The "PreMed" Paradox

Updated: Jul 13, 2020

The PreMed Paradox – Why Focusing on Learning is important for the long game.

I am writing this post in the wake of a final I’m taking 2 weeks early before I depart for Officer Development School as part of the Health Professions Scholarship Program (HPSP) through the United States Navy Reserve. I’m sharing that because it’s important to have context surrounding the paradox that I hope to explain to you.

The competitive nature of medical school applications creates an innate need to outperform and over perform. It makes sense, if other people will have high GPA’s, you probably need to as well. But as I wrap up studying for my Principles of Drug Action Final I am reminded about something I emphasized as a teacher – memorization is a tool that will allow you to succeed in certain dimensions, learning is a lifelong skill that can apply to anything you do. I want you to think about that. Memorization is important, it will help you digest the billion facts, 20,000 anatomical terms, and in my case the 200 drugs on my test tomorrow morning. But memorization is a component of the “end goal”. The end goal is to be a talented and effective physician that serves his/her/their patients in whatever specialty they have chosen. To do that you need to do more than know facts, you have to mold those facts into problem solving, then multi-task understanding them in the greater context of serving your patients. Then, communicate them in an easy to understand way to patients, while providing a whittled down, highly articulate version to your attending of-the-day. Oh, did I mention this needs to happen in the blink of an eye eventually?

So why do you care? You just want to get in.

Because a parallel and complex piece of developing as a physician is how well you set yourself up for success in the near AND far future. Think about those peers who really have it together. They have their schedule, or they know exactly what they have to do to score highly, they might move through school with some sort of creepy grace. (Spoiler alert, I was literally never one of those people) So as you’re navigating learning glycolysis in detail, dipping your toes into nucleophilicity, and perhaps making your first cadaveric dissection, don’t forget to challenge the status quo and focus on learning – not memorizing. This could come up in a ton of ways so let me go back to those examples:

1) Glycolysis. I learned glycolysis far more than I needed to. One of my closest friends has Type 1 Diabetes. And it drove me nuts not understanding how he dropped into DKA when I was with him one night. But then I imagined him receiving his diagnosis and being told why he suddenly has excess products of fat breakdown and why it caused him back pain, delirium, and emesis. I want to go into primary care – this matters to me. Want to go into surgery? Great, hope you’re ready for a T1DM patient during your 8-hour surgery. Chase, WHAT IS YOUR POINT?? I’ll reference my blog post on balancing passion and obligation. Find passion in your obligation to learn things that might seem mundane. If you talk to anyone, they remember disease process because they saw a patient with it during 3rd year. You can do that right now.

Find passion in your obligation to know things, and make sure you learn them. This type of habit will pay absolute dividends on the MCAT, in your basic science classes, and will translate to success in clinical years and beyond.

What you will hear when you start medical school is the importance of learning efficiently. True. Medical School is high volume. But let’s learn EFFECTIVELY so we can function efficiently instead. Undergraduate studies should be fun, you should look back on long hours of studying with some sense of pride. But focus on how you are going to learn to be a doctor before you are one and things will fall into place much easier than they could have.

So, let me tie it back in to why I am up writing this before my exam. I have 186 drugs I have to know for my exam tomorrow. We were given a drug list of those we had to know. I spent time memorizing why -azoles are good for certain fungal infections, or why caffeine can lead to muscle spasms, but beyond that I went through the drugs/categories and wrote down the names or scenarios from my life that relate to them. (this was fun during our antihistamine lecture being that my seasonal allergies are AWFUL, and I had taken a majority of those medications) Someone I know got surgery including a nerve block. We don’t use tetracaine for those – wrote her name by it. I had 11 teeth removed and got put under with nitrous oxide, so you know what I put for that. I had a double ear infection and was given amoxicillin for it, boom.

This may not be how you learn – but I suggest you find out how you can practice thinking in a way that will work for you as a doctor. You will build on the foundations you set today – and they will never stop helping you tomorrow.

Curious about dialing in your learning? Chase was a high school teacher and writes curriculum for education from high school and up through his medical school electives. He works with students locally and digitally to optimize their learning. HE IS AN EDUCATION NERD. And he is willing to work with you.

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