Study Techniques

Reading and re-reading textbooks/ notes.

• Pros- simple.

• Cons- passive. Easy to not absorb information as your eyes pass over the same text.

Reading and highlighting textbooks/ notes.

• Pros- simple. More interactive than merely reading.

• Cons- similar to re-reading- still relatively passive. Risk of highlighting everything and not focusing on key points.

Reading and handwriting notes in your own handwriting.

• Pros- active engagement in learning, reframe the information in your own style. You can color-code, reorganize, personalize it.

• Cons- takes more time.

When to study

There are two key circadian rhythm patterns. In his book When: The Scientific Secrets of Perfect Timing," Daniel H Pink refers to these as "chronotypes." There are three chronotypes (larks, owls, and third birds), but the differences between them are largely inconsequential, so they are simplified to two different groups, classically known as early bird and night owl. If you haven't identified your chronotype, you can do a few relatively straightforward steps to determine your pattern. Identifying your chronotype will give you a framework to plan your peak time for analytical tasks, such as studying.

If you have any control over your daily schedule, even if it's just weekends, take advantage of your inherent pattern to optimize your studying. Early morning studying before class/ clinical rotations might be optimal for some, while others are more conducive to evening learning.

What has worked for me?

I used to be a read and re-read type. I'm a fast reader, so it worked to get through high school and medical school. During surgery residency, I used iAnnotate PDF, which allows me to highlight and make notes. When I was entering fellowship, I renovated my style. First, I wrote notes for the handful of critical care texts that I read (Fink and Marino) and the trauma text (Mattox). During the summer before my ACS fellowship, I typed notes while reading Fink and Marino. I used iAnnotate PDF because it allows me to highlight and make notes. I did switch to a hard copy of Civetta because I needed a new format to re-ignite my focus. I used old fashioned lined paper and pencil and then rewrote them into a notebook. After I got burnt out on textbooks, I made the leap to reading journal articles. Switching to primary literature was a monumental change in my studying.

I always marvel at attendings who can quote journal articles with ease. It always strikes me that their memory is so crisp...I've never had that gift. When I started reading articles, I developed a system for finding, reading, and then recording the salient findings.

How I built my literature database for Acute Care Surgery

1. There are several ways to find articles. Surgical Clinics (previously known as Surgical Clinics of North America) is one of my favorite journals for reviewing broad topics. Every article is evidence-based, with abundant references. The most current journals will be a treasure trove of high-yield references.

2. The open journals and published guidelines (read: free!) are another excellent resource. The references in reviews and guidelines are the basis of evidence-based medicine.

3. Read! You don't have to read every word, and as you read more articles, you will develop a sense of which papers can be perused and which deserve a more diligent review, such as landmark articles (see suggested articles).

4. Highlight, make notes and ask yourself, "how will this change my practice".