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Struggling to stay afloat: Studying for med school finals

ocean-690224_1920Studying for finals in medical school is like trying to survive a rip tide. That's the most accurate way I can describe what it feels like right now, very near finals week of my second quarter of medical school -- the quarter that all the second- and third-years told us would be the most academically challenging quarter of our pre-clinical years.

Born and raised in Hawaii, most of my childhood memories are from being in the ocean, so this metaphor holds lots of meaning for me. For the people that it may not resonate with, here’s a rip tide primer: Rip tides flow inwards, out to deeper water; they’re powerful collections of waves that can quickly suck you far away from shore. In Hawaii, we were always told that swimming straight back to dry land and safety is impossible and tires even the strongest of swimmers. Hundreds of people die every year off the coasts of the United States trying to do just that.

I’ve been caught in a few rip tides in the past, and it is terrifying. The powerful current comes at you all at once and sweeps you further out, towards the ocean flounder and flail before you fully realize what’s happening. If you’re going to survive, you need to remember what you were taught and concoct a plan for survival. Through it all, you feel helpless.

To survive a rip tide, you need to do something unintuitive. Instead of making your way straight to shore and inevitably be overpowered by the current’s strength, swimmers and surfers are told to swim parallel to the shore, keeping a good head on their shoulders and sensing the path of least resistance out of the rip tide. This strategy may not be intuitive, but it makes sense.

Studying for medical school finals is similar: The powerful wave of finals comes at you all at once and sweeps you further out, into a place of discomfort and fear. You flounder and flail before you fully realize what’s happening. If you’re going to survive, you need to remember what you were taught and concoct a plan for survival. Through it all, you feel helpless.

To survive medical school finals, you also need to do something unintuitive. Instead of gaining a true understanding of all the important concepts and why things are the way they are, you wind up consuming and remembering the flood of information by other means: mnemonics, repetition, “brute force memorization,” Anki decks, quizzing and getting quizzed by classmates, and if you’re lucky, practice exam after practice exam. The strategy may not be intuitive -- and in this case, it doesn’t make sense.

I doubt this is the best way to determine whether medical students have learned the foundational material that’s supposed to set them up to be successful physicians. Instead it seems to me an assessment of who’s able to employ the most efficient memorization mechanisms to solidify information in their minds long enough until the big “brain dump” time, as one of my classmates put it, when we have the pleasure of taking the exam then not thinking about the material again… or at least until our board exams.

After listening to yet another one of my bitter rants about finals week, my patient boyfriend, who is graduating from law school this year, told me that the pedagogy of law school hasn’t changed much since the 1800s and he imagines that the same can be said about the pace of change for medical school. It makes me sad to admit that his statement is, for the most part, correct. My theory is that change to the medical school pedagogy has been so slow because cohort after cohorts of medical students are too mentally exhausted after going through the ringer to even think about how the system could be improved. That’s how my classmates and I feel right now, at least: mentally exhausted.

Maybe one day, finals week won’t leave medical students feeling like they’re trying to survive a rip tide. Until then, wish us luck as we struggle to stay afloat, support each other, lock our eyes on the big picture goal, and make our slow way back to the shore.

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category

Natasha Abadilla was born and raised in Hawaii, graduated from Stanford undergrad in 2014, and spent two years doing public health work in Kenya before returning to the Farm for med school. She is currently a first-year student who enjoys writing, cooking, eating desserts, running, and scrubbing into the OR. 

Photo by Unsplash

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