How I’d Make the Jump From Sixth Form to Medical School Now

articles Med School

One of the first lectures I had at Cambridge (I remember to this day it was one of the first anatomy lectures we had on the muscles of the flexor compartment of the forearm!) took me several hours to turn into handwritten notes.

By the time I had finished, I had used roughly as much paper as I would have used for an entire topic of A-level Biology.

This was not sustainable.

The problem was that I had arrived at medical school with a revision system that had worked extremely well at school. During A-levels, I made almost entirely handwritten notes, guided heavily by mark schemes and the questions that seemed to come up repeatedly. I did as many past-paper questions as I could and used textbooks mainly to find gaps in my knowledge before an exam.

It worked. So naturally, I assumed some scaled-up version of the same system would work at university.

It didn’t.

By Christmas of first year, I did really bad in my mocks. That was probably the point when I properly realised that the answer wasn’t simply to spend even longer making notes.

I needed to change how I was learning.

For me, the jump from sixth form to medical school was the biggest academic jump I had made at that point. There is obviously much more content, but I don’t think the volume is the most important difference.

In my opinion, the rules of the game change.

The biggest mistake you can make is assuming that the study system that got you into medical school will automatically get you through it.

You don’t need to have everything figured out before you arrive. I certainly didn’t. A lot of first year is working out what actually works for you.

I can’t tell you exactly what that system will be. But I can tell you what I got wrong, what I changed and what I wish I had understood earlier.

Revise for the exam you actually have

This was probably the biggest change in how I thought about revision.

At A-level, past papers were incredibly powerful because questions and mark schemes were relatively predictable. If you did enough of them, you started recognising the same ideas appearing again and again.

That didn’t translate directly to pre-clinical medicine at Cambridge (there’s a seperate article on doing well at clinical medicine).

There were practice questions, but I couldn’t rely on learning a relatively small collection of repeated answers. The same concepts might appear again, but completely different information within those concepts could be tested.

My first response was essentially to try to learn everything by making enormous sets of notes.

Hence the small deforestation project happening on my desk.

What I eventually realised is that you should build your revision backwards from the way you are going to be examined.

That doesn’t mean learning the bare minimum required to pass. It means accepting that medicine contains an absurd amount of information and you cannot learn every fact to exactly the same depth.

Your assessment tells you what you need to be able to do with that information.

For multiple-choice questions, I found Anki much more useful than handwritten notes. It forced me to retrieve information rather than repeatedly read it, and spaced repetition meant the things I struggled with appeared more frequently. Those underlying ideas — retrieval practice and spacing — are also reasonably well supported by learning research, including within medical education.

But even then, I initially used Anki badly.

I made all my cards myself and, as the year went on, ended up with far too many of them. A lot of the cards were also too long. I would turn one over, see a paragraph staring back at me and immediately feel overwhelmed.

I’m particularly bad at memorising long cards, so I started splitting them into several much smaller questions.

For me, that made recall much easier and made getting through the cards significantly faster. It also taught me another useful lesson: using the right tool badly is still using it badly. Switching to Anki wasn’t the solution by itself. I still had to work out how to make it useful for me.

Essays required something completely different.

At Cambridge, I had essay-based exams as well, where memorising isolated facts wasn’t enough. I needed to understand the larger picture and be able to construct an argument from it.

So I practised essays.

I used previous essay questions to guide which topics I revised in greater depth and relied heavily on insight from my supervisors about areas that were worth knowing particularly well. That approach was specific to the way I was being examined; your medical school may assess you completely differently.

That’s really the point.

Don’t arrive thinking you need to use Anki because medical students use Anki, or make notes because you have always made notes.

First understand the exam. Then choose the revision method.

Have a simple system for everything else

The other big change at university is that studying stops being the only thing competing for your time.

There are lectures and teaching sessions, but also sport, societies, seeing friends, applications, projects and eventually all the random things you decide would somehow be a good idea to take on at the same time.

I’ve always preferred a simple daily to-do list.

I don’t like planning every hour of my day. Some people love time-blocking and it works brilliantly for them; I would rather know what needs to be done and make sure I have done it by the end of the day.

Importantly, my list doesn’t contain my scheduled university teaching. If I have a lecture or supervision, that’s already happening.

The list is for the things I control outside of that: my own revision, personal work and whatever else I need to get done.

And one form of physical activity is almost always on there too.

The system isn’t perfect.

During second and third year I started applying for internships and cold-emailing lots of labs. The number of things I wanted to do expanded rather faster than the number of hours in a day.

So I did what anyone with a to-do list can easily do: put an entirely unrealistic amount of work on it and then fail to finish it.

A to-do list is only useful if it helps you decide what matters. It becomes much less useful when it turns into a written record of everything you feel guilty about not doing.

The exact system doesn’t matter that much. Time-block if you like time-blocking. Use a calendar. Write three things on a piece of paper.

Just have something.

University gives you far more control over your time than school does. That freedom is great, but it means nobody is going to design your day for you.

Medicine shouldn’t take up your whole life

For me, the non-negotiable was exercise.

At Cambridge, that was mainly badminton and the gym, and I tried to do some form of physical activity almost every day.

I genuinely think exercise is one of the best drugs you can take.

That is obviously my slightly excessive way of putting it, but the broader evidence is very much in favour of being active: current UK guidance recommends regular physical activity for both physical and mental health, and research also suggests benefits for cognition and memory, although the size of those effects varies.

For me, though, the main reason was simpler.

It gave me a point in the day where I wasn’t thinking about medicine.

When your workload starts increasing, it is very easy to treat everything outside work as optional. Exercise gets pushed back because you have another lecture to revise. Then another. Then another.

I think that is backwards.

Having something completely separate from your degree built into your week makes the rest of it much easier to sustain.

It doesn’t have to be sport. It could be music, a society, seeing friends or something else entirely. I just think there should be some part of your life where your medical school performance is completely irrelevant.

And that brings me to the thing I probably took least seriously when I first started.

Actually enjoy university

You will worry about exams.

You will probably spend at least some of first year convinced that everyone around you understands something that you don’t.

There will always be another lecture you could revise, another card you could do and another thing you could add to your CV.

But you are also at university.

Join things. Meet people. Try things you have never done before. Go out. Play sport. Waste some time.

You don’t get these years back.

I don’t think the goal before starting medical school should be to construct the perfect productivity system and arrive with every hour optimised. You probably won’t know what works for you yet, because you haven’t actually experienced the problem you’re trying to solve.

I didn’t.

I arrived with a system that had worked before, discovered quite painfully that it no longer did, changed it, got parts of the new system wrong as well, and changed those too.

That process is probably more useful than any single revision technique I could recommend.

So if you’re about to start medical school, you don’t need to have everything figured out.

Get good at noticing when something isn’t working. Change it quickly. Keep the systems that make your life easier. And make sure medicine has an important place in your life without becoming the whole thing.

That is probably what I wish I knew most before I started.