Back when I was in medical school, studying for a big exam meant holing myself up in my room for 48 hours straight with no contact with the outside world, eating pizza for breakfast and frozen waffles for dinner, drinking massive quantities of caffeine, taking intermittent breaks to watch TV or surf the internet, and only seeing the light of day through my window. For me, cramming was very effective to learn a lot of material in a short amount of time for an upcoming exam, but I felt that I never learned the material quite as well and what I learned didn’t stick in my long-term memory. Also, cramming like this was not particularly healthy.
Once I had kids, it really didn’t work anymore. Having 48 hours to myself became an impossible luxury. Actually, even 2 hours without someone asking me for a cup of milk would be nice.
Fortunately for me, it’s rare that I take exams anymore. But medicine is a field that requires you to constantly learn and keep up, so just because I’m not studying for the boards right now doesn’t mean I don’t have to continue my education. Unfortunately, after a full day of work, followed by picking up the kids, feeding them, bathing them, and singing their bedtime songs (“again, Mama!”), I’d much rather settle down with an episode of The Big Bang Theory than pull out a textbook and start reading.
So how does the mother of young children keep up with her education?
Here are some strategies that have worked for me:
Look It Up As You Go
When you hear about something that is unfamiliar to you, look it up immediately. Since it would be rude to whip out your smartphone in front of a patient, wait until you’ve left the room.
My strategy for learning in the moment is to look up information as soon as I’ve left the patient. I open up a browser window on my phone and type it in, so I won’t forget to read about it the next chance I have a free moment. That moment may come when I’m waiting for a meeting to start, if I have downtime between patients, or when I’m grabbing a bite for lunch.
Sometimes I also look up information immediately before seeing patients. Recently, I saw a patient who presented with suspected leprosy. That’s something we don’t see a whole lot of in this country in this day and age, so my knowledge base on the topic was admittedly small. Before going into see the patient, I took time to read about the diagnostic criteria and symptoms, so I would know what leprosy lesions looked like, and I could correlate what I had just read with what I was seeing in front of me. It also allowed me to be able to feel more qualified to answer the patient’s many questions.
Resources for Your Smartphone
Looking things up on a smartphone is really the easiest way I’ve found to learn on the go. My favorite app is Epocrates for looking up everything you could possibly need to know about drugs, such as which antipsychotics prolong the QT interval or what new medications will require an adjustment in your patient’s Coumadin dosing. This is a great resource during practice or while you’re studying for the boards. While I use the free version of Epocrates, there’s also an upgrade that includes clinical practice guidelines, diagnostic tools, treatment guides, and lab tests.
Even more often, I use the website eMedicine, which has detailed information on every medical condition in an easy-to-read and accessible format. UpToDate is also a great resource, although you will need a subscription.
Also, don’t disregard good old Wikipedia. A 2005 study in the journal Nature found that the accuracy of Wikipedia was comparable to that of Encyclopaedia Britannica. There have also been studies in the Guardian, PC Pro, Library Journal, and several peer-reviewed academic journals in which Wikipedia fared well. For instance, Seminars in Dialysis published “An evaluation of Wikipedia as a resource for patient education in nephrology” in March/April 2013, and wrote “Wikipedia is a comprehensive and fairly reliable medical resource for nephrology patients that is written at a college reading level.” Psychology Medicine published “Quality of information sources about mental disorders: a comparison of Wikipedia with centrally controlled web and printed sources in August 2012, and wrote “The quality of information on depression and schizophrenia on Wikipedia is generally as good as, or better than, that provided by centrally controlled websites, Encyclopaedia Britannica and a psychiatry textbook.” That’s high praise! One caveat found in some comparative studies is that Wikipedia articles are sometimes incomplete. A study in Annals of Pharmacotherapy, December 2008, “Scope, Completeness, and Accuracy of Drug Information in Wikipedia,” noted, “Wikipedia has a more narrow scope, is less complete, and has more errors of omission than the comparator database [Medscape].”
The most prudent thing to do is to consult several websites to get complete and thorough information on a topic.
Participating in CME (Studying for the Boards or Not)
There are tons of great conferences to earn CME credits around the country and abroad. But since traveling can be difficult when you have young children, you can get plenty of CME credit without leaving town.
I’ve been to several lectures at local medical schools and earned up to 30 CME credits at a time — and I was still home in time for dinner. Staying local is a great option, and there’s usually excellent food available for breakfast and lunch!
If going to lectures isn’t your thing, there are plentiful CME activities online. I recently completed a thorough review of Physical Medicine and Rehabilitation through Oakstone, watching videos online on my iPad, covering topics such as multiple sclerosis, stroke, neck and back pain, and sports medicine. Another excellent website for CME activities that offers credits specific to the CME requirements for each state is NetCE. This can be incredibly helpful if your state has a stringent risk management or pain-management requirement (like my home state of Massachusetts does).
Finally, make sure you join the academy for your specialty. Not only will this keep you abreast of any conferences to attend, but often the websites offer a variety of free or discounted learning activities if you are a member. My specialty academy, the American Academy of Physical Medicine and Rehabilitation, offers dozens of self-assessment exams, case studies, and journal CMEs.
Being a mother of young kids has forced me to find ways to keep current in my field using methods that take up only a small percentage of my time. I’ve found that I can use these strategies for lifelong learning — and I’m sure they’ll give me a leg up when I eventually have to turn to studying for the recertification boards in only 5 short years — my first MOC exam. After all, I won’t ever be able to go back to those med school cramming days… and I don’t want to!
Sara Cohen, MD, is a staff physician at Braintree Rehabilitation Hospital.
This post is part of the “Lifelong Learning” series. Read about a mid-career perspective on lifelong learning in medicine by Dr. John Mandrola, a clinical electrophysiologist and blogger at drjohnm.org and theheart.org, and find out how a busy doctor and mother of three keeps up with core medical knowledge.
Very good post . Thank you.
Keep learning outside the boards prep is important to keep up dated and understand better what one learned under pressure . There are many possibilities these days .
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