SOME THOUGHTS ABOUT STRATEGY WHEN REVISING FOR FINALS
There is a lot to do when revising the entire medical curriculum. If you have a good strategy, you will save valuable time. First of all, you need a syllabus or overall table of contents telling you everything you need to learn, including all the softer topics of ethics, law and public health. For an overview of this, please see the “Medical Finals Syllabus” section.
Next, you need to structure and approach the actual medical content. Here are a few ways to approach it:
- Least organised (but often recommended by senior physicians): “Read around” what you see during the day when you’re on the wards. I found this approach useless on its own, but some people learn best this way.
- Perhaps the most organised: by pathology, i.e. specific diseases. It’s easy to structure by different sub-topics (respiratory, cardiology, …) and therefore keep an overview of what you are doing, especially early during clinical studies when things may get a bit overwhelming otherwise. Cambridge students will have worked through the pathology syllabus this way in the 2nd clinical year.
- By cases: similar to the specific-disease approach, but perhaps more memorable if linked to cases one has seen during the clinical placements.
- By presenting symptom: e.g. chest pain, shortness of breath, … : I think this is also very useful for the early clinical years and definitely a good way to prepare for the communication skills examination. Also, it is a good way to start thinking about the process of diagnosis and what is called “clinical reasoning”.
- By examination findings: e.g. jaundice, weakness, … : Useful to pull things together for the practical exam. Especially when focusing on distinguishing symptoms.
- By specialties: e.g. medicine, surgery, subspecialties.
- Work through a comprehensive book “cover to cover”, e.g. the Oxford Handbook of Clinical Medicine.
I used a combination of these approaches:
- I made a syllabus that was initially structured by specialties.
- For each specialty, I then listed the most important presenting symptoms and examination findings. This gets you to start thinking about the particular specialty. (I will later elaborate on this section for my preparation of the practical exams).
- Then, I would work through the most important diseases in each specialty, mainly using the OHCM or more specific Oxford Handbooks.
- Once that was done, I made overviews pulling it all together.
- In the very end, I prepared flashcards to learn everything by heart.
The next important question you need to answer for yourself is: Will you prepare your own notes? I’m obviously the type who loves making notes, but to make comprehensive notes for finals for all exams and all specialties AND then read them all to learn them is a HUGE task – I applaud everyone who manages this. On the graduate course, where there is limited time, it is perhaps not possible. I managed to make notes for communication skills, OSCE, surgery, public health and law, but decided that I would NOT make notes on all of medicine. Instead, I used a set of notes from a previous student at a London university that was floating about among the students (e-mail me if you’d like to know more). The medical notes basically contained a bullet-point summary of the OHCM with half to a single A4 page per disease. I printed these, so that I could annotate everything with my own reading (there had been a newer edition since).
Have you got any other ideas? If so, please e-mail me – I’d love to hear them.