A bit of a hot topic to talk about. We’ve all surely been guilty of it.
I think we all need to have a conversation about cramming, why it happens and what we can do about it.
It’s okay to cram information into your short-term memory as the exams near, however laziness throughout the whole year is another story. The effects of cramming are fatal. Not only will we touch upon the mental aspects of it, but also how much of a deficit it is for your future career.
The yearly content a medical student studies is extremely high. There’s no doubt. I believe a systematic routine is a better approach for productivity and efficiency throughout the year. I’m not forcing everyone to have beautifully organized schedules to go through their day but treating medical school like a work routine provides a different way of seeing the workload in medical school. It really is like a 9-5 job. That doesn’t mean it has to be miserable. The point I’m trying to deliver is that our focus needs to be more on the system rather than the goal (Atomic Habits, James Clear). We are all so carried away by our ambitions, our goals, what we want to be, but don’t put the effort to curate a system, an environment for that goal. Our outcomes should be focused less on results and more on our identity. Ultimately, who do we want to become? The lazy, unmotivated student who procrastinates all year and tries to cram in old work during prep leave. Or the student who keeps up with their content load, stays organized, and puts the effort into creating a study routine every single day. These are two different identities, but BOTH may have the SAME goals. When we consider the effects of cramming, it doesn’t only apply to medical students, but is a universal phenomenon. Many students get dragged into a vicious cycle of unproductivity and a guilt-ridden mindset around studying. The cycle fuels itself until a deadline, an exam date or another trigger stops it momentarily. But even that is problematic because the momentary motivation soon disappears with the work that has piled up thus far. This further leads to feelings of guilt, disappointment, and stress. It is not only damaging to one’s mental health but also to the result. We can’t expect to pass an annual exam and study for three days. Sometimes, we get lucky, but there’s no guarantee for this. I believe it to be an important skill to organize yourself around your study needs. Although cramming can benefit at times, there’s no guarantee for its success. The ramifications of this include the ambiguity of the result, a buildup of stress, lack of information, feelings of imposter syndrome, disorganization, and unproductive feelings that feed on a continuous cycle.
The effects of this are particularly seen in Viva where students are asked questions orally. Often, the examiners will dive deep into mechanisms behind concepts, and cramming in a short period of time can only provide so much background context. Students get stuck at questions, unable to explain detailed processes/concepts that may require some abstract or critical thinking. This can take a toll on confidence levels, as well as self-esteem. I’m not trying to frighten anyone here, although I am trying to provide a perspective in its authentic form. An interesting way to explain this has been presented by MD Prospect: a student who has been working every day for a couple of hours cannot be compared to someone who’s trying to cram in the last month of school. The second student will never be able to reach the level of the first student no matter how much effort, strategies or thinking they put into their studying. It can only do so much. It might be enough to pass the exam but could cause problems later when the knowledge must be applied clinically or becomes relevant in other subjects in the upcoming years. Not only that, these things become bad habits. This becomes a part of a student’s identity. When we commit to certain habits, we are essentially choosing an identity for ourselves (Atomic Habits, James Clear). We are creating the system to allow for these bad habits to grow and flourish. The change starts with our identity, our mindset. It’s not our goals that matter, but who we want to become. This doesn’t mean we have to make our lives miserable with routines. The reason they become miserable is because the system isn’t in place, or the identity conflicts with the outcome. A smoker can’t quit smoking unless he decides that he’s not a smoker anymore. The thought process behind goals is as such that the result matters so much more than the process, and that at times can be toxic. Why? Because when there’s no success, it feels pointless. So, we stop after a couple of days of trying. That’s why most good habits fail to be continued. The system is broken, the identity conflicts with the current one, and the consistency is not there. When we start observing our identity and what we want to align ourselves with, we will notice why we’re so comfortable with our bad habits. It’s because we’re not ready to let them go, to become someone different. We hold onto these comfort zones to feel secure, stagnant, and align with our identity. Most students enforce heavy study schedules upon themselves with reachable goals, but no commitment to changing who they are, so it lasts temporarily. A routine lasts a lifetime, it reflects our repetitive behavior (habits), which in turn reflects our identity. When these don’t align, our bad habits remain stagnant. So, what’s with cramming? It’s a problematic habit. It has nothing to do with motivation, and everything to do with your identity and system. There’s no reason to live without goals, they provide direction, but outcomes that have a direction, but no commitment will never go through. Our brain loves comfort, and as much as we want to hold onto this, we need to break through these subtle temptations to gain personal autonomy. It is imperative to our growth as human beings.
To take this conversation to the initial question, I would say No. This is not to say don’t study the day before the exam, in fact I would encourage a bit of cramming before your exams. There are too many details and we all need a memory refresher. However, I would advise against doing this most of your year. The roadblocks in the first couple months of medical school are understandable and we all get dragged into a phase of imposter syndrome and unproductivity. That’s not to say that we can’t have these humane phases in life, but what happens majority of the time?
There’s no magic formula; it’s a trial and error process. It’s not the same journey for every person, and it doesn’t have to be.
Stay Humble
Medtasticdays