So, you're going to medical school.... MKII
Due to popular demand I've decided to reproduce a thread with the same title that is aimed at people who are hoping to join medical school this coming autumn or perhaps in the autumn of 2026.
Whilst this thread is mostly written for the prospective student who is hoping to attend medical school at the University of Bristol, it likely will have some utility for students applying to study elsewhere and it may even have some helpful points for those hoping to study Veterinary medicine or dentistry or perhaps other courses which are similarly content dense
This thread simply contains the sum total of my own experiences and things that I would have personally found useful to know ahead of time. I am hoping this post and the others I make after it are useful to someone somewhere, aid their transition to medical school and make their first year as enjoyable as possible. However, this is only my own advice. It is neither right or wrong and your own mileage may vary.
First up: Note taking
There is no getting around the fact that studying at medical school involves studying a lot of content in a relatively short space of time. This means that studying with conventional pen and paper note-taking techniques may be very difficult. I attempted this in my first year and it simply didn't work for me for a couple of reasons. Firstly, my handwriting is just useless for this kind of use and there was just so much content to write down. Storing and handling all this results in you carrying endless amounts of paper around all of the time. This also means that organising and reviewing this material could be needlessly complex. I don't want to say it's completely impossible because I know people who have done it and I know that people who completed medical school many years ago did exactly the same thing and were still very successful. However, the majority of your lectures are going to be delivered by PowerPoint and the lectures themselves will be available ahead of time in PDF format that you can download. This means that you can effectively attend a lecture and make notes on it without having to write, draw or recreate a lot of the material in the lecture. Short of printing every lecture on paper ahead of time and annotating those whilst making a lot of hand notes I just can't see it would work, not to mention the cost of printing everything constantly.
The length and size of lectures is such as they could be anything from 10 to maybe 70 PDF pages/powerpoint slides in length. That is a lot of paper just to handle even if you used the 4 slides per A4 page technique. It just all sounds like a great deal of grief for no return. I myself like the feel of paper, I like writing and I like real textbooks but all the evidence seems to suggest that there is utterly no difference between text on paper and text on a digital screen. It's merely information in written form howsoever it is presented to you.
For this reason, I would strongly recommend that you fully adopt the use of digital note-taking applications such as OneNote, Notion or EverNote if you are not already. These apps allow you to cut and paste entire lectures into a page and freely annotate them. You can write side notes, highlight things, draw, sketch, cross out, delete etc all entirely on-the-fly. There is literally nothing you cannot cut and paste into OneNote and it is nearly limitless in size. You can put in very complex diagrams, photographs of medical conditions, text from other sources etc etc very very readily and then either type notes or handwrite notes with them using a stylus and touchscreen device. Make this your first pass note-taking technique before you begin to sieve information out of your notes.
EDIT: Support for OneNote for Windows 10 is ceasing this later this year. If you decide to use OneNote be sure you are using the desktop app version which is the newer version and will still be supported as part of the MS Office suite of apps.
Content storage. From day one it is very important that you get used to storing your notes and other content in an organised and logical fashion. Put year 1 content in a year 1 main folder, with individual subfolders organised neatly by case or topic. In OneNote I had a single note book for year 1. I had a single section group for each case, within that was an individual section for each lecture and within each section there would be a page for the lecture itself, a page for any exam questions and a page for other resources I added to go with it. The curriculum at Bristol (and in many other places) follows a spiral pattern, this means that content you will learn next year will overlap greatly on content you encountered the year before. This means that you may need to revisit content in future years so make sure it is all stored in a logical fashion that enables you to find it again 3 or 4 or 7 years from now. This will all help you later, especially when it comes to your post-graduate studies and later examinations.
Storage. Due to the above reasons and because you can destroy a laptop by dropping it or with spilt coffee, you must store all your content including OneNote and and downloaded lecture files on a cloud type system. Either use your free University OneDrive or use your own personal one- you get something like 1TB free with Office 365 if you subscribe to that. Alternatively I know Apple and Google and the like have their own system. Use whatever you need to but make sure your content is kept securely and neatly on those services so that no matter what happens, nothing is lost. Make sure your OneNote is being saved in the same fashion. The above also means that you can access anything, anywhere and on any device. On the train, on a plane on the bus, sat in the library, in the cafe, etc. What is more, these systems will permit retrieval many years into the future long after your laptop battery or power supply has been recycled.
Devices. You will need a laptop as a minimum. I know people who have nothing but a swish Apple mac laptop and they seem to get along fine but I also know people who have a laptop and an ipad or otherwise use a similar touchscreen device that they use to annotate their lecture notes with using a stylus. There are also writing tablet type devices you can attach to a regular laptop (I have no idea how good these are, however). The use of a tablet and stylus means you can annotate and highlight content at speed and easily keep pace with any lecture as it is presented. This is very very handy.
Microsoft make the SurfacePro which is what I used. All such devices are similarly expensive so try them out in an Apple store or PC world before you buy anything. Of course, with an Ipad you might also buy an attached keyboard and mouse and use it instead of laptop, too. The bonus of this being that they are smaller and lighter than a real laptop which is a big bonus considering how many hills there are in and around Bristol. Two things I would however advise against, are using Chrome based devices, (simply because I am not sure they are fully compatible with all University services though perhaps others can chime in here and tell us different). The other thing you need to be wary of is if you happen to own the most powerful gaming laptop on Earth. There may not be a lot of plug sockets in a lecture theatre and these things can deplete their batteries very rapidly if they are used without them being plugged in. Just something to be aware of.
EDIT: Sometimes you will have a lot going on at the same time when studying. You could be reading a lecture, making notes, typing an essay, reading an online textbook or making anki cards with many of these things happening at once. This means you can have a rather busy desktop/screen. I found that this was all made a lot easier by having a second monitor. Buy a second monitor you can plug in and use to extend your desktop whilst working. Leave it in your residence when not at home or away but plug it in when you get back for the longer study sessions. Beg, borrow or ask for one for Christmas. It makes life so much easier.
About Anki. Anki is an open-source based-repetition programme that lets you learn virtually anything. It is very popular in medical schools all over the world. It has a lot of optional add-ons and is evolving all the time. Also, by using the Ankiweb online service you are storing your content in the cloud and so you can review your flash cards on any device anywhere anytime: on the train, on the bus, waiting for a lecture to start, wherever, whenever.
The key thing however is this: if you intend to use Anki, then between now and September begin using it if you aren't already and then get used to using it and understanding how it works. This will make the jump into studying at medical school a lot smoother and a lot less stressful. There may be ready-made decks available for any first year in any school if you ask around politely.
Following on from other from earlier advice be sure to begin using it as your primary study resource from day one, lecture 1.
Under the Anki philosophy it is your Anki notes and Anki cards which will become your primary learning resource, your primary recall/revision method AND the primary reservoir of notes that you refer to. The material you store in OneNote will become secondary to your Anki deck and remain merely a source of reference largely. As part of the process I will later explain, you will have to 'sieve' the content in your lectures or textbooks before processing them into a far more palatable and bite-sized format as you create your Anki cards.
I can promise you will be glad of making this decision early on rather than deciding 3 months into the course that actually using Anki would be a good idea. Changing your mind later you will then have a much larger task of putting content into Anki if you change study methods halfway through the year because putting material into Anki takes time. I know people who fell into this trap part way through the first academic year and I don't for one minute believe it was in any way optimal. You can completely bypass this if you just opt to study this way from day 1.
Anki is very simple but it isn't very pretty and basically looks just about functional without being particularly spectacular compared to any other applications you might be used to. There are indeed other resources such as quizlet but I've never used them so I can't comment on how good they are. Anyway, irrespective of which app you use, you must get used to storing content in a logical fashion with decks and tags to organised in such a way to help you find specific cards should you ever need to find them again.
For example. Year 1 has it's own Anki deck. Within that deck are largish subdecks assigned to a particular case and within those are individual smaller decks of 20-100 cards which pertain to a specific lecture. 1 sub deck to each individual lecture. This means that if you realise one day, that heck you just can't remember much from lecture 5 of the urinary case, you can go straight to that deck of cards that covered that lecture and review them specifically or edit/add to them.
In any event, even if you don't decide to use anki or otherwise, be sure to get your study method in place as soon as you can. Certainly by the end of Freshers week would be good to have some system in place and certainly it would be best to have it optimised by the end of the first working week of lectures once you become familiar with the pace of content delivery and you learn how quickly you need to be picking it up. By Christmas is the very latest you want to be having to change anything in all honesty.
Textbooks. I do not recommend that first year medical students anywhere immediately go out and buy a lot of textbooks. They tend to be hugely expensive and very hefty: you won't be able to carry many of them around and you certainly won't want to carry them around campus because you'll be getting plenty of cardio without them. At Bristol the key textbook for first year is Naish's Medical Sciences. You can probably buy a second hand copy of this for less than £10. If you wish to buy any book you could buy that. The University library has endless numbers of online Ebooks you can access remotely and for free: read them on your second monitor and you can add information to Anki on the other screen. It really becomes so effortless once you become proficient at juggling your notes and textbooks and creating your cards to revise from.
Do not go out and buy Gray's anatomy; I was given my copy as a gift but it costs over £150 and is just far too detailed for any first year medic. I did find Rohen's anatomy atlas useful as it contains actual specimen images. However, the same applies; this is not a cheap book and it can be accessed online for free. There are many other anatomy resources you can use and your school will have lots of ways to mitigate the fact you cannot take any digital devices into any dissection room due to reasons of confidentiality. You will be given a reading list also which you can refer to before you spend a lot of money on books. I have a list of some more specific texts I will discuss later which may be useful for studying, especially when it comes to physiology.
Be organised. Use a digital calendar to manage your lectures, tutorials appointments and the like. Any doctor will tell you that their work life is very busy. Yours is going to be also. Make this as easy as you can and just get good at using Outlook or similar to run your academic life. Again, you can view this on a phone, a computer etc anywhere, any time. Get used to doing it and using it and you're going to have less problems in your first few weeks. Get outlook on your phone and setup the timetable medical school send you. It tells you the timings, the rooms and groups. This being on your phone means you can access all this information anytime you like.
Difficulty level. It is logical to wonder about how difficult the course is. I did too. The reality is that by simply turning up on the first day of the course you have already completed the most difficult aspect of it: gaining a place. No university (and especially not Bristol given it's historical competition ratios) gives these places away readily. You've attained the grades needed. You've hit the entrance examinations hard. You've scored well in interview. Do all this and you have already shown that have the minerals to be successful and become a competent doctor.
Someone once told me that they viewed medicine as the most challenging of any university course. I don't know if that is true or not as I've never studied law, mathematics or engineering but I can tell you most challenging aspect I encountered was the belief that I could actually complete it. I don't know how to best describe this but there is a scene in the movie 'The Matrix' which sort of sums up feeling I had at the time having spoken with a second year who had successfully completed first year. In the movie Neo observes Morpheus leap a huge rooftop gap in a single bound and has the shock of witnessing what he believed was impossible. That was me in about week 4. I had begun to embrace self-doubt and lacked self-belief. All I can advise is that if this happens to you at any stage, you must do your best to ignore it. You must give up all fear or doubt and just make the jump. The reality is that a lot of people will have passed year 1 of medical school in the past and for some of them not a huge amount of actual graft was involved. I am not saying this is in any way optimal but I am telling you that you will pass if you merely turn up on time reliably, attend everything and put in a sustained level of effort throughout the year. If you have obtained a place you're good enough to pass first year and then pass the years after that because passing first year will build your confidence for you. It really is that simple.
Performance and comparison. I know a lot of you reading this will have full A's at A level. Or you've got 45 distinctions in Access. Or you've smashed International Bacc. Those are very worthy achievements and you will be rightly proud of them. However, the cohort of people you will be shoulder to shoulder with now in year 1 will also have those same achievements behind them. This also means that the default 'excellent' grade A yardstick you once had is now actually the 50% mark. The pass mark for your first year's worth of attainment may now be surprisingly low on first glance. This means that yes, someone can get through all 4 or 5 or 6 years of the course and score maybe 60% at everything and guess what, they are qualified the same as you come the end of it. This doesn't mean anything involved is laughably easy (tl;dr,: it's not), it just means that all of you in the cohort are exceptional to begin with.
However, despite your achievements thus far, you can't really rock up at day 1 and expect to be absolutely amazing at everything from the outset. All of the content you will learn is new to everyone. I know A levels are not something you get free with a packet of cereal but even so a lot of this content is not something you will cover in prior study, even if you have completed a degree before hand. I had worked in various rather intense clinical environments for years before and there was stuff I haven't ever encountered, too. So you can't expect to be automatically perfect at everything and in the same breath, you can't be disappointed by the fact someone had a higher mark in a particular exam or a particular essay (essays being thankfully rare at Bristol): none of that matters. You'll graduate and finish alongside everyone else and suddenly you're a doctor with MB ChB behind your name the same as anyone else. Medical school is actually supposed to be fun, not a source of stress or disenchantment. You need to enjoy your time there because believe me it passes in the blink of an eye and you will soon grow into a very different person to what you are right now. Run your own race and embrace the journey. Don't compare yourself to someone else. Compare the person you are to who you were at the end of A levels. Some of you are going to spend 100K doing this thing and most of you will be devoting a minimum of 10 years of your life to the 'altar' of medicine. Be all you can be. Learning in a degree is very different to learning in school or college before it. What you learn, how you learn and how you pass examinations is whatever it is that you do. I am only suggesting a study method here but there will be a vast difference between what I learned, what I know or what I understand compared to any other person within the course. The maze you walk through is your own, you just end up at the same exit as everyone else.
And finally...
If you have read nothing else I have posted here, I'd be satisfied if you remember nothing but this final point. I want to share with you one of the most important things anyone anywhere has ever shared with me.
A long time ago now a very wise and senior doctor explained to me what they termed 'the 5% rule'. Their belief (which I have since learned to be 100% true) was that that there is intrinsic human 'healing value' in simply being there for a person in the moment of need and having them know that you care.
As a medical student and beyond you are going to meet people whose circumstances may not be good; they may even be extremely dire. Without being too graphic they could have just been hit by a bus. They might have a child who has septic shock. They could be in critical care. They could be anywhere and suffering from any medical condition you can name. However, irrespective of all of this, in none of the above scenarios and in no other situation is there any reason you cannot give someone that all important first 5%. It is the most important 5% of any patient interaction. Giving someone that 5%, being there for them and making sure they know that you care has a very real and genuine healing value that cannot be measured with any laboratory test. You might not be able to alter their outcome but you can still be there and that means that they didn't have to suffer alone. Medicine is both an art and a science. You have come this far: you'll (eventually) get that Bristol medical student lanyard, that I call 'the red cord of courage'. Learn the science of course, but from day one you can leverage your communication and people skills and give anybody, anywhere, that all-important first 5%. The human touch and how you impact those around you will be the difference between being an acceptable doctor and an exceptional one. You can have this ability from day one of the course.
Hope this all makes sense and is helpful. More study and anki tips plus discussion around other revision resources etc to follow.
E.
Whilst this thread is mostly written for the prospective student who is hoping to attend medical school at the University of Bristol, it likely will have some utility for students applying to study elsewhere and it may even have some helpful points for those hoping to study Veterinary medicine or dentistry or perhaps other courses which are similarly content dense
This thread simply contains the sum total of my own experiences and things that I would have personally found useful to know ahead of time. I am hoping this post and the others I make after it are useful to someone somewhere, aid their transition to medical school and make their first year as enjoyable as possible. However, this is only my own advice. It is neither right or wrong and your own mileage may vary.
First up: Note taking
There is no getting around the fact that studying at medical school involves studying a lot of content in a relatively short space of time. This means that studying with conventional pen and paper note-taking techniques may be very difficult. I attempted this in my first year and it simply didn't work for me for a couple of reasons. Firstly, my handwriting is just useless for this kind of use and there was just so much content to write down. Storing and handling all this results in you carrying endless amounts of paper around all of the time. This also means that organising and reviewing this material could be needlessly complex. I don't want to say it's completely impossible because I know people who have done it and I know that people who completed medical school many years ago did exactly the same thing and were still very successful. However, the majority of your lectures are going to be delivered by PowerPoint and the lectures themselves will be available ahead of time in PDF format that you can download. This means that you can effectively attend a lecture and make notes on it without having to write, draw or recreate a lot of the material in the lecture. Short of printing every lecture on paper ahead of time and annotating those whilst making a lot of hand notes I just can't see it would work, not to mention the cost of printing everything constantly.
The length and size of lectures is such as they could be anything from 10 to maybe 70 PDF pages/powerpoint slides in length. That is a lot of paper just to handle even if you used the 4 slides per A4 page technique. It just all sounds like a great deal of grief for no return. I myself like the feel of paper, I like writing and I like real textbooks but all the evidence seems to suggest that there is utterly no difference between text on paper and text on a digital screen. It's merely information in written form howsoever it is presented to you.
For this reason, I would strongly recommend that you fully adopt the use of digital note-taking applications such as OneNote, Notion or EverNote if you are not already. These apps allow you to cut and paste entire lectures into a page and freely annotate them. You can write side notes, highlight things, draw, sketch, cross out, delete etc all entirely on-the-fly. There is literally nothing you cannot cut and paste into OneNote and it is nearly limitless in size. You can put in very complex diagrams, photographs of medical conditions, text from other sources etc etc very very readily and then either type notes or handwrite notes with them using a stylus and touchscreen device. Make this your first pass note-taking technique before you begin to sieve information out of your notes.
EDIT: Support for OneNote for Windows 10 is ceasing this later this year. If you decide to use OneNote be sure you are using the desktop app version which is the newer version and will still be supported as part of the MS Office suite of apps.
Content storage. From day one it is very important that you get used to storing your notes and other content in an organised and logical fashion. Put year 1 content in a year 1 main folder, with individual subfolders organised neatly by case or topic. In OneNote I had a single note book for year 1. I had a single section group for each case, within that was an individual section for each lecture and within each section there would be a page for the lecture itself, a page for any exam questions and a page for other resources I added to go with it. The curriculum at Bristol (and in many other places) follows a spiral pattern, this means that content you will learn next year will overlap greatly on content you encountered the year before. This means that you may need to revisit content in future years so make sure it is all stored in a logical fashion that enables you to find it again 3 or 4 or 7 years from now. This will all help you later, especially when it comes to your post-graduate studies and later examinations.
Storage. Due to the above reasons and because you can destroy a laptop by dropping it or with spilt coffee, you must store all your content including OneNote and and downloaded lecture files on a cloud type system. Either use your free University OneDrive or use your own personal one- you get something like 1TB free with Office 365 if you subscribe to that. Alternatively I know Apple and Google and the like have their own system. Use whatever you need to but make sure your content is kept securely and neatly on those services so that no matter what happens, nothing is lost. Make sure your OneNote is being saved in the same fashion. The above also means that you can access anything, anywhere and on any device. On the train, on a plane on the bus, sat in the library, in the cafe, etc. What is more, these systems will permit retrieval many years into the future long after your laptop battery or power supply has been recycled.
Devices. You will need a laptop as a minimum. I know people who have nothing but a swish Apple mac laptop and they seem to get along fine but I also know people who have a laptop and an ipad or otherwise use a similar touchscreen device that they use to annotate their lecture notes with using a stylus. There are also writing tablet type devices you can attach to a regular laptop (I have no idea how good these are, however). The use of a tablet and stylus means you can annotate and highlight content at speed and easily keep pace with any lecture as it is presented. This is very very handy.
Microsoft make the SurfacePro which is what I used. All such devices are similarly expensive so try them out in an Apple store or PC world before you buy anything. Of course, with an Ipad you might also buy an attached keyboard and mouse and use it instead of laptop, too. The bonus of this being that they are smaller and lighter than a real laptop which is a big bonus considering how many hills there are in and around Bristol. Two things I would however advise against, are using Chrome based devices, (simply because I am not sure they are fully compatible with all University services though perhaps others can chime in here and tell us different). The other thing you need to be wary of is if you happen to own the most powerful gaming laptop on Earth. There may not be a lot of plug sockets in a lecture theatre and these things can deplete their batteries very rapidly if they are used without them being plugged in. Just something to be aware of.
EDIT: Sometimes you will have a lot going on at the same time when studying. You could be reading a lecture, making notes, typing an essay, reading an online textbook or making anki cards with many of these things happening at once. This means you can have a rather busy desktop/screen. I found that this was all made a lot easier by having a second monitor. Buy a second monitor you can plug in and use to extend your desktop whilst working. Leave it in your residence when not at home or away but plug it in when you get back for the longer study sessions. Beg, borrow or ask for one for Christmas. It makes life so much easier.
About Anki. Anki is an open-source based-repetition programme that lets you learn virtually anything. It is very popular in medical schools all over the world. It has a lot of optional add-ons and is evolving all the time. Also, by using the Ankiweb online service you are storing your content in the cloud and so you can review your flash cards on any device anywhere anytime: on the train, on the bus, waiting for a lecture to start, wherever, whenever.
The key thing however is this: if you intend to use Anki, then between now and September begin using it if you aren't already and then get used to using it and understanding how it works. This will make the jump into studying at medical school a lot smoother and a lot less stressful. There may be ready-made decks available for any first year in any school if you ask around politely.
Following on from other from earlier advice be sure to begin using it as your primary study resource from day one, lecture 1.
Under the Anki philosophy it is your Anki notes and Anki cards which will become your primary learning resource, your primary recall/revision method AND the primary reservoir of notes that you refer to. The material you store in OneNote will become secondary to your Anki deck and remain merely a source of reference largely. As part of the process I will later explain, you will have to 'sieve' the content in your lectures or textbooks before processing them into a far more palatable and bite-sized format as you create your Anki cards.
I can promise you will be glad of making this decision early on rather than deciding 3 months into the course that actually using Anki would be a good idea. Changing your mind later you will then have a much larger task of putting content into Anki if you change study methods halfway through the year because putting material into Anki takes time. I know people who fell into this trap part way through the first academic year and I don't for one minute believe it was in any way optimal. You can completely bypass this if you just opt to study this way from day 1.
Anki is very simple but it isn't very pretty and basically looks just about functional without being particularly spectacular compared to any other applications you might be used to. There are indeed other resources such as quizlet but I've never used them so I can't comment on how good they are. Anyway, irrespective of which app you use, you must get used to storing content in a logical fashion with decks and tags to organised in such a way to help you find specific cards should you ever need to find them again.
For example. Year 1 has it's own Anki deck. Within that deck are largish subdecks assigned to a particular case and within those are individual smaller decks of 20-100 cards which pertain to a specific lecture. 1 sub deck to each individual lecture. This means that if you realise one day, that heck you just can't remember much from lecture 5 of the urinary case, you can go straight to that deck of cards that covered that lecture and review them specifically or edit/add to them.
In any event, even if you don't decide to use anki or otherwise, be sure to get your study method in place as soon as you can. Certainly by the end of Freshers week would be good to have some system in place and certainly it would be best to have it optimised by the end of the first working week of lectures once you become familiar with the pace of content delivery and you learn how quickly you need to be picking it up. By Christmas is the very latest you want to be having to change anything in all honesty.
Textbooks. I do not recommend that first year medical students anywhere immediately go out and buy a lot of textbooks. They tend to be hugely expensive and very hefty: you won't be able to carry many of them around and you certainly won't want to carry them around campus because you'll be getting plenty of cardio without them. At Bristol the key textbook for first year is Naish's Medical Sciences. You can probably buy a second hand copy of this for less than £10. If you wish to buy any book you could buy that. The University library has endless numbers of online Ebooks you can access remotely and for free: read them on your second monitor and you can add information to Anki on the other screen. It really becomes so effortless once you become proficient at juggling your notes and textbooks and creating your cards to revise from.
Do not go out and buy Gray's anatomy; I was given my copy as a gift but it costs over £150 and is just far too detailed for any first year medic. I did find Rohen's anatomy atlas useful as it contains actual specimen images. However, the same applies; this is not a cheap book and it can be accessed online for free. There are many other anatomy resources you can use and your school will have lots of ways to mitigate the fact you cannot take any digital devices into any dissection room due to reasons of confidentiality. You will be given a reading list also which you can refer to before you spend a lot of money on books. I have a list of some more specific texts I will discuss later which may be useful for studying, especially when it comes to physiology.
Be organised. Use a digital calendar to manage your lectures, tutorials appointments and the like. Any doctor will tell you that their work life is very busy. Yours is going to be also. Make this as easy as you can and just get good at using Outlook or similar to run your academic life. Again, you can view this on a phone, a computer etc anywhere, any time. Get used to doing it and using it and you're going to have less problems in your first few weeks. Get outlook on your phone and setup the timetable medical school send you. It tells you the timings, the rooms and groups. This being on your phone means you can access all this information anytime you like.
Difficulty level. It is logical to wonder about how difficult the course is. I did too. The reality is that by simply turning up on the first day of the course you have already completed the most difficult aspect of it: gaining a place. No university (and especially not Bristol given it's historical competition ratios) gives these places away readily. You've attained the grades needed. You've hit the entrance examinations hard. You've scored well in interview. Do all this and you have already shown that have the minerals to be successful and become a competent doctor.
Someone once told me that they viewed medicine as the most challenging of any university course. I don't know if that is true or not as I've never studied law, mathematics or engineering but I can tell you most challenging aspect I encountered was the belief that I could actually complete it. I don't know how to best describe this but there is a scene in the movie 'The Matrix' which sort of sums up feeling I had at the time having spoken with a second year who had successfully completed first year. In the movie Neo observes Morpheus leap a huge rooftop gap in a single bound and has the shock of witnessing what he believed was impossible. That was me in about week 4. I had begun to embrace self-doubt and lacked self-belief. All I can advise is that if this happens to you at any stage, you must do your best to ignore it. You must give up all fear or doubt and just make the jump. The reality is that a lot of people will have passed year 1 of medical school in the past and for some of them not a huge amount of actual graft was involved. I am not saying this is in any way optimal but I am telling you that you will pass if you merely turn up on time reliably, attend everything and put in a sustained level of effort throughout the year. If you have obtained a place you're good enough to pass first year and then pass the years after that because passing first year will build your confidence for you. It really is that simple.
Performance and comparison. I know a lot of you reading this will have full A's at A level. Or you've got 45 distinctions in Access. Or you've smashed International Bacc. Those are very worthy achievements and you will be rightly proud of them. However, the cohort of people you will be shoulder to shoulder with now in year 1 will also have those same achievements behind them. This also means that the default 'excellent' grade A yardstick you once had is now actually the 50% mark. The pass mark for your first year's worth of attainment may now be surprisingly low on first glance. This means that yes, someone can get through all 4 or 5 or 6 years of the course and score maybe 60% at everything and guess what, they are qualified the same as you come the end of it. This doesn't mean anything involved is laughably easy (tl;dr,: it's not), it just means that all of you in the cohort are exceptional to begin with.
However, despite your achievements thus far, you can't really rock up at day 1 and expect to be absolutely amazing at everything from the outset. All of the content you will learn is new to everyone. I know A levels are not something you get free with a packet of cereal but even so a lot of this content is not something you will cover in prior study, even if you have completed a degree before hand. I had worked in various rather intense clinical environments for years before and there was stuff I haven't ever encountered, too. So you can't expect to be automatically perfect at everything and in the same breath, you can't be disappointed by the fact someone had a higher mark in a particular exam or a particular essay (essays being thankfully rare at Bristol): none of that matters. You'll graduate and finish alongside everyone else and suddenly you're a doctor with MB ChB behind your name the same as anyone else. Medical school is actually supposed to be fun, not a source of stress or disenchantment. You need to enjoy your time there because believe me it passes in the blink of an eye and you will soon grow into a very different person to what you are right now. Run your own race and embrace the journey. Don't compare yourself to someone else. Compare the person you are to who you were at the end of A levels. Some of you are going to spend 100K doing this thing and most of you will be devoting a minimum of 10 years of your life to the 'altar' of medicine. Be all you can be. Learning in a degree is very different to learning in school or college before it. What you learn, how you learn and how you pass examinations is whatever it is that you do. I am only suggesting a study method here but there will be a vast difference between what I learned, what I know or what I understand compared to any other person within the course. The maze you walk through is your own, you just end up at the same exit as everyone else.
And finally...
If you have read nothing else I have posted here, I'd be satisfied if you remember nothing but this final point. I want to share with you one of the most important things anyone anywhere has ever shared with me.
A long time ago now a very wise and senior doctor explained to me what they termed 'the 5% rule'. Their belief (which I have since learned to be 100% true) was that that there is intrinsic human 'healing value' in simply being there for a person in the moment of need and having them know that you care.
As a medical student and beyond you are going to meet people whose circumstances may not be good; they may even be extremely dire. Without being too graphic they could have just been hit by a bus. They might have a child who has septic shock. They could be in critical care. They could be anywhere and suffering from any medical condition you can name. However, irrespective of all of this, in none of the above scenarios and in no other situation is there any reason you cannot give someone that all important first 5%. It is the most important 5% of any patient interaction. Giving someone that 5%, being there for them and making sure they know that you care has a very real and genuine healing value that cannot be measured with any laboratory test. You might not be able to alter their outcome but you can still be there and that means that they didn't have to suffer alone. Medicine is both an art and a science. You have come this far: you'll (eventually) get that Bristol medical student lanyard, that I call 'the red cord of courage'. Learn the science of course, but from day one you can leverage your communication and people skills and give anybody, anywhere, that all-important first 5%. The human touch and how you impact those around you will be the difference between being an acceptable doctor and an exceptional one. You can have this ability from day one of the course.
Hope this all makes sense and is helpful. More study and anki tips plus discussion around other revision resources etc to follow.
E.
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Reply 1
Hey there, thanks for posting a question in the Medicine forum. 
The Medicine forum gets a high volume of questions being posted, and some of these are already answered by the resources and Megathreads that members of the community and volunteers have created. This is an automatic post which is designed to highlight these resources. Below is a list of threads and articles that could answer your question (you should be looking in the original post of the megathreads). If one of the below threads is a more relevant place to ask your question, please post a reply in that thread to ask your question. If your query is answered by one of the Megathreads or articles linked below, and you would like us to close this thread for you, please reply to this thread with just the words "thank you". A member of our team will then get it locked.
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The "Which Medical School Should I Apply To?" Uberthread
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Medicine A-Level subjects queries
Work Experience and Voluntary Work
2024 Applicants :
Official Undergraduate Medicine 2024 Entry
Graduate Entry Medicine 2024 Entry
GAMSAT 2024 / 2025 entry discussions megathread
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2024 entry A100 / A101 Medicine fastest and slowest offer senders
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Official Thread: (Undergraduate) Medicine 2025 entry
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GAMSAT 2025 / 2026 entry discussions megathread
UCAT 2025 Entry Discussions Megathread
Medicine 2025 entry for resit/ retake/ gap year applicants
A100 Medicine for International Students 2025 Entry
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2025 entry A100/ A101 Medicine fastest and slowest offer senders
Medical Schools Index 2025 Entry
Other application years:
Official Thread: (Undergraduate) Medicine 2026 entry
Official Thread: Graduate Entry Medicine 2026 Entry
Useful Articles:
GCSE Requirements for Medicine
Everything you need to know about the BMAT
Work Experience as a Graduate or Mature student
Medicine Personal Statement Advice
Medicine Personal Statement Advice (Graduate Entry)
Interview Frequently Asked Questions
MMI Medicine Interview Tips
What to do after an unsuccessful first application
Funding medicine as a second degree
For Community Feedback:
Medicine Community Feedback and Suggestions
If your query is answered by one of the Megathreads or articles linked above, and you would like us to close this thread for you, please reply to this thread with just the words "thank you". A member of our team will then get it locked.
The Medicine forum gets a high volume of questions being posted, and some of these are already answered by the resources and Megathreads that members of the community and volunteers have created. This is an automatic post which is designed to highlight these resources. Below is a list of threads and articles that could answer your question (you should be looking in the original post of the megathreads). If one of the below threads is a more relevant place to ask your question, please post a reply in that thread to ask your question. If your query is answered by one of the Megathreads or articles linked below, and you would like us to close this thread for you, please reply to this thread with just the words "thank you". A member of our team will then get it locked.
Megathreads
(Please read the first post, before then posting any further questions you have within that thread.)
The "Which Medical School Should I Apply To?" Uberthread
The Ultimate 'Am I Good Enough For Medicine?' Angst Thread
Medicine A-Level subjects queries
Work Experience and Voluntary Work
2024 Applicants :
Official Undergraduate Medicine 2024 Entry
Graduate Entry Medicine 2024 Entry
GAMSAT 2024 / 2025 entry discussions megathread
UCAT 2024 Entry Discussions Megathread
Medicine 2024 entry for resit / retake / gap year applicants
A100 Medicine for International Students 2024 Entry
Medicine Interview Discussion 2024 Entry
2024 entry A100 / A101 Medicine fastest and slowest offer senders
Medical Schools Index 2024 Entry
2025 Applicants :
Official Thread: (Undergraduate) Medicine 2025 entry
Official Thread: Graduate Entry Medicine 2025 Entry
GAMSAT 2025 / 2026 entry discussions megathread
UCAT 2025 Entry Discussions Megathread
Medicine 2025 entry for resit/ retake/ gap year applicants
A100 Medicine for International Students 2025 Entry
Medicine Interview Discussion 2025 Entry
2025 entry A100/ A101 Medicine fastest and slowest offer senders
Medical Schools Index 2025 Entry
Other application years:
Official Thread: (Undergraduate) Medicine 2026 entry
Official Thread: Graduate Entry Medicine 2026 Entry
Useful Articles:
GCSE Requirements for Medicine
Everything you need to know about the BMAT
Work Experience as a Graduate or Mature student
Medicine Personal Statement Advice
Medicine Personal Statement Advice (Graduate Entry)
Interview Frequently Asked Questions
MMI Medicine Interview Tips
What to do after an unsuccessful first application
Funding medicine as a second degree
For Community Feedback:
Medicine Community Feedback and Suggestions
If your query is answered by one of the Megathreads or articles linked above, and you would like us to close this thread for you, please reply to this thread with just the words "thank you". A member of our team will then get it locked.
Reply 2
21
I'll add some more guidance on using Anki in the coming days. It's a very effective tool which just takes a little bit of learning to perfect and make really really effective for your learning.
Hi
I've moved this to a more relevant subforum and stickied this thread for now. It looks really useful, as was the previous edition
I've moved this to a more relevant subforum and stickied this thread for now. It looks really useful, as was the previous edition
Reply 4
21
Original post
by KA_PHi
I've moved this to a more relevant subforum and stickied this thread for now. It looks really useful, as was the previous edition
I've moved this to a more relevant subforum and stickied this thread for now. It looks really useful, as was the previous edition
Thank you very much KA_P
I never know where to put things.
Original post
by ErasistratusVThank you very much KA_P
I never know where to put things.
I never know where to put things.
No worries!
Reply 6
21
Cut and paste from my MK1 thread directly:
Additional:
For those of you who are wanting to know what you could be doing over the summer holidays before you start medical school.
-Have a rest and enjoy your holiday so you are well rested before medical school starts.
-Take up part time work and earn money- you will need this for all the partying and clubbing and whatever else you intend to do in first year.
-Learn to drive and complete your driving test. Being able to drive and have access to a car will be useful later in the course when you are on clinical placements or sent to a GP practice some miles away from where you reside. You are likely to need to drive for your foundation years if nothing else.
-Start playing with Anki and learning how it works. It is a very different way of learning and almost feels like cheating but it really does work.
-Really important: start your anatomy learning journey now. Start with the basics. Name all the major bones of the skeleton, the bones that make up the skull, learn anatomical terminology and what it means: superior/inferior, proximal/distal, superficial/deep. Learn what transverse, axial, lateral, sagittal and coronal views of the body are. Learn the major arteries and veins in the body. By way of example: it would be useful for a first year to enter medical school knowing that the right subclavian (subclavian: beneath the clavicle) vein feeds drains the upper limb and that the two major veins draining into it are the basilic and cephalic veins. This level of detail is ample for the early steps of the process. You will learn the complete and total detail of the femoral triangle maybe at some stage when you are an orthopaedic surgeon who is training to do hip replacements.
Bones of the skull- frontal, occipital, temporal and parietal. It's not about learning everything 100% off by heart but instead learning a bit so that you could work out a structure by using a process of elimination.
In University you will start by learning subjects in layers. Having a small amount of basic knowledge lets you begin to build in the detail in your anatomy and physiology knowledge earlier on and makes the learning process smoother. The key to it is spaced repetition which is where Anki and similar software really comes into it's own.
Books- if you really must buy some then Kunar and Clark's clinical medicine and Guyton and Hall's medical physiology are rammed full of first year detail and should get you through any sticking points that you could encounter in lecture material. A copy of the Oxford handbook of Clinical medicine (the 'Cheese and Onion') can be useful for later stages of the course.
Any other questions, feel free to post them here or PM.
Additional:
For those of you who are wanting to know what you could be doing over the summer holidays before you start medical school.
-Have a rest and enjoy your holiday so you are well rested before medical school starts.
-Take up part time work and earn money- you will need this for all the partying and clubbing and whatever else you intend to do in first year.
-Learn to drive and complete your driving test. Being able to drive and have access to a car will be useful later in the course when you are on clinical placements or sent to a GP practice some miles away from where you reside. You are likely to need to drive for your foundation years if nothing else.
-Start playing with Anki and learning how it works. It is a very different way of learning and almost feels like cheating but it really does work.
-Really important: start your anatomy learning journey now. Start with the basics. Name all the major bones of the skeleton, the bones that make up the skull, learn anatomical terminology and what it means: superior/inferior, proximal/distal, superficial/deep. Learn what transverse, axial, lateral, sagittal and coronal views of the body are. Learn the major arteries and veins in the body. By way of example: it would be useful for a first year to enter medical school knowing that the right subclavian (subclavian: beneath the clavicle) vein feeds drains the upper limb and that the two major veins draining into it are the basilic and cephalic veins. This level of detail is ample for the early steps of the process. You will learn the complete and total detail of the femoral triangle maybe at some stage when you are an orthopaedic surgeon who is training to do hip replacements.
Bones of the skull- frontal, occipital, temporal and parietal. It's not about learning everything 100% off by heart but instead learning a bit so that you could work out a structure by using a process of elimination.
In University you will start by learning subjects in layers. Having a small amount of basic knowledge lets you begin to build in the detail in your anatomy and physiology knowledge earlier on and makes the learning process smoother. The key to it is spaced repetition which is where Anki and similar software really comes into it's own.
Books- if you really must buy some then Kunar and Clark's clinical medicine and Guyton and Hall's medical physiology are rammed full of first year detail and should get you through any sticking points that you could encounter in lecture material. A copy of the Oxford handbook of Clinical medicine (the 'Cheese and Onion') can be useful for later stages of the course.
Any other questions, feel free to post them here or PM.
Reply 7
21
Ok, so to start off some forum posts about anki. You can have a play with this in the coming months and over the summer so you know how to work this little program way ahead of time and stave off problems learning it all from scratch in the first weeks or months of Uni.
First of all however: this thread/post is in no way intended to be a complete guide or tutorial and your mileage might vary but this is how I worked Anki. Have a play with it now and see how you prefer it to be set up. You're all 100% cleverer than me I assure you and maybe you will find other, better ways to make it work for you.
First things first:
Creating decks. Anki cards are organised into decks, which are small (or large) collections of cards that are grouped together according to how you decide to organise them.
You are going to need to keep everything nicely organised from day 1, because you are going to be using anki from day 1, lecture 1.
So, you will create a new main deck for each year of the course (assuming you use anki in years 3, 4 etc- many people do not).
So let's start by creating a new deck: Year 1 preclinical (just an example).
This is the main deck under which all your year 1 content will live. You can then begin creating new sub-decks for specific cases (Bristol is case based learning) or subject topics. For example, you might create a subdeck called 'Biochemistry'. Create that and drag it on top of your year 1 preclinical deck. Magically, it becomes a subdeck of your year 1 deck.
Now, for each new lecture you will need to create a new 'mini' deck of anki cards that will live in the specific subdeck it relates to. For example: L1 Biological molecules, L2 Amino acids, L3 Cell membranes, and so on, all of which will live under the 'Biochemistry' subdeck nice and neatly. Create the deck using the create deck function, give it the appropriate name then drag it over the top of where they should live and you're done. This makes a few things possible:
Card tags.
For every card you make, you should probably add tags to them, (although many people do not). Tags are descriptive labels you can add to cards as you make them to help searching for them later on. This is helpful for revision purposes when you can ask anki to make a custom study deck for cramming purposes. It is best to logically tag cards as you create them (although it is possible to do this retrospectively in the card browser) for reasons of speed. For example, if you are working on the anatomy of the gastrointestinal system, then you can add the tags 'anatomy' and 'gastrointestinal' as labels to help search for them later. This is all optional but you want to be organised and efficient and it makes the whole thing more user-friendly.
Settings
Two settings you are definitely going to want to change:
Set both of these to 9999 cards.
Yes, that is right, we are removing the normal limits that Anki defaults to. Why are we doing this? Because we're Bristol medical students and we're in it to win it: we can readily do 500 anki card reviews per day if necessary because we're bringing our A game to this Masters level course.
Learning steps
Now, when you are reviewing anki cards, anki asks you to select from 4 possible options based on how difficult you found the card to answer:
Option 1: this means you didn't get this right and you need to be asked it again
Option 2: this means you got this right but it was hard so you should probably be asked this again tomorrow or in a few days time because that would help you remember it
Option 3: you got this question right, normal difficulty
Option 4: easy peasy, ask me again in 4-5 days or a weeks time
So your learning steps should likely be:
15 minutes (got it wrong), 1 day (found it hard), 3 days (got it right but normal difficulty) with your 'easy' internal say 5 or 7 days tops.
This is where the magic of anki really happens: it is showing you content more or less often based on how difficult you found the content. Now, provided you actually read the content and answer honestly, the more and more amazing this process becomes because it is using spaced repetition to force-feed information into your memory even though you don't realise it.
One last thing though: with Anki you are going to get the answers to cards wrong. That is the whole point of anki: the algorithm is supposed to be finding the content you don't know so you can focus on it. If you're doing lots of reviews and adding new cards and keep getting 20 or 30 or 50 questions wrong a day, don't become disheartened: your process is working as intended. Cards you get wrong it asks you more often whilst content you know is drifted forward into the future. In time it becomes quite addictive for some and basically gamifies the learning process into something tangible.
Insertion order: I always leave this as random, given that exam questions are likely in random order I would leave it this way. This also means you can't game questions with undue ease merely because all the questions relate to the same area of content. Consultants do not ask medical students questions in this way, just trust me on that.
I'll add more to this thread in the coming days, including ideas on making cards, designing questions and writing effective answers and what you might want to include and how to use different card types for maximal advantage. Also some ideas about note-taking and other general work flow ideas.
Any questions just ask.
First of all however: this thread/post is in no way intended to be a complete guide or tutorial and your mileage might vary but this is how I worked Anki. Have a play with it now and see how you prefer it to be set up. You're all 100% cleverer than me I assure you and maybe you will find other, better ways to make it work for you.
First things first:
Creating decks. Anki cards are organised into decks, which are small (or large) collections of cards that are grouped together according to how you decide to organise them.
You are going to need to keep everything nicely organised from day 1, because you are going to be using anki from day 1, lecture 1.
So, you will create a new main deck for each year of the course (assuming you use anki in years 3, 4 etc- many people do not).
So let's start by creating a new deck: Year 1 preclinical (just an example).
This is the main deck under which all your year 1 content will live. You can then begin creating new sub-decks for specific cases (Bristol is case based learning) or subject topics. For example, you might create a subdeck called 'Biochemistry'. Create that and drag it on top of your year 1 preclinical deck. Magically, it becomes a subdeck of your year 1 deck.
Now, for each new lecture you will need to create a new 'mini' deck of anki cards that will live in the specific subdeck it relates to. For example: L1 Biological molecules, L2 Amino acids, L3 Cell membranes, and so on, all of which will live under the 'Biochemistry' subdeck nice and neatly. Create the deck using the create deck function, give it the appropriate name then drag it over the top of where they should live and you're done. This makes a few things possible:
1.
You can now revise a specific case or organ system or problem or topic should you find you are weaker in one subject area. Having made these little decks and organised everything nicely from day 1 means revising specific topics is very straight forward.
2.
You can even pick out individual lectures and revise them specifically should you feel the need to do so. You can also add to, edit or delete cards from a specific lecture should you later find the need to.
3.
This also makes it easier to follow your anki deck should you ever wish to donate them to a person in the years below.
For every card you make, you should probably add tags to them, (although many people do not). Tags are descriptive labels you can add to cards as you make them to help searching for them later on. This is helpful for revision purposes when you can ask anki to make a custom study deck for cramming purposes. It is best to logically tag cards as you create them (although it is possible to do this retrospectively in the card browser) for reasons of speed. For example, if you are working on the anatomy of the gastrointestinal system, then you can add the tags 'anatomy' and 'gastrointestinal' as labels to help search for them later. This is all optional but you want to be organised and efficient and it makes the whole thing more user-friendly.
Settings
Two settings you are definitely going to want to change:
•
New cards to learn per day
•
Maximum reviews per day
Yes, that is right, we are removing the normal limits that Anki defaults to. Why are we doing this? Because we're Bristol medical students and we're in it to win it: we can readily do 500 anki card reviews per day if necessary because we're bringing our A game to this Masters level course.
Learning steps
Now, when you are reviewing anki cards, anki asks you to select from 4 possible options based on how difficult you found the card to answer:
Option 1: this means you didn't get this right and you need to be asked it again
Option 2: this means you got this right but it was hard so you should probably be asked this again tomorrow or in a few days time because that would help you remember it
Option 3: you got this question right, normal difficulty
Option 4: easy peasy, ask me again in 4-5 days or a weeks time
So your learning steps should likely be:
15 minutes (got it wrong), 1 day (found it hard), 3 days (got it right but normal difficulty) with your 'easy' internal say 5 or 7 days tops.
This is where the magic of anki really happens: it is showing you content more or less often based on how difficult you found the content. Now, provided you actually read the content and answer honestly, the more and more amazing this process becomes because it is using spaced repetition to force-feed information into your memory even though you don't realise it.
One last thing though: with Anki you are going to get the answers to cards wrong. That is the whole point of anki: the algorithm is supposed to be finding the content you don't know so you can focus on it. If you're doing lots of reviews and adding new cards and keep getting 20 or 30 or 50 questions wrong a day, don't become disheartened: your process is working as intended. Cards you get wrong it asks you more often whilst content you know is drifted forward into the future. In time it becomes quite addictive for some and basically gamifies the learning process into something tangible.
Insertion order: I always leave this as random, given that exam questions are likely in random order I would leave it this way. This also means you can't game questions with undue ease merely because all the questions relate to the same area of content. Consultants do not ask medical students questions in this way, just trust me on that.
I'll add more to this thread in the coming days, including ideas on making cards, designing questions and writing effective answers and what you might want to include and how to use different card types for maximal advantage. Also some ideas about note-taking and other general work flow ideas.
Any questions just ask.
Reply 8
21
Nearly forgot: Ankiweb.
Yes, you should use this service. Using Ankiweb means that you set up an Anki account and upload your data/cards/decks to the anki web service.
This then means that you can:
A access your stuff on multiple devices
B not lose anything if your laptop self-destructs
You should also definitely be using the cloud data service for OneNote or Notion or whatever note-taking programme you use for much the same reasons.
Yes, you should use this service. Using Ankiweb means that you set up an Anki account and upload your data/cards/decks to the anki web service.
This then means that you can:
A access your stuff on multiple devices
B not lose anything if your laptop self-destructs
You should also definitely be using the cloud data service for OneNote or Notion or whatever note-taking programme you use for much the same reasons.
Reply 9
21
Two good anatomy resources to look into, particularly for the Bristol curriculum:
Clinical Anatomy: Applied anatomy for students and junior doctors by Harold Ellis and Vishy Mahadevan
Human Anatomy: A colour atlas and textbook by Gosling, Harris, Humperson, Whitmore and Willan.
Both very useful. You may be able to find older second hand copies available.
Whilst I am on the subject of anatomy, bear in mind that you will not be allowed to take any digital devices into any DR or anatomy suite for reasons of confidentiality. Don't worry, there are several resources in place to mitigate this fact.
Clinical Anatomy: Applied anatomy for students and junior doctors by Harold Ellis and Vishy Mahadevan
Human Anatomy: A colour atlas and textbook by Gosling, Harris, Humperson, Whitmore and Willan.
Both very useful. You may be able to find older second hand copies available.
Whilst I am on the subject of anatomy, bear in mind that you will not be allowed to take any digital devices into any DR or anatomy suite for reasons of confidentiality. Don't worry, there are several resources in place to mitigate this fact.
Reply 10
21
I think logically 'work flow' comes next.
As I mentioned earlier, there is a caveat with this in that it is only the method I used and it worked ok for me. You might find some other better way. If you have a photographic memory or can learn simply by reverse osmosis you'll be far quicker and slicker at learning than I am.
So, having decided on your note-taking method of choice: OneNote/Notion/Evernote or whatever software you choose to use (have an experiment with them and see which works best) you begin to organise it into grouped sections/folders for each week or case of study.
You might also bring an A4 pad and pen and simply write notes on this and then take photos of them with your phone and put these into OneNote if you don't want to type on a laptop or write on a tablet during the lecture (or you don't have these devices etc). Anyway, here is my workflow and this should apply fairly well to both first and second year.
Step 1: Preparation
On the weekend before or at the start of each week, you logon to the University website and download and populate your note-taking software with all the lecture materials (normally these are powerpoint style 'slides' available for download as PDFs or similar documents) for each lecture that week/fortnight so that you can view them. This will save time and means you can view them during the lecture as the presenter goes through the material. Gather any other notes or documents that pertain to each lecture and group them on additional pages in each section as needed (I'm using OneNote terminology here as this is what I use and have used for some years prior to entering Uni). Each week/case/fortnight or block thus has it's own section group and then each lecture or practical has it's own section and within those are the bits and pieces that you collect for each lecture.
Step 2: Attend the lecture
Following your individual timetable, you then attend the lecture and other activities as scheduled. During the lecture, you simply follow what the presenter is saying and make additional notes alongside the lecture slides as required.
Protip: if the presenter says something is important or likely to be in the end of year exam, be sure to write this down, highlight it or do whatever to ensure you don't miss that fact. At the same time you can also go through the lecture slides highlighting important/interesting or key points or crossing out unrelated content (all lectures will contain some material that is either not that important, extraneous, beyond your intended level or simply too complex to remember accurately).
During this process you are thus beginning to sieve the content to find the material that is important and determine what you are going to try to commit to memory with Anki.
There will be occasions where a lecture contains material you do not fully understand at the time*. It happens to everyone- as I mentioned earlier in the thread, everyone is likely coming to this course with nothing in the way of prior knowledge. That's ok. There is no time to google stuff extensively in lectures- just try to keep up and follow what is being presented.
Protip 2: if a practical, demonstration or lecture includes any quizzes, questions, especially exam-style multiple choice questions, put them into anki. That is grade A revision material for you right there.
Step 3: Into anki it goes
Once the lecture is complete, you can go over the notes you have made and begin to put this material into Anki for the purposes of learning and retaining the information. I will go into specific details of this later as it will take quite some time and a lot of prose and thought on my part to explain. This is the first and critical part of the real learning process. Taking some care and time to add content to anki to build it into a concise, accurate and palatable information source that will be in a more digestible form than simply reams of paper or endless lecture slides. This is a skill and will take some time to master but you will do so quickly even if you have never done it before because you'll be doing it a lot. Develop this study habit and you can use Anki to effectively master content of any depth and breadth, even in post-graduate study.
Step 4: Anki reviews
So here we are, day 1, lecture 1 completed and put into Anki and it's done. You might not ever need to look at that particular content in OneNote again; because here it all is, in the form of Anki cards- bite-sized nuggets of information that are way more digestible than reading though a 50 page PDF document and trying to revise from it. You've adjusted the Anki settings as I described earlier in this thread, now you just have to review the material by doing Anki cards daily and steadily adding this material into your memory bank. So long as you are relatively consistent and not too daft with the number of cards you are making, you are likely going to be doing around 200-300 card reviews per day. Some people do more, others do less. It all depends on how you have made your cards and how many you choose to make.
*A word of warning: understanding course content is far more important than simply being able to recall it. If there are aspects of a lecture you do not understand, you should not blindly just add that material to anki and consider it done with. Anki can help you learn and retain information but it certainly cannot make you understand it.
In medicine the trick is recalling material and knowing how to apply it. All medical schools teach you to do this because their exam questions and much of the content delivery is going to train you to do it subconsciously until it is second nature. You simply will not be able to do this if you do not understand a particular concept involved. Therefore, if you don't understand a particular aspect of a subject, you need actively do something about it, such as:
• Ask a friend/fellow student to explain it. Explaining something to someone else is actually an excellent way of going over material as revision.
• Consult a textbook (reading lists help here, some lectures will specifically recommend particular books for a given lecture but they are not always essential).
• Watch a Youtube video that explains it: the USA is a literal goldmine of this material because of how the USMLE system works and it really does extend down to brass tacks in every aspect of medicine at a physiological level. And there are shed loads of people producing videos on this kind of content. If you still don't understand something being presented by one channel, try another or another after that. And it's free!
• Email the lecturer directly if none of the above works: just bear in mind they are likely very busy people (many will be practising doctors themselves or professors involved in high level research) so you might have to wait some days for a response.
Step 5: But I'm using a downloaded deck someone else made?
This is a totally legitimate strategy that largely eliminates the need for step 3 which is largely the most time consuming step in the process. Mind, you will likely still need to actually attend the lecture and review the material, and add in or remove content from that deck to suit the lecture material.
Over time University lectures may change or be presented by a different presenter. Or the curriculum may change slightly to put more emphasis on condition A rather than condition B. You also need to ensure you actually understand what is being presented and also make sure what is in those anki cards is accurate: the people who make anki cards are human beings as well and no deck of anki cards I have ever made was 100% accurate, believe me I find the odd mistakes in my own cards weeks or months later. The understanding of content I found was central to the part of my work flow where I converted lecture notes into Anki. This part of the process was where I would break down concepts into manageable pieces of information and that aided my understanding of them. It was also an error-checking function of sorts: I found that it was basically impossible to Ankify content if I didn't understand it properly. I remember there was maybe one or two instances in first year where I had to watch a youtube video to grasp the content involved. Literally 3 minutes of video at most, and pop, it was like a lightbulb going off and I could understand it. It can be hard to follow complex material in lectures where maybe 50 slides are being covered in an hour. If you are leap-frogging through content dense topics and don't get it on the first try in the lecture theatre, don't worry: you have more time in the comfort of your own residence to chew the fat as you put material into Anki.
As I mentioned earlier, there is a caveat with this in that it is only the method I used and it worked ok for me. You might find some other better way. If you have a photographic memory or can learn simply by reverse osmosis you'll be far quicker and slicker at learning than I am.
So, having decided on your note-taking method of choice: OneNote/Notion/Evernote or whatever software you choose to use (have an experiment with them and see which works best) you begin to organise it into grouped sections/folders for each week or case of study.
You might also bring an A4 pad and pen and simply write notes on this and then take photos of them with your phone and put these into OneNote if you don't want to type on a laptop or write on a tablet during the lecture (or you don't have these devices etc). Anyway, here is my workflow and this should apply fairly well to both first and second year.
Step 1: Preparation
On the weekend before or at the start of each week, you logon to the University website and download and populate your note-taking software with all the lecture materials (normally these are powerpoint style 'slides' available for download as PDFs or similar documents) for each lecture that week/fortnight so that you can view them. This will save time and means you can view them during the lecture as the presenter goes through the material. Gather any other notes or documents that pertain to each lecture and group them on additional pages in each section as needed (I'm using OneNote terminology here as this is what I use and have used for some years prior to entering Uni). Each week/case/fortnight or block thus has it's own section group and then each lecture or practical has it's own section and within those are the bits and pieces that you collect for each lecture.
Step 2: Attend the lecture
Following your individual timetable, you then attend the lecture and other activities as scheduled. During the lecture, you simply follow what the presenter is saying and make additional notes alongside the lecture slides as required.
Protip: if the presenter says something is important or likely to be in the end of year exam, be sure to write this down, highlight it or do whatever to ensure you don't miss that fact. At the same time you can also go through the lecture slides highlighting important/interesting or key points or crossing out unrelated content (all lectures will contain some material that is either not that important, extraneous, beyond your intended level or simply too complex to remember accurately).
During this process you are thus beginning to sieve the content to find the material that is important and determine what you are going to try to commit to memory with Anki.
There will be occasions where a lecture contains material you do not fully understand at the time*. It happens to everyone- as I mentioned earlier in the thread, everyone is likely coming to this course with nothing in the way of prior knowledge. That's ok. There is no time to google stuff extensively in lectures- just try to keep up and follow what is being presented.
Protip 2: if a practical, demonstration or lecture includes any quizzes, questions, especially exam-style multiple choice questions, put them into anki. That is grade A revision material for you right there.
Step 3: Into anki it goes
Once the lecture is complete, you can go over the notes you have made and begin to put this material into Anki for the purposes of learning and retaining the information. I will go into specific details of this later as it will take quite some time and a lot of prose and thought on my part to explain. This is the first and critical part of the real learning process. Taking some care and time to add content to anki to build it into a concise, accurate and palatable information source that will be in a more digestible form than simply reams of paper or endless lecture slides. This is a skill and will take some time to master but you will do so quickly even if you have never done it before because you'll be doing it a lot. Develop this study habit and you can use Anki to effectively master content of any depth and breadth, even in post-graduate study.
Step 4: Anki reviews
So here we are, day 1, lecture 1 completed and put into Anki and it's done. You might not ever need to look at that particular content in OneNote again; because here it all is, in the form of Anki cards- bite-sized nuggets of information that are way more digestible than reading though a 50 page PDF document and trying to revise from it. You've adjusted the Anki settings as I described earlier in this thread, now you just have to review the material by doing Anki cards daily and steadily adding this material into your memory bank. So long as you are relatively consistent and not too daft with the number of cards you are making, you are likely going to be doing around 200-300 card reviews per day. Some people do more, others do less. It all depends on how you have made your cards and how many you choose to make.
*A word of warning: understanding course content is far more important than simply being able to recall it. If there are aspects of a lecture you do not understand, you should not blindly just add that material to anki and consider it done with. Anki can help you learn and retain information but it certainly cannot make you understand it.
In medicine the trick is recalling material and knowing how to apply it. All medical schools teach you to do this because their exam questions and much of the content delivery is going to train you to do it subconsciously until it is second nature. You simply will not be able to do this if you do not understand a particular concept involved. Therefore, if you don't understand a particular aspect of a subject, you need actively do something about it, such as:
• Ask a friend/fellow student to explain it. Explaining something to someone else is actually an excellent way of going over material as revision.
• Consult a textbook (reading lists help here, some lectures will specifically recommend particular books for a given lecture but they are not always essential).
• Watch a Youtube video that explains it: the USA is a literal goldmine of this material because of how the USMLE system works and it really does extend down to brass tacks in every aspect of medicine at a physiological level. And there are shed loads of people producing videos on this kind of content. If you still don't understand something being presented by one channel, try another or another after that. And it's free!
• Email the lecturer directly if none of the above works: just bear in mind they are likely very busy people (many will be practising doctors themselves or professors involved in high level research) so you might have to wait some days for a response.
Step 5: But I'm using a downloaded deck someone else made?
This is a totally legitimate strategy that largely eliminates the need for step 3 which is largely the most time consuming step in the process. Mind, you will likely still need to actually attend the lecture and review the material, and add in or remove content from that deck to suit the lecture material.
Over time University lectures may change or be presented by a different presenter. Or the curriculum may change slightly to put more emphasis on condition A rather than condition B. You also need to ensure you actually understand what is being presented and also make sure what is in those anki cards is accurate: the people who make anki cards are human beings as well and no deck of anki cards I have ever made was 100% accurate, believe me I find the odd mistakes in my own cards weeks or months later. The understanding of content I found was central to the part of my work flow where I converted lecture notes into Anki. This part of the process was where I would break down concepts into manageable pieces of information and that aided my understanding of them. It was also an error-checking function of sorts: I found that it was basically impossible to Ankify content if I didn't understand it properly. I remember there was maybe one or two instances in first year where I had to watch a youtube video to grasp the content involved. Literally 3 minutes of video at most, and pop, it was like a lightbulb going off and I could understand it. It can be hard to follow complex material in lectures where maybe 50 slides are being covered in an hour. If you are leap-frogging through content dense topics and don't get it on the first try in the lecture theatre, don't worry: you have more time in the comfort of your own residence to chew the fat as you put material into Anki.
(edited 2 months ago)
Reply 11
21
Sorry for the info-dump. I've cut and pasted a lot of the relevant stuff from my much older thread.
I'd add more about Anki and actually show some examples too in the next day or two.
I'd add more about Anki and actually show some examples too in the next day or two.
Reply 12
Original post
by ErasistratusVI think logically 'work flow' comes next.
As I mentioned earlier, there is a caveat with this in that it is only the method I used and it worked ok for me. You might find some other better way. If you have a photographic memory or can learn simply by reverse osmosis you'll be far quicker and slicker at learning than I am.
So, having decided on your note-taking method of choice: OneNote/Notion/Evernote or whatever software you choose to use (have an experiment with them and see which works best) you begin to organise it into grouped sections/folders for each week or case of study.
You might also bring an A4 pad and pen and simply write notes on this and then take photos of them with your phone and put these into OneNote if you don't want to type on a laptop or write on a tablet during the lecture (or you don't have these devices etc). Anyway, here is my workflow and this should apply fairly well to both first and second year.
Step 1: preparation
On the weekend before or at the start of each week, you get on to the Uni website and then download and populate your note taking software with all the lecture materials (normally these are powerpoint style 'slides' available for download as PDFs or similar documents) for each lecture so that you can view them. This will save time and make mean you can view them during the lecture as the presenter goes through the material. Gather any other notes or documents that pertain to each lecture and group them on additional pages in each section as needed (I'm using OneNote terminology here as this is what I use and have used for some years prior to entering Uni). Each week/case/fortnight or block thus has it's own section group and then each lecture or practical has it's own section and within those are the bits and pieces that you collect for each lecture.
Step 2: attend the lecture
Following your individual timetable, you then attend the lecture and other activities as scheduled. During the lecture, you simply follow what the presenter is saying and make additional notes as required. Tip: if the presenter says something is important or likely to be in the end of year exam, be sure to write this, highlight it or whatever to ensure you don't miss that fact. At the same time you can also go through the lecture slides highlighting important/interesting or key points or crossing out unrelated content (all lectures will contain some material that is either not-important, extraneous or simply too complex to remember accurately). During this process you are thus beginning to sieve the content to find the material that is important and that you are going to try to commit to memory with Anki. There will be times where the lecture contains material you do not fully understand at the time*. It happens to everyone- as I mentioned earlier in the thread, everyone is likely coming to this course with nothing in the way of prior knowledge. That's ok. There is no time to google stuff extensively in lectures- just try to keep up and follow what is being presented. Protip- if a practical, demonstration or lecture includes any quizzes, questions, especially exam-style multiple choice questions, put them into anki. That is grade A revision material for you right there.
Step 3: into anki it goes
Once the lecture is complete, you can go over the notes you have made and begin to put this material into Anki for the purposes of learning and retaining the information. I will go into specific details of this later as it will take quite some time and a lot of prose and thought on my part to explain. This is the first and critical part of the real learning process. Taking some care and time to add content to anki to build it into a concise, accurate and palatable information source that will be in a more digestible form than simply reams of paper or endless lecture slides. This is a skill and will take some time to master but you will do so quickly even if you have never done it before because you'll be doing it a lot.
Step 4: anki reviews
So here we are, day 1, lecture 1 completed and put into anki and it's done. You might not ever need to look at that particular content in OneNote again; because here it all is, in the form of anki cards. You've adjusted the anki settings as I described earlier in this thread, now you just have to review the material by doing anki cards and daily and steadily adding this material into your memory bank. So long as you are relatively consistent and not too daft with the number of cards you are making, you are likely going to be doing around 200-300 card reviews per day. Some people do more, others do less. It all depends on how you have made your cards and how many you choose to make*.
*A word of warning: understanding course content is far more important than simply being able to recall it. If there are aspects of a lecture you do not understand, you should not blindly just add that material to anki and consider it done with. Anki can help you learn information but it certainly cannot make you understand it.
In medicine the trick is recalling material and knowing how to apply it. All medical schools teach you to do this because their exam questions and much of the content delivery is going to train you to do it subconsciously until it is second nature. You simply will not be able to do this if you do not understand a particular concept involved. Therefore, if you don't understand some particular aspect, you need actively do something about it, such as:
• Ask a friend/fellow student to explain it. Explaining something to someone else is actually an excellent way of going over material as revision.
• Read a book (reading lists help here, some lectures will specifically recommend particular books for a given lecture but they are not always essential).
• Watch a youtube video that explains it: the USA is a literal goldmine of this material because of how the USMLE system works and it really does extend down to brass tacks in every aspect of medicine at a physiological level.
• Email the lecturer directly if none of the above works: just bear in mind they are likely very busy people (many will be practising doctors themselves) and you might have to wait some days for a response.
Step 5: but I'm using a downloaded deck someone else made?
This is a totally legitimate strategy that largely eliminates the need for step 3 which is largely the most time consuming step in the process. Mind, you will likely still need to actually attend the lecture and review the material, and add in or remove content from that deck to suit the lecture material.
Over time University lectures may change or be presented by a different presenter. Or the curriculum may change slightly to put more emphasis on condition A rather than condition B. You also need to ensure you actually understand what is being presented and also make sure what is in those anki cards is accurate: the people who make anki cards are human beings as well and no deck of anki cards I have ever made was 100% accurate, believe me I find the odd mistakes in my own cards weeks or months later.
As I mentioned earlier, there is a caveat with this in that it is only the method I used and it worked ok for me. You might find some other better way. If you have a photographic memory or can learn simply by reverse osmosis you'll be far quicker and slicker at learning than I am.
So, having decided on your note-taking method of choice: OneNote/Notion/Evernote or whatever software you choose to use (have an experiment with them and see which works best) you begin to organise it into grouped sections/folders for each week or case of study.
You might also bring an A4 pad and pen and simply write notes on this and then take photos of them with your phone and put these into OneNote if you don't want to type on a laptop or write on a tablet during the lecture (or you don't have these devices etc). Anyway, here is my workflow and this should apply fairly well to both first and second year.
Step 1: preparation
On the weekend before or at the start of each week, you get on to the Uni website and then download and populate your note taking software with all the lecture materials (normally these are powerpoint style 'slides' available for download as PDFs or similar documents) for each lecture so that you can view them. This will save time and make mean you can view them during the lecture as the presenter goes through the material. Gather any other notes or documents that pertain to each lecture and group them on additional pages in each section as needed (I'm using OneNote terminology here as this is what I use and have used for some years prior to entering Uni). Each week/case/fortnight or block thus has it's own section group and then each lecture or practical has it's own section and within those are the bits and pieces that you collect for each lecture.
Step 2: attend the lecture
Following your individual timetable, you then attend the lecture and other activities as scheduled. During the lecture, you simply follow what the presenter is saying and make additional notes as required. Tip: if the presenter says something is important or likely to be in the end of year exam, be sure to write this, highlight it or whatever to ensure you don't miss that fact. At the same time you can also go through the lecture slides highlighting important/interesting or key points or crossing out unrelated content (all lectures will contain some material that is either not-important, extraneous or simply too complex to remember accurately). During this process you are thus beginning to sieve the content to find the material that is important and that you are going to try to commit to memory with Anki. There will be times where the lecture contains material you do not fully understand at the time*. It happens to everyone- as I mentioned earlier in the thread, everyone is likely coming to this course with nothing in the way of prior knowledge. That's ok. There is no time to google stuff extensively in lectures- just try to keep up and follow what is being presented. Protip- if a practical, demonstration or lecture includes any quizzes, questions, especially exam-style multiple choice questions, put them into anki. That is grade A revision material for you right there.
Step 3: into anki it goes
Once the lecture is complete, you can go over the notes you have made and begin to put this material into Anki for the purposes of learning and retaining the information. I will go into specific details of this later as it will take quite some time and a lot of prose and thought on my part to explain. This is the first and critical part of the real learning process. Taking some care and time to add content to anki to build it into a concise, accurate and palatable information source that will be in a more digestible form than simply reams of paper or endless lecture slides. This is a skill and will take some time to master but you will do so quickly even if you have never done it before because you'll be doing it a lot.
Step 4: anki reviews
So here we are, day 1, lecture 1 completed and put into anki and it's done. You might not ever need to look at that particular content in OneNote again; because here it all is, in the form of anki cards. You've adjusted the anki settings as I described earlier in this thread, now you just have to review the material by doing anki cards and daily and steadily adding this material into your memory bank. So long as you are relatively consistent and not too daft with the number of cards you are making, you are likely going to be doing around 200-300 card reviews per day. Some people do more, others do less. It all depends on how you have made your cards and how many you choose to make*.
*A word of warning: understanding course content is far more important than simply being able to recall it. If there are aspects of a lecture you do not understand, you should not blindly just add that material to anki and consider it done with. Anki can help you learn information but it certainly cannot make you understand it.
In medicine the trick is recalling material and knowing how to apply it. All medical schools teach you to do this because their exam questions and much of the content delivery is going to train you to do it subconsciously until it is second nature. You simply will not be able to do this if you do not understand a particular concept involved. Therefore, if you don't understand some particular aspect, you need actively do something about it, such as:
• Ask a friend/fellow student to explain it. Explaining something to someone else is actually an excellent way of going over material as revision.
• Read a book (reading lists help here, some lectures will specifically recommend particular books for a given lecture but they are not always essential).
• Watch a youtube video that explains it: the USA is a literal goldmine of this material because of how the USMLE system works and it really does extend down to brass tacks in every aspect of medicine at a physiological level.
• Email the lecturer directly if none of the above works: just bear in mind they are likely very busy people (many will be practising doctors themselves) and you might have to wait some days for a response.
Step 5: but I'm using a downloaded deck someone else made?
This is a totally legitimate strategy that largely eliminates the need for step 3 which is largely the most time consuming step in the process. Mind, you will likely still need to actually attend the lecture and review the material, and add in or remove content from that deck to suit the lecture material.
Over time University lectures may change or be presented by a different presenter. Or the curriculum may change slightly to put more emphasis on condition A rather than condition B. You also need to ensure you actually understand what is being presented and also make sure what is in those anki cards is accurate: the people who make anki cards are human beings as well and no deck of anki cards I have ever made was 100% accurate, believe me I find the odd mistakes in my own cards weeks or months later.
this is so so useful omg can’t thank you enough
Reply 13
21
Original post
by Anonymousthis is so so useful omg can’t thank you enough
We're just getting started. 😁
I'll run through how to use Anki in detail with some examples and then we can talk about to tackle the clinical years as there is a bit of a shift at Bristol between years 1/2 and the years beyond it. As I've mentioned in other threads, it's in year 3 where you go from 'medical student' to 'student doctor' so I feel it's important to help people with this also.
I'd be remiss if I didn't help all the folks coming to school in September, especially the good people following behind me at Bristol. I'm very passionate about medical education and I write this stuff to try to help people so they can avoid any pitfalls that I encountered. This whole thing is supposed to be fun.
Reply 14
21
More snip and paste:
Ok, so I'm coming back to this thread again to talk about anki in detail. But first- my usual disclaimer: this is what I did and what seemed to work for me, I can't say if this is the correct way or the wrong way or the best way. You guys are likely all far cleverer, more dedicated and better at IT than me. Therefore, if you have suggestions or ideas that can improve on this then by all means feel free to post them here.
Let's recap the basics I have hopefully discussed already (and assuming using Anki is a strategy you intend to use of course):
• We set the maximum reviews per day in Anki to 9999 because we are medical students who will very soon be granted what I call the 'red cord of courage' lanyard and we're going to master this process, in this masters-level degree that we are committing ourselves to.
• Individual lectures are put into individual anki sub-decks to aid easy management (and review) of our anki decks in the future.
• We will begin using anki from day 1, lecture 1 and completing our card reviews from day 1, lecture 1. Because changing our minds about study processes in about Mid-January is genuine nightmare I wouldn't ever wish on anyone.
• All anki cards are given appropriate tags and organised into individual lecture decks due to the points below.
• When creating anki cards or decks- we bear in mind that we might need to review this material at a later date in the future- maybe 2, 3 or 7 years from now when the whoosh of F1 and F2 are completed and we realise we've forgotten parts of core content that we might want to scrub up on now we're pursuing speciality training in something like anaesthetics or intensive care medicine or trying for the USMLE, MRCP, etc. Good and careful creation of anki cards pays off bigly later.
• We consider that all content, year 1 or beyond, has (sort of) equal importance and weight, more or less. It is a sort of secret nobody talks about that some of the very best doctors out there will be those who are absolutely epic at understanding pathology and health at a physiological level. What this means in practice for us right now though, is that skipping entire cases or blocks of content during Uni because you don't find them interesting, even if that may permit you to complete the course, may well come back and bite you later given that throughout F1 and F2 you will be rotating through several different 'jobs'. So yes, that renal/kidney content (for example) really is something you should have a good handle of- it will likely come in useful one day later on.
• We create anki decks as a sort of reservoir as knowledge that we will craft, shape and possibly change or improve over time. Even though we might well forget knowledge over time because we've been working intensely in a particular speciality for the last 2 months and have forgotten something somewhere else, we are able to pick up, understand and relearn or extend our knowledge because we've been given the essential set of tools throughout our University training that allow us to do this.
• We use anki web or otherwise back up all our work to cloud services like OneDrive because this work we complete will become as important as an old family heirloom and preserved for posterity and possibly even donated to the people making those first few steps we did right behind us.
Ok and deep breath... I know it's exciting as I have been right where you are now. This is all very cool, isn't it?😁As I mentioned earlier in the thread, Anki is a very powerful tool and I would be the first to admit I have only a relatively superficial understanding of how it works and what it can do. For this reason, I kept it simple and used only a limited number of card types and not massive numbers of add-ons. Also, anki is changing, upgrading and improving all the time so there might be some changes in later newer versions.
Anyway the card types I used were:
Basic- the question and answer kind, the simplest type. On the front is the question, on the back is the answer.
Cloze deletions. You write out sentences (paragraphs) and then hide various terms that you would like to be able to remember. This was the main kind of card I used as they are also the quickest and let you write notes in your own words to make the individual 'questions' (cards) out of.
Cloze overlapper- this is similar to cloze deletions but is designed specifically for lists of things, it is aimed at helping you not only remember lists of specific things but also the order in which that list might appear (should that be useful). I remember using this to help me remember the accessory muscles of respiration at one point and it worked, although I have likely forgotten this now. Lists aren't exactly all that useful in medicine (or at least my brain doesn't work that way) so I didn't make huge numbers of these.
Image question and answer or Image Q/A- this is absolutely ideal for simple 'see it and say it' questions. That image of a chest radiograph showing a pneumothorax: in that goes, question is: 'what pathology is evident in this 23 year old male with a sudden onset chest pain and shortness of breath that occurred whilst he was playing football'?
Image occlusion- Image occlusion is by far and away the simplest card type, you cut and paste an image in and then draw shapes over the parts of the image or diagram you want to try to learn.
Now, I'll try to discuss and explain some of the things I learned about the above during my time using anki.
Basic cards. These actually take more time than you think to create because you can only create one at a time. You can speed the process up using the pins in fields to retain text or images etc but I always found them rather slow. The good news is that they seem to be useful for remembering simple points and the more specific they are the more rapidly they can be reviewed/answered. However, I found that the creation of the question is as important as creating the answer. If you create obscure or weird questions: you are going to have a hard time reviewing these kinds of cards as it's simply you and whatever you've included in the question. If there is nothing in the question to help you, well, you're down to brute force memorisation and that will be harder than it needs to be.
What I definitely have seen in some other decks (not made by me I might add), is where people create what I would consider an ok question but perhaps weakly worded: 'What are the layers of the small intestine?' (err, ok, are we talking inside out or outside in? superficial? deep? which part of the small intestine? are we including the serosa???) for example, and then in the answer they place an entire unedited lecture slide.
I don't have a photographic memory so this just would not work for me. Everyone likes visual information so diagrams etc are useful but I'm not so sure creating questions and then answering them with entire lecture slides is such a hot idea. I found with basic cards that good or even detailed specific questions were good and short, simple or logical answers were best. Design the questions to walk you at least part of the way to the answer: remember, pulling answers out of your brain during the review process of Anki cards is actually quite a tough proposition. Design the questions to help you and the remembering part comes from the repetition and the actual re-reading of material. No exam question will ever ask you to pull an answer out of thin air as Anki does- the answer is always on the page in front of you in an exam because they are multiple choice.
An example of a reasonable basic card:
'What class of medication is the anti-depressant citalopram?'
Answer: selective serotonin reuptake inhibitor (SSRI).
See what I've done here? I've told myself this is an antidepressant so I've massively narrowed the potential answer field rather than have the entire BNF as a starting point. I could even improve on this by listing 5 possible answers, full on exam style in the question (but this takes even more time and involves a lot more effort).
Lastly, I tried to avoid creating lists as answers. For example, the Question: what are the side effects of citalopram?
This would appear legit at first glance but not if the answer then lists about 20 common side effects that stream right down to the bottom of your monitor. Maybe pick 3 important ones? This comes down to another skill you will develop over time: deciding what is key or important information and what might be simply found from the BNF or other sources as required.
Doctors use many resources available to them and you will see a number of them using various phone apps or checklists or guides or references to aid them. It's not just about memorising everything under the sun.
Ok, so I'm coming back to this thread again to talk about anki in detail. But first- my usual disclaimer: this is what I did and what seemed to work for me, I can't say if this is the correct way or the wrong way or the best way. You guys are likely all far cleverer, more dedicated and better at IT than me. Therefore, if you have suggestions or ideas that can improve on this then by all means feel free to post them here.
Let's recap the basics I have hopefully discussed already (and assuming using Anki is a strategy you intend to use of course):
• We set the maximum reviews per day in Anki to 9999 because we are medical students who will very soon be granted what I call the 'red cord of courage' lanyard and we're going to master this process, in this masters-level degree that we are committing ourselves to.
• Individual lectures are put into individual anki sub-decks to aid easy management (and review) of our anki decks in the future.
• We will begin using anki from day 1, lecture 1 and completing our card reviews from day 1, lecture 1. Because changing our minds about study processes in about Mid-January is genuine nightmare I wouldn't ever wish on anyone.
• All anki cards are given appropriate tags and organised into individual lecture decks due to the points below.
• When creating anki cards or decks- we bear in mind that we might need to review this material at a later date in the future- maybe 2, 3 or 7 years from now when the whoosh of F1 and F2 are completed and we realise we've forgotten parts of core content that we might want to scrub up on now we're pursuing speciality training in something like anaesthetics or intensive care medicine or trying for the USMLE, MRCP, etc. Good and careful creation of anki cards pays off bigly later.
• We consider that all content, year 1 or beyond, has (sort of) equal importance and weight, more or less. It is a sort of secret nobody talks about that some of the very best doctors out there will be those who are absolutely epic at understanding pathology and health at a physiological level. What this means in practice for us right now though, is that skipping entire cases or blocks of content during Uni because you don't find them interesting, even if that may permit you to complete the course, may well come back and bite you later given that throughout F1 and F2 you will be rotating through several different 'jobs'. So yes, that renal/kidney content (for example) really is something you should have a good handle of- it will likely come in useful one day later on.
• We create anki decks as a sort of reservoir as knowledge that we will craft, shape and possibly change or improve over time. Even though we might well forget knowledge over time because we've been working intensely in a particular speciality for the last 2 months and have forgotten something somewhere else, we are able to pick up, understand and relearn or extend our knowledge because we've been given the essential set of tools throughout our University training that allow us to do this.
• We use anki web or otherwise back up all our work to cloud services like OneDrive because this work we complete will become as important as an old family heirloom and preserved for posterity and possibly even donated to the people making those first few steps we did right behind us.
Ok and deep breath... I know it's exciting as I have been right where you are now. This is all very cool, isn't it?😁As I mentioned earlier in the thread, Anki is a very powerful tool and I would be the first to admit I have only a relatively superficial understanding of how it works and what it can do. For this reason, I kept it simple and used only a limited number of card types and not massive numbers of add-ons. Also, anki is changing, upgrading and improving all the time so there might be some changes in later newer versions.
Anyway the card types I used were:
Basic- the question and answer kind, the simplest type. On the front is the question, on the back is the answer.
Cloze deletions. You write out sentences (paragraphs) and then hide various terms that you would like to be able to remember. This was the main kind of card I used as they are also the quickest and let you write notes in your own words to make the individual 'questions' (cards) out of.
Cloze overlapper- this is similar to cloze deletions but is designed specifically for lists of things, it is aimed at helping you not only remember lists of specific things but also the order in which that list might appear (should that be useful). I remember using this to help me remember the accessory muscles of respiration at one point and it worked, although I have likely forgotten this now. Lists aren't exactly all that useful in medicine (or at least my brain doesn't work that way) so I didn't make huge numbers of these.
Image question and answer or Image Q/A- this is absolutely ideal for simple 'see it and say it' questions. That image of a chest radiograph showing a pneumothorax: in that goes, question is: 'what pathology is evident in this 23 year old male with a sudden onset chest pain and shortness of breath that occurred whilst he was playing football'?
Image occlusion- Image occlusion is by far and away the simplest card type, you cut and paste an image in and then draw shapes over the parts of the image or diagram you want to try to learn.
Now, I'll try to discuss and explain some of the things I learned about the above during my time using anki.
Basic cards. These actually take more time than you think to create because you can only create one at a time. You can speed the process up using the pins in fields to retain text or images etc but I always found them rather slow. The good news is that they seem to be useful for remembering simple points and the more specific they are the more rapidly they can be reviewed/answered. However, I found that the creation of the question is as important as creating the answer. If you create obscure or weird questions: you are going to have a hard time reviewing these kinds of cards as it's simply you and whatever you've included in the question. If there is nothing in the question to help you, well, you're down to brute force memorisation and that will be harder than it needs to be.
What I definitely have seen in some other decks (not made by me I might add), is where people create what I would consider an ok question but perhaps weakly worded: 'What are the layers of the small intestine?' (err, ok, are we talking inside out or outside in? superficial? deep? which part of the small intestine? are we including the serosa???) for example, and then in the answer they place an entire unedited lecture slide.
I don't have a photographic memory so this just would not work for me. Everyone likes visual information so diagrams etc are useful but I'm not so sure creating questions and then answering them with entire lecture slides is such a hot idea. I found with basic cards that good or even detailed specific questions were good and short, simple or logical answers were best. Design the questions to walk you at least part of the way to the answer: remember, pulling answers out of your brain during the review process of Anki cards is actually quite a tough proposition. Design the questions to help you and the remembering part comes from the repetition and the actual re-reading of material. No exam question will ever ask you to pull an answer out of thin air as Anki does- the answer is always on the page in front of you in an exam because they are multiple choice.
An example of a reasonable basic card:
'What class of medication is the anti-depressant citalopram?'
Answer: selective serotonin reuptake inhibitor (SSRI).
See what I've done here? I've told myself this is an antidepressant so I've massively narrowed the potential answer field rather than have the entire BNF as a starting point. I could even improve on this by listing 5 possible answers, full on exam style in the question (but this takes even more time and involves a lot more effort).
Lastly, I tried to avoid creating lists as answers. For example, the Question: what are the side effects of citalopram?
This would appear legit at first glance but not if the answer then lists about 20 common side effects that stream right down to the bottom of your monitor. Maybe pick 3 important ones? This comes down to another skill you will develop over time: deciding what is key or important information and what might be simply found from the BNF or other sources as required.
Doctors use many resources available to them and you will see a number of them using various phone apps or checklists or guides or references to aid them. It's not just about memorising everything under the sun.
Reply 15
21
Cloze deletions. As I said, these did most of the heavy lifting for me. The notes you can create may be short or long or quite detailed (though very long notes are probably best avoided), but you can write out passages of text and include diagrams etc and then you select the parts to hide and so you can create a dozen new cards in seconds very quickly. Here is an example:
The arteries of the upper limb are arranged as follows: the [1subclavian] artery originates from the aorta, passes beneath the clavicle and descends through the axilla as the [2axillary] artery. It then passes between the biceps and triceps muscles as the [3brachial] artery before bifurcating at the anterior aspect of the elbow into the [4ulnar] and [4radial] arteries, respectively.
Cool, so with one little paragraph I've just logically outlined the main arterial supply of the upper limb, I've a nice diagram to look at (not within the text but perhaps provided in the 'extra' field that won't be revealed until I have answered, or maybe you provide an overview diagram as above that doesn't tell you all the answers but does let you follow a logical line of thinking) to refer to if I have gone wrong and not only that but in 1 fell swoop and from making just 1 'note' I have created 4 separate 'cards'. This is a neat way of building learning by associations which we know a lot of our brains really like.
It also helps that I'm creating my own notes in my own words and selecting information from lecture material as a filtering process so it sort of replicates the conventional note taking process.
But what we didn't do was: copy and paste an entire essay of text into the note field, create 27 separate cloze deletions and consider it a done deal. Trust me on this: when you're reviewing these cards many months from now that last thing you want to have to read is a veritable sledgehammer of text at 7pm on a Saturday night. Anki is supposed to help you; not punish you. It's the repetition in Anki that gives you the ability to recall, not the difficulty of the questions.
Cloze overlapper. If I remember correctly this was actually an anki add-on but as I said this is something I only used for very specific content and so I didn't make hundreds of these. A list of the accessory muscles of respiration sort of feels a legitimate use here whilst asking yourself to remember the 20 side effects of citalopram, nah, you're going to wear out your brain long before you remember all of those. Yes, asking anyone to remember the (7?) accessory muscles of respiration is a big ask, particularly in list form, but in reality any exam won't ask you to do this. It will instead ask you something like: which of the following are accessory muscles of respiration? and then give you 5 possible answers to choose from. Anki will have made it so that whilst you really struggle to remember the 7, you will be just that 'familiar' with them to the point that answering the exam question will be a far easier proposition because you will be able to game the question and eliminate many of the answers through familiarity alone. As with the other cards, include any relevant details, notes or diagrams in the 'extra' field on the cards to help you as you go through the reviews.
This post is long enough so I'll pause here. Any questions etc feel free to ask.
The arteries of the upper limb are arranged as follows: the [1subclavian] artery originates from the aorta, passes beneath the clavicle and descends through the axilla as the [2axillary] artery. It then passes between the biceps and triceps muscles as the [3brachial] artery before bifurcating at the anterior aspect of the elbow into the [4ulnar] and [4radial] arteries, respectively.
Cool, so with one little paragraph I've just logically outlined the main arterial supply of the upper limb, I've a nice diagram to look at (not within the text but perhaps provided in the 'extra' field that won't be revealed until I have answered, or maybe you provide an overview diagram as above that doesn't tell you all the answers but does let you follow a logical line of thinking) to refer to if I have gone wrong and not only that but in 1 fell swoop and from making just 1 'note' I have created 4 separate 'cards'. This is a neat way of building learning by associations which we know a lot of our brains really like.
It also helps that I'm creating my own notes in my own words and selecting information from lecture material as a filtering process so it sort of replicates the conventional note taking process.
But what we didn't do was: copy and paste an entire essay of text into the note field, create 27 separate cloze deletions and consider it a done deal. Trust me on this: when you're reviewing these cards many months from now that last thing you want to have to read is a veritable sledgehammer of text at 7pm on a Saturday night. Anki is supposed to help you; not punish you. It's the repetition in Anki that gives you the ability to recall, not the difficulty of the questions.
Cloze overlapper. If I remember correctly this was actually an anki add-on but as I said this is something I only used for very specific content and so I didn't make hundreds of these. A list of the accessory muscles of respiration sort of feels a legitimate use here whilst asking yourself to remember the 20 side effects of citalopram, nah, you're going to wear out your brain long before you remember all of those. Yes, asking anyone to remember the (7?) accessory muscles of respiration is a big ask, particularly in list form, but in reality any exam won't ask you to do this. It will instead ask you something like: which of the following are accessory muscles of respiration? and then give you 5 possible answers to choose from. Anki will have made it so that whilst you really struggle to remember the 7, you will be just that 'familiar' with them to the point that answering the exam question will be a far easier proposition because you will be able to game the question and eliminate many of the answers through familiarity alone. As with the other cards, include any relevant details, notes or diagrams in the 'extra' field on the cards to help you as you go through the reviews.
This post is long enough so I'll pause here. Any questions etc feel free to ask.
Reply 16
21
Image question and answer or Q/A. As I mentioned, this is the best choice of card type for simple image-based questions and so very valuable for anatomy, histology and radiology content. However, I would still say that taking some care with the cards is a good idea. Whilst some pathologies in images are immediately obvious, some are quite subtle and 6 months later it can be harder to spot them than when it was fresh content you encountered. Wording the question to include relevant detail is important because it aids you in answering. So, instead of the question saying 'what pathology is present in this CT scan'?, you might provide helpful clues- relevant details about the indicated patient history or the presenting complaint, what vertebral level or plane is it showing and so on. For the subtle pathologies it may also be useful to include a second image in the extras field of the card with the relevant structure(s) highlighted or indicated so that if you get the question wrong you can at least have it pointed out to you what you needed to be looking for. I remember making a chest radiograph card of this type that had something on it that I consistently failed to identify and then, perhaps a few months after the relevant lecture, I couldn't actually 'see' the pathology outlined in the answer, either. So again, careful preparation whilst the cards are being made can really pay off. Where it would fall down is where I simply tried to make the answers just too lengthy. As I said earlier, I just don't have a photographic memory and my mind simply doesn't work that way so I tried to keep answers succinct.
Image occlusion. This is one of the simplest kind of anki cards to create. Because they are very visual it is possible to learn a great deal of content at a good pace with them. However, the ease at which you can create them may lead to it's own problems. I found that I needed to careful what images or lecture slides I made these kinds of cards from. Firstly, it is very easy to go overboard and choose images that are just too complex and then occlude everything that might be labelled in a diagram. In no time at all you've created dozens of sometimes very difficult to answer questions. I remember making some very detailed image occlusion cards wherein the origin, insertion, innervation and arterial supply for nearly every muscle in the upper and lower limbs was neatly included using this card type. In the end I realised I was just making a very big workload for myself and would simply be overwhelmed if I tried to learn it all, so I carefully suspended a sizeable number of them and instead focused on some of the more prominent structures.
I have also noticed in some online anatomy decks that I tried out where they had created a lot of image occlusion type cards but had not included any relevant title or notes with them. This proved quite troublesome because I later couldn't effectively manage the cards with the card browser because they had no identifiable title or label. Anki gives image occlusion type cards a unique identifier which is just meaningless letters and numbers and so I couldn't go and selectively edit particular cards if I needed to later.
Not including a title or description for these cards also meant I had absolutely no guidance for answering the question and it generally put me off from using them. So the same as above: make the cards, include the relevant titles or question header, any remarks or sources etc to help you know what you are supposed to be answering and where you went wrong if you can't answer it. This takes a moment when creating the cards through image occlusion but is very difficult to do after the event. If you've merely got an image of a joint and some occluded boxes, how do you know if you are supposed to be recalling what is behind them if you have no guide? Am I trying to guess the joint type, the ligaments, the tendons, the muscles, the nerves? The sheer ease at which you can create these types of cards will only compound this problem unless you take care when you first make them.
I hope this gives a reasonable though perhaps a bit wordy explanation of how I used the cards. What I will do later is use a passage of text and then outline the ideas I might have in attempting to put that content into anki so it might be learned and memorised. It will require a little bit of thought on my part first but it will be a good way to illustrate how I used the app and how I selectively filtered information to help make the learning curve of school easier.
Image occlusion. This is one of the simplest kind of anki cards to create. Because they are very visual it is possible to learn a great deal of content at a good pace with them. However, the ease at which you can create them may lead to it's own problems. I found that I needed to careful what images or lecture slides I made these kinds of cards from. Firstly, it is very easy to go overboard and choose images that are just too complex and then occlude everything that might be labelled in a diagram. In no time at all you've created dozens of sometimes very difficult to answer questions. I remember making some very detailed image occlusion cards wherein the origin, insertion, innervation and arterial supply for nearly every muscle in the upper and lower limbs was neatly included using this card type. In the end I realised I was just making a very big workload for myself and would simply be overwhelmed if I tried to learn it all, so I carefully suspended a sizeable number of them and instead focused on some of the more prominent structures.
I have also noticed in some online anatomy decks that I tried out where they had created a lot of image occlusion type cards but had not included any relevant title or notes with them. This proved quite troublesome because I later couldn't effectively manage the cards with the card browser because they had no identifiable title or label. Anki gives image occlusion type cards a unique identifier which is just meaningless letters and numbers and so I couldn't go and selectively edit particular cards if I needed to later.
Not including a title or description for these cards also meant I had absolutely no guidance for answering the question and it generally put me off from using them. So the same as above: make the cards, include the relevant titles or question header, any remarks or sources etc to help you know what you are supposed to be answering and where you went wrong if you can't answer it. This takes a moment when creating the cards through image occlusion but is very difficult to do after the event. If you've merely got an image of a joint and some occluded boxes, how do you know if you are supposed to be recalling what is behind them if you have no guide? Am I trying to guess the joint type, the ligaments, the tendons, the muscles, the nerves? The sheer ease at which you can create these types of cards will only compound this problem unless you take care when you first make them.
I hope this gives a reasonable though perhaps a bit wordy explanation of how I used the cards. What I will do later is use a passage of text and then outline the ideas I might have in attempting to put that content into anki so it might be learned and memorised. It will require a little bit of thought on my part first but it will be a good way to illustrate how I used the app and how I selectively filtered information to help make the learning curve of school easier.
Reply 17
21
More snipping and pasting:
I keep meaning to come back to this thread, I have had some more brainwaves over the last few weeks which I will include.
I have, I think(?), already warned about the possibly limited utility of lists and any Anki cards involving lists. However, the thought did occur to me that I have in the past made 'reverse questions' whereby the question includes a list of content and then asks you to provide an answer based on this information, rather than asking you to cite a list of material.
So, by way of example, a nice (on the face of it) Basic style card:
Question (front): 'List 5 clinical features likely to be observed with a presentation of acute pancreatitis'
Answer (back):
Abdominal pain
Nausea/vomiting
Abdominal guarding
Pyrexia
Raised serum amylase/lipase
Now, this is a very tough gig for anyone to have to pull a full list of 5 things out of their head on demand. However, it makes a bit more sense to make a card that instead asks:
Question (front): 'Abdominal pain, nausea/vomiting, abdominal guarding, pyrexia and raised serum amylase/lipase are clinically suspicious of which acute gastrointestinal pathology?'
Answer (back): Acute pancreatitis
Now, this is a far more practical AND palatable Anki card. The question itself begins to point you at at least the right organ system and directs you in the region of an acute pathology. The card itself doesn't try to make you remember 5 clinical signs of pancreatitis, but it does make you more familiar with the features of pancreatitis itself and you'll likely remember which kind of puzzle pieces to look for when you see a particular presentation.
My brain simply does not work in a fashion that allows me to remember lists by rote and I am not sure that lists will be useful in practice given that not every patient with acute pancreatitis will present with all 5 or more features every single time.
What I am attempting to illustrate here is that reasonable familiarity and reasonable understanding and reasonable recall is enough. You just don't need 100% accurate recall or rote memorisation in every subject area nor should you strive for that.
I keep meaning to come back to this thread, I have had some more brainwaves over the last few weeks which I will include.
I have, I think(?), already warned about the possibly limited utility of lists and any Anki cards involving lists. However, the thought did occur to me that I have in the past made 'reverse questions' whereby the question includes a list of content and then asks you to provide an answer based on this information, rather than asking you to cite a list of material.
So, by way of example, a nice (on the face of it) Basic style card:
Question (front): 'List 5 clinical features likely to be observed with a presentation of acute pancreatitis'
Answer (back):
Abdominal pain
Nausea/vomiting
Abdominal guarding
Pyrexia
Raised serum amylase/lipase
Now, this is a very tough gig for anyone to have to pull a full list of 5 things out of their head on demand. However, it makes a bit more sense to make a card that instead asks:
Question (front): 'Abdominal pain, nausea/vomiting, abdominal guarding, pyrexia and raised serum amylase/lipase are clinically suspicious of which acute gastrointestinal pathology?'
Answer (back): Acute pancreatitis
Now, this is a far more practical AND palatable Anki card. The question itself begins to point you at at least the right organ system and directs you in the region of an acute pathology. The card itself doesn't try to make you remember 5 clinical signs of pancreatitis, but it does make you more familiar with the features of pancreatitis itself and you'll likely remember which kind of puzzle pieces to look for when you see a particular presentation.
My brain simply does not work in a fashion that allows me to remember lists by rote and I am not sure that lists will be useful in practice given that not every patient with acute pancreatitis will present with all 5 or more features every single time.
What I am attempting to illustrate here is that reasonable familiarity and reasonable understanding and reasonable recall is enough. You just don't need 100% accurate recall or rote memorisation in every subject area nor should you strive for that.
Reply 18
21
I'm in the middle of writing the post which explains the process by which content is sieved, neatly divided up and entered into Anki.
However, in the meantime, I have had some brainwaves about the course in general. Again, this is specific to Bristol and it will appear as if I am forever championing Bristol but some/much of what I have written here will be applicable to many other institutions.
Case based learning
If you didn't know already, the Bristol curriculum revolves around case-based learning. Now, I have worked in healthcare a fair while and in the past I've encountered doctors who were quite negative in their attitudes toward case-based learning. Mind you, for some of them, it basically didn't exist as a teaching method back when they did their training. A sizeable number of professionals you might encounter will have followed a traditional didactic type of programme where the teacher simply delivers information to the students and they do their best to absorb that through the format of 9 to 5 lectures all day, every day for the bulk of the 5 years. In short, in comparison to their style, they think CBL is a cop out.
The reality of this is that it is not. People believing CBL is cop out don't appreciate what it actually is. It's actually based on an actual learning theory for the most part but that's almost coincidental in this context.
Case based learning is a learning method used at Bristol designed to achieve several things at once. For the first two preclinical years of the course, there are course a lot of lectures, laboratory sessions, skills sessions, small group work etc etc etc in addition to your normal case-based learning sessions. If that sounds like a recipe for being busy, then yes, you are going to be busy. But maybe Bristol medicine isn't as crazy busy as other places.... more on that later.
The first bonus obtained from case-based learning is that every fortnight you will be given a range of cases to discuss, explore, research and then discuss as a group. These cases thus serve as a focal point that give you context for all the other learning you will recieve in that fortnight. It also teaches you important considerations that will be applicable later in the clinical years of the course. You will learn to approach any individual case through the prism of anatomy, the prism of physiology or the prism pathology as well as exploring a case from the perspective of sociology, psychology etc. Bristol also includes increasing emphasis on disability, diversity and disadvantage. There is also some teaching on global/community or population level health considerations. Case based learning is thus giving you the full range of tools to be able to approach any particular patient or case presentation from the variety of different angles that could be encountered in real world practice. Doctors within healthcare systems are the only professionals who are trained to do this from day 1. You're going to be experts at it by the end of year 5.
As you can imagine, there is a lot of moving parts in the above so if it sounds like it could be both challenging and quite exciting, you'd be right.
Next, the nature of case based learning is that it is based on small group work that is essentially self-directed by the students themselves. At the outset of every case fortnight, you will be given some often very detailed cases to approach, discuss using your existing knowledge base (In first year your knowledge base obviously might be limited but that's ok) and then determine the group's collective learning needs: basically areas that need to be discussed and researched properly. Each student is then assigned a particular area that interests them. Later in the fortnight you then reconvene and present your findings to the rest of the group.
The above is essentially replicating what a lot of multidisciplinary teams do every single working day. I myself have also sat within very high level MDT meetings where complex cases are discussed amongst senior doctors and the process is essentially the same only with a lot more background and a massive knowledge base. The overall aim is to bring the knowledge and skill of multiple members of the team into coherent focus to drive patient care. You're learning to take footsteps on a process that you could be involved with regularly until you reach retirement. Might as well learn now rather than later.
As students though, you are gaining in other ways from CBL as well.
Firstly, you will be gaining a lot of exposure to quite complicated content and often a lot of serious sharp-edge research because 10 other people in the room will present their work to you. This means you are benefitting from an otherwise relatively small individual amount of work magnified many times over. And what is more, the benefit of this is nearly limitless because this is determined by how much effort and time you can expend upon the process. Being entirely student driven, your horizons are your own and so it becomes quite self-motivating as you pursue the content that interests you as individuals. If you want to get into a deep discussion about which anti-platelet agent to use in case A then you do the research and present your argument: the shoe is on your foot and you've got the floor.
The second benefit however (also arguably the most important one in first year), is that it trains students to communicate effectively with other people who might have a range of levels of understanding. Whilst you get specific training on this also, it primes you neatly for the later stages of the course and is developing your key skill that you will rely on as a working doctor from day 1 of F1 and beyond. I would also say it teaches key listening and reasoning skills also.
Lastly, the other benefit is that it is teaching students how to be self-motivated and self-directed learners. For the preclinical years of any course anywhere, there will be a lot of lectures and course-directed learning from the top downwards. Yes, some of the people delivering those sessions will be serious research scientists, professors and clinicians in their own right. But medicine isn't static and only a small portion of the content you will need to know later is available in lecture format. Someone once told me that 'planet medicine' doubles in size every 8 years, such is the pace of research effort and technological change. I can fully believe that. So the key message is that as a medical student, a student doctor and doctor beyond that you will rely on the self-directed learning skills you are taught very early on. You decide on your learning needs. You decide on what to learn. You decide what references to use. You decide how to learn. You decide what level of performance is adequate. You decide which patients to see. You decide which cases to follow up or learn about in detail. You are getting a heads-up on this process from day 1. Embrace it and make it work for you. You can also use CBL as a form of check list when revising because you can read back through the cases and make sure you fully understand each moving part of them. This can guide revision efforts for the end of year examinations of year 1 and year 2.
Effective consulting
As part of first and second year at Bristol, you will participate in what are termed effective consulting sessions. These are small group sessions normally led by a practicing doctor and they operate as a stimulated environment in which you will practice communication and consultation skills with each other, with the teacher or with actors. The aim is to simulate real patient encounters and to start to push your performance envelope when it comes to consulting with patients. Needless to say, this is a very important skill set to maximise. I will also reiterate points based on my experiences of healthcare to date: namely, the most common complaint from patients regarding healthcare (other than waiting times) is that doctors do not listen- basically, poor communication. If I remember correctly research involving NHS organisations shows that most customer complaints stem from poor communication. Your training at Bristol is going to make you an expert communicator and thus you can negate a lot of this.
Somewhat uniquely, I can also speak from the perspective of a person who worked as a professional in another walk of life and who has worked in business where I was obliged to deal with a variety of internal and external customers. I have a lot of experience in encounters of other professions. I will thus say this quite openly and it should not surprise anyone: the difference between an acceptable doctor and an exceptional doctor lies solely within your ability to communicate with patients and their families. You can have average clinical skills but if you are able to find that common ground with patients, reassure, explain to and support them it won't be long before people remember you and then start to ask for you by name. That is the sign of an exceptional doctor. This means that you must attend and make every effort to benefit from your effective consulting sessions. I'd be the first to admit that I do not like role play at all. I am of a somewhat reserved and perhaps even shy nature and I'd be the last person on Earth who would ever complete A level or GCSE Drama, but I still used effective consulting to help me extend my skills. I can fully appreciate that talking to people about things as delicate as their health is a pretty intimidating prospect: that was me once as well. But the people who run the programme at Bristol have been doing this for a very long time, they know what their students find challenging and they have designed the curriculum to alleviate these challenges. Making mistakes in EC is ok: it's a safe environment. A number of people amongst you will be born naturals for this. Maybe you have involvement in drama or you are just a naturally open and confident communicator. Not everyone is so fortunate but still we can all push ourselves to develop.
Of course, whilst all this is going on, you will still be attending primary and secondary care placements throughout first and second year anyway so you get a chance to see other doctors run their consults and then talk to real patients for yourself. The GPs involved in this process will have all volunteered to do it and in my experience they were very patient and really inspirational in their approach to consultation skills. Leverage that experience to build yourself the consultation style that best fits you.
Clinical years
Ok, so some points about third year and beyond. At Bristol, the third year is where the course shifts up a gear. There is no hiding that fact. I like to think of it is as the jump you will all make where you go from 'medical student' to 'student doctor'. Exciting? Heck yes. Nervous? Probably but it is in this jump where you will see the biggest gain in yourself and amongst your peers. No more walking up to campus now: It's hospital life for you now, where all the sights and sounds, all the happenings and of course the patients are to be found.
The first aspect to embrace is that there will not be a huge amount of formalised teaching and lectures to absorb any more. There will be some, usually more focused on specific and maybe devilishly complex things but in the main they are rarer. At times are some smaller tutorials to help bring more complex presentations or pathologies into the light.
Case based learning continues to give some structure to your working week and to give some guidance on what learning needs to take place but it very much remains a canvas and frame around which you must paint your own painting yourself. You have the tools and a reasonable grasp of the process now, so you should be able to work through the necessary content reasonably well without spending every waking hour in front of a computer. Which is just as well because you've skills to practice and patients to clerk now, too.
This all dovetails nicely to the point I made much earlier in this post. I have worked with and know a number of other students who attend or whom have attended other medical schools. Some of them seem to spend hours writing endless essays and countless other 'tasks' which to me would be literal kryptonite and merely get in the way of my own learning processes I have already outlined on this thread. At Bristol, there is a reasonable amount of spareness in the year 1 and year 2 timetables that is not otherwise consumed by lectures, lab sessions or skills sessions or CBL or EC. I have met people who managed to study first and second year almost entirely within a normal 9-5 working day and I believe it is possible. Being motivated people these same people also manage to write journal articles in their spare time, too. I admire that kind of dedication.
The point is that this is something of a benefit to studying at Bristol. And the same open-ended course structure does continue later into the course, too. Of course the idea again is to encourage students to develop self directed study habits early on. However, this can present it's own challenges.
Students may find this lack of overall direction quite an unnerving factor in of itself, especially in the preclinical years. Coming from A level this is a very big shift where lessons are timetabled and you have one syllabus and one textbook and everything is very neat and orderly and organised. But this isn't A level. This is a masters degree. And you're going to be continuing to learn long after you have your MB ChB and way into the future when you are a registrar, where there is similarly no pure teaching timetable provided. So you're entering into a kind of bargain with the medical school whereby you are accepting you're now adult learners who are embracing the responsibility involved to drive your own learning. The medical school has promised that you will be granted those magic 5 letters after your name if you complete all of the requirements of the course. However....
It is now your own responsibility at every stage of the course to fulfil your end of the bargain.
This means: turning up, attending, participating, engaging with the learning process and then reflecting upon your performance and identifying what areas you can focus on improving next.
I can fully appreciate that for anyone, on any year of the course, walking through the doors of a hospital, especially in your 'working clothes' (University scrubs) can be quite an intimidating prospect. A lot of people have never had any exposure to the inner workings of a hospital. Getting work experience in one is nearly impossible and until my adult life I'd never so much as seen the inside of a GP surgery. It was all new to me and a very unfamiliar environment. I'd worked in healthcare some years before I applied to Uni and Bristol academies include some sizeable hospitals I'd never set foot in before. A labyrinth of corridors, departments, doors with locks that don't seem to want to open for you and which bar entry. Thousands of staff you don't know.
So I accept that it can be intimidating at first. It can also be quite intimidating to begin to speak with patients on your own at their bedside when you are first sent to talk to them (I can't remember if this happens in first or second year, possibly both). That's ok. Like with your EC sessions, you'll dip your toe in the water first and go from there. It gets easier and easier, I promise you and it really can be good fun. As your understanding and confidence grows, you'll understand more and you'll be contributing more later on, too. I can't stress this enough though, you need to put yourself out there and put the effort in to direct your own learning and your own practice. The best piece of advice someone once gave to me was that you should treat each placement as a multimillion pound learning resource. You're a Bristol medic: not only is every area and aspect of the place available to you but the people there will be expecting you and very pleased to see you appear. Virtually everyone in the place was a student once. They know what it is like. If nothing else ask the F1s/F2s if they don't mind adopting you for the morning/afternoon/evening. They know what it was like to be a student as they only graduated recently and they will want to help you (they have their own sign offs to get so many of them love teaching feedback). My other piece of free but very valuable advice is that if you want to find a patient to talk to, to clerk, to examine or to just practice consults with, ask the nurses or HCAs looking after the ward or bay. They will know their patients very well and will point you in the right direction. The nurses and HCAs are the people you will be working with as an F1 and it's your job to support them as they will support you. They have skills and expertise as well: make use of these. A doctor is supposed to be a scientist, a teacher and a leader all in one. No other course is designed to put you on that platform.
A regular University of Bristol student lanyard is an unremarkable object. It does not mark you out in any way other than being a regular member of the student population. One of a few hundred on a particular course amongst a sea of thousands of others. But you're Bristol medical students. You will be given -at some stage- that red lanyard which you have worked very hard to obtain. It's the red cord of courage and it's the key to opening any door in any department in any hospital you might be sent to. I've worked in several of these hospitals and I know a good number of doctors, most of whom will have graduated elsewhere. In discussions with them I can tell you that in the main they have high expectations of Bristol medics because of the reputation of the school and the standards the students in the years before you have have set. You've won your lanyard and you've been given a place. You're studying the same course and content the rest of us have. You deserve to be in the place and doctors are going to want you to step up. Prior to entering medical school I'd seen Bristol medical students involved in almost every department in the places I have worked. I've seen our colleagues in theatres. I've seen them closing wounds. I've seen them putting in cannulas in trauma calls in resus. I've seen them running their own consults and doing their own examinations in the emergency department. I've seen them running their own clinics. I've seen students placing arterial lines under supervision in ITU. There is literally no aspect of patient care that you cannot ask to be involved with for the purposes of learning. If you love orthopaedic surgery you can spend a lot of time in CEPOD or following the registrar to fracture clinic. If you love radiology, you can get to sit next to the radiologist and learn how they report scans. If you love cardiology, neurology, nephrology, paediatrics, psychiatry you can head to that department when you get time. That red lanyard is like a talisman of learning. You just have to show interest, ask people and doors will open.
That's a lot of text for now.
However, in the meantime, I have had some brainwaves about the course in general. Again, this is specific to Bristol and it will appear as if I am forever championing Bristol but some/much of what I have written here will be applicable to many other institutions.
Case based learning
If you didn't know already, the Bristol curriculum revolves around case-based learning. Now, I have worked in healthcare a fair while and in the past I've encountered doctors who were quite negative in their attitudes toward case-based learning. Mind you, for some of them, it basically didn't exist as a teaching method back when they did their training. A sizeable number of professionals you might encounter will have followed a traditional didactic type of programme where the teacher simply delivers information to the students and they do their best to absorb that through the format of 9 to 5 lectures all day, every day for the bulk of the 5 years. In short, in comparison to their style, they think CBL is a cop out.
The reality of this is that it is not. People believing CBL is cop out don't appreciate what it actually is. It's actually based on an actual learning theory for the most part but that's almost coincidental in this context.
Case based learning is a learning method used at Bristol designed to achieve several things at once. For the first two preclinical years of the course, there are course a lot of lectures, laboratory sessions, skills sessions, small group work etc etc etc in addition to your normal case-based learning sessions. If that sounds like a recipe for being busy, then yes, you are going to be busy. But maybe Bristol medicine isn't as crazy busy as other places.... more on that later.
The first bonus obtained from case-based learning is that every fortnight you will be given a range of cases to discuss, explore, research and then discuss as a group. These cases thus serve as a focal point that give you context for all the other learning you will recieve in that fortnight. It also teaches you important considerations that will be applicable later in the clinical years of the course. You will learn to approach any individual case through the prism of anatomy, the prism of physiology or the prism pathology as well as exploring a case from the perspective of sociology, psychology etc. Bristol also includes increasing emphasis on disability, diversity and disadvantage. There is also some teaching on global/community or population level health considerations. Case based learning is thus giving you the full range of tools to be able to approach any particular patient or case presentation from the variety of different angles that could be encountered in real world practice. Doctors within healthcare systems are the only professionals who are trained to do this from day 1. You're going to be experts at it by the end of year 5.
As you can imagine, there is a lot of moving parts in the above so if it sounds like it could be both challenging and quite exciting, you'd be right.
Next, the nature of case based learning is that it is based on small group work that is essentially self-directed by the students themselves. At the outset of every case fortnight, you will be given some often very detailed cases to approach, discuss using your existing knowledge base (In first year your knowledge base obviously might be limited but that's ok) and then determine the group's collective learning needs: basically areas that need to be discussed and researched properly. Each student is then assigned a particular area that interests them. Later in the fortnight you then reconvene and present your findings to the rest of the group.
The above is essentially replicating what a lot of multidisciplinary teams do every single working day. I myself have also sat within very high level MDT meetings where complex cases are discussed amongst senior doctors and the process is essentially the same only with a lot more background and a massive knowledge base. The overall aim is to bring the knowledge and skill of multiple members of the team into coherent focus to drive patient care. You're learning to take footsteps on a process that you could be involved with regularly until you reach retirement. Might as well learn now rather than later.
As students though, you are gaining in other ways from CBL as well.
Firstly, you will be gaining a lot of exposure to quite complicated content and often a lot of serious sharp-edge research because 10 other people in the room will present their work to you. This means you are benefitting from an otherwise relatively small individual amount of work magnified many times over. And what is more, the benefit of this is nearly limitless because this is determined by how much effort and time you can expend upon the process. Being entirely student driven, your horizons are your own and so it becomes quite self-motivating as you pursue the content that interests you as individuals. If you want to get into a deep discussion about which anti-platelet agent to use in case A then you do the research and present your argument: the shoe is on your foot and you've got the floor.
The second benefit however (also arguably the most important one in first year), is that it trains students to communicate effectively with other people who might have a range of levels of understanding. Whilst you get specific training on this also, it primes you neatly for the later stages of the course and is developing your key skill that you will rely on as a working doctor from day 1 of F1 and beyond. I would also say it teaches key listening and reasoning skills also.
Lastly, the other benefit is that it is teaching students how to be self-motivated and self-directed learners. For the preclinical years of any course anywhere, there will be a lot of lectures and course-directed learning from the top downwards. Yes, some of the people delivering those sessions will be serious research scientists, professors and clinicians in their own right. But medicine isn't static and only a small portion of the content you will need to know later is available in lecture format. Someone once told me that 'planet medicine' doubles in size every 8 years, such is the pace of research effort and technological change. I can fully believe that. So the key message is that as a medical student, a student doctor and doctor beyond that you will rely on the self-directed learning skills you are taught very early on. You decide on your learning needs. You decide on what to learn. You decide what references to use. You decide how to learn. You decide what level of performance is adequate. You decide which patients to see. You decide which cases to follow up or learn about in detail. You are getting a heads-up on this process from day 1. Embrace it and make it work for you. You can also use CBL as a form of check list when revising because you can read back through the cases and make sure you fully understand each moving part of them. This can guide revision efforts for the end of year examinations of year 1 and year 2.
Effective consulting
As part of first and second year at Bristol, you will participate in what are termed effective consulting sessions. These are small group sessions normally led by a practicing doctor and they operate as a stimulated environment in which you will practice communication and consultation skills with each other, with the teacher or with actors. The aim is to simulate real patient encounters and to start to push your performance envelope when it comes to consulting with patients. Needless to say, this is a very important skill set to maximise. I will also reiterate points based on my experiences of healthcare to date: namely, the most common complaint from patients regarding healthcare (other than waiting times) is that doctors do not listen- basically, poor communication. If I remember correctly research involving NHS organisations shows that most customer complaints stem from poor communication. Your training at Bristol is going to make you an expert communicator and thus you can negate a lot of this.
Somewhat uniquely, I can also speak from the perspective of a person who worked as a professional in another walk of life and who has worked in business where I was obliged to deal with a variety of internal and external customers. I have a lot of experience in encounters of other professions. I will thus say this quite openly and it should not surprise anyone: the difference between an acceptable doctor and an exceptional doctor lies solely within your ability to communicate with patients and their families. You can have average clinical skills but if you are able to find that common ground with patients, reassure, explain to and support them it won't be long before people remember you and then start to ask for you by name. That is the sign of an exceptional doctor. This means that you must attend and make every effort to benefit from your effective consulting sessions. I'd be the first to admit that I do not like role play at all. I am of a somewhat reserved and perhaps even shy nature and I'd be the last person on Earth who would ever complete A level or GCSE Drama, but I still used effective consulting to help me extend my skills. I can fully appreciate that talking to people about things as delicate as their health is a pretty intimidating prospect: that was me once as well. But the people who run the programme at Bristol have been doing this for a very long time, they know what their students find challenging and they have designed the curriculum to alleviate these challenges. Making mistakes in EC is ok: it's a safe environment. A number of people amongst you will be born naturals for this. Maybe you have involvement in drama or you are just a naturally open and confident communicator. Not everyone is so fortunate but still we can all push ourselves to develop.
Of course, whilst all this is going on, you will still be attending primary and secondary care placements throughout first and second year anyway so you get a chance to see other doctors run their consults and then talk to real patients for yourself. The GPs involved in this process will have all volunteered to do it and in my experience they were very patient and really inspirational in their approach to consultation skills. Leverage that experience to build yourself the consultation style that best fits you.
Clinical years
Ok, so some points about third year and beyond. At Bristol, the third year is where the course shifts up a gear. There is no hiding that fact. I like to think of it is as the jump you will all make where you go from 'medical student' to 'student doctor'. Exciting? Heck yes. Nervous? Probably but it is in this jump where you will see the biggest gain in yourself and amongst your peers. No more walking up to campus now: It's hospital life for you now, where all the sights and sounds, all the happenings and of course the patients are to be found.
The first aspect to embrace is that there will not be a huge amount of formalised teaching and lectures to absorb any more. There will be some, usually more focused on specific and maybe devilishly complex things but in the main they are rarer. At times are some smaller tutorials to help bring more complex presentations or pathologies into the light.
Case based learning continues to give some structure to your working week and to give some guidance on what learning needs to take place but it very much remains a canvas and frame around which you must paint your own painting yourself. You have the tools and a reasonable grasp of the process now, so you should be able to work through the necessary content reasonably well without spending every waking hour in front of a computer. Which is just as well because you've skills to practice and patients to clerk now, too.
This all dovetails nicely to the point I made much earlier in this post. I have worked with and know a number of other students who attend or whom have attended other medical schools. Some of them seem to spend hours writing endless essays and countless other 'tasks' which to me would be literal kryptonite and merely get in the way of my own learning processes I have already outlined on this thread. At Bristol, there is a reasonable amount of spareness in the year 1 and year 2 timetables that is not otherwise consumed by lectures, lab sessions or skills sessions or CBL or EC. I have met people who managed to study first and second year almost entirely within a normal 9-5 working day and I believe it is possible. Being motivated people these same people also manage to write journal articles in their spare time, too. I admire that kind of dedication.
The point is that this is something of a benefit to studying at Bristol. And the same open-ended course structure does continue later into the course, too. Of course the idea again is to encourage students to develop self directed study habits early on. However, this can present it's own challenges.
Students may find this lack of overall direction quite an unnerving factor in of itself, especially in the preclinical years. Coming from A level this is a very big shift where lessons are timetabled and you have one syllabus and one textbook and everything is very neat and orderly and organised. But this isn't A level. This is a masters degree. And you're going to be continuing to learn long after you have your MB ChB and way into the future when you are a registrar, where there is similarly no pure teaching timetable provided. So you're entering into a kind of bargain with the medical school whereby you are accepting you're now adult learners who are embracing the responsibility involved to drive your own learning. The medical school has promised that you will be granted those magic 5 letters after your name if you complete all of the requirements of the course. However....
It is now your own responsibility at every stage of the course to fulfil your end of the bargain.
This means: turning up, attending, participating, engaging with the learning process and then reflecting upon your performance and identifying what areas you can focus on improving next.
I can fully appreciate that for anyone, on any year of the course, walking through the doors of a hospital, especially in your 'working clothes' (University scrubs) can be quite an intimidating prospect. A lot of people have never had any exposure to the inner workings of a hospital. Getting work experience in one is nearly impossible and until my adult life I'd never so much as seen the inside of a GP surgery. It was all new to me and a very unfamiliar environment. I'd worked in healthcare some years before I applied to Uni and Bristol academies include some sizeable hospitals I'd never set foot in before. A labyrinth of corridors, departments, doors with locks that don't seem to want to open for you and which bar entry. Thousands of staff you don't know.
So I accept that it can be intimidating at first. It can also be quite intimidating to begin to speak with patients on your own at their bedside when you are first sent to talk to them (I can't remember if this happens in first or second year, possibly both). That's ok. Like with your EC sessions, you'll dip your toe in the water first and go from there. It gets easier and easier, I promise you and it really can be good fun. As your understanding and confidence grows, you'll understand more and you'll be contributing more later on, too. I can't stress this enough though, you need to put yourself out there and put the effort in to direct your own learning and your own practice. The best piece of advice someone once gave to me was that you should treat each placement as a multimillion pound learning resource. You're a Bristol medic: not only is every area and aspect of the place available to you but the people there will be expecting you and very pleased to see you appear. Virtually everyone in the place was a student once. They know what it is like. If nothing else ask the F1s/F2s if they don't mind adopting you for the morning/afternoon/evening. They know what it was like to be a student as they only graduated recently and they will want to help you (they have their own sign offs to get so many of them love teaching feedback). My other piece of free but very valuable advice is that if you want to find a patient to talk to, to clerk, to examine or to just practice consults with, ask the nurses or HCAs looking after the ward or bay. They will know their patients very well and will point you in the right direction. The nurses and HCAs are the people you will be working with as an F1 and it's your job to support them as they will support you. They have skills and expertise as well: make use of these. A doctor is supposed to be a scientist, a teacher and a leader all in one. No other course is designed to put you on that platform.
A regular University of Bristol student lanyard is an unremarkable object. It does not mark you out in any way other than being a regular member of the student population. One of a few hundred on a particular course amongst a sea of thousands of others. But you're Bristol medical students. You will be given -at some stage- that red lanyard which you have worked very hard to obtain. It's the red cord of courage and it's the key to opening any door in any department in any hospital you might be sent to. I've worked in several of these hospitals and I know a good number of doctors, most of whom will have graduated elsewhere. In discussions with them I can tell you that in the main they have high expectations of Bristol medics because of the reputation of the school and the standards the students in the years before you have have set. You've won your lanyard and you've been given a place. You're studying the same course and content the rest of us have. You deserve to be in the place and doctors are going to want you to step up. Prior to entering medical school I'd seen Bristol medical students involved in almost every department in the places I have worked. I've seen our colleagues in theatres. I've seen them closing wounds. I've seen them putting in cannulas in trauma calls in resus. I've seen them running their own consults and doing their own examinations in the emergency department. I've seen them running their own clinics. I've seen students placing arterial lines under supervision in ITU. There is literally no aspect of patient care that you cannot ask to be involved with for the purposes of learning. If you love orthopaedic surgery you can spend a lot of time in CEPOD or following the registrar to fracture clinic. If you love radiology, you can get to sit next to the radiologist and learn how they report scans. If you love cardiology, neurology, nephrology, paediatrics, psychiatry you can head to that department when you get time. That red lanyard is like a talisman of learning. You just have to show interest, ask people and doors will open.
That's a lot of text for now.
Reply 19
21
Ok, as promised, this is a post which will outline in detail how you go from taking lecture content and converting it into a form within Anki that is comprised of bite-sized flashcards which will give you a level of sufficient recall and thereby reliable long-term understanding of the content. This then serves as your working memory that you would use as a basis to solve clinical questions.
As a basis for this post I have selected a page from the online version of the excellent and well-loved Zero to finals textbook of medicine which is both freely available online AND in an audible/podcast format as well as in paper format (I have all 4 of them because once again, I love paper). Regardless of which format you prefer I can fully recommend these textbooks as a valuable reference source and a reservoir of knowledge from which to begin creating Anki flashcards for your clinical years.
The condition I will discuss today is pulmonary embolism. It is viewable from the zero to finals website here:
https://zerotofinals.com/medicine/respiratory/pe/
The Zero to finals textbooks and many other resources like are it aimed at students approaching their finals give a condensed, easy to read and easy to understand level of content which is just perfect for people in the clinical years of the course. It is thus ideal for those who need to cover a lot of conditions quickly or need to revise material in the run up to exams.
On reading that web page however, there is a fairly lengthy page of text and a heck of a lot of detail. Crumbs. How do we go about trying to remember all that?
No problem. This is where Anki excels.
Let's break down the page one step at a time.
'Pulmonary embolism (PE) describes a blood clot (thrombus) in the pulmonary arteries. An embolus is a thrombus that has travelled in the blood, often from a deep vein thrombosis (DVT) in a leg. The thrombus will block the blood flow to the lung tissue and strain the right side of the heart. DVTs and PEs are collectively known as venous thromboembolism (VTE)'.
It also includes discussion on risk factors for PE, the presentation of PE and also VTE prophylaxis.
As with all the zero to finals content, that is a very digestible piece of prose but this is a lot of moving parts.
We can rewrite this into a shorter format for the purposes of Anki-ification to cover just the important parts.
This is a perfect place for some Cloze deletions because we have some interlinked concepts which really make sense when presented together:
'A pulmonary embolus occurs where a blood clot reaches and lodges within the pulmonary circulation. Most typically, thrombi arise from the venous vascular network within the [1lower limb]. Pulmonary embolism may cause [2right] sided heart strain which may be detected via [3ecg]'.
Ok, so that's 3 separate cloze deletions neatly bundled together in one Anki note and we've added a bit of our own knowledge, too to form our own notes.
Now we have a list of presenting features:
'Presentation
Pulmonary embolism can be asymptomatic (discovered incidentally), present with subtle signs and symptoms, or even cause sudden death. A low threshold for suspecting a PE is required. Presenting features include:
There may also be signs and symptoms of a deep vein thrombosis, such as unilateral leg swelling and tenderness'.
Now, that's a lot of information. But we need to decide on the more important parts here. Being able to recall on demand every one of those when someone mentions pulmonary embolism is impressive but you just won't be able to do it for every MLA condition, nor should you. Our overall aim is to get a reasonable understanding and recall of a condition, the causes of it, risk factors, it's investigations and overall management. We're not here to become a walking encyclopaedia on pulmonary embolism just yet.
This is a perfect situation for a Basic Anki card:
Front (question):
A patient presents with acute shortness of breath, pleuritic chest pain and haemoptysis. Basic physical observations also reveal tachycardia, mild hypoxia and hypotension. What pathology should you suspect in this patient?
Back (answer): pulmonary embolism
So we've condensed down the list of presenting features and gathered up some important information in a single palatable Anki card. Now, of course, all of those features, plus the stuff like fever and a raised respiratory rate are far from specific to this condition but that isn't our aim. Our aim is to become familiar with the presenting features of pulmonary embolism so that if we encounter something that looks and feels like it could be a PE, we know to consider a PE.
Roughly the same kind of card could be made for the list of risk factors.
We can also make a cloze deletion note regarding Virchow's triad:
Patients are at highly increased risk of venous thrombosis where the factors comprising [1virchow's] triad exist simultaneously.
Pre-existing cardiovascular disease, physical injury (i.e. surgery) or inflammatory processes may cause [2endothelial] injury, whilst genetic disorders, autoimmune or neoplastic conditions or hormone treatments can induce a [3hypercoagulative] state. Frailty or immobility (i.e post-operative or during long haul flights) further contribute to this by inducing venous [4stasis] greatly increasing the risk of both [5deep vein thrombosis] and [5pulmonary emoblism].
Another reasonably short but detailed note comprising 5 flashcards. Again, we've rewritten the information and added our own knowledge. We could of course just make a basic anki card asking the 3 components of Virchow's triad if we so wished but that's heading back toward brute force recall of a list. Your mileage on that might vary. As I've mentioned previously I personally dislike lists of information and much prefer important content presented in a logical format with background information to give context. I know that my way of learning works best where I am building lots of associations and linking concepts into an intricate 'web' of knowledge.
This is probably a lengthy enough post for now. I'll add to this more later in subsequent posts.
As a basis for this post I have selected a page from the online version of the excellent and well-loved Zero to finals textbook of medicine which is both freely available online AND in an audible/podcast format as well as in paper format (I have all 4 of them because once again, I love paper). Regardless of which format you prefer I can fully recommend these textbooks as a valuable reference source and a reservoir of knowledge from which to begin creating Anki flashcards for your clinical years.
The condition I will discuss today is pulmonary embolism. It is viewable from the zero to finals website here:
https://zerotofinals.com/medicine/respiratory/pe/
The Zero to finals textbooks and many other resources like are it aimed at students approaching their finals give a condensed, easy to read and easy to understand level of content which is just perfect for people in the clinical years of the course. It is thus ideal for those who need to cover a lot of conditions quickly or need to revise material in the run up to exams.
On reading that web page however, there is a fairly lengthy page of text and a heck of a lot of detail. Crumbs. How do we go about trying to remember all that?
No problem. This is where Anki excels.
Let's break down the page one step at a time.
'Pulmonary embolism (PE) describes a blood clot (thrombus) in the pulmonary arteries. An embolus is a thrombus that has travelled in the blood, often from a deep vein thrombosis (DVT) in a leg. The thrombus will block the blood flow to the lung tissue and strain the right side of the heart. DVTs and PEs are collectively known as venous thromboembolism (VTE)'.
It also includes discussion on risk factors for PE, the presentation of PE and also VTE prophylaxis.
As with all the zero to finals content, that is a very digestible piece of prose but this is a lot of moving parts.
We can rewrite this into a shorter format for the purposes of Anki-ification to cover just the important parts.
This is a perfect place for some Cloze deletions because we have some interlinked concepts which really make sense when presented together:
'A pulmonary embolus occurs where a blood clot reaches and lodges within the pulmonary circulation. Most typically, thrombi arise from the venous vascular network within the [1lower limb]. Pulmonary embolism may cause [2right] sided heart strain which may be detected via [3ecg]'.
Ok, so that's 3 separate cloze deletions neatly bundled together in one Anki note and we've added a bit of our own knowledge, too to form our own notes.
Now we have a list of presenting features:
'Presentation
Pulmonary embolism can be asymptomatic (discovered incidentally), present with subtle signs and symptoms, or even cause sudden death. A low threshold for suspecting a PE is required. Presenting features include:
•
Shortness of breath
•
Cough
•
Haemoptysis (coughing up blood)
•
Pleuritic chest pain (sharp pain on inspiration)
•
Hypoxia
•
Tachycardia
•
Raised respiratory rate
•
Low-grade fever
•
Haemodynamic instability causing hypotension
There may also be signs and symptoms of a deep vein thrombosis, such as unilateral leg swelling and tenderness'.
Now, that's a lot of information. But we need to decide on the more important parts here. Being able to recall on demand every one of those when someone mentions pulmonary embolism is impressive but you just won't be able to do it for every MLA condition, nor should you. Our overall aim is to get a reasonable understanding and recall of a condition, the causes of it, risk factors, it's investigations and overall management. We're not here to become a walking encyclopaedia on pulmonary embolism just yet.
This is a perfect situation for a Basic Anki card:
Front (question):
A patient presents with acute shortness of breath, pleuritic chest pain and haemoptysis. Basic physical observations also reveal tachycardia, mild hypoxia and hypotension. What pathology should you suspect in this patient?
Back (answer): pulmonary embolism
So we've condensed down the list of presenting features and gathered up some important information in a single palatable Anki card. Now, of course, all of those features, plus the stuff like fever and a raised respiratory rate are far from specific to this condition but that isn't our aim. Our aim is to become familiar with the presenting features of pulmonary embolism so that if we encounter something that looks and feels like it could be a PE, we know to consider a PE.
Roughly the same kind of card could be made for the list of risk factors.
We can also make a cloze deletion note regarding Virchow's triad:
Patients are at highly increased risk of venous thrombosis where the factors comprising [1virchow's] triad exist simultaneously.
Pre-existing cardiovascular disease, physical injury (i.e. surgery) or inflammatory processes may cause [2endothelial] injury, whilst genetic disorders, autoimmune or neoplastic conditions or hormone treatments can induce a [3hypercoagulative] state. Frailty or immobility (i.e post-operative or during long haul flights) further contribute to this by inducing venous [4stasis] greatly increasing the risk of both [5deep vein thrombosis] and [5pulmonary emoblism].
Another reasonably short but detailed note comprising 5 flashcards. Again, we've rewritten the information and added our own knowledge. We could of course just make a basic anki card asking the 3 components of Virchow's triad if we so wished but that's heading back toward brute force recall of a list. Your mileage on that might vary. As I've mentioned previously I personally dislike lists of information and much prefer important content presented in a logical format with background information to give context. I know that my way of learning works best where I am building lots of associations and linking concepts into an intricate 'web' of knowledge.
This is probably a lengthy enough post for now. I'll add to this more later in subsequent posts.
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