How I Would Study in Med School (If I Could Start Over)

going to medical school was an amazing unique experience that I never want to do again by the time I graduated medical school there are a lot of things that I wish I had done very differently and they would have made mid School much easier or saved me a lot of time and stress and so let me tell you the mistakes that I made I'll tell you what I did what problems it led to which weren't like that obvious at the time and then what I would do differently or how I managed to change things up

by the time I graduated and hopefully it can save you some of the Str that I went through going through medical school myself for those of you that are new to the channel welcome I'm Dr Justin Sun I'm a learning coach and the head of learning at I can study but in my past life I worked as a junior doctor for a couple of years before deciding that my true passion and Alignment lay with education and educational entrepreneurship and social Enterprise and so that's what I do now so for the last 10 years I have

been helping students from around the world learn to learn more efficiently so let's just jump into it with the first mistake that I made which was that I really over engineered a way of learning that was suited for exams and this was fine in my pre-clinical years and when I entered into my clinical attachments in hospitals uh which for me was in my third year of medical school I actually failed my first run that first one was General medicine or for those of you in North America Internal Medicine which you probably know is like a

major major attachment and this came as a shock to me because I was doing reasonably well in my preclinical examinations so I didn't really expect to bomb so hard in my clinical attachment and the reason was because I was learning in a way that was fine for the exam but it wasn't translating very well to clinical placement and the way that I would need to use that knowledge in real life and so not only could I not really use my knowledge effectively but also I built a system that was really more around shortterm memory like

learn it for this exam and then a month or two later I don't really needed anymore so I wasn't creating strategies that allowed me to build foundational knowledge and carry that through year after year so what ended up happening was that I would probably every single year of not only medicine but also working as a doctor relearn the same things that I had learned and just kept forgetting over and over and over again and so that was probably one of the biggest mistakes that I made was was just overlearning for exams without having more foresight

into how I would need to use that information in the future but another aspect of it was that I wasn't very Discerning about the level of detail that I needed I had a general sense that I needed to learn everything and I was very focused on a lot of very specific details so I would have fragmented discret but like a copious amount of factually accurate technical specific information and detail but when it came to really understanding how everything worked at a big picture level I was very disjointed it was very fragmented so when I started

seeing patients that didn't just have like this disease with this particular symptom cluster and they had atypical presentations of a disease and they were slightly older and they were on this medication and a previous comorbidity and they had this type of surgery and they also have this other disease and they've got this other thing which maybe is diagnosed or maybe not but you don't know cuz the record was from 20 years ago it just became way too confusing because I didn't know how all these different aspects interacted with each other to affect the presentation of

the patient in front of me or the management for them moving forward and I'd look at my scene and they used to be a to like take all these things and just come to these very Nuance really well synthesized management plans and and differential diagnoses for the patients very quickly and it became obvious to me that it wasn't just because they had memorized more than me they fundamentally were able to see the patient and all that information through a different lens like it made sense to them in a way that it just did not make

sense to me that was not about just knowing more facts I never already thought about how you can understand information in a different way through preclinical when I was in preclinical there was a method of understanding a topic that was given to me like this is how you learn antibiotics this is how you learn you know microbiology this is how you learn genetics this is how you learn Anatomy whatever it is and that is the way that I would learn it the way it was given to me is the way that I would learn it

and if it was hard to understand it's just like I guess this is kind of a harder topic I just need to study more more I didn't go out of my way very often to look for a simpler way to put it all together as a proportion of time wasted this probably wasted the most amount of time for me throughout all of medical school which was that I didn't utilize my clinical attachment days very effectively there were a lot of days where I rock up and I wasn't really interested in what was happening during the

ward round I wasn't interested in what was happening during the patience like I didn't really even want to see patience because I felt like I had such a knowledge deficit that I just wanted to go and study like I would come to the hospital just to show face show my seniors like hey I'm around I exist please remember me for when you do my marking forms hey by the way can I go and just study now and thinking back on it it is important to take time independently to study but there's also a lot of

learning that I could have gained from Clinical placements that I just completely ignored there are just some things that you cannot learn from just studying like you need the patient there to be able to understand what you're learning in context to give it relevance and that's what I found was that when I was studying it purely academically I didn't have a sense of relevance for how I could use this information and all the nuances around it and so it was very hard for me to make sense of it and organize it because I just didn't

know how I need to apply it at the end of this video I also talk about how you can make the most of clinical time this is what I recommend to all my clinical medical students now this is what I started doing in my final year of medical school and it it just makes clinical days so much more valuable okay so let me give you a couple of examples now specifically of things that I had learned like this wrong way and the way that I had changed it so that you've got a bit more context

and I'll end off with like a few specific concrete recommendations that I would recommend for any medical student I promise you this is going to make your medical school life much easier much more enjoyable and just like you're going to save a lot of time so here's what happened I was sitting there in the ward and my consultant otherwise known as an attending physician he sat down after I saw a patient and he said okay your patient here has chest pain what are you thinking about and I said okay well there are some things it

could be like it could be an MI mardan function it could also be a PE and I just could not think like I was choring for ideas for chest pain which is like the most typical like the most classical you know symptom that you should probably be prepared for and that's when I realized I'd never really thought about it from that perspective before like I had thought about it from such a disease Focus that i' never really thought about it from a symptom focus when someone just presents to you with whatever they have how can

I navigate backwards to figure out what disease or diseas is I got going to sit in my differentials and I just couldn't use my knowledge in that direction it was just too fixed it was just too rigid and this came up time and time again it happened for diabetes it happened for shock uh because the way that I learned something like diabetes was that I learned it like this right I'd learn okay this is diabetes this panop these are the complications andever I tested myself I test myself like this as well hey what are the

microvascular complications of diabetes Well the macrovascular complication of diabetes I didn't test myself from the other way around I didn't say okay let's say that someone has blindness in their eyes what are the differential diagnoses for that what are the possible things and what are the questions that you would have to ask to rule in or rule out certain diagnoses the clinical reasoning part of my studying I just did not think about it until way too late in my medical school and a lot of medical schools now have realized that that's a problem with the

way that they teach and so there are these things they're technically called spiral curriculums or spiral integrated curriculums or integrated curriculums but the idea is that you have a lot of this clinical scenario thinking all the away from the beginning in your preclinical years which is a great step but I also work with a lot of students that are going to medical schools they teacher this way now and what I've realized is that they still compartmentalize it they still learn every disease as a disease basis first and then way way way way down the line

they then try to go backwards and then they get overwhelmed and overloaded and because medical school is challenging and there's a lot of volume to study it's just too much and people just end up more confused and so one of the things that I wish I had done and then I started doing later on is I just studied it purely from the clinicals perspective first I learned it from a clinical reasoning perspective to begin with and then later when I'd understood that I'd come back to the path of physiology and then reinforce my learning at

a disease Focus because that actually makes a lot more sense rather than learning the disease one by one and then trying to bring it together to see you know how you can look at it from a symptom first perspective I just learned it from a symptom and sign perspective first and then I worked my way through the differentials and then patted up with pathophysiology so if someone comes in with chest pain I would start thinking okay pain in the chest could come from the skin could come from the bones could come from the muscles I

just work my way in could be the plura could be The myocardium could be neurogenic so I would start in that order and then I think okay so what are the things that I can think of that could be affecting things there and anytime I didn't understand or I thought I was missing something then I would go to learn more about that particular disease so that I would be able to work through my differential and clinical reasoning process a little bit more what this meant was that my knowledge was much more functionally organized to begin

with and I had the same level of detail but I had much more context to it and a great example of where this came in handy was when I learned about shock so when I first learned shock in prein I learned it pretty much like this I just had all the different types of shock all the different possible ideologies the pathophysiologies and all the like various clinical findings like cardiac output is down or up or jvp is elevated or not or neutral or you post and heart raid like I would just learn all of these

different things and I have these committed to flash cards actually you know what I literally for this particular topic I literally Drew handwritten cards and blue tacked them to my wall and I so proud because they were very pretty and I literally got no value out of it I probably looked at them like five times and uh I never really remembered anything about them to this day I don't remember what it looks like other than the fact that it used to hang right above the door handle on my wall so this is how I learned

shock and I managed to you know pass all my exams if you ask me hey what are all the symptoms of hypo volic shock what are all the signs I would have been able to give you an answer honestly I don't remember anymore but when I worked in Ed my senior pulled me aside and he was like hey let's just talk about shock for a second he was like you know I know that when you go through mid School you learn it this way but let me show you a way that's just much faster so

he takes a piece of just random clinical paper and he just draws a very simple diagram and he just says hey look at the end of the day shock is just about a pump the tubes that are connected to the pump sit sitting inside a container that is your body and then there's fluid being pumped through the tubes so if you've got shock it's either going to be a problem with the pump a problem with the tubes a problem with the container or a problem with the fluid and that's all the different types of shocks

and he went through and then he mapped every single part of shock and all the different types and ideologies to this framework and he said so when you're seeing a patient all you need to do is ask yourself is there a problem with the pumps and you know exactly what questions to ask is a problem with the pipes you know the questions to ask is a problem with the fluid you know the questions to ask is a problem with the container you know the questions to ask and for me that was a transformative way of

thinking one of the things that I said before was that I didn't spend a lot of time when I was studying academically to deliberately make things simpler and here's the reason why it would have helped me a lot because just looking for like an image for this video I actually found that there are a lot of other ways that of thinking about shock and I found this particular image here which classifies shock in a very similar very simple way and I don't know when this was published but if I had taken the time to deliberately

take something that I thought was overwhelming and very detailed and say there must be a simpler more intuitive way to understand this what could it be if I had taken the time 10 15 20 minutes to take this information and deliberately try to make it simpler and more intuitive I probably probably could have arrived at this kind of or this kind of conclusion by myself years earlier but I didn't and as a result I had a gap in my knowledge and I wish I had done that for anatomy as well I've restudied Anatomy again and

again and again almost every single year and it's only when I actually did a run in Orthopedics that it kind of clicked how I needed to be thinking about it and it clicked for me during surgery I was retracting a body cavity as you do just trying to maintain tension and not have the consultant surgeon yell at me we've all been there and also not trying to fall asleep it's a long operation it's like a 4 and 1 half hour operation just standing there almost falling asleep passing out and after the operation he comes out

to me and he says so what did you learn and to be honest I learned that I hate retracting body cavities so I didn't really learn anything and I tried to make something up like oh it's really interesting seeing how you did the suture it was cool to see the hip replacement go in how you dealt with the bleeding and he was like okay okay okay it was like do you notice where I switched from using the the scalp of dimy and where I moved to blunt dissecting do you know why I did that and

honestly first of all I didn't notice that he did that and second of all I had no idea why I wasn't even thinking about why and he proceeded to explain to me that that is the point at which the I can't remember I think may have been like a offshoot of the femoral artery like a very important artery passes around there so you need to be careful around that area which is why he stopped and he started blunt dissecting instead and I thought okay that's actually a really good point and I probably should have known

that and now I feel like an idiot for not knowing that but that's also when I had the realization that the reason that you would need to know Anatomy is not just to know Anatomy but you need to use that knowledge somehow and I'd never really thought how to use the knowledge of anatomy Beyond like just a very obvious clinical corate that was taught to me in lectures so when I started going back through my anatomy and now thinking okay let's imagine that I'm operating how would I study the anatomy if I was operating and

there's this really good scene in this like Korean movie like TV series on Netflix and there's this one medical student who has to perform surgery on this other person and because he's still a student he has has no idea how so he spends all night studying his Anatomy textbooks to devise a strategy for operating and the reason that I think that scene is really good is because that's exactly the way that I started to study I put myself in the position where I thought what if I'm the first person to ever do this operation how

does that make me look at Anatomy differently and when I started doing that Anatomy became so much easier more engaging and more just enjoyable and more memorable to learn because there were consequences there was a context and a sense of relevance to what I was learning and again yes it does take longer but surprisingly not that much longer and the time you're spending is a lot more enjoyable and you just remember so much more that you're going to save your time like truckloads in the long run because something like Anatomy is useful for all forms

of medicine like even saying someone's got chest pain to think well how can you work through that well you can take an anatomical approach well if you don't know your Anatomy well enough to think about the chest wall and work your way from out to in and understand the structures that are in place that cause chest pain that's not going to be very easy for you if you don't know your abdominal and Anatomy well enough that if someone says hey you've got like LIF upper quadrant pain and then you can work through anatomically to think

where that could be caused from it's going to be very difficult whereas learning the anatomy very well sets a good foundation for all the other type of learning that you're going to have to do here are my final tips here's the things that I wish I had done that I encourage you to do first of all as much as possible whenever you can try to make things simpler and more intuitive don't just learn it the way that it's given to you find a way to understand it it may be less detailed but give yourself something

simple to base things on I have a skeleton of a simple intuitive understanding and a framework to think through whenever you feel like man there's a lot to remember and a lot to memorize here whenever you feel that sense that this could be overwhelming find a way to break it down and make it simpler you can always go and learn the details and you should but you should always do that after you have a very simple intuitive way of understanding the entire topic it's going to help you also whenever possible look for the clinical coret

ask yourself how am I actually going to use this knowledge before you try to learn anything through a patho Fizz or a disease or you know very discret isolated perspective find a way to think about it from a clinical perspective first understand it from a clinical perspective first and then go back to learn more details about the disease or the pathophys again it's going to make it much easier and it's going to make it make more sense and you're probably going to do better for all of your examinations as well because most medical schools around

the world are transitioning towards having examinations that reflect clinical application of knowledge uh a little bit more closely remember you are not a medical student you are a doctor in training and that's a difference you can try to just keep memorizing and smashing things through forever but trust me it doesn't really work the friends that did that and got their way through medical school and thought hey why do you need to change the way that you're studying you just need to memorize it more now they're studying to become a specialist and they're having to relearn

all that stuff all over again because they don't remember any of it and now they're having to learn it through the methods that I'm teaching you now and honestly there is no reason that you can't just learn it like how a specialist in training is trying to learn it when you're a pre-clin medical student it's just a better more intuitive way to learn the material my next tip is to pick your losses you really can't learn absolutely everything that you learn in medical school or just in medicine in general like it's straight up impossible and

you do have to learn a lot of things so I would recommend that you kind of pick your losses don't try to learn everything make a decision about what is important for you to learn and why again coming back to that clinical application and the things that you feel are less important you can still try to fit them in when you've got time but don't try to cover everything the final tip here is just how to make use of clinical placements more effectively I said that I talk about this at the end and this is

the final tip when you're going into a clinical placement there is a wealth of information that you can possibly extract Center you're studying based on the likely things you will learn from your next day or week in clinical practice don't study the things that are like less relevant if you know that the common conditions you're likely to see in a given placement chest pain and shortness of breath and some kind of skin rash and you like headache back pain center your studying around those things because what you want to do is you want to study

something and the very next day you want to have a clinical experience that builds on what you just studied that could be through seeing a patient or it could be attending a surgery if you know that you have to spend time in theater and you're going to be there observing a surgery anyway study about that condition and that surgery the day before so that when you're in there having the mandatory experience and spending the time that you cannot Escape you are at least engaged and you are gaining value from that there is some part of

your learning that is being built on and consolidated and that also allows you to ask very good questions that your senior is going to realize you really are putting an effort to getting learning out of this experience and that's something they appreciate because trust me when I started having students under me when I was a doctor it's very very clear to see which students actually care and put in effort and which ones are just there to burn time and the ones that are there to burn time you don't really feel very motivated to help them

along whereas the ones that are motivated you are more motivated as well to teach them and help them be involved in more things and to you know go out of your way a little bit more to help their education and I really regret what I did when I was in my you know early rotations in clinical placements where the things that I would be studying on a daily basis with things that my University curriculum said that I need to learn by the end of that placement and it wasn't really based around the experiences that I

anticipated that I'd have the next day or or during that week and what I've realized now is if IID focused it on those clinical experiences I would have covered probably 90 95% of what I would have needed to know based on what my University mandated and the other 5% I could have just easily fitted in around that time or just before my assessment it wouldn't have been a problem but instead I wasted a lot of time and Ward rounds and clinical attachment days were so draining and so tiring and I was not very- engaged and

I didn't get a lot of value out of them because I didn't do this so a bit of a long video but I hope this has helped you I certainly wish someone sat down and told me this stuff when I went into medical school if you want some more techniques around what to do specifically during lectures or with your note taking or with your revision strategies or revision timing or what to do with your flash cards and make them more effective these types of other specific techniques I do also have a guided step-by-step program where

I've taken all of these techniques looking at the research triing them and seeing what works and what doesn't across thousands of students stud and packaging it into a single guided step-by-step program that teaches you an entire Learning System if you're interested in that you can check that out at Icon study.com there's a link in the description I also have a ton of other videos that provide more specific techniques that you can check out on my YouTube thank you so much for watching I hope this helps and I'll see you next time