latter. Many med schools don't require rote learning - I did very little of that as a med student, myself.
 

frootloop

Doctor
Moderator
Passing exams is something you have to do before you become a doctor at all, let alone think about being a competent one... It's easy to down-play exams after you've passed them haha. It isn't students' fault that they have to focus on passing exams, either.

In clinical years there has been a lot less need for memorisation, but there's still an awful lot of content you just straight up have to know before you can start applying it. Preclinical though? There was a butt-load of it. It's pretty hard to 'reason out' most of anatomy, for example - especially when you're a junior student with very limited context to place the content in (our med school has essentially zero clinical exposure till 4th year).
 

chinaski

Regular Member
Passing exams is something you have to do before you become a doctor at all, let alone think about being a competent one... It's easy to down-play exams after you've passed them haha. It isn't students' fault that they have to focus on passing exams, either.

My point is that memorising lists isn't enough, even if your med school creates the false impression that it is by passing you based on that alone ("pass" means "good enough to graduate and work, right?"). Like I said, you can choose to do enough to pass, which may well be spitting out lists like a performing seal, or you can actually learn stuff contextually and understand what the lists mean - and yes, if you don't have clinical exposure, that's harder, but not impossible. And again, not all med schools are like yours, particularly those that incorporate clinical exposure into the "pre-clinical" years.

I get the impression lots of med students come to university thinking they can rely on methods that got them through high school, which for a lot of them was learning a prescribed, predictable, set amount of stuff, and formulaically regurgitating it in exams. My point is that in medicine (and in tertiary studies in general), that isn't enough. You're not training to be an automaton.
 

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frootloop

Doctor
Moderator
I agree entirely that it isn't even close to sufficient. I was arguing that it is still necessary though, to some extent, given the sheer volume of information you need to pick up during medical school.

The OP did essentially equivalate 'studying' and 'memorising', though, so you're right that they probably need to focus more on their learning habits rather than trying to find new memorisation techniques!
 

chinaski

Regular Member
I agree entirely that it isn't even close to sufficient. I was arguing that it is still necessary though, to some extent, given the sheer volume of information you need to pick up during medical school.

I'd suggest that if memorisation is your main strategy to cope with the volume of material you need to know, unless you are a savant, it's not going to end well. ;)
 
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frootloop

Doctor
Moderator
I'd suggest that if memorisation is your main strategy to cope with the volume of material you need to know, unless you are a savant, it's not going to end well. ;)
I'm not sure how you got 'main strategy' out of 'necessary, though, to some extent'... The vast majority of my learning is done on the wards, backed up later by some reading around the things I've just seen.

But if you have a better way to learn, for example, exact % prevalences of various diseases (something we need to know for those exams you hate us studying for - if never again afterwards) than simple memorisation, I'm all ears.
 

chinaski

Regular Member
I'm not sure how you got 'main strategy' out of 'necessary, though, to some extent'... The vast majority of my learning is done on the wards, backed up later by some reading around the things I've just seen.

I was using the general form of "you" (moreover, to those like the OP who may think memorisation is the key to study) - not you specifically. Apologies, including your quote there did look as though I was implying the singular "you".

But if you have a better way to learn, for example, exact % prevalences of various diseases (something we need to know for those exams you hate us studying for - if never again afterwards) than simple memorisation, I'm all ears.

Nope - I suppose this illustrates a point for future applicants to research the syllabus and examinations of potential med schools, as certainly they don't all examine silly stats to a great extent. BTW, not sure how you jumped to the conclusion that I "hate" the concept of students studying for exams. I don't recall suggesting anything of the sort.
 

Benjamin

ICU Reg (JCU)
Emeritus Staff
What techniques do you use to memorize information (schemas, terminology, pictures, exact data etc.) [...] how do you memorize information?

There are a lot of different techniques for learning information (learn, not memorize!) and I think that early medical school is almost more about finding out how you best learn than the actual content. There is absolutely only one good way to find out how you best learn - practice and experiment. As Chinaski said many people (including myself!) thought I could get away with the same techniques I used in high-school: reading something a few times, using it once or twice and then leaving it until the exams when I would read over it again. I found out pretty quickly that this didn't exactly work.

My learning techniques changed a lot over the 6 years of medical school and realistically are still changing now depending on what the content I'm learning is and how much of a grasp I have on it - learning about cardiac anatomy is a simple re-read of the information in my anatomy text but trying to learn about interpreting echocardiograms requires me to sit down with a few different textbooks (anatomy, ultrasound & cardio text), a video source (of USS echocardiograms) & a list of cases to individually go through pathological processes & how they appear on the USS screen. There are however some consistently good strategies that I've found:
  • Adding an extra layer of depth that requires you to understand the first layer (i.e. interpretting echos requires cardiac anatomy knowledge) will ensure that you have that first layer nailed-down and also highlight areas you didn't realise were lacking. This mostly comes in during clinical years where you suddenly have to use your clinical examinations to actually come up with diagnoses or management plans.
  • If I can teach a topic then I understand it/if I can explain it to someone with either a base level of knowledge and they can use those explanations to learn it then I know my understanding is relatively complete. There is no way I would know heart murmurs as well as I do if I hadn't spent multiple weeks teaching them to different students and explaining them multiple different ways. I also wouldn't know my musculoskeletal anatomy anywhere near as well as I do if I hadn't been employed as a tutor or (on the point above) if I hadn't worked as a prosector (dissecting the models for class).
  • Getting someone with a far greater level of knowledge than you to listen to your explanations/listen to you talk through a topic will absolutely confirm whether you know it or not. Firstly, it takes a shit-load of confidence (usually engendered by a lot of study) to be comfortable explaining diabetes/thyroiditis/diabetic keto-acidosis to an endocrinologist that you've asked to critique you, & they'll be able to actually help you out when you get stuck/give you explanations that are better than your own/add depth to your understandings by linking other key points. If you find someone that's happy to do this with you then try your best to keep them around.
  • Use multiple different learning strategies rather than just relying on one - i.e. don't just read through a textbook, don't just write out things on a whiteboard, don't just talk about them to yourself, don't just visualise the actual process... do it all. In general I find my best way of learning is reading about something while highlighting the heck out of it (e.g. cardio anatomy/physiologyy), writing the key topics on a whiteboard (cardiac cycle, electrical pathways & ion channels, valves, ventricles & atria, great & cardiac vessels) then explaining each of them in turn +/- drawing and explaining diagrams where relevant, then sitting down and visualising the processes involved ... followed by doing all of this in order to teach one of your colleagues. Adding an extra layer of depth (as in my first point) such as incoporating this into an explanation of a pathophysiological process or linking it to one of your clinical examination findings (heart murmurs etc.) will help as well.


Are you in medical school to pass exams, or to become a competent doctor? Passing an exam by memorising lists won't make you the latter. Many med schools don't require rote learning - I did very little of that as a med student, myself.

I certainly agree with this premise, though I think my opinion is a bit separate from yours. I feel that memorization is an important step in developing a contextual understanding for a lot of things in medical school but that it's only one of the first steps. There are a lot of topics in medicine that require a broad understanding of the topic before you can delve deeper into them and many of these require some element of memorization to hold information in your head until you make those links. Similarly, for examinations I feel that there is a difference (as you describe) between studying to understand the topic and studying for exams - often exam study came in the week or two before them & largely involved practice/memorization of key exam topics.

I felt that the work I did during term in medical school was what would make me a competent doctor (still to be seen, haven't passed intern year yet!) but that this work didn't necessarily translate directly to examinations. The base of it always did - being able to examine & come up with a plan for a patient will always be the crux of any clinical medical school OSCE - i.e. your day-to-day practice will translate directly. In saying that there is a difference between being able to come up with the answers and being able to come up with them in time - I absolutely memorised & practiced to death all of my clinical examinations, the tables out of Talley & O'Connor for 'correlation of signs & symptoms to disease' & many more things that I already knew so that if someone asked me that question in an OSCE I could say it without thinking and give myself more time to think about other things. If I could walk into an 8 minute cardio exam on infective endocarditis and finish it in 5 minutes knowing I haven't missed anything then I could go back outside and begin preparing for a station I wasn't so good at - e.g. the haematology examination I knew was 2 stations ahead.

It's not that I didn't know those answers or didn't contextually understand them, but OSCE's in medical school are a dance/act more than they are a test most of the time. Keeping in mind though that I made them a dance/act/streamlined process after I knew and could explain the content in my sleep.

Similarly, when the questions are short response and ask things like "what are the clinical signs of ...?" or "what is your management plan for ...?" or "what are your priorities in investigating this patient?" I found these easily came from my actual work through medical school rather than direct memorization. Unfortunately there certainly were parts in my degree (JCU) which often tested some relatively obscure knowledge. These tended to come about specifically in our multiple choice questions and in our "extended match" question banks - especially in the earlier years for our humanities/ecology of health subjects where we would be tested on obscure social sciences frameworks.

I think a topic that a lot of people can understand the need for memorization is in organic chemistry. Yes, there is a need for a contextual understanding of the actual processes & theory but at the same time if you can't rapidly reproduce the organic chemistry pathways then you have no framework on which to base that contextual understanding. Quite frankly, I don't think there are many people who can learn about the ways the glycolysis, TCA, pentose-phosphate & glyconeogenesis (+ others) pathways interlock & then draw out & explain the pathways without ever having put effort into memorizing them - it's far easier (for most) to draw out the pathways, rote-learn them & then add contextual information onto that framework. In that sense I find memorization an invaluable tool; it is only the initial part of the learning process but certainly is an essential skill. The same applies for neuroanatomy/anatomy in general: it's very hard to generate an in-depth understanding at the start without having the actual anatomical positions of things memorised because every description is relative to other structures rather than in a fixed position - e.g. the .... pathways run lateral to the ... and inferior to the ....

I think this thread has come at an interesting time since it's so early in the semester, realistically my advice is that you shouldn't be focusing on preparing for exams at present but rather focusing on trying to understand the content. Being able to pass the exams will come with understanding the content, not with memorization alone ... but often getting HD's won't come without memorizing some content.
 

frootloop

Doctor
Moderator
Ok, so med school finals are pretty broad, and I'm hopeless at sticking to specific timetables of which topics I'm going to study and when.

I've passed ELM and every run in ALM (bar the two remaining ones) without too much trouble. So the underlying assumption of this study method is that I do actually know most of the basics. I may need a few quick refreshers on some of the stuff I haven't seen in a while, but I know what those things are. By and large I'm taking the uncharacteristically optimistic stance that I'm competent enough that cramming the basics would be an inefficient use of the ~1.5 months I have left.

So what I'm doing is question banks (like passmedicine, BMJ OnExamination, and a bunch of books). The questions I get right are obviously things I know, and don't need more time spent on them. The questions I get wrong, or I'm unsure of/get right by guessing, are either subjects my knowledge is lacking in, or details I'd forgotten.

If I decide something is simply a detail I've overlooked/forgotten, I add it to my notes and attempt to commit it to memory with everything else. I usually quickly go through the relevant section of USMLE Step 2 First Aid as well.

If I decide my knowledge on that particular topic is lacking, I write it up more or less as though I'm explaining it to a patient (obviously with a bit of extra colour). For example:
1) What is the disease? (Pathophys, symptoms/signs, effects on life)
2) What causes it/'why did I get it'? (risk factors, epidemiology, preventative measures)
3) What tests are involved in diagnosing it? What else could it be?
4) What treatment options are available/how is the disease managed?
5) What is the prognosis?
6) Other stuff like follow-up, any other details specific to the disease which don't fit under that rough framework.

Then I say that out loud in an OSCE voice a few times, until I'm confident that I could not only answer MCQs/SAQs on the topic, but take a good history for it and explain various aspects of it in a patient education OSCE.


Overall, I figure if my basic knowledge base is insufficient (which I'm pretty confident it isn't), it's a bit late now. So while this method doesn't 'cover everything', nothing will - and it doesn't really need to. I figure this is the most efficient way of identifying and patching gaps in my knowledge base.

Thoughts?
 

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