How to Study in Veterinary School

Spaced repetition is not only about revisiting the material more often, but also about reviewing it at the right time. It turns out that

Because forgetting typically follows an exponential curve, the trick is to time your study sessions around the curve and revisit key points of information right when they’re about to fade from memory. The key concept is spacing your studying and self-testing over time, as opposed to massing, or "cramming," because this spacing helps to flatten your forgetting curve so you retain information longer.

Since your familiarity with different subjects can vary greatly, different bits of information have different forgetting curves. Studies show that you should have the following:

While this strategy is effective for all fields of study, it’s especially important for students in the veterinary field, who have to retain key knowledge and skills in order to care for their patients. One study found that without spaced repetition, students forgot up to 33% of their basic science knowledge after one year, and more than 50% after 2 years. But when students and residents applied spaced repetition strategies in their studying, they significantly outperformed their counterparts, with some studies showing close to 40% greater learning retention.

Knowing all of this, why does cramming persist as a popular behavior? The truth is that cramming is often effective in the short term. Pulling an all-nighter can certainly help you pass tomorrow's exam, but 1 month later, you’ll have forgotten much of that information. Since you'll likely need that information for the rest of your career, it’s a good idea to space out your study sessions. And it's also important to note that spaced repetition doesn’t help just with knowledge retention; it also helps with skill retention, whether placing an IV or doing a lumbar puncture.

Applying spaced repetition is not always simple. Students—especially those in the health and medical fields—have to remember thousands of bits of knowledge. It can be incredibly hard to keep track of when it’s time to revisit each piece of information, especially since each bit of information follows its own forgetting curve. This is why researchers and software developers have created computer algorithms to help students optimize their studying.

These algorithms prioritize your studying based on what you do and don't recall. That is, if you get a question wrong, the algorithm automatically prioritizes that information for repetition and de-emphasizes the information in questions you answered correctly. Thus, these algorithms can actually reduce your overall study time by making sure you’re not wasting time studying information that you already reliably recall.

One of the best things about spaced repetition is that you gain a lot by studying smarter, not necessarily longer. With just a little more organization and forethought, you can achieve a whole lot more. However, spaced repetition may feel unnatural at first. You're not used to studying something you feel is still sort of fresh in your memory. Also, when you take time to study something you learned just a few days ago, you might be concerned that you should be using that time to study something you learned today. But spaced repetition will leave you better off in the long run.

Let's say that you want to learn concepts A, B, and C.

The traditional model has you master each in turn through massed practice (block practice) which looks like this:

On the surface, this strategy makes sense. You practice a skill until you achieve proficiency and then (and only then) do you move on to the next one. However, this strategy often falls short:

That’s what interleaving does: it allows you to work on multiple skills at the same time by alternating between them, which looks like this:

Interleaving helps you figure out how concepts overlap and differ, which increases your retention overall. Interleaving also makes you do spaced repetition.

So, when you learn about the various diuretics, do not practice all the thiazides followed by all the loops; instead, interleave them, and mix up how you learn things!

Having taken dozens of high-stakes tests, ranging from class finals to the SAT and ACT, you've probably come to associate tests with the end of a learning experience, rather than as part of it. But the truth is that low-stakes formative testing can play an integral role in the learning process. This phenomenon happens for a number of reasons. One is that

When you read a textbook chapter or re-read your notes, you're engaging with the material in a relatively passive way. We like to think that we’re information sponges—that we absorb knowledge as it passes across our eyes—but it turns out that real learning happens when we actively engage with the material, like when we think about how it relates to other material we have learned or are learning.

Actively thinking about the material increases the likelihood that you'll recall the information when you need it later on, like during an exam. So active retrieval of information through testing strengthens the underlying knowledge. In other words, testing actually improves knowledge retention compared to less active forms of studying, such as rereading information or rewatching lectures.

In fact, the more actively you engage with the material, the better. Research has shown that you should take the time to test yourself in ways that force you to struggle with the material, rather than just focusing on plain recall. The benefits of testing are greatest when the questions are complex and you really need to push yourself to come up with the answer.

Another reason that testing is so effective has to do with the dynamics of recalling. In order to answer a question on a test, you have to search through your memory and retrieve the answer, right? Well, it turns out that—at least in one respect—your memory is more of a muscle than a filing cabinet.

When you first rode a bike, you probably fell over a lot, and your movements were rough and wobbly, but with practice, those movements became easier and smoother. Think of memory as working in the same way:

For example, one study compared residents who tested themselves vs. those who simply restudied information about two diseases. Every 2 weeks, one group did practice tests, while the other group simply re-read the information. Six months after they originally learned the material, those who had taken practice tests scored 13% higher than their counterparts, showing greater long-term retention.

Let’s say you’re trying to remember the six drugs or drug classes that are known to cause pancreatitis, or inflammation of the pancreas. The list is:

Clinically, it’s really helpful to have these six drugs or drug classes in your working memory so that you can spot them on a medication list and think about them as a potential cause of pancreatitis.

Start with picking a place that you’re familiar with. This can be an actual place, such as your home, the gym, a store, or someplace you’ve seen on television, or a place you've imagined.

Next, you identify specific spots called “loci” in that place. It’s nice to pick really distinct spots, and in this case, we pick out six spots since there are six things to remember. Let’s use your bedroom as the palace and we'll pick:

Next, you have to create images for each term you’re trying to remember. You'll imagine an image on each spot. You use the images because it's comparatively easy to first remember a roomful of images—especially if they're attention-grabbing—and then remember the things you associated with each image. You can try a few approaches to come up with the images.

The more unique and descriptive the image, the better it will stick, because the mind loves to hang on to interesting visual images in familiar settings. But rather than trying to analyze which trick you’re using, you should simply use whatever image first springs to mind.

So in our pancreatitis example, you might imagine, for example:

Picture in your mind all these things in your bedroom!

Of course you're not going to draw anything. You'll just imagine the memory palace and the things in it. However, you must pick the right material on which to apply this learning tool. Typically, the best material is very concrete, like the steps of a process or a list of some sort. Fortunately, that's just the kind of thing we have to learn a lot of in medicine.

The reason that memory palaces work so well is that our brains are better at remembering concrete images and locations, as opposed to abstract things like names and numbers. By using these images as a stand-in for abstract information, the memory palace provides a scaffold to help your brain organize and connect concepts. You learn faster while forgetting less, and creating the images themselves makes learning more enjoyable, adding a little flavor to the usual study routine. Although personalized images are the easiest to remember, if you belong to a study group, consider whether you can build a memory palace that will work for both you and others. Even thinking how you would build a memory palace relevant to others will increase your likelihood of recall.

Stanford behavioral scientist BJ Fogg reduces behavioral change to 3 variables:

If you think about any behavior—exercising, quitting smoking, or studying using the techniques described above—you need a certain level of motivation and ability, followed by a trigger to implement the behavior.

Let’s say you want to study new material and review past concepts on a daily basis. Your motivation is a desire to do well in classes and board exams and, more importantly, to be able to take good care of your patients.

On this last point, the key is not to burn out on the triggers so that they lose their effectiveness. One way to decrease the likelihood of this happening is by making each trigger relevant by syncing it to your individual curriculum and schedule—so you practice answering questions on gram-positive bacteria when you’re actually learning about them in class or seeing patients with infections in clinic, rather than getting that information at random, less meaningful moments.

Stanford researcher Carol Dweck has found that when people are faced with challenges, they often develop different mindsets, or thought patterns, surrounding their problem and their ability to overcome it.

When students with these mindsets were given easy problems to work on (much like the problems you may have encountered as an undergraduate), both groups were successful. However, they responded quite differently when faced with a more challenging, difficult task.

When asked to choose between additional easy or difficult problem sets:

The most important part of this research was not defining these mindsets, but discovering how easily they could be overcome when students were made aware of them. In other words, lifelong mindsets about achievement and ability can hold us back, but they are not set in stone, and those who overcome them are more likely to succeed. Even if you are someone who breezed through your undergraduate years, you will undoubtedly face greater challenges in veterinary school. Remember that it is not natural for all topics to come easily to a person, and that you can move forward by working hard and applying yourself to the topics you struggle with the most.