Preparing for Medical School

Four factors are involved in doing well in college: academic ability, determination, good study skills, and proper time management. There are, however, a good number of pitfalls that should and can be avoided to enhance your chances for success. The following are ten tips that may prove helpful:

The following discussion covers (1) organizing oneself, (2) writing term papers, and (3) taking examinations.

Organizing for College Life

It is important to be aware of the fact that during high school, competition may not necessarily be very intense, because not all students are considering college or postgraduate careers. Under these circumstances, students may not be motivated to acquire good study habits in order to succeed. This is especially true if they find that, with a modest amount of work, they can attain adequate grades to be admitted to a college, even the one of their choice. Upon entering college, where competition is usually much more intense, knowing how to study is obligatory if the student is to have a good enough academic record to get into a professional school.

College life is very time consuming; it preempts the largest block of one's daily activities. It has built-in time commitments, such as: (1) the need to attend lecture and recitation classes, as well as laboratory sessions; (2) library research and term paper writing; and (3) study in preparation for periodic midterm and final examinations. In addition to these educational time demands, there are those of a personal nature, such as eating, relaxation, social life, and participation in extracurricular activities. Leading a balanced college life that meets both your personal and educational needs is the most desirable formula for achieving academic success. It also ensures enjoying your stay in college, which is a unique time in one's life.

The key to adequately meeting both your school and personal obligations is the proper allocation of your time. This can be done either in a disorganized or in an orderly manner (without the need for extreme regimentation). Thus, if you establish a seven-day grid (Table 3.2, page 36), with a time plan schedule from 8:00 a.m. to 10:00 p.m., you can readily see: (1) if you have allotted the needed time to meet all your responsibilities, and (2) how much spare time you have available and where it is in order to meet unforeseen demands and unexpected challenges.

Having formulated your semester's course of study, you should initially fill in the time where you have scheduled lectures, recitations, and laboratory sessions. Next, you should factor into your schedule that one hour of class time on average requires two hours of study time. Thus, a typical 16-hour semester course load requires 32 hours of study time, resulting in a basic total weekly educational time commitment of 48 hours (exclusive of special test study time). Place any other regular commitments into the time grid, such as travel to and from school, attendance at religious services, social obligations, etc. With these items placed in their proper time frame, your actual available free time becomes readily evident and can then be allotted to meet your personal needs.

You should recognize that allocation of study time also needs to be flexible, since: (1) the same course may demand a varying amount of study time at different intervals during the course of a semester, depending on such variables as complexity of topics and frequency of examinations; and (2) different courses vary significantly in their overall study time requirements, depending on their inherent difficulty, quality of the instruction, and ability of the student. With this in mind, you should be prepared to make appropriate adjustments in your initial study time schedule to accommodate changing circumstances. It is obviously also essential that you prioritize your study time so that you place appropriate emphasis not only on time allotment, but also in the sequence in which you study your subjects in the context of their importance and difficulty. Successfully completing the highest priority assignments should be satisfying enough to motivate you to proceed with other, perhaps less appealing, projects. It is vital for your health and the success of your study efforts that you allot adequate time for meals, recreation, relaxation, and sleep.

Failure to provide time for any of these four vital areas can diminish the efficiency of your study efforts. A consistent fulfillment of your study plans will allow you more freedom to enjoy your rest periods without feeling any sense of guilt for having taken time off.

It is also important that you put to good use the time breaks between classes for relaxation, makeup reading, or review of material, prior to a lecture or lab. This will allow you to get the most out of these learning opportunities.

Time-demanding projects, such as term papers or laboratory reports, should be placed into your study time schedule as soon as it is practical. You can then work on them in a timely fashion, rather than hastily completing them in order to meet a competing assignment.

Genuine study involves intense concentration that can usually be done more efficiently in short time intervals. Thus, you should try to utilize study time blocks of 30 to 60 minutes to avoid mental fatigue. Also, try to avoid studying closely related subjects in sequence, so as to minimize the confusion between them.

Another major benefit that comes from having and adhering to a study schedule is that it reduces the possibility of your work piling up. Such a situation can produce stress that may impede your academic progress. It is obvious that studying under pressure is not as effective as studying under favorable conditions.

Table 3.2 TIME PLAN

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
a.m. 8:00
9:00
10:00
11:00
12:00
p.m. 1:00
2:00
3:00
4:00
5:00
6:00
7:00
8:00
9:00
10:00

With an appropriate study plan — one that has periodically been reviewed and adjusted — potential problems with exams can be avoided. You will find that, under these circumstances, you will not need to cram for tests, but, rather, you will be able to review intensively. Moreover, you will likely retain the basic information longer and be able to build upon it, as you absorb more advanced material.

Mastering the art of time management will surely pay substantial dividends during your professional education and training. It may prove to be one of the keys to your future success. Medical students and residents face the challenge of mastering knowledge and technical skills in order to attain diagnostic and treatment proficiency. To achieve such formidable goals, it is essential that health professionals-in-training maintain good physical and mental health, which is constrained by intense time demands.

It is assumed that since healing practitioners are devoted to improving the lifestyle of their patients, they surely will be alert to their own well-being. Unfortunately, this is frequently not the case. Their concerns focus so intensely on career responsibilities and their daily obligations as to frequently result in neglecting their own health status.

A recent published report claimed that medical students felt an incessant need to study while giving little thought to properly managing their time. To achieve study goals and to compress them into a restricted time frame often leads to formulating strategies that are not beneficial to one's well-being. This may include staying up all night, living on fast food and snacks, getting minimal exercise, and having no social life. To avoid such deleterious practices in the future, mastering the art of time management early on can prove to be a most valuable asset.

Physical Setting

After establishing an appropriate study schedule, it is essential to secure a suitable and conducive atmosphere, where your study plan can be carried out. The first place to consider is your home or dorm room. This location is a good choice if you are its sole occupant and can enjoy the privacy and solitude that is necessary for successful study. However, the presence of siblings in the home or roommates in the dorm may make this location impractical, unless you can control entry or gain the cooperation of the occupant(s).

Learning in the Classroom

Benefiting from Lectures

Lectures provide an excellent way of securing ideas, facts, and viewpoints. To get the most out of lectures, it is important to improve your listening skills. To accomplish this, the following should be taken into consideration:

Recitation Classes

Many courses consist of two (or three) lectures per week and one recitation or discussion hour. This arrangement is especially desirable where lecture classes are large and the only opportunity available to discuss the course material is during a recitation hour. The following is suggested in order to get the most from the recitation interval:

Writing Term Papers

Term papers are traditional college assignments. In general, they are usually not favored by students because they challenge the individual much more than study assignments. However, the preparation of term papers provides a useful vehicle to learn how to properly and clearly express yourself. This is a vital communication skill that is invaluable in the world you will work in.

Our educational system in large measure is a structured one, requiring that you simply recall information that has been presented. Preparing term papers requires independent thought, since it necessitates your evaluating and synthesizing information from multiple sources. As a result, you can formulate conclusions that you support with facts, thereby reflecting your ability to reason along logical lines.

Writing an attractive and effective term paper requires proper topic selection (assuming you have a choice), ability to obtain appropriate information (research skills), talent at organization, and clearly expressing your thoughts.

Instructors usually provide submission deadlines for the term paper. Once you know the deadline, you should set up a work schedule so that you can meet it. This should consist of the following interim deadlines:

• topic selection date
• rough draft date
• semifinal draft date
• final draft date

Obviously, you will need adequate and appropriate spacing between these four stages. By getting right to work, you can proceed in a systematic manner. You will also find yourself under less pressure. Concentrate on the quality of your work rather than only progressing toward its completion. If you delay working on your term paper, you will eventually need a crash program to catch up. This could impair the quality of your end product as well as your other educational obligations, which may then have to be neglected to meet this commitment. The above schedule should allow about one week between each of the drafts so that you can have a fresh look at the material before you move on to the next stage. These time intervals should be included in your overall work schedule.

Selecting a Topic

Your instructor will usually provide you with general guidelines on dealing with the term paper, including the general topic. The choice of a specific topic may well be left to you. The idea is to find a topic that will be of strong interest. This is especially important because it will serve to motivate you to face up to the challenging task in a forceful and positive manner.

If the instructor does not assign a specific topic nor offer a list of topics from which to choose, your initial approach should be to look at your text and determine relevant issues that fall into the general topic category. The bibliography dealing with the topic may provide some clues that are worth pursuing. Some additional research involving encyclopedias and/or current periodicals may shed light on possible appropriate topics that deserve consideration.

In selecting a topic, it is critical that you avoid choosing one that is too broad and thus cannot be readily covered, or, on the other hand, selecting a topic that is too narrow for you to find adequate source material to meet the needs of the topic. Even after making a topic decision, you need to be prepared to be flexible in determining its ultimate scope. As you proceed with organizing and writing your first draft, you may decide to enlarge or shorten the original desired coverage. Your initial clue as to the possible need to make any adjustment will come from the review of the library index and periodical index, which will provide insight as to the amount of information that is available. You must bear in mind the approximate length of the term paper as prescribed by the course instructor. Excessive length or brevity relative to the guidelines set should be avoided.

Before you invest extensive effort, but after you have formulated your term paper topic, you should check its appropriateness with your instructor. If you have selected more than one topic, present them all to your instructor, but indicate your preference. If you have difficulty choosing a topic, but have ideas that merit further discussion, arrange to do so with your instructor. Your discussions should be prearranged, by appointment, so that you can receive the time and attention you need. Avoid a spur-of-the moment inquiry. Also avoid any arranged meeting that you attend without any ideas to discuss. Offering some ideas of your own will demonstrate that you have given serious consideration to selecting a topic. This may lead to an exchange of ideas with your instructor that can produce possible subjects for further consideration. If you have no ideas to offer, you will convey a negative impression that is obviously not in your best interest.

Researching a Term Paper

Prepare an outline to serve as an organizational guide. This guide will enhance the presentation of your thoughts in a clear, organized, and concise manner.

There are two types of outlines that are used — topic and sentence outlines. Topic outlines are used in short essays and consist of a few words or phrases that highlight the major topics or subtopics that the essay will cover. Sentence outlines are used in longer writing projects and consist of one-sentence summaries for each of the topics or subtopics. This is used in term papers and will force you to determine exactly what you want to say. Such a sentence outline can serve to help determine the overall validity of the organizational scheme you have formulated for the project.

A suitable starting point for your research is an encyclopedia. Consult both general and specialized types. Try to have the reference librarian help you in your search for source material.

One of the keys to successful research is taking adequate notes. A useful way to do this is to record information on 5 × 7 cards, writing on one side only so that the cards can later be spread out. You should fully identify your reference source for sorting. For books, you should indicate title, author(s), publisher, year of publication, page where information is found, and total number of pages. For articles, you need to identify the name of the periodical, title of article, author(s), volume, issue number, date, and inclusive page numbers.

Material in books that contain important information or tables and/or charts should be photocopied, using the library's (coin operated) copy machine.

In cases where you copy text verbatim, you must use quotation marks, or you should paraphrase the text, using your own words to summarize the author's views. If you do not do this you will be guilty of plagiarism — a serious academic offense.

If your topic involves an issue that has more than one view, seek material that presents the alternative viewpoints, using the various reference sources noted earlier. You may need to broaden your reference heading if you are unable to adequately secure information under the headings you are currently using. If the standard sources are inadequate, you may want to make use of The New York Times Index and/or Readers' Guide to Periodical Literature (starting with the most recent edition). You probably will need to look through back issues as well as microfilm in your search for source material. You also may have to utilize the resources of other libraries to acquire all of the material you need. These include public, central municipal, and college libraries. Universities frequently have specialized departmental libraries that can prove to be invaluable in your research.

To facilitate your effort, avoid repeating the information you have already recorded. Merely note the additional source for inclusion in your bibliography. Any work done by the instructor should obviously be noted in the body of the text, if appropriate, and certainly in the bibliography. (The reason for this should be obvious.) Avoid working on a project with someone else, even if you have the instructor's approval, because collaboration has inherent difficulties and an especially superior product is usually expected.

When you find that you have obtained the information you seek and sources provide only confirmatory data, you can begin preparing the rough draft of your term paper. Using a computer is strongly recommended.

The Rough Draft

Before starting your rough draft, review your outline and amend it as necessary. Then arrange your research index cards according to your outline. Number your cards in sequence.

Make a special effort to draft the initial paragraph so that it contains the premise of your paper and so that it comes across in a forceful manner. Next, you should clarify how you intend to achieve the goal of establishing the proposed premise.

Having defined your goals, you can now proceed to outline your research data, using the information from your cards to present your ideas. When presenting an author's ideas or providing support from one of your sources for a statement you are making, note with a superscript the card number containing the reference source. At this writing phase, place your emphasis on quality of the ideas, rather than on the flow of the language. At the next stage you can concentrate on improving the paper by elaborating on the details of your presentation. This rough draft should be clear and concise and should accurately present the information you secured in the course of your research. If it is appropriate to use a chart or table to support your argument, note the place in the text where it belongs.

After presenting the facts and viewpoints based on your research and evaluating them, you need to arrive at a concluding paragraph that can be supported by what you have established.

At the conclusion of this phase of the project, it is essential to pause for several days, so that you will have an opportunity to gain a fresh overview of what you have written in your rough draft. After the appropriate interlude, reread the draft to see if it is properly organized and if there is continuity between the paragraphs. If not, amend it by relocating paragraphs or merely adding appropriate connecting phrases. While making any of these necessary changes, make notes about any other alterations you wish to incorporate in the text and proceed to work on the next stage of the term paper.

Semifinal Draft

Examine each paragraph carefully to see that the opening sentence serves to introduce the theme of the paragraph. The balance of the paragraph should provide the supporting detail. Evaluate the paragraph for clarity and elaborate where necessary to be sure that you have fully expressed your thoughts. However, try to avoid excessively lengthy paragraphs.

The effort that you put into preparing the semifinal draft will determine how much work will be needed for the final draft. You should use a word processor or computer to prepare your paper. This makes correcting much easier and should obviously facilitate carrying out any alterations due to grammatical errors.

At this point, you should once again set your paper aside for a few days before you tackle the final draft. During this interlude, it would serve you well if you were able to arrange for an outsider to review your draft, especially a person who is qualified to check for spelling, grammar, and punctuation, as well as for clarity and continuity. With potentially useful comments in hand, you are now in a position to review your semifinal draft and get the paper ready for submission.

Final Draft

Your term paper will need a title page. If a format has not been assigned by the instructor, prepare a title page on your own. It should contain the title of your paper, the course name, number, and section, the name of the instructor, and your own name. The title you select should be informative and attention-grabbing.

Your final draft should incorporate the comments that you feel are appropriate from an outside reader. In rereading it, try to avoid radical alterations that may introduce new difficulties in continuity and exposition. This stage is designed to put the final touches on your paper, rather than make major revisions of it.

The final copy should have a two-inch border along the left margin (for comments) and should be double-spaced (except for lengthy quotations, which can be single-spaced).

All text pages should be numbered, preferably using the format page 1 of 10, page 2 of 10, etc. Place your name at the top of each page to ensure that it will not be lost. If a table of contents is needed, prepare one.

References should be numbered sequentially in Arabic and placed as close to the relevant material as possible. They should be identified, preferably on separate pages at the end of the paper. Your instructor may provide references and a style manual or sheet showing how these should be presented. If none is provided, your librarian can show you a source for this information.

Find a suitable presentation binder for your term paper, one that will make a positive impression without being flashy or costly. Make sure the pages are in the proper order before you insert them in your binder.

Taking Examinations

An integral part of our educational system is taking examinations. While it is acknowledged that they are imperfect measures of an individual's knowledge or ability, they are an accepted means of determining academic progress and thus help to establish a basis for advancement.

In addition to being a grading tool, exams can have a positive value in that they can encourage or motivate the student to achieve. Doing well on exams can improve one's self-esteem.

Students sometimes tend to fear exams, being concerned that they will not perform well. This can become a self-fulfilling prophecy, because it can lead to anxiety and this, in turn, can interfere with one's performance on the exam. Intense pre-examination anxiety must be avoided (realizing, of course, that some degree of nervousness is reasonable).

Knowing that you have done everything necessary to prepare for an exam should provide you with a sense of self-confidence that is strong enough to achieve a potentially good performance. Relaxing just before an exam is therefore very desirable.

Reducing anxiety

A major prerequisite for reducing anxiety is to get a good night's sleep just prior to the exam. This should be obtained, if at all possible, without the use of any sleep-inducing aids so as to avoid any chance of a hangover that could interfere with your performance the next day.

A more active approach that may prove helpful is to employ one of the common tension-reducing methods. A common exercise is to sit down (in a comfortable chair, when possible), close your eyes, and take deep breaths. Hold each breath for about five seconds before exhaling. You should find your tension diminishing as you proceed with counting your breaths (approximately 20). Practicing this exercise will improve the results.

When possible, avoid mingling with other anxious students just prior to the exam, since this can have a negative effect on your state of mind. Waiting just outside the door of the exam room for the instructor to arrive is not recommended, nor is trying to get information from others at the last minute. You should, however, avoid being too far from the exam room at the appointed time, since being there on time is essential to remaining calm. If the exam room was or is one of your classrooms, try to sit in your usual seat, if possible. Remember that once the exam starts, and you focus attention on it, your nervousness should be gone.

General Exam Advice

Here are some important tips:

If you know how the exam is weighted pointwise, allot your time in answering the questions in a proportional manner.

Nature of Exams

Your exam can have three formats: objective, subjective, or a combination of both types of questions. Objective questions appear in the form of true-false, multiple-choice, matching, or completion. Science and mathematics exams are usually presented using an objective format. This is also true in other areas, where a large class size is involved, since it facilitates rapid grading. Objective exams are thought by some to entail less bias. Subjective examinations, on the other hand, consist of essay questions, with reasoning, analysis, and opinion rendering. This is the preferred type for humanities and social science courses. Subjective exams are viewed favorably because they are thought to measure the depth of knowledge and understanding.

Taking Objective Exams

Objective exams are recognition tests; you should not read into the question any elements that are not self-evident. The most straightforward, rather than obscure, meaning should be considered. Your answer should be based on the lectures and reading assignments for the course.

Questions have equal value, so avoid spending too much time on any one in particular. Answering all the questions that you know at the outset will provide you with time to consider and act on those you do not know. This includes guessing.

Accept questions at face value; do not add, change, or delete words to make the meaning more acceptable to you.

On multiple-choice completion questions, try to answer the question in your own words first, then find the answer that most closely approximates it. This is likely to be the correct one. In alloting time, expect multiple-choice questions to take twice as long per question as true-false questions. Also, when entering answers on an IBM card, one solid black stroke is enough; multiple strokes are superfluous and avoiding them will save some time.

True-false Questions

1. Beware of mandatory words: “never,” “always,” “must.” They presuppose that, if any exceptions exist, the answer must be false. If guessing an answer to a question that has a mandatory word, then the answer chosen should also be false.
2. Similarly, you have to beware when such mandatory words as “generally,” “normally,” and “seldom” are used, since they clearly imply exceptions to the question and these would make the statement false. When guessing in this context, it is best to choose true.

Multiple-choice Questions

If you are uncertain about any of these questions and you have to guess, use the following guidelines:

1. If two answers contain similar sounding words, pick one of these.
2. If two answers are almost identical, choose one of these.
3. If among the choices an answer is unusually short or long, select one of these.
4. Eliminate extreme answers from consideration and choose from among the others.
5. If you are unable to make any choice, select the third answer. It has the highest probability of being correct.

Taking Subjective Exams

Subjective exams, in addition to recall, require organization and, frequently, conclusions. The following suggestions can prove helpful:

1. Read all the questions carefully and then select the easiest question to answer first.
2. After selecting the question, do not begin writing your response immediately. Rather, organize your answer in a logical order by noting down headings and subheadings, and then proceed.
3. The essay should be structured so that you initially present your position, follow it up with relevant data or arguments, and then draw the appropriate conclusions (offering other options when desirable).
4. Allot an appropriate amount of time for each question. When the time is up, wrap up your conclusions and move on.
5. At the outset, merely identify the question without repeating it. This will save time.
6. Try to have a strong lead sentence in each paragraph, with the following sentences supporting or flowing from this opening one.
7. When possible, use the technical vocabulary of the course.
8. Try to make your sentences short and as uncomplicated as possible. The sentences should not be mere definition statements, but should be supported by facts or arguments when possible. These should, preferably, be arranged in order.
9. If providing a definition, try to give it a broad meaning and use the instructor's wording when possible.
10. If you have answered in what you consider a satisfactory manner, do not seek to “flesh it out” with irrelevant information.
11. If you do not know an answer to an essay question and have left it to the end and still have no recall, write on a closely related issue in the hope that you will get partial credit.
12. Leave some space after each essay question in the case you recall some additional information later and time permits you to come back.
13. Neatness is very desirable; if it is difficult to read your writing, the instructor may be negatively biased. Write your essay in ink to enhance neatness.
14. Write your essay on one side of the page, leaving the other side for use, if necessary, later.

Upon Exam Completion

When you finish the exam, you will have a natural impulse to want to leave the room. You should make use of any remaining time to review your answers. Answers to objective questions should be altered if you feel that they were misinterpreted or answered wrong. Do not do so merely on impulse.

Review of your answers may also bring to your attention any questions that have inadvertently gone unanswered or may have been answered in the wrong place (a not uncommon situation that can prove disastrous). In a situation where you were forced to guess, rereading a question may bring the correct answer to mind. For essays, rereading can bring to light a point or issue that was overlooked, probably because we think faster than we write. Computations should be rechecked, especially the position of decimal points.

After leaving the classroom, make notes pertaining to the questions asked so that you have an idea of the type of exams the instructor gives, a useful reference for future exam preparation.

Memorization Techniques

Over the past several decades medical educators have been carefully scrutinizing the curriculum in order to update it and keep it relevant to the demands of a modern medical practice. One of the unstated goals is to reduce the extent of memorization needed and concentrate on the reasoning processes involved in problem solving. While some progress has been made, there is and will always remain a mass of essential information that has to be memorized, in college, medical school, and postgraduate training, in order to successfully complete these programs.

Below are some memorization techniques that may prove beneficial during your education. They can be divided into three categories:

A. Organize

B. Think

C. Recall

Succeeding as a Premedical Student

In the preceding section detailed advice is outlined on various important aspects affecting your potential success as a college student in general. This section focuses on ways to enhance your career prospects, specifically as a college premedical student.

It is essential that throughout your college career, you evaluate your progress at regular intervals, certainly at the end of each semester. While doing this, it is important that you keep abreast of the admissions criteria and standards at medical schools that traditionally accept students from your school. To secure this information, you may have to tap several sources; tips on potential sources for useful information are outlined below:

Another set of factors associated with your success as a premed student involves academic components (such as GPA and science cum). The following additional tips are relevant to this important area: