Bad Advice Struggling Med Students Receive — And What To Do Instead
We have spent years working with struggling med students (and veterinarians, PharmDs, PAs, and those in other medical fields) and during that time, we have heard a lot of bad advice our students have received. Struggling during your medical education can feel incredibly isolating, but you’re not alone.
There are struggling med students in every class of every med school across the country and beyond. They’re just hidden and probably suffering in silence. More than likely, they’re also getting at least some terrible advice on this list.
A caveat, some of this advice might be good or even great for some learners. But, we can’t treat all med students the same.
Bad Advice for Struggling Med Students
- Make sure you’re studying enough
- Let me give you some study tips
- Figure out your learning style
- Review the material five times
- Study like me!
- Rewatch or reread lecture
- Condense your notes
- Use Anki
- Make a schedule
- Make sure this is what you want.
If you identify with any of these 10 pieces of bad advice for struggling med students, you’re not alone! Learn more about ways to succeed in med school with the STATMed Study Skills Class.
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Transcript
Ryan Orwig: I was recently asked if I could make a top 10 list for bad advice given to struggling medical students. So I framed this primarily for classroom learners.
But all of this stuff can apply across the spectrum into board study as well. It includes related fields, like veterinarians, PharmDs, PAs, et cetera. These are students who end up benefiting from our STATMed Study Skills Class. I think they are in every class of every med school across the country and beyond. They’re just hidden and probably suffering in silence and likely getting at least some of this list of bad advice. As with everything I do, please keep in mind, some of this advice might be good or even great for some learners. My whole thing is not looking at all med students the same. Different students need different things. So let’s go.
For number one, let’s go with this. Make sure you are studying enough. I mean, okay, but what does that even mean? Most of the frustrated and struggling medical students I meet tell me all they’re doing is studying. If not studying, they’re sleeping, eating, maybe trying to catch a break here or there, if they’re lucky. But, mostly, they’re either studying or feeling guilty when they’re not studying. It’s just hollow advice and it underscores this reality. No one teaches smart, highly intelligent, highly motivated students, especially adult learners in med school, how to study.
Methodology matters, and we acknowledge that in most walks of life, but I find this to be largely lacking in medical school. We do not teach our students how to study, full stop. So asking them if they’re studying enough is bad advice that misses the point that maybe the issue is we need to teach them how to study in med school.
This ties into bad advice number two, which is, “let me give you some study tips.” Tips are disconnected and lack connective context. I mean, for some students, of course, tips might work and that’s great. But for the struggling students I meet, and let me tell you, they’re super smart and super motivated and super hungry. But for them, tips are just enough to frustrate. A tip might be preview before lecture. This can be great advice or terrible advice depending on the given student. If this gives the learner sufficient insight into the concepts being discussed or the structure, then that’s awesome. But many of my frustrated med students have been given this advice. Then they try it out but don’t get any value from it. So they eventually stop doing it. Then they feel like there is something wrong with them because it doesn’t work or add value.
It’s almost like gaslighting them. I mean, making them feel like they’re the ones to blame, when in reality, that study tip just doesn’t have enough meat on the bone to give value for what they individually need. We teach a skill in our Study Skills Class that students can use to find structure before going into lecture. We call this frameworking. This takes hours, spread across at least two days to teach, really teach. That’s not a tip. That’s a whole scale, end-to-end skill set. Then we teach how this skill connects to other core study methods to augment and build off of lecture, then into the reading and marking and then into retrieval practice. This all takes many, many hours, all built into a specialized scope and sequence. Tips can be just enough to frustrate. So that’s why this can be a really bad piece of advice in my book for a struggling medical student.
All right, number three is figure out your learning style. I really hate this one. I think most people have had to take some sort of learning inventory at some point in our education. That tells you if you’re auditory, kinesthetic, visual, et cetera. First of all, there’s no research to support the validity of these learning styles. It’s just like an urban legend we’ve all been sold on, and even if you prefer, say, visual learning, you have to learn how to take information on board and other modalities. This gets into the always preferred, desirable difficulties and mixed modalities we always wanna be operating in. I just want you to watch out for anyone who wants to sit you down to take an evaluation for your learning style because that is a waste of time. And so, yes, bad advice.
Okay, number four is when people tell you the secret to thriving in med school is to make sure you review the material X amount of times, which might be three times, might be five times, or whatever the flavor of the week is. Are repeated experiences with the material good and important? Of course. Is there a magic number? No. I find that this is held over some students’ heads like the reason they’re failing is that they’re not getting that final pass in, that magic number with the material. So they’ll say, “I just can’t get that fifth pass in. If I could, then I would pass.” I mean, maybe, but that seems kind of hopeful and generic to me. But this speaks to so many bigger issues, like what counts as a pass through the material? Are you just skimming and reviewing?
In my book, reviewing is a bad word study-wise. Reviewing to me means passively looking over the material that we’ve already studied. This is likely passive, low yield that entrenches familiarity and creates an illusion of productivity. Do we want multiple experiences? Yes, but we should find ways to make each pass build off of itself, engage us at a deeper cognitive level and avoid passive rereading.
So we can piggyback this off of number five, which is the study-like-me advice. Some of your super successful peers might study exactly like what I just complained about and they might be great at it. They might get great results, good for them. They might let their eyes slide over the notes and really soak it up and truly learn it. This likely involves some robust processes happening invisibly, subconsciously, internally for them way back inside the back burner of their brains. But works for one student will not necessarily work for another. So we have to be careful when we ask our peers for help in the areas of studying, because if you ask, they’ll likely often gladly and earnestly try to help you. But just remember, what works for them might not align with your learning needs. So that takes us to number six, which is to rewatch or reread lecture. I don’t think blanket rewatching or rereading is a good idea. Yes, it’s something to do, so it’s easy advice to give, but is it tactical? Is it going to give you yield in an effective and efficient way? Not likely, and keep this painful nugget in mind. After initial reading, subsequent rereadings will have diminishing returns. This is why when we teach students how to read the material the first time in the STATMed Class, we focus on teaching them two main things. Number one, how to connect the details to the hidden structure of the lecture or the content. And number two, how to set that material up, so that you can self-quiz off of the material as a means of multiple revisitations via retrieval practice.
Okay, number seven is the elusive skill of condensing your notes. This is like a pot of gold at the end of the rainbow. So many students are seeking this skill, which is essentially taking, like, I don’t know, 50-slide PowerPoint and condensing it into three pages of notes that they can then reread as many times as possible before the exam. Again, some students are incredibly gifted at the combo of making these notes and profiting from rereading them, the danger is trying to force this skill onto someone else who is not hardwired to learn like this. This falls into the category of if it works for you, that’s great, but I meet loads of frustrated students pursuing this, and we use our course STATMed Class methods instead for much more effective and efficient ways to learn in a way that suits their needs. All right.
Number eight is related and that is force feeding every student to use the same learning tool, whatever that tool might be. Anki is a great example of this phenomenon. Many med students thrive using Anki, which is a note-card-like self-quizzing software. It’s great because it builds in some of the most important aspects of advanced learning like retrieval practice, distribution, and interleaving, and it’s all automated. So what’s not to like? Look, this works for most med students, whatever most means. 55%, 80%, 90%, I don’t know, but it works for most because most med students, this is my belief, are bottom-up learners and high-structure builders. This means they can learn from details, meaning without having structure first. But what about the ones who this doesn’t work for? As I said at the top, I assure you, they exist in every class and every med school across the country. They’re just hidden and silently suffering. So sometimes Anki’s not gonna work for somebody, and when Anki doesn’t work for them, they feel likely to conclude that it’s their fault. So yeah, this is one of the ones that really frustrates me as a piece of advice. You can find more on my thoughts on all the stuff elsewhere in our channels, in our blog.
Number nine is make sure you are making and following a schedule. This is a thorny one yet important, okay? Look, time is your greatest commodity in med school, and I think med students have to figure out the best ways to plan and optimize their time to be successful and healthy and to be in control of their outcomes. I think making schedules can be an extremely important part of that success, but here’s why I think this is often bad advice. When someone is assigned to make a schedule, we act like we actually know how to make a schedule under the demands of med school, of the med school lifestyle, and the med school culture and the demands of a med student, which most of our students do not know how to do. So when someone tries and fails to make an effective schedule, they feel ashamed or becomes something that they’re punished at for failing. It usually goes like this. A student sits down and they make a schedule, which takes time, which will almost immediately stop lining up with reality. So if they feel like it doesn’t work, so they feel like failures, they conclude they suck at time management, so they wad the schedule up and throw it away. And there’s no insights built into it, so they’re not gonna get any better from the act. Even worse, perhaps, an advisor or a counselor asks them about this and it looks like it’s the student’s fault for not being good at this. None of this is helpful. I think scheduling is essential, but it has to be taught more robustly, broken into multiple tools and ideally taught in tandem with study skills. And scheduling, in particular, should require some sort of tracking mechanism to provide feedback so the student can get better week by week knowing they will always be off and make mistakes one way or the other and that that’s okay. But just telling a student to make a schedule and stay on top of it is bad advice that will likely make the student feel worse, at least in my experience. But we can be much better than that.
And then finally, number 10, I have more I could choose from, but I’ll go with this one. Make sure this is what you want. I mean, ugh. I’ve talked with scores of struggling med students over the last 20 years who were working themselves to the bone, leaving it all on the line knowing that they face staggering financial debt, knowing that their dreams of becoming a doctor were on the line, likely knowing that they had not yet cracked the best ways to study medicine and yet they’re holding their metaphorical hand over the metaphorical fire day in and day out.
They’re struggling, they’re suffering, they’re scared, they’re alone, and their advisor or their peer or there family member ask them, “Are you sure this is what you want career-wise?” I mean, look, that hurts. These people are smart and motivated and hungry. They just don’t know how to study and learn from the fire hose of medical education and maximize their time in a manner that’s suited for their learning needs, full stop. So this is another really tough one for me to swallow.
So those are 10 bad pieces of advice sort of, off the top of my head. I wanted to include some that are just straight up bad, like the learning styles one, and some other ones like Anki that are only bad for some and great for others. So I think this little talk covers a nice, wide spectrum. When med students are struggling, I don’t think they need a hug or like an ice cream cone. I mean, maybe that would help a little. I don’t know. It’s not really my forte, but I think what they really want to know is that others have been where they are now, struggling and looking for help, and that someone out there has seen these patterns before and knows how to solve many of these study based and time based and test-taking based issues. I’m not saying we have all the answers, but we do have some pretty good ones. So that’s 10 bad pieces of advice for struggling med students. If you identify with these, you’re not alone. I hope this helped and thanks for watching.