How to Study in Medical School: A Practical Guide

Studying in medical school is a whole new game. Naturally, we may be tempted to fall back on the methods we’ve always used (and likely found success with) in the last couple years of academic grind. Unfortunately, the sheer amount of information that we have to learn—and memorise—in medical school renders most of those well-worn methods ineffective.

So how do we retain all that information? How do we maximise the efficiency and efficacy of our studying? There is, in fact, a lot of science out there on how to study effectively. This article considers tried-and-tested study techniques, and offers a practical guide for studying in medical school.

Section 1: The Two Key Principles

Active Recall and Spaced Repetition

When it comes to effective studying, there are just two key principles: active recall and spaced repetition.

There are tons of articles, including evidence-based research, that support the use of these two techniques. You can google the terms and read through all the theories and evidence (or refer to the Appendix at the end of this article). But in brief:

Why It Works: The Forgetting Curve

A quick look at the ‘forgetting curve’: the dotted grey lines below represent what happens if you don’t stimulate your memory with spaced repetition. You want to be on the teal lines: retaining the information in the long-term. (Again, backed by solid research.)

BOTTOM LINE: Active recall and spaced repetition are the governing principles behind the most effective study methods. Combine the two, and you have a killer formula for academic (and medical school) success.

Section 2: Study Materials and Resources

Before considering how to study, here’s a quick rundown of the main resources you’ll come across in medical school, and how you can utilise each one for maximum effectiveness:

Lecture Slides, Notes, and Recordings

It makes perfect sense to study your content mainly from the lecture materials provided. Firstly, your school has curated the curriculum in a particular way, with a particular sequence. It is designed to help you learn the content systematically. Furthermore, whatever is in the materials will be precisely the content knowledge tested for exams.

Supplementary Readings

These refer to pages and sections from select textbooks that have been assigned as compulsory reading in a particular module. This signals that the content is directly relevant to the module, and will be tested in exams.

You should therefore read these texts. If you find them slightly lengthy, you could make summary notes from them (or rely on others’), or convert them into Anki cards (more on Anki in the next section).

Textbooks

Textbooks are not a great resource for medical school. Granted, there are great textbooks out there, but there are often greater YouTube videos and reading them may enhance your understanding. However, they offer completeness of information at the expense of conciseness and clarity. Furthermore, reading textbooks is the epitome of passive review—a direct contrast to active recall. If you spend hours reading through a whole textbook chapter, odds are you will have a better understanding, but will not have retained any of the crucial details.

So what do we use textbooks for?

1. A more complete understanding. Sometimes lecture slides may be a bit lacking. Or there’s just a certain concept that was not well-explained. Textbooks are great, credible reference materials to consult. (Although, arguably, you could try consulting Google first. If you still don’t understand, or if there’s a gap in your knowledge, then turn to textbooks.)
2. Nice diagrams and illustrations. Visuals are extremely useful when it comes to learning anything, and medicine even more so. Textbooks often have great illustrations, not just for anatomy, but also concepts in physiology, and histological slides in pathology, for instance. They may also have useful summary tables. Often your lecture slides will have images that are taken from these well-established textbooks. But, unless you’re looking for a particular diagram from a specific textbook, you can try Google Images first. The reason is simple: by googling, you comb the whole database of resources out there to find the best image to suit your particular needs. This way, you don’t need to limit yourself to just one textbook, and don’t have to flip through pages searching for the best image. The database, of course, may exclude copyrighted images from the most recent editions of some textbooks. So it’s only when you’re unable to find a satisfactory image that you turn to textbooks. (Or if you come across a blurry version and want the high-resolution one in the book.)
3. Satisfying your boredom. This only applies to a select few students who have mastered the entire syllabus with ease and are now bored out of their minds, looking for some extra reading, and also happen to love Guyton’s Physiology more than Harry Potter. (Disclaimer: I’m not sure if these people exist, but something tells me that maybe they do.)

Your school may well provide you with a list of “recommended textbooks”. Unless it’s just an “essentials” list, it probably has too many books listed. From combing through blogs and student forums, coupled with my own experience, I have distilled the top few textbooks for medical students in the pre-clinical years.

Section 3: Study Methods

The Low-Yield Interventions – Passive Review

Annotating and Taking Notes

I used to annotate all my lecture slides and had to take down everything the lecturer said. I realised that this was a huge waste of time.

You may argue that writing short notes as you go along helps you to make sense of the content. But once again, it’s passive! review! It doesn’t help you to retain the information, and it takes an inordinate amount of time (which can be better spent testing yourself with active recall).

Making Notes

There is, perhaps, some benefit to making notes. The one downside to Anki is that by creating separate cards, the information becomes fragmented. You won’t get the big picture and the logical flow. Having a set of notes overcomes this limitation.

You can: (1) use the lecture materials, (2) use existing notes, or (3) make your own notes.

(2) is probably the best option. (1) is not bad too, but it does mean that perhaps you’ll have to annotate or add on some extra information to the lecture materials.

The last option, making notes, is an awfully time-consuming process. It’s only good if you want to synthesise information from different sources and organise your thoughts as you go through the content.

In short, all three are possible options, and you should choose the one that works best for you. Lastly, if you do make notes, I suggest that you don’t handwrite them. It’s just… not worth it.

The High-Yield Interventions – Active Recall

Anki

Anki is arguably the single best intervention for medical school studying. It’s a flashcard programme that combines active recall and spaced repetition.

Note, however, that not all medical students use Anki! In fact, there are people who score well and have never touched Anki. So don’t think that it’s a must.

It’s just that for the majority of people whose brains have forgetful tendencies i.e. mine (see the ‘forgetting curve’ above), Anki is simply the best way to ensure that you retain the massive amount of content taught in medical school.

I will be publishing a separate article on using Anki for medical school—a concise, straightforward guide with the optimal settings and all you need to get started. It’s really not a steep learning curve.

Practice Questions and Tests

This is very self-explanatory. Not only are practice questions a perfect method of active recall, they’re also particularly useful when you’re preparing for exams.

VERDICT: Active recall trumps all. Use any other methods, including making notes, to organise your thoughts. But in terms of truly retaining the information, Anki and practice questions will save your life.

Other Optimisations

There are some other optimisations which are particularly useful for medical school.

Mnemonics

Mnemonics are amazing. The only caveat is not to overuse them. If you do, you’ll have so many mnemonics to juggle that you risk forgetting some of them. My principle is one based on minimalism: if I can memorise it relatively easily without a mnemonic, then I won’t use a mnemonic.

For longer lists, and especially if the mnemonic is memorable, I do love using them. There are many “common” and widely used mnemonics. I have also come up with a few of my own mnemonics to help with certain longer lists that are specific to our lecture slides.

Example: Some Lovers Try Positions That They Cannot Handle – for the eight carpal bones: Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate

VERDICT: It’s amazing how much easier you can recall factual information with well-crafted mnemonics. Just resist the urge to “mnemonify” everything.

The Feynman Technique

The Feynman Technique is an efficient method of learning a concept quickly by explaining it in plain and simple terms. It’s based on the idea that if you can’t explain it simply, you don’t understand it well enough.

This, to me, is not a study method per se, but a principle that is very true and good to incorporate into any learning process. You can make a habit out of it. For instance, when listening to a lecture, break down the concept in your mind and explain it to yourself as simply as possible, without the scientific jargon.

Other Popular Study Methods

Some widely touted study methods are discussed below in brief, particularly in the context of studying for medical school.

Mind mapping

I personally do not use mind maps. I find them to be disorganised, rather than clarifying my thoughts. However, if you work well with mind maps, it can definitely be another low-yield intervention lumped together with annotating and making notes.

VERDICT: Mind mapping may be good for you to organise your thoughts and visualise interconnections, particularly if you have a more non-linear way of thinking.

The SQ3R Method and PQ4R Method

When I first saw these acronyms, I thought they sounded a lot like clinical screening tools. In fact, they simply stand for:

• SQ3R: Survey, Question, Read, Recite, Review
• PQ4R: Preview, Question, Read, Reflect, Recite, Review

Each step above is quite self-explanatory. If you’d like, you can read more into them, though I honestly feel that it is unnecessary.

VERDICT: These “methods” are likely already integrated in some form into your current study habits. There’s nothing really game-changing here.

Memory Palace

The memory palace technique is about converting information you want to memorise into imagesplaced in a familiar mental location. The idea is that you can mentally walk through your Palace looking at these images to recall them.

For medical school, this technique is not of great utility. First of all, it can only be used for memorising lists of information, not concepts. And for such lists, mnemonics often do the job.

The reason why memory palaces are so popular is likely because they’re used by memory champions all over the world. These are people who train themselves to memorise the digits of pi in the shortest possible time, for instance. These kinds of feats are not really equivalent to the kind of information we’re learning in medical school.

Secondly, if you wish to use this technique, how many memory palaces would you need? Wouldn’t that just jumble up everything in your head?

I’ve used this technique only sparingly. In fact, only for one specific thing I had to memorise. It was also more of visualisation and conjuring up a narrative in my mind than placing things in a familiar building.

VERDICT: The memory palace has little utility in learning medical school content. However, you can try using visualisation, particularly to memorise specific lists of information.

Appendix: Research and Evidence on Active Recall and Spaced Repetition

Butler A. C. (2010). Repeated testing produces superior transfer of learning relative to repeated studying. Journal of experimental psychology. Learning, memory, and cognition, 36(5), 1118–1133. https://doi.org/10.1037/a0019902

Dunlosky, J., Rawson, K. A., Marsh, E. J., Nathan, M. J., & Willingham, D. T. (2013). Improving Students’ Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology. Psychological science in the public interest : a journal of the American Psychological Society, 14(1), 4–58. https://doi.org/10.1177/1529100612453266

Ebbinghaus H. (2013). Memory: a contribution to experimental psychology. Annals of neurosciences, 20(4), 155–156. https://doi.org/10.5214/ans.0972.7531.200408

Karpicke, J. D., & Blunt, J. R. (2011). Retrieval practice produces more learning than elaborative studying with concept mapping. Science (New York, N.Y.), 331(6018), 772–775. https://doi.org/10.1126/science.1199327

Karpicke, J. D., & Roediger, H. L., 3rd (2008). The critical importance of retrieval for learning. Science (New York, N.Y.), 319(5865), 966–968. https://doi.org/10.1126/science.1152408

Murre, J. M., & Dros, J. (2015). Replication and Analysis of Ebbinghaus’ Forgetting Curve. PloS one, 10(7), e0120644. https://doi.org/10.1371/journal.pone.0120644

Roediger, H. L., & Karpicke, J. D. (2006). Test-enhanced learning: taking memory tests improves long-term retention. Psychological science, 17(3), 249–255. https://doi.org/10.1111/j.1467-9280.2006.01693.x

Disclaimer: TLM has no affiliation with any of the resources or companies mentioned above. They are shared here simply as potentially useful tools to enhance your learning.