How medical school students memorize a lot of stuff and regurgitate it instantly under ridiculous time pressure

Summary

Med school students look carefully for the information that they absolutely need to know. Once they find important information, they study it deeply, taking notes to form connections of why and how things are the way they are. Their aim is to never have to study it again.

The building blocks of complex theories are facts. Med school students use flashcards with spaced repetition to memorize facts. When the facts are too disconnected to be easily memorized, they use mnemonics and associative narratives to make it easier to memorize the facts.

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For those of you who don’t know, I run a tutoring company called Trevor Klee, Tutor. We do test prep for graduate exams. As a result, I’m constantly dealing with people who need to learn a lot of material that either they haven’t encountered since high school, or have never learned.

Needless to say, I have a lot of thoughts about teaching in general and teaching how to learn specifically. But, I don’t want to talk about my thoughts today (as undoubtedly valuable as they are). Instead, I’d like to discuss what med school students think.

My girlfriend is currently in medical school. She’s about to take her STEP 1 exam, which is a giant exam covering the entire first two years of medical school. It’s also one of the most important determinants of what residency a med school student gets into, including what specialization they get into.

In other words, the score on the STEP 1 exam is perhaps the single largest factor in where med school students will work, what they’ll do, where they’ll live, and their future salary. Med school students are naturally smart and competitive. Put them them in a situation like this, and you’ve basically put study strategies/memorization techniques into a Darwinian survival of the fittest.

Some of the strategies that almost all the medical school students agree on shouldn’t be surprising. Every medical school student reads a ton, uses a ton of flashcards, and does a lot of practice questions and exams. It’s a ton of work, and there is zero way around it.

I’m more curious on the things they do which are more surprising. Here they are in no-particular order.

Specific methods med school students use to study for huge exams

1) Every medical school student uses Anki for flashcards because of its built-in spaced repetition. Spaced repetition means that flashcards you get wrong you see more frequently than the ones you get right. The idea is to learn information, then help it make its way from short-term to long-term memory. So, when you see a question on the topic 4 months later, it’s still instantly recallable.

This information is always bite-sized, not the complex information they’ll need for their actual exams. However, complex theories and relationships have atomic facts underlying them. Without the facts at your fingertips, the details of the theory aren’t fleshed out, which means that you don’t really understand the theory in the first place.

2) Medical school students study their readings deeply the first time around. As long as the information is valuable (and they discuss endlessly which topics are “high yield” for their exams), they try to understand the reading as much as possible.

That means taking notes, yes, but it also means forming connections in your notes beyond the text. Why is the body structured the way it is? Why do you use one drug for one condition, but another drug for a very similar one?



The aim for a medical school student is to never have to read a passage twice. As tempting as it is to try skimming the passage once, and then reading it later, or just skimming it multiple times, it doesn’t work. To skim valuable information is to waste your time.

3) Similarly, medical school students study valuable test questions deeply. A lot of them use a program called UWorld, which creates practice questions for the STEP exam (and other exams). They use this program because it’s famous for having difficult questions and in-depth explanations.

Students in med school will frequently spend as long reviewing their answers and the explanations as they did doing the questions the first time around. Doing questions is not enough to learn the concept. Doing questions and reviewing the right answer is not enough. In order to truly learn, medical school students force themselves to review the entirety of the question and answer, and form connections beyond the question itself.

4) Med school students are always looking for mnemonics and memory tricks for difficult to memorize facts. For instance, there’s a popular study tool and video series called Sketchy, which associates drugs, microbes, and concepts with memorable characters and events.

To help students learn about acid-base disorders, for example, Sketchy draws the journeys of PHrodo, as he deals with low acid lava in the valleys and basic blue pools of water high up in the mountains (get it? Low pH acid, and high pH bases?). Samwise Gamgee dropping a box of sodium bicarbonate is added to illustrate that, in metabolic acidosis, serum bicarbonate is low.

The illustrations get more complex as conditions and complications to the disorders are elaborated upon. Crucially, though, the same images are repeated when possible, to create a story and an association in the students’ minds. Ideally, when students next try to remember all the details of acid-base disorders, they can just remember the details of the adventures of PHrodo, and put a narrative to what would otherwise be unconnected facts.

5) Med school students minimize the amount of time they spend on non-productive studying. So, this isn’t to say that med school students don’t procrastinate. They do, and they have problems with it just like the rest of us.

However, when med school students study, they try to make the most out of their studying time. One simple way that many students do this is by speeding up lectures to 2x speed. While not everybody can speed read (and it’s debatable whether it’s teachable), it’s possible for anyone to simply speed up lectures on Youtube or your video player of choice.

It’s annoying and hard to get used to at first, but, once you do, you can get through the less information dense part of lectures 2x faster. If the material gets particularly dense, you can just pause the lecture to think about it, or slow it down to normal.