[Music]
what is up guys karma medic here and
welcome back to another dose
in today's video i want to talk about
how it is that i take my notes as a
fourth year medical student studying at
king's college london because i've
realized this has changed quite a bit as
i've progressed through medical school
i'm gonna break up this video into two
parts the first of which is showing you
and explaining to you how it is that i
take my notes and why i think that my
note-taking method is valuable and then
in the second part of the video i'm
gonna run through some real-time live
examples of me taking these notes so
that you can see how it is that i do it
so now as a fourth year medical student
i'm currently two years into my clinical
rotations
two years of being in the hospital
talking to patients carrying out
physical tasks and clinical exams
and so the vast majority of my learning
comes from being in that physical
environment so the vast majority of
knowledge about diseases their
underlying pathologies
treatments and things like that i should
have already learned and studied in my
first three years of medical school and
the evidence for me having learned and
studied all this knowledge is hundreds
and hundreds of handwritten notes that
i've taken on my ipad which i've
uploaded to notability and synced across
all of my devices so that the
information is readily available to me
whenever i need it now what i usually do
year after year is once my lectures and
tutorials start i listen to or watch
them and then start taking handwritten
notes again
on my ipad after i write down my lecture
notes i would read and study them and
then write a condensed version of those
notes
read and study the condensed version and
then again write down another condensed
version of those notes and repeat the
process over and over again until i've
distilled my notes down to just the most
important facts and pieces of
information now the good thing about
this technique is that one
it reinforces my learning and memory by
forcing me to physically write out the
information each time
and two that's pretty much it the
negative things about using this
technique is that as i'm sure you know
if you've written lecture notes before
it takes a long long time
and i've actually already written this
material somewhere else in my
handwritten notes if you take any one of
the major clinical diseases in medicine
for example
rheumatoid arthritis copd heart failure
diabetes any of these major topics i've
probably written notes on them
at least four or five times in
completely different places and so now
if i'm writing down notes on those
topics again i'm just duplicating them
i'm repeating effort that i've already
done before
and then the third bad thing about this
method of note-taking is that it's
extremely extremely passive it involves
very little
active learning you have to really force
yourself to think about what it is that
you're writing out
in order to have that active component
of learning as a result of all of this
when i started my fourth year of medical
school i decided that i was going to
take
no more handwritten notes no more
rewriting the same topic
disease pathology whatever over and over
again so this brings me on to my active
method of learning now in my fourth year
of medical school which is doing past
paper questions and reviewing old notes
that i've written in notability
so at this point i'm using information
that i gain from past paper questions
and from already existing
banks of knowledge that are already
there on the internet i'm literally copy
pasting them into my own categorized
organized method of notes and learning
from there i've decided that rewriting
out all that information for me
personally i think is going to be a
waste of time now this begs the question
of why do i think that past paper
questions are the best way for me to
learn as a fourth year medical student
first of all they forced me to actively
recall pieces of information that i've
already learned before that are stored
somewhere deep in my brain
if i read a question and then google the
answer and write it down that's not
going to make me actually think about
the question and try and retrieve that
information from my brain
going through that process of trying to
dig through the information in your
brain
is what helps build those strong
connections with that factor with that
knowledge or with that explanation or
whatever it is that you're trying to
remember the second thing is that past
paper questions are
extremely relevant and hyper focused
around two things
one what it is that i need to know in
order to pass and excel in my medical
school exams
and two most of the information is
directly relevant to what i need to know
for clinical practice as a future doctor
the reason certain topics are frequently
tested in question banks and in past
paper questions
is because those are the topics that are
going to be most important for clinical
practice in the future now i know
there's obviously a whole bunch of
questions that are purely memorization
based factory call etc most of the
questions that you'll find in a question
bank are actually good
fair questions that get you thinking
about different presentations
differential diagnoses clinical exams
whatever it is
the third thing is that past paper
questions or question banks really help
you cut through the noise of all the
information that exists in medicine for
example
this is a book that's probably quite
common within medical circles it's
called clinical medicine by kumar and
clark this is the big version
it is absolutely massive and huge now
i'm sure that all of the information in
this book is very interesting helpful
and useful
but in terms of what you actually need
to know in order to practice good
medicine as a doctor in a hospital
it's not every single thing that's in
this book and so what i find past paper
questions really help do is cut through
this noise and tell you what are the
most important things that you need to
focus on for example if i realize in
past paper questions that
the topic of heart failure comes up very
often then i will know that heart
failure is an important topic of course
having been to the hospital i know that
there are a lot of patients with heart
failure
and so what i can do is i can go to the
heart failure part of this book and i
can read it in intense detail but a lot
of the other things in this book like
poori faria
cutanea tarda i don't need to know in
this much detail i need to know very
simple facts and pieces of information
about
which question banks will do very well
for me so yeah past paper questions
really help you narrow down and focus on
what the most important what the most
common topics and diagnoses and diseases
are and then the fourth thing is that
question banks have a lot of metadata
that no other type of studying provides
for you what i mean by metadata is for
example
how well you're performing against the
average student who's taking the exact
same questions as you how well you're
performing in different sections or
systems of the body
rest cardio endocrinology whatever you
can even see your progress over time and
it sort of helps you identify what your
weaknesses and your strengths are if you
find that you're scoring 19 95
in the cardiology section but maybe 60
or 70 in rest
then you know that you need to read up
more and study more on the respiratory
section and then some question banks
like the one that i use even has a
comment section and the great thing
about a comment section is that it is a
collection of students going through the
exact same thing as you
if you found that question hard to
answer then chances are a bunch of other
people did too
and then people who didn't find it so
hard to answer will comment letting you
know what their methods of memorization
or what their learning and understanding
is of that topic
and i usually find that the comment
section is very very helpful it also has
some great banter which i'm sure we'll
see later on in the video i've always
known this as a student but as i enter
my
eighth year oh god eighth year of
education across two different
universities i realized this more than
ever
which is that studying lecture notes
tutorials talking to your friends
watching youtube videos whatever it is
is about half of the work it's half of
the studying that you need to do the
other half
is actually putting all of that work and
studying into practice by doing practice
questions or past paper exams and quite
simply for me the single biggest regret
i have for when i wrote my usm lee step
one earlier this year in the summer is
that i didn't do more practice questions
because i know
for a fact that if i had done more
practice questions i would have scored
better than i did all right so that's
the end of my ramble about why it is
that i think past paper questions are an
excellent way to study for medical
school exams
now let me show you exactly how it is
that i do this
all right so this is my note-taking
method as a fourth year medical student
i've got past medicine which is a
question bank on the left half of my
screen
and notion which is where i harbor all
my notes on the different conditions
that i need to know in medical school on
the right half and a big thank you to
notion for sponsoring this video if you
don't know notion is a completely free
app that you can use to organize pretty
much anything in your life whether
that's your projects your schoolwork
your to-do lists literally anything i
personally use it to manage my entire
youtube workflow from coming up with
ideas scripting them
writing down notes from my podcast i
also use it for everything to do with my
medical school keeping track of lecture
notes to-do lists bigger projects essays
research work etc
and also my daily to-do lists my larger
life to-do list and bigger projects i
use the app
every single day and find it extremely
useful if you want to try out notion for
yourself i'll leave links in the
description down below where you can
download it and try it out for free
thanks again to notion and back to the
video one of the best things about this
question bank is that they have a
textbook within this textbook you can
click this button over here
and it will actually sort pieces of
information based on how important they
are
or how often they show up on exams now a
lot of you might be thinking yeah nasser
these do show up less often on exams but
they're also important for clinical
practice and you should know them as a
doctor and i completely agree with you
however at the same time the things that
show up more often on exams are the
things that are more important or
relevant for clinical practice because
they are more common or
important in clinical practice so if
you're pressed for time for an upcoming
exam or you need to be as efficient as
possible in your studying sorting out
the information that you want to review
like this is a good way of doing that so
as you can see here on the right i have
all the different topics or systems that
i need to know for medicine organized
quite neatly into these different pages
and within each of them i have
subheadings and more pages with more
information on each of these specific
topics now all the information that you
see here
pretty much everything that has been put
into these different categories has been
directly copy pasted from the past
medicine question bank
and the review textbook so within each
one of these pages i'll read through the
information try to understand it and
figure out what's actually going on
highlight different pieces of
information put things in bold use
different colors
whatever it is i need to do to sort of
help refresh my memory on this topic or
learn it from scratch
and then usually at the top as well i'll
write things in my own words what i
think was most important that i took
away from this information and this way
the vast majority of the studying that i
do is active it's reading questions
thinking about information trying to
fit different pieces of the puzzle
together and then the note-taking aspect
is a much smaller percentage of my time
i think this will probably be a lot
easier if i just show you so let's get
started with that see this first
question
what blood results would be in keeping
with your suspected diagnosis you
suspect he may have hemochromatosis and
take some bloods
alright so hemochromatosis is what it is
a condition where you have
excess levels of iron in the body you
have too much iron in the body and you
can't store it properly
and so it leaks into places where it
shouldn't be for example the testicles
or the liver and i think in the brain as
well so it can cause some neurological
problems what blood results would i
expect with this
so transferrin is used to transfer iron
around the body if we have
tons and tons of iron in the body we
have an overload of iron then i'm going
to say that transferrin is going to be
high
ferritin ferritin is the storage of iron
in the body
if we have an overload of iron i'm going
to expect ferritin to be high as well
tibc refers to how much the body is
looking for iron so if we're iron
deficient then tibc will be high that's
what i remember so now it must be low so
transfer in high fahrenheit and tibc
low nice that way i've sort of worked
through the question i've managed to
arrive at the right answer which is
great especially since i'm doing this
live
on camera so the first important thing
that happened there is i had to think
really long and hard about a whole bunch
of different
aspects of medicine in order to arrive
at the right question if i was simply
taking notes on hemochromatosis okay
hemochromatosis is a lot of iron
a lot of iron means you'll get these
blood levels then i won't be actively
thinking about the information i won't
be trying to suck it in and absorb it
and learn it and remember it now that
i've learned this very valuable piece of
information
i know that we're talking about
hemochromatosis so i'm going to go back
to my
conditions and i'm going to put in
hemochromatosis hemochromatosis is what
kind of fits in a lot of different
places but let's go with metabolism so
the first thing that i do is i copy
paste all this information
that the question bank provides me with
on hemochromatosis all right as you saw
when i was answering this question
i already know a decent amount about
hemochromatosis and enough
in order to answer that question
correctly so all these notes here i'm
going to read through but i'm going to
scan through them i'm not going to read
them in super intense detail i'm not
going to try and like understand every
single aspect of it
if i read something that's new that's
different that i haven't heard of before
or that i think is important
i will write it up over here in caps
lock at the same time i'm going to
highlight pieces of information here
that i think are important so let's do
just that so what was the main learning
point
about this okay investigations will show
so those are the main lab results that
i'm going to see and i'll highlight them
in
i don't want to do green i want to do
red or yellow actually for
investigations
so i know that this is the important
information that i took away from this
question so now i'm going to read
through the information and look for
other important things that i need to
know
sort of iron absorption metabolism i
guess i put it in the right in the right
place
caused by inheritance hfe okay on
chromosome 6. so anything that i
highlight
in yellow has to do with investigations
anything i highlight in green has to do
with treatment or management anything in
red is something very important and
anything written in caps lock or bold is
obviously something very important as
well now you'll see as i go through my
notes i try and do this color coding as
often as possible but
i'm not going to lie some of the times
i'm just really not bothered i'll
highlight a piece of information and
color it something whatever the color is
just so that i can have it colored and
know that it's important in the future
so that's just a quick example of how i
would take the information that i
learned or that i already knew
from a past paper question and put it
into my notes the last thing i do before
i move on to the next question is i
check the comment section but there's no
comment section on this question so
on to the next one all right so again
starting with the final sentence of the
question
given the likely diagnosis which imaging
is like to be diagnostic i can't answer
based on the sentence so i need to read
this first what's going to be diagnostic
so sensorineural hearing loss means it's
not conductive it's something to do with
the nerves
anything that sort of doesn't show me
soft tissue connective tissue
type things is not going to be very
useful for me autoscopy you're not going
to be able to see anything to do with
sensorineural hearing loss doppler
ultrasound is going to be for blood flow
unless there's not enough blood flow to
unnerve i'm not sure that's going to
help me too much
x-ray of the head is going to show me
physical structures so
don't think that'll help either i think
it's either ct head or mri of the cpa
i know that this uh piece of anatomy is
involved in hearing loss
but i'm trying to remember why it's for
a schwannoma so a brain tumor that grows
at this specific place can affect
hearing loss or it can affect hearing
loss
the only thing is i would expect this
stem to be showing me or leading me
towards something that shows that this
patient might have like neurological
symptoms because of a mass growing in
her brain that would lead me to a tumor
gonna go with this great happy i knew
that and there we go the main important
learning point here is that acoustic
neuromas
i think otherwise known as schwannomas
are best visualized by an mri of the cpa
so
i got to the thing that they were trying
to get me to look at or think about in
this question and again
i had to actively recall that piece of
information from
something that i did while i was
studying for my step one exam
so let's see if i can find that
neurology so somewhere in these notes i
will have written about the cerebellar
pontine angle
a schwannoma in the brain schwannoma
classically at the cerebellopontine
angle so i have these notes somewhere
i've written them down before and i
don't want to go and keep writing it
down a hundred times here we go hearing
loss tinnitus and ataxia the
stem mentioned hearing loss and tinnitus
and i said that i
wish the stem had told me something else
some other neurological sign that would
indicate a tumor in the brain which is
ataxia so i know this information i've
written it down before i've learned it
i've studied it and so i don't want to
go ahead and keep writing it over and
over again now what i'm going to do is
take away this
very important information so a
vestibular solanoma is
a tumor but i wouldn't necessarily put
it under my categories of oncology
because that's more for
like cancers cancer cancers so instead
i'm going to put this in neuro
under tumors and i don't think i have a
page for tumors so i'm going to make a
new one
like i said i know almost all this
information already so now i'm just
going to read it i'm going to scan
through it and see what i think is most
important
so ninety percent of cerebellar pontine
angle tumors very important because
that's how i arrived at the answer to
the question classical history is
vertigo hearing loss tinnitus and an
absent corneal reflex so that's part of
the triad from my previous notes that i
didn't have
now this is quite important which i
hadn't remembered properly so it can
affect these cranial nerves 8
five and seven so again since this is
important i am going to highlight it and
now i'm going to read it and try and
understand it and remember it so
now another piece of information that i
know is important because i've studied
this before is this here so i'm going to
highlight it i know it's going to come
up on the exam at some point this is
quite good management
urgent referral to ent it's likely to
come up on my exam so i'm going to
highlight it as well so like i said last
thing that i do is i check the comment
section because either there's going to
be something really funny which is going
to make me laugh and make studying this
a little bit funner or
there's going to be some useful piece of
information there written by other
students that i can use in my own notes
so can someone explain why this can't
just be meniere's disease i didn't even
consider meniere's disease as a
differential diagnosis
maybe i should have because 14 other
people also consider this to be
meniere's disease
so let me read about why it might be
that differential you expect to get all
other symptoms veneers oral fullness
episodic in nature distance vertigo
sphere
patient can't function okay so probably
the reason i didn't consider it as a
differential is because it was missing
all these things
however now i can go to my meniere's
disease note
where i say ear nose and throat here and
here's
the disease put the information here and
so now i have written
more notes and added more notes to some
other topic that i hadn't even
considered before
alright and then you usually also get a
couple salty comments from people who
think that the question wasn't good
honestly i don't care if the question is
good or not if it's in a question bank
if it's a piece of information that i
need to know there's no point being
salty or not either know it or i don't i
learn and i move on now that we've seen
the comment section we can move on to
the next question i think i'll do one
more question on camera and then we'll
call it for this video because it's been
getting quite long okay since this
question is very similar to the first
one it might be something different but
since it's similar i'll do
i'll do a different one all right so i
see a picture what's the most likely
diagnosis
kind of need to read this time i'll be
honest with you i have absolutely no
idea polymorphic eruption of pregnancy
never heard that before pumpholics i've
never heard that before herpes
gestationus
never heard that before it sounds made
up but usually when something sounds
made up it turns out to be the right
answer anyway lycan planus i think is
more of a vaginal disease not around the
umbilicus i'm guessing either way so
let's let's just go with this word that
i've never heard of before okay
it was wrong 72 got it right here's a
good example of a question i've gotten
wrong where i knew absolutely nothing
about
what this was so i'm going to go down to
the bottom what is this topic skin
disorders associated with pregnancy so
i'm going to go to my absent gynae i'm
going to go under obs
i'm going to write page
skin conditions all right associated
with pregnancy so
i'm going to copy paste this information
and i'm going to read through it and try
and learn it and understand it atopic
eruption of pregnancy
72 of people who answered this question
got it right so clearly it's
more common knowledge than i would have
expected that i thought so
i'm going to put it in bold and i'm
going to highlight it because clearly
it's important management
is usually asked about so i will put
this here and i guess this is an example
of what it looks like
the important thing is that i've learned
a new piece of information okay i've
highlighted or made in bold whatever i
think is important
and so now next time pregnancy skin
condition comes up
i will hopefully have some information
about it to help me answer the question
so that's everything that i wanted to
talk about in this video
hopefully i've explained why it is that
i like to use question banks and notion
as a note-taking method in my fourth
year of medical school and why i find it
valuable and hopefully you've also seen
how it is that i read and interpret a
question extract important information
and take notes from them if you've got
any comments or feedback or there's
anything you'd like to let me know
please do in a comment down below
otherwise i'll catch you in the next one
peace
[Music]
let's wait for the ambulance to pass
okay i think it's far enough this is
what happens when you don't record a
video for a couple of weeks
no emails go away go away i'm explaining
things now
going i don't need you right now
progressive cerebellar hv in first year
of
life telangiectasia skin lesions dilated
blood vessels and ears nose face neck
icy immunocompromised so increased
infection
all right so i can still read these