Journal reading

Journals usually refer to periodicals/publications usually of an academic nature. Its readership is usually restricted to members of the profession or related fields. However with the increase in internet use and emergence of free access journals, the general public too now have access to and do read these scholarly publications.

• The publishers of journals range from commercial book publishers-like the one publishing you text books to those published by learned societies.
• Journals range from subscription only (you must pay to buy a copy) to those freely available online.
• Some are "peer reviewed" and others are not.
• You can also start your own journal!

Work flow for journal publication:

1. Scientist/ doctors do research and write up their findings
2. Write up sent to editor of journal
3. Editor sends your write up for peer review (this is review by other researcher/experts in the field you are writing about).
4. Editor either accepts or rejects your paper. Sometimes they ask you to make modifications and resubmit.
5. You get letter of acceptance and your research work gets published.
6. If your research gets rejected to might want to send it to another journal and the process starts all over again.

A word of caution when journal reading:

• Not everything published in a journal should be accepted as "fact"-even if is published in a very reputed journal
• Errors, misinterpretation and falsification of data are well known occurrences.
• "Peer review" is NOT a form of guarantee / quality control measure.
• Quite often research is done by postgraduate students who are supervised-the extent of supervision is of course not known !
• Many of those engaged in medical research are not doctors!

Should I read from journals or textbooks?

Ok. This one is difficult to answer because educators tend to feel that at university level students should be reading mainly or at least as much as possible from original sources ie journals.
But I think an exception should be made for medicine.
Typically most medical students will cover about 20 main /core subjects over a 5 year period. In addition to this they will have a large number of practical classess / clinical sessions. All this adds up to a huge amount of time.
Firstly not being a doctor yet, it is likely that you will not have a clear idea about the area you want to cover and to the depth of knowledge you will need.
To try and satisfactorily cover a topic just by reading journals is a time consuming and tedious task, not to mention your that your medical library will probably not subscribe to every single medical journal! This will invariably lead to "gaps" in your knowledge.

So in this instance my advise would be:

• Read a small concise textbook before the lecture class- this will give you an overview of the entire topic quickly
• concentrate during the lecture class/ practicals etc- these tend to give you a broad outline as to the area to be covered, important topics and the depth of knowledge needed.
• Read a more detailed "standard/ recommended" textbook.
• Practise writing out answers for past year questions-not necessarily only those from your medical school.

Pick a few oft repeated questions and do a bit of journal reading on this. If you do happen to get asked these questions especially for a viva-voce you will be able to impress the examiner!

Help ! my lecturer doesn't know everything

Yup, your lecturer doesn't know everything. Medicine comprises a huge body of constantly evolving knowledge. Most doctors (medical lecturers) are very selective about how much of that they plan to use to treat patients or teach to undergraduates. So quite often if you ask your lecturer something deemed too detailed or perhaps unnecessary for a medical student you will be politely steered away from such level of detail.
On the other hand you sometimes come across students whose "basic knowledge" of the topic is shaky but the student seems very interested in the minute details. This sort of student is very worrying. It is almost as if they cannot see the woods for the trees.
Lecturers however tend to be more eager to discuss this minutae with postgraduate students. Somehow there seems to be less risk of confusing a postgraduate than an undergraduate student. Probably because postgraduates students are qualified doctors themselves and will treat all information with a degree of caution just like the lecturers themselves.

Next post: should I read from journals and textbooks?

In the good old days

Medical lecturers have this unpleasant habit of refering to their glorious past. Somehow or other they were always harder working, smarter, more responsible than you are. So is it true?
In a way those who are now in their 50's and 60's did have a better education than you. The study methods they used in school closely matched that used in university. So basically they entered university better prepared than you.
Most medical students today are of the "work book/ assessment book/ tuition/ model answer" generation. You probably have never had to read proper textbooks and reference books to formulate answers to past year questions. They were given to you at the back of workbooks or as model answers by your teacher. So basically you come into university disadvantaged- through no fault of your own.
Are your lecturers smarter than you? Probably not. Don't forget that your lecturers have had many years since qualifying to rectify their mistakes and acquire new knowledge. So if at all they appear smarter it is due to "the passage of time".
Are your lecturers more responsible than you? Definately yes. They have a practising licence to lose if they are careless. You on the other hand don't have much to lose except your time and fees.

Critical thinking

I must admit that I have never fully figured out what "critical thinking" means. My educated guess is that you basically have to carefully study the problem/ situation you are faced with and come up with the best response/ solution for it.

Does practising medicine require critical thinking? YES/ NO/ MAYBE.
Medicine is problem solving- so logically speaking it requires critical thinking
However it is not quite the same kind of "open-ended " critical thinking that someone discussing literature or history may use.
It is a sort of "guided critical thinking". In most exams along with the question an answer key is also created- so that means that the response expected from you is more or less pre-scripted. So in reality it is probably not really critical thinking but rather "appropriate thinking". The person who gets to qualify as a doctor is one whose line of thinking more or less matches that of the examiner or well established guidelines- at least for undergraduate medicine.

Rote learning

Rote: more or less means memorisation without full/any comprehension.
Is this a useful skill? YES YES YES.
Should I use it as a main learning stratergy in medical school? NO NO NO
Most educators / medical lecturers caution against any rote learning. I think they arebeing over cautious. It has its place in medical education though not a very prominent one. Medicine is a little bit strange because patients present with problems-ie almost your entire career is spent problem solving. BUT the knowledge required to solve these problems comes neatly packaged as systems. This being the case it is very difficult to create a "perfect curriculum". From time to time you will find yourself having to study things that you don't quite understand yet. So this is where rote can be useful. Remember- small areas of information you don't fully understand YET.

Next post- "critical thinking" in medicine

Not doing well.......

Very often medical students (from various medical schools) tell me that in spite of working hard they find it difficult to do well. Most of them were high acheivers in school. Well, I don't have a magic formula for sucess, but here are a few things that you might want to look at.

• Language-most medical textbooks and medical journals are written in English. So, it follows that you must have a very good command of the language. Your language abilities should be close to that of a first language speaker/user. Make use of every opportunity to improve your language skills.
• Understand your educational background- most of you (students educated in Asia) probably come from a system which almost entirely emphasises rote learning. The main goal is usually not "to be educated" . The goal is to score a string of A's by any legal means possible! That being the case your previous educational experience does not prepare you for university type learning.
• Exam oriented learning- in medical school you are in effect learning a profession. The end goal is to be competent or rather provide proof of competency. This being the case the "mugging/ cramming" type learning stratergy which worked so well in school may not work here. You have to remember in the 5th year what you learnt in the 1st year!

Next post- more on rote learning

Intro

I am starting this blog to help students do better, particularly medical students. With a heavy curriculum, at times it can get difficult for students to figure out why they have done badly in spite of their best efforts. In the main this blog is to cater for students from Asian countries as there is a lot of similarity in the way the various Asian cultures view education.

So please feel free to leave your comments or even requests for topics to be discussed.