Do:

. . . change your study habits.  You don’t have to be a genius to graduate with an MD but you do have to learn how to study smartly.  First this means forgetting the principle of learning everything.  There is simply too much and you will most certainly bog down and become demoralized if you start down that path.  Yes, you will not have the warm fuzzy feeling in your tummy when you walk into exams that connotes that there is nothing “they” can throw at you that you can’t handle.  However,  let’s face it, life is not like that and medical life is certainly not like that.  At best, after four years you will know enough to graduate but you will not know everything.  You will simply know what you don’t know, what to look up and where to do the looking up when patients present you with their problems.  That is the hallmark of a good doctor.

 . . . plan on a “steady as she goes” study regimen and then stick to it.  If you have traditionally been a “crammer” then this will feel very alien to you and it will be very tempting to drop off your schedule.  Don’t give in to temptation!  A methodical routine every day will serve you best and avoid “hair-tearing” as exams draw near. 

 . . . think carefully about how you learn best.  Some gifted students literally do seem to “suck it up off the page” but they are not the majority.  There is a lot of rote learning to do and this may be quite different from the logical kind of problem-solving that you have come to expect in pre-medicine courses.  During the first half of year one, let’s say till Christmas, plan to try out a variety of techniques to get facts from the pages and lectures into your long-term memory.  For some it involves Socratic style study groups, where the enthusiastic exchange of facts seems to stimulate the “little grey cells,” for others learning is best served up as a solitary activity that involves actively working with the material to be learned.  By “working with” the material, don’t assume that this means underlining with high-lighter (unless you love the magical arts of self-delusion).   Rather, think of it as something more rigorous that you can do with the facts you must learn.  Perhaps you might want to make a habit of boiling down each page or chapter into ten “earth-shaking” words, or perhaps the topic leads itself to some pictorial or graphical representation or mnemonic  that, once created, will forever after pop into your mind whenever the topic comes up.  Once you’ve attached the twelve cranial nerves to the line “Old Olympus Towering Tops, A Finn And German Viewed Some Hops,” how can you ever forget such deathless prose?  For those of you who are not particularly creative, there are many websites which have collected medical students’ mnemonics and offer them up for you to use, gratis; just search on “medical mnemonics.” 

. . . be kind to yourself when you study.  There are no prizes at graduation for the student who studies to the point of exhaustion for four years, depriving him or herself of all joy and relaxation.  Besides, you can’t learn without regular breaks and if you think you are the exception to that rule you are again back to practising the black art of self-delusion.  First, block out your study time.  Then plan to study no more than one hour at a time.  (This will vary and you will have to experiment a little.)  At the end of your study hour, take a break for about half an hour.  Wasteful?  Not at all.  You will study more efficiently if you know you have a limited time to get the material learned and that you have something different to look forward to in a short time.  That break can be just about anything as long as it is completely different from studying.  While it could be watching your favourite program on TV or talking to your boyfriend on the phone, it could also be washing your hair or biking around the block or scrubbing that annoying ring off your bathtub.  You would be surprised how much better you work if you build in a “reward.”  Remember, a treat for a job well done doesn’t just work for training dogs!

The principle also works when you want to take an evening off to go to the movies, or a car rally or play hockey.  Just remember that these nights off are exceptions not the routine way to spend your time.  Remind yourself that you have to earn them and that means focussing on your planned studies in advance of the “event” so you can truly feel justified as you “lace up” at the rink.

Don’t:

. . . hold on to the competitiveness t hat may have insinuated itself into your thinking and behaviour as you struggled to get into medicine.  Medicine is a collegial profession and the more you give up of yourself and your talents to others, the more you will get in return.  This altruism will stand you in good stead, not just in medical school, but in your medical life.  If your are living a life that seems to be “every person for him/her self” then you are doomed to feel less and less satisfied with your medical career.  If you see your fellow students struggling, take it as an opportunity to reach out and listen, maybe to help.  Getting the residency of choice and later the appointment of choice will depend primarily on how well you conduct yourself medically and personally on a day-to-day basis.  You won’t reach your career goals by stepping over the bodies of your friends and colleagues in your focussed march to the top.

 . . . let the concept seep into your thinking that because you are smart, and because you got into medical school and because you work hard and make personal sacrifices, that you “deserve” to be treated as special by the rest of the “mere mortals” who exist in the world.  One of the most consistent complaints of medical students and residents is that they behave arrogantly with other members of the health care team and even with patients.  If you catch yourself talking down to your colleagues or thinking cynically about patients (remember House of God?) then it is time to check to see where your feet are.  Chances are that you are hovering at least a few feet off the ground in a beatific attitude.  People who hover are doomed to fall.  Remember that truth.

Jim Silcox, Professor Emeritus, Department of Obstetrics and Gynaecology, University of Western Ontario, and 3M National Teaching Fellow.

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