Pearls of Wisdom – Keys to Effective Studying As you approach your board exam, one of the most important assets your can have is a positive attitude: You can do this! Another essential asset is effective boundaries. Five boundaries essential to effective study

1. Time Some study best in the evening, some in the morning. Pick a time of day within your schedule that fits your key productivity period. We recommend 2 hours of study each day from now until your board exam. Study for 50–55 minutes, take a 10-minute break—but only 10 minutes!—and continue to study another 55–60 minutes.

2. Place

Find a quiet place with minimal distractions. The place can vary from day to day, so long as distractions are minimized. (We realize they cannot be eliminated entirely.) Initially, sit only at a desk; NO sitting on the bed.

3. Mental Boundary

By far, the most important study boundary that must be established is your mental one. Internal distractions can gain great power if you do not go through a process to set up a very firm mental boundary around your study time. How in the world do you do this? Well, it is simply a process of: Confirming the importance of the final result of all of this studying:

– Passing your board exam. Doing so will immediately take a lot of pressure off of you and those around you.

– Better patient care. This not only helps your patients but also their family members. Better patient care can truly benefit future generations.

– Other results and rewards that are personally important to you. Make a list of things that will give you the incentive to study hard in order to pass your exam.

Agreeing that you will allow these important results to translate into a mental

boundary. This is deeply engrossing and sometimes provides an exciting place of learning.

Your mental boundary should be very thick, but also flexible. The thickness of the boundary prevents distractions from luring you away from your focus. The flexibility is necessary for real life to happen. Stuff does happen. With this boundary in place, you can deal with distractions and then get right back to studying.

4. Study Method: There are many study methods, but the one I suggest is Preview, Investigate,

and Review. Preview. When developing a strong foundation of a vast amount of knowledge, it works best

for most of us to lay the big beams (main topics/concepts) first and then attach the smaller structures. The preview process is your foundation. Start a new section by reviewing the list of topics in the Personal Trainer Emails. Read each topic and then pause a bit and see what pops up in your mind. This process gets you acquainted with all of the material in the section. It also starts adding little “sticky nodes” onto your current foundation of medical knowledge. These sticky nodes* will end up attaching to each other and future nodes of information that form. Remember that it is not the process of reading the topics but rather the process of reflection and pondering that creates sticky nodes in your mind. If you are using MedStudy’s Internal Medicine Review Core Curriculum, you should also read the headings of the section

and complete the same exercise. Keep it very relaxed. There is no pressure. Let ideas and associations pop into your mind. Some like to draw diagrams while doing this. Using 1 spiral notebook per section, works well. Others make flashcards as they go. Do what works for you.

Investigate. Now that you have pondered the topics, locate information about each topic.

You can utilize the Internet (pay attention to the source), textbooks, or MedStudy’s Internal Medicine Review Core Curriculum. If you use the Internal Medicine Review Core Curriculum, investigate the content of the paragraphs. Some of you are serial readers—serial reading works very well with the Internal Medicine Review Core Curriculum material, as it is written in a lecture format, with one item logically following the other. Annotate text, highlight, and/or make notes. Some will like to read the highlighted material first and then read more as that stimulates interest. Some will start with the Quick Quizzes and then search the highlighted material for the answer. The point is to let your interest drive you through the process. Annotate text, highlight and/or make notes. Read for understanding making more sticky nodes and connecting projections*. When you feel like you have a good grasp of the material, move on to “Review.”

Review. Whereas previewing and investigating are done once, reviewing is a multi-step process. Reviewing involves moving the material from immediate recall to intermediate-term memory and then to long-term memory. You do this by beefing up the sticky nodes and connecting projections. The more ways you find to review, the better. A good system is to always review the material from the previous day at the beginning of the study period. The first review on the next day is important. Most people remember about 50% of the material the next day and about 35% after 7 days. The review will, of course, be quick and should get your knowledge level back up to par. In addition, you should briefly review the section topics again in several weeks. MedStudy Personal Trainer emails will remind you. Another way to reinforce review is to study with friends. Assemble a study group. Go over the same material in different ways, perhaps using MedStudy’s Internal Medicine Board-Style Q&A Premium, or Internal Medicine Core Scripts® Flash Cards. Using complementary products within the same review system can be amazingly valuable.

* “Sticky nodes” and “connecting projections” are completely made-up terms that explain how I interpret the process of developing a long-term memory. Basically, each time a fact is previewed, investigated, or reviewed, a sticky node is made or the original one gets larger. Each time a fact is associated with another fact, a connecting projection is made between the two associated nodes. Connecting projections increase the size of each node and increase stability of both attached memories. Closely associated nodes can become confluent as they grow. The bigger the node and the more projections, the more long-term the memory becomes. You want your medical knowledge memory bank to look like a dense engineering marvel, not a spindly contraption dreamed up by Dr. Seuss!

5. Study Schedule: The MedStudy Personal Trainer provides a schedule complete with 13 sections, topic lists from sections, and review reminders.

Sections. MedStudy divides the studying into 13 sections—Allergy and Immunology,

Cardiology, Dermatology, Endocrinology, Gastroenterology, General Internal Medicine, Hematology, Infectious Disease, Nephrology, Neurology, Oncology, Pulmonary Medicine, and Rheumatology,

Topic Lists. Each personal trainer email will have a list of topics to study from one of the 13 sections, along with the suggested number of days to study. The topic list for each section ranges from 5 topics in Neurology to 24 topics in Gastroenterology, Infectious Disease, and Pulmonary. The list might seem overwhelming, so break it down into manageable parts. Take the number of topics and divide by the number of days in your study period and round up. Say the study period for a section is 10 days, so 24 divided by 10 is 2.4. By rounding up, you

should study 3 topics a day during that study period and that will leave 2 days at the end of the study period for review. Most importantly: – Write the topics on a study calendar and mark them off as you complete. – Take notes as you go along.

Establishing and enforcing these five boundaries of Time, Place, Mental Boundary, Study Method, and Study Schedule is a matter of self-discipline and motivation. You know you want to pass. Remember the mental boundary you have created for yourself. Don’t make the process intimidating: Take the material in small amounts and you’ll be through everything before you know it. If you don’t understand something, make a note to yourself to review again. If you still don’t understand it, ask someone perhaps at MedStudy’s Internal Medicine Intensive Certification Board Review Course or Internal Medicine Recertification Board Review Course. You can also listen to MedStudy’s Video Board Review of Internal Medicine. Check out several topics on MedStudy’s youtube.com account. Remember to start each study period by reviewing the previous day’s topics. In addition, MedStudy Personal Trainer emails will remind you to review information studied periodically throughout the process. In addition, the last 3 weeks of this study schedule is dedicated to reviewing information one last time before your exam. A note on learning styles Knowing your learning style helps you find ways to study smarter, rather than longer. If you do not know your learning style, go to http://www.vark-learn.com/english/page.asp?p=questionnaire Take the quick 16-item test. Choose the answer which best explains your preference and tick the box next to it. Please select more than one if a single answer does not match your perception. Leave blank any question that does not apply. Results will be provided after completion. You can also elect to receive a detailed report on your specific learning style for a nominal charge. Here are short descriptions of the 4 most common learning styles. Keep in mind that most people benefit from select elements of each style. The important thing, according to this theory of learning, is to identify your style strengths and to develop a strategy that works for you.

The Visual learner focuses on seeing and has to think a while before understanding; becomes distracted by movement; enjoys descriptive passages while reading or pauses to form images in his or her mind; prefers direct, face-to-face interactions; wants to see demonstrations, diagrams, and tables; and takes notes, makes lists, and uses highlighters and other color codes.

The Auditory learner enjoys listening; becomes distracted by irrelevant noise; likes to

explain/discuss information in conjunction with others, such as in study groups; likes to read aloud; gains knowledge from live presentations and videos; and uses word associations to remember facts and cases.

The Read/Write learner prefers text-based information and words. These learners need to

write down what they are learning, make lists, and turn graphs into words. The Tactile/Kinesthetic learner prefers tangible devices and resources; becomes distracted

by nearby activity; prefers action over simple reading; prefers demonstrations, such as case

studies; enjoys pacing or walking while studying; and uses practice tests or written notes to memorize.

Throughout the MedStudy Personal Trainer lessons, I will include helpful hints based on your learning style. Bottom line, take-home message for the first study period: Enjoy starting off on this incredible journey and commit powerfully to the first section. The enjoyment you receive from your progress toward realizing your very important goals, from your increasingly sharp mind, and from your stronger foundation of knowledge will take over to make it easier to continue. Give yourself one month to find the method that works for you. --Tony Robert A. (Tony) Hannaman, MD Editor-in-Chief, Course Director MedStudy www.medstudy.com