In this episode I will address the question “How can I possibly learn all this material?”
Now as you know, it is my promise to give you something in every episode that you can use immediately to memorize more medicine, faster. In episode 1, I gave you a pdf guide to troubleshoot your study strategy. In this episode I am going to give you a guide that walks you through exactly how to use First Aid during your first two years.
This question “How can I possibly learn all this material” sums up why med school is so difficult. You’ve heard it’s like drinking from a firehose, and that’s absolutely true. Now there’s really only two options. Either you reduce the volume, or you increase your ability to absorb the volume. I’m going to talk about reducing volume today, and in the next two episodes I will talk about increasing how much you absorb.
The best tool for reducing the volume of material is a book called First Aid for the USMLE Step 1. The way it works is by helping you separate high-yield facts from low-yield facts so that you can get the most return for your mental investment. You won’t technically need this book until a couple of months before you start studying for Step 1, but by using it early in your career, you can be killing two birds with one stone – studying for your school exams and preparing for Step 1 at the same time.
I. Call to Action
Now, a call to action. Buy an old copy of First Aid today. You can get it on Amazon. Don’t buy the most current edition, buy last year’s edition, used. I wouldn’t go older than that, because the publisher definitely finds a huge amount of errata every year and they do make critical updates to the content depending on what’s being heavily tested. The exception is if you are an M2 and there will not be another version released before you take Step 1. Then you should buy the new edition – because for actual Step 1 studying, you never, ever study from an old version.
Okay, so I recommend that everyone buy First Aid, but the way you use First Aid is vastly different depending on your year. Everything I’m about to say is summarized in a PDF I posted called “Guide to Using First Aid During M1 and M2” and you can download it in the show notes at sholamd.com.
II. Using First Aid During M1
I’ll start with M1. Remember that M1 year is about learning the basic concepts in medicine, understanding the building blocks of pathophysiology and pharmacology, and learning the language of medicine. None of these things is covered well in First Aid. And to be honest not much of it is “high-yield” for boards, which is why it’s not covered well in First Aid. That’s because it’s too fundamental. Step 1 creates a bell curve and if they tested on the basics everyone would ace it. There would be no distribution.
The material in M1 is mostly conceptual, and you need those concepts to be a good physician, to take good care of your patients, and to be able to explain to your patients what is going on in their bodies. There is not much you can do to reduce the volume here – it’s more about finding ways to study more efficiently by creating a study strategy, which I will cover on future podcasts.
Now I know that’s not what you want to hear, and I wish there was a way to reduce the volume during M1, but stick with me because I’m going to give you some tips for what you CAN do.
But one more disclaimer first: during M1, you can use the basic science sections of First Aid to help you review, but be warned that this can backfire. First Aid can be a distraction and can intimidate you early on, and you might feel like you have more volume instead of less. There’s a lot of information in there, things you won’t have seen yet and likely won’t understand yet. So when you start using First Aid, just proceed with caution and if you feel overwhelmed by it, give yourself permission to put it away.
So here are the four ways I suggest using First Aid during your first year of med school:
- Confidence boost before the exam. Most of the summaries in FA are very basic, and you will have learned it in much more detail than First Aid goes into. You know, it feels good to go through FA and prove to yourself that you actually know a lot about the subject. Then you can take that positive energy into the exam.
- Diagrams. For the visual learners especially, seeing the information laid out in a new way can reinforce it.
- Mnemonics. They are highlighted in red so you can easily skim and find them. Now I’m a huge advocate of creating your own mnemonics, but if you are pressed for time, this can save you from having to make your own.
- Clinical context. Usually right next to a concept they will have the most high-yield disorder associated with it. This is great because a lot of the time professors will give you like 10 rare diseases that can come from one abnormality. It’s because they’ve been studying this in their lab for the last 15 years and they are entirely fascinated by it. I loved that about my professors, and hated it too, because it’s overwhelming! FA can help you focus on the most common association, which is actually the most likely to be tested on your school’s exam as well. If you think about it, a good professor is going to teach you 10 rare disease associations, then test you on the most common one. Another caution though: if you see something in First Aid that your professor hasn’t discussed in lecture or in lecture notes, just ignore it. You aren’t missing anything. Most likely it will be taught in another course or during organ blocks in M2 year. Keep your eye on the prize! Worry about your M1 grades, and building your basic medical knowledge because step 1 will come soon enough.
III. Using First Aid During M2
Now for M2s, the advice is entirely different. M2s need to be incorporating their First Aid into an overall study strategy. This will drastically reduce the volume of material you are focusing on. For M2s, First Aid offers great graphics, mnemonics, a way of categorizing and contextualizing the material, clinical correlations that bring the organ systems to life, and a framework for checking your understanding of the material. The problem med students run into is that they don’t use First Aid the right way. They try to memorize everything in it. I hear this all the time – if I memorized every page of First Aid, could I get a 280 on Step 1? That’s entirely the wrong approach. I’m going to walk you through how to use First Aid, step by step (no pun intended!).
- At the beginning of your organ block, skim the corresponding section in First Aid. Look for any clever mnemonics and just try to get a basic idea of what you will be learning. Don’t take any notes. Just kind of file away what information is in there.
- Then, put it away and focus on your class. You can take it out every once in a while as a reference book, but it can sometimes get too distracting. So I would use it sparingly.
- Then, about one week before your block exam, go back and re-read the section more carefully. At this point, it should feel like First Aid is complimenting your knowledge, not giving you more to memorize. For me, I would always find something in First Aid that gave me an “a-ha!” moment. You know, I had been studying hyperparathyroidism for a week, but then I saw a graph in First Aid and suddenly everything made sense. For you, perhaps something you were struggling with will click into place and this is effectively reducing the volume of material you have to review over and over.
- Next, identify critical concepts you may have glossed over, but ignore anything your professor did not highlight. There will be plenty of time to learn it later. I was always looking through First Aid like, ooh, rhabdomyomas, I better learn about these! Which is crazy because it won’t be on your block exam, and by the time you get to Step 1 you will have forgotten it anyway. What you are looking for here are things that your professor talked about, but that you underestimated. For example I remember during Cardiovascular, right above the blurb on rhabdomyomas was the section on myxomas, which are cardiac tumors that are very high-yield, and my professor had talked about it, had put in a slide about it, but I had kind of ignored it thinking it was just him being eclectic. So that’s how First Aid can help you – if a fact is in there and also in your lecture notes, it’s worth memorizing now.
- And finally, put high-yield elements into your long-term memory system, and leave professor-specific details in your short-term memory system. That might sound confusing if you don’t feel like you have a memory system. For me, my short-term memory system was flash cards, and my long-term memory system was this thing called the memory palace which I’m going to be doing a video series about on my site. If you don’t have a system like this, don’t worry, but sign up for that video series because it will probably change your life like it changed mine. And in the meantime just remember that you want to be memorizing facts in First Aid in such a way that you will easily recall them when it comes time to study for Step 1. A little extra effort now will save you a world of headache and stress later.
IV. On Taking Notes in First Aid
A word to the wise for M1s and M2s – resist the urge to transfer class notes to your First Aid. I mean, just think about it. People always want to annotate the margins. You are basically writing low-yield content into the industry standard for high-yield content! If a fact is truly high-yield, and it’s not in First Aid somewhere, it’s because it is a concept you will know by Step 1 anyway, so you don’t need to write it in. Don’t take notes in there. The only exception is if you have a very clever mnemonic that you will use again in the future, this is a great place to store them. Otherwise, remember that the point of using First Aid is to reduce volume, so don’t water it down with extra material.
I hope this podcast has given you some ideas about how to use First Aid to reduce the volume of material you have to memorize.
Please go to the show notes at www.sholamd.com/2download and download the “Guide to Using First Aid.” And more importantly, put these ideas into action as soon as you get your book. If you have the book, pick one of your lectures from today and look it up in First Aid. Spend no more than 5 minutes – seriously! It’s easy to get caught up in this exercise. But just look at what the similarities and differences are. Was there anything in FA that you found helpful? Did looking at it help you pick out the most important concepts from your lecture? Was there something in FA that you mistakenly thought wasn’t important in lecture? I’d be curious to hear what you think, so please post a comment in the show notes at sholamd.com. See you next time!