Perhaps the most tired refrain when it comes to medical school advice is that students should study not by memorizing content but by thoroughly understanding the concepts being taught. It seems to me that everyone that says this to students thinks that he's the first person to ever think of it. In fact, most of us have been hearing this exact same advice since high school of earlier. I'm a little jaded on this piece of advise, at least as its usually given, because I think it lacks truly helpful meaning for the rigor of studies involved in medical school and, if taken the wrong way, can seriously trip some students up. In principle, the "don't memorize--understand" prescription is basically true--you cannot possibly turn all of the material you will cover in medical school into lasting and useableknowledge by only memorizing. There should be an emphasis on really engaging with the material, making connections in your knowledge, understanding the relationships between concepts, and realizing when some particular fact being studied is really just an instance of a more general phenomenon. Nevertheless, I have problems with the general advice of "don't memorize--understand." I think it needs to be questioned in at least two ways. 1. It's just not always true. Medical students absolutely must memorize some things. It's just a plain fact that some--even most--of the things we are tested on and which we apply in the clinic are not amenable to some higher understanding that enables them to be more easily committed to memory. For example, the side effects of a particular drug to not necessarily follow from a deeper understanding of how the drug works--often, pharmacologists don't even fully understand why drugs have particular side effects (or there is controversy on that point). Nevertheless, the physician needs to know the side effects of the drugs he commonly prescribes. How is he to accomplish this end? By memorizing them! Moreover, medical school involves learning an entire language that is used to communicate with other healthcare professionals. We don't say "sweaty." We say "diaphoretic." We don't say "winded." We say "dyspneic." Often, our clinical mentors want us to not only know the medical term for things but also the eponym--the names of the people who discovered it (e.g., "adrenal failure secondary to meningococcemia" should also be remembered as "Waterhouse-Friedrichson Syndrome"). The fact is that much of medical school curriculum needs to be memorized, and some part of that requires additional consideration for higher understanding. The exhortation "don't memorize, understand" fails to acknowledge this and defaults on the much more difficult goal of actually helping students figure out what needs to be understood and what needs to be memorized. 2. Understanding is hard to do. It's easy enough to tell people to study to understand rather than memorize, but in actual practice this is really difficult. How to best study to achieve understanding is a huge, complex topic in pedagogy--it's often really hard to figure out. Accordingly, most of the students I've encountered who were over-memorizing did not actually set out with the goal of memorizing everything--they actually thought they were studying to understand the material and just ended up only having a shallow understanding of the material because their methodology was, unbeknownst to them, not ideal for their stated goal. In order for the advice of "don't memorize--understand" to carry any usefulness, it would need to be accompanied by real principles of how to study in order to reliably achieve a strong conceptual understanding of the material. These principles are usually conspicuously absent. What's actually needed: Undoubtedly, the people who are telling students "don't memorize--understand" are really trying to help. Unfortunately, for the reasons I've elucidated, I think it's really not very helpful at all (and can often be perceived as patronizing by students seeking advanced degrees). What we really need instead is a method that students can use to reliably separate the material that needs to be memorized from the material that needs to be more deeply understood and a method that they can apply to achieve consistent understanding of the latter type of material. I have a few ideas on this, but that's the subject for future posts. Source
