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Adjusting to the New World of Clinical Sciences

While studying basic science in Antigua, you have a set schedule. You know that you will be home from class at a certain time and you can set aside a certain number of hours each day to study. In the clinical semesters, time management becomes your best friend. Studying has to be approached in a different way as your schedule is constantly changing. Some days at the hospital have a lot of downtime, so you have to be ready to study whenever you find yourself with nothing to do.

The best way to go about this is to always have something with you: whether it is a small pocket textbook or flashcards. That way, when you have ten minutes to spare, you can commit a few facts to memory. This works great especially if you have a long commute on public transportation in the morning. For example, I email myself ‘high-yield’ facts or ‘medical pearls’ and store them in a folder on my phone so that I can quickly scroll through them when I have a few minutes to spare.

One of the best things about being in the hospital is that you have the opportunity to tailor what you study to the patients you are actively treating. For example, while I was doing Family Medicine in Atlanta, I had the opportunity to examine a patient in the emergency room with acute pancreatitis and then admit them to the medicine floor for treatment. In the same day, I examined a patient who came into the emergency room in diabetic ketoacidosis (DKA). In that case, the patient was admitted to the ICU for closer monitoring.

When I come across a disease that I need to study, I write a quick note to myself either on my phone or in a notebook, as a way to remind myself to read about it later. With the above cases, my notes simply said ‘pancreatitis and DKA.’ At the end of the day, when I get home, I go to my textbooks and read about the pathophysiology and treatment options for whatever diseases are on my list.  If I come across any high-yield facts, I’ll send myself an email so I can review it at a later date during some downtime.  Not only does that count as my studying for the night, but I’ve now associated that disease with an actual person who I saw and examined.

Another example occurred while I was doing my Internal Medicine rotation in Brooklyn, with a patient who came into the clinic with gout. During basic science lectures, we were taught that gout is a painful, red, swollen joint (most often in the ‘big toe’) that is associated with eating red meat, chocolate, drinking excess alcohol, and caffeine. What you don’t get from reading a book is that the person is in so much pain that they can barely walk or move the affected joint. Seeing how a disease affects someone’s daily activities makes it stick in your mind in a way that a textbook can never teach you.

In the beginning, this system can be overwhelming because you see so many different things when you are first thrown into the wards. By actively learning about a disease right after you see it on the wards, you make a mental ‘bookmark’ so, the next time you see it, you automatically know what to do for that patient.

It may feel like you have less time to study while in clinical rotations, but you have to think of the eight to twelve hours you spend at the hospital every day as your actual study time. Whatever free time you have at night to read textbooks is simply a way for you to reinforce what you learned during the day on the wards.

by Justin Capasso, Class of 2014