Eat Your Pancakes

Going into medical school, I had heard many things about the difficulty of it. Whether people equated it to drinking from a firehose, eating stacks of pancakes, or some other analogy, it certainly did not disappoint. I knew early on that my study habits during undergraduate years would not be adequate or organized enough to keep up with medical school.

Knowing this, I came in and hit the ground running. Instead of haphazardly organizing my notes in one big folder and casually flipping through powerpoints (as in undergrad), I completely revamped my studying. I moved everything to the computer, where I took notes in word documents organized in a weekly file, and would on a daily basis turn these notes into Anki flash cards to be constantly reviewing topics from the beginnings of the blocks, in order to not fall behind. I honestly credit a large part of my success and sanity during this early period to my systematic and organized method.

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This was a huge shift from my previous methods and one that I am particularly proud of – it worked to help me survive preclinical years and provided me with a solid foundation as I hit the wards. Things began to make sense. It was systematic, regimented and so modular that I could customize and modify every aspect of my learning.

However, I quickly found that the wards were an entirely different beast. Pre-set answers and truisms gave way to clinical subtlety and the benefit of experience. I recall certain situations during my surgical sub-internships – for instance, we had a patient, a 22 year-old female who suffered a ruptured appendicitis. She underwent surgery and I in my inexperience suggested that she would be able to be discharged 1-2 days following surgery. Not having taken care of a patient in this situation prior to this, I was summarily told I was wrong, and taught that patients who suffer from a perforated appendicitis tend to develop a severe ileus and a prolonged stay. That patient ended up requiring a nasogastric tube placed and stayed in the hospital for 10 days. I saw firsthand the benefit of experience in predicting this course and how it was not something I would have been able to learn with my numerous flash cards. It is always humbling to realize how much there is to continue to learn and exciting to know how much more expertise can be gained by learning in the present and being observant and reflective.

With all of this, what I’ve learned to date is just the beginning. As new developments, therapies, diagnostic modalities and such arise there is still more learning to be done. And as with any other profession, there is experiential learning to be done as there is always such subtlety to patient presentations and the truism that “the patient is not a textbook”. However, I have also grown to appreciate the fact that basic science underpins so much of medical practice, still – I often find myself reminding myself of basic mechanisms because it truly does help me understand the patient presentation, their course and how to expect complications of their stay. Being able to integrate these two aspects of medicine – clinical and basic science will continue to serve me well and I am eager to see how my experiences will allow me to grow and reach a point where I can integrate all of my knowledge in an effective manner.

Medical Knowledge:

  • Demonstrate a broad working knowledge of the fundamental science, principles, and processes basic to the practice of medicine and apply this knowledge in a judicious and consistent manner to prevent common health problems and achieve effective and safe patient care.