Study Skills for Medical
Students: Part II
Latha Chandran MD, MPH
Associate Dean, Academic Advising
Interim Chair. Dept of Pediatrics
SUNY at Stony Brook
Features of an MS1
 Intellectual
self doubt
 Workload anxiety
 Competition vs cooperation
 Loss of status!
 Difficulty with authoritarian
hierarchy
 What is the big picture?
Exams
 Each
course has small exams, quizzes,
labs, NBME shelf exams
 USMLE Step I before third year
 USMLE Step II before graduation
 USMLE Step III during residency
 Specialty boards after residency
 and thereafter………………..!
Time Management
 As
a doctor, one needs to do lots of
things!- see patients, teach, learn,
read, leadership roles, community,
exercise, keep friends and family
 Give up the idea that you are a
student
 You are a professional MD in training
 Practice using your time WISELY!
Final goal
 Pass
USMLE Step I II and III
 Pace yourself like a long distance
runner- practice, practice and
practice to build up endurance
 Each hour in class- spend two hours
outside of class
 Take INTERNAL control of your time
 Beware Ns and Ps- mngt by crisis!
Memory curve
 Imaginary
line illustrating the process
of remembering and forgetting
 Try to create an optimal memory
curve- takes practice
 Reinforce and expand your learning
style dimensions IMMEDIATELY
after you learn something new
 Use other sensory modalities to
remember
Memory curve graphic
Long term memory
 Break
it down into small pieces
 DAILY routine of memory
reinforcement
 Guard against procrastination
Common causes of academic
difficulty
 Time
Management issues
• travel, family, friends, other activities
 Material
management issues
• not preparing, no daily reinforcement
• no CONSCIOUS system of study
• no “ own notes”
 Mental
Health issues
• depression, LD, ADD
Tips for optimal learning
 Create
a schedule and follow it
 It is your best friend
 Skim read/ pre read
• generate questions, new terms, charts,
graphs, compare/contrast data
 Attend
lecture
 Sit in the front, away from
distraction, good lighting
Tips for optimal learning
 Analyze
data
 Memorize- see, hear, say, apply,
teach
 Mnemonics for physical objects
courses ( Funny ones)
 Flash cards
 Create your OWN flow charts,
compare/contrast
Tips for optimal learning
 Fit
new material into existing info
 Practice every day the first week of
exposure, use all your senses, and
reinforce
 You will be able to cut down on study
time later for memory brush ups
 Add music to your environment if
auditory
Schedule construction
 When
are you most alert? AM, PM?
 How much sleep do you need?
 Do you need large blocks of
uninterrupted time for work?
 Do you need a break after 1-1.5
hours?
 How long a break, what to do then?
 When do you study alone? With
others?
More tips
 Stay
with one topic for at least 1.5
hours
 Work with related material
 Intersperse difficult subjects with
easy ones
 Use your highest energy time for the
most difficult subject
 Volunteer to teach in your group this
topic
Learning environment
 Music/
food/ pleasant views
 Vary sensory use- the more sensory
input the more sustained memory
 Visual- different colors/ shapes/
sketches, spatial models, slant of
writing
 Kinetic- use LARGE paper/chalk
board
Time Accountability
 Time
log for sensors
• Use a 15 mt block daily calendar
• pay attention to your natural rhythms
 Time
pie- weekly pattern of time use
for Ns and Ps- like chunks of time
 Using both is IDEAL for both groups
 First create a personal time pie
Study sandwich
 Put
in the difficult subject between
two slices of easy ones
 Do not fall behind- if you do, catch up
on the weekend
 Work on the most current material
first
 To kill time is to murder your chances
for success
Taking notes
 Ear
to hand
 One sided; Leave other side of page
for text book notes, study group
notes-differ color
 Leave large margins for LABELING
More on taking notes
 If
unclear, leave gaps
 Fill in spaces/ blanks after talking to
another reliable note taker ( use
different color, need extra attention)
 This is YOUR permanent record
 Have a reliable note taking partner
each your colleagues
Concept Mapping
Learning syndromes and their
management
 Reference:
Robert Burns, Medical
Teacher Vol 28, No 3, 2006, pp 230233
 Nine syndromes
 Peculiar predilection to affect early
medical students
 Management
Six chambered heart syndrome
 Excessive
analysis of test questions
 How many chambers does the heart
have?
 Are the two auricles chambers? If so
six is the right answer
 REMEDY: Come up with the answer
WITHOUT looking at the options
Slip and Slide syndrome
 Studying
for the exam that is most
imminent to the exclusion of the
other concurrent subjects
 Very common
 Fosters cramming and memorization
versus actual learning
 REMEDY: Make a contract to study
each course’s stuff THE DAY you
encounter it- not LATER!
Slip and slide syndrome experiment
 University
of Arkansas- Three
courses running simultaneously
 Every third Monday – two exams, and
every third Tuesday- one exam
 Courses rotated as to which exam
came first
 Did the students like it?
Slip and slide experiment
 Results:
• Students did better than predicted in all
three courses!
 Why?
• Never allowed to slip and slide
 KEEP
UP should be your mantra
Oh Yeah syndrome
I
have seen this before
 So I don’t have to pay attention
 Depth of understanding required by
medical school faculty very different
 Oh Yeah turns into Oh No at the time
of the exam!
 REMEDY: Be aware, pay attention to
the detail and the focus
Too many books syndrome
 Buying
lots of books will NOT
translate into learning
 REMEDY: Buy only the required
course materials and USE them well
Post Genius syndrome
 Prior
outstanding academic record
 Now receiving a C for the first time
 Bell shaped distribution for grades
 REMEDY: C in a med school course is
an acceptable place to start from
Irrelevant material syndrome
 “I
will never need to use this when I
become a physician- so why do I need
to learn this?”
 Very common
 REMEDY: Crucial to understanding
clinical relevance
 Also understand principles of life long
learning
Alternate Syndrome
I
was on the waiting list, so I can’t be
as good as the others
 Motivation is key
 27th alternate admitted as the
bottom most rank in the class- ended
up graduating first in class in four
years
 REMEDY: know that the playing
ground is level when you start
Old Test Question Syndrome
Variant of the Oh Yeah syndrome
 Slight rewording of the stem results in a
different answer being correct
 Failure to detect the change in the stem
results in incorrect answers
 Eg: Masson- trichrome stained section of
tongue: Identify the organ, identify the
blue staining material, identify the germ
layer of origin of the surface epithelium
 70% error rate!

MEUL syndrome
 Memorize
Everything- Understand
Little
 Very common and very problematic
 If you got away with rote
memorization in college, you can’t now
with soooooo much material!
 REMEDY: verify understanding after
each major concept
MEUL syndrome treatment
Divide content into “bite sized pieces”
 After each bite ( max 30 mts) use the split
brain study method, where the other half
of the brain poses questions and challenges
to your understanding- see if you have
TRULY understood what is going on
 Delayed ignition study method- in the car,
understand it before you turn on the
engine

• Brief and Intense
General counsel
 Get
ahead and stay ahead
• Prereading and reading the SAME day
• Mental participation during lecture
– Core content guessing
– Active listening