DIP Episode 62 - The Central Dogma of Studying (for medical students, residents, or any learner)

Okay, welcome. My name is Divine. This will be the 60 second episode of the Divine intervention podcasts and Today's podcast is kind of an unusual topic although every so often I will have an usual topic podcasts But this is more about in fact, I think I'm gonna title this podcast the central dogma of studying or I don't know let's call it the studying manifesto whatever floats your boat But basically in today's podcast I want to give my thoughts on How I think people should study especially medical students and residents now Before I jump in I think I want to see a few things though. First thing is You probably shouldn't believe everything I say, okay I've always been a believer in fact checking what people say or Investigating things for yourself, right? I mean who knows I could be selling you? Sneak oil right now, but These are my thoughts On things I think work in general for people and things I have seen to work in many people I've worked with right I mean This is This is largely based on just my experience from I mean, I've been a tutor and a teacher now for what probably like I don't know like 12 to 15 years right and I've worked with thousands and thousands of students so this is Something that just sort of comes from my experience teaching other people and also from learning from other people and also from being a learner Myself, right?

So Take everything I say with a grain of salt, but just all I'm just pleading with Pleading with this podcast is just hear me out think for yourself and Hopefully you find this to be helpful or even if you don't agree with everything I say at least to sort of point you in the right direction or give you some thoughts on potential steps You may be able to take to get to your desired destination study wise So with that said let's go ahead and jump writing so I'm going to break up this basically the way I'm going to structure this conversation is we're going to Discuss certain principles that I think apply to every form of learning and Then at the end I will show you exact I will try to show you it It's not necessarily like they're not necessarily examples, but they're kind of like It's kind of a logical ending to my conversation in this podcast and you see what I mean Just sort of follow follow me to the end and you see exactly what I mean. So let's start with the first principle The first principle is the principle of understanding right Regardless of what you say whatever you want to if you ever want to learn anything you need to understand it first Don't try to blindly memorize things.

And I mean this is something that happens with Medical students residents people that are involved in the field of medicine right medicine involves a lot of information it's a ton of stuff to learn in a short period of time and Usually the thought is you know what Yes, I'll never use it again in the future I just might as well just go ahead and just memorize it right now and just move on with my life And the truth is you do need to memorize stuff in med school But the thing is if you have a basis in understanding It's much harder to forget things that you understood the first time that's the first thing Second thing is if you get an unusual question that tests that concept in like a very weird bizarre way You can see through whatever crap. They are trying to put in front of you in an exam question You can see through all that crap and pick up on what is potentially the right answer So I will encourage you it's hard work. It's a lot of effort But wherever possible try to understand and the truth is there are certain things that Don't Necessarily have some degree of understanding behind them and I will talk about those how to handle those specific topic areas As we proceed with this a podcast because I imagine so we'll say oh divine But there's some stuff that you just need to memorize code. There is no logic be there is no Mechanism or whatever behind it.

Yes, that is absolutely true and I'm gonna visit that visit that shortly Now the second principle is kind of like a query from the first right so if obviously you're gonna spend time understanding things right You need to start early you need to start early right so Met School involves a lot of information, right? But if you want to learn all that information in The detail and with understanding that you need for exams then you need to start early So some people may say that this involves you oh that you are the person that from the very first day of a block you're beginning to Study ahead and people think oh this person is overdoing it well The thing is at the end of the day, right? I would rather be a physician that Really knows and understands my stuff than a person that Wait still three days before an exam and again don't get me wrong there are people that can certainly do that They can sit down three days before a test pull up all their notes Cram everything dump it on a test and they're good to go But the thing is again at the end of the day ask myself What kind of foundation are you building in three days as against a person that built a foundation over three weeks? I think if you ask that yourself that question you begin to ask you You begin to say like in the long term, right? Again, this may sound like me speaking in parables, but in the long term What's the foundation that's going to hold up on that scrutiny?

Right so just to keep those things at the back of your mind When you're deciding if like your timeline with regards to studying I give you an example When I was a medical student at Hopkins right we had block exams, right and in general my strategy was from day one of A block I started studying hard from the very beginning right because the temptation is to be like This exam is in four weeks who gives a crap right but the thing is if You spend the time from the very beginning studying hard Putting in a few hours every day Then when the time for the exam rolls around you're not under so much pressure and not under so much duration You're not wondering oh no, what do I do? How do I get how do I get around this huge room of information? Right and the thing is when you start early You don't have to start picking and choosing okay. I need to concentrate my efforts here. I need to concentrate my efforts there I will skip this slide.

I will skip that slide because you just have so much time before you and the thing is people may say but ah You're killing your lifestyle by not enjoying like the first few days of Of a new block or whatever why are you spending all this time studying when you could just like enjoy now and then leave it off to the end The thing is less analyze that argument right so One thing that is very crippling for many medical students is test anxiety, right test and just anxiety about tests Anxiety about studying anxiety about the medical process in itself One very powerful way to feed that anxiety is to wait till the last minute So the thing is just for purposes of your own mental health it makes sense to start early. That's what two When you start late, right again like I said you may not have the time to learn things in as much detail as you need to learn them to Do well on exams In fact the thing I like many people may have noticed this about me The two to three days before an exam are usually my least stressful days because I'm feeling very good about the test at that point Right versus a person that's like oh three days before a test That's when they're doubling up your efforts and everything trying to study It just does not make much sense and there's really no need to put yourself through that pain So again, I will encourage you say for example, right?

You have your medical student you've got an intumet school You know that you have the USM at least step one exam coming up like two years into your time in med school I'm not saying that oh from day one start spending six hours a day studying for step one But think about it. Let's assume that you say okay, you know what my exam is in a year from now And you set up a one-year plan and you study consistently for like 45 minutes to an hour every day For that big exam you notice that when you're dedicated period rules around You're not under so much stress. You're not under so much pressure And you actually kind of enjoy the process because again, you've laid a long-term foundation that will carry you in those big moments where you need to perform now Third principle is using resources that represent the universe of what you need to know in fact This is probably related to a later principle our discourse, but basically what I mean here is not spreading yourself to think Okay, so the thing is you've probably had those med school classmates where You ask them something You ask them like oh, what's the mechanism behind this? What is this this this and that and boom they pull it out of a hat and you're like wait Man, how did you learn this piece of information like how do you know this stuff like how do you know right off the top of your head? the thing is And again, this is why I pre like before I jumped into this presentation.

I said you know what um Take everything I say with a green of salt, but the thing is I know a lot of smart people I know a lot of people that have absolutely destroyed exams um, at least I also know that from personal experience and the thing is In many cases if you actually dig deep and analyze what these like what these people know You'll be surprised that they know a lot About a limited amount of information like that limited amount. They know it like they know their names Versus a person that uses 10 different resources. So they have they're using like a larger breath Of resources in terms of trying to learn but Ask them random questions about that larger breath And they don't know much about it. The way sort of think of it is it's like let's assume you have a one bedroom apartment Right a one bedroom apartment. I mean, I'm not saying you should live in a one bedroom apartment I'm just just follow the analogy, but It's much easier to keep a one bedroom apartment Squeaky clean than it is and that's working. I mean, obviously if you have maids and servants or whatever you can do whatever you want But If you have a one bedroom apartment, it's much easier to maintain is squeaky clean And if you have a 10 bedroom apartment and you have to like Basically if you want to maintain that 10 bedroom apartment squeaky clean You literally have to like work all day Every day to keep that bedroom clean right?

So the thing is I see many medical students They try this resource that resource this resource that resource and you're like Why am I so bogged down at the end of the day? Why do I feel like I have no time for a personal life blah blah blah The reason is you're using way too many resources right The key thing you want to do before you start studying for any exam or before you start any new block is always to ask yourself Is there one resource that potentially covers at least 90% of the information I need to know for a given block or for a given exam If you figure out what that resource is take that one resource Learn it and know it like you know your name And then take the discipline to tune out every other thing that people are saying right because the thing is there is this I guess let's call it bad behavior that operates in med students where Be see someone using a resource they're not using and they begin to get anxiety and begin to panic They're like oh crap This person is using this resource. I'm not using it. So that means I cannot do as well as this other person No, that is not true. You don't have to use everything that every person is using You don't have to do that.

You absolutely do not have to do that Use the thing is find the resource that works find the resource that represents most of what you need to know It may not necessarily represent a hundred percent But usually my threshold like my mental threshold for picking up study resources was Is there anything that has at least 90% of what I need to know for an exam if you find that resource pick it up Learn the crap out of it and then tune out every other thing. I mean, I know this I mean personally from say for example right my micro block in medical school I know many people during that micro block they use this resource and that resource They use like 506 different resources. They use sketchy. They use their class notes They use questions. They used first aid. They use this. They use that right and you're like oh Oh, I'm using all these fancy resources and making all these fancy diagrams I'm looking at all these fancy charts and you're like, hmm wow if During those periods I said oh man, I'm not using all these resources. These people are using I would have freaked out Right and again, I would have bought myself them But the thing is during my micro block in med school. I had an amazing time Yes, did um, am I saying I did not study absolutely not I studied But I limited myself to like one or the most two very good resources Spend pretty much all my time on those resources and was able to do pretty well on my micro exam.

So At the end of the day Find one or two good resources that hits 90% of the information you need to know Learn the crap out of those one or two resources one preferably and you should be able to get to your goal Now next principle is In fact, you know what let me let me join this to the next principle because I basically just wrote some bullet points down and then I'm just discussing this like sort of like a freestyle format The next principle here is finding context Find in context This is such an important principle and because it's so important I'm going to try to give as many examples as I can The thing is You cannot just blindly memorize things right In med school don't get me wrong you need to memorize what you need to memorize with wisdom There is a difference between memorizing something with wisdom and memorizing something blind Okay, there is a big difference between those two things and the big difference is context You see some people they can real out list of things for you but They don't have any sort of like logical means for learning and appreciating that information the thing is The super smart people you know that you're like wow How do you just bring out this information from like the just pull it out of your hat like Right of the bat like that The reason behind that is they've learned that information in some logical way shape of form Let me give you some examples The one that I love the most right is obviously if you can learn mechanisms right piling on mechanisms I mean if you've ever listened to um Like any teaching by a dr.

Goliath is like a great pathology teacher you see that You always tells you that if you can learn the mechanism behind something you will never forget that thing And that is one thing that I've always taken to heart for years and years and years and years If you can understand the mechanism behind something one You'll learn it so much better Two you memorize it so much better and three If you're tested on that concept that you really understand the mechanism behind Are behind you have no problems You have I tell you you have no problems getting things right on that concept Because the thing is The examinations you take as a medical student as a resident as a fellow.

He doesn't matter right they're all Just different representations of those concepts you have learned right they may not put it like in a classic way They could put it in an unusual way The thing is when they give you an unusual presentation of a concept you're supposed to know That's basically what defines a hard question But if you have that deep understanding of mechanisms I sort of look at it as say for example Uh man is married to a woman right He knows his wife he's been married to half for like 50 60 years Even if he's let's assume his wife tries to trick him by like Changing her voice or something or trying to put on like like a mask to look like a different person That man that has been married to that woman for like 50 60 years Will be able to pick up who his wife is from like a mile away right because he just knows like he just knows it Like there's just a chord that has that just strikes Deep down in his heart when his wife is around him right so the thing is if you ever Truly want to learn something One very good way to put context behind that thing to make it much easier to learn and much better to learn is to try to pile on mechanisms if you have if you can Infuse some mechanistic detail behind something you learn You'll establish much stronger connections in your brain that will help you understand that information And be able to apply it in unusual ways and also do well on exams especially when you get on usual questions but obviously It is there isn't there basically no mechanisms Behind certain things or there are certain things that just make absolutely no sense If you're trying to apply a mechanistic basis to them.

So are there other strategies you could use to try to Make things contextual for learning and again This is going with the overarching principle of learning by context right What are some other things you can do? So what are things you can do are to for example build a clinical correlation Around a specific topic right so take for example right the medicine Review videos that I have right it's about like 13 hours of video One of the things I feel that makes that medicine those medicine review videos really good is I don't just Present the information in the context of oh How is a fifth treated or oh how is aiotic stenosis treated? How does aiotic stenosis present no One thing I think that really made those medicine videos good is I spend the time to ask myself okay This concept how did very likely present in a clinical vignette or in a patient or an exam If you can put something in the in a clinical context Right it makes it much easier to learn because in your mind you can build a mental image of Oh wait This team presents like this even if you don't like even if you cannot put your finger on the concept or you're like wait This clinical presentation I'm seeing looks a lot like a clinical presentation.

I've been exposed to in the past Once you can make that connection you can usually pick out like this is the most likely etiology of whatever is going on This is the most likely concept that is being tested if you can do that It makes things very memorable and very easy to learn and remember So how do you Use this strategy the thing I tell people is Try to look up the classic common presentation of a particular disease If you know what the classic common presentation is try to build your knowledge around that classic common presentation And it makes it much easier to learn Now next thing is What what are some other strategies that you could use to try to put context behind things?

Um one of the strategy I use is to try to compare one thing with the other right So the classic one this is something you encounter in your third year of med school The classic one is a patient that has hyperthyroid right Uh Hyperthyroidism right can be caused by many things right you it can be caused by Graves disease which is probably the most common cause actually is the most common cause in the US It can be caused by a toxic multi-nodular goiter right it can be caused by a toxic adenoma right you can have the phyrotoxic phase of Hashimoto's thyroiditis right you can have postpartum thyroiditis You can basically have many things that can cause a hyperthyroid state I guess you can call it like phyrotoxicosis Now the thing is if you can build a chart that basically compares the radioactive iodine optic results in each of these scenarios.

I just cited It makes it much easier to remember because the thing is you're no longer trying to remember individual things You're now trying to remember multiple things in the context of multiple other things right So for example like oh Graves disease you have diffuse optic on a ryeus scan toxic multi-nodular uh toxic multi-nodular goiter you'll find multiple areas like Like discrete multiple areas of increased optic on a ryeus scan and then oh toxic adenoma you see like one focal discrete area of increased optic on a ryeus scan think about it if you can sort of learn things by grouping It's much easier to remember it's much easier to remember groups of things that it is to remember singular individual things Now again, what is another strategy that could be used to our context to things one Other strategies sort of like learning things in like a logical group, right? So let me give you an example, right? So the example I'll use here is like the the binary pathologies right so like coliolethyasis colesestitis colidocolethyasis and ascending colonitis, right? How have I always learned this information? Well, I've always learned this information is in my mind Visualizing a diagram of the biliary system, right? So it's like oh you have the um, you have the um Like the gallbladder that drains into the cystic duct, right?

And then you have the right and left intra hepatic ducts coming together to form the common hepatic duct and then the common hepatic duct joins up with the cystic duct to form the common bowel duct, okay? And then the pancreatic duct joins up with the common bowel duct to draining to the ample of water, right? Into the early part of the Gwadnam, right? So think about it if you construct that diagram in your mind you then need to start putting um multiple things along that path to sort of figure out like okay. Oh, if you have a stone here This is the pathology creates if you have a stone here. This is the pathology creates, right? So for example, you could say oh if you have a stone in the cystic duct, well um, that can cause like biliary collic but however if Behind that obstructing stone you have an idis, you have inflammation, then you have colicestitis And then you take it a step down further. You're like oh, okay, you know what? But what if this stone is not in the cystic duct? What if it's in the common bowel duct? Well, if it's in the common bowel duct, that'll be collido-colytthiasis, but you know what? There's this principle that oh if a stone obstructs something you can have an infection build up behind it. Well If that infection builds up behind the stone in the common bowel duct that is ascending coliditis. Boom, right?

So notice you've learned for pathologies just by constructing a simple diagram that helps you group things together In fact, this is in fact, I'll say this is probably one of the most Important reasons why first aid for the USMLE step one is a great book first aid for the USMLE step one has its faults But one I'll see probably like the most important parts of first aid at the summary diagrams that it has summary diagrams, right? For example, right? I mean there is like first aid I mean like first aid has this um I mean, I'll just pick out a few examples, right? Like say for example, you're studying micro, right? They have a diagram positive algorithm. They have a gram negative algorithm, right? They have diagrams that summarize the diuretics they have diagrams that summarize the antibiotics, right? The classic thing I used to do right before exams are to say okay, you know what? I've learned all this information. Well, let me go ahead and look at this summary first aid diagram You look at those diagrams and then just try to start explaining things to yourself. You're like oh This is how this diuretic fits here. This is how that diuretic fits there Oh, this is how this antibiotic does this.

This is how the antibiotic does that if you have those logical diagrams or logical mechanism for sort of like putting things that it sort of looks like steps in a process It just makes things that much easier to learn that much easier to remember So I'll encourage you if you can find a logical diagram that explains something or you can make your own logical representation of something By all means pursue that route.

It makes learning certain things especially things that have no rhyme or reason behind them Makes them much easier to remember makes them much much much easier to remember Now Let's jump to the next principle right so the next principle is the use of practice questions And this is where I probably have a few months of disagreement with people The thing is the common the common thing you hear when you When you speak to people is oh, I use practice questions to learn the material Now here's the thing Here's my belief practice questions are phenomenal they're fantastic they're great if you do more practice chances are you will You'll do pretty well on an exam But the thing is I feel that people use practice questions For the wrong reasons right so the thing is I generally do not subscribe To having practice questions be your first exposure to a given content That just to be perfectly honest makes absolutely no sense to me The thing that makes more sense to me is having some kind of exposure In the form of like oh like a reading you've done or a video you've watched or something Having some kind of like first exposure to the material from somewhere And then using those practice questions to fact check your understanding or to guide for the study Right because the thing is and this is something I've noticed with many medical students right You see people say oh I'm learning so much from you world like oh you know what I'm gonna just completely turn down for a state blah blah blah blah blah And all that stuff.

I'm just gonna like just focus solely on you world Read the explanations and I'm good to go the thing is There are many people that have done very well using that strategy But the thing is at the end of the day Just in fact you probably have personal experience with this and again I'm saying this because I've had experiences with many people have thought many people have treated that I've run into this problem Let's assume you read a your old explanation like three weeks ago Ask yourself right here right now Do you really remember the bulk of that explanation you read? The thing I've noticed is that many times when people say they are using questions to learn Yes in the moment when they are reading that answer explanation It's making perfect sense to them.

They're like oh this material is flying right into my brain But the thing is at the end of the day What you may just be doing is memorizing an answer explanation as again is deeply understanding and answer explanation Here's one thing I also just just sort of do it as like a controlled experiment on your own self Take two pieces of information and try two different approaches first approach Learn that information from a book or a video or whatever and then do practice questions on that and read the explanations versus Find practice questions on another topic just read those explanations um do the questions and then compare like On that those two circumstances where do you feel like you've learned more or where do you feel like you remember things better Or where do you feel like you're getting a deeper understanding and appreciation for the information you just learned I'll let you answer that question on your own But I encourage people and the thing is people may say but divine it takes so much time to study something first The truth is I'm not saying oh your first exposure Try to learn every bit of every piece of information before you attack a subject. No Even if you just do like a cursory just 30 mini just blow by and just say okay.

Oh these are the major topics in this thing These are like the big picture concepts that they are discussing before you approach questions That is a lot better than Making your very very first exposure to a given material Be in the form of practice questions again That this is where I want you to not misinterpret what I'm saying practice questions are great I use practice questions all the time But the thing I've noticed is that I and many people have tutored and many people have worked with They gain a lot more from practice questions when they have some knowledge base before they approach those practice questions And the thing is having that knowledge base also makes it much quicker for you to go through those practice questions And the thing is I can almost promise you this You gain a lot more from practice questions When you have a knowledge base is something you may not believe onto you personally try it for yourself now next Principle is Something that again Choose what works for you, but the principle I'll say is try to concentrate your learning on a part of the day that Works for you, right? and Again These are my own thoughts on things, but I personally believe that most people could probably learn best If they concentrate they are learning in earlier during like earlier parts of the day, right? Because the thing is When you begin to let your study in dragging to like later part So say for example right? I'll give you my own personal example for me.

I love studying in the mornings, right in the mornings Things just flying to my brain very easily But once he gets like to like five six p.m. in the evening I need to apply a lot more effort to learn the same piece of information Versus in the morning I could literally like sit down for an hour and digest like 20 pages of information in that one hour Very easily without any qualms versus waiting in the evening in the evening I may like be able to digest like Five or six pages an hour and then it ends up taking me like four or five hours to learn the same piece of information I could have I could have learned in the morning in an hour, right? So that is why in general most of my studying is concentrated in the very early hours of the morning between like Four and seven a.m. Those are like power periods for me I learned things much better during those time intervals and it's something I found to work for me and again What works for me may not necessarily work for you, right? So you may be the person that learns very well and very quickly at night If that's what you've noticed with your body's physiology My own means do that but I was saying general for the great majority of people and again I mean obviously I can't say I have a sample size of seven billion people But I probably have a sample size of about Five to six thousand people that I have to learn a thought in some way shape of form Uh over the course of the last couple of years, right?

And the thing I will say is that For many people they can actually learn a lot if they concentrated a study in in the morning versus leading the evening Because that's just kind of how the body works right the the way in general the body has been set up It's for you to sleep at night wake up in the morning get stuff done and then retire in the evening So I feel like trying to do things in the evening when you're supposed to retire It's kind of like counterproductive to what the body's natural physiology dictates But again, I have certainly seen people that Mornings and afternoons are just evil times for them What in the evenings they just completely per cop right that is a question you have to answer for yourself And I will let you answer it accordingly now Next principle is being a good test taker So this one is a little more in the difficult side of things right so The thing is you can Learn all you want for a test right and the truth is in general if you know everything that's gonna be Tested on a given exam chances are you do pretty well on that exam right I mean like Uh, you probably know this from undergrad there are those classes where you'll give it like a course syllabus You memorize the syllabus you dump it on a test you get a hundred easier spy right But the thing is there are certain exams and it's again as a match student you'll be exposed to many of these kinds of exams Like the USMLE step one or step two ck or step three You can know everything and do again you can do pretty well But the thing is if you want to getting those very high score ranges You do need to be a good test ticker like that is the one thing I have seen that can elevate people from 1% towel sort of like basically like taking themselves to the next level in terms of percentile scores That's being a that's being a good test again being a good test sticker is hard It takes a lot of pract

ice But I personally believe that it's a skill that can be learned right and I'm seeing this one from personal experience right.

I mean I Have been a good test again in the past But I feel like probably over the past like five six years I've become an even better Test sticker right and there are people that I know personally that have learned how to be good test stickers I mean there people have worked with they've been like just Completely terrible test stickers But over time we became much better at test-ticking. So it's it's a skill that you can learn But it requires effort on your part So What kind of effort is required to be a good test sticker the thing is you need to spend Not just a lot of time taking practice tests We also have to spend probably More time now you spend taking those tests and analyzing them right So this was probably one of the more painful parts of my study Going through practice exams the thing is I mean literally it may take me like three hours to take a practice test But to be perfectly honest sometimes it may take me like seven eight hours to review that practice test And things you may be saying like oh divine seven eight hours Are you just spending that time like looking at pieces of information you didn't know? Yeah, I'm spending some of that time looking at pieces of information. I didn't know But The honest truth is I probably spend about half of that time Just asking myself okay divine What were your thoughts behind this question? What were you thinking when you were getting this question wrong? What were you thinking when you were getting this question right?

Or if you didn't even know the concept that was being tested is there a way you could have finagled your way is there a way you could have sort of like mapped out Like follow the course that essentially made you would have made you give this question right Even if you did not know the concept I asked myself all those and many other questions as I analyze my practice tests And I feel that over time if you begin to do that kind of intense detailed question analysis You can begin to pick up on certain Systematic error patterns in the way you think in the way you approach questions And when you can figure out those error patterns and begin to eliminate them consciously You'll notice that you begin to do a lot better on exams really like When you become a great test sticker It just makes the path to doing super well on exams much easier because the thing is it sort of builds that confidence within you that you know what Even if I don't know all the concepts that are going to be tested on this exam I'm still going to get most of the answers right Because believe it or not there are many questions I have gotten right in my life not because I knew the concept But because I just knew that you know what Based on these Core principles I know with regards to test-ticking This is likely not the right answer this is likely not the right answer.

Oh, this is very likely the right answer Those That likes almost like sixth sense when you're taking an exam It comes from being a good test sticker and again. It's a skill that can be learned. It's something you can absolutely learn on your own If you just spend a lot of time analyzing your tests It's something you can know if say for example right you for let's assume you had like a buddy or close friend That has say for example you had let's say you had like Let's say you're second year med student right then let's say you have like a third or fourth year med student That has experience with the exam you're planning to take If you could pick that person's brains if they could watch you like taking a test Or they could review a practice test with you and sort of see oh, yeah Wait, why do you get this question wrong?

What were you thinking when you were taking this when you were answering this question Those people that have experience with the test you're trying to take we can pick out Patterns is it's kind of like having a coach right that I mean that's why great Great like basketballers or soccer players or whatever have coaches right they can spot errors in Your game and basically point out those errors Correct you and constantly great and grill you on those errors if you keep making them so that at some point You just sort of snap out of making those errors and you get to your potential So you can learn this on your own you can find someone that has experience with the test you're preparing for to sort of like analyze your thinking and the way you are approaching questions and Just Keeping up with that practice is one thing that I have found to be very helpful Will be coming a good test again Even if you're a person that you're like oh man, I'm always average on an exam I promise you like again, I'm not seeing this just from personal experience. I'm seeing this from The experiences of many people I know there many people I know that We're initially bad test stickers, but at the end they became phenomenal test stickers, right?

So again, it's possible Okay, it's something you can learn you just need to be willing to put in the effort to analyze practice tests Okay now The next principle is knowing the kinds of tests you're taking right so the thing is The same strategy may not necessarily work for every exam right so for example in undergrad we had these exams where You got the course syllabus you read the course syllabus You understood the course syllabus you committed all of it to memory you get a perfect score those exams Like you don't need to be a good test sticker anything like that to do well on those exams All you need to do is you just need to know all the information that a professor expects you to know and it's gonna Shop on on the exam But there are other exams I had in undergrad right like my organic chemistry exams or Exams you have in net school like step one step to ck for example where No, you know the information is not all you need to do you need to do other stuff in addition to knowing the information To really kill those exams.

So it's one thing I will encourage you to do Don't don't approach an exam blindly don't just say oh I've done this before Well, if if I've been successful with the strategy before uh that means I'm gonna be successful with the strategy If I apply this to this exam that is not always true That is absolutely positively not always true Different tests demand a different kind of thinking right so for example I mean like my most recent example is with the usmly step three right the thing is For step two for the step to seek exam You can do well by a sort of like having a certain kind of thinking in the way you approach Questions but the thing I was noticing when I was preparing for step three is whenever I applied like that same kind of thing I was like wait I still keep getting questions wrong and I had to make certain adjustments in the way I Thought about things to begin to get Answers correct. I mean questions correct.

So that's one thing I will encourage you to do again Taylor your study strategy Taylor your study thinking to the kind of exam You're about to take and again you may not necessarily know about the exam you're taking Ask someone that has taken that exam right Ask someone right people always willing to give back ask someone and they may be able to point out Those unique like the unique things Relief into the exam that you're preparing for and then the Last principle that I'll talk about this is where I said this podcast we cannot end in a weird way But the last reason I want to talk about is repetition right Repetition is probably the cornerstone of any good study strategy If you don't repeat You will not memorize you will not you will not learn things the way you're supposed to learn them for exams repetition repetition repetition repetition repetition is so key it is so key And here is why I think repetition makes sense the thing is The more times you go through something You if I let me let me tell you Let me tell you two things that I've noticed When you post your path of repetition the first thing is Whenever you repeat something you'll learn something new each time You'll learn something new each time You may not necessarily pick up on everything on your first go through a given body of information When if you go through that thing many times Your brain will sort of require itself to begin to pick up on something new that you did not learn During your previous session going through that material This is something that I can almost opine that pretty much everyone has experienced at some point The more times they go through something the more times they begin to like see like they're like wait How did I not see this two days ago when I was reading this thing they're like wait I might just see this for the first time That's a benefit you're getting because you're rep

eating that information That's one too and it's kind of like a corollary from the first thing The thing is the more times you repeat you go through things The more you begin to pick up on on usually relationships that people may not necessarily see What do I mean by that?

There are certain times where I've tried to learn certain things and on my fourth or fifth pass Through the material. I'm like wait So this is how this thing actually works The reason I picked up on those things is because my brain is beginning to say okay, you know what divine you looked at this thing the first time you looked at this thing the second time you looked at this thing the third time You're looking at this thing the fourth time You're learning you're picking up on some new things some like nuances as you go along with multiple repeats Those new nuances you're picking up on may begin to help you establish on usual relationships Between those things that you're trying to learn. So I will encourage you It doesn't matter whatever studies strategy you use if you slap on repetition with that study strategy You'll learn things so much better And the thing is and this is where I'm going to sort of end this There are multiple means of repeating things and this is where it becomes about the uniqueness of the individual Many times right when people say I want to repeat something the first thing that comes to mind is on key Again Don't take this as me saying I have anything against on you in fact actually on key is a phenomenal resource On key is great.

It's it's almost magical in a sense because again, I know many people that have used on key and they have absolutely crushed the exams But I probably know just as many people that have used on key in Great excruciating detail And they did not do as well as they expected on their exams The thing is the fact that everyone is using on key does not necessarily mean that on key Is your unique means of repeating information? So I'll say that again the fact that everyone is using on key does not mean That on key is your unique constitutional means of repeating information Going through the same information multiple times is a principle. It's a study principle You need to use it regardless of the study strategy you use For you to be successful but but The specific means you use for repeating that information is what defines you as a unique learner You cannot Say for example right for a person like myself Anki is not a great means for me to repeat information It's just a means of repeating information that I've never found to be fun for myself It's fun. In fact like I know some people that anki is almost like a game to them Those people obviously should use anki To power through that body of information multiple times What a person like myself. I mean obviously that's I mean that's part of the reason why I have a podcast website in the first place I'm a person that learns phenomenally well if Something is put in an audio visual format.

I can listen to a podcast 12 times if I have to To learn something or to repeat something Versus having to go through an on key deck like 12 times to acquire the same amount of information The thing is when you figure out the means of repetition that works well for you You'll be so much more efficient with your studying there are people that use anki and it is crazy efficient for them What for a person like me Can I learn something well by using an anki absolutely? I can but it will take me Probably like three or four times the amount of time I could have spurned Learning that same piece of information by just watching a video Or listening to an audio tape and the thing is the thing that works best for you may not necessarily Exist if they don't exist create them right. I'll give you a classic example During my pediatrics rotation right I knew that the resource that represented the body of information I have to learn was BRS pediatrics. BRS pediatrics I mean I mean again, I'm not seeing this to push any specific resource on anyone But I'm telling you that in general BRS speeds Contains pretty much everything you need to know to crush your third year pediatrics and be an exam So I knew that okay, that was the unfortunate reality that was staring me down. So I was like you know what?

I might as well go ahead and create my own BRS pediatrics audio resource right so I literally got the book and created Audio tapes of each chapter of the book and when I created those audio tapes I just listened to those audio tapes multiple times.

So over the course of the eight weeks of my pediatrics rotation I was probably able to go through the BRS pediatrics book like five or six times How did I do that because I put the repetition the task of repeating that information in a format that works well for me I did not if I had said you know what oh divine you know what Take BRS speeds make an onky deck of BRS speeds One I would have given up after the first like three or four chapters But to even if I toughed it out to the end I probably will not have been able to make my way throughout the entire book pursuing that strategy okay, so The thing I tell people is find the means of repetition that works well for you If onky is what works well for you by all means do that But the thing is there are some people for which onky is not the best means or the most efficient means of repeating information For some people it may be videos it may be audio like myself For some people it may actually be getting a book believe it or not the good old fashion like get a bio book Give that book read that book four or five times it actually works well for certain people I mean literally there is a friend I have that this guy literally only does is he just buys a book that represents all he needs to know reads that book like five or six times and then he destroys his exams That's the method that works for him There are other people where What may work for them is teaching that's actually another thing that actually works for me Uh, and again, I'll just sort of throw it out there if you can teach something you know it pretty well If you can teach something well you know it pretty well because the thing is in the process of teaching You're gonna get asked a lot of quite right say for example right you're preparing to give a lecture on a topic right The shared terror of knowing that people may ask you a question and you may not be able

to answer it Is enough motivation to make sure you learn that information in the deepest way possible So if you can teach something multiple.

I mean take for example in undergrad right This is like classic classic classic teaching as a means of repetition About two years before I took the MCAT And again, this was when organic chemistry was a big part of the MCAT right like two years before I took the MCAT That was when I took my first organic chemistry class right after I took my okam class The next thing I did was I started teaching okam 21 I could find right to groups of people In fact, I became a tutor that basically thought okam right and the thing is after teaching okam so many times and answering so many okam questions from so many people I became so good at okam that even if I saw a mechanism that I had never seen before I could predict what that mechanism could be At about the time I was like ready to graduate from from undergrad because I was like wait Yeah, like this principle this principle this principle that principle these are the things that underlie Electron pushing a person that's rich in electrons gives elect gives Electrons to a person that's poor in electrons nuclear fauver's to selectro file and by putting those pieces of information together in the context of again The multiple nuances that picked up on as I repeated that information by teaching I could take you could give me like oh The vine take the small or could take that molecule How will this reaction work and again even if I had never seen this reaction before I had never seen this mechanism before I could just go off of those core principles and all the again all the repetition I had done to pick up on no Ancest that people may not necessarily establish because they've not had multiple repetitions And I could use that to begin to predict certain things Same thing with these standardized tests like step two ck like step one like step three You you can almost guarantee yourself.

They're gonna see Questions on those exams that you have never seen before right? I mean if anyone tells me that they took any of the usmeli exams and every single question they saw They have seen they had seen that concept somewhere in the past I think I'll be willing to call you a liar the thing is at the end of the day the thing that Makes certain people get certain questions correct even if they've never seen the information before Is the fact that they've repeated all the pieces of information so well They have picked up no answers from those multiple repeats that they take those no answers and begin to apply them to unusual scenarios And then end up getting those questions correct so I will encourage you find your preferred means of repetition It could be anki it could be videos it could be audio it could be reading a book it could be teaching it could be whatever find it It's unique is almost like think of it as like your Your repetition phenotype or your repetition genotype if you may right your repetition genotype is unique to yourself as an individual Okay, once you can figure out that repetition genotype and use it with whatever you're trying to learn You can become a very good learner and you can become a very good test speaker.

So I know this has been a lot of rambling and I know that I've said a lot of arms and ass here, but this was something where I literally just Walk up this morning which happens to be my one day off over the past two weeks And I just wrote down some bullet points and then just said you know what I'm just gonna whip out my phone And just record a podcast that just basically mentions my thoughts on these bullet points I wrote down and again You may say like why should I waste the one hour listening to those or why did you just waste the one hour listening to those podcasts? The thing is I very strongly believe that if you take these peace like these uh These are pieces of advice to heart you will Become a better learner I can almost Promise you that I mean again, you can't say anything with a hundred percent certainty But I can say that the overwhelming majority of people that I've worked with that have ended up being very successful People that used a lot of this advice, okay, they used it conscientiously.

So again, I'll encourage you to Just think about this to get everything I just said with a grain of salt But evaluate it for yourself and pick out the good discard the potential bad and go from there okay, and Before I end I just want to voice that I Do want to want tutoring for the USM maybe exams and for med school exams and for the medicine in training exam That's for residents obviously So if you ever want private tutoring for those feel free to reach out divine intervention podcasts at gmail.com Or you can use the contact or tutoring Then at the top of the website and reach out to me and we can set something up. So I wish all the best I will try to use my one day off in the past two weeks or wisely to make a few more podcasts before I get back on service tomorrow So feel free to reach out with any questions. I hope you have a wonderful day, and I hope the lakers win the game today God bless. See you next time

Understanding; never try to blindly memorize facts without grasping the underlying concept or mechanism.

As early as possible (long-term foundation); building knowledge over weeks prevents last-minute cramming and reduces test anxiety.

Find one or two core resources that represent at least 90% of the necessary information, and ignore all others.

By finding context—specifically by learning mechanisms, building clinical correlations, comparing related concepts, or using diagrams.

Use them after gaining initial exposure (reading/videos) to fact-check and guide study efforts; do not let them be your first source of information.

Repetition—the cornerstone of studying. The key is finding a unique means of repetition that works for the individual (e.g., audio, teaching, specific book).

Linking facts to mechanisms, clinical presentations, or other related concepts so that information can be retrieved logically rather than by rote recall.

90% of the required information (the "90% rule").

Learning mechanisms, building clinical correlations, and comparing/grouping related pathologies (e.g., hyperthyroidism causes).

It forces deep understanding because the fear of being asked an unexpected question motivates the learner to master the material thoroughly.

Creating audio recordings (audio-visual format), reading a physical book multiple times, or teaching the subject.

Memorizing with wisdom involves understanding context and mechanisms; blind memorization is rote recall without underlying comprehension.

Linking facts to mechanisms, clinical presentations, or other related concepts so that information can be retrieved logically rather than by rote recall.

90% of the required information (the "90% rule").

Learning mechanisms, building clinical correlations, and comparing/grouping related pathologies (e.g., hyperthyroidism causes).

It forces deep understanding because the fear of being asked an unexpected question motivates the learner to master the material thoroughly.

Creating audio recordings (audio-visual format), reading a physical book multiple times, or teaching the subject.

Memorizing with wisdom involves understanding context and mechanisms; blind memorization is rote recall without underlying comprehension.