school. Here's what you need to know about how  teaching and learning styles vary between each  

stage in your training to become a future doctor. Dr. Jubbal, MedSchoolInsiders.com. 

High school learning is terribly inefficient,  and that's by design. Grade school is largely  

a form of day care for children and adolescents  while parents are gone to work. From early in  

the morning until mid afternoon, you're in school,  and most of your time in school is spent in class  

being lectured to. Homework assignments often  feel like busy work, rather than genuine efforts  

to teach you something valuable, and certain  classes seem completely irrelevant altogether. 

Your schedule and curriculum are both structured  and regimented, leaving little room for electives  

or exploring your curiosity. Perhaps you have  optionality with which physical education,  

or PE class to take, or maybe some selection  with the type of history class you enroll in.  

If you're really lucky, perhaps you get the  opportunity for an automotive workshopping  

class, which I wish I had a chance to do. College is your first foray into adulthood,  

and for the first time in your life  independence is thrust upon you,  

both inside and outside of the classroom.  Your learning will be more self-directed and  

independent compared to high school. Compared to  high school, you'll spend much less time in class,  

and there will be many more distractions  tempting you away from your academics. 

Of all the stages in training, college offers the  most flexibility in what you actually study. The  

major you chose will dictate what range of courses  you must take over your four years. You will still  

have general education requirements, or GE's,  but compared to high school you have much more  

flexibility with which courses you take and your  day to day schedule. You can start early, late,  

and even have an extra day or two off per week. When I first started college, I hated waking up  

early so much that I actually signed up for  the engineering level calculus to fulfill  

my mathematics requirement rather than the  math course designed for life science majors.  

The former was much more difficult than  the latter, but my desire to sleep in  

was greater than the spread in difficulty. On the premed track, however, there is less  

flexibility, particularly in the first two years.  There are certain medical school prerequisite  

courses you must take, including biology,  chemistry, physics, biochemistry, and so on.  

It's only after fulfilling your prerequisite  courses, in your latter two years of college,  

that you'll be able to explore your curiosity  and courses related to your chosen major. 

In terms of learning environment, it's primarily  large lecture halls with hundreds of students,  

at least at larger institutions. But if you attend  a smaller liberal arts college, you won't get lost  

in large auditoriums in the same way. Do note  that several of your classes, such as English,  

will generally be more intimate classroom sessions  of 20 or 30 students with active participation. 

Medical school is the largest departure  in learning style. Similar to high school,  

there is little flexibility in what you study,  and you're set on a mostly fixed curriculum  

and learning path. And similar to college, it's  heavily self-directed and independent learning,  

but to an even further extent. Interestingly, one  of the most common strategies shared amongst top  

scoring medical students is that they applied  pressure with surgical precision to both the  

like and subscribe buttons on this video. In high school, you spend most of your time  

learning in the classroom, and a few hours  here and there on your own. In university,  

it shifts towards fewer hours in the classroom  and a larger proportion of work done on your own.  

Medical school magnifies this to the extreme,  where the overwhelming majority of your  

learning and studying will be on your own,  outside the classroom. This is in addition  

to 2-6 hours of classroom learning per day. But it isn't just a traditional large lecture hall  

classroom. Because medical school is focused on  teaching you to become a competent and effective  

doctor, there are a variety of teaching modalities  that come into play. Your first two years,  

termed the preclinical years, are primarily  lecture based. Your latter two years,  

or the clinical years, are focused on  learning in the hospital or clinic. The  

learning styles in each stage are quite different. Your preclinical years will be spent primarily in  

the auditorium and small group classroom sessions.  You'll also have various labs to teach anatomy,  

histology, pathology, and relevant  skillsets for the hospital or clinic. 

Historically, medical school was primarily  classroom lecture-based. But in the last  

two decades, more and more medical schools  are transitioning to interactive forms of  

teaching to improve medical students' learning. One of the most common forms is PBL, or problem  

based learning. PBL, common in your preclinical  years, is where you meet in small groups of 6-10  

students twice per week. On the first day, you'll  be introduced to a case presentation. There's  

a hypothetical patient presenting with a certain  concern, and you'll ask questions to work them up.  

There's a physician facilitator in the room as  well to make sure the group doesn't get stuck  

or derailed. You'll assign various tasks  and responsibilities amongst yourselves,  

so that during the next session later that week,  each student will teach the others what they've  

learned. One student may focus on the differential  diagnosis, another on the disease pathophysiology,  

another discusses treatment, and so on. Team based learning, or TBL, is a hybrid  

between classroom and small group learning.  You'll attend lecture in a large auditorium,  

but there will be several breaks throughout  the lecture to work through problems with  

a few other students. This type of teaching  style is less common at most medical schools. 

There will be other small group forms sprinkled  throughout medical school. At my medical school,  

we had a practice of medicine, or POM course,  that was a continuous thread over all 4 years.  

It covered the ethical side of practicing  medicine, to communication skills, to the  

different types of health insurance  models around the world and so on. 

I'm a huge proponent in the value of a  proper medical school anatomy experience,  

even more so if you're considering something  surgical for residency. In the traditional  

medical school anatomy experience, you'll have  between 4 and 6 students assigned to a cadaver,  

and you'll spend most of your first year  dissecting and learning about all the  

organ systems. You'll get your hands dirty,  literally, and this is one of the best ways  

to have a true and deep understanding of human  anatomy. There's also a prosection, meaning a  

cadaver that's simultaneously being dissected in  stages by the instructors for students to view  

as a reference. After all, sometimes there are  anomalies in anatomy, or perhaps your anatomy team  

inadvertently caused damage to certain structures  on your own cadaver. Doing your own dissection  

in combination with viewing the prosection  allows you to get the best of both worlds. 

Some medical schools forgo a traditional anatomy  experience in favor of only prosections. At  

these programs, you don't do any dissections  yourselves, and simply view the cadaver that is  

prepared by the instructors. As a senior medical  student, you may get the opportunity to become an  

anatomy instructor, and I'm very glad I did. It's  rewarding to teach first year medical students,  

and also a great way to reinforce key anatomy  prior to starting a surgical residency. 

There are also small group lab sessions  for histology and pathology, whereby you're  

observing slides through a microscope of various  healthy and diseased tissues throughout the body.  

If you're color blind, like I am, then this will  likely be one of your least favorite classes. 

Medical school isn't just about learning  information, but also learning various skills.  

On my first day of medical school orientation,  we learned how to draw blood on each other,  

which also served as an awesome ice  breaker. In both your preclinical years,  

you'll spend considerable time in small group  workshops learning various clinical skills.  

This includes everything from the basics of how to  use a stethoscope to learning physical exam skills  

or more nuanced techniques like performing a  lumbar puncture to test cerebrospinal fluid.  

For most of the physical exams, you'll practice  on each other, but for the male and female  

genital physical exams, you'll have a standardized  patient. As you progress to your clinical years,  

you'll focus on more advanced techniques,  such as the laparoscopic surgical techniques. 

To learn how to be most effective in patient  interaction, you'll do practice or group OSCE's,  

or Objective Structured Clinical Examinations,  whereby you simulate a patient encounter with  

a standardized patient. It's completely normal  to feel nerves in your first several GOSCE's,  

as you're being watched through cameras by  an attending physician and some classmates,  

all of whom will give you feedback.  Over time and with practice,  

this will become second nature  and any anxieties will vanish. 

During your clinical years, you'll be primarily  self-directed and spending most of your time in  

the hospital, clinic, or operating room. Learning  is less structured, and is primarily downstream  

of what patients you have on your service.  You'll occasionally be asked to prepare  

presentations for the attending and residents  based on patient pathologies. For example,  

if a patient on your internal medicine service  has kidney pathology, you may be asked to prepare  

a simple 5 or 10 minute presentation on the types  of nephrotic syndrome, a form of kidney disorder. 

It's common to still attend small group sessions  once per week, but these are a relatively minor  

part in your learning. Based on your rotation,  you may have skill workshops. For example,  

while on your surgery rotation, you'll have some  workshops focused on various surgical techniques,  

including suturing and knot tying. But if you've  been following either this or my personal channel,  

then you know I strongly advise students to  be practicing these techniques on their own  

before they get to their surgery rotations.  Other examples include learning how to  

intubate a patient, place a central line,  or perform a thoracentesis or paracentesis. 

In your fourth and final year of medical  school, you'll attend sub-internships,  

or audition rotations, whereby your expectations  and level of responsibility are elevated. I  

explain these further in another video, but with  regards to learning style, it's quite similar to  

your third year core clinical rotations. You may  be asked to present something more substantial,  

and rather than just your attending and a couple  residents, it may be at grand rounds in front  

of a few dozen attendings and residents. The  pressure is on but you'll be able to handle it. 

Despite the variety of different learning formats,  it's interesting that medical schools don't place  

a heavy emphasis on learning how to learn.  That's the main reason I created this YouTube  

channel - to help you understand how to study  better. And this becomes even more important  

since the overwhelming majority of your medical  school learning will be self-directed, outside  

of the classroom. To be the most successful, you  need to be focusing on active learning methods,  

leveraging the times in the day when you  are mentally fresh, and strategic with all  

aspects of your study environment, including  whether you study by yourself or with friends. 

If you'd like to learn more about how to study  better, check out my study strategies playlist,  

or this other video. Much love,  and I'll see you guys there.