With some time behind me, I can now look back on neuro block and feel an honest bit of job-well-done, despite barely passing.

Looking at my grades for the past ten weeks of medical school, you might rightly conclude that I’m a stunningly marginal student: two points above the pass-fail mark, barely skirting by and maintaining essentially the same score as Course One. This isn’t much of a surprise to me because I am actively attempting to study as little as possible. My goal is to be an efficient student, not necessarily a studious student. Searching for the best (input)/(output) ratio, or Minimal Effective Dose, for (time spent studying)/(exam performance) has been tricky. Trickier than I thought it would be. A few months ago, I reckoned that I had just about zeroed-in on my ideal study method.

I had a tough go at Course One, the biochem block. I cruised through the lectures multiple times, wrote outlines of the material covered, and then as the exam approached, reviewed a self-made document that is my own special-sauce synthesis of the major concepts. Starting Course Two, I mostly abandoned that style due to the large amount of time invested for relatively poor exam performance and weak long-term memory retention. Instead, I opted for more active studying methods with fewer lecture passes—crucial time spent with a whiteboard copying charts and utilizing flashcards to enhance my rote memorization of facts and relationships.

This shift away from passive osmosis (lecture outlines and synthesis) towards active learning (whiteboards and flashcards) reflects my self-perceived learning strengths and weaknesses: I can latch onto overall concepts relatively quickly, but the nitty-gritty facts tend to elude easy entry to the long-term memory banks. Working this weak link will yield the highest return on time and effort invested not just for Course Three, but for the rest of my time at medical school.

Tim Ferriss calls it meta-learning, or the process of learning how to learn. Abraham Lincoln summed it up this way: “Give me six hours to chop down a tree and I will spend the first four sharpening the axe.” However you describe the mindset, it’s an approach that looks to leverage time for the greatest benefit. The Ferriss method involves dissecting the essential moving parts before diving into the practice of learning. The Lincoln method speaks of old-fashioned prep time, ensuring that your tools are effective before you expend any energy. Taken into the medical education context, I am trying to find methods of study that are effective for both the short-term (preparation for the next exam) and the long-term (US Medical Licensing Exams at the end of MS2 and MS4). I’m putting myself through the painful process of learning how to learn, taking many and multiple approaches to the synthesis and retention of information. The key is failing fast— when I realize something might not be working, I stop and move laterally as quickly as possible.

To this end, I’m building up a few habits and routines to help me sharpen the axe. I find that flashcards are painful, difficult, and exactly what I need in order to digest the endless barrage of facts and associations presented in a medical school lecture— so I’ve signed up for four years of Firecracker MD, a product/service designed to help medical students prepare for both their classes and the USMLE Step One. Everyday, I’m assigned eighty flashcards with algorithmically-determined content based off of what I’m learning in class and what material I need to review in order to keep it fresh. A long commitment made on a bit of a whim, I’m very intrigued to see how this daily practice serves me in Course Three and beyond.

Additionally, I’m committing to lecture-based flashcard review everyday on top of Firecracker. A fellow student creates monster decks with almost all of the lecture material included and I’ve been riding that wave for a few weeks now: I failed Exam 3, but I attribute that to my inconsistency rather than this study method overall. Finally, a weekly drawing session for anatomical landmarks and structures will help me stay on top of the many muscles, nerves, and folds we are expected to know. Drawing, rather than flashcards, for this information-type seems more effective because I’m fairly a kinesthetic learner so holding a pen, sketching out structures, and being aware of relationships helps me learn much faster and retain these bits much longer.

Taken together, these studying methods will add up to maybe an hour, 90min each day. I’m hoping that the consistent and regular material review will evenly distribute exam prep to the weeks leading up, rather than mashed up in the days before. And ideally, my scores will finally start their upward trend. Only time and a few exams will tell.

Course One was stressful and rough. Course Two was tough but manageable and life outside of school made things quite enjoyable. For Course Three, the cardiovascular system, I’m hoping the hope of a scientist that I’ve figured out the Eugene method and can finally stop fiddling with my studies. If not, I’ll commando-roll out of that sticky spot and find a new way to sharpen my axe.