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Lessons Learned From First Year

JeffglassesJeff Wonoprabowo -- I'm sitting here in my room on the island of Kauai. It's the week before classes resume and my second year begins. Coincidentally, I've met two of my classmates on Kauai within two days of arriving on the island.

Being this close to the start of a new school year, I can't help but remember the feelings I felt before starting first year. I also can't help but think about what I've learned during the first school year.

My cousin, who is now an OB/GYN, told me to just study like I did in college. Unfortunately for me, I hardly studied at all in college. I was in an undergraduate program that was heavily math-based. I used to cram and be alright for tests because all I needed to know were theorems and/or concepts. The rest could be figured out or derived during an exam. Medical school was a big shift for me because now the majority of my studying consists of rote memorization.

So, from the perspective of someone who has had his share of first-year struggles, here are some of the lessons I learned from first year.

1. Figure out your learning style and figure it out fast. This one seems like it'd be common sense. But sometimes students find out that their way of studying isn't working and instead of changing their approach, they go at it harder. Personally, I felt that going to lectures helped me. But I know many of my classmates hardly ever showed up. If you thrive in a good group study, seek out some classmates and make a group. If not, then don't be forced into one. However, even lone "study-ers" can benefit from the occasional discussion with classmates.

2. Seek help. Students who make it into medical school are used to being near, if not at, the top of their respective classes. It might be hard to ask for help. If you need help, put aside your pride and ask for it. At my school there are tutors available for the first and second year students. I think that if I had sought out a tutor, I could have had some better scores. Don't wait until it's too late to get help.

3. Make time to do other things. It's really easy to get caught up with studying when the pressure starts piling up. But it's important to remember to make time to do things outside of schoolwork. Volunteer to tutor high school students. Take up a new hobby. Continue an old hobby. Go to the gym. Or even go and volunteer at a free clinic so you can get patient interaction. Don't let studying define who you are.

4. Study hard. Push yourself -- at least through the first semester. Then, you can decide how much you can afford to pull back while still attaining acceptable (in your eyes) scores. It's easier to "ease off the throttle" because you're studying more than you need to, than to "floor the pedal" trying to catch up at the end of the school year.

5. Finally, visualize. Remember the reason you wanted to go into medicine. Don't forget it. Then, picture yourself done with medical school and residency, and practicing medicine. Aim for that goal. Try not to let the stuff in between -- the grueling hours of studying in medical school or running around in residency -- get you down. They might be necessary parts of the journey, but they sure aren't the destinations.

Good luck!

September 3, 2008 in Jeff Wonoprabowo | Permalink

Comments

I just completed my third year and it was only on this leg of the journey that I finally come to many of these realizations. I only wish there had been someone to have explained all this earlier on. But on the upside, now that you know, you're in a position to make things easier for those who come after. Big ups on a great post.

Posted by: Bhaijan | Sep 9, 2008 3:03:48 PM

Sorry to say, but with all due respect, this is the kind of BS I listened to and failed my first year because of. I am now repeating my first year and doing well thanks to my school being understanding and giving me a second chance. It's not about any of the above. It's not about figuring out your "learning style;" if you've gotten this far, then you already know how you prefer to learn. It's not about seeking help; most of your classmates, if not all, don't care. They are just trying to make it, themselves. It's also not about studying hard. Slow and steady wins the race, no matter what your "learning style." It IS about studying smart. Here are some better tips.

1. Study a little each day. Even if it's just a half hour, study SOMETHING each day. If you stay on top of things, you'll be amazed at how much free time you have. If you don't, you'll wonder how anyone can possibly do it. Believe me, I've been in both situations.

2. No matter what ANYONE tells you, first year is about memorizing and regurgitating. It's not about understanding or expanding your knowledge like undergrad and grad school are, it's just a great big vocabulary lesson.

3. Your professors are there to make every subject more complicated than they are. They do this very, very, very, very, very, very, very well. They will give you all kinds of extraneous information and minutia, and totally cloud the big picture. Do not, I repeat, do not help them by making it more complicated than it is when you study. Your job is to figure out what really matters and memorize it. Your job is to teach yourself and find the big picture.

4. No matter what classes your school throws at you during the first year, the top priority are the anatomy disciplines. They will take 95% of your time, and they will be the reason for the torticollis you are suffering at the end of the year.

5. You cannot possibly memorize the enormous volume of information that is thrown at you. Figure out what you need to know, and what you don't need to know. Research on memory has shown that memory is a reconstructive process. Figure out how to take in information in small chunks so that you can reconstruct it later. Get with other people and practice quizzing each other. This will teach you to think in this way.

Posted by: Justin | Sep 9, 2008 3:04:23 PM

I forgot to mention regarding getting help:

It's not about seeking help from professors, either. Most of your professors at this point are PhDs. They don't understand what you are going through, and they also don't understand why you aren't able to understand things after one lecture on a level that it took them seven years of grad school to grasp.

Posted by: Justin | Sep 9, 2008 3:07:57 PM

I'm sorry that you disagreed and think my post is a bunch of BS. I guess you provide the other side of the coin.

In my experience, people in my class have been very willing to help each other out. Sorry about your experience. And at Loma Linda, the professors loved it when you came in for help and were helpful. All the professors I've talked to have not had the problem of forgetting how it is to be a student. And if one needs help, the school of medicine matches you up with tutors. So maybe Loma Linda paints a nicer picture. Thanks for opening my eyes to the way it is in other schools.

Also, I disagree that anyone who has made it this far (into medical school) knows how to study. I didn't. I hardly ever studied in undergrad -- and when I did I crammed (this is in my post if you read it). That's why I had to radically change my own study habits.

Finally, you make very good points with your #s 4 and 5. Both of those are very useful tips for first years -- and second years alike.

Jeff

Posted by: Jeff W | Sep 9, 2008 4:15:33 PM

I wrote that my professors haven't forgotten about how it is to be a student.

If I could clarify: Our professors, many of whom are PhDs instead of MDs seem to understand that they are not teaching students in a PhD program when the lecture to us. They understand they are teaching future CLINICIANS.

I often heard a professor saying that if we were his PhD students we'd have to memorize this and that.. but since we were medical students.. we wouldn't have to go into that detail.

Posted by: Jeff W | Sep 9, 2008 4:21:32 PM

actually, reading both sides of the coin was very comforting for me...as i am a third year student and beginning my clerkships i have this back log of frustration about not getting some things and i dont know why it alw seems like the the stuff u didnt memorize is what u get asked! i think its a cosmic joke.

seriouslly, thanks guys.

Posted by: cc Sharma | Sep 9, 2008 10:36:57 PM

i always inspired by this kind of information but in the end i just forgot everything when i really have to face all the stress. i'm a 4th year student now and i'm still not sure whether i had my learning style right since clinical and preclinical are totally different world for me. i was too blur when i started my 3rd year and things only make sense now thanks to clinicians who repeatedly keep teaching us the same thing and reminds us to know the basic stuff so that we could graduate and be a doctor.

oh yea, my professors back then when i was in my 1st and 2nd year are so nice also and they always trying hard to make things easy for us.i wish i studied better in my preclinical years but life has to go on. good luck to all!

Posted by: rae | Sep 10, 2008 9:18:16 AM

i always inspired by this kind of information but in the end i just forgot everything when i really have to face all the stress. i'm a 4th year student now and i'm still not sure whether i had my learning style right since clinical and preclinical are totally different world for me. i was too blur when i started my 3rd year and things only make sense now thanks to clinicians who repeatedly keep teaching us the same thing and reminds us to know the basic stuff so that we could graduate and be a doctor.

oh yea, my professors back then when i was in my 1st and 2nd year are so nice also and they always trying hard to make things easy for us.i wish i studied better in my preclinical years but life has to go on. good luck to all!

Posted by: rae | Sep 10, 2008 9:22:17 AM

I'm Afriad i tend to agree with Justin a little more than Jeff.

Even in the British system, which i'm under here in Australia, the preclinical teaching is remarkably poorly handled by PhD's in a disparate call-in system. The result of this discord is that nobody knows what is going on and the avenues for help are scant.

Furthermore, the material taught is often poorly selected as the MD's do not design the theoretical curriculum.

This means that you need to study in order to pass exams which is something you need to be used to. It's a total state of being switched on. Put your life aside, if necessary, to get through the psychological torture because the point is that it will not last forever and you will eventually be free.

Reach for support from counsellors and parents-people who have a professional or vested interest in you.

Medical Students are by their nature anti-social so prepare not to be able to rely on them. I've been a medical student for 3 years now and I can tell you that I have had no problem settling back into the human race after the stress of my first few years; just got to get through.

Well done on an excellent post.

Posted by: Grant Ross | Sep 10, 2008 9:55:24 AM

As an addendum may i agree with the following point:

5. You cannot possibly memorize the enormous volume of information that is thrown at you. Figure out what you need to know, and what you don't need to know. Research on memory has shown that memory is a reconstructive process. Figure out how to take in information in small chunks so that you can reconstruct it later. Get with other people and practice quizzing each other. This will teach you to think in this way.

This is soo important in an age where funding grants are based on esoteric minutiae that promise drug sales to the companies. Just because thiozoladine looks hot in your undergraduate does not mean that anybody cares in the hospital. My experience is that you have to trivialise what is taught to you because you cannot possibly know all of it. I have a B Med Sci course up my sleeve and i don't remember any of it.

Really agree with the anatomy thing. My opinion is that you have to visualise yourself in front of the patient and think about the fact that one day, it will just be you and them. If the stuff you're learning does not help you help them; you are learning the wrong game. And sorry,but learning another cytokine or enzyme in a biochemical pathway won't help the patient-it either works or the patient would have died in utero. Smart ppl ought to know that by now.

Posted by: Grant Ross | Sep 10, 2008 9:58:32 AM

I'm so inspired & motivated with the useful tips that you've recommended to me as I'm now a 1st Year medical student in Malaysia...thank you so much for your fruitful opinions & recommendations...hope it'll be a boost for other medical students to improve their leaning styles in medicine....thank you...

Posted by: Putri | Sep 10, 2008 10:27:48 AM

I'm a new med rookie from Nigeria and the trick is just to be constistent with d books. That way u have time for other things and med skool wont be a bore

Posted by: olutoyosi omotoso | Sep 10, 2008 10:42:45 AM

In my oppinion the initial shock you get as soon as you enter medschool is necessary. I don't believe someone can consistently explain how the first year should be taken or give tips to freshmen that they can consider reasonable. The same way I believe people learn much more from what they live and experience than from what others tell them or what they read.
Medschool isn't like any other thing you've experienced before. It makes people change a lot on its course of happenings. It has a power of renewing and at the same time brings you maturity. Only experience can tell precisely what it is like.

Posted by: bandaid | Sep 10, 2008 12:06:00 PM

Sorry, Jeff, I didn't mean to offend, but I knew it would anyway. It's hard to contradict someone without doing so. I just had to put out there how it really is, from someone who is living it for the second time around. The statements you made are really just a repetition of the feel-good popular myths that are floating around every university.

For the record, the professors and fellow students here are nice and helpful, too, but don't really know how to help. The professors are certainly empathetic and remember what it felt like to be a student, but they forget how challenging it can be to learn the relatively simple stuff that they go to great lengths to overcomplicate. Everyone is told that their school is special, and that their professors and students are more friendly and helpful. My school has tutors and everything, too. Really, comparing schools is not helpful and only shows that you are quite beholden to the dog and pony shows that they put on for all of us, and simultaneously totally missing the point. I hope I am wrong about that, but ostensibly, that is what is going on with your comments. Even if it is, I was your age once, and I was probably more naive at the time, so please don't feel that I am putting you down.

You can take what I say or leave it, I don't care. I just have a pretty good perspective, having been a graduate student in biology before coming here, and having a degree in psychology adds to my understanding of the situation.

Also, I would point out that you shouldn't feel so unique that you didn't study much or at all in undergrad. That is the norm for people in med school. Few people in medical school really did any studying. Heck, I didn't even take notes all through two undergrad degrees and all of the classes for the master's degree that I'm working on. That doesn't mean I don't know my learning style. If you don't know your learning style, then you must have got into med school accidentally.

Posted by: Justin | Sep 10, 2008 12:26:10 PM

Totally agree that the first year is about developing a learning style that suits, at the expense of anything else suggested. Good article Jeff.

Posted by: Mark | Sep 10, 2008 1:16:59 PM

Thank you so much I've actually started my first week of 1st year med and it is already getting to me. But your information is very accurate and useful.

Posted by: Ola Ahmed | Sep 10, 2008 2:06:02 PM

I totally agree with Grant Ross , being a part of similar British system of medicine. Pre clinical teaching is very poorly handled and there is hardly any help. And even if there is , one dosent know what help he actually needs.
I also agree with Justin, In the first year of medical school you CANNOT know how to study. Its like entering into a new frame altogether. All one cares about is somehow to pass and move to the next level.
How I wish we had someone to guide us in the first place, rightly. I feel that as first year you are like a bunch of cattled that blindly follow the rearer.
According to me the best way (after experience) to deal with the first year is to find a GOOD study partner , who's wavelength matches yours and pull your way through understanding stuff well as the first year marks the foundation of or your medical career. Pull out reference books and try and relate to everything. Medicine is not about memorizing but there is a logic and a reason to most of the things and why they are. Try and integrate Anatomy, Physiology and Biochemistry and then first year can become a little more interesting.

Posted by: Leena Jalota | Sep 10, 2008 3:45:02 PM

Justin,

No need to apologize. You’re entitled to your opinions. The great thing about this forum is that we can share and exchange ideas and experiences. And all of us blog to share our own personal experiences.

Again, I did agree with most of your points. Thank you for adding them to the discussion. As I said in my previous post, they are helpful to both first and second year students.

However, how does one go about studying efficiently (even if it is “just a half hour”) and teaching one’s self and finding the big picture?

For me, I had to figure out my learning style first. I think the way I did it in undergrad was good enough to get me through my degree. But it definitely wasn’t good enough for medical school. You can’t study smart unless you first know how you learn (efficiently). That’s why I ended up requesting a leave-of-absence and starting over the following year. I just couldn’t hack it the first time through. Had I stayed for the whole year, I am certain I would have a “fail” on my transcript instead of a “withdraw incomplete.”

You seem to believe that anyone who has made it into medical school should know their learning style. That’s a good theory. I wish it were true. But it wasn’t for me. That’s why I performed horribly during my first quarter. So maybe I did get into medical school accidentally.

The tips I wrote about in my post are tips I wish I had followed. Had I followed them earnestly, I’d like to think I would’ve figured things out quickly enough to be graduating in 2010 instead of 2011. If I had followed my tips, I would’ve been able to actually use the excellent points you brought up.

We apparently have different experiences with asking professors and classmates for help. But you don’t want to compare schools. But I brought up my experience with professors only because of your comment saying that “the professors are there to make every subject more complicated than they are. They do this very, very, very, very, very, very, very well.” I think readers, especially pre-meds, would like to hear both sides. I’m sure you have professors at your school who are excellent at distilling important clinical information and I have some that are horrible at it. Do I think all my professors are excellent lectures? Absolutely not. And that’s why I selectively attend my lectures.

I’ll accept that I’m young and naïve. And until I age and wise-up to the world, I’ll continue to take what those who have gone before me have to offer.

Posted by: Jeff W | Sep 10, 2008 4:43:51 PM

Great blog!
Organise, Summarise and Revise my friends!

Posted by: VR1J | Sep 10, 2008 7:13:49 PM

Both Justin and Jeff have good points, depending on how they experienced med school and what works for them. I, for example, didn't have much problem understanding but had a hard time memorizing stuff.

As with professors and students helping out, I find some students more helpful that professors. Students tend to be more sympathetic as compared to professors. Most professors, and this is based on my experience, tend to act superior over their students. It sometimes can be a good thing because you learn to be independent and find out for yourself. However, they should also guide you in lessons. Rare are those professors who would impart knowledge to you freely and voluntarily. I would sometimes think that professors who don't help are just full of themselves or do not know what they are talking about.

Anyway, great info for students in the medical profession!

Posted by: Pam | Sep 10, 2008 8:09:45 PM

i totally agree that one has to, acquire study skill in his or her 1st year in medical school. it is way too deifferent the way we use to study at high school or junior level.

Posted by: sikelela | Sep 10, 2008 8:32:59 PM

Im a graduate of accounting course, I was to go on a law school but unfortunately i did not pass the entrance instead I pass the Nursing aptitude. That’s how medical course open doors for me, its quite expensive because I earn so little but god is so kind to make life so easily, money just come and go, books are almost all available for me to read but time is so little for me to take a peak on my books.
By the way Im on a special program in nursing, its a 3 years course for degree holder. most of us in the classroom are working students, we work during the day and go to school after office hours. so...dat gives us very little time to study and rest. i am not very fond of science but i simply love to study and read, read, read. With the situation its quite impossible for me to memorize, like we all know that in medical course its more on memorizing. Im on my second year now and Im quite relieve to pass the my theory subjects, what I did is not to memorize but to read, if there’s instances or part where in memorization is deem necessary, I simply read twice or three times to be able to remember.
A little of what i learn in business school also is applicable like time management. since, my books needs a lot more attention, i manage my time to work, go to school, read between breaks, and do whatever my body calls. It is important also to pay attention to what your body calls for, like for instead my body calls for a long sleep, good food, and good music or sometimes companion to sit awhile and talk anything under sun, anything...for me its kind of a gift to myself after long hours of hard work. And after giving sometimes for myself i have all the energy again to go back to my daily routine.
Im done with theories and now what im trying to overcome is, to be healthy as i go along for completion of my cases for PRC. During my first college years my social life is so active and so much fun. For now, since I have another goal, what I did is to cut almost all the fun and hanging out with friends. Life for me is easy, I just have to put a little of my math subjects. If u do not have a hard time in problem solving your life can be like mine. If there is problem you just have to find solution or if not apply the trial and error or if the outcome is not so likely charge it to experience and go on with whatever you want to do and achieve, life must go on...and along the way it has full of surprises. if its applicable to me it might be to you also...

Posted by: claire misuarez | Sep 10, 2008 8:39:32 PM

Im a graduate of accounting course, I was to go on a law school but unfortunately i did not pass the entrance instead I pass the Nursing aptitude. That’s how medical course open doors for me, its quite expensive because I earn so little but god is so kind to make life so easily, money just come and go, books are almost all available for me to read but time is so little for me to take a peak on my books.
By the way Im on a special program in nursing, its a 3 years course for degree holder. most of us in the classroom are working students, we work during the day and go to school after office hours. so...dat gives us very little time to study and rest. i am not very fond of science but i simply love to study and read, read, read. With the situation its quite impossible for me to memorize, like we all know that in medical course its more on memorizing. Im on my second year now and Im quite relieve to pass the my theory subjects, what I did is not to memorize but to read, if there’s instances or part where in memorization is deem necessary, I simply read twice or three times to be able to remember.
A little of what i learn in business school also is applicable like time management. since, my books needs a lot more attention, i manage my time to work, go to school, read between breaks, and do whatever my body calls. It is important also to pay attention to what your body calls for, like for instead my body calls for a long sleep, good food, and good music or sometimes companion to sit awhile and talk anything under sun, anything...for me its kind of a gift to myself after long hours of hard work. And after giving sometimes for myself i have all the energy again to go back to my daily routine.
Im done with theories and now what im trying to overcome is, to be healthy as i go along for completion of my cases for PRC. During my first college years my social life is so active and so much fun. For now, since I have another goal, what I did is to cut almost all the fun and hanging out with friends. Life for me is easy, I just have to put a little of my math subjects. If u do not have a hard time in problem solving your life can be like mine. If there is problem you just have to find solution or if not apply the trial and error or if the outcome is not so likely charge it to experience and go on with whatever you want to do and achieve, life must go on...and along the way it has full of surprises. if its applicable to me it might be to you also...

Posted by: claire misuarez | Sep 10, 2008 8:40:28 PM

Lessons Learned From First Year
Im a graduate of accounting course, I was to go on a law school but unfortunately i did not pass the entrance instead I pass the Nursing aptitude. That’s how medical course open doors for me, its quite expensive because I earn so little but god is so kind to make life so easily, money just come and go, books are almost all available for me to read but time is so little for me to take a peak on my books.
By the way Im on a special program in nursing, its a 3 years course for degree holder. most of us in the classroom are working students, we work during the day and go to school after office hours. so...dat gives us very little time to study and rest. i am not very fond of science but i simply love to study and read, read, read. With the situation its quite impossible for me to memorize, like we all know that in medical course its more on memorizing. Im on my second year now and Im quite relieve to pass the my theory subjects, what I did is not to memorize but to read, if there’s instances or part where in memorization is deem necessary, I simply read twice or three times to be able to remember.
A little of what i learn in business school also is applicable like time management. since, my books needs a lot more attention, i manage my time to work, go to school, read between breaks, and do whatever my body calls. It is important also to pay attention to what your body calls for, like for instead my body calls for a long sleep, good food, and good music or sometimes companion to sit awhile and talk anything under sun, anything...for me its kind of a gift to myself after long hours of hard work. And after giving sometimes for myself i have all the energy again to go back to my daily routine.
Im done with theories and now what im trying to overcome is, to be healthy as i go along for completion of my cases for PRC. During my first college years my social life is so active and so much fun. For now, since I have another goal, what I did is to cut almost all the fun and hanging out with friends. Life for me is easy, I just have to put a little of my math subjects. If u do not have a hard time in problem solving your life can be like mine. If there is problem you just have to find solution or if not apply the trial and error or if the outcome is not so likely charge it to experience and go on with whatever you want to do and achieve, life must go on...and along the way it has full of surprises. if its applicable to me it might be to you also...


Posted by: claire misuarez | Sep 10, 2008 8:48:34 PM

I feel the comment about haven't been able to figure out your learning style should be rephrased. Since for me before entering medical school i always used to make notes in point form although it worked for me till college, but when i entered medicine i started to see my problem-'There were too many things to remember and know' and every time you learn something new you feel that you know less about the same topic. i know it sounds contradicting but if you really did study medicine you will agree with me. i was then approached by my facilitator she showed me a new way of making notes and revising, although reluctant at first but i gave in and it made all the difference. i started to feel medicine was actually quite fun and exciting. So i think it is better to phrase the sentence as 'haven't been able to figure out your best learning style for that particular field'.

i would like to say what Leena Jalota mentioned in her last sentence is very true. if one were to be able to integrate all of what we have studied from different subjects it not only makes medicine more interesting but also makes it more real and easier to grasp.

i am studying in the UK and believe me the PBL system they used here was something quite new for me. since i only had about only between 0 to 5 hours a week with the professors or lecturers in that particular field. on top of that you don't get to see them most of the time let say after the week of that particular topic. this was particular frustrating but it made me to look up books more and made me more self efficient.

Posted by: phang | Sep 10, 2008 9:23:33 PM

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