Wikipedia is going to get me through Medical School

I got back from the first big exam (Mini 1) and I’m really disappointed. As much as I’ve studied, I could already tell in the past couple days that it wasn’t going to be good. Everything’s been going sideways for a while – I just didn’t want to open my mouth and jinx it. I knew it was coming. It was just too late to change course.

The test is over so I’m saying it out loud now.

I still have to look at the results but I can already tell you what I got. Besides Physiology, I got anywhere from 40% (at the worst) to 70% (at the best) on every other subject tested. This estimate is based on the results I was getting the practice Multiple Choice Questions (MCQs) I was taking and how confident I was answering each question on the actual exam. This is about as bad as I was expecting it to go and this is exactly where I didn’t want to be, one month into medical school. And like I always say, when you try and completely fail, it’s time to change the pattern – doing twice as much of the same is just an exercise in futility and recipe for disaster.

And besides, I couldn’t study twice as hard if I tried. There just aren’t enough hours in the day.

[Physiology is a different story. Like I’ve said a couple times in the past, I’ve previously taken Human Physiology twice and Animal Physiology once. Besides the equations which I committed to memory (Fick’s Law of Diffusion, Van’t Hoff Equation, Nerst Equation, Goldman-Hodgkin-Katz Equation), I didn’t waste a single hour studying for Physiology. (And of course, there wasn’t a single question that required any of the equations.) Without even looking at my notes, right now, I could tell you everything there is to know about action potentials, the effects of ionic concentrations across membranes, and the importance of solute concentrations in solutions of varying osmolarities.]

I had a study strategy from the day school started and, for the most part, I stuck to it. It didn’t work so I’m going to do something new. In other words, for everyone reading who’s been following along, disregard every study tip I’ve shared on this blog for the past month. If you follow it, you’re going to fail.

(This also makes me wonder how many current medical students read my blog and have been waiting for me to fall on my ass.)

*squints eyes*

The good news is I still have time to fix my mistakes and change what I’ve been doing. And after taking Mini 1, I have a lot more information to go off of when it comes to what I think is going to work best.

First of all, this exam is the hardest test you would have ever taken (just like the MCAT before it). The difference between the Mini’s and the MCAT is that the MCAT challenges you through the way in which questions are asked of you (passage based questions, focusing on critical thinking instead of strict memorization) and the Mini’s challenge you to bring your own information to the table in order to answer the questions efficiently. For as much information they curriculum throws at you on a daily basis, they also expect you to expand upon that information on your own and in addition.

I’m not saying that the exam is going to test you on information that hasn’t been given to you.

I’m saying if all you do is sit in class, pay attention, review, re-read, and self-test yourself, you’re only going to have a fraction of the information that’s presented to you on the actual exam – the important fraction, but still just a fraction. You could piece it together, if necessary, but you’re still missing big chucks (and you’re clearly missing the point).

The majority of questions are going to be asked with their clinical applications in mind. If it’s a bone question about the medial epicondyle of the humerous, it’s most likely going to reference a common injury that leads to damage (fracture, break, avulsion) of the medial epicondyle of the humerous and it’ll test you on the effected nerves and arteries in the surrounding area or the new found limited movements of the associated limbs and the muscles that are compensating for the resulting loss of function. If it’s a question about a particular enzyme that inhibits a ribosomal subunit, it’s going to reference a common disease that affects that enzyme’s ability to function and it’ll test you on the body’s response to cope with that stress. Without the context in which to frame the question correctly, the majority of the questions might as well be written in foreign languages. Through it all, you’re left sifting through the scraps, attempting to narrow down answer choices. And all you end up with is the most likely correct answer, never with absolute certainty of its correctness.

You’re left to connect the dots in the moment, when in reality, the dots have most likely already been connected – you just have to put in the active, extra effort to look.

From the practice questions I’ve been doing for the past few days, this is a problem I knew was coming. This is also the reason why I’ve been spending so much time on Wikipedia. (And no, if I ever make it to graduation, I’m not going to use Wikipedia as my primary source of information. If I have a question, I’ll reference the proper medical journals or friends that are smarter than me on the subject. Wikipedia is just too good a tool and there just isn’t enough time for anything else.)

My new strategy for Mini 2 (in one month) is this:

• Start going to all non-Anatomy classes (again) and focus on subject matter that is either stressed by the professor or is particularly confusing. Write that down, underline it, and highlight it (and whatever else it takes to get my attention later). That night, hop on Wikipedia, research, and read about common, clinically related applications for that topic.
  
• Continue skipping Anatomy and “Media Site” it online later. (I like to take my time in drawing each bone, muscle, nerve, and artery.)
  
• Hunt down different sources of MCQs on all the subjects and attempt to answer them on a daily or bi-daily basis. Find out what I don’t know and check out (whatever it is) on Wikipedia later that day.
  
• Attempt to preview all classes again, before lecture. A quick scan of the Power Point files, at the minimum.

(I've had a couple days to think about what I'd do differently and this is what I came up with.)

I’ll try to stick to this approach for the next month and see how it works. I’m going to be all over Wikipedia and hopefully, it’s going to get me through medical school.

(And it better work or I’m going to be repeating 1st semester.)

I have a bad feeling about this. (Biochem)

So the first big test is tomorrow and I have a bad feeling about this -- about Biochem, specifically.

Last night I completed the "official" mock Mini exam and got 3 out of 15 Biochem questions correct. That's only 17%. (I'm not worried about histology, anatomy, or physiology. On those sections, I did fine.)

So, I spent the last 24 hours going over the previous lectures, looking up keywords and diseases on Wikipedia (Turner's Syndrome, Klinefelter's Symdrome, Down's Syndrome, etc.), and going through a lot of the questions I got wrong. A lot of what I got wrong were genetics/karyotyping questions and biotechnology questions.

I just finished more Biochem practice questions. The four sub-topics I covered were:

1. DNA Biotechnology
   
2. DNA Structures & Replication
   
3. Transcription
   
4. Translation

And again, the Biotechnology got me with only 5 out of 10 correct. I got 7 out of 9 DNA Structure & Replication questions correct. Transcription and Translation weren't too bad either. And of course, these four sub-topics are only about 10 of the 25 lecture hours dedicated to Biochem. (I still have more practice tests to go through.)

The test is at 1:00pm tomorrow afternoon and there's not much else I can do except to keep going through practice questions and look up all my mistakes.

This is how I, a 2nd year at USC-SOM, am doing it...

masteravenger625 writes in response to "Tackling Mini 1":

This is how I, a 2nd year at USC-SOM is doing it: pharm, intro to clinical med, and pathology 2...

Wake my ass up at 7-8 to go to 8AM class till 2-3 usually...sometimes noon. Study a bit during lunch. Study until regrouping time at 6-7 at which ill join some folks at dinner. Study again till 1-2 in which then I go for a 5 mile jog and bed. Rinse and repeat. I study from a book and listen to a guy named Goljan about pathology when I run. I do BRS as well as incorporate their high yield stuff into the higher level of thinking that the school wants me to know. Memorizing isnt the problem. Its the integrating how stuff works together on top of tons of new shit that seems be a shotgun appraoch to medical education. Right now I have a 3.4 GPA. I desparately need it to go up so this is why i've been going to class more often. Folks here seems to add more than what is in powerpoints in an effort to bring us to class. Oh and sometimes they tape their lectuer but thats only 1/3 classes....bummer.

Hi,

Everyone always says that it just gets harder and harder, the farther you get into medical school (in whichever school you go to).

You're definitely doing a lot more than I am now. But I bet you didn't study like that in your first month of your first semester. If I ever become an MS2, I bet I'll have to work my way up, just like you did.

I think I brought this up before, but I'll do it again;

Looking back to my premed days, I got a lot of B's in classes I really shouldn't have. I got a B in both O.Chem I and II. I would bet anything that if I put in a single, extra hour of studying 3-5 days a week, I could have gotten A's. I actually liked O.Chem. The questions were like puzzles (and I like puzzles).

Looking back, I think it's hilarious how insignificant an amount of study time that really is.

Tackling Mini 1

The first major exam is in six days (next Monday) and it's obvious to me that I need to step it up. It's also obvious to me that this is much more than an "all-nighter" or weekend review situation. At the minimum, this is a week long review that should have started yesterday.

It's interesting what you'll hear, if you keep your ears open.

Just listening to other people about their study techniques, it almost sound like everyone is doing it differently. Some students know upper classmen (or are dating them) and have access to a lot of extra review material. Other students are sticking with the same "preview, take notes, and review" that they've been using since the semester start. (The same approach I did away with after week 1.)

Some students spend a lot of time in lab and other students put in extra hours and days into Media Site to re-watch the lectures. At least one student was advised by a 4th semester student (while I was eating lunch on the bench next to them) to take as little notes as possible and just listen intently to the lectures and re-watch them later.

Other students are focusing solely on pneumonics and have been in triage-mode from the start, picking out what they think (and what they've been told) is high yield material. And other students (like me) have stopped going to class altogether and have been taking detailed notes on every lecture... but have been taking twice as much time to get through each lecture in the process.

I have a 3 day weekend, 180 pages of notes (that will continue to grow in these final days), and my week is going to go something like this:

• (Tuesday - Thursday) Wake up at 7:00am and get to the study area by 8:00.
  
• Finish taking notes for that day's lecture and add it to the rest.
  
• Also print out and review hand-out material.
  
• Depending on mandatory classes for that afternoon (like anatomy lab or PBL) and how dense the lectures are that day, go home around 2:00-5:00pm.
  
• Get home, eat, and relax a little bit.
  
• Review all 180+ pages of notes.
  
• (Friday) General review and spend some time in the anatomy lab, hopefully having enough time to examine each of the 22 cadavers.
  
• (Saturday) Dig up all of the (hundreds?) of multiple choice practice questions scattered around from multiple sources and complete as many as possible.
  
• (Sunday) Get together with at least a couple other people and start quizzing each other.

By Monday, I would have gone through my own notes at least 3-4 more times, spent some quality time in the anatomy lab, and try to get a back-and-forth review session thing going with at least one other person.

A couple things to remember:

1. This exam is 30% of the Biochemistry grade.
   
2. This exam is 23% of the Histology grade.
   
3. This exam is the easiest of the 3 exams given throughout the semester so you better score high now and not have to play "catch up" on later exams.
   
4. It's only going to get harder.

A lot of students are approaching this in a lot of different ways.

Everyone learns differently.