Wednesday, September 8, 2010

How To Survive Medical School Part 3: Prioritise

This is quite a timely post, as I am on a very busy rotation and have not been writing much recently. Also, I am going to be keeping this brief, as I have to keep going with the study.

If you cannot prioritise, you will not survive medical school. That may sound extreme, but it is very true. If you have gotten in, you are probably already pretty good at prioritising, but compared to other areas of study, medicine is so huge that you need to improve on this skill rapidly if you are to keep your head above water.

There are so many things that you feel expected to know and to do, and you will never have time for them all, even if you had twice the hours in the day that you do. Perhaps you are one of those brilliant people who does not need to study and who remembers everything forever the minute you read it. I'm not, and neither are any of the people I know.

If you are like me, you have to sit down, study and understand things before they stick. Then you forget all about them until you are examined or asked on the wards. Krebs cycle, anybody? If you are a physician and work with metabolic defects, it probably sticks in your mind because you understand it and can see how it works on a practical basis. I have finite room in my brain, and it tends to be reserved for things that I use regularly. Thus, until I work with patients with these problems, my understanding will never be any more than superficial.

Yes, these things are all important and I would love to have the time. One day I really hope I can have a deeper understanding. But at the moment, when we stare down the barrel of regular and very specific examinations, things like this get left to the side, apart from the odd revision where I open the textbook, look wistfully at all of the things that I would like to learn, then close it and go back to the things that I need to learn right now.

What do I think are the important priorities as a medical student? That is completely and utterly up to you. My advice is to work out what you need to do the most, then do that first. Take it all in baby steps.

I have tried to write out my priorities as they are, but they do change from time to time.

1) Personal health and hygiene. Yes, I need to shower and eat breakfast. I also need to go to the GP on occasion. My dentist regularly nags at me because I don't see her often enough and I'm not an obsessive flosser, but I don't really care. I brush twice a day and don't need fillings, so beyond that is just too much for me. Medical students get sick, too, so get that pap smear done, keep up to date on your jabs and health checks and make sure that you are still around to finish the course. You can generally schedule these things around your class times or rotation obligations, so make sure you keep up with them.

2) Aim to be a safe and competent doctor. This is my number one priority after being alive and in one piece. This is why I desperately try to be better at pharmacology than I already am (and why it terrifies me that we don't cover more of these things in our course).

This is why I like to focus on the "Red Flag" diagnoses that you should never, ever forget about. The things that will kill your patients, or seriously harm them if you drop the ball. There are the diagnoses that you need to think a little bit laterally to spot. Then there are seemingly small things like the decimal place or the units on a drug chart. This is scary stuff. What is the point of doing really well in medical school if you aren't a safe doctor?

This might mean that you have to speak to somebody at your school or clinical rotation if you feel that you are not being properly supervised or taught, or find alternative ways to learn. As one wise person told me, if you are in court defending yourself a couple of years from now because you didn't know how to do something as well as you should have, they won't be interested in your excuses about not being taught properly in medical school.

3) Passing exams. I know it might sound obvious, but it is sensible to do your best to pass your exams. I would like to think that if you used common sense and studied topics from the viewpoint of how you will be thinking as a doctor, you will be fine. You might not be. It depends on the course. Don't forget to name the most likely diagnosis first and use common sense. Past papers can be very useful, so look at them to see the type of question you might be asked, but don't forget to study more than just the past exams and don't forget aim number 2.

You can split your content into what you really need to know, what you should know and what you would like to know if you had the time. It can be hard to sort these things out in first year, but this is where the other more experienced students come into it.

4) Study may have to come first, before other things that are more fun. Yes. this hurts, but it is true. You need to have some fun, but it needs to be in moderation, and your learning needs to come first.

Really important family gatherings are something that you should try not to miss if you can. Less important get-togethers may have to become a lot less frequent. If you never, ever miss an episode of Neighbours or CSI, you may have to change your priorities.

This is one of the reasons that some medical students get the reputation for working and partying hard. They spend most of their time studying their butts off, then when it is time to let their hair down, they get it all out of their system in one hit. I favour a more balanced approach, but we are all different. I'm more of the tortoise to their hare.

Binge drinking is dangerous and I feel strongly that there should not be medical student society events that endorse it. Clearly I'm odd, but if you are studying so very hard to fill your brain with knowledge and build up a respectable career, why take part in an activity that can seriously harm or kill you, or ruin everything that you have worked so hard to achieve? I like alcohol, but binge drinking on the scale I have seen in medical school has been an unpleasant surprise.

5) Occasionally you may have to take some time out to recharge. This might be as long as a weekend off uni work, or an hour or two to watch your favourite movie. I would choose to pass exams over taking some time out, but if you can afford it and need to de-stress, see if you can salvage some valuable time for yourself, even if it is just an hour or so for a massage or to get your hair done.

These are the priorities that have gotten me through medical school so far. Things might be different for you, and that is okay. The most important thing is to learn to take things one step at a time and to work out what you need to do the most, and get that done.

Good luck.


Jamieakamusekid said...

Loving the "how to survive med school" series. Thanks TGWTBS

The Girl said...

No worries. Glad to be of help. :)

Julie said...

Hi there,

Just to let you know I've listed you on Mediblog UK. Hope that's ok with you; if not, let me know.

The Girl said...

Thanks, that is great. :)