The first chunk of medical school is over, which does indeed bring with it tons of reflection on tons of different things. These 2 years have been a busy, busy and I’ve learnt an awful lot, and not just in terms of academics, but also about myself. If you read one of the posts I wrote about halfway through my first year here, in which I wrote about things you might not know about medical school you may remember a mention about changing study techniques many times. And guess what, this post is a zoomed in closer consideration of that. In other words, I thought it’d be fun to go through my journey of finding new ways to study and learn throughout the years…
The very beginning
I didn’t go into medical school with a lot of plans, I didn’t plan how I was going to study or buy any stationery. (When I say this you can think of it as an extreme; the only pens I had at uni at the beginning were the free ones everyone throws at you in fresher’s week!) We have training PBL cases here at Manchester, 2 of them to get us started. For the first case we just read through it and practised picking our cues and creating a learning agenda; for the second case we went a step further and attended a few lectures and answered the questions in the learning agenda. This was really helpful for me as it started getting me thinking about how I’d like to work and kickstarted the process of exploring learning techniques.
Right from the beginning, for training case 2 I tried typing up my PBL notes. I typed up the questions in Comic Sans and used the online resources provided by the university to try and answer them as best as I could. I used 2 accent colours for the case (pink and green it was). For the case lectures, I just went and sat and listened – I really can’t remember trying to make any notes (I don’t know what I was thinking!) After the lectures I remember going to the library, struggling to find a seat and trying to decipher the lecture to type some of what was mentioned up in my PBL notes.
This week we also had an introductory anatomy session where we were told to prepare by learning the planes and other anatomical, which I did with a friend. I remember how mind boggling I found simple anatomical terminology. Words such as anterior, posterior, medial, lateral, proximal, distal which I wasn’t used to using on a day-to-day basis. But like we were told, these become second nature in no time.
Still right at the beginning but now we’re out of the 2 weeks of “training cases” so we start to get more of an idea of what this first semester would entail. A recommended reading list was mentioned to us so I went to check it out to find a page with an endless scroll of textbooks. I decided pretty early to ignore that seeing as I couldn’t see myself reading through all those 50+ textbooks anyway and I certainly wouldn’t be able to afford all of them.
I did go to the library though and blindly take out a pile of books that had a mention of any words that seemed remotely familiar to me. Anything that said Anatomy, Physiology, or any mention of reproduction (as semester 1 is on “life cycle”). Me and my flat mate went together and loaned about 20 huge thick textbooks that we dragged out of the library and waited at the bus stop to take back home with us. Needless to say, we didn’t open a single textbook for the whole time they sat on our bookshelf to gather dust. Before the summer holidays after first year, we dragged all the unopened books and returned them and never looked back.
I did speak to a then 2nd year student about textbooks and which ones to get pretty early on and she told me that you don’t really need textbooks for Medicine and it’s certainly not necessary unlike other courses where the recommended reading is practically compulsory. She said you can get everything you need from the internet and the only textbook she’s used is Moore and Daley’s Clinical Anatomy (which is one that’s freely provided as an eBook by the university). It from this day onwards that I held on to my “no textbooks” mantra and what a relief it was.
I used the Internet, YouTube videos and resources given by the university to find all the information needed for my PBL cases and it all worked out. Hand on heart, you don’t need textbooks. There are so many incredible free online resources and reliable websites out there and I’m just so glad I exist in the internet era, I cannot imagine trying to learn anatomy or understand physiology without the use of videos. I’ve linked some of my favourite YouTube channels for medical school here for anyone interested.
For Anatomy, I initially started by trying to make notes using Moore’s and Snell’s (I had a free eBook). I actually started by trying to handwrite my Anatomy notes and now that I look back on it I cannot believe how crazy that was. We have to know a huge amount of anatomy, I’d say that makes up the greatest bulk of work we have in a week: I can barely just about type it up never mind write it up using lots of fancy pens and colours.
I soon switched to just typing them, but I did make flashcards so I was still handwriting something. I just felt as though for Anatomy the physicality of drawing a diagram or writing out the weird muscle names with a pen helped to remember them.
I also started accumulating quite a collection of flashcards so I found some cute A6 popper wallets that I used to store them all, topic by topic.
I typed my PBL notes, but for lectures I’d print out the handouts and annotate around them. I considered taking a device with me to type up notes during the lecture, but then I decided the effort of physically writing would help me to stay more focussed and prevent zoning out. I did manage to concentrate in lectures, but I often fell behind on them because physically writing things up by hand is sloooowww. Here’s the big arch lever file I stored all my lecture slides in, using dividers for each case.
I also handwrote myself a couple of pages to summarise each PBL case. I used the 2 colours that used for the case to create the summary because colour association works for my memory! I just thought I’d find it so much easier to learn from a physical sheet of paper (which I’d been used to doing all my school life before then) rather than a laptop screen.
Not a lot changed between semester 1 and 2. At some point along the way I discovered TeachMeAnatomy which has 100% been a lifesaver. My anatomy notes are practically derived from there. The diagrams are so useful and it breaks things down in simple easy-to-understand language which I can’t say the same for any textbook. Here’s a little peek into me working on some anatomy notes.
I continued to use flashcards for anatomy, but for some topics with lots of vessels I decided to draw out a detailed diagram. It’s quite hard to learn blood vessels and their branches sometimes, especially when there are lots of branches such as with the aorta so drawing this out numerous times to make it all neat and perfect certainly helped with embedding it in my head.
For anatomy revision I also created a lot of colourful, but messy diagrams. I think that’s when I started to truly understand that visualisation is the only real why to learn anatomy.
PBL continued in the same way for me: typed up notes, handwritten summaries. About halfway through the semester I realised I could no longer keep up with taking handouts to lectures and I started taking my laptop in and making notes under the powerpoint slides, I did fall quite behind with my summaries in semester 2 though as near the end the PBL cases because quite long so I have to put my hands up and admit that for the last few cases my summaries are still not complete. Here’s me working on the summary for the Asthma case in the learning commons, followed by a look at the complete summary page.
For PBL we’re always encouraged to bring in a summary page to our closing case session rather than print out the whole set of notes. This is supposed to encourage us to commit some of it to memory and prevent just reading paragraphs off during the discussion. In semester 2 I tried doing that and I have to say it does help you get an overall grasp of the case as you’ll have just reviewed it before the session. These summaries were very brief and not very neat as I only needed them to jog my thoughts during the session.
Each of our PBL cases are focussed around a central pathology, so I also started summarising each of those pathologies.
Semester 3 & 4
My learning methods didn’t really change through year 2 so I’ll just talk about both semesters together. The way I did PBL didn’t change but the cases got a lot longer so I don’t think I ever had a chance to summarise the case before the closing case session. Instead, I’d print out bits of my 60+ page case and take that in to the session with me.
The cases were so long that I could no longer do my page summaries on a case so instead I split each case into further subtopics (often based on the PBL questions). I’d then use those to create a handwritten summary of a particular area. I did this during the revison time we had at the end of the semester, I had absolutely no time during the PBL weeks. For semester 4, even during the revision time I was not able to do this.
I’m saying the PBL content increased, which it did, but the Anatomy content multiplied several-fold! Year 2 was very Anatomy-heavy and it certainly was difficult to make sure I had gone through a tooic before attending the anatomy sessions every week. The flashcards I used to make last year went out of the window pretty early on. I was still making the typed notes and just about getting those finished and did not have time to condense that into flashcards. The only thing I made flashcards for was the muscles, so in year 2 that was the leg muscles, facial, tongue, neck, eye, palate, ear, abdomen. I like to have muscles on flashcards as you can easily list the origins, insertions, actions and innervations and learn it with a structure.
The rest of anatomy did not have any flashcards made for them and to be honest it was difficult to learn it without using flashcards as I couldn’t test myself or check that I was actually learning it. Hence why at the end of semester 4 I went ahead and made some flashcards for some of the remaining anatomy, but this time on quizlet as opposed to on paper – that saved a lot of time and essentially served the same purpose as the physical flashcards I had.
For Anatomy, I also made some diagramtic summary pages (not too neat, but not too messy either) as I was trying to get more of that visualisation in. A couple of colours, a brief outline of the struture the topic was about and then I added all the key points surrounding that topic/structure as annotations. This helped me get my head round the Anatomy especially because semester 3 was about the internal structure of the brain which is quite abstract and difficult to picture. So instead of having a complex sentence just sat in my notes, I tried to draw something out to break down any complexity – I wasn’t too bothered about the diagrams being strictly anatomically accurate, but concerned with having it down on paper in a way that I could understand it.
And along with my attempt to visualise structures more, I found myself turning to an app I downloaded at the beginning of 1st year but always seemed to forget about so never actually used. The app is called Visible Body and defintely recommend it. It did make the whole head and neck area more visible as those parts of the body aren’t as accessible as say the arm which you can run your fingers over to trace a blood vessel for example.
I’m talking a whole lot about Anatomy because year 2 was a LOT of Anatomy and because of that I had to find new ways to juggle it all and learn it all. My anatomy learning methods changed and so did my approach to lectures. From about halfway through second year I’d miss the odd lecture and listen to the podcast in my own time. I’d often have a look at the lecture slides in advance to determine how complex a particular lecture was going to be so I could decide whether I think I’d be able to keep up with making notes or whether I felt I’d have to come and re-listen to the podacst after the lecture. If I thought I’d neec to listen to the podcast I tended to stay home and just listen to teh podcast so I could do it in my own time and would only have to hear the lecture once. Since I switched to typing in lectures I have to admit concentrating was a bit more difficult and I’d often find myself zoning out or just typing every sentence I heard without actually understanding what was being said. By the end of the year I had completely stopped going to any lectures at all.
So that’s about it, how I studied over the past 2 years. Not a lot different to A-levels with all the summarising and making notes. I did not used to do anything digitally for A-levels either so that’s a bit different, but I’d say the biggest change was use of flashcards because I did not do that for A-levels at all. We also had PEP (research assignment) in both years 1 and 2 and I also approached that differntly over teh 2 years, but more about that in a future post.
I think as I start my clinical years a lot more will change and I’ll have to re-learn how to learn all over again…