C’s Get Degrees

6th – 17th March

What’s the secret to passing veterinary exams? Hey, if I knew the answer to that question I’d be drinking more Jäger in the city and less Scotch on the sofa. You can’t pass vetmed and have a raging social life.

But every single semester culminates in an exam season, it’s the endpoint, the big finale. From the moment my bum hits the seat in the first lecture, my goal is set: pass the bleeding exams. And since it occupies my mind every second of every day, I wonder why I’ve never given you any insight. So here it is, here is how I muddle through.

Every student has their own way, and mine is not necessarily the best, nor is it the worst. But it’s my way, and you might find it interesting, maybe even useful. It’s not a method built on the advice of others or from a magic study Bible, it’s just where I’ve ended up.

I’m confident that if applicants knew the extent of the workload at vet school, there would be a hell of a lot less of them. And that’s coming from someone who hasn’t started third year yet, when the degree steps up another two gears. Can’t wait. Balanced against the incredible science, the hilarious practicals, and a sense of belonging to a vet school family is a relentless onslaught of information, nights of sleep lost trying to climb back on top of the workload, and an inability to escape the crackling, buzzing, itching anxiety that fills your mind and every inch of your body.

Half the problem with this degree is that there are so many different types of information, all delivered in different ways, requiring different approaches and tested differently in the exams. Anatomy and histology are very visual, physiology is full of numbers and chemical processes, clinical and animal handling skills are very much practical, animal management and public health are very wordy. So I’ve chosen a random topic to represent my predominant learning process: welcome to renal.

So the adventure begins here, in the lecture theatre at Easter Bush:

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I sit in the aisle seat on the third row up in the leftmost block. No ifs, no buts, that is my seat and I expect it to be vacant when I arrive. Although sometimes there’s a mature student there, and I’m intimidated by them so I scuttle up to the next row. The lectures are meant to be 50 minutes long, but often run over. We can have between 1 and 5 lectures in a day and they do what they say on the tin: the lecturer stands at the front and delivers their information. Some of them are far better at it than others.

Unusually for a university degree, we are provided with notes before each lecture, and this is due to sheer volume of content and the importance that the information is accurate. I’ve tried a number of different techniques, but for the most part I end up just sitting and listening, highlighting key words in the notes as I go to keep me a) on the same page as the lecturer, and b) awake. Some lecturers seem to deliver a completely different lecture to the one in the notes, and you just have to roll with it.

What I’m aiming to do in a lecture is allow myself to hear the concepts for the first time and just understand them, rather than try and learn it as it comes. I guess the lecture theatre isn’t particularly my learning environment, it’s my understanding environment. I allow the lecturer to help me make friends with the concepts before I get to know them better in my own time.

I add written comments to the sides of the notes, which allows me to explain to my future self what the notes mean when I inevitably look back on them and don’t recognise any of it. Unless of course the comments I write make no sense either.

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Do you see that note right at the bottom?

I often add lots of large question marks. Everywhere.

Armed with this new information, my next step is condensation. This is the time-consuming stage for me, and it takes determination. You can’t finish a long day and just chill in the evening and go to bed, ready to face the next day. There’s no boundary between the working day at the vet school and the working day at home. I live with another vet, and I know that every day of the week we both get home, beeline to our desks and continue working into the evening.

During this time, I’m taking the notes and whittling them down into a form that I can memorise later on in the learning process. I try to get each concept onto a side of A4, creating sort of a mini poster for it. I strongly believe that if something can be expressed as a diagram, picture, or flow chart then it damn well should be. These posters will be mentally photographed and filed in my mind to be called up when I need them. If I can take three paragraphs of words and express them as a diagram, I can then memorise the diagram and when it comes to an exam question or a tutorial problem, I can then write three paragraphs of words back from it. It’s something of a shortcut that works for me.

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I write in block capitals because my handwriting is appalling, but as you might have noticed, I’ve become pretty good at writing in a straight line. This exercise isn’t just condensation, it’s translation too. In order to turn the information into  a new format, you have to really understand it – it’s not a copy and paste exercise. It’s a thought process. The resulting pages are all organised in the way that information is organised in my mind, and so it makes sense to me this way. When I copy, I just copy, but when I translate, I learn (for the most part).

Colours are also important. Every time I use a coloured pen it’s deliberately chosen because it has connections with particular themes in the page or in the wider topic. A simple example is that on a particular renal page, blue connects with water, orange with tubular fluid, red with electrolytes, and green with organic compounds. Or the connection may be wider than that, for example in my neurology notes red is either connected functionally to motor tracts or anatomically to the telencephalon. Broader still, in endocrinology red is any inhibitory regulatory pathway whereas green is any stimulatory regulatory pathway.

At first this is relatively simple, but I only have six colours. Everything I write down has to be assigned to either red, orange, green, blue, purple, or pink. For the structure of the equine colon, this colour sequence corresponsed to: caecum, left ventral colon, right ventral colon, right dorsal colon, left dorsal colon, transverse colon, rectum. In pituitary axis hormones, it corresponds to: prolactin, thyroid stimulating hormone, growth hormone, adrenocorticotrophic hormone, vasopressin, and gonadotropins. In central nervous anatomy, they correspond to: telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon, and spinal cord. Do you see the problem?

Each colour corresponds to a large array of different structures, processes, substances, and functions depending upon the context. It gets tricky to keep information strands separated, and once they convolute they can become really hard to remember. But colours act as my anchor for connections. Connections, connections, connections. You have to keep information connected to keep it memorable. As well as colour, a bit of Greek and Latin keep my connections connected. If I know the origin of a word, I’ll remember it, and connect it to other words with the same root but in other contexts and concepts. Medical terminology might sound fancy, but in reality it’s a bit of a shortcut.

Connections can be as obscure as the way I try to remember the distinction between two liver enzymes: alanine aminotransferase (ALT) has an L in the acronym, and so I remember this one is almost exclusively expressed in the Liver and so is a more reliable indicator of liver status than aspartate aminotransferase (AST). AST has an S in the acronym and so I remember that this is also expressed in Skeletal muscle among many other tissues, and so is less reliable as an indicator of liver status. I also remember that 13 is an unlucky number, and you’re right unlucky if you need a liver biopsy, so liver biopsies should be taken from the right 13th intercostal space of the horse.

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Bruce

Or take for example the way I reinforced the primary function of the thalamus. Bruce the Conscioos Thalamoose reminds me that the thalamus is the relay switch for afferent conscious sensation and proprioception, as opposed to subconsious, which is cerebellum.

Half the art is spotting those connections in the first place. But everyone remembers better by making connections!

So I spend my evenings and weekends condensing, colour-coding, and connecting information. That can take a very long time.

A day or so after a lecture that contained anatomy there inevitably comes a dissection. Sometimes we’re given an animal or part of an animal to dissect as per the instructions provided, and photograph it for revision purposes. Other times, the room is filled with pre-dissected specimens for us to inspect, touch, photograph, and answer questions about. It’s useful to turn up already having learnt the information from the lecture, but I usually haven’t managed that. It’s a great learning experience, because anatomy is a 3D topic, and to actually see it in real life is the only way to properly understand it.

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This is a section through the renal cortex… apparently

Following a lecture that contained histology, there’s a histology lab session. We set up microscopes, find slides with the tissue specimens we need, and examine them under the microscope. There’s usually a worksheet of questions to complete and most people, myself included, take photographs for revision. As an aside, taking photos down a microscope is flipping difficult. Histology can be a right pain, because every damn tissue in the body looks the same to me all stained pink. On the left is an image I took during my renal histology lab, showing the renal cortex. It might as well be testicular tubules, all looks the same. But we have to identify these in exams, so you kinda have to learn to recognise it.

Right, so then I hit the big milestone: 4 weeks until exams. Other people might do things differently, but 4 weeks is my marker for beginning revision. It’s worth pointing out that we only get one week off for revision before exams, so during the first 3 weeks of my revision period, I’m attending lectures and writing them up in the evening as before, but now also trying to shoehorn in time to go back to the beginning and start revising the course’s material. I don’t always make a written plan, but I’ll have an idea of the relative size and difficulty of each topic, and know that I have to set milestones, e.g. I must start reproduction by the start of week 2 and be finished by the end of week 3, if I’m to revise everything in time.

But making time for revision can be a problem. The lectures during the day and writing them up during the evening has to carry on, so my only option really is to extend the work into the night. I can also try and make my writing-up more efficient, maybe by printing some diagrams instead of drawing them. As it happens, the eight hours between about 8pm and 4am are my cognitive peak. I am most focused, efficient, and productive during these hours of the night, so I’ll start by getting some revision done there. The normal routine of 6-8 hours of work on Saturday and Sunday expands to around 14 hours, breaking for lunch, dinner, and a quick food shop. Once the lectures end, it’s 14 hours of study between around midday to 4am every day for 9 days. I’m not 100% efficient with this time, I get sidetracked and distracted, slow down, speed up, and mess about. But this is the time period I dedicate to working during revision week.

What the hell am I doing with this time?

I’m not educated in learning theory, but I know what has and hasn’t worked for me so far. In first year I entered a bit of a battle with my brain, trying to get it to do things and being frustrated when it wouldn’t. It can be very discouraging when you spend hours on a concept, go back to test your understanding and retention, and you find that it’s all slipped through the net.

I can’t say I never get frustrated any more, because I know that all students have times where they just sit back in their chairs and think I can’t do thisI’ve tried and tried but there’s too much stuff and not enough time. It can feel like one step forward and two back.

But I’ve come to an agreement with my brain now. It’s a quid pro quo, we gotta work together on this. I try to give it things that it needs, and in return it pays attention and tries to hold on to information. I know that it can be done, because hundreds of students before me have done it. So what does it want? Time, repetition, food, sleep, and recall, recall, recall. Now unfortunately there ain’t no rest for the wicked, and time is limited, so sleep has to be backbenched temporarily. Food is easy: I get snacks and eat pretty much all day. Some people argue that snacks distract, but your brain uses most of your glucose, and I can feel it slipping out of focus when it’s not properly fed. Mostly it’s Pringles, but for some reason I really do like peanut butter during revision.

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I realise it’s starting to sound like I don’t listen to anyone’s advice, but my revision habits seem to work despite breaking convention. People often advise that you work for an hour and then take a fifteen minute break. Fine, if that works for you. I find that getting my brain going is like winding the engine of an old car, it takes way too long to get running again. As long as there’s food around, I’m happiest when I just keep plugging away. Breaks for lunch and dinner, and a few trips to the khazi are all that’s needed. That’s not to say I don’t get distracted staring out of the window or googling videos of wobbly kittens and pretending it’s neurology revision.

I know I have a particular hang-up about revising the topics from start to finish. I don’t like to jump from one topic to another. If we were taught renal anatomy, then histology, then fluid principles, then GFR control, etc. in that order, then that’s the order I’m going to revise it in. And endocrine revision doesn’t start until renal is finished. Again, I’ve heard you shouldn’t do that, and that you should keep changing it up to stay focused. But changing it up gets messy and confusing when I do it.

What I do change up is the techniques I’m using to revise it. The key to knowing a piece of information is being familiar with it. To remember details, you have to keep recalling them, but not just rote-learning or parrot-fashion. I build myself quizzes using a free piece of software, which allows me to rapidly and repeatedly cover large topics in just a few minutes. By this stage of learning I’m memorising the details.

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I might also talk aloud, discussing information and concepts with myself or an imaginary examiner. I might redraw important diagrams over and over and over on a whiteboard until I can’t get them wrong. I also have printouts of my dissection images that I’ve labelled, and I cover the labels, try to identify the structures, and then uncover the labels to see if I was right or wrong. None of these techniques are one-time things though, they have to be repeated for the same piece of information a number of times spread over increasingly larger intervals of time.

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The final stage, now that understanding, condensing, connecting, and memorising have (hopefully) been achieved, is answering exam questions. I save these until the last few days before the exams and they serve both to reinforce knowledge, and polish my exam technique and written communication. This can only prepare me for the short answer written exams, not the other ones, but I take every past paper question I can find, or the learning objective from the lectures, and answer them all from start to finish. I set a timer for 10 minutes, because that’s what I’ll have in the exam. I hand-write the responses in a single attempt, essentially simulating exam conditions.

Once the time runs out, I stop, and go and find the poster I made about that topic. If there are things in my answer that are wrong or missing, I’ll make handwritten notes to reinforce those points, and then come back later and do the question again. I keep doing this until all the questions have been answered, and answered fully and correctly. I try and time this to last right up until the night before the first exam. At this point, I’ll go and redo quizzes for my weakest areas to reinforce the details there. After that, it’s pretty much a case of praying.

And so this is how I worked my way up to the AB3 exams just before the Easter break. Those exams followed the same structure as AB1 and AB2 in first year, and the first set of AB3 exams in December of second year: a short-answer paper, an interpretation and MCQ paper, and a spot exam. My results arrived after a couple of weeks, coming in at 85% for AB3. As cobbled-together and unconventional as my revision techniques may be, they seemed to work this time!

I usually write to you about the most exciting parts of my week, because they’re the bits that are worth sharing, but that’s not a complete representation of life as a vet student. This, studying, is what we spend a lot of our time doing. It’s also why I write so infrequently. Don’t get me wrong, the pace keeps me busy, interested, and challenged. And I thought some of you might find it interesting to know how this lass muddles through! My techniques are not set in stone, I adjust them for different subjects and inevitably they will have to change to adapt to the increased workload of third year. I might find a better way, or just a different one. But this is how it goes at the moment. If you’re a student reading this for tips, I only have one: do you. Don’t let anyone else tell you what to do. Listen out for tips and try new things, but if in the end it works for you then do it!

As it happens, Scotch on the sofa is a far more attractive idea for a Friday night in my opinion – and it’s cheaper. Rowena and I are becoming well-versed in the last three decades of film; from The Shawshank Redemption and Good Will Hunting to The Hateful Eight and Moana, you name it and we’ve probably seen it. And so this kind of life suits me to a tee. This post brings us to the end of last semester, and in my next post I’ll write about my placement working in an aquarium – thanks for reading, and I hope to see you there!

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