I’m sure there are people out there who just love biochemistry. In fact, I know there are people like that because I’ve met some of them. I will admit that there are some general biochemistry concepts that I find to be particularly elegant and I like the idea that everything is so tightly regulated across long and complicated pathways. However, I hate learning said pathways. Rote memorization is not something I’ve ever been particularly good at and while I quickly picked up the purposes of the various pathways and the general idea of all of them, I have learned and forgotten the specifics more times than I can count. One of my favorite things about the curriculum that my school has shifted to is that we learn all of the pathological alongside all the normal. So when we kicked off our medical school education with some good old-fashioned metabolism pathways, I had some clinical correlates to go along with them. Instead of just trying to cram isolated pathways into my brain, I was able to focus more heavily on the particular steps that are implicit in specific disease processes. A specific enzyme is much easier to learn when you can associate it with information like symptoms, prevalence, and treatment options. It is important to get a handle on the basics of each pathway, but I found that the most important parts to learn in depth were those associated with diseases we may someday see. It was very difficult to sift the information the first time around. We covered the majority of our in-depth biochemistry in our very first module and I had not yet become comfortable with the reality that it is impossible to learn everything in medical school. I was determined to learn every little detail about everything. There was one weekend I spent more than 10 hours just drawing and re-drawing pathways in order to memorize every single detail. For one thing, even that didn’t really solidify every aspect of them into my brain. More importantly – I wasn’t even tested on that stuff. It may be a different situation in a more traditional curriculum with a dedicated biochemistry class, but in our integrated curriculum we got asked about the parts that contribute to disease. And in a way it makes sense. As doctors we are much more concerned with the areas that might go wrong. It’s pretty unlikely that a patient will come in some day with perfectly functioning biochemistry pathways and ask you to tell him or her all about them. It’s much more likely that someone will come in with a disturbance somewhere along the way and knowledge about that is truly helpful. The other frustrating thing about biochemistry is that it’s the type of information that flees your brain rapidly the second you stop studying. At least that has been my experience. A lot of it is brute force memorization and the longer it has been since I stared at it, the less I remember. To that end, I’m not really trying to re-learn it until USMLE® Step 1 is much, much closer. The same goes for microbiology. At this point I’m planning on trying to study those topics as close to my actual test date as possible. There are certainly things on both topics that do come up again in organ systems. As we re-learn the portions that are particularly applicable I have been getting some reinforcement, but when it comes to the particulars that haven’t been revitalized, they can wait. I have much more enjoyable things to learn first. Source
