Learning Medicine by Remembering Everything

by Paul on May 4, 2011

Learning medicine requires assimilating gobs of information by reading and re-reading texts, sitting through lectures, and hands-on experience with patients. But if you ask Joshua Foer, freelance journalist and 2006 USA Memory Champion, you’ll hear a different explanation for how we learn. In his book, Moonwalking with Einstein: The Art and Science of Remembering Everything, Foer explains how he went from covering the USA National Memory Championship as a journalist, to winning it a year later, and along the way reveals that expertise in most fields has mostly to do with memory — memory which can be developed.

I know, I know, it’s a little insulting to think that your doctor or PA is just someone who has memorized a bunch of stuff, but Foer makes a strong argument (drawing on neuroscience and memory research) that in some interesting ways you might not realize, that’s what they are. No, they didn’t mindlessly run through flashcards for years and *poof * become bright clinicians. Their memory developed through experiences that built on one another until they became easy to remember because they formed a web of interrelated items, each reinforcing the other. Most importantly for medical students, there are ways hamper this process, and ways to ramp it up. As Foer’s experience proves, your memory can be trained, and with practice you can remember everything*

I started reading his book because I thought, “Geez, if I were better at holding on to the things I learn in class (beyond and exam), I might put them to great use - and maybe even shorten the wait to becoming a good clinician.” It’s something that medical students talk about all the time — they get discouraged about how hard it is to take everything in in a way that will keep it there for any length of time.

Don’t think you have a good memory? Join the club. Foer’s memory was mediocre at best when he started, but with training, he was able to memorize the order of a deck of cards in 100 seconds, among many other impossible-sounding feats which definitely do apply to medicine. I highly recommend his book for premeds and pre-PAs. It explains in fascinating detail how your memory works and how you can expand it.

(Also available in audio format from iTunes, audible.com, amazon.com, and all the other big bookstores that I can’t remember right now).

*Okay, maybe not everything, but definitely far more than you do right now.

Louispaladino May 5, 2011, 11:35 am
I think the book looks interesting, and your review overall is encouraging, but I don’t really understand the point of the deck of cards reference. How long could one retain that info? Why would one need/want to memorize something that quickly? I feel like without more explanation, it makes the book seem like a collection of tricks and fluff. Could you elaborate when you have time?

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- Paul May 5, 2011, 9:16 am
  It’s a fair question, Louis.
  No, memorizing a deck of cards in a minute and a half is a gimmick that demonstrates what a trained memory can do. But there are other feats that may be more relevant to medical students. Memorizing poetry or faces might not seem useful, but they use poetry in the competition because it’s verbal and not so logical, and faces because they are entirely visual. If you can memorize poetry quickly and accurately, you can remember drug interactions, side effects, and what we call “pathognomic” features of diseases (signs or symptoms that make a certain diagnosis highly likely, such as Koplik spots in measles.) If you can remember the names of many faces, you can also remember how a vertical mattress stitch looks compared to a running stitch, or the appearance of granuloma annulare compared to pityriasis rosea). I can’t claim to have mastered these skills yet, but they have already changed how I study. Rather than relying so much on repetition, I’ve begun to concoct elaborate (and unforgettably bizarre) stories to seal those memories in for much longer. The fairly famous memory palace technique is also helpful. Probably my favorite part of the book is its discussion of what makes a chess grandmaster better than a very good chess player. Research described in the book makes it clear that these people aren’t much, if any, smarter than the rest of us. But they have a memory bank of games that gives them insight that they don’t even realize. The book isn’t just about cramming tons of useless crap into your gourd. It’s a kind of a user’s guide to memory. If you know how your memory works, you can maximize its potential. Clearly, some won’t find it useful. But for those who are always taking in new ideas and applying them to enrich what they already know (like me) it’s a fun and helpful read.
  
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neard September 4, 2012, 7:58 am
hey, i have just used this method in medicine, it works really well. but now im in clinical years, so i need to know all the differentials. can you give me a detail examples of how you make mental images regarding a disease, symptoms, side effects, treatment, etc. and also how you make it to study pathology and microbiology. i can build the pictures, but i really need to know how to organize it, there must be some pattern

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- Paul September 4, 2012, 9:18 pm
  I did pretty well by trying to picture a particular patient with each disease. If the disease was more common among Mediterranean males who were overweight, that’s what I would picture. If I had a friend or family member who had a particular illness, I would try to picture them. As in the memory books, picturing absurd images helps to make the memories “stickier.”
  
  Instead of memorizing differentials, try to learn the different pathologies in groups, such as learning the most common seronegative spondyloarthropathies (rheumatoid conditions that test negative for rheumatoid factor), or learning the major infectious skin conditions (staph, impetigo, tinea, viral exanthems, etc.) When you learn the major disorders in a group, every time you think of one of them, the others in that group won’t be far behind. It also helps if you’re going to memorize to do it in groups of three. The three most common differentials for chest pain, the three most common differentials for vertigo, etc. Sure there are many more than three causes for many illnesses, but you need to start with the most common. Once you learn those, it’s easier to learn the less common ones.
  
  I wish you luck. Please let us know if you come up with any good systems.
  
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Sandy April 5, 2013, 8:37 pm
One way I have learned is through using acrostics. An example from Wikipedia shows an acrostic poem in English written by Edgar Allan Poe (ELIZABETH):

Elizabeth it is in vain you say
“Love not” — thou sayest it in so sweet a way:
In vain those words from thee or L.E.L.
Zantippe’s talents had enforced so well:
Ah! if that language from thy heart arise,
Breath it less gently forth — and veil thine eyes.
Endymion, recollect, when Luna tried
To cure his love — was cured of all beside -
His follie — pride — and passion — for he died.

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Learning Medicine by Remembering Everything

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