The DrCris “Just don’t look stupid” study plan
I have been reading a lot of med student blogs recently, so I am inspired to share my “Just Don’t Look Stupid” Study plan. I still use it regularly when planning my surgical study. I also browbeat any students I come across to try to make them into disciples of the plan. It is my main medical soapbox, so I am surprised it took me so long to share it.
Medical School Teaches Poor Priorities
Medical school is usually taught by clinical. Students get exposed to a wide variety of medical cases, and varied, interesting and rare cases get exposure. This is also a huge downfall of the system. “Unique learning opportunities” mean that bread and butter cases get de-emphasized - they are just not interesting enough.
When medical school is over, you suddenly have to deal with COPD, pneumonia, cardiac failure, and diverticulitis. The “exciting cases” happen maybe once a week or once a month, and will be treated by more senior doctors.
Your overall ability as a doctor will be based on your knowledge of simple every day cases. If you know them back to front, you will shine. If your seniors are busy, you should have the ability to initiate appropriate investigations and treatment for these common conditions. Failing to know details of histiocytosis X or Wilsons Syndrome will not lead to bad reports. But failing to know the best antibiotic for community acquired pneumonia will.
Just don’t look stupid
Stupidly common
Every time you start prep for a new rotation, list the 20 conditions that are most common, and therefore most important.
- Learn them back to front.
- If you are doing clinical rotations, see at least 5 cases for each. If you can’t find 5 cases, you have chosen the wrong 20 conditions.
- Learn all the details of the cases including meds and doses, even though that might not be required at your stage. For these common conditions, you need to know all algorithms without looking it up.
Stupidly important
Once you know those 20 topics back to front, then choose 5 conditions that are uncommon, but life-threatening or catastrophic, or easily misdiagnosed, and therefore important. Learn them back to front as well. See if you can find at least one case to see on each of these five. If you can’t find an inpatient case, then look up a historical patient and write a summary of their illness, and review their investigations.
The rest
Once you have your 25 conditions committed to memory, then you can select another 10, and work through them. These are extra-value. Try to avoid seeing rare cases on your own time as much as possible. The structure of med school will make sure you see enough of the rare stuff. Study to the beat of your own tendon-hammer and concentrate on the important.
If you are clever, you will end up studing most of the stuff you would have anyway, especially if you have multiple rotations in one discipline. This system simply makes sure you learn it in the right order, and you don’t miss something really important.
Selecting the stupidly common
It is not always easy to select the best topics to cover, and they will vary a bit depending on your location. I favour the survey approach.
- Survey all the consultants of your unit, and the registrars/residents you trust. They will each be unable to restrict their list to 20, but compile the suggestions anyway.
- Check the admission diagnoses in your ward for three consecutive mondays.
- Survey the ED presenting complaint lists for three days in a row, and pick any cases that relate to your current rotation.
- Compile all these lists and you should find lots of conditions on multiple lists.
- Choose the top 20.
Continue to avoid looking stupid
As you progress through training, the stupid cases will change. Interns who don’t know really common cases look stupid. Residents or registrars need to know less common conditions to avoid looking stupid, but they need to know them in more depth. Consultants or Fellows need to know really uncommon cases, but only in a very limited field.
This is how I plan my study, and you may not agree. However, you should choose whether you are studying to pass exams, or to be a good doctor. They are different purposes.
![](http://a1.twimg.com/profile_images/59997330/Portrait_2008_comic-style_normal.jpg" rel="image)
: Tanzverbot ab 0 Uhr? Die spinnen die Bayern... http://tr.im/EXMF 11/14/09 09:02pm![](http://a1.twimg.com/profile_images/220038732/me_normal.jpg" rel="image)
: RT @gypsydust @weirdchina: ...Chinese officials being told to dump their mistresses! http://tr.im/EXmF 11/14/09 06:37pm![](http://a1.twimg.com/profile_images/519970224/twitterProfilePhoto_normal.jpg" rel="image)
: not bad http://tr.im/EXmf 11/14/09 06:34pm![](http://a1.twimg.com/profile_images/499128640/twitterProfilePhoto_normal.jpg" rel="image)
: @AllanSorensen Perhaps, but not for the reasons you think. http://tr.im/ExkZ and http://tr.im/ExlX and http://tr.im/Exmf 11/08/09 05:46pm
Related posts:
- How to study a surgical procedure As a final addition to my study advice, I want...
- How to study a medical condition I have been sharing my medicine study advice, and I...
- Menubar Study Hacks Schedule your breaks with Alarm Clock My Mum and Dad...
- Think about your overall study strategy After finding a treasure trove of old backups, I have...
- Using an iPod to make your medical life easier I recently read a great post by the Online Education...
Did you enjoy this post? Why not leave a comment below and continue the conversation,
or subscribe to my feed and get articles like this delivered automatically to your feed reader.
Thanks for this! Creating a list of top 20 conditions can also be a useful learning tool for qualified doctors. After reading this I decided to write a list of what I would consider to be my top 20 consulations as a GP. I got my husband, also a GP to do the same. A few interesting points arose from this. Firstly, we found it surprising difficult to create a list of 20. Although in gerneral practice we in theory see a bit of everything, when it comes down to it there are probably only 10-15 regular conditions. Secondly, our lists were very different. As expected, I had far more “women’s problems”. He had more complex conditions than me. (I wonder what this says about us as GPs!) Lastly, it got us thinking as to whether our lists were an accurate representation of what we actually see. I thought I might keep a record for a week or two of what I’m actually seeing. Once I have a definitive list of 20 I’ll go through it and make sure I’m up to date on all the topics. So thanks for this blog post. It’s given me something useful to use for my forthcoming annual appraisal. “It is far more common to see an unusual presentation of a common illness than a usual presentation of an uncommon illness”. Not sure who said it first, but one of my favourite consultants said it to me. [...] have been sharing my medicine study advice, and I wanted to give some advice on how to learn a condition. I was about in the middle of my [...] hey doc. . This is some awesome advice you’ve given! Will definitely make a list & work accordingly in my internship next year. [...] This list can be adapted for any procedural specialty, and I recommend you combine it with my Don’t Look Stupid Study Plan. [...]Comments
(It drives me up the wall when people (med students quite often) criticize doctors for not ruling out the esoteric which isn’t even that likely given the signs and symptoms when one of the 20 most common is a far better bet. Eg. patient has once been to Africa (10 years ago) and student wants to rule out African sleeping sickness as a cause for their fatigue. Patient reports having recently gone vegan…. Duh.
Diabetes is my little friend…I feel that if you need to know ridiculous amounts of detail about anything, sugar sickness is it).
Once again, thanks for sharing your soapbox. It sounds like an excellent one.
Thanks.
Cheers!Leave a comment
Best advice ever. I’ve spent the last 5 years complaining to everyone who would listen at my school that it simply makes no sense to emphasize stuff that we will not see then complain to us that we don’t know the basics. Their response: This is how it’s always been done. Apparently tradition trumps common sense. The thing that sucks though is it doesn’t really coincide with outstanding grades, but I guess that’s life. I’d rather be a good doctor with OK grades than the guy who got 100% and can’t manage diabetes. I’m gonna send this to some of my friends.