My Pharmacology NBME percentile score is back and that verified what I already knew. I suck at Pharm. Not only do I suck at Pharm, I also dislike it. (Yes, I am using rationalization, an immature ego defense.) Why do I dislike it? Because it is just memorizing a bunch of strange-sounding names and apparently random drug interactions and side effects. Of course there is also the mechanism of action (which I find somewhat interesting). It is tough to attach meaning to what seems like an unimportant pile of facts. But I know Pharmacology is HUGELY important. It is integral to the practice of medicine. I know it is essential to understand which drugs are the first-line approach for each disease. It is also important to be able to counsel your patient on how to take the medication and what to expect while taking the medication in order to help the patient adhere to using the drug and to enhance the physician-patient relationship. And there are all kinds of other reasons Pharmacology is important, but that would make this post way too long. Because of my concern for my future patients, and because of the approaching USMLE STEP 1, I will be spending a lot of time focusing on Pharmacology in this blog.
I finally figured out how I can make myself learn Pharmacology. Unfortunately, I did not hone in to these techniques until after most of the Pharmacology class was over. I taught high school Biology for three years before I started medical school, so I learned several methods to enhance memory formation. I should have put them to use earlier, but I was afraid it would take too much time. It turns out that these techniques are actually kind of fun and do not take that long. In fact, the time I put into this method is much higher yield than going over flash cards over and over again. So, the idea is to INTERACT creatively or personally with the material in some way—repetition is NOT enough. And I’ll explain the specifics of what I mean by INTERACT in a little bit. Through this interaction, you make the material personal to you. I also think when you interact with the material you use several different parts of your brain, so you are probably branding that information into many synapses in various areas.
How do you interact with your learning? For Pharmacology, I made up rhymes and imagined ridiculous drug advertisements and jingles. I made up stories or fake patients that serve as mnemonics for me. Some of these things start to sound like the ravings of a schizophrenic patient, but I’ll share lots of them here in case they help you as well. You can also draw cartoons or pictures. Writing lyrics and putting them to a well known tune would be extremely helpful, but I have not tried that. It is also helpful to share this stuff with your friends because talking about it reinforces it. If you make up a mnemonic for the cephalosporins, share it and explain it to your friends. It’s better if it is funny or rhymes. And…things that are disgusting, vulgar or offensive…are easier to remember. For example, I will NEVER forget that trazodone can cause priapism. Trazodone? Tragic bone. I learned that when my husband was in med school. He just mentioned it once when he was studying Pharmacology, but it stuck. When I am old(er) and have vascular dementia and cannot remember the names of my children, if you say “trazodone” questioningly, I will still answer “tragic bone”.
I call or text friends and family members with various diseases and ask them what drugs they take. When I study the sleep aid drugs, I think about my friend Jim (a fake example). He told me he experiences some day time sleepiness on Trazodone. I tell Jim he should watch out for priapism. If that ever becomes a problem, he can switch to Zolpidem or a benzodiazepine. And when I learn new information about insomnia or sleep aids, I think about it in the context of Jim and how it will affect him. If I learn something useful to Jim, then I text him about it. Making it personal really helps it to stick.
I only use this method for things that I just do NOT know, even after finishing classes. I am not wasting my time doing this for things I already have down pat.
I took my First Aid to Kinkos, had it hole-punched and put into a 3-ring binder. I put tabs on all of the different sections (obviously all of this is not my idea—lots of people are doing this). Whenever I read First Aid, I annotate it, highlight things, underline and put boxes around important words using various colored markers and highlighters. Humans are really visual and we LOVE color and graphics. We also love looking at our own handwriting and our own work, so you are going to pour over your First Aid even more if you personalize it. Write all over it, spray your perfume on it, kiss on it, paste in your personal photos (obviously exaggerating a bit, but certainly do make out with your First Aid if you think that could boost your Step 1 score) and make it yours even if that isn’t usually your style. Nobody is going to want to buy your used First Aid anyway. They will want the new, improved 2012 edition. Anyway, if you can think of how something would be better understood with a diagram or chart, make one yourself by hand on a piece of paper and put it in your First Aid. Use lots of colors and images where appropriate. If you make up a list of mnemonics (or come across them), or a cartoon or poem or whatever else, then write it down neatly and put it in an appropriate section in First Aid. Cut or photocopy useful images out of Netter’s (or another useful reference) and put them in your First Aid.
An example of a chart to help me compare the types of arthritis in one spot. Good for self-quizzing. Notice how my complete inability to draw stuff did not stop me from making this neat illustration of an edematous hand with scary, wrinkly, monster witch fingers.
How I annotate and highlight and write all over everything in First Aid.
Clearly, I am a bossy and uptight ex-teacher. I’m sure you use lots of these ideas or have thought of them already. You know what works the best for you, so stick to what works or try some of my suggestions if you are in need of changing things up.
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