Fletcher Moore

April 21, 2013

A word to incoming M1s

Filed under: Uncategorized — Fletcher @ 10:01 pm

As I approach the end of my second year of medical school and start thinking more about finals, step one, and third year, I am very much regretting the way I elected to study and construct notes. This regret began at the beginning of second year and has weighed on my mind since, but I was unable to change course. My method was solid, rehearsed, predictable, and working; there was too little time and too big of a risk to try out a new method.

My method was to approach each lecture (and associated powerpoints, handouts, etc), convert it to easy-to-memorize bullet points (flashcards), and then memorize it. Repeat. From discussions with my classmates, I learned many do something like this. Some memorize directly from the given material without any intermediate steps. I don’t prefer this latter approach since there is a huge signal to noise ratio in the material, and sifting through the “noise” over and over is very miserable for me. At the same time, it may be faster overall since making your own notes takes up a lot of very valuable time. That said, my method has a drawback that has taken me until now to really appreciate.

There is a high degree of redundancy in the presented material, which most, I think, find valuable. Yet I have memorized the cycle of female hormones at least five times in my life now, the genetic mutation responsible for sickle cell disease at least three times, and so on ad nauseum. Even so, I wouldn’t be able to recite this information to you now, and I need to know it for my upcoming licensing exam.

Sure, I will not have to invest much energy in relearning these and a mountain of other facts in a few weeks. My point is not that I feel unprepared, but rather that much my time has been wasted by my own note-taking methodology. My notes are organized according to class, test, and further into individual lectures with worthless headings. The amount of redundancy buried in these notes is discouraging to think about. If a professor now presented me with sickle cell again, I would create a fresh set of notes just because it would be difficult to find all the notes I have already made on the subject.

Here is an example. In your histology class fall semester you may learn about hyperprolactinemia when the pituitary is first discussed. At the time, the professor may mention that bromocriptine is a treatment, but he goes on to say you do not need to know it for the upcoming test. Nonetheless, you are ambitious, and you jot down “bromocriptine”, not really understanding anything about it, but afraid it just might be one of those “random” facts that appears on the exam, a phenomenon you are now very familiar with. In the spring the following year, you may learn about hyperprolactinemia again in physiology. This time you hear that dopamine tonically inhibits the production of prolactin, but nothing else. A full year later you learn that bromocriptine is a D2 agonist in pharmacology. Each time you have have made a completely new note, written in a completely different way under a completely different heading. This is the rule, not the exception. I estimate my notes are mostly redundant with previous notes in some way or another.

What I wish I had done, and now want you to consider, is this: a) organize all of my material by topic, not lecture or test or class. b) add to or modify existent material instead creating again de novo as it is presented. The time savings would have been enormous, and my understanding far more holistic. That said, the implementation is not an easy problem. For one, a newcomer would not know how to best organize the material. Secondly, how do you use your database once constructed?

I propose this algorithm, assuming you use a computer, which is what I would do if I could go back in time. 1) Copy the organizational structure of First Aid, a review book you will eventually become very familiar with anyway. Make sure all topics you create are searchable or otherwise easy to find (word documents nested in folders or flashcards organized into decks, etc). Diseases should be listed alphabetically. 2) When approaching a new lecture, make notes directly into the master database, editing it as needed. 3) At the same time create a copy of the relevant material for the upcoming test in a new place so that you can memorize the material without any “noise”. 4) Delete the copy after you are done with it to prevent discordant information from developing.

Your future self would thank you, but s/he probably doesn’t realize how much time s/he has saved over the last two years since s/he has been taking careful organization for granted.

August 4, 2012

Europe Photos

Filed under: Uncategorized — Fletcher @ 10:26 am

These were taken with a Galaxy S Vibrant camera. For now I am hosting them on Google+.

Munich 1

Berlin

Hamburg

Amsterdam

Leiden

Holland Dunes

Cochem

Munich 2

Switzerland

Lugano and nearby Italy

November 5, 2011

3 months in

Filed under: Uncategorized — Fletcher @ 2:05 pm

It has been too long since my last post. There is an inherent problem with being a medical school student and maintaining a public profile. I am certain an increasing number of potential patients will be googling their potential doctor’s names–as will potential employers. So each post must be made with the utmost professionalism. Not that I mind. At some point a few years ago I decided to abandon pseudonyms/internet handles in favor of my real name in order to force myself to be more responsible with my contributions. Afterall, the anonymity is somewhat illusory anyway, and moreover, why interact with a stranger online differently than a face-to-face encounter?

With the above in mind, knowing that the audience is general, arguments cannot be made willy-nilly and opinions on controversial subjects cannot be made without defense. With the OWS protests I have been wondering about collective moral responsibility, ethics, and economics lately. My standard for a post on the matter would require a fair amount of research, and I do not have the time. Such is the life of a medical student. Consequently the blog has been somewhat lifeless.

In other news, biochemistry does not consume less time the second time around, and gross anatomy has been the highlight of my life for the last three months. I am not sure how one measures happiness, but I have been somewhere near the top end of my scale lately. Or perhaps I just had two cups of coffee and my memory is distorted. It is hard to trust your own emotions and memories the more you read what science has to say about them. I recommend Steven Pinker, Antonio Damasio, and Michael Gazzaniga for those looking for literature on neuroscience directed at a lay audience.

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