From 1st to 4th Year: How to Operate at Your Best in Medical School

Getting accepted into medical school is a significant accomplishment. Now that you’re ready to tackle medical school, Picmonic and one of our favorite doctors, Dr. Chris Tenore, have thoughtful and practical recommendations to help you make the most of these years.

Remember that Picmonic is here for you from day one to work in conjunction with your classes. More than 800,000 students around the world have found the resources, support and levity of our picture mnemonics, or Picmonics, help them excel in a class or on a specific topic. As a med student, your time is valuable and we all want you to use it effectively and efficiently, so let’s dive into Dr. Tenore’s advice for success starting from wherever you are in medical school.

LEARN TO MASTER STUDYING

Preparing for Class

Whether your class is in-person, virtual live or on-demand in 2020, knowing the best way to use the format and resources available to each class is step one. I highly recommend watching or attending classes live, versus watching the recordings. Being present in real-time keeps any student more engaged with the content and any discussions happening. Planning for your classes will also help you set your schedule and help you to keep it.

Schedules are going to be an important part of using your time effectively and anything that forces part of that schedule productively is a good thing. Start planning and implementing your med school prep schedule at the beginning of the semester. I recommend studying a little each day, with free time in the afternoons/evenings and planned days off here and there. As you get closer to the end of the term you will need to plan time to study every day.

After the Class

If you don’t know the secret about repetition, I’ll be the one to tell you. Repetition is key to retaining information. Picmonic knows this and has built it into their Picmonic Learning System with the results to prove it works. Retaining knowledge requires repetition. Always try to review class notes at least once in the day or two after each given class, and try to space out your reviews on different apps or resources during the days between your class.

Beyond the Textbooks

Textbooks and lectures offer all the information you need. But thinking about information in different forms from different resources can lead to better retention. I benefited from trying other methods like drawings and mnemonics and I encourage others to try these as well. Picmonic for Medicine is the best resource I’ve found for this. Our brains store drawings and mnemonics easily for quick recall, without the necessary brute force memorization that using textbooks requires of you. You can also get creative and make your own, either for just you or to share with Picmonic.

One tip I can’t stress enough is to work with your med school classmates. Form study groups with your new peers. It will enhance your motivation while fulfilling socialization and friendship during these years where school and studying are the priority. Some schools offer peer tutoring programs. If your school has one, take advantage of it!

Creating solid study habits and schedules as a med student early in your program is important. Doing well in your classes sets you up for success throughout school and beyond because there is a correlation between class scores and Step 1 scores down the road.

STUDYING FOR USMLE STEP 1

The USMLE Step 1 is something you either have, or will soon, hear a lot about in your preparation to becoming a medical doctor. This eight-hour test will assess your understanding of scientific concepts that are basic to the practice of medicine so it should be no surprise that studying for this will be a priority and something you work towards.

Step 1 Study Schedule

Start slow and build up your stamina. Think of this like training your body to run a marathon. Plan your studying, schedule it and increase incrementally. If you’re taking USMLE Step 1 in June or July, start studying in January or February. Begin integrating Step 1 prep with a few questions here and there. I also recommend reviewing Step 1 First Aid with your classes.

First Aid is the gold standard for USMLE Step 1. Coupled with Uworld followed by consistent review on Picmonic for each topic, you will set yourself up for success. Start slowly and increase the amount of questions you do during studying the closer you get. In the two or three months before your test, your goal should be at least one set of questions per day. It’s best if you have a dedicated study period, especially in the weeks before the test when you should plan to do as many questions as possible. A great goal would be getting through Uworld twice if possible. Using Picmonic throughout your Step 1 studying will help retention on the topics you’ve been studying in First Aid and Uworld. But, through all of this Step 1 prep, keep yourself as balanced as possible with some of the tips below.

Studying Resources for Step 1

Many of the resources and best practices I recommend for Step 1 prep are going to be beneficial throughout your program. But three resources stand out as a key to USMLE Step 1 success: Uworld, QBanks and First Aid.

It is in your best interest to use these resources as much possible. Remind yourself, though, that it is nearly impossible to know all of the material in Uworld, QBanks and First Aid for USMLE Step 1. Schedule these into your studying plans and be consistent. You should try to integrate Picmonic from the beginning, but definitely as you review topics during Step 1 prep and when you get topics wrong, Picmonic will be a very beneficial tool to understand what you know and, more importantly, what you don’t know yet. Base your degree of studying on your own personal career goals, such as which specialties you are interested in applying to.

By about six months before you take Step 1, you should start integrating First Aid into your studying routine. It will help you with med school prep for regular classes whenever it aligns too, which is an added bonus!

When you work on bringing together everything from your courses, textbooks, Uworld and First Aid, you will absolutely benefit by having Picmonic in your life. It was crucial for me in passing both Step 1 and Step 2. You should be dedicating time to Picmonic before you start studying for Step 1, but at the least, be sure to block time for Picmonic alongside First Aid the closer you get to the test. There is a significant amount of First Aid content also covered by Picmonic, and the more you review information through different processes, the better.

There are other resources out there, but in my experience, these are the most effective. I also know some students have used the paid review courses. These can be very expensive, but they work well for certain students who appreciate the regimented schedule and pace. No matter what you use to study, weigh the pros and cons of each and how they fit your needs. Once you find a good routine and beneficial resources, stick to it because the approach to studying for Step 2 is similar to Step 1 prep.

ADVICE FOR CLINICAL ROTATIONS

Your clinical rotations will be an exciting, eye-opening experience. It will challenge you and excite you about your future as a doctor. Picmonic is a great resource to use during rotations when you are exposed to something new during your rotation because there is going to be a lot to learn quickly, and your classroom is a little different than before. Here is how to make the most during your clinical rotations.

Working with Supervisors

One of the most important things you can do when you begin your clinicals is to make a good first impression. Follow these proven tips I’ve seen from both sides of this experience.

First, your evaluators are generally looking for students who have a few key characteristics:

  • Motivated – be the person who is asking for new tasks and getting involved whenever possible, within reason.
  • A team player – particularly as a student, and as a resident, you want to be someone who works well with others. Try not to come across as standoffish, arrogant, or cynical.
  • Curious – asking valuable, thoughtful questions and/or reading up on cases independently shows you have the innate drive to learn.
  • Professional – do your best to show up on time every day and have a good rapport with others. Complete assigned tasks on time and don’t ask to leave early too often.

Second, you need to take initiative in your job and with your classmates. If you aren’t given specific tasks, ask your preceptors things like “Is it okay if I follow this patient?” or “May I accompany you?”. If you are on with a resident preceptor, try asking “Is it okay if I try to write a note on this patient?” or “Can you review my note?”. You can also ask to watch or participate in simple procedures like doing an IV placement. Doing this shows interest and also takes the responsibility off of them to do this for you.

And lastly, it may seem small, but before your exit each day, ask them “Is there anything else I can help with?”. Being in a teaching hospital and working with students is rewarding work for many providers. By showing initiative, and showing interest with effort (like reading and researching on your own), you will stand out in a good way from day one.

Works Well With Others

Without a doubt, your clinical knowledge is absolutely vital to your success in clinicals. However, building off some of my recommendations above, your ability to work well with your peers, supervisors and others is the only way to truly succeed in clinicals and in the real world.

Put effort into meeting people and remembering their names. This includes nurses, nurse assistants, front desk staff, managers and others. Treat everyone with professional respect and consideration.

One more thing that can set you apart in a good way is to offer to do a small group presentation. Try to do this at least once during rotations. It can be a 10-minute presentation on an interesting case you had or something you are particularly interested in. Be sure to tell your fellow med students so they can plan accordingly.

QUALITY OF LIFE

It can be tempting to throw yourself into school and forget to strive for balance. Your courses, studying and clinicals will have to be your priority right now; there is no getting around that. But you have to maintain your quality of life, and having balance and breaks are actually crucial to success.

I talk a lot about schedules and planning for how and when to study. But you should also make a schedule that includes taking breaks. It is so important to give your mind and body these breaks. You may be tempted to study for hours on end, but you will greatly benefit from brief, intermittent breaks for stretching, eating, and relaxing a little.

Staying healthy is important to operating at your best. I am not advocating this as the time to start a new diet or workout regimen. Keep it simple with healthy practices like:

  • Having a consistent sleep schedule of 7 to 8 hours every night,
  • Doing 20-30 minutes of physical activity like yoga, jogging, weight lifting or swimming most days, and
  • Socializing with med school friends, friends from home and family even if it’s brief or virtual.

Lastly, medical school is going to ask a lot of you. Ensure you keep tabs on your mental health. Doing the recommendations above will definitely help, but it is normal and expected to feel stressed and anxious in medical school. Burnout among physicians is higher than most other careers so have a plan of how you will handle the ups and downs. Talk to someone when you’re stressed, and don’t be embarrassed to reach out for professional help if you need to, because that will help you be the best student and doctor you can be.

TAKE ADVANTAGE OF OPPORTUNITIES

You will have the opportunity to complete projects while in medical school. Get involved with groups and take leadership positions. My advice: make them count!

Go the Extra Mile

I recommend completing one or two projects during medical school in which you have a leading role, to make yourself the best candidate you can be for residency programs. Taking the opportunity to develop and showcase your leadership skills is one of the best opportunities for students. You could present your work as a poster or a lecture at your school or a conference. The important thing is to take advantage of these opportunities.

Quality improvement (QI) projects can be pretty compact and straightforward so they would be a great place to start. Other projects, on the other hand, like research projects or getting your name on a paper, will be harder to do. These generally aren’t required except for highly competitive or technical specialties. Either way, look to your faculty mentors for guidance.

Outside of school, you can – and should – get involved with community projects if it fits your time and interests. Again, these may or may not be healthcare-related and that doesn’t necessarily have to be the focus. You can volunteer your time for a cause, lead a committee, spearhead a fundraising opportunity or any number of other worthy causes.

PLANNING YOUR CAREER

You may have an ideal career in mind before you even start your first class, but if you don’t or if that ideal career changes during school, it’s a good idea to dedicate some time to deciding what your career should look like and how to get there. From forums like studentdoctor.net to one-on-one networking, there are many ways to gain exposure to opportunities that can make your career path a little easier to navigate.

During your 3rd and 4th year, try to spend elective time working on projects or in clinical rotations in specialties that you’re interested in. These experiences can provide a depth of insight to help solidify your focus.

Networking Tips

As you get further into your med school career, it will become more important to dedicate time to researching the specialties you’re interested in. Take it a step further by looking up residents or fellows and asking to talk with them about their experiences in the field. Similarly, take time to talk to professors and faculty at your school or hospital. They may have experiences or connections that will provide insight for your decision making process.

Now, if you are already set on a specialty, start planning towards that early in school. Reach out to people in this field during your first two years. You will be able to discuss projects with these contacts and look to them for career planning.

Medical school offers you unique opportunities to meet professionals, network with peers and professors, and to get involved. Use this time to your advantage to showcase and develop skills and connections to set yourself up for success in school and in your career.

Resources and different apps – like Picmonic for Medicine – along with mentors, peers and medical professionals all want to see you excel in your program and have a successful career. You know that this time will push you and require you to dedicate yourself, but you aren’t alone. Take advantage of the opportunities and professionals who are happy to support you!

Dr. Chris Tenore attended medical school at Albert Einstein College of Medicine in New York. He completed his pediatric residency at Yale New Haven Hospital in Connecticut, and a clinical informatics fellowship at Mount Sinai Health System in New York. He is currently practicing pediatric urgent care at the Children’s Hospital of Orange County in California.

Dr. Tenore attended medical school at Albert Einstein College of Medicine in New York. He completed his pediatric residency at Yale New Haven Hospital in Connecticut, and a clinical informatics fellowship at Mount Sinai Health System in New York. He is currently practicing pediatric urgent care at the Children's Hospital of Orange County in California.
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