31 July 2007
If you are taking a lab course, you need to add the dates and times of your various lab sessions to your calender along with the topics of each lab. If you list your labs by subject matter of each experiment, you can relate these to your lecture material for better integration of the course subject matter. If your course has a recitation section, be sure to list this too as you do not want to skip any recitation sections. These sections can be invaluable when it comes to test preparation time.
Once you have set your master schedule for the semester, fill in your schedule for the week. This means filling in how much time it takes for you to get to school, the times of your classes and labs, your study time - remember one hour of study for each hour of lecture and 45 minutes of study for each hour of lab-your meal times, your work out times and your bedtime. If you are using a computer-based program for your daily schedule, print out your next day’s schedule when you are studying the night before. Look at it and be sure that you have organized and prepared for the classes that are on this schedule.
Class preparation means look at the subject matter of the upcoming lecture. Review the assigned readings - pay close attention to any bold words, headings and topics-review the syllabus and do any assigned problems. If you have difficulty with any of the problems, put notes or checks where you had difficulty so that you can walk into your professor’s office during office hours and get your questions answered. Don’t wait until after the lecture to work pre-assigned problems. Most of the time, anything that you had difficulty with, can be answered in class. If you wait until after class, you will be behind. Attempt assigned problems before your lecture.
Listen to your lecture and take notes only on the things that you know are not in the syllabus or text book. (See my previous study skills posts for how I would cut my textbooks). Take notes on things that help you to understand the important points of the lecture or clarify concepts that you previously did not understand. As I have outlined in other study skills posts, I would take notes on the left side of my notebook only using the right 2/3rds of the page. The left 1/3 of the page would be left blank so that I could write in summaries of the notes or definitions of terms that were important. On the right pages of my notebook, I would recopy notes that were taken in a hurry so that they were legible. I would also place notes and information from my text book.
Most of the time, I took lecture notes on my laptop computer or on looseleaf notebook paper. I discovered the utility of using notebooks that were designed for law students (summary paper) and then resorted to making my own version of these summary pages. I would print out my notes and clip them into a looseleaf notebook so that I could highlight them or make notes to myself as I studied. I would review the previous lecture, study the current lecture and preview the upcoming lecture doing the text readings.
As I stated under Organic Chemistry, I never walked into any lab unprepared. My lab prep consisted of knowing the purpose of the experiment; how long each step would take; what data needed to be obtained and what conclusions/observations I would be expected to make. I kept a sticky note in my lab manual or notebook with the steps of the experiment briefly outlined so that I could refer to my note. This make any lab write-ups pretty easy to finish. If there were pre-lab exercises, these were done before I attended lab. I would also consult my textbook if the material covered in lab didn’t correspond with the lecture (most of the time the lab material was a bit ahead of the lecture).
For courses like English and Math, I made sure that I had a solid reading schedule that kept me ahead of the class. Again, I would have problems worked before coming to class. In English, I would make sure that I had thoroughly covered the readings taking notes as to tone, argument and subject matter as I moved along. Again, sticky notes were good for making extra notes in my reading books. I could past them in and add them to my professor’s notes after the lecture.
Soon after each lecture, I would quickly review the lectured material filling in any words that I had left out or drawing arrows to link materials. I would make any quick notes of things that needed to be clarified during office hours. In terms of Math and English, I would have circles around any problems that I had attempted but was not able to complete before class so that I could get my questions/problems taken care of. If these were not taken care of in the lecture, they would be taken care of during office hours.
My professors got to know me pretty well because I would attend office hours even if I was sure that I had mastered the material. It doesn’t hurt to have a “tune-up” and a “knowledge-check” even if you are sure that you are understanding everything. Sometimes these “tune-up” sessions would give me valuable insight as to what to emphasize for the exams and what to place less emphasis on. I figured that if I was paying thousands in tuition for each course, I was going to get every bit of instruction out of the course that was available. It also gave the professor a chance to get to know me which was good when I requested a letter of recommendation for graduate/medical school. I always received high praise for my business-like attitude and organization of my coursework.
Spending so much time preparing and previewing for each class made studying and review for each exam practically effortless. By the time the exam rolled around, I had been over each lecture a minimum of three times. I reviewed the previous weeks lectures on the weekend. By staying ahead of the professor and the class, I always had plenty of time to integrate the materials for every class. My attitude toward university coursework (honed by loads of experience in secondary school) was that my “job” was to master this material. I needed to thoroughly master my coursework because it was background for my graduate studies and I wanted the best undergraduate education that my university offered.
Don’t get the idea that I spent every waking hour in front of a book. I used my university time to attend lectures and seminars on any subject matter that was of interest to me. I went to lectures on the Holocaust, aerospace engineering, mathematical theories, social theories, political science in addition to departmental seminars in biology, chemistry and physics. I obtained a departmental seminar listing during the first week of class and added these to my schedule. Even if you do not completely understand everything in a seminar, you can pick up valuable experience and broaden your knowledge base for free. These seminars are also a great opportunity to get to meet the faculty and learn their research interests.
As a medical student, I tried to attend grand rounds in Surgery, Medicine and Pathology as much as my schedule would permit. These grand rounds became invaluable for USMLE (all steps) as the speakers always presented both the basic and clinical science of their discipline. It was my interest in every aspect of medicine that lead me into academics and today, continues to allow me to keep up with basic science as well as clinical science.
As a student of science and medicine, you have to be quite proactive and a bit of a self-learner when it comes to the mastery of your craft. If you take the time to start keeping up with the literature and attending seminars/grand rounds while you are an undergraduate, you can carry those skills into graduate/medical school. You cannot afford to be a passive learner relying on the professor’s lectures for your entire education. I totally attribute my performance on the Medical College Admissions Test (MCAT), United States Medical Licensing Exam (USMLE) and my specialty board/in-training exams to my attendance at all of those seminars and grand rounds. By listening to the “cutting-edge” leaders in various subjects, you learn to analyze information and you learn to present information logically. These skills are free and the seminars are often free and easy to take advantage of.
Finally, approach your studies as you job. If you are working and attending class, you need to be organized but you need to do both well. I always recommend that students who work, need to take less hours. It is not useful to load up on semester hours only to do poorly or mediocre in the coursework. Take less hours in the first place, do well, and if you find that you have free time, use that time to attend seminars/grand rounds. If you are a full-time student with no employment, use some of your free time for seminars and experiences that widen your educational experience. You only get once chance at your university experience and you need to be sure that you are getting the most out of every class for you money. Make your studies of prime importance and be proactive about getting your needs met.
17 July 2007
Organic Chemistry is the chemistry of carbon-containing compounds. It is not the basis of Biochemistry, though both chemical disciplines share carbon as a component for many of the compounds that are studied within each discipline. O-Chem is centered around carbon and the special characteristics of carbon-containing compound families while B-Chem generally looks as structure, function and characteristic reactivity of macromolecules that contain carbon. This is why I could happily study B-Chem in graduate school and not be a particularly "carbon-friendly" chemist.
O-Chem starts out with the special atomic characteristics of carbon that are responsible for it's bonding and reactivity. There are plenty of explanations of reaction mechanisms that must be mastered and absorbed as these basic reaction mechanisms will present themselves repeatedly as you move through the course. Rather than look at them as abstract and in isolation, learn them and be able to recognize them as a recurring theme as new carbon-containing families are presented. In short, you should be able to look at the way electrons behave in the various mechanistic schemes and apply that knowledge to new reactions as you encounter them.
O-Chem has a specific vocabulary that includes terms like nucleophile, electrophile, substitution, replacement, degradation etc. It is a very good idea to keep a list of the new terms as you encounter them and make sure that you understand them within the context of your o-chem study. One of my techniques was to take class notes on the left side of my spiral notebook. The right side was reserved for adding notes from my textbook and for working problems. I also kept a running tally of terms by leaving the last ten pages of my spiral notebook clear and using those for listing new terms and their definitions. I would circle in red, the new terms that I had defined in my notebook glossary as they were mentioned in my notes.
O-Chem requires daily study while you are taking the course. You need to review the previous lectures and notes, preview the next lecture and study the current lecture notes within the context of how they fit with the assigned reading and problems. Always look at an o-chem problem by making a note of the concept that the problem will be illustrating. Every o-chem problem or synthetic scheme has a concept behind it. Make a practice of noting these as you work the problems and studying the concepts as you work the problems.
O-chem also builds upon previous principles. For example, as you are introduced to the simple alkane family of compounds, the characteristics of this family should be compared and contrasted to the alkenes, alkynes, aromatics and other families as they are introduced. Make yourself get into the habit of reviewing summaries and characteristics of each old family as new families are introduced. This will greatly help you with synthetic schemes and problem-solving.
Before you go to lab, you should sit down with your lab book, write out a simple outline of each experiment with a listing of the steps that you will be doing. You should do any pre-lab exercises and review any topics in your text as they relate to your experiment. Many organic labs require that you answer post lab exercises, write up a report and submit these for grade. Look over your post experiment questions before you begin the lab so that you can be sure that you have obtained the proper observations that will enable you to answer these questions easily.
If you are required to keep a laboratory notebook, make sure that you include the following:
- The purpose of the experiment
- The experimental procedure
- Your data (tabular form is a good way to present this
- An explanation of your data that includes possible errors
- Any spectra (NMR, GC, Mass Spect that you obtained
- A summary of your observations
Don't record data on little scraps of paper! Those little paper scraps can get lost and your grade will suffer. Get used to preparing for each experiment and recording your data directly into your laboratory notebook. I used to take photos of my experiments as I went along and pasted these directly into my laboratory notebook so that my instructor knew exactly what my reaction setup looked like as I progressed through an experiment. I also pasted my NMR spectra and GC results directly into my lab notebook with annotations and directions to my conclusions about their appearance.
As you encounter a new family of compounds, look at their reactions and usefulness in synthetic schemes. Again, you may want to keep a running list of characteristic reactions of each family as they are presented. With each lecture, link to the previous lecture and study a whole weeks worth of material and data on the weekend.
O-chem is a preview and practice course for many of the courses in medical school. The manner in which you approach your o-chem will be good practice for medical biochemistry, pharmacology, microbiology and pathology. These medical school courses build heavily on their introductory concepts just as o-chem builds upon the concepts that are presented at the beginning of the course. Like o-chem, these courses require daily mastery and will increase your vocabulary exponentially.
What you cannot do with o-chem or any other pre-med course is decide mentally that you cannot master this course or that it's a "weed out" course in which the professor is out to "destroy your career". No professor has the time or energy to care about working to destroy any particular student. While there are good professors and poor professors, the material to be mastered in o-chem or any other subject, does not change. Don't let your feelings about a particular professor distract you from the business of learning.
Learning to tune out your fellow classmates i.e. those who whine, complain and otherwise attempt to distract you, is another good characteristic to develop. Some immature folks are going to brag that they "never study and get As" or that "the professor doesn't give As" or my personal favorite, "you can't possibly earn an A because you are not that smart". Don't buy into any of this stuff. Look at the course syllabus as soon as you get it. Look at the requirements for each grade and decide that you will meet them. At the first sign of trouble, get some help.
Check out the O-Chem help site at Frostburg State University. This site is under construction but can be an excellent adjunct to any o-chem coursework. Use the site as a tool not as a substitute for attending class and working your assigned problems. The URL for the site is: http://www.chemhelper.com/ This site requires registration but has a message board, discussion forums and plenty of resources for any o-chem student. In addition to this site, there are likely others too including possibly one at your school so utilize them as you need them.
Don't underestimate the value of attending recitation sections and tutorial sessions. These sections/sessions are great opportunities to get your questions answered or reinforcement of your knowledge of the material as you learn it. Don't skip these sessions and don't skip class. Utilize the office hours of your professor and make an appointment for a consultation at the first sign of trouble. Don't wait until a couple of days before the exam to seek help.
Keep up with your homework and studies. Again, I cannot overemphasize the importance of keeping up and not getting behind. Few people fail or do poorly in o-chem because they cannot understand the material. Most people struggle because they get behind and cannot catch up. Don't get behind and don't skip class. If possible, get ahead of the class and stay ahead. If something comes up that takes time away from your daily study, take care of it quickly and get back on track. If you are taking o-chem during the summer, skipping even one day of study can be a "deathblow" to your total course performance.
Finally, get a copy of the Biological Science Topics for the MCAT(o-chem starts on page 12 of this document) and make sure that you are systematically checking the topics off from both your General Biology and o-chem course as you go along. This document can be downloaded at : http://www.aamc.org/students/mcat/preparing/start.htm Go to the Tests Sections and download the topic lists (pdf documents) for Biological Sciences, Physical Sciences and Verbal Reasoning. These three documents can help to keep you on track as you move through all of your pre-med coursework.
15 July 2007
As I have mentioned in other posts, you need to be thoroughly prepared for each class before you enter the classroom. The volume of material will not allow you to sit in lecture cold. This preparation means having your text/syllabus reading done before you hear the lecture. In addition, you need to have thoroughly mastered the previous lecture's material before you move into the current lecture's material. Gone are the days of sitting down on the weekend and learning the previous week's work. Studying and learning are daily "friends" once you reach medical school.
You are going to hear differing opinions on class attendance. Some schools have mandatory attendance while others don't care except for the occasional mandatory session. If you have signed up for a problem-based learning curriculum, you are going to be subject to mandatory attendance. In general, if class attendance is optional, attend class until you find that you are more adept at mastery of the material on your own or when you feel that your learning is being slowed by the lecture.
When students are sitting in lecture, they are listening to the lecture material being presented in an aural manner. Their isn't much mental processing of the material unless you have a base to which your are mentally linking as the lecturer presents the material. Most of the "learning" of the lecture material will take place when you go home and review the lecture presentation.
Some students will sit in lecture and "personalize" the material as the lecturer presents. This is generally a distraction and leads to those "sometimes annoying" classroom debates between one student and the lecturer. When I was a freshman medical student, these debates would generally occur during out psychiatry lectures when the professor would present a controversial theory or treatment. There was always one or two students who felt the need to be the "moral pulse" of the class. The rest of us learned to tune out and tune back in once the lecturer got back on track. Most experienced lecturers are adept at redirecting but occasionally, these interludes could go on for several minutes leaving me time to pour a fresh cup of coffee (or water) or take a breather.
For many students, taking notes seems to be oppressive. Don't fall into this category. There are very few notes that must be taken for the most part. Don't fall into the trap of thinking that you need to take down every work that comes out of a lecturer's mouth. When this happens, you become more clerical than engaged in information acquisition. You need only write a word here or there as most lecturers will have downloadable handouts/slides. Once you reach the point of figuring out how the lecturer approaches the subject matter, you can take a word here and there to direct your learning later on.
If you are a participant in a problem-based learning curriculum, you will have to become adept at linking medical concepts. I can tell you that by the time your first two years are done, you will become nauseated at the mention of the words "learning issues" and "learning goals". While problem-based learning (PBL) is admirable, sometimes one or two group members - usually the loudest and less shy - can dominate conversations or delay progression. At this point, an excellent facilitator (another word that will bring on nausea) will intervene but sometimes the group dynamics can get in the way of obtaining the information that you just need to learn.
Other things to think about are time-management in general. Yes, there are only 24 hours in the day and you will need to sleep at some point. I did find that after a couple of weeks, I could actually study when I was tired and that more coffee was not necessarily going to keep me awake. Having and keeping a fairly detailed daily schedule that included timing for the necessities of life (sleeping, eating etc) was helpful but there are going to be some days when the schedule is going "out the window" and your time will be spent in less productive ways. (You want to try not to have too many of these types of days). When this happens, forgive yourself, forgive the person (s) who wasted your time and get back on track as soon as possible.
Getting enough sleep is going to become something of an experimental journey for you. Resist the urge to listen to people who say that they "go for days on 1 hour of sleep" or the people who say "if you are sleeping 8 hours a night, you are not studying enough". Both of these are extremes and you will find that some the amount of sleep you "need" is just that, the amount that you "need".
If you are drowsy most of the daylight hours, you are probably not getting enough quality sleep. If you are drowsy when the lecture hall is too warm and dark and the professor's voice is monotone, you are normal. If your sleep quality is not good, be sure that you are getting enough "de-stressing" (physical exercise is good for this) or getting enough rest (being overtired can disrupt your study efficiency).
If your sleep pattern is disrupted, try some good sleep hygiene such as getting in bed at the same time every night. Don't try to read or study in bed (keep the bedroom for sleeping and recreation). Don't have a television in the bedroom (Ok, but un-plug it). Avoid coffee, tea and high caffeine "energy drinks" within four hours of bedtime. Avoid exercising before bedtime as it can disrupt your sleeping patterns as do naps of more than 45-minutes in the afternoon.
Be sure that your bedroom does not contain molds and too much dust. If you have allergies, these things will decrease your sleep efficiency and disrupt your sleeping patterns. Clean and dust your bedroom on a regular basis. If possible, wash your pillows monthly too.
Finally, forgive yourself if you find that your don't have everything together perfectly for the first set of exams. Adjusting up or down is part of the adjustment phase of medical school. You are definitely going to find that some subjects will demand more of your time and some will demand less. In the beginning, keep up with everything but generally give the time where it is demanded most.
Don't try to "explain" your schedule or study needs to anyone. Every medical student is different. If you can get through the semester, get the material mastered and get some stress relief on a regular basis, then you have gotten off to a strong start. Your family is not going to understand the pressure of your daily routine so don't expect this understanding. Your classmates will understand and your professors (to a certain degree) will understand but searching for "understanding" is largely counterproductive outside of medical school.
Start strong and finish strong but in the first few weeks, just get the start under your belt. Largely the study skills that you have brought with you from undergraduate/graduate school will work in medical school. Do realize that you are human and will make mistakes. At the beginning, there are no fatal mistakes so use this time to "ratchet up" or "ratchet back" until your reach your optimum.
The best words of advice that I received as I started medical school were "you create your own success and you create your own luck". Don't overanalyze and above all, don't be afraid of the task that is in front of you. You will adjust and you will have some successes. Overall, you just have to be willing to make adjustments daily and adapt.
01 July 2007
Orientation Week usually starts out with some type of "check-in". In my case, the Dean of Students called names from a roll. We had previously been warned that if we were not present for roll call, our "seat" would be given to the next person on the wait list. Needless to say, everyone was present and accounted-for that morning. Following roll call, there was the obligatory introduction of the Deans. This was followed by a speech given by a speaker that was chosen by the second-year students the year before.
By the time the introductions and speeches were over, the greater part of the morning had disappeared. There was a meeting of your second-year advisers (second-year medical students) who would share their advice on navigating the curriculum. This meet-and-greet was filled with horror stories about certain professors and warnings about behaviors to avoid. With some of the tales of woe, I wondered how anyone survived the first year and made it into second year.
My own second-year adviser was a lovely but quite young lady. She was the daughter of a registered nurse and was very enthusiastic about all of the adventures that she had experienced in first year. She and her tight-knit group of friends, gathered us together and spoke to us (their advisees) as a group. We were able to get the benefit of a collective experience rather than single reports. This turned out to be a blessing. My second-year adviser also led me to her car where she presented me with a cardboard box of old exam, used and filled-in course syllabi and her books from first year. "I started putting this together for year after my first exams last year", she said almost apologetically. I was speechless but thanked her profusely. That box turned out to be one of the major keys to my success during my first year. I happily passed on her stuff and mine to my two advisees when I became a second-year student.
After our meetings with our second-year advisers, it was time to get our photographs done for the student directory. We lined up and had out photos taken by the medical photography service. Following the photo for the student directory, we were taken to the Student Services building for photo identification cards. Our physical examination papers were collected along with our immunization records as we moved from Student Services to student health. Once we had accepted admission to medical school, we were told to bring proof of immunization and undergo a physical examination by a physician. (My uncle took care of this for me, had his office staff copy my records and put together a nice package).
During the evening of our first day, we were bused and car-pooled to a local park where the second-year students had prepared a cookout for us. This was our first introduction to the wonderful world of "free-food" in medical school. Our first day of orientation ended around 8pm.
On the second day, we were introduced to our microscopes and course syllabi. Each of us was issued a microscope (if you didn't have your own as I did ) and were issued thick syllabi for Biochemistry, Gross Anatomy, Introduction to the Practice of Medicine and Psychiatry. In addition, we were given a couple of hours to purchase books (already furnished by my second-year adviser). We also had lockers issued (I could actually stand in my huge locker) where we could store our necessities. On this day, the student health department singled out students whose records were not complete and gave them strategies for getting their immunizations and records done. This meant downtime for me. At the end of the day, free pizza courtesy of one of the student organizations.
On the third day, which turned out to be a Thursday, we were treated to a morning meeting with Financial Aid and Student Organizations. The Student Organizations had set up tables with sign-up sheets for us to join groups. I signed up for the American Medical Association and new organization called "Students with Families" (a non-traditional student organization). The afternoon was spent organizing our class and electing temporary class officers. We elected temporary officers because we actually didn't know anyone and would elect permanent officers later in the year. I actually volunteered to become the Vice-President for Education in charge of note-service because I had some experience from graduate school with running a note service.
The Dean's Reception was held on the evening of the third day. This is where I met my best friend from medical school. Over the four years, we would share triumphs and tragedies but it was at this reception that we met the various Deans up close and shared a line or two of conversation. In addition, there was more free food and an opportunity to wear something other than our jeans and T-Shir's that had become our orientation outfit.
On our last full day of orientation, we had information sessions from the chairmen of various departments. This gave us an opportunity to mingle with the faculty. We were also introduced to the school's computing system and issued laptop computers if we didn't already own a suitable laptop. Again, that locker was getting full. For students who were not immune to Hepatitis B, there was the first in a series of three Hep B vaccination shots (thankfully, I could bypass this step too). On the evening of our last day of orientation, there was a White Coat Ceremony where we were cloaked in our white coats by graduates of our medical school and issued the Hippocratic Oath.
Orientation had taken the better part of a week. Many of us were not ready to just get down to the business of attending classes and adjusting to the course schedule. Our syllabi need to be filled in and mastered, our textbooks read and highlighted. On the next Monday, we would be "going live" in terms of our classwork.
Over the first week, I came to have a list of things that I could not do without. These things were carried in my backpack and spread on my table in front of me during lectures. These were:
- My laptop computer for downloading power-points and the professors writing on the "smart board".
- My pens of four colors: black for notes, red for emphasis, green for projects and blue for notes from the text book.
- My Easy Reader book stand that held my looseleaf notebook that contained pages from my textbooks that were cut and 3-hole punched.
- My highlighters in four colors: bright yellow, pink, green and blue.
- A micro tape recorder (now replaced by a digital tape recorder) for making sure I didn't miss anything if I fell asleep in class.
- A sweatshirt as the lecture room was always freezing even if the outside temperature was above 100F.
- My travel coffee mug and a thermos of fresh coffee (Starbucks was a short walk from the lecture hall).
- A liter-bottle of water (kept me awake in the afternoon).
- My Walkman (now replaced by an MP-3 player).
These were my daily companions during first and second year of medical school. Even today, I always read and study with my pens and highlighters handy. My Easy Reader book stand is also with me as is my Sony Viao laptop computer for making notes and reading the myriad of PDF documents that I have downloaded.
Other things that I would learn but not mentioned during Orientation Week, was not to worry so much about not doing well on my first set of exams. I more than passed every exam but I saw many of my classmates head into a "tail-spin" after receiving their first failing grades. On our first Gross Anatomy exam, 85% of the class failed the exam. For some students, this was their first failure ever and they had difficulty shaking it off and moving on. In my case, I remembered that my wonderful second-year adviser had said, "You are going to encounter something that will give you problems, ask for help and put your failures behind you fast.". She also encouraged me to help my fellow students who as she said, would "become colleagues that I would refer patients to in the future". She was right because the more I helped my fellow students, the higher my grades became.
We all survived that first semester but we lost a couple of students at the end of second semester. One of my classmates decided that he wasn't going to spend another moment doing that much studying for anything. Another had illnesses and just wasn't able to keep up with the material. In the end, we all experienced the molding that would mark us as physicians.