Organising notes and information while studying

"Hello IkaN!
I hope you're okay and happy :)
Can you teach me how to be organized? How can I save my notes?
I don't know why I'm so untidy. I want to be just like you, helping others & having good grades! <3
Please help me out here!"

- Email by an awesomite

Hello! I'm okay and at peace (:

Your organization depends on where you study from.

I study from books and ebooks so my study life seems very complicated to others.

I can read while I'm in the bus or in the train on my phone, so I always have ebooks or audio lectures with me. I can't write while traveling so everything I learn is saved on my phone. When I study with my books at home, I like having the traditional pen & paper to write, doddle and draw. Or a white board.

Here's how I save the information I have studied:

1. Make subject wise notebooks and write notes in it:
This is effective when you're studying from multiple text books and you need to merge all information into one for fast review during exams. I recommend making notes after you've read from all the textbooks if you're using this technique. You don't need to be tidy!
PS: This is time consuming.

2. If you're using ebooks, highlight and bookmark:
I read Harrison (Which is a HUGE internal medicine book) this way. The bookmarks would show me the topics I've read and while revising, I'd go through the highlighted lines only.
(App I use: Adobe Reader)

3. Type your notes and make sure they're synchronised:
If I have too much information on the digital platform and too little time to write on paper, copy paste on a notes app. Make sure you sync and back em up.
(Apps I use: Google Keep, ColorNote)

4. Blog:
The internet a wonderful place to save everything! (Many a times, I look for my own notes on Google =P)
If you don't have time for a fancy blog, just a simple tumblr with your study material is a good way to keep things in one place.
(Apps I use: Blogger, Tumblr)

Extra tips:
- Make a separate book for points you write during lectures. They're not always important but you will want you refer that book for the one thing your teacher said that you can't recollect while studying.
- If you think it's important, always write / save it somewhere. In my experience, you regret the things you didn't save =P
- Don't always focus on making the notes. Understand the information first, then organize it so that you revise and remember it.

The fact that you find me someone you wish to be like makes me happy. I hope I live up to the image you have of me =)

Until next time!

I am finding first year MBBS extremely difficult and tough

"Sis.. I just joined medical college. Finding it extremely tough to study. None of the subjects seem familiar. I'm losing all my positivism and feeling helpless."

Firstly, take a moment to congratulate yourself. You've made it to medical school! New subjects is going to be so much fun!

"I feel left behind. I'm not able to answer. What is taught in lecture is very minimalistic compared to text book."

Studying Biochemistry

"Just came across your blog. I must say you are very inspirational. I am first year medical student but I find it hard to study biochemistry. I would like to know if there is a good way to learn it. Any tips?" -Asked by email

How to speed read

I have modified a lot of general principles of speed reading for us, medical students, because we need to understand what we read.

Repeating PG entrance exam

"I'm a PG aspirant... This is my third year of PG preparation. I lost all interest in medicine. I've lost all hope too. I'm just tired of trying. I don't know who to talk to. I don't know how you get so much passion to write your blogs. I don't how to study also."

I understand that giving an exam for the third time must be really frustrating and tiring.

So my advice to you is - Make sure you prepare so well this time that it's your last attempt and that you get whichever post graduation seat you desire. Study real hard, no excuses.

It's natural that you tend to lose interest in learning repetitive facts. Maybe you should try hunting for new ideas, new perspectives and gain a different understanding of old concepts?

Google about facts you've learnt earlier. This time, instead of memorizing, think of why.

Question everything - Why does this muscle cause that movement? Why does sickle cell anemia cause leukocytosis? Why does phenytoin produce vitamin B9 deficiency?

Trust me, questions and curiosity will awaken an unexplored passion in you - The one you lost in studying the same things over and over again.

Study tips: Anxiety for test day

This is my first time talking to anyone I follow on anywhere... Be it twitter or tumblr. I am not very involved in social media, but I guess I am a bystander.

I am messaging you because I am in a bit of a dilemma. I am writing my USMLE step 1 exam in 5 days. I have been studying for it, believe it or not, for 2 years.

In this time, I have been home, my parents looking after me after I had gone to a med school on the island. I suffer from text anxiety... So like in the middle of the exam my brain just gives up, I feel at loss of hope. I just get this overwhelming feeling of failure.

I have bought the exam twice now and my date is scheduled for the last day possible. My parents are just fed up and they want me to get moving with my life. I have inconveninced them.

I have written all the NBMEs and I have never got a score above 300. I study so hard, but I hate to memorize if that makes sense. I have watched all the Kaplan videos, all the DIT videos and I have completed both Q banks. I know everything, but when it comes to route memorization... I can't do it for some reason, because I have this fear of it even is going to stick. I don't know what to do and I hoped some wise words from you might help me. You have some awesome things to say and they helped me lurch back up on a low day. I am literally trying to fly the coop right now.

Hope I am not intruding with my story.

- Email from an awesomite

Hey!

I'm glad you chose to speak to me.

The USMLE step 1 exam is scary. And it gets scarier as it gets closer. I had scheduled it on the last day too! My mum needed to go abroad and I had inconvenienced her. I never scored above 300 either in my NBME. But I got a good score on my step.

I'm telling you this to assure you that this is normal. That many have gone through the feelings you're going through and have made it before you. That you're not alone. That there is always hope.

You made it through various exams as you got here. Let's do this and get done with it. You have studied and you can trust yourself in midst of self doubt. You can do this.

You shouldn't be afraid of consequences. You've given your best shot. You have worked hard. Be confident that it'll work out for you in the best possible way.

Now this is a personal belief - I believe that not all five fingers are the same. Everyone is unique. That you have your own limitations and strengths. So some will score better than you, some won't. Accept it.

Once you have done your preparations well and that there is not one more thing you could've done, you must not worry about the results. Everything happens for the best. There's a good reason behind why things don't work out the way we want to - we don't see it right now but it doesn't mean it's not there. So I'm content with the results even before they come out.

I also believe that scores don't matter. That you can do wonderful things with your life without the scores. Yes, a good score will help you feel good about yourself and open doors - but a fear of a bad score shouldn't fill you with despair. The little anxiety you get should help you work hard, not come in your way.

I understand your memorization dilemma. Remembering things comes to us with repetition whether we like it or not.

There's not much you can do 5 days before the exam. But if there are certain high yield facts that you know you have not memorized - You can store facts in your short term memory and then forget them forever. We are capable of it. So you can't memorize everything, but please do what you can!

On the exam day: Focus on the question. Don't let your mind wander - go into past disappointments or future failures. Stay there. Read the question. What's the best answer to this question? Hmm.. This is an interesting one. What could the answer to this be? What are they trying to tell me in this question? Oh I don't know about this - will read about it later. The hints they're giving me are awesome. Ooh. This is a tricky one! I likey! I love medicine and it's enough. I'm living my passion. I'm lucky to be here. And that positivity, I tell you, will pull you through and give you hope.

I'm glad the things I said helped you. I hope this does too.

You're not intruding, be free to message me whenever you like (:

I understand that you might not get the time to reply after reading this - so I'll hear from you after the step. All the very best to you. I'll pray that you do well.

Love,
IkaN

How to study pharmacology

First, you need to get the concepts right. Speed read and get a big picture, then understand the little details.

I dived into minute things I didn’t understand right away.. Now that I look back, I think I should’ve been patient.
Anyway, lil doubts made great blog posts!
Example: Why is lidocaine preferred in patients with arrhythmias following myocardial infarction?

It’ll take time to get a hang of the names of various drugs.. If mnemonics work for you, you should try making em! Try to put mechanism in the mnemonic to make it simpler (That’s what I do!)
Here are some recent examples of how I make my pharmacology mnemonics -
Antifungal drugs with mechanisms
Antiparkinsonism drugs with mechanisms

There are certain drugs which are unique and that is why remembering mechanism of action or their pharmacological property becomes very difficult :/
I talk about how to remember them in this post --> http://medicowesome.blogspot.ae/2014/06/pharmacology-study-tip.html

I requested my study group awesomites to contribute their tips so that I can share them. Here are the suggestions, tips, tricks, life hacks they told us! :D

One awesome way is to make a self constructed table. Side by side drugs.. Uses. Side effects and specific points. Helps a lot.
- Great tip by Sakkan.

I had small classification charts put up all over my cupboard and wall! I Would revise them at night....Since I found classifications a bit volatile.
- The repetitive memorization trick was submitted by Priyanka. (I made flash cards for the same!)

One useful tip is whenever you see a sachet of drug.. Just read the contents and dosages.
- Awesome tip by Sakkan. (Wish I did that earlier!)

And try explaining uncles and aunties taking them what's going on :D
- I like how Sakkan said, "Try" explaining. (She says she gets a lot off oooo, aaa and even a couple of blank faces too!)

I always discussed pharmacology with my friends, and mostly, taught juniors. You get good karma + revision.
- Manisha (Good karma always helps!)

It is very volatile but this subject manages appear everywhere.. All subjects. Everywhere there are therapeutic drugs mentioned. Makes it really difficult to grab the essence if you don't do pharmacology.
- Sakkan's way of telling us take pharmacology seriously.

I drew small cartoons...Of concepts I found difficult to remember.
- Priyanka (Send us your cartoons soon, girl!)

Book recommendations by awesomites:

A very good book for pharmacology is Colored Atlas pharmacology. For retaining most of it. By thieme. A page of drug and a page of illustration. Very helpful.

And there's at a glance series. Exists for all subjects. Comprises cool diagrams, flowcharts and accompanied with a page of description. Pretty standard text in her very easy format.

Motsbys pharmacology memory note cards. If you like cartoons this little book is great. (It's very adorable.) I have to admit there are drawings which I dont really get. Thats why doing your own drawings also comes in handy :)

I wonder if all international students refer Katzung or whether they have local authors too.
I think Lippincott is the standard, internationally.
Lippincott is simple to understand- standard and interesting book to read.
A book very commonly referred to in India is KD Tripathi.
We have Farrukh Jabbar, here, in Pakistan.

That's all!

I'll keep updating the post, adding new tips and tricks, till then, stay awesome!

-IkaN

Study group discussion: Studying physiology

Could you share with me tips to study pre med subject? Like physiology perhaps?

Physiology is my major, I draw diagrams basically. Understanding the stimulus and response first, then learn the steps in the middle.

Yup, flow charts for physiology!

Physiology is easier when you start at the big picture then elaborate on each pathway.

And make lots of notes. Here's a link on that http://medicowesome.blogspot.ae/2014/12/how-to-make-concise-medical-notes.html

I used to draw a lot of flow charts in physiology..and Youtube, try subscribing to armando hasudungan or medcram..They have nice videos!

Study group discussion: Remembering Anatomy

Is there any easy way to remember the relations of the viscera?

Diagrams will help you remember the relations! There are a few mnemonics for arteries and stuff but in general, painting a picture in your head is the best way to remember!

Use Atlas for visualisation, see  videos of anatomy (Acland, Dalhousie) for awesome live experience... Highly recommended.

Seeing the viscera during cadaver dissection also helps in anatomy.

For anatomy, I find it helpful to draw the pictures out and label them. This allows you to appreciate the boundaries. 

I always drew diagrams in anatomy..Netter's helped a lot. 

Dissections are equally important...I  always read anatomy and revised it in my dissection class

I have no idea about USMLE Step 1

I have noticed that some of my readers haven't spoken to anyone about USMLE step 1 exam and ask very basic questions about the preparation so I decided to write a separate post on it.

For those who have started preparing for the exam and have a general idea
- You'll find most of this post useless and redundant.
- I have marked asterisks (*) for important points you might wanna look at :)

Lastly, most of these are replies from conversations that I've had with real people so
- I haven't sequenced them in order.
- Ignore grammatical errors that I may have overlooked.
- Some of them have shout outs to Indian medical students (Simply because I know the Indian system better and it's hard to separate those points and write em again. Please don't mind that. I love you all equally, medics of the world!)

Okay, let's begin!

I just started. Which books do I get?
Kaplan notes and Goljan pathology.
* Don't buy First Aid initially since you'll be requiring a new edition in the last 3-6 months of your prep.

How do I start preparing?
You'll have to start with Kaplan videos. Supplement them with notes. Add extra points, stuff not mentioned in the videos to it. Hear Goljan audio while travelling, cleaning the house. Read the book and know it cold.

What is Goljan audio?
Recorded lectures of an absolutely amazing pathology professor, Edward Goljan.

What all is encompassed in Step one? Which subjects?
Anatomy, Biochemistry, Physiology, Pathology, Microbiology, Pharmacology and Behavioural science.

* It has a lot of clinical questions as well so it's hard for me to restrict the syllabus to basic sciences. For a hypothetical example, say, a question on burns was asked on my Step. In India, it is taught in Forensic Medicine and Toxicology and Surgery. So you get the idea? You require an over all comprehensive knowledge for Step 1.

Behavioural science?
It's Biostatistics from Preventive and Social Medicine (3rd year minor for Indian medical students) and Psychiatry from Medicine (3rd year major for Indian medical students).

If there are minor and major subjects, won't I score better if I give the exam after I am done with MBBS?
Yes, I think people who give the exam after they complete final year score better than those who give it in their basic science years simply because people from first year and second year lack clinical knowledge essential for Step 1.

I must say, my opinion is biased on my experience. I know of a senior who gave his exam before final year and scored a 265 on his Step 1 (So that's pretty awesome and you should go ahead, give the exam without doubt in your basic science years!)

Umm so why give Step 1  early?
- You're utilizing your time efficiently.
- You'll need the score to apply for electives in certain colleges.
- You get "done" with the exam and you can chill out.

When and how to register?
You'll need an ECFMG id to give the exam. That requires college stamp. You'll get the instructions online. If you can't figure it out, email me.

When do need to get the id? ASAP?
3-6 months before you feel like giving the exam, you make the id. It takes approx 1 month to make.
The thing with ECFMG id is that you need to pay a certain amount of money to make the id. That's why, I recommend you to make it when you're absolutely sure about giving the exam.

What is uWorld?
It's an online question bank. They are questions which are similar to those on Step 1 and essential to get an idea of what the exam is like.

When do I start with uWorld?
It is a resource you would like to use in the later months of your preparation because it is difficult (You can't do it without having any knowledge) and because it trains you for the real exam.

Are there other questions banks that I can do?
Many. Kaplan Q bank, USMLE Rx to name a few.
* Unlike uWorld, you can start with other question banks well before the exam because they are not very similar to the real exam, they scare the shit out of you with facts you don't know and motivate you to study.

What is NBME?
Mock exams created by examiners who write questions for the test. They predict your score.

I've heard you need to do research stuff in the field you are interested, is that right?
Yes. Research and electives are required for residency.

How do I become a part of some research?
That is later. In USA. Give your step exams first.
For Indian medical students - You can do research in India as well but it has no value. You'll get experience but that's about it. No credibility.
Procedure in very short: You'll need to contact the HOD of that department, get permission from ethics committee and contact a professor who would like to mentor you for research.

No advantage of research in Step 1?
Nope. They help you in residency match. Just get a good score for now and worry about the other details later.

(I'll keep updating the post with recent questions as and when I can.)

Related posts:

Preparing for the USMLE Step 1 exam

http://medicowesome.blogspot.ae/2015/01/preparing-for-usmle-step-1-exam.html

USMLE for Indian medical students 

http://medicowesome.blogspot.ae/2015/01/for-indian-medical-students.html

Giving the test you failed in while studying for the next exam

I'm a third year med student and today I just got my result for the annual exam and I flunked in biochem :'(
It's been like the end of the world to me today. I feel so hopeless and helpless.
I really have no idea how I'm gonna retake the exam while having the 3rd year classes side by side... I really really hope that I can do as what you did and be just awesome as you are in the future but right now I don't have a clue. Any suggestion about how to manage things side by side? - Asked on Tumblr

I'm sorry you have to go through this :(

It's not the end of the world even though you feel like it is. There is so much ahead of you.

Although I have never been through it, I had a friend who had failed and had to give the exam again in the next year.

This is what we did -

Regret and forget:
You can take a few days off to cry, feel bad about it. Regret, hate, feel guilty and blame whoever you want to. But be done with it. Once your few days of sadness are over, you have no right to complain, feel hopeless EVER. You're not allowed to feel like this again. It's very similar to what they show in movies - write on a piece of paper and burn it.

This is important because you can't feel bad for yourself while you're preparing, you can't have low energy or blame others in that phase. It's going to be very hard and you have to be strong.

Get your spirits up: Believe that you can do this. Half the battle will be in your head - the previous failure will haunt you and the anxiety will try to take over. Make sure your winning the battle in your head. YOU CAN DO IT.

Plan: Now, you have new syllabus to study and give the re-exam, right? How many months for the re-exam? How much time do you have to study for the new exam?

Tips: You wanna study the very important and parts you were weak again very throughly.

You can do it side by side, you'll need to discipline yourself to study one particular amount of time for the re-exam and one slot for the new syllabus. You can give less time for the new stuff and then study over time for it later. Passing this subject is your priority.

I love this part, telling the success story - My friend did it. She passed the exam the second time and did good in the next year subjects as well. If she can do it, you can do it too!

You will do great and you'll be much more awesome than me in the future. I believe it! :D
(The fact that you spoke about it and aren't giving up is evidence of the same.)

Just work really hard and keep fighting your way through it. All the very best!  Drop by and update us on your progress sometime later :)

Avoiding negative thoughts

Low self esteem is a challenge I'm also facing. I can ignore it while I'm studying or doing something but it's always in my thoughts during transportation times. - Tumblr

I know ignoring negative thoughts can be really hard, especially when your mind is free to wander while traveling. I listen to motivational tapes or audio lectures to keep me occupied when I wish to ignore these thoughts while transporting myself.

Inability to concentrate before exams

"I have exams in less than 2 weeks and I'm unable to concentrate. Thought of sending you a message."

At times, our concentration does begin to taper right before exams. Maybe it's because exams are pressurizing and we don't want to learn while we are stressed.
Here's what you can do, with varying success -

Read out loud: It's just a way of making sure you are studying something. If your mind starts wandering, you'll won't understand what you are reading out and you'll alert yourself.

Write: Fill up pages with words that are important. It helps you stay on topic and concentrate. Whenever I am unable to concentrate, I make mini notes on what I will write in the exams. (I also write extra points that others are not likely to write in the exam, pretend my answer is going to be the best - Just to boost my spirit and make myself feel better!)

New year

Here's something written by a friend as motivation for new year.

Thanks for letting me publish this, Raman! -IkaN

So many years have passed and you kept making resolutions every year, same ones year after year just to keep them for few  weeks or may be months.

But this year, it's time to stop making resolutions and start making decisions; decisions firm enough to make this year the absolute best year. 

And while doing so, promise yourself not to fall back on your old ways, and affirm yourself every morning that these decisions ate the ones that are going to help you make new rituals in order to change your life in a positive way forever. And additionally, after a span of some 5 or 10 years you will be looking back at 2015 with a sense of satisfaction and gratitude.

USMLE for Indian medical students

What is the best time to start preparing?
As soon as you have the slightest gut feeling that you might wanna go to the US. It's better to start preparing early and then change your mind than to start late.
I started in March of my third year. Ideally, you should start in your early second year.
It's never "too late" to start. I have a friend who started in internship and nailed the exam within a few months. Preparation time varies.

Preparing for the USMLE Step 1 exam

"How do I prepare for the USMLE Step 1 exam?" -The most requested post ever!

The essentials - Kaplan videos & notes (for basics) + Goljan book & audio + uWorld + First Aid is the general way to go for most IMG students.

Kaplan videos and notes: They are a good start. If you are time restricted, you may want to skip stuff, fast forward through it.

Anxiety and depression before exams

"How do you manage stress before an exam? I study a lot, but I stress too much and I usually forget everything before the exam. I have anxiety and depression because of this." -Asked on Tumblr

Sounds like you need to believe in yourself a little more. You study a lot. There is no reason for you to worry so much! 

You should start your day with positive thoughts. Affirm this to yourself every morning, "Today is a great day to study and be productive." Clap your hands while you do this. It'll flip your mood right around! Before exams, "I have studied enough and I will do well."

Trust yourself, you've got this. You are a medical student. Getting into medical school ain't easy, but you did it.  You can do this too. 

We have different reasons for getting stressed out -

When you get tired of studying

"Sometimes I get the feeling that my brain can't take more information. Can this be? What can I do when I have this feeling?" -Asked on Tumblr

Yes, it can be! We often get exhausted and feel like we can't take any more information.

In my experience, taking breaks is the best solution for this. I read a research a while back (Don't remember where!) that your performance deteriorates after 45-60 mins of studying depending upon your capacity. If you take a 5-15 min break, however, you do much better.

You can exercise, eat, mediate, dance, listen to music or an inspirational tape if you want in this mini tape. Closing your eyes and lying doing for a while is very relaxing.
Do not use your phone. Your phone has text all over and reading does exhaust you.

I usually get really distracted if I take mini breaks after studying for an hour and don't return to books for another hour. If you have the same problem, you can study for 2-3 hours straight and then take a longer break like a shower, have a long lunch break or a walk around the park.

Dealing with stress and studying before exams for medical students

"I am overwhelmed with exams. I have an anatomy exam coming up. I am slowly beginning to lose hope. Advice would be very much appreciated, thank you!" -Asked on Tumblr

Medicine does get overwhelming. Mostly because no matter how much you study, you will always feel under prepared. It's normal to feel this way.

But don't let it get to you. This part is important because if you feel hopeless, you won't work as much as you should and the guilt will feedback. You need to break the cycle and focus on what's in front of you. There is always hope.

Take a deep breath. Say this aloud - "I've got this. I can do this."

Exercise. Exercise gives you endorphins. Endorphins make you happy. Happy people kill exams!
(Do 20 jumps right now and then read further :D )

Laugh. It's a mature defense mechanism. You'll learn it in psychology. (Another reason for you to survive anatomy right now - so you can read new things next year!)

Acknowledge that you're stressed, laugh about it and be okay with it. Or pretend to be. Fake it till you make it. (PS: If you fake laughter, you'll end up laughing for real.)

Smile. Look at this smiley (:

It's smiling at you, please smile back!

Laughing and smiling alone is a HUGE stress buster.

How to make concise medical notes

Making concise notes is easy!

Write key words, no sentences allowed.
Use arrows, mini organs instead of words.

Flow charts are awesome.

Draw diagrams, write points in it.
Number your points, so that you have a nice flow while revising what you wrote.

Here's an example -