Okay, I guess I'm just needing a little encouragement from some of you who are a little further along, but I just have to know if anyone else is feeling this way… it's almost finals of first semester, and although I'll pass all my classes (our system is pass/fail), I really wonder if I'm learning anything. It seems I am able to put lots of stuff in my head for an exam, but a few weeks, heck a few days, later, it's gone. Was it only a few weeks ago I could tell the innervation of all the leg muscles, for example? Now it seems I vaguely remember that there ARE nerves to muscles in the legs. I know it's a long way off, but if none of this stuff stays in my head, how will I ever be able to pass boards, let alone treat patients? And after living in fear that I wouldn't be able to pass my classes for the first half semester, and studying constantly, now I'm finding myself having trouble even making myself study for the upcoming exams. I'll get through, I know, but… has anyone else felt this way? Is this a normal feeling? I know that my panic at the start was more or less normal, because everyone in my class felt this way, but I don't think everyone else is having this much trouble studying now. Please let me know if anyone else felt or feels this way, or if I really just need to get my act together and quit whining. Or maybe a little of both.
Epidoc,
I think you are expressing a common concern, at least common to me. I'm pretty sure I have a congenital brain leak. However, the MSIII's and IV's have assured me that the stuff you really need to remember will be presented over and over, ad nauseum. In other words, if you're worried that you missed that lecture on collateral circulation of the upper extremity, don't worry, you'll see it again. That helped me not worry so much about the brain leak…
Kristi W. at Student Doctor Network, who is MS II (III?), expressed the same concerns you are now in her SDN diary. She felt this great frustration over cramming in facts that she knew would only stay with her long enough to take the test. She said it had really begun to affect her studying habits, as well. If I recall correctly, she had cut her study time in half. Granted, she is married and has a child, and I believe those factors also played a role in this decline in her dedication to the books.
Old Man Dave used the term “bulemic learning” to describe the med school process to me.
Right now I’m worried because I can’t remember some things I learned for my past Anatomy and Physiology test, and I’m in my pre-reqs.
I can only empathize a wee bit, but I offer tons of sympathy.
I feel the same way and I think most people do. It is impossible to learn and commit to long term memory all the factoids they are throwing at us. But I don't think they expect us to learn it for good the first time round. Our anatomy professors (who are very big into anatomy education itself as one was the president of the association of anatomy professors and such) tell us that a high level of retention from a medical school anatomy course is about 15 percent. The key is that you will be able to learn it about 5 times faster the 2nd time around. The 3rd time around, you'll learn about 10 times faster. So the night before you are about to head into that hernia repair during thrid year, you'll open up your trusty Netter and turn the pages of your trusty Moore and learn the antomy of the inguinal region lickety split and impress the pimping surgeons the next day. You might forget it all the following day, but by your third (or fourth, or fifth) hernia repair, you'll know the inguinal region like the back of your hand (if you know that region yet…extensor digitorum, etc.).
Don't worry, I don't think there are any unique feelings in medical school. The ups and down and various permutations thereof have all been felt at one time or another by your classmates and colleagues of past and present across the country (and probably the world). You are definitely not alone in what you're going through.
I’m with you in two ways. First, I have a hard time learning everything I want to learn. Second, all of the students at my school worry about this because often we never learn some of the details that other med students are required to know. When the school switched to a problem-based learning style and significantly trimmed its anatomy hours, the designer of the new curriculum explained it to a group of anatomy professors. “But your students won’t know any anatomy!” one protested. “Ah yes,” our guy evidently replied, "But they will know that they don’t know any anatomy."
Somehow it all works out. At some level you just sort of have to trust that the system works, your school somehow manages to produce doctors, and by the time you’re done, you won’t kill people on any regular basis. Still, it is terrifying. I asked one of my tutorial leaders, “Do you ever get past the stark terror that you’re going to kill someone?” He said, in his bleak Eastern European way, "Yes. But it takes a very very long time."
That said, if you can focus on the patients as your reason for learning, I think it not only helps motivate you but also to clear out some of the extraneous stuff you don’t actually need to focus on. (Every medical student at nearly every school seems to report that the PhDs who teach some of this stuff are a little more excited about certain kinds of details than we are.) But, at the same time, I’ve been having a hard time studying too, and I guess my answer for myself is like your last line: it’s a little bit of both–relax, it’ll be OK, and for my own comfort and pride, I need to get my s**t together. It’s not an easy balance; on the other hand, given the impossible volume of information we could learn but won’t throughout our career, it’s a balance we’ll have to get used to at some point. Might as well be now.
sf/boston joe
I’m with you all on this one…I feel like I can’t ever learn enough, remember enough, etc. (Yet I’ve done “well”). My advisor says do not worry about every drop coming out of the firehose…just go for the gist, plus the pertinent details. Right. I’m nervous already!
That said, my physiology professor told me something that might help: she recently read that to learn the same percentage of what’s “knowable right now” (in terms of medical info) as med students did in the 60’s (that is, “knowable back then”), people who are in med school now would need to be there for 64 YEARS!
It IS an impossible amount of info 
, but we live in interesting times 
!
Thanks everyone for your replies. I do feel better knowing that other people are feeling the same. I know that my school does turn out good docs, and so the system MUST work. Somehow 
I guess I better get back to studying for Phys and Genetics…
Hi there,
You will not remember everything in the detail as when you first learned it for the exam. Sometimes your brain does a “data dump” for self-preservation. What does happen is that when you get to the clinical learning (what you will be doing for the rest of your life), you start to see the perspective of what you have crammed into your brain first and second year. You will have the background to really understand why you are performing a task or ordering a test etc.
Yesterday I did an inguinal hernia repair with my boss, the residency director. During the night before, I read up on all of the anatomy, the surgical anatomy, the indications and pitfalls of hernia repair etc, so that he could pimp me without me falling flat on my face. I found myself stressing over things like remembering exactly where the conjoint tendon ran and how the nerves ran, who to look out for etc. My boss popped into the operating theatre with a swagger and promptly began to explain each layer as we went through so that the medical student could get a good perspective. He did’t bother to pimp me or the student, he showed me a couple of great suturing tips and talked me gently throught he whole case. I was thrilled. (I will write about the experience in detail on my next diary entry) I had a smile on my face when I finished the case that is still there.
The point here is that if I had not gone through the detailed learing, the review for the pre-Board during third year clerkship and the night-before review, I would not have seen or appreciated the sheer beauty of doing that simple case yesterday. Sure you are going to forget things but you can’t review what you have not learned in the first place. Reviewing is like meeting an old friend again but you have to recognized them as a friend in the first place though. As others have said, don’t worry about what you think you have forgotten, it will come back very quickly. Even though I did fairly well on USMLE Step I, I would hate to have to take that test today. Talk about forgetting things.
Natalie
I cannot help myself…I am sitting here chuckling reading the posts in this thread. I am not laughing at any of you, I am luaghing at myself as I uttered those same words thousands of times throughout my Ugrad & basic science years of medical school. Believe me, you are learning way more than you realize. But, you are immersed in a group of habitual academic overachievers who are struggling to master a massive & very foreign body of material. No matter how awesome your Ugrad school was, they teach subjects from a non-medical perspective. You learn OChem for the Chem of it, Calc for the math of it, Bio for the bio of it – and none of it for the human medicine of it…a sometimes diametrically opposed perspective.
What will begin to happen, as it did for me & Nat & every other physician out there, “things-medical” or “things-science” will begin to sublty creep into your vocabulary and into your conversations. Where once before you could not discuss much of anything with a professor w/o feeling like a complete boob, you will gradually begin to be able to entertain stimulating & enlightening conversations with your classmates and your professors.
I wish I had a dollar for everytime I complained about not retaining anything. And, I wish I had 2 dollars for everytime I spouted something of in the course of a discussion that surprised me that I knew it. We’d be talking about some glycolytic pathway and here I would spout of some factoids about what goes in, Kreb’s cycle, lactic acid metabolism…and just amaze myself that I still knew it. Frequently during clinical discussions or lectures, I find myself piecing together long-stored factoids from years 1&2. Once you have them , they’re still there – just harder to drag into the light.
So, take it easy & relax. Besides, a relaxed mind finds it easier to recall stuff. And, like Ash pointed out – medical school requires a lot of bulemic learning: gorge on it, stuff your gourd w/ factoids & run to the exam with your fingers in your ears to stave off leakage – and then vomit up the info on the exam. The funniest part is…after hearing about these topics over & over again, from a A&P and BioChem & Histo & Phsysiologic perspectives – they begin to reinforce one another and congeal into a dynamic information base that you barely begin to learn to apply to patient care situations during years 3&4.
It gets much much better!!!
R - E - L - A - X!!!