In this post, we’re discussing how mental framework and rounds-based thinking are even more effective ways to study and organize your medical learning. 

Mental Framework

When you give yourself a mental framework for your studies, it allows you to structure your thinking around systems or core disciplines, such as anatomy. For example, when trying to come up with causes of heart failure, do not rattle off random diseases—you may recall having viewing in a reference table (e.g. Coxsackie virus, ischemia, pregnancy). Rather, consider the layers of the heart (endocardium, myocardium, pericardium) and what etiologies could affect each layer.

Additionally, when trying to answer a question correctly (e.g. “What is the best response by a physician to a patient in X clinical scenario?”—classic behavioral science question!), try to develop an approach that you mold to each scenario. For example, the correct response will almost always be the one that A) shows empathy and B) asks for more information. Keep this in mind and apply to future scenarios!

When you approach your learning in this manner—as opposed to solely trying to memorize UWorld or cram all of First Aid into your head—you’re challenging yourself to think in a more dynamic and effective manner. And who doesn’t want to be as effective as possible in the world of medical learning?

Think Like You Are On Rounds

What happens when your attending pimps you on rounds about a mechanism of disease, differential for a common presenting symptom, or side effect profile of a drug? Do you have time to consult Harrison’s or Up-To-Date? No you do not! In this situation, you need to recall specific, bullet-style information. You do not need to remember EVERY drug side effect: you need the top 1-2.

This is exactly the type of recall we need to practice for the USMLEs. We may not remember every key point related to hemochromatosis, but we need to remember 3-5 important ones (e.g. iron overload, bronze diabetes, transferrin saturation, restrictive cardiomyopathy, tx with phlebotomy…). That will help us to answer the question correctly.

On a parting note, also keep the following in mind throughout your first two years of medical school: What will I need to remember when on clinical rotations? A textbook will not tell you.

Stay tuned for future posts in which we discuss which resources are best for learning medicine in this way.