The Way to Study Medicine
By Stephen Goldberg, MD
The following suggestions about how to study medicine are not the result of scientific survey, but reflect my own experience in teaching medical students for 25 years. The suggestions also arise from my service as President of the MedMaster Publishing Company for the past 27, years and from the feedback I have received from students and instructors throughout the world.
The biggest problem in medical education today is an old one: There is too much to know, and not enough time to learn it. The problem is more acute today than it has been in the past, because of the great increase in medical information and even the addition of new courses in medical school. How can you digest and remember so much information, whether it’s for your general medical education or your USMLE/COMLEX review?
While memory aids such as mnemonics and humor certainly can help, it is more important that you really understand the material rather than just memorize it. Understanding it is key, because you can apply the information to a great variety of medical situations instead of using a cookbook approach that lacks understanding and applies to only a narrow spectrum of textbook medical cases. Moreover, once you understand, it becomes much easier to pick up and remember more esoteric facts, as opposed to just trying to remember isolated bits of information.
Despite the importance of reference texts, it can be difficult to go through them in the short times allotted for medical-school courses. Also, the information can be so overwhelming that it becomes difficult to see the forest for the trees, and acquire an overall understanding. While it is important to have the reference text, the initial phase of acquiring understanding is best achieved through the small book that helps you see the big picture. Once you’ve managed that, you can delve into the reference texts or elsewhere in greater detail as time permits, and you’ll have greater success than just trying to memorize information.
Your time to study for the USMLE/COMLEX may be limited, especially since studying often needs to be done while other medical school courses are underway. While you could review a book that contains isolated facts that may appear on the boards, you won’t acquire an understanding this way. While passing the boards is important, so is having the understanding necessary to be a good clinician. Ideally, you should have this before you review isolated facts for the boards. Such understanding can be achieved through the small book that focuses on clinical relevance and overall understanding, ideally read at the time the course is taken, but later if needed. The focus of the USMLE/COMLEX is on clinically relevant material, so that small book will likely contain the most relevant facts for passing it.
Once you’re on the wards, the question is how to make the most efficient use of your time in continuing your medical education. Not only is your time limited, but you’ll often find yourself fatigued from long periods on call. Trying to study a book like Harrison’s Medicine from cover to cover is likely to be futile. You need a more efficient method of learning. Reading journals can help you keep up on current information, but your primary focus in the medical-school years should be on acquiring the general broad information that is common knowledge. This in itself is a very large task. It has often been said, and I agree, that the best way to learn and retain medicine is through patient interaction. But to supplement this learning experience, it is important to do a certain amount of critical reading. Learning from your residents can be very useful, but the literature is more likely to be accurate. The most efficient way to do this reading, in my view, is to ask specific questions about the patient conditions you’ve seen during the day, and then seek out specific information in your reading. You should have specific questions to research, and then look for specific answers. In that way, over time, you will have learned the most important information related to the common diseases you are likely to encounter.
In the old days, such research would mean either having the necessary reference texts at hand, which might not have the information you need, or which might be several years out of date, or going to the library to search through heavy tomes of Index Medicus for pertinent references, and then hoping the library had the corresponding journals for review. This could be time-consuming, though, and difficult to accomplish when you’re already fatigued from a busy day. Today, the Internet provides a much quicker and more efficient way of searching for information. By using a general or medical-specific search engine, it is now possible to find important current and practical information about virtually any medical condition.
The ideal way to learn medicine, then, in my view, is to:
• Learn from the patient.
• Acquire a general understanding through the small, clinically relevant book that provides the overall picture, so you can see the forest rather than the trees. Humor and mnemonics can help, but understanding is key.
• Seek out particular points of information through the Internet.
• Keep a reference text at hand.
• Read journals as time allows.
Stephen Goldberg, MD
Professor Emeritus, University of Miami School of Medicine
President, the MedMaster Publishing Company
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