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One issue I find most students struggle a bit with when studying is revisiting old material. There never seems to be a good time to go back to your old lectures to brush up on the basics of physiology, pathology, pharmacology or even your favorite topic, biochemistry! How can you make sure to squeeze in that crucial extra review needed to solidify old concepts without falling behind on the new ones? Here are a few tips on how to incorporate old material into your day to day and why it’s necessary to do so.

Spaced repetition is one of the most useful tools in your arsenal when it comes to reviewing for your boards. The trick is that you should be using it not only for dedicated study but for the months preceding it. The way to do so is simple, effective, and engaging that, when done right, it will allow you to branch off from one topic into twelve others without having to stop and re-read Stedman’s or Guyton and Hall. Let me give you an example with polycythemia.

When you come across this term in lecture, or see it in your lab values, you should develop a blueprint for how you think about it. Start off with the categorization of it and then the causes. Firstly, it must be broken down into relative vs absolute. Then once its broken down into these categories, absolute is further categorized into primary and secondary. Primary includes any causes that increase RBC production via intrinsic factors (i.e. the JAK2 mutation in Polycythemia Vera) while secondary will include any disease that causes increased EPO (COPD, renal cell carcinoma, pheochromocytoma…etc). You should then quickly think of the key characteristics for these diseases and branch out from there.

turn your 230 into a 260 on the USMLE in 24 hours

For example, pheochromocytoma can present like a panic attack. What are the key distinguishing features between these two? How do the treatments differ? Is there any associated disease with pheochromocytoma that I should worry about (Hint: MEN2). Using this thought process will allow you to passively review material without having to sit down and reread year-old lectures (although you will have to look up something every now and then). The utility in this is that when you come to these topics in your organized studying (i.e when you are going one system at a time) you will be able to breeze through it as it’s been a part of your spaced repetition. Trust me when I say you will want to skip reading about MEN1 and MEN2 during dedicated, so put the work in beforehand!

One word of caution in using this method is to always make sure the topics you branch off to relate to your original topics. Using pheochromocytoma from our previous example. Once you’ve listed all the diseases that could be associated with this neoplasm, there is no need to go into the path, physio, pharm, biochemistry, or any other aspects of the diseases you related to pheochromocytoma. Their time will come in another spaced repetition session.

Lastly, try and make this an enjoyable activity. Grab a couple of your friends and help each other develop a broad knowledge base when it comes to any topic. You are always more likely to remember your friend telling you about a subject compared to your 80+ year old professor with a thick Caribbean accent (great guy just hard to understand). As always, good luck studying everyone and hoping for the best for you all in your future endeavors!!!

did you know that 24 hours could earn you 30 more points on USMLE Step 1?
Ali Elsaadi

Ali Elsaadi

Ali graduated from the University of Houston with a Bachelor of Science in Biology in 2016. He is an MD candidate for the class of 2020 at St. George’s University. Ali is currently rotating at an NYU Langone affiliated hospital in Brooklyn, New York. He plans to apply for general surgery and hopes to specialize afterward. His interests outside of medicine include learning languages and recipes from different cultures.
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