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"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
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
July 2013 Issue of IMpact
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