Medical school is definitely a challenge, and that’s putting it mildly. Medical students are expected to master incredibly complex biological and chemical systems, usually more than one and in a short amount of time. Traditionally, students have learned through drills, ‘cramming’ for hours at a time until the information sticks.
However, emerging brain science suggests a better technique might be spaced repetition.
The Science of Memory
The first serious studies of learning and memory were performed by Dr. Hermann Ebbinghaus in the late 1800s. If you’ve ever heard ‘learning curve,’ that’s a term he pioneered, to describe how easy or difficult a particular information set was to master.
He also developed the less well-known ‘forgetting curve,’ which is the rate of information decay. Most of the information you take in during one sitting fades after just twenty minutes! Dr. Ebbinghaus also noticed further drop-offs in information retention after an hour, and then again after one day.
Students took this forgetting curve to heart, and took to drilling themselves repeatedly until the ‘forgetting curve’ was completely overcome. Yet this likely isn’t the most efficient way to study.
One of Dr. Ebbinghaus’ experiments involved him memorising a list of nonsense syllables, then putting the list away until he’d forgotten all of them. He’d then re-learn the list of syllables, and noted he spent far less time memorising the list the second time than the first. When he put the list away until he forgot everything again, he found that re-learning the syllables a third time was even easier.
This study indicates that even though we may have ‘forgotten’ an important piece of information with our conscious mind, the subconscious has somehow saved that information. When needed, we can bring that information back to the forefront of our awareness. Thus, the basis for spaced repetition.
The technique is much like it sounds. Working with both the learning curve and the forgetting curve, you don’t sit for six hours straight drilling yourself with flashcards. Rather, you split the hours up across the span of weeks or even months.
The idea is, you train your brain that this information is meant to be kept out of your memory savings. By repeating the act of pulling this information out of your subconscious, you better cement it in your long-term memory. You literally train yourself to keep pulling this information out of storage. Thus, your brain never relegated it to your subconscious, and you can retain whatever topics you’re currently working to master.
The most basic spaced repetition technique involves flashcards. A phrase or image on one side of the card is meant to jog your memory or prompt a question, with the answer on the other side of the card. It’s a simple method, but quite effective.
The first time you study, go through your flash cards enough times to remember most of the information. Then, put them away and don’t think about the cards or the information on them. A full day later, review them again. Then, put them aside for three days. Increase the intervals between studies. You may need to refresh your memory after a particularly long interval of not studying, but you should notice that each ‘refresh’ period grows shorter and shorter each time.
Of course, technology has allowed medical students the world over to move beyond flashcards. After all, spaced repetition only works if you adhere to a strict calendaring system, and that’s for all your classes and test preparation.
Fortunately, there are many services which provide well-structured spaced repetition learning environments, including those specifically tailored to medical students. Though spaced repetition is a useful skill when studying for exams like the USMLE or your clinical exams, most students find a structured system gives them the best results.
And in the era of COVID, when gathering a study group together at the library is impossible, solo study techniques like spaced repetition are becoming more important to medical students. The good news is that many instructional companies have met the challenges of providing quality learning support through online portals.
Many of these programs are priced to be within a student’s budget. And since you can study online, you no longer need to lug heavy, expensive textbooks around. These programs also provide immediate feedback, letting you know which concepts you’ve mastered and which ones still need work.