Study Hacks for Medical School

What would happen if an extra hour suddenly appeared on today's calendar? How about two? Most would welcome the additional time to complete errands, spend time with family, or pop in at the mall. Students invariably see "extra" time as more opportunity to study or work on projects. However, if a way to increase study efficiency existed, those additional hours could encompass more leisurely activities.

Readers of Daniel Kahneman's Thinking, Fast and Slow encounter a revolutionary declaration about the two minds that inhabit us all. These systems—the eponymous "fast" and "slow"—provide a conceptual framework that distinguishes instantaneous subconscious thoughts from those that involve sustained, concerted effort. Understanding this mental duopoly exposes both the expansive potential and restraining pitfalls that beset even the most seasoned minds. Like a machine, the brain possesses the capacity for great feats and yet falls prey to the problem of scarcities in terms of time and energy.

How, then, can students of any stripe manage to fight against academic rigors and their own neural networks to absorb and consolidate information in time for a difficult test or an approaching deadline? Many freeze in panic or even distance themselves emotionally, only to follow up by prematurely rationalizing an "inevitable" failure to perform. Fortunately, mental stagnation is not a foregone conclusion but rather a temporary obstacle meant to be challenged and overcome.

Study Hack 1: The Quiet Battlefield

To quell the fear of defeat in battle, the infamous general Sun Tzu presciently urged warriors to know the enemy as well as they know themselves. Just as a general commands soldiers into war, so too must every student command an arsenal of text and code to make the grade.


The study session begins even before the books open. In fact, a successful student must first mold her environment to suit her needs. This requires selection of a quiet, secluded location to drown out interference through deafening silence. Start by physically turning off cellphones and placing them completely out of sight to avoid a surprisingly inevitable brain-drain. Researchers have found "that the mere presence of [students'] own smartphones impaired their performance on tasks that are sensitive to the availability of limited-capacity attentional resources... [even though they] did not interact with or receive notifications from their phones."


This suggests an insidious effect forcing students to subconsciously suppress the urge to reach for their phone. Just as muscles fatigue under sustained loads, so too does the mind eventually succumb to the progressive drag of electronic devices. Better to avoid this scenario by wholly unplugging from the outside world to focus 100% on the task at hand.

Study Hack 2: The Pomodoro Technique

Even an empty room still houses an invisible threat: procrastination. The bane of study efforts inevitably creeps in with each passing minute. Even when overt distractions disappear, the mind tends to wander off on anything marginally more interesting than the material laid out on the desk. Every minute of a dedicated study period not devoted to actual studying is a total waste of time.

Regain control of time and alleviate the anxiety married to that upcoming deadline by chunking the day into discrete packets of time. The Pomodoro technique—Italian for "tomato"—does just that. First coined by writer Francesco Cirillo who used a tomato-shaped timer, the method requires participants to set an alarm for 25 minutes and carry out the task at hand completely uninterrupted. Once it sounds, break for 5 minutes to cool down the brain and prepare for the next interval. Rinse and repeat through four full pomodoros, and then take a longer break for about 30 minutes.

Study sessions structured in this manner enable students to accomplish a day's work without perceiving the level of fatigue normally felt during long, uninterrupted study cycles. The short breaks punctuating the day are sufficient to initiate the consolidation process and enable longer study periods.


Study Hack 3: Provide Space, Don't Cram

The Pomodoro technique is further enhanced by another level of global design. With the daily timing schedule set, now it's time to think more longitudinally over the weeks and months that encompass an entire semester. Herein lies an opportunity to take advantage of the brain's dependency on repetition for long-term memory storage: Study structures that incorporate spaced repetition vastly outperform single, large cramming sessions.

Students engaged with various material—from foreign languages to cartography to facial recognition studies—all benefited from controlled dispersion of information over a predefined time period. The concept centers on the idea that consecutive exposure to information plays on primal tendencies to maximize the "need probability [of memories]" wherein "memories are considered in order of their [importance] until the need probability is so low that it no longer is worth considering any more."

This makes sense in that the "retrievability of a memory is strongly related to the probability of that particular memory being needed...[and] repetition would surely be one clue indicating that a particular fact was important." Therefore, the sure-fire way to convince the brain that a fact bears significance rests in repeatedly presenting that fact over a long stretch of time.

Study Hack 4: Test Thyself

One overarching caveat reigns supreme: Although spaced repetition aids in the mastery of basic knowledge acquisition, it merely plants the seeds, relying on the student to harvest a useable product. Disjointed facts necessarily require assembly through the perennial, tried-and-true practice of self-assessment.

Testing persists as a mandatory component of long-term understanding. In one experiment, researchers created four equally timed study-quiz (SxQx) conditions, as follows:

• S0Q0: Wherein participants studied a list of 40 Swahili-English word pairs for 5 seconds each and were quizzed on the entire list immediately after; and
  
  
• S1Q, SQ1, and S1Q1: Wherein successfully recalled pairs were dropped from the study, quiz, or both conditions, respectively.
  

Subjects experienced four cycles of the assigned SxQx condition and returned a week later to take a test on the entire list. The study's authors found that testing conditions S0Q0 and S1Q outperformed the others by a factor of four. Thus, scenarios where successfully recalled pairs were dropped from the self-assessment quiz resulted in much worse outcomes. In fact, "repeated retrieval practice [ie, testing] enhanced long-term retention, whereas repeated studying produced essentially no benefit." In effect, the brain must deliberately call forth acquired information or else students face a very real "use it or lose it" situation.

Study Hack 5: Remember What We Said? Don't Cram!

Conveniently, the first phase of a sister study in 2015 replicated the original experiment. The researchers subsequently retooled the original methodology in the second phase such that participants experienced all four SxQx conditions, with 40 word pairs divided evenly under each condition.

This "within-subject" design establishes a real-time crossover scenario wherein subjects experience control and treatment conditions simultaneously. Remarkably, although the authors reproduced the original "between-subjects" findings, their "within-subjects" reconstruction challenged the previous conclusions: "...[R]estudy opportunities, if properly spaced, can enhance the learning of previously recalled information.... One possible explanation for this puzzle is that restudying previously recalled information, even if it is properly spaced, has negligible effects on learning if that same information is also repeatedly tested."

The scientists effectively teased out the positive effects of spaced learning and confirmed the practice as an important tool for long-term reinforcement. Moreover, the team strongly linked the superior efficacy of spaced learning and self-testing over passive review. The message is clear: Period-ize learning intervals, employ testing strategies, and do not cram.


Every student wants to perform at the highest level. For some, that ability arrived as a package deal along with the eye color, height, and sex inherited from mom and dad. The rest of us falling below the 95th percentile must take advantage of every opportunity to move further to the right of the mean. That requires more than an aimless approach to the required material.

Accomplished students actively construct a study plan and configure the surroundings to maximize their chance of success. Whether using 3x5 flashcards or Quizlet, one highlighter or a rainbow of colors, effective study strategies share common features borne out in the literature: Fully remove all distractions, temporally disperse the material, and repeatedly test concepts.


These three simple rules stand to beget untold benefits to students at every level. And should a day arrive with an extra hour or two, spend them far away from any educational material. The beach is always a good option.

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