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Medical Student Perspective: Memory Mountain: A More Pleasurable Route

“Rote memorization,” an all-too-familiar concept for medical students, has become somewhat of a tradition in medical education. I wonder: Must we all attempt to digest a trees-worth of paper notes to earn the coveted suffix of “MD?” Are we all just victims of hippocampal hazing? All joking aside, mass memorization seems to be a necessary and innate part of medicine, and some medical subject matter simply requires memorization. The knowledge expected of a doctor is vast, and this is a path, though challenging, that we chose to traverse. Is there, however, a path less painful, less arduous?

A seasoned medical student can “cram” in dozens of microorganisms, drugs, and inflammatory mediators right before a block exam. Ask these same, talented students to recall the tested material a month later, and the information will be long gone. This “pack-and-purge” study method works…for a while. Problems start to arise in preparation for BIG exams, like finals or USMLE STEP 1. Poor recall also impacts performance on the wards, during rounds, and when counseling patients. Medical school undeniably requires too much information to simply memorize, and unless a student possesses super-human brain powers, the student faces “out-with-the-old, in-with-the-new” studying.

I must first concede that I am terribly guilty of cramming for tests. In fact, I was quite good at it. As expected, I eventually found myself against a mountain of memorization I could not conquer. I was forced to devise a way around rote memorization. It was the end of my second year, classes had ended, and the time had come to devote 100% of my time and energy to STEP 1 prep. Despite a great review course, question bank, and popular study text, I found myself dancing around the section on microbiology and anti-microbial pharmacology. I felt overwhelmed, incompetent, and panicked. STEP 1 was approaching, globus pharyngis was threatening to cut off my airway, and something drastic had to be done.

I fought off the gut urge to melt into a pile of tears, flashcards, and chocolate and instead decided to make studying fun. As you may know, medical students love colored pens/pencils, even the guys. You will see us in class with our display of brightly colored writing utensils, and you will laugh when you hear someone spill all 100 during lecture. So naturally, I gathered my own arsenal of beautiful pens, took advantage of my love for drawing, and grabbed a stack of paper. I resolved to sketch out everything I needed to learn: the organisms, the symptoms they caused, and even what the antimicrobials reminded me of. Macrolides turned into macaroni, tetracyclines rode 4-wheeled bikes, and Leptospirosis sported a surf board. I was using visual cues, colors, and associations. Big deal you say. This is learning 101, done before, proven, but it did not stop here.

I quickly recognized one of my biggest weaknesses: I take notes but do not review them. So, what to do with all of these semi-embarrassing drawings that I took hours to craft? I thought of taking them to the gym, multitasking on the elliptical. “No, too many distractions.” What about pinning them up around my room? “No, that will throw off the feng shui.” Where will I look at this daily? Bingo: the shower. I slipped my notes into cover sheets, put them in a plastic binder, and mounted the binder above my shower stall. I decided to study a couple pages every time I showered and only when I showered. By sticking to this plan, I never felt guilty about long showers, I smelled great, and I enjoyed studying. On test day, I felt confident. More importantly, I still remember much of my shower studying as a third year student, where you are graded on ward performance and medical recall.

I regret that it took me until late in my second year to change my study habits. I hope you can revive the way you study much earlier. The purpose of this article is not to encourage you to study in the shower, but rather to provoke abstract thinking about studying. Rationing hobbies, shower time, exercise, grocery shopping, etc. seems a bit absurd, but we are all guilty! Instead of denying these basic pleasures, pair a topic you dread with something you enjoy. Bad + good = better than before. Write eye anatomy on the mirror, make up love songs about hormones, read physiology on a hike, teach immunology to your dog, make maps, jokes, whatever. Just make sure you step back and examine who you are as a person, what you enjoy, what you are good at, and what you are not good at. Compile this information and re-create how you will study for your next big exam. Memorization, though necessary, should never be miserable.

Lorraine (Lori) Myers, MS3
Indiana University School of Medicine
Email: lomyers@iupui.edu

Lori Myers

Back to July 2013 Issue of IMpact

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